Search

Background: Laryngoscopy is a diagnostic procedure utilized in critical care to examine and visualize the larynx through the diversion of upper airway structures. Its primary functions are airway management and tracheal intubation. The objective of this study was to detect the predictors of laryngeal exposure during microlaryngeal surgery (MLS). Methods: An analytical cross-sectional study was conducted on a consecutive sample of 100 patients presenting laryngeal lesions that were trans-orally microsurgeries to treat various glottic diseases (biopsies revealed 68% benign lesions such as vocal fold polyps, cysts, and nodules, and 32% glottic masses) and prepared for MLS. Results: This study included 100 patients presenting laryngeal lesions from both sexes with the age of 47.0 ± 14.7 years, in multivariate logistic regression analysis, all these parameters were significant predictors for Cormack–Lehane and Italian Grading (P < 0.05). Body mass index (BMI) (OR = 3.449, 95% CI = 2.463–8.187), mandibular protrusion test (OR = 2.981, 95% CI = 1.922–4.044), mento-sternal length (OR = 3.722, 95% CI = 1.980–7.794), and atlanto-occipital joint (AOJ) extension (OR = 1.572, 95% CI = 1.865–4.263). Cormack–Lehane and Italian Grading was significantly associated with BMI, mandibular protrusion test, Mallampati Index, mento-thyroid, mento-sternal length, and AOJ extension, it increased with BMI of > 35, with more protruded mandible (class C), higher Mallampati Index (class III) and shorter mento-sternal distance (≤ 12.5 cm). Conclusions: During microlaryngeal surgery, BMI, mandibular protrusion test, Mallampati Index, mento sternal and AOJ extension were significant predictors of Cormack–Lehane and Italian Grading which makes it easier for laryngeal exposure. [ABSTRACT FROM AUTHOR]

Background: The determining effect of facial hard tissues on soft tissue morphology in orthodontic patients has yet to be explained. The aim of this study was to clarify the hard-soft tissue relationships of the lower 1/3 of the face in skeletal Class II-hyperdivergent patients compared with those in Class I-normodivergent patients using network analysis. Methods: Fifty-two adult patients (42 females, 10 males; age, 26.58 ± 5.80 years) were divided into two groups: Group 1, 25 subjects, skeletal Class I normodivergent pattern with straight profile; Group 2, 27 subjects, skeletal Class II hyperdivergent pattern with convex profile. Pretreatment cone-beam computed tomography and three-dimensional facial scans were taken and superimposed, on which landmarks were identified manually, and their coordinate values were used for network analysis. Results: (1) In sagittal direction, Group 2 correlations were generally weaker than Group 1. In both the vertical and sagittal directions of Group 1, the most influential hard tissue landmarks to soft tissues were located between the level of cemento-enamel junction of upper teeth and root apex of lower teeth. In Group 2, the hard tissue landmarks with the greatest influence in vertical direction were distributed more forward and downward than in Group 1. (2) In Group 1, all the correlations for vertical-hard tissue to sagittal-soft tissue position and sagittal-hard tissue to vertical-soft tissue position were positive. However, Group 2 correlations between vertical-hard tissue and sagittal-soft tissue positions were mostly negative. Between sagittal-hard tissue and vertical-soft tissue positions, Group 2 correlations were negative for mandible, and were positive for maxilla and teeth. Conclusion: Compared with Class I normodivergent patients with straight profile, Class II hyperdivergent patients with convex profile had more variations in soft tissue morphology in sagittal direction. In vertical direction, the most relevant hard tissue landmarks on which soft tissue predictions should be based were distributed more forward and downward in Class II hyperdivergent patients with convex profile. Class II hyperdivergent pattern with convex profile was an imbalanced phenotype concerning sagittal and vertical positions of maxillofacial hard and soft tissues. [ABSTRACT FROM AUTHOR]

Copyright of Aydin Dental Journal is the property of Aydin Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a case study of a 40-year-old man with temporomandibular joint synovial chondromatosis. It is reported that this condition manifested with symptoms including progressive occlusal changes, chin deviation, and left preauricular swelling over several years. It is further reported that despite no prior joint disease or trauma, diagnostic imaging revealed thickened, calcified synovium around the left mandibular condyle, leading to joint widening and condylar subluxation.

Background: The chin is an essential element of the facial unit and influences how people perceive facial aesthetic appeal. Hyaluronic acid (HA) gel injections are tried‐and‐true therapies for regenerative therapies with a record of success in efficacy and safety. Aims: To determine the best type of concentration of HA and way of injection for deep and superficial planes of chin. Materials and Methods: VYC‐20L and VYC‐25L (Juvederm Voluma XC® Juvéderm Volux®; Allergan plc) are 20‐ and 25‐mg/mL HA gels with lidocaine, respectively, were injected with cannulas and needles on the bone, respectively. Results: Chin reinforced respecting the measures with good contouring. No serious complications. Patient was satisfied with results. Discussion: We advise using VYC 20L superficially above the muscle or with a cannula for injection, and we recommend using VYC 25L in the supraperiosteal plane. [ABSTRACT FROM AUTHOR]

Facial aesthetics play an important role in the personality and beauty of a person. A 42-year-old woman who had a 12-year history of rhinoplasty before visiting us that her surgeon did an extraoral genioplasty by grafting excess cartilage of her nose to chin for esthetic reasons. The patient had a deformity that resulting soft tissue ptosis in the chin. To correct this, we removed grafted cartilages from the chin then performed a routine advancement genioplasty. Finally, we did bone grafting among advancement operations. Thus, we made the facial contour of her face appear slenderer and smooth after surgery. The surgeon must be aware of possible long-term complications. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 40-year-old woman diagnosed with cutaneous leishmaniasis after returning from a trip to Costa Rica. Topics discussed include the clinical presentation and diagnostic challenges of leishmaniasis, treatment options such as miltefosine, and the importance of preventing sand fly bites in endemic areas.

