Search Results (702)

Background/Objectives: Lateral patellar dislocation (LPD) is a common pathology of the adolescent knee and a major predisposing factor for patellofemoral instability (PFI). The pathogenesis of PFI involves a combination of anatomical and biomechanical contributors, with increasing evidence pointing to sex-specific differences in knee morphology. Despite this, the developmental course of these parameters and their variation between sexes remain insufficiently characterized. This study aims to investigate sex-related differences in patellofemoral joint geometry among skeletally immature patients with a history of PFI, focusing on how these anatomical variations evolve with increasing knee size, as represented by femoral condylar width. Methods: A total of 315 knee MRIs from patients under 18 years with documented PFI were retrospectively analyzed. Trochlear morphology, patellar tilt, axial positioning, and sagittal alignment were assessed using established MRI-based parameters. All measurements were normalized to bicondylar width to account for individual knee size. Sex-specific comparisons were performed using independent t-tests and linear regression analysis. Results: Females exhibited significantly smaller femoral widths, shallower trochlear depth (TD), shorter tibial tubercle–posterior cruciate ligament (TTPCL) distances, and lower patellar trochlear index (PTI) values compared to males (p < 0.05). In males, increasing femoral width was associated with progressive normalization of patellar tilt and sagittal alignment parameters. In contrast, these alignment parameters in females remained largely unchanged or worsened across different femoral sizes. Additionally, patellar inclination angle and PTI were significantly influenced by knee size in males (p < 0.05), whereas no such relationship was identified in females. Conclusions: Sex-specific morphological differences in patellofemoral geometry are evident early in development and evolve distinctly with growth. These differences may contribute to the higher prevalence of PFI in females and underscore the importance of considering sex and knee size in anatomical assessments. Full article

Background: Midportion Achilles tendinopathy (Mid-AT) is a complex condition that may be exacerbated by anatomical variations of the plantaris tendon. Recent anatomical studies, particularly the classification proposed by Olewnik et al., have enhanced the understanding of plantaris–Achilles interactions and their clinical implications. Objective: This review aims to assess the anatomical types of the plantaris tendon, their imaging correlates, and the impact of the Olewnik classification on diagnosis, treatment planning, and surgical outcomes in patients with Mid-AT. Methods: We present an evidence-based analysis of the six anatomical types of the plantaris tendon and their relevance to Achilles tendinopathy, with emphasis on MRI and ultrasound (USG) evaluation. A diagnostic and therapeutic algorithm is proposed, and clinical outcomes of both conservative and operative management are compared across tendon types. Results: Types I and V were most strongly associated with symptomatic conflict and showed the highest benefit from surgical resection. Endoscopic approaches were effective in Types II and III, while Type IV typically responded to conservative treatment. Type VI, often misdiagnosed as tarsal tunnel syndrome, required combined neurolysis. The classification significantly improves surgical decision-making, reduces overtreatment, and enhances diagnostic precision. Conclusions: The Olewnik classification provides a reproducible, clinically relevant framework for individualized management of Mid-AT. Its integration into imaging protocols and treatment algorithms may improve therapeutic outcomes and guide future research in orthopaedic tendon pathology. Full article

Aim: Pacifiers play a critical role in the early stages of craniofacial and palate development during infancy. While they provide comfort and aid in soothing, their use can also have significant impacts on the growth and function of the oral cavity. This study aimed to simulate and predict the behavior of six different types of pacifiers and their functional interaction with the tongue and palate, with the goal of understanding their potential effects on orofacial growth and development. Materials and Methods: Biomechanical analysis using Finite Element Analysis (FEA) mathematical models was employed to evaluate the behavior of six different commercial pacifiers in contact with the palate and tongue. Three-dimensional solid models of the palate and tongue were based on the mathematical framework from a 2007 publication. This allowed for a detailed investigation into how various pacifier designs interact with soft and hard oral tissues, particularly the implications on dental and skeletal development. Results: The findings of this study demonstrate that pacifiers exhibit different interactions with the oral cavity depending on their geometry. Anatomical–functional pacifiers, for instance, tend to exert lateral compressions near the palatine vault, which can influence the hard palate and contribute to changes in craniofacial growth. In contrast, other pacifiers apply compressive forces primarily in the anterior region of the palate, particularly in the premaxilla area. Furthermore, the deformation of the tongue varied significantly across different pacifier types: while some pacifiers caused the tongue to flatten, others allowed it to adapt more favorably by assuming a concave shape. These variations highlight the importance of selecting a pacifier that aligns with the natural development of both soft and hard oral tissues. Conclusions: The results of this study underscore the crucial role of pacifier geometry in shaping both the palate and the tongue. These findings suggest that pacifiers have a significant influence not only on facial bone growth but also on the stimulation of oral functions such as suction and feeding. The geometry of the pacifier affects the soft tissues (tongue and muscles) and hard tissues (palate and jaw) differently, which emphasizes the need for careful selection of pacifiers during infancy. Choosing the right pacifier is essential to avoid potential negative effects on craniofacial development and to ensure that the benefits of proper oral function are maintained. Therefore, healthcare professionals and parents should consider these biomechanical factors when introducing pacifiers to newborns. Full article

