Unusual photodynamic characteristics of the light-oxygen-voltage domain of phototropin linked to terrestrial adaptation of Klebsormidium nitens.

Phototropin (Phot), a blue light-sensing LOV domain protein, mediates blue light responses and is evolutionarily conserved across the green lineage. Klebsormidium nitens, a green terrestrial alga, presents a valuable opportunity to study adaptive responses from aquatic to land habitat transitions. We determined the crystal structure of Klebsormidium nitens Phot LOV1 domain (KnLOV1) in the dark and engineered different mutations (R60K, Q122N, and D33N) to modulate the lifetime of the photorecovery cycle. We observed unusual, slow recovery kinetics in the wild-type KnLOV1 domain (τ = 41 ± 3 min) compared to different mutants (R60K: τ = 2.0 ± 0.1 min, Q122N: τ = 1.7 ± 0.1 min, D33N: τ = 9.6 ± 0.1 min). Crystal structures of wild-type KnLOV1 and mutants revealed subtle but critical changes near the protein chromophore that is responsible for modulating protein dark recovery time. Our findings shed light on the unique structural and biochemical characteristics of the newly studied KnLOV1 and its evolutionary importance for phototropin-mediated physiology.

Morphometric Study of Malleus, Incus, and Stapes of Middle Ear Along With Associated Clinical Significance.

The ear ossicles transmit sound from the external ear to the inner ear. The aplasia, hypoplasia, erosion, and trauma to the ear ossicles cause conductive deafness, which can be corrected by ossiculoplasty, for which detailed knowledge of morphometry of the ear ossicles is very essential. So, the study was carried out. The aim of the study is to analyze the morphometric data and correlate it with clinical significance. The study was conducted in the Department of Anatomy using 47 malleus, 46 incus, and 10 stapes of known age, sex, and side. The various parameters of these ossicles were measured with vernier calipers. The parameters were compared with other studies, and associated clinical significance was elaborated. The means in mm of the total length, length of handle, length, and width of the head of the malleus are 6.8 ± 0.5, 4.4 ± 0.4, 2.7 ± 0.3, and 2.6 ± 0.3, respectively. The mean of the total length, width, length of long process and short process of incus in mm are 6.7 ± 0.5, 4.7 ± 0.4, 3.7 ± 0.3, and 2.7 ± 0.4, respectively. The mean of the total height, length, and width of the foot plate of stapes in millimeters are 3.2 ± 0.4, 2.7 ± 0.2, and 0.8 ± 0.3, respectively. The various parameters associated with ear ossicles of different populations were found to vary on the right and left sides and also in different sexes. The data will be of immense use in ossiculoplasty and the designing of prostheses to restore hearing.

Parents's knowledge and awareness about hepatitis B can influence the vaccination of their children.

BACKGROUND: Birth-dose (Hep-BD) followed by three additional doses (Hep-B3) of hepatitis B virus (HBV) vaccine are key to eliminating HBV by 2030. Unfortunately, Hep-BD and Hep-B3 coverage in our country is poor. AIM: To studied the parent's knowledge and awareness about HBV infection, its prevention, consequences and vaccination. METHODS: Parents of 6 months to 8 years old children were interviewed to assess their knowledge & awareness about hepatitis B, its transmission, prevention, illness caused by this, and vaccination. Eighteen close-ended questions were administered, and responses were recorded as 'yes', 'no', or 'not sure'. HBV knowledge score was calculated based on the sum of correct answers. Each correct response scored one point and incorrect, missing or 'not sure' responses received no points. Categorical data are presented as number (%) and numerical data are expressed as median. Data were compared using Chi2 tests and level of significance was kept as P < 0.05. RESULTS: Parents (58.3% mothers) of 384 children (89.9% age < 5 years; 82% age-appropriately vaccinated) were included. Three hundred and twenty-two (83.9%) children were Hep-B3 vaccinated. 94.3%, 87.5%, and 29.2% parents knew about polio, tetanus, and hepatitis B vaccine. Overall, 41.2%, 15.8%, and 23% parents knew about hepatitis B transmission, consequences of infection, and prevention respectively. Only 7.6% parents knew about three-dose schedule of hepatitis B vaccination. Only 23% parents believed that vaccine could prevent HBV, 15.7% knew that HBV affects liver. Parents of Hep-B3 vaccinated children were significantly more aware about HBV than the parents of unvaccinated children (P < 0.05 for 17/18 questions). CONCLUSION: The knowledge and awareness among the parents about hepatitis B is poor. The Increasing knowledge/awareness about HBV among parents may improve Hep-B3 vaccination coverage.