The heightened public interest in and usage of non-invasive cosmetic procedures has translated to the practice of jawline and chin augmentation. Implants have historically been a cornerstone of chin augmentation; however, more recently, as non-invasive procedural techniques and modalities develop, questions have been raised as to whether there is still a need for implants. Francesca Ramadan explores the innovative options available to address even the most acute patient concerns. [ABSTRACT FROM AUTHOR]

STUDY OBJECTIVES: To evaluate the effects of bupropion on periodic limb movements during sleep (PLMS) and chin electromyography tone in children taking it for their mood disorder, compared to the effects of selective serotonin reuptake inhibitors (SSRIs) and of bupropion combined with SSRIs. METHODS: Six adolescents (aged 16.0 ± 0.63 years) taking bupropion alone and 6 adolescents (aged 15.9 ± 1.36 years) taking bupropion in combination with an SSRI antidepressant were recruited, along with 10 adolescents (aged 16.2 ± 0.2 years) taking different SSRIs, and they were also enrolled together with 17 age- and sex-matched control patients (aged 15.5 ± 1.26 years). Polysomnographic studies were obtained, and participants leg movement activity during sleep and muscle tone were assessed quantitatively (atonia index) during all sleep stages. RESULTS: Participants taking SSRIs showed PLMS indices significantly higher than those of control patients, whereas adolescents taking bupropion showed only slightly increased indexes of nonperiodic leg movements during sleep. No differences in PLMS were observed between adolescents taking bupropion alone or in association with SSRIs. The atonia index showed, within each sleep stage, the lowest values in the 2 groups taking SSRIs and the highest in the control patients; adolescents taking bupropion alone tended to show values slightly smaller than those of the control patients. CONCLUSIONS: We found that similar to adults, in adolescents SSRIs but not bupropion are associated with increased PLMS. Bupropion also seems to counteract the SSRI-induced increase of PLMS, when administered in combination; thus, the dopaminergic effect of bupropion seems to outmatch the antidopaminergic action of SSRIs. Conversely, bupropion does not counteract the effects of SSRIs on chin electromyography tone. CITATION: DelRosso LM, Mogavero MP, Fickensher A, Bruni O, Schenck CH, Ferri R. Effects of bupropion and SSRI antidepressants on leg movement activity and chin muscle tone during sleep in adolescents. J Clin Sleep Med. 2023;19(1):151-161.

STUDY OBJECTIVES: To test the hypothesis that children taking trazodone have less leg movements during sleep (LMS) and higher rapid eye movement (REM) sleep atonia than children taking selective serotonin reuptake inhibitors (SSRIs) but more than normal controls. METHODS: Fifteen children (9 girls and 6 boys, mean age 11.7 years, standard deviation [SD] 3.42) taking trazodone (median dosage 50 mg/d, range 25-200 mg) for insomnia and 19 children (11 girls and 8 boys, mean age 13.7 years, SD 3.07) taking SSRIs for depression, anxiety, or both were consecutively recruited, as well as an age- and sex-matched group of 25 control children (17 girls and 8 boys, mean age 13.7 years, SD 3.11). LMS were scored and a series of parameters was calculated, along with the analysis of their time structure. The Atonia Index was then computed for each non-REM sleep stage and for REM sleep. RESULTS: Children taking trazodone exhibited slightly higher leg movement indices than controls but lower than those found in children taking SSRIs and their time structure was different. Chin electromyogram atonia in all sleep stages was not significantly altered in children taking trazodone but was decreased in children taking SSRIs, especially during non-REM sleep. CONCLUSIONS: In children, SSRIs but not trazodone are associated with a significantly increased number of LMS, including periodic LMS, and increased chin tone in all sleep stages. The assessment of periodic limb movement disorder and REM sleep without atonia might not be accurate when children are taking SSRIs because of their significant impact. CITATION: DelRosso LM, Mogavero MP, Bruni O, Schenck CH, Fickenscher A, Ferri R. Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children. J Clin Sleep Med. 2022;18(12):2829-2836.

Purpose: The objective of the present article was to evaluate the ımpact of dental midline angulation in asymmetrical faces. Materials and Methods: A full‐portrait image was used to create a set of digitally modified images with a different degree of facial asymmetry, towards the right and the left side of the face respectively. Half of the images were designed with an equivalent angulation of the dental midline in respect to the curve of the lower third of the face and half of them without. Through a web survey, 250 laypeople and 250 orthodontists were asked to assess the attractiveness of each image separately. Results: As the asymmetry of the face was increased, facial attractiveness was further decreased both for laypersons and orthodontists. For each one of the modified images, when the dental midline was following the curve that was formed from the inclination of the simulated asymmetry of the face, the smile attractiveness scores were significantly higher compared to a straight dental midline. Conclusion: Facial asymmetries derived from the inclination of the nose, the chin and the commissural line of the lips can significantly affect the smile attractiveness. An orientation of the dental midline towards the facial asymmetry in order to follow the facial curve, can be beneficial for the smile attractiveness compared to a perpendicular to the face dental midline. During the design of a smile, clinicians have to take into consideration deviations in facial midline, in order their restorations to be in harmony with the rest of the face. Clinical Significance: During the design of a smile, clinicians have to take into consideration deviations in the facial midline, in order their restorations to be in harmony with the rest of the face. [ABSTRACT FROM AUTHOR]