In vitro propagation of avocado faces several limitations. To optimize the establishment phase, we evaluated three plant material types: etiolated shoots, 30-day covered field shoots, and uncovered field shoots, collected at two time points. Biochemical and anatomical analyses were conducted to understand material performance during establishment. Across both collection times, etiolated shoots exhibited minimal oxidation, enhanced bud sprouting, reduced malondialdehyde (MDA) and reactive oxygen species (ROS) levels, increased peroxidase (POD) activity, and improved xylem development, consistently outperforming field-derived materials. Using etiolated shoots, we optimized disinfection and in vitro multiplication protocols. Pre-disinfection with 3 mL L⁻¹ Phyton 27^® and 2% sodium hypochlorite yielded the highest survival rates. In multiplication experiments, varying concentrations of 6-benzylaminopurine (BAP) and meta-topolin (MT), supplemented with gibberellic acid (GA₃), did not significantly affect growth variation. However, 8.88 µM BAP with 0.29 µM GA₃ resulted in the greatest number of sprouted buds. Full article

Spruce wood is a natural polymeric material, consisting of cellulose, lignin, hemicelluloses and other secondary components, which gives it a unique chemical footprint and architecture. Varnishes are used in musical instruments to protect the wood against humidity variations, wood being a hygroscopic material, but also to protect the wood from dirt. The varnishes used both to protect the wood from resonance and to ensure a special aesthetic appearance are either polymeric varnishes (nitrocellulose, oil-based) or volatile solvents (spirit). In this study, the color changes, the surface morphology and the chemical spectrum produced by three types of varnishes, applied in 5, 10 and 15 layers, on resonance spruce plates were analyzed. The results revealed significant changes in the color parameters: the lightness decreased by approximately 17% after the first layer, by 50% after 5 layers, by 65% after 10 layers and by 70% after 15 layers. The color parameters are most influenced by the anatomical quality of spruce wood (annual ring width and earlywood/latewood ratio) in the case of oil-based varnishes and least influenced in the case of nitrocellulose varnishes. The chemical fingerprint was determined by FTIR spectrum analysis, which revealed that the most pronounced absorptions were the double band 2926–2858 cm⁻¹, corresponding to aliphatic methylene and methyl groups (asymmetric and symmetrical C-H stretch), and the bands at 1724 cm⁻¹ (oil-based varnish), 1722 cm⁻¹ (nitrocellulose varnish) and 1708 cm⁻¹ (spirit varnish), all assigned to non-conjugated carbonyl groups in either carboxylic acids, esters aldehydes or ketones. The novelty of the study lies in the comparative analysis of three types of varnishes used in the musical instrument industry, applied to samples of spruce resonance wood with different macroscopic characteristics in three different layer thicknesses. Full article

Background: Colorectal liver metastasis (CRLM) represents a major clinical challenge in oncology, affecting 25–50% of colorectal cancer patients and significantly impacting survival. While multimodal therapies—including surgical resection, systemic chemotherapy, and local ablative techniques—have improved outcomes, prognosis remains heterogeneous due to variations in tumor biology, patient factors, and institutional practices. Methods: This review synthesizes current evidence on prognostic factors influencing CRLM management, encompassing clinical (e.g., tumor burden, anatomic distribution, timing of metastases), biological (e.g., CEA levels, inflammatory markers), and molecular (e.g., RAS/BRAF mutations, MSI status, HER2 alterations) determinants. Results: Key findings highlight the critical role of molecular profiling in guiding therapeutic decisions, with RAS/BRAF mutations predicting resistance to anti-EGFR therapies and MSI-H status indicating potential responsiveness to immunotherapy. Emerging tools like circulating tumor DNA (ctDNA) and radiomics offer promise for dynamic risk stratification and early recurrence detection, while the gut microbiome is increasingly recognized as a modulator of treatment response. Conclusions: Despite advancements, challenges persist in standardizing resectability criteria and integrating multidisciplinary approaches. Current guidelines (NCCN, ESMO, ASCO) emphasize personalized strategies but lack granularity in terms of incorporating novel biomarkers. This exhaustive review underscores the imperative for the development of a unified, biomarker-integrated framework to refine CRLM management and improve long-term outcomes. Full article