Prevalence and Morphometry of Occipital Foramen in Dry Skulls and its Clinical Implications.

The occipital emissary foramen (OEF) located on the occipital bone transmits the occipital emissary vein, which connects the occipital vein to the confluence of cranial venous sinuses. The OEF varies in incidence, number, size, and location. Knowledge of this foramen is essential for carrying out suboccipital and transcondylar surgeries without clinical implications. Hence, the study was planned. The aim of the present study is to elaborate on incidence, location, and morphometry consisting of the number and size of this foramen in light of clinical bearing in the context of the Indian population. The study was carried out in the Department of Anatomy using 80 skulls of unknown age and sex. The occipital bone of the skull was observed for the incidence, number, size, and location of the occipital emissary vein and associated clinical implications were elaborated. The incidence of occipital foramen was 36.25% and detected in 29 skulls. All these occipital foramina were patent. The mean diameter of this foramen was 0.6 mm. The most common location of these foramina was the left side of the foramen magnum, followed by the left side of the external occipital crest. The information about the incidence, number, size, and location of OEF is important to prevent catastrophic bleeding during surgery in the region of the occipital bone. The awareness of differential morphometry and morphology of occipital foramina is of great importance for neurosurgeons during suboccipital craniotomy and skull base surgeries, including far lateral and transcondylar approaches to access posterior cranial fossa for management of pathologies in the cranial cavity.

Mastoid Emissary Foramina in Dry Skulls: Its Morphometry, Topography, and Associated Clinical Implications.

Mastoid emissary foramen transmitting mastoid emissary vein connects the posterior auricular vein with the sigmoid sinus. This foramen and so the mastoid emissary vein varies in prevalence, number, size and location, knowledge of which is essential for carrying out uneventful surgeries, especially retrosigmoid, mastoidectomy, and skull base surgeries. There is a paucity of literature on this foramen in the Indian context, so the study was done. The purpose of the study is to elaborate on the prevalence, number, size, and location of mastoid foramen in dry adult skulls. The study was conducted in the Department of Anatomy using 90 dry skulls of unknown age and sex, and prevalence, number, size, and location in these skulls were noted. The mastoid foramen was detected in 27.8% of skulls, with an incidence of 31.1% and 12.2% on right and left sides of skulls, respectively. The number of foramina ranged between 1 and 4. The mean diameter of this foramen was 0.9 mm, and the most frequent location was mastoid process. The detailed morphology and morphometry of mastoid foramen are of utmost use to neurosurgeons, ENT surgeons, radiologists, and vascular surgeons as it transmits mastoid emissary vein and meningeal branch of the occipital artery, which may be injured during various surgical procedures involving mastoid region and skull base causing catastrophic hemorrhage. In addition to this, mastoid emissary vein may be the source of thrombus, causing thrombus of sigmoid sinus creating helm of neurological complications.

Study of Topography of Stylomastoid Foramen With Respect to Nearby Landmarks to Carry Out Facial Nerve Block With Minimum Complications.