Aim: The chin‐down posture is a widely used compensatory manoeuvre for patients with dysphagia. The aim of this study was designed to systematically measure the effectiveness of chin‐down manoeuvre application. Methodology: We retrieved the PubMed, Web of Science, Embase, Cochrane Library, EBSCO, Medline, CNKI, WANFANG, VIP and SinoMed databases from inception to 30 August 2022. Raters independently screened literature according to inclusion and exclusion criteria. The quality of the included literature was evaluated, and data were extracted. The software Review Manager software 5.3 was used for statistical analysis. Results: Fourteen studies with a total of 571 patients were included in this meta‐analysis. The meta‐analysis indicated that chin‐down manoeuvre could significantly reduce the risk of aspiration (MD = −1.35, 95% CI [−2.25, −0.44], Z = 2.92, p <.01), decrease the chin angle (MD = −12.20, 95% CI [−14.61, −9.79], Z = 9.91, p <.001), shorten oral transit time (MD = −0.81, 95% CI [−1.20, −0.43], Z = 4.17, p <.001), reduce the maximum swallowing pressure at upper oesophageal sphincter (MD = −82.07, 95% CI [−112.77, −51.37], Z = 5.24, p <.001) and decrease pharyngeal residue. Conclusions: Existing evidence indicated that chin‐down manoeuvre could reduce the risk of aspiration and pharyngeal residue, decrease the maximum swallowing pressure at UES. More large‐sample, high‐quality clinical trials are still needed in the future to further ascertain the results of this research. [ABSTRACT FROM AUTHOR]

The facial lower third and chin contribute significantly to overall facial balance. Beginning with an anatomical exploration, this article defines the chin's unique features and the evolutionary significance of its projection in humans. The often-overlooked senescent changes of the chin are discussed, as well as congenital contour and projection defects. A sequential treatment model is offered to manage these inherent and acquired lower-third deformities. [ABSTRACT FROM AUTHOR]

Background Although maxillomandibular advancement is the treatment of choice for obstructive sleep apnea syndrome (OSAS) in the presence of underlying maxillomandibular complex hypoplasia, there is still a gap in the literature regarding the impact of genioplasty upon upper airway volume (UAV). Objectives The aim of this study was to evaluate the impact of isolated osseous genioplasty upon UAV. Methods A retrospective analysis of all patients subjected to isolated osseous genioplasty between July 2015 and July 2022 was conducted. Cone-beam computed tomography was performed preoperatively and postoperatively to assess the chin and hyoid 3-dimensional (3D) spatial position and UAV changes after surgery. Results A total of 44 patients were included in the study. Regarding surgical movements of the chin, almost all patients received a sagittal movement (n = 42; 39 forward and 3 backward), while in 8 patients a vertical movement (5 upward and 3 downward) was applied, and in 6 patients the chin was centered. Statistically significant increases in total UAV (P =.014) and at the level of the oropharynx (P =.004) were observed. Specifically, chin centering, upward and forward movements enlarged the oropharynx volume (P =.006,.043 and.065, respectively). Chin advancement enlarged the hypopharynx volume (P =.032), as did upward movement of the hyoid bone (P <.001). Conclusions Results of the study suggest that aesthetic osseous genioplasty impacts the UAV: each 3D spatial chin movement differently impacts the upper airway by enlarging or narrowing it. However, further studies addressing the apnea-hypopnea index are required to assess its effectiveness in treating OSAS. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

The chin, a distinguishing feature of Homo sapiens, has sparked ongoing debates regarding its evolutionary origins and adaptive significance. We contend that these controversies stem from a fundamental disagreement about what constitutes a well‐defined biological trait, a problem that has received insufficient attention despite its recognized importance in biology. In this paper, we leverage paleoanthropological research on the human chin to investigate the general issue of character or trait identification. First, we examine four accounts of the human chin from the existing literature: the mandibular differential growth byproduct, the bony prominence, the inverted T‐relief, and the symphyseal angle. We then generalize from these accounts and propose a three‐stage framework for the process of character identification: description, detection, and justification. We use this framework to reinterpret the four accounts, elucidating key points of contention surrounding the chin as well as other morphological characters. We show that debates over the chin carry broad and important biological implications that extend beyond this trait and that are not mere semantic issues of definition. Research highlights: The general problem of how to appropriately define and identify phenotypic traits is exhibited in debates about the human chin.Trait identification can be usefully split into the stages of description, detection, and justification. [ABSTRACT FROM AUTHOR]

Background: Chin flaws are far more common than recognized. Denial of genioplasty by parents or adult patients can present a surgical planning enigma, especially in patients with microgenia and chin deviation. This study aims to investigate the frequency of chin imperfections on patients seeking rhinoplasty, review the conundrum they generate, and offer management suggestions based on over 40 years of the senior author's experience. Methods: This review included 108 consecutive patients presenting for primary rhinoplasty. Demographics, soft tissue cephalometrics, and surgical details were obtained. Exclusion criteria included prior orthognathic or isolated chin surgery, mandiblular trauma, or congenital craniofacial deformities. Results: Of the 108 patients, 92 (85.2%) were female. Mean age was 30.8 years (SD±13, range 14–72). Ninety-seven (89.8%) patients exhibited some degree of objective chin dysmorphology. Fifteen (13.9%) had Class I deformities (macrogenia), 63 (58.3%) Class II (microgenia), and 14 (12.9%) Class III (combined macro and microgenia in the horizontal or vertical vectors). Forty-one (38%) patients had Class IV deformities (asymmetry). While all patients were offered the opportunity to correct chin flaws, only 11 (10.1%) underwent such procedures. Five (4.6%) patients had simultaneous osseous genioplasty (mean advancement 7.8mm, range 5–9mm); 7 (6.5%) received fat grafting to the chin (mean volume 4.4cc, range 1–9cc). Conclusions: A considerable proportion of primary rhinoplasty patients possess quantifiable chin dysmorphology on circumspect examination, high-resolution photographs and cephalometric analysis. Only a small number agree to surgical interventions that pursue full facial harmony. Potential reasons for these findings, patient aversion, and mitigation strategies will be discussed. Level of Evidence III: 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. [ABSTRACT FROM AUTHOR]

Since coming to power, Xi Jinping has significantly elevated the importance of national security and technological innovation in the country’s overall priorities. He has invested considerable time, effort, and political capital to establish an expansive techno-security state based upon his strategic and ideological vision. This brief examines the five major methods Xi’s administration has undertaken to develop its techno-security state: developing a national security state, innovation-driven development, military strengthening, military-civilian fusion, and economic securitization.