Fish coloration plays an important role in reproduction and camouflage, yet capturing color variation under field conditions remains challenging. We present a standardized, semi-automated protocol for measuring body coloration in the popular model fish threespine stickleback (Gasterosteus aculeatus). Individuals are photographed in a controlled light box within minutes of capture, and color is sampled from eight anatomically defined standard sites in human-perception-based CIELAB space. Analyses combine univariate color metrics, multivariate statistics, and the ΔE* perceptual difference index to detect subtle shifts in hue and brightness. Validation on pre-spawning fish shows the method reliably distinguishes males and females well before full breeding colors develop. Although it currently omits ultraviolet signals and fine-scale patterning, the approach scales efficiently to large sample sizes and varying lighting conditions, making it well suited for population-level surveys of camouflage dynamics, sexual dimorphism, and environmental influences on coloration in sticklebacks. Full article

Introduction: Hip abductor strength is essential for pelvic stability, lower limb alignment, and injury prevention. Weaknesses of the gluteus medius and minimus contribute to various musculoskeletal conditions. Lateral band walks and monster walks are elastic resistance exercises commonly used to target the hip abductors and external rotators in functional, weight-bearing tasks. Therefore, the aim was to summarize the current evidence on the biomechanics, muscle activation, and clinical applications of lateral and monster band walks. Methods: This narrative review was conducted following the SANRA guideline. A comprehensive literature search was performed across PubMed, Scopus, Web of Science, and SPORTDiscus up to April 2025. Studies on the biomechanics, electromyography, and clinical applications of lateral band walks and monster walks were included, alongside relevant evidence on hip abductor strengthening. Results: A total of 13 studies were included in the review, of which 4 specifically investigated lateral band walk and/or monster walk exercises. Lateral and monster walks elicit moderate to high activation of the gluteus medius and maximus, especially when performed with the band at the ankles or forefeet and in a semi-squat posture. This technique minimizes compensation from the tensor fasciae latae and promotes selective gluteal recruitment. Proper execution requires control of the trunk and pelvis, optimal squat depth, and consistent band tension. Anatomical factors (e.g., femoral torsion), sex differences, and postural variations may influence movement quality and necessitate tailored instruction. Full article

This study aimed to identify anatomical regions and developmental stages in broiler chickens that serve as reliable thermographic indicators of acute heat stress. Broilers aged 14, 21, 35, and 39 days were exposed to controlled heat stress, and surface temperatures across 12 anatomical regions were recorded using infrared thermography. Thermal response metrics (maximum, minimum, and mean peak variation) were analyzed with repeated-measures ANOVA and eta squared (η²) to quantify the strength of physiological responses. Principal component and cluster analyses grouped body regions based on their thermal sensitivity. The comb and wattle consistently showed the highest temperature increases (ΔT = 2.3–4.1 °C) and strongest effect sizes (η² ≥ 0.70), establishing them as primary thermoregulatory markers. As age increased, more body regions—especially peripheral zones like the drumstick and tail—exhibited strong responses (η² > 0.40), indicating an expansion of thermoregulatory activity. Cluster analysis identified three distinct sensitivity groups, confirming anatomical differences in thermal regulation. Thermographic responses to heat stress in broilers depend on age and region. The comb and wattle are the most reliable biomarkers, while peripheral responses grow more prominent with maturity. These findings support the use of targeted, age-specific infrared thermography for monitoring poultry welfare. Full article