Nadbath facial nerve block is the most common procedure to anesthetize the facial nerve at stylomastoid foramen in intraocular surgeries, but it is associated with complications. Also, this foramen exhibits ethnic and racial variations with regard to its location. There is scanty literature describing the topographical location of this foramen. So, the study is carried out. The purpose of the study is to describe the topography of stylomastoid foramen from the surrounding landmarks so that Nadbath facial nerve block can be performed with minimum complications. The study was conducted using 80 adult dry skulls of unknown age and sex, and the distance of this foramen was measured from the tip, upper end, and lower end of the anterior border of the mastoid process and jugular foramen. The statistical analysis consisting of mean, SD, median, range mode, and t test was calculated. Mean distances of stylomastoid foramen from the upper end, the lower end of anterior border and tip of mastoid process and jugular foramen on right side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.49±0.06 cm and those on left side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.5±0.06 cm, respectively. The mode of these distances was 1.5, 1, 0.8, and 0.5, both on the right and left sides. The topographic information about stylomastoid foramen given in this study is useful to anesthetists to carry out Nadbath facial nerve block successfully with minimum complications.

Sofosbuvir/Velpatasvir/Voxilaprevir for Hepatitis C Virus Retreatment in Difficult-to-treat Patients: A Real-life Observational Study from India.

Background and aim: Hepatitis C virus (HCV) treatment fails to achieve sustained virological response at 12 weeks (SVR12) in 5-10 % and requires retreatment with second-line drugs. We report our experience of sofosbuvir/velpatasvir/voxilaprevir use for HCV retreatment in a small cohort of difficult-to-treat Indian patients. Methods: We reviewed our HCV databases to identify the patients who had failed to achieve SVR12 after treatment with sofosbuvir in combination with either daclatasvir, ledipasvir, or velpatasvir with/without ribavirin on one or more occasions. Participants were excluded if they had (i) decompensated cirrhosis, (ii) HIV coinfection or (iii) chronic kidney disease, or (iv) prior organ transplantation. All the participants were treated with sofosbuvir/velpatasvir/voxilaprevir plus ribavirin for 12 weeks. Treatment outcome was categorized as successful or failure if HCV RNA was undetectable or detectable at SVR12, respectively. Results: Fifteen patients (male 67 %; genotype-3 80 %) were included in the analysis. Ten (67 %) had cirrhosis. Five, eight, and two participants had previously failed one, two, and three courses of pegylated-interferon free, sofosbuvir containing direct acting antiviral (DAA) regimens respectively. Fourteen participants had failed to at least one course of the sofosbuvir/velpatasvir combination. Fourteen patients achieved SVR12, and one patient was lost to follow-up. Treatment was successful in 100 % and 93.3 % of per-protocol (PP) and intention to treat (ITT) analyses, respectively. Conclusion: Sofosbuvir/velpatasvir/voxilaprevir combination is an effective second-line therapy in India for difficult-to-treat HCV patients.

Wormian Bones: Prevalence, Topography, and Implications.

BACKGROUND: Wormian bones also known as sutural bones are asymmetrical and shapeless bones occurring in cranial sutures and fontanelle of the skull. Their incidence is reported to vary in population. The exact etiology is debatable, but their formation is under the control of both genetic and environmental factors and has great anthropological and clinical implications related to the cranium. Due to high clinical relevance of Wormian bones, the study was carried out. The aim of the study is to expound the incidence and topography of Wormian bones along with clinical significance in dry adult skulls of Indian origin. METHODS: The study was conducted in the Department of Anatomy using 200 complete adult dry skulls of unknown age and sex. All the sutures in the skull were inspected for the presence of Wormian bones. The Wormian bones were classified into 10 categories, and associated implications were brought out. The Wormian bones were photographed, and details were compared with the available literature. RESULTS: The Wormian bones were observed in 190 (380 sides) skulls with 186 on the right side and 108 on the left side. The predominance site of sutural bone was lambdoid suture followed by sagittal suture. The least common site of Wormian bone was lambda. CONCLUSION: The detailed information of precise topography, frequency, and number of Wormian bones is of utmost use for surgeons performing surgery on the skull, anthropologists for identifying races, and forensic scientists for investigating child abuse cases.