Lip and chin avulsion often results from orofacial trauma that occurs primarily in dogs and cats. Suture placement passing through the skin and around the incisor or canine teeth is the most common reconstructive method in animals. However, the reconstruction would be challenging in young puppies and kittens due to the limited growth of the teeth. A two-month-old kitten was presented for avulsion of a bilateral mandibular lip avulsion following a high-rise syndrome. Oral examination and skull radiographs demonstrated no mandibular fracture. Dental fracture was not observed. After aseptic preparations and under general anesthesia, four intraosseous-subcutaneous ‎sutures using 3-0 nylon were placed to adhere the degloved lip and chin to the mandibular bone. The sutures passed through the both mandibles and the subcutaneous tissue. Then, the labial mucosa and gingiva were opposed by simple continuous sutures using 4-0 Dexon. Post-operative antibiotic and anti-inflammatory were administered. Chlorhexidine mouthwash was ‎recommended for the first five days after surgery. Sutures were removed two weeks later. Infection, abscess formation, necrosis, and dehiscence are the commonly reported complications after lip and chin reconstruction. Using this technique, no complications were observed during a six months period.

Introduction: Tooth eruption anomalies occur in both temporary and permanent teeth. They also affect all maxillary and mandibular teeth, in particular the incisors. Localization outside the maxilla is a rare phenomenon, with psychological, functional and above all aesthetic consequences. In traditional African society, mystical considerations can be evoked to explain it. The aim was to manage an ectopic permanent incisor located on the chin, in order to avoid the disturbances that can occur in children. Case presentation: This was an 11-year-old child whose lower permanent incisor had erupted outside the mandibular bone, in the cellular tissue of the chin arch, outside the chin and lower lip muscles. Treatment: it consisted of extraction of the affected tooth, followed by suturing of the wound and antibiotic therapy. This treatment not only restored aesthetics and function, but also prevented the marginalization of the young patient. Conclusion: This case study highlights the need for aesthetic, psychological and functional management to ensure the patient’s well-being and overall development.

Osseous genioplasty and chin augmentation with implants are the two main treatment options for retrognathia. This retrospective cohort study was performed to compare the prevalence of complications and patient satisfaction following osseous genioplasty and chin augmentation by implant. Eighty patients were included: 38 underwent advancement osseous genioplasty and 42 received chin implants (alloplastic, either Medpor or Silastic) intraorally or extraorally. The patients were assessed for complications 12 months after surgery, including neurosensory disturbances, infection or extrusion, wound dehiscence, and the need for reoperation. Patient satisfaction was evaluated using a visual analogue scale. The infection rate was significantly higher in the chin implant group than in the genioplasty group (P = 0.028). Moreover, dehiscence and the need for reoperation appeared to be more common following chin augmentation with implants. However, there was no significant difference in the prevalence of neurosensory disturbances between the two groups (P = 0.137). In the chin implants group, the extraoral approach resulted in a lower dehiscence rate than the intraoral approach. Patients in the genioplasty group had significantly higher satisfaction scores than those in the chin implant group (P = 0.001). Overall, the rates of the complications assessed were lower and patient satisfaction was higher after osseous genioplasty when compared to chin augmentation with implants. [ABSTRACT FROM AUTHOR]

Alluzience (abobotulinumtoxinA RTU; Ipsen, Paris, France and Galderma SA, Lausanne, Switzerland) is the first ready-to-use (RTU) botulinum toxin type A liquid solution approved for the treatment of glabellar lines in Europe. In this article, the authors provide consensus recommendations on the aesthetic usage of abobotulinumtoxinA RTU. Members of the International Board on Alluzience convened to develop consensus on the treatment of glabellar lines as well as other facial wrinkles based on their own extensive experience. Consensus recommendations were developed to provide practical guidelines for injection of abobotulinumtoxinA RTU. General guidance on proper assessment, treatment planning, and patient education is provided, as well as specific injection guidelines per indication. Indications covered include glabellar lines, crow's feet, horizontal forehead lines, lateral eyebrow lift, lower eyelid wrinkles, bunny lines, drooping nasal tip, perioral wrinkles, drooping mouth corners, masseter hypertrophy, hollow cheek lines, dimpled chin, and platysmal bands. These guidelines provide a practical framework to support routine injection of facial muscles with Alluzience. Level of Evidence: 5 [ABSTRACT FROM AUTHOR]

Background: The profound influence of orthodontic treatments on facial aesthetics has been a topic of increasing interest. This study delves into the intricate interplay between orthodontic treatments, facial feature alterations, and aesthetic perceptions. Methods: A total of 73 patients who had undergone orthodontic treatment were included in this study. Facial photographs were taken before and after treatment. Ten orthodontists provided facial aesthetic ratings (FAR) for each patient's frontal, profile, and overall views. 48 facial landmarks were manually placed by the orthodontists and normalized using Generalized Procrustes analysis (GPA). Two types of phenotypes were derived from facial landmarks. Global facial phenotypes were then extracted using principal component analysis (PCA). Additionally, 37 clinical features related to aesthetics and orthodontics were extracted. The association between facial features and changes in FAR after orthodontic treatment was determined using these two types of phenotypes. Results: The FAR exhibited a high correlation among orthodontic experts, particularly in the profile view. The FAR increased after orthodontic treatment, especially in profile views. Extraction of premolars and orthognathic surgery were found to result in higher FAR change. For global facial phenotypes, the most noticeable changes in the frontal and profile views associated with FAR occurred in the lip area, characterized by inward retraction of the lips and slight chin protrusion in the profile view, as well as a decrease in lip height in the frontal view. The changes observed in the profile view were statistically more significant than those in the frontal view. These facial changes were consistent with the changes from orthodontic treatment. For clinical features, two profile features, namely pg.sm.hori and pg.n.ls, were found to be associated with FAR following orthodontic treatment. The highest FAR scores were achieved when pg.sm.hori was at 80° and pg.n.ls was at 8°. On the other hand, frontal clinical features had a subtle effect on FAR during orthodontic treatment. Conclusions: This study demonstrated that orthodontic treatment improves facial aesthetics, particularly at lip aera in the profile view. Profile clinical features, such as pg.sm.hori and pg.n.ls, are essential in orthodontic treatment which could increase facial aesthetics. [ABSTRACT FROM AUTHOR]