Background: Identifying the etiological factors of syringomyelia, which can cause progressive neurological deficits in the spinal cord, is critically important for both diagnosis and treatment. This study aimed to assess the cranial morphometric features of patients with idiopathic syringomyelia by conducting comparative analyses with individuals diagnosed with Chiari Type I, Chiari Type I accompanied by syringomyelia, and healthy controls, in order to elucidate the potential structural contributors to the pathogenesis of idiopathic syringomyelia. Methods: In this retrospective and comparative study, a total of 172 patients diagnosed with Chiari Type I and/or syringomyelia between 2016 and 2024, along with 156 radiologically normal individuals, were included. The participants were categorized into four groups: healthy controls, Chiari Type I, Chiari Type I with syringomyelia, and idiopathic syringomyelia (defined as syringomyelia without an identifiable cause). Midline sagittal T1-weighted MR images were used to obtain quantitative measurements of the posterior fossa, cerebellum, intracranial area, and foramen magnum. All measurements were stratified and statistically analyzed by sex. Results: In cases with idiopathic syringomyelia, both the posterior fossa area and the cerebellum/posterior fossa ratio differed significantly from those of healthy controls. In male patients, the foramen magnum diameter was significantly larger in the Chiari + syringomyelia group compared with the idiopathic group. A significant correlation was found between the degree of tonsillar descent and selected morphometric parameters in female subjects, whereas no such correlation was observed in males. Both Chiari groups exhibited significantly smaller posterior fossa dimensions compared with the healthy and idiopathic groups, indicating greater neural crowding. Additionally, in Chiari Type I patients, increasing degrees of tonsillar descent were associated with a decreased incidence of syringomyelia. Conclusions: Anatomical variations such as a reduced posterior fossa area or altered foramen magnum diameter may contribute to the pathogenesis of idiopathic syringomyelia. Cranial morphometric analysis appears to offer diagnostic value in these cases. Further prospective, multicenter studies incorporating advanced neuroimaging modalities, particularly those assessing cerebrospinal fluid dynamics, are warranted to better understand the mechanisms underlying syringomyelia of unknown etiology. Full article

Background: Inadequate presurgical planning is a key contributor to suboptimal outcomes in orthognathic surgery. This study aims to assess the accuracy of a digital surgical planning workflow conducted prior to any orthodontic intervention. Methods: Digital planning was performed for 26 patients before orthodontic treatment (T0) and compared to the actual preoperative planning (T1). Digitized plaster casts were merged with CBCT data and converted to orthodontic setups to create a 3D virtual head model. After voxel-based registration of T0 and T1, dental arches were virtually osteotomized and repositioned according to planned outcomes. These T0 segments were then aligned with T1 planning using bony landmarks of the maxilla. Anatomical landmarks were used to construct virtual triangles on maxillary and mandibular segments, enabling assessment of positional and orientational differences. Transformations between T0 and T1 were translated into clinically meaningful metrics. Results: Significant differences were found between T0 and T1 at the dental level. T1 exhibited a greater clockwise rotation of the dental maxilla (mean: 2.85°) and a leftward translation of the mandibular dental arch (mean: 1.19 mm). In SARME cases, the bony mandible showed larger anti-clockwise roll differences. Pitch variations were also more pronounced in maxillary extraction cases, with both the dental maxilla and bony mandible demonstrating increased clockwise rotations. Conclusions: The proposed orthognathic surgical planning workflow shows potential for simulating mandibular outcomes but lacks dental-level accuracy, especially in maxillary anterior torque. While mandibular bony outcome predictions align reasonably with pretreatment planning, notable discrepancies exceed clinically acceptable thresholds. Current accuracy limits routine use; further refinement and validation in larger, homogeneous patient groups are needed to enhance clinical reliability and applicability. Full article

Background: Sexual dimorphism in Asian elephants (Elephas maximus) is evident in external features, but skeletal differences remain underexplored. This study aimed to examine the skull, scapula, and pelvis using traditional morphometric methods to assess sex-related variation. Methods: Eleven skeletal specimens were analyzed, including nine skulls, eleven pelves, and eighteen scapulae. Linear measurements were obtained using measuring tape and calipers. Statistical analyses included Mann–Whitney U tests, Pearson’s correlation, and logistic regression for sex prediction. Results: No significant differences were found in skull measurements between sexes. However, the pelvis and scapula exhibited notable variation. Significant pelvic parameters included pelvic girdle length (p = 0.024), symphysis length (p = 0.012), and pubis shaft perimeter (p = 0.048). Scapular differences were observed in diagonal breadth, mediolateral width, and spine length. Logistic regression using pelvic measurements yielded 100% accuracy for female classification and 66.67% for males, with an overall prediction accuracy of 90.91%. Conclusions: The pelvis demonstrated the highest reliability for sex determination. These findings enhance the anatomical understanding of Asian elephants and support applications in conservation, forensic science, and population studies. Future research with larger sample sizes and advanced imaging may improve the precision of morphometric sex prediction models. Full article