Biomanufacturing of glycosylated antibodies: Challenges, solutions, and future prospects.

Traditionally, recombinant protein production has been done in several expression hosts of bacteria, fungi, and majorly CHO (Chinese Hamster Ovary) cells; few have high production costs and are susceptible to harmful toxin contamination. Green algae have the potential to produce recombinant proteins in a more sustainable manner. Microalgal diversity leads to offer excellent opportunities to produce glycosylated antibodies. An antibody with humanized glycans plays a crucial role in cellular communication that works to regulate cells and molecules, to control disease, and to stimulate immunity. Therefore, it becomes necessary to understand the role of abiotic factors (light, temperature, pH, etc.) in the production of bioactive molecules and molecular mechanisms of product synthesis from microalgae which would lead to harnessing the potential of algal bio-refinery. However, the potential of microalgae as the source of bio-refinery has been less explored. In the present review, omics approaches for microalgal engineering, methods of humanized glycoproteins production focusing majorly on N-glycosylation pathways, light-based regulation of glycosylation machinery, and production of antibodies with humanized glycans in microalgae with a major emphasis on modulation of post-translation machinery of microalgae which might play a role in better understanding of microalgal potential as a source for antibody production along with future perspectives.

Prevalence, morphology, morphometry and associated clinical implications of mastoid emissary veins: narrative review.

The mastoid emissary vein connects the posterior auricular vein to the sigmoid sinus and varies in size, number, location, and course, resulting in clinical complications. This study was conducted in response to the vast clinical implications associated with this vein. The aim of this review is to highlight and describe the prevalence, varied morphology, and morphometry of the mastoid emissary vein, how these varied parameters cause clinical complications, and how these can be rectified and avoided. A literature survey was conducted using various databases and different terms related to mastoid emissary vein were used to search the literature. Pitfalls related to surgery in the vicinity of this vein and their remedies were elucidated. The literature search revealed that the prevalence, morphology, and morphometry of mastoid emissary veins vary immensely and are responsible for morbidity and mortality. Pre-operative identification of mastoid veins is thus essential and so multidetector computed tomography of the temporal bone should be scheduled before planning surgery.

A veia emissária mastóidea que conecta a veia auricular posterior ao seio sigmoide pode variar em tamanho, número, localização e curso, resultando em complicações clínicas. O objetivo desta revisão é destacar e descrever a prevalência, variação morfológica e morfometria da veia emissária mastóidea, além de como esses parâmetros causam complicações clínicas e como corrigi-las e reduzi-las. Foram conduzidas buscas em diversas bases de dados utilizando diferentes termos relacionados à veia emissária mastóidea. As armadilhas relacionadas a procedimentos cirúrgicos realizados nas proximidades dessa veia e as respectivas soluções foram descritas. A pesquisa na literatura revelou que a prevalência, a morfologia e a morfometria da veia emissária mastóidea variam imensamente, sendo responsáveis ​​por alta morbidade e mortalidade. Portanto, a identificação da veia mastóidea deve ser realizada no pré-operatório através de tomografia computadorizada multidetectores do osso temporal, antes do planejamento cirúrgico.

Variations of venous drainage of the thyroid gland and their surgical implications: a narrative review.

Diseases of the thyroid are common worldwide, so knowledge of its normal and variant anatomy, especially of the veins of thyroid, is essential for safe and successful surgery involving the anterolateral neck. The aim of this study is to consolidate all information related to venous drainage of the thyroid gland as a ready reference for vascular and endocrine surgeons. The study was conducted at the Department of Anatomy and the literature search was carried out using the Pubmed, Scielo, Researchgate, Medline, and Scopus databases. Various terms related to the thyroid gland and its venous drainage were used to explore the literature. The literature review revealed that the superior and middle thyroid veins have the fewest variations in terms of course and termination while the inferior thyroid vein has the most variations in terms of course and termination. Detailed knowledge of normal and variant anatomy of the thyroid veins is of utmost use for vascular surgeons performing anterolateral neck surgery, especially tracheostomy, a lifesaving procedure, minimizing intraoperative and postoperative complications and morbidity and mortality.