BACKGROUND: Playing the violin often requires a rotated and lateral flexed neck, leading to potential neck and shoulder problems. An ergonomic chinrest (EC) with or without a shoulder rest (SR or WSR) may enhance neutral neck positioning, but the feasibility of the EC needs to be studied. OBJECTIVE: Our goal was to evaluate the usability of the EC for a two-week familiarisation period, including aspects such as playing performance, comfort level, and emotional response (e.g., feelings about using the product) among a group of violinists. METHODS: A one-arm feasibility study was conducted to assess the feasibility of violinists playing with EC every day for two weeks. Six violinists who usually played with SR were included and asked to divide their daily playing time equally between SR and WSR. Feasibility outcomes were measured as adherence (days), compliance (playing hours per day) and usability (5-point Likert scale and open-ended questions). Compliance was achieved with a minimum of 25% playing time. RESULTS: Daily violin playing with EC showed high adherence of 89.3%. Compliance with the 25% play time criterion was met for SR, but not for WSR. Low playing performance (median 45.8 points difference), long confidence time (two violinists failed to reach a confidence level) and mainly negative feedback (26 out of 33 comments) were found in WSR compared to SR. CONCLUSIONS: The feasibility of playing WSR was low and negatively impacted playing performance. As a result, a larger-scale study will only evaluate the EC with SR due to greater feasibility. [ABSTRACT FROM AUTHOR]

Metastatic lesions of the jaws are a diagnostic challenge because of their scarcity and uncharacteristic clinical-radiographic features. Carcinoma of unknown primary origin (CUP) is characterized by the existence of metastatic disease with no recognized primary neoplasm after a comprehensive work-up. CUP shows a poor prognosis with limited treatment choices. This paper presents a 64-year-old male with a chief complaint of paresthesia of the chin and lower lip. Panoramic radiography showed an ill-defined radiolucency in the left mandibular molar area and the residue of the first molar root. Microscopic examination demonstrated features of mucin-producing adenocarcinoma and was not similar to common neoplasms of the jaw. The whole-body scan revealed multiple osseous uptakes. CDX2 was diffusely positive. However, in the end, the origin of the primary tumor was not determined. Considering the aforementioned data, the diagnosis of metastatic adenocarcinoma with unknown primary origin was made. CUP of the oral cavity is an extremely rare event. The possibility of metastasis should be raised in a patient who complains of paresthesia. Awareness of the clinical and histopathologic features of these malignancies is crucial for clinicians and pathologists to have a proper diagnosis. [ABSTRACT FROM AUTHOR]

Preoperative evaluations of difficult airways are imperative, especially in newborns. The hyomental distance is a reliable index for predicting difficult airways in adults. However, few studies have evaluated the value of the hyomental distance for predicting difficult airways in newborns. It is unclear whether the hyomental distance forecasts a restricted or difficult view when using direct laryngoscopy. We intended to develop an effective system for predicting difficult tracheal intubation in newborns. A prospective observational clinical study. Newborns aged 0 to 28 days undergoing oral endotracheal intubation with direct laryngoscopy for elective surgery under general anesthesia were enrolled. The hyomental distance and hyoid level tissue thickness were assessed by ultrasound. Other parameters, such as the mandibular length and sternomental distance, were also evaluated before anesthesia. The glottic structure view under laryngoscopy was graded according to the Cormack-Lehane classification. The patients with Grade 1 and 2 laryngeal views were assigned to Group E. Those with Grade 3 and 4 views were assigned to Group D. A total of 123 newborns were recruited for our study. The incidence of poor visualization of the larynx during laryngoscopy in our study was 10.6%. The multifactor logistic regression results showed that the hyomental distance was a powerful predictor of difficult laryngoscopy (OR = 0.16, 95% CI 0.03-0.74, P =.019). The curve with the highest sensitivity and specificity and the maximum area under the curve (AUC) was the hyomental distance. The receiver operating characteristic (ROC) curve for the hyomental distance suggested that the best cut-off value was less than equal to 2.74 cm, with an AUC of 0.80 (95% CI 0.64-0.95). It is noninvasive and feasible to accurately measure the hyomental distance with ultrasound in newborns, and the results are reliable. We believe that the hyomental distance measured with ultrasound could be used as a marker for predicting difficult laryngoscopy in newborns. [ABSTRACT FROM AUTHOR]

Mentoplasty or genioplasty is a simple procedure to enhance facial aesthetics. While usually considered simple, it might present certain difficulties during execution, especially when a minimally invasive approach is preferred. Drilling and cutting guides are a valuable tool to overcome such challenges but usually require larger incision and dissection to allow adequate positioning and bone rigid fixation. In this article, we describe a novel guide design that permits adequate bone repositioning while preserving minimally invasive protocols. [ABSTRACT FROM AUTHOR]

Background Traditionally, the patient's head is placed in a neutral position with a chin-lift to facilitate light wand guided endotracheal intubation. However, our study found that the sniffing position was more effective. In this study, we aimed to compare the two positions of light wand guided endotracheal intubation. Methods Sixty adult patients were included in the study, after obtaining informed consent, and were randomly assigned to one of two groups: a control group in a neutral position with a chin-lift (group C, n = 30) and a sniffing position group (group S, n = 30). In group C, the anesthesiologist inserted a light wand after lifting the patient's mandible using the thumb of their non-dominant hand inside the patient's mouth. In group S, a light wand was inserted after the patient's head was flexed with the neck extended. We assessed variables such as light-search time, number of intubation attempts, time to achieve intubation, and side effects including blood tinge on the endotracheal tube, hoarseness, sore throat, and anesthesiologist satisfaction. Results The light-search and intubation times were shorter in group S than in group C. The incidence of blood tinge on the endotracheal tube was higher in group C than in group S. Anesthesiologist satisfaction was higher in group S than in group C. Conclusions The sniffing position was more effective in facilitating light wand guided endotracheal intubation than the neutral position with a chin-lift.