Background/Objectives: The inferior thyroid artery (ITA) is an essential component of the thyroid gland’s vasculature, with significant clinical and surgical implications due to its anatomical variability. This systematic review aimed to describe the prevalence of ITA anatomical variants and their association with clinical conditions or surgical implications. Methods: A comprehensive search was conducted in MEDLINE, Web of Science, Google Scholar, CINAHL, Scopus, and EMBASE on 20 November 2025. Eligibility criteria included studies reporting on the presence of ITA variants and their correlation with pathologies. Two authors independently screened the literature, extracted data, and assessed methodological quality using the AQUA and JBI tools. Results: Of the 2647 articles identified, 19 studies involving 1118 subjects/cadavers were included. Variations in ITA origin, absence, and additional arteries were reported, with the most common variant being direct origin from the subclavian artery. Clinically, these variations were associated with increased risk of intraoperative hemorrhage, potential nerve damage, and challenges in preoperative planning, particularly during thyroidectomy and other neck procedures. Conclusions: Understanding the anatomical diversity of the ITA is crucial for reducing surgical risks and improving patient outcomes. The review highlighted the need for more standardized research protocols and comprehensive data reporting to enhance the quality of evidence in this domain. Preoperative imaging and thorough anatomical assessments tailored to individual patient profiles, considering ethnic and gender-related differences, are essential for safe surgical interventions in the thyroid region. Full article

Background/Objectives: Computed tomography (CT) of the head is vital in diagnosing neurological conditions but poses concerns regarding radiation exposure. Traditional diagnostic reference levels (DRLs) are based on anatomical regions, potentially overlooking variations in radiation requirements driven by clinical indication. This study aimed to establish clinical indication-specific DRLs (DRLCIs) for adult head CT to support precision benchmarking and optimise patient safety. Methods: A retrospective observational study was conducted using data from 378 adult patients undergoing non-contrast CT head scans between September 2022 and February 2024. Data on patient demographics, protocols, and radiation dose metrics (Computed Tomography Dose Index Volume and Dose–Length Product) were extracted using DoseWatch™ software. Protocol parameters were standardised across clinical indications such as trauma, stroke, headache, seizure, and infection. Descriptive statistics and correlation analyses were performed. Descriptive statistics, including means, standard deviations, and percentile distributions, were calculated. Correlation analyses were conducted using Pearson’s correlation coefficient to examine relationships between dose metrics and patient variables such as age and body mass index. Results: Mean CTDIvol values ranged from 50.58 mGy (trauma) to 52.90 mGy (infection), while DLP values ranged from 1052.52 to 1219.98 mGy·cm. Percentile distributions were narrow, indicating effective protocol standardisation. The strongest correlation was observed between CTDIvol and DLP (r = 0.89), while age and body mass index showed negligible influence on dose metrics. Comparative analysis showed alignment with international benchmarks from the UK, Qatar, Bahrain, and Nigeria. Conclusions: This study establishes DRLCIs for adult head CT, demonstrating consistent radiation dose delivery across indications with minimal variability. Clinical indication-based benchmarking enhances dose optimisation and aligns with global radiological protection frameworks. Full article

Background/Objectives: To review the dimensions of the round window region (round window niche, bony structures surrounding the niche, and the membrane itself). Methods: Medline, EMBASE, Cochrane Library, and Google Scholar databases were searched by two independent reviewers. Anatomical and radiological studies on the round window region were screened. Studies reporting at least one dimension for the round window (RW) niche and/or the RW membrane were included. Results: Sixteen studies met the inclusion criteria (13 anatomical and 3 radiological studies) for a total number of 808 temporal bones with at least one dimension reported. The structures measured varied across the different studies with 12 reporting RW membrane dimensions (area and/or at least one distance), 8 detailing RW niche dimensions (height, width or depth) and 6 which measured at least one element of the RW bony overhangs (posterior or anterior pillar, RW tegmen). Surface area of the RW membrane varied between 0.32 mm² and 2.89 mm², with a minimum dimension (minimum diameter or height or width) comprising between 0.51 mm and 2.1 mm. When the bony overhangs surrounding the membrane were not considered, the minimum diameter was between 1.65 mm and 1.97 mm. Conclusions: The dimensions of the RW region are intrinsically variable, but the heterogeneity of the measurements reported also contributes to these variations. Posterior pillar, RW tegmen, anterior pillar, and their relative development probably account for a large part of this variability. The future RW membrane devices should be ≤1 mm in their maximum dimension, whether or not individually tailored, to fit most of the RW membranes. Full article