As doenças da tireoide são comuns em todo o mundo; portanto, o conhecimento tanto da anatomia normal quanto de variações anatômicas, especialmente das veias tireóideas, é essencial para uma cirurgia segura e bem-sucedida da região anterolateral do pescoço. O objetivo deste estudo é consolidar todas as informações relacionadas à drenagem venosa da glândula tireoide para pronta referência a cirurgiões vasculares e endócrinos. O estudo foi realizado no Departamento de Anatomia, e a pesquisa bibliográfica foi realizada nas bases de dados PubMed, SciELO, ResearchGate, MEDLINE e Scopus. Vários termos relacionados à glândula tireoide e sua drenagem venosa foram considerados para busca na literatura. O levantamento da literatura revelou que as veias tireóideas superior e média apresentam as menores variações em termos de trajeto e terminação, enquanto a veia tireóidea inferior apresenta as maiores variações. O conhecimento detalhado da anatomia normal e de variações anatômicas das veias tireóideas é de extrema utilidade para os cirurgiões vasculares na realização de cirurgia anterolateral do pescoço, especialmente traqueostomia, um procedimento que salva vidas, minimizando complicações intra e pós-operatórias, morbidade e mortalidade.

Morphological Study of Stylomastoid Foramen at the Base of Skull and its Role in Facial Nerve Palsy.

The facial nerve emerges out of skull through the stylomastoid foramen located between styloid process and mastoid process. Unilateral paralysis of facial nerve is known as Bell's palsy and is reported to be caused most frequently by herpes simplex virus. The herpes infection is comparatively common but Bell's palsy is not very common. So, other causes of Bell's palsy like variation in morphological forms of stylomastoid cannot be ruled. There is paucity of literature elucidating morphological shapes of this foramen and correlating these forms of foramen with Bell's palsy. Hence the study was carried out. The aim of this study is to expound varied forms of stylomastoid foramen and to bring out clinical implications. The study was conducted in the department of anatomy using undamaged 70 adult dry human skulls of unknown age and sex. The morphological shapes were observed, interpretated and compared with available literature and their clinical implications were brought out. Most common shapes observed were round and oval followed by square shapes. Round shaped foramina were observed in 40 skulls on right sides constituting 57.1% and in 36 skulls on left side constituting 51.4%. While oval shapes were found in 16 skulls on right side (22.6%) and in 12 skulls on left side (17.1%). Rare variants of the foramen include triangular, serrated and closely applied to styloid process. The rare morphological forms were mostly observed to be unilateral in occurrence. Unilateral Bell's palsy is common, so, the rare morphological forms might be responsible for Bell's palsy.

Cell-type specific role of autophagy in the liver and its implications in non-alcoholic fatty liver disease.

Autophagy, a cellular degradative process, has emerged as a key regulator of cellular energy production and stress mitigation. Dysregulated autophagy is a common phenomenon observed in several human diseases, and its restoration offers curative advantage. Non-alcoholic fatty liver disease (NAFLD), more recently renamed metabolic dysfunction-associated steatotic liver disease, is a major metabolic liver disease affecting almost 30% of the world population. Unfortunately, NAFLD has no pharmacological therapies available to date. Autophagy regulates several hepatic processes including lipid metabolism, inflammation, cellular integrity and cellular plasticity in both parenchymal (hepatocytes) and non-parenchymal cells (Kupffer cells, hepatic stellate cells and sinusoidal endothelial cells) with a profound impact on NAFLD progression. Understanding cell type-specific autophagy in the liver is essential in order to develop targeted treatments for liver diseases such as NAFLD. Modulating autophagy in specific cell types can have varying effects on liver function and pathology, making it a promising area of research for liver-related disorders. This review aims to summarize our present understanding of cell-type specific effects of autophagy and their implications in developing autophagy centric therapies for NAFLD.