We present a 20-year-old patient with subglottic and tracheal stenosis was taken for a tracheal resection and end-to-end anastomosis. The patient's neck was positioned in hyperflexion using chin stitches to minimize tension at the anastomosis. On post-operative period, the patient developed paresthesias in upper and lower extremities associated with motor weakness. Magnetic resonance imaging was performed showing lesions compromising ventral spinal cord at the level of C4–C5 and C6–C7. Chin stitches were removed and neck flexion was reduced. The patient remained in the intensive care unit with vasopressors, physical therapy and intravenous fluid-therapy to maintain mean arterial pressure above 90 mmHg. After 3 weeks, the patient was discharged with no neurologic deficit. There are few cases reported of acute ischemic spinal injury following tracheal reconstruction. If this complication arises, neck posture should be corrected, maintenance of MAP above 90 mmHg and implementation of early physical therapy is key to improve neurologic outcomes. [ABSTRACT FROM AUTHOR]

Annie Chiu,1 Vince Bertucci,2 Daniel Dal’Asta Coimbra,3 Dan Li4 1The Derm Institute, Redondo Beach, CA, USA; 2Private Practice, Woodbridge, Vaughan, ON, Canada; 3Department of Cosmetic Dermatology at Santa Casa de Misericórdia, Rio de Janeiro, RJ, Brazil; 4Department of Plastic and Reconstructive Surgery, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of ChinaCorrespondence: Annie Chiu, The Derm Institute, 1636 Aviation Boulevard, &num;201, Redondo Beach, CA, 90278, USA, Tel +1 (310) 939-9800, Fax +1 (310) 939-9888, Email drchiu@thederminstitute.comBackground: Interest in aesthetic rejuvenation of the lower face and neck is growing, but published expert guidance is limited.Objective: Review aesthetic concerns of the lower face and neck and provide expert guidance on evaluation and treatment.Methods: Twelve international experts participated in an advisory board on lower face and neck aesthetic treatment. They completed a premeeting survey and met twice, reviewing responses and discussing patient evaluation and treatment strategies. They developed decision tree algorithms on patient assessment and treatment planning and sequencing, using clinical cases as a reference.Results: Treatment concerns include neck and lower face skin laxity, structural bone deficiency, insufficient or excess volume, submental fat, jowls, platysma bands, and masseter muscle prominence. Advisors agreed that the lower face and neck may be the most challenging areas to assess and treat; treatment goals include lower facial contour and overall facial harmony/balance. Advisors recommended first ruling out a surgical approach, then determining whether midface treatment is needed to support the lower face, and lastly evaluating the lower face for significant submental fat, excess or insufficient volume, and structural bone deficiency. To treat the lower face and neck, an anatomical layer approach, moving from deep to superficial layers, beginning with structural support, was recommended. Assessment and treatment decision trees were based on this approach.Conclusion: The lower face and neck are important but underrecognized areas of aesthetic concern. This article provides expert guidance and a suggested algorithm for assessment and treatment aimed at achieving satisfying and harmonious facial aesthetic results.Keywords: Chin, jaw, patient satisfaction, plastic surgery, treatment outcomes, algorithms, decision trees

Abstract Objective As the population ages, facial plastic providers must remain aware of the treatments to prevent and reverse the external signs of aging. In the mandibular region, skin laxity and soft tissue sagging in the jawline may lead to jowling and chin ptosis along with reduced chin projection. While surgical procedures, including chin implantation, may be performed, nonsurgical procedures are becoming increasingly popular due to their temporary, noninvasive, yet effective methods. This review covers the use of hyaluronic acid, calcium hydroxylapatite, poly‐l‐lactic acid, and polymethyl methacrylate in the jawline. Methods PubMed was searched for data on the mechanism of action, pertinent anatomy, indications, contraindications, technique, and evidence supporting the safety and efficacy of the fillers. Results There are a wide variety of fillers available for use in the lower face with unique characteristics and application methods. While the advantages of injectable fillers include relatively affordable cost, minimal patient discomfort, and limited recovery times, taking measures to prevent short‐ and long‐term complications is necessary for optimal results. Conclusions Understanding the benefits and limitations of injectable fillers in the jawline can help providers appropriately counsel and treat patients.

objective：To discuss the morphological changes and related factors of soft and bone tissues in chin in the skeletal class Ⅲ malocclusion patients at three dimensions after orthognathic operation. Methods：A total of 19 adult patients underwent orthognathic operation were collected， including 9 males and 10 females. All the patients received craniofacial computed tomography (CT) scans one week before operation(T0) and 12 months after (T1) operation to obtain the facial data of the soft and bone tissues， with a three-dimensional reconstruction and registration by using ProPlan CMF 3. 0 software. The measurements and calculations were made on the thickness of chin soft tissue， the horizontal， sagittal， and vertical changes in anatomical landmarks， and the correlation and ratios between them. Results：The most significant retrusion of soft tissue after operation was in the lower lip vermilion and the mentolabial fold area. The posterior displacement of soft tissue was gradually decreased， spreading from this area to the periphery. The posterior change in the submental area was relatively minor， with an anterior trend at the submental point. Compared with T0 time point， the soft tissue thickness at the lower lip (LL)at T1 time point was increased (P<0. 05). The linear regression analysis results showed that at the horizontal(X)， as the bone tissue changed to the left，the anatomical landmarks of soft tissue in chin LL (B=0. 795，R²=0. 832)， mentolabial sulcus (Si)(B=0. 876，R² =0. 987)， soft tissue pogonion (Pos)(B=0. 890，R² =0. 971)， and menton of soft tissue(Mes)(B=0. 942，R²=0. 978) showed negative changes， all moved to the left； the movement directions of soft and bone tissues were consistent. At the sagittal (Y) direction， as the bone tissue moved backward， the LL (B=0. 882，R²=0. 934)， Si (B=0. 946，R²=0. 847)， Pos (B=0. 839，R²= 0. 909) and Mes (B=0. 666，R² =0. 455) all moved backward，and the movement directions of soft and bone tissues were consistent. At the vertical (Z) direction， as the bone tissue moved upwards， the LL (B=0. 932， R² =0. 686)， Si (B=0. 834，R² =0. 469)， and Mes (B=0. 925，R² =0. 709) moved downwards， while the Pos (B=0. 487，R²=0. 444) moved upwards. In horizontal， sagittal， and vertical directions， the correlation between soft-tissue movement(ΔSM) and bone-tissue movement(ΔBM) of chin anatomical landmarks was generally strong (0. 6

This article presents a case study on the management of an ectopic permanent lateral incisor in a child's chin. The study focuses on an 11-year-old child who had a lower permanent incisor that had erupted outside the mandibular bone, causing aesthetic and psychological issues. The treatment involved extracting the affected tooth, suturing the wound, and administering antibiotics. The study highlights the importance of addressing aesthetic, psychological, and functional concerns to promote the well-being and overall development of the patient. The article also discusses early dental trauma and its socio-cultural considerations in Côte d'Ivoire, as well as the inclusion of permanent central incisors with root anomalies resulting from such trauma. Furthermore, it explores the known and unknown causes of eruption defects in upper central incisors. [Extracted from the article]

This essay takes issue with the subordination of aesthetics to ethics in Ethical Literary Criticism. Ethics and aesthetics must coexist for either to realize its full value through literature. For any ethical lesson to take hold, it must be presented in a pleasing form so that the reader can learn without undue resistance. Part of the role of the critic is to discern beneath the seductive aesthetic form its ethical kernel, which more often than not remains elusive. The works by Russell C. Leong and Marilyn Chin, which provide literary entertainment and ethical illumination simultaneously, demonstrate the inextricability and interdependence of ethics and aesthetics. The “lessons” therein are exceptionally delectable on account of the two writers’ multiple consciousness as Chinese Americans and ethnic Americans concerned with other marginalized groups, their visceral empathy with racial and sexual minorities, and their scintillating poetics, especially their novel deployment of Chinese expressions and classical allusions. Their ethics and aesthetics are mutually constitutive and enabling.

Lip and chin avulsion often results from orofacial trauma that occurs primarily in dogs and cats. Suture placement passing through the skin and around the incisor or canine teeth is the most common reconstructive method in animals. However, the reconstruction would be challenging in young puppies and kittens due to the limited growth of the teeth. A two-month-old kitten was presented for avulsion of a bilateral mandibular lip avulsion following a high-rise syndrome. Oral examination and skull radiographs demonstrated no mandibular fracture. Dental fracture was not observed. After aseptic preparations and under general anesthesia, four intraosseoussubcutaneous sutures using 3-0 nylon were placed to adhere the degloved lip and chin to the mandibular bone. The sutures passed through the both mandibles and the subcutaneous tissue. Then, the labial mucosa and gingiva were opposed by simple continuous sutures using 4-0 Dexon. Post-operative antibiotic and anti-inflammatory were administered. Chlorhexidine mouthwash was recommended for the first five days after surgery. Sutures were removed two weeks later. Infection, abscess formation, necrosis, and dehiscence are the commonly reported complications after lip and chin reconstruction. Using this technique, no complications were observed during a six months period. [ABSTRACT FROM AUTHOR]

Living in much of the borderland between modern Burma and India, the ethnic Chin discontinued the practice of their old religion and massively converted to Christianity after Christian missionaries evangelized and Christianized them in the twentieth century. There is a high cost to be paid by the Chin for practicing Christianity. Persecution, repression, and exile have defined their existence and history, and tens of thousands eventually left Burma and resettled in the United States after they had lived in India and Malaysia as refugees for years. Their stories, both challenges and opportunities, are, however, overlooked, and this article, thus, explores their lived experiences in the United States. [ABSTRACT FROM AUTHOR]

Japanese Official Development Assistance has benefited educational development by hook or by crook. Japan has been providing grant aids for grassroots development in Myanmar for more than half a century, which has had a significant degree of effectiveness for the recipients. The Japan Grant Assistance for Grassroots Projects has specifically benefited the education sector in Chin State, Myanmar, especially in building infrastructures for schools, including providing buildings, desks, and plumbing facilities. It is suggested that there are still quite a few primary factors requiring development to access quality education in Myanmar. Based on extensive research among educators and relevant officials in Chin State, this research surveys existing issues for educational infrastructure in the state and assesses some of the challenges for educational development in the region. It also assesses how Japanese Grant Assistance for Grassroots Projects has assisted the barriers. The scope of this research is from 2015 to 2020. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has significantly impacted global economies and individual health. This study uses data from the China Family Panel Data (CFPS) in 2018 (before the pandemic) and 2020 (during the pandemic) to a) estimate the relationships between the perceived risk of unemployment and individuals’ mental health, physical health, and health behaviors; and b) explore the variations of these relationships between rural and urban adults in China. Methods: Ordinary linear regression models or Logit models are employed, depending on the nature (continuous vs. discrete) of the dependent variables. Results: We find that the perceived risk of unemployment was statistically and positively associated with the risk of depression, and the association was greater for rural adults than for urban adults. Rural-urban variations were observed in various dimensions. For rural adults, the perceived risk of unemployment was statistically and negatively associated with life satisfaction, the probability of gaining weight and becoming obese, the probability of having adequate sleep, and computer-based screen time. These associations were statistically insignificant for urban adults. On the other hand, the perceived risk of unemployment was statistically and negatively associated with self-rated very-good-to-excellent health condition and health-compromising behaviors (e.g., smoking and drinking) for urban adults; but such associations were statistically insignificant for rural adults. Discussion: These findings suggest that rural and urban adults exhibited dierent psychological and behavioral responses to the unemployment risk during the COVID-19 pandemic. Public policies aiming to improve health and employment should be strategically designed to address the unique needs of urban and rural populations [ABSTRACT FROM AUTHOR]