Variations of venous drainage of the thyroid gland and their surgical implications: a narrative review / Drenagem venosa da glândula tireoide e suas implicações cirúrgicas: revisão narrativa

Abstract Diseases of the thyroid are common worldwide, so knowledge of its normal and variant anatomy, especially of the veins of thyroid, is essential for safe and successful surgery involving the anterolateral neck. The aim of this study is to consolidate all information related to venous drainage of the thyroid gland as a ready reference for vascular and endocrine surgeons. The study was conducted at the Department of Anatomy and the literature search was carried out using the Pubmed, Scielo, Researchgate, Medline, and Scopus databases. Various terms related to the thyroid gland and its venous drainage were used to explore the literature. The literature review revealed that the superior and middle thyroid veins have the fewest variations in terms of course and termination while the inferior thyroid vein has the most variations in terms of course and termination. Detailed knowledge of normal and variant anatomy of the thyroid veins is of utmost use for vascular surgeons performing anterolateral neck surgery, especially tracheostomy, a lifesaving procedure, minimizing intraoperative and postoperative complications and morbidity and mortality.

Resumo As doenças da tireoide são comuns em todo o mundo; portanto, o conhecimento tanto da anatomia normal quanto de variações anatômicas, especialmente das veias tireóideas, é essencial para uma cirurgia segura e bem-sucedida da região anterolateral do pescoço. O objetivo deste estudo é consolidar todas as informações relacionadas à drenagem venosa da glândula tireoide para pronta referência a cirurgiões vasculares e endócrinos. O estudo foi realizado no Departamento de Anatomia, e a pesquisa bibliográfica foi realizada nas bases de dados PubMed, SciELO, ResearchGate, MEDLINE e Scopus. Vários termos relacionados à glândula tireoide e sua drenagem venosa foram considerados para busca na literatura. O levantamento da literatura revelou que as veias tireóideas superior e média apresentam as menores variações em termos de trajeto e terminação, enquanto a veia tireóidea inferior apresenta as maiores variações. O conhecimento detalhado da anatomia normal e de variações anatômicas das veias tireóideas é de extrema utilidade para os cirurgiões vasculares na realização de cirurgia anterolateral do pescoço, especialmente traqueostomia, um procedimento que salva vidas, minimizando complicações intra e pós-operatórias, morbidade e mortalidade.

Prevalence, morphology, morphometry and associated clinical implications of mastoid emissary veins: narrative review / Prevalência, morfologia, morfometria e implicações clínicas das veias emissárias mastóideas: uma revisão narrativa

Abstract The mastoid emissary vein connects the posterior auricular vein to the sigmoid sinus and varies in size, number, location, and course, resulting in clinical complications. This study was conducted in response to the vast clinical implications associated with this vein. The aim of this review is to highlight and describe the prevalence, varied morphology, and morphometry of the mastoid emissary vein, how these varied parameters cause clinical complications, and how these can be rectified and avoided. A literature survey was conducted using various databases and different terms related to mastoid emissary vein were used to search the literature. Pitfalls related to surgery in the vicinity of this vein and their remedies were elucidated. The literature search revealed that the prevalence, morphology, and morphometry of mastoid emissary veins vary immensely and are responsible for morbidity and mortality. Pre-operative identification of mastoid veins is thus essential and so multidetector computed tomography of the temporal bone should be scheduled before planning surgery.

Resumo A veia emissária mastóidea que conecta a veia auricular posterior ao seio sigmoide pode variar em tamanho, número, localização e curso, resultando em complicações clínicas. O objetivo desta revisão é destacar e descrever a prevalência, variação morfológica e morfometria da veia emissária mastóidea, além de como esses parâmetros causam complicações clínicas e como corrigi-las e reduzi-las. Foram conduzidas buscas em diversas bases de dados utilizando diferentes termos relacionados à veia emissária mastóidea. As armadilhas relacionadas a procedimentos cirúrgicos realizados nas proximidades dessa veia e as respectivas soluções foram descritas. A pesquisa na literatura revelou que a prevalência, a morfologia e a morfometria da veia emissária mastóidea variam imensamente, sendo responsáveis ​​por alta morbidade e mortalidade. Portanto, a identificação da veia mastóidea deve ser realizada no pré-operatório através de tomografia computadorizada multidetectores do osso temporal, antes do planejamento cirúrgico.

Machine Learning-Based Regression Framework to Predict Health Insurance Premiums.

Artificial intelligence (AI) and machine learning (ML) in healthcare are approaches to make people's lives easier by anticipating and diagnosing diseases more swiftly than most medical experts. There is a direct link between the insurer and the policyholder when the distance between an insurance business and the consumer is reduced to zero with the use of technology, especially digital health insurance. In comparison with traditional insurance, AI and machine learning have altered the way insurers create health insurance policies and helped consumers receive services faster. Insurance businesses use ML to provide clients with accurate, quick, and efficient health insurance coverage. This research trained and evaluated an artificial intelligence network-based regression-based model to predict health insurance premiums. The authors predicted the health insurance cost incurred by individuals on the basis of their features. On the basis of various parameters, such as age, gender, body mass index, number of children, smoking habits, and geolocation, an artificial neural network model was trained and evaluated. The experimental results displayed an accuracy of 92.72%, and the authors analyzed the model's performance using key performance metrics.

Ossification of Pterygospinous and Pterygoalar Ligaments and Their Clinical Significance: An Anatomic Study.

ABSTRACT: Pterygospinous and pterygoalar ligaments, present in close proximity of foramen ovale at the base of skull, ossify creating pterygospinous and pterygoalar foramina, which causes problems in accessing retro and parapharyngeal spaces, trigeminal ganglion for treating trigeminal neuralgia by thermocoagulation and blocking it. Besides, these anatomical entities may compress nearby neurovascular structures causing discomfort to patients. Considering immense clinical significance associated with ossification of pterygospinous and pterygoalar ligaments, the study has been carried out. Aim of the study is to provide extended new classification related to pterygospinous and pterygoalar foramina and associated clinical significance. Seven hundred thirty skull bases were observed for variant ossification pterygospinous and pterygoalar ligaments and a new classification of occurrence of these anomalies has been proposed. Literature search revealed that incidence of formation of various forms of pterygospinous and pterygoalar foramina in world populations ranges between 1% and 31.2% and 1.3% and 62.4%, respectively. The highest incidence of complete pterygospinous foramen was observed in Brazilian population followed by Anatolian population and that of incomplete pterygospinous foramen also in Brazilian population. Various neurovascular structures are present in relation to pterygospinous and pterygoalar ligaments. Comprehension of foramina formed by ossification of these ligaments at the cranial base is imperative for proper planning and treating trigeminal neuralgia, clinical neuralgias involving oral and maxillofacial region and carrying out interventions like transfacial needle approaches to the foramen ovale and also for evaluating skull base radiographs. Therefore, thorough knowledge of these entities is of utmost use to anesthesiologists, dentists, and oral maxillofacial surgeons and neurosurgeons.

n-Player Stochastic Duel Game Model with Applied Deep Learning and Its Modern Implications.