Pointing with the chin is a practice attested worldwide: it is an effective and highly recognizable device for re-orienting the attention of the addressee. For the chin point to be observed, the addressee must attend carefully to the movements of the sender's head. This demand comes into conflict with the politeness norms of many cultures, since these often require conversationalists to avoid meeting the gaze of their interlocutor, and can require them to look away from their interlocutor's face and head. In this paper we explore how the chin point is successfully used in just such a culture, among the Chatino indigenous group of Oaxaca, Mexico. We analyze interactions between multiple dyads of Chatino speakers, examining how senders invite visual attention to the pointing gesture, and how addressees signal that attention, while both participants avoid stretches of mutual gaze. We find that in the Chatino context, the senior (or higher-status) party to the conversation is highly consistent in training their gaze away from their interlocutor. This allows their interlocutor to give visual attention to their face without the risk of meeting the gaze of a higher-status sender, and facilitates close attention to head movements including the chin point. Abstracts in Spanish and Quiahije Chatino are published as appendices. Se incluyen como apéndices resúmenes en español y en el chatino de San Juan Quiahije. SonG ktyiC reC inH, ngyaqC skaE ktyiC noE ndaH sonB naF ngaJ noI ngyaqC loE ktyiC reC, ngyaqC ranF chaqE xlyaK qoE chaqF jnyaJ noA ndywiqA renqA KchinA KyqyaC. [ABSTRACT FROM AUTHOR]

For decades, violent conflict has caused forced displacement throughout Myanmar. Chin people, largely from the northwestern Chin state in Myanmar, have been subjected to this violence resulting in displacement and resettlement with refugee status for thousands of Chin people. Scholars have often endeavored to understand the psychological outcomes of displacement and resettlement, with empirical work often dedicated to the onset of posttraumatic stress, depression, anxiety, and other Western-defined constructs of mental illness being correlated with traumatic experiences. These endeavors fail to center cultural explanations of mental illness among specific cultural groups like the Chin. Therefore, we used a community-collaborative, grounded theory approach to interview Chin people (N = 20) resettled in the midwestern United States. Grounded theory analyses led to identification of two categories reflecting participants' explanatory models of mental illness: (a) The Brain is Not working and (b) Causal Beliefs of The Brain not Working. The first category has one subcategory (Symptoms of the Brain not Working) and the second category is separated into three subcategories: (a) Going Crazy, Being Born Like that, and Thinking too Much as Causes, (b) Religion as an Explanation, and (c) "Control Your Heart": Personal Responsibility and the Onset of Illness. These are discussed in light of the need to better understand cultural models of illness for Chin people with refugee status in contexts of resettlement. Specific attention is afforded to potential importance of this idiom of distress. [ABSTRACT FROM AUTHOR]

Objective To investigate the morphological characteristics of the chin in patients with congenital absence of lower incisors with different vertical facial types， and to explore their differences with the normal population. Methods 120 female adolescent patients were stratified randomly selected as the study subjects. Among them， 60 cases of congenital loss of a lower incisor were assigned into the experimental group， and 60 cases without tooth loss were allocated into the control group. There were 20 cases of high angle， average angle and low angle in each group. All patients took lateral cephalometric films. The measurement results were statistically analyzed. Results The height and curvature of the chin from large to small were high angle group， average angle group and low angle group （all P < 0.05）. The maximum chin height in the experimental group was （21.20±1.32） mm， the minimum chin height was （16.91±1.57） mm. In the control group， the maximum chin height was （23.96±1.04） mm， and the minimum chin height was （19.70±1.66） mm. The chin angle in the high angle group was smaller than that in the low angle group（both P < 0.05）. In the experimental group， the ANB， Y-axis and chin curvature were significantly larger （all P < 0.05）， while SNB， chin height， chin thickness， minimum chin thickness， posterior chin thickness and chin angle were significantly smaller compared with those in the control group （all P < 0.05）. Conclusions The chin morphology is different among patients with different vertical facial types. The chin morphology of patients with congenital loss of the lower incisors is different from that of normal population. In orthodontic treatment， extensive attention should be paid to the chin morphology of patients with congenital loss of lower incisors， thereby designing a reasonable treatment regimen.

The objective of this case report is to describe the treatment of a dentofacial and temporomandibular joint (TMJ) deformity by means of reconstruction with a customized TMJ prosthesis and orthognathic surgery. The article discusses the therapeutic approach and the importance of functional and esthetic rehabilitation of the patient. A 22-year-old man displayed sequelae of osteomyelitis diagnosed at 6 years of age, including facial asymmetry, laterognathism, unsatisfactory occlusion, and mandibular retrognathism. Computed tomography revealed a deformity of the left mandibular condyle, ramus, and fossa. The patient underwent 1-stage surgery that involved bimaxillary orthognathic surgery and mentoplasty in conjunction with reconstruction of the left TMJ with a customized prosthesis. Postoperatively, substantial improvement was observed in the patient's facial pattern and masticatory function, and the beneficial changes have been maintained through 2 years of follow-up. The positive outcome in this patient suggests that TMJ reconstruction using a customized prosthesis in combination with computer-guided orthognathic surgery can be a satisfactory approach to correct a mandibular defect. The advantages of 1-stage surgery for the surgeon include shorter treatment time and more predictable results, while the benefits for the patient are good esthetic and functional results and improved quality of life. [ABSTRACT FROM AUTHOR]