This paper provides a conceptual foundation for stochastic duels and contains a further study of the game models based on the theory of stochastic duels. Some other combat assessment techniques are looked upon briefly; a modern outlook on the applications of the theory through video games is provided; and the possibility of usage of data generated by popular shooter-type video games is discussed. Impactful works to date are carefully chosen; a timeline of the developments in the theory of stochastic duels is provided; and a brief literature review for the same is conducted, enabling readers to have a broad outlook at the theory of stochastic duels. A new evaluation model is introduced in order to match realistic scenarios. Improvements are suggested and, additionally, a trust mechanism is introduced to identify the intent of a player in order to make the model a better fit for realistic modern problems. The concept of teaming of players is also considered in the proposed mode. A deep-learning model is developed and trained on data generated by video games to support the results of the proposed model. The proposed model is compared to previously published models in a brief comparison study. Contrary to the conventional stochastic duel game combat model, this new proposed model deals with pair-wise duels throughout the game duration. This model is explained in detail, and practical applications of it in the context of the real world are also discussed. The approach toward solving modern-day problems through the use of game theory is presented in this paper, and hence, this paper acts as a foundation for researchers looking forward to an innovation with game theory.

Is inadequate anatomical knowledge on the part of physicians hazardous for successful clinical practice?

PURPOSE: The physicians say that the least anatomy is required for clinical practice. But the disease causes anatomical distortions or variations in structures impairing functions of organs and systems. So, the diagnosis and analysis of treatment of disease depend on interwoven inter-relationship among Anatomy, Physiology, Pathology, Radiology and clinical sciences. Consequently, the upcoming doctors are to be cultivated sufficient anatomy. Therefore, the objective of this study is to analyze viewpoints of medical students, faculties and practitioners regarding degree of need of Anatomy in clinical practice. METHODS: A feedback survey has been carried out among students and faculties to seek their views on the need of Anatomy in clinical practice using two hypotheses. Hypothesis 1 defines the degree of need of Anatomy ('most essential', 'essential' and 'least essential') in clinical practice based on answers of questionnaire by medical students and faculties, whereas hypothesis 2 assigns weights depending on knowledge and experience of the feedback providers. The means/weighted means of views have been statistically analyzed. Additionally, the literature survey was carried out on the demand, necessity, importance, usefulness and applicability of Anatomy in clinical practice. RESULTS: Our statistical analysis revealed that Anatomy is 'most essential' for clinical practice. In literature survey too, the inadequate knowledge of anatomy among medical students leads to poor comprehension of clinical practice. So, anatomy is most essential for clinical practice. CONCLUSION: Sound knowledge of Human Anatomy is most essential during medical practice for Physicians.

Morphometry and Morphology of Vascular Foramen on the Trochlear Groove of the Distal Femur and Its Implications.

Background and objective Nutrient foramina in supracondylar, medial condyle, lateral condyle, and intercondylar fossa have been described in the literature. The author of the present study observed a vascular foramen on the trochlear groove, which has not been previously reported in the literature. The aim of the study was to elaborate on the morphology, morphometry, and associated clinical implications of this foramen. Materials and methods Forty-five unpaired femora of unknown sex available in the Department of Anatomy at the Uttar Pradesh University of Medical Science (UPUMS), Saifai, India were observed to examine the incidence, shape, size, and location of the foramen on the trochlear groove of the distal femur. The incidence and shape were observed and its location in relation to the upper and lower articulating margin of the patella was recorded using a divider and scale. Results The trochlear foramen was observed in 25 femora, accounting for 55.6% of the total. The average diameter of the foramen was 4 mm. The average distance of the foramen from the upper patellar articulating surface was 2.4 cm and its distance from the lower margin was 0.7 cm. All the foramina were round in shape. The largest number of foramina were located in the midline, and seven foramina were located to the left of the midline of the trochlear groove. Conclusions The incidence of the trochlear foramen was 55.6%, meaning that more than half of the population possess this foramen on the trochlear groove. The maximum number of these foramen, amounting to 64%, were found in the midline of the trochlear groove. The morphologic and topographic knowledge of the trochlear foramen is essential for orthopedic surgeons during operative procedures in the region of the distal femur.