Search Results (106)

Background/Objectives: Hyperexcitable neuronal activity associated with seizures may disrupt brain homeostasis resulting in abnormal glucose and nutrient management and metabolism. Specialized ependymal cells known as tanycytes line the third ventricle wall bridging communication between the brain, CSF, and blood. Despite their positional importance, whether tanycytes are impacted by epilepsy is unknown. Here, known protein markers of tanycytes were assessed in the Kcna1-null mouse model of genetic epilepsy with spontaneous recurrent seizures (SRS mice). Further, whether an anti-seizure metabolic ketogenic diet (KD), previously proven effective in SRS mice, restored protein levels was determined. Methods: Known tanycyte proteins, including glucose transporter 1 (GLUT1), glial fibrillary acidic protein (GFAP), and doublecortin (DCX, to determine potential neurogenic differences) were examined throughout the anterior–posterior axis of the third ventricle using immunofluorescent histochemistry. Results: Decreased GLUT1 immunoreactivity and elevated GFAP levels were found in the SRS cohorts. The number of neurogenic DCX-expressing cells did not differ. Two weeks of KD treatment reduced GFAP to WT levels. GLUT1 remained low in KD-treated SRS mice. Conclusions: These data suggest that the expression of proteins important for the structure and function of tanycytes is altered in preclinical epilepsy and is differentially restored with KD treatment. Whether tanycytes actively participate in the pathophysiology of epilepsy or associated comorbidities is an intriguing possibility given their integral role in brain homeostasis. Full article

Traditional force plate-based systems offer high measurement precision but are limited to laboratory settings, restricting their use in real-world environments. To address this, we propose a method for estimating a three-axis ground reaction force (GRF) and two-axis center of pressure (CoP) using a shoe embedded with three uniaxial load cells. The estimation was conducted under five gait conditions: straight walking, turning, uphill, downhill, and running. Data were collected from 40 healthy young adults. Four deep-learning models—Fully Connected Neural Network (FCNN), Convolutional Neural Network (CNN), Sequence-to-Sequence Long Short-Term Memory (Seq2Seq-LSTM), and Transformer—were evaluated. Among them, Seq2Seq-LSTM and CNN achieved the highest performance in predicting both GRF and CoP. However, the medio-lateral (ML) components showed lower accuracy than the vertical and anterior–posterior directions. In slope conditions, particularly for vertical GRF, relatively higher root mean-square error (RMSE) values were observed. Despite some variation across gait types, predicted values showed high agreement with measurements. Compared with previous studies, the proposed method achieved comparable or better performance with a minimal sensor setup. These findings highlight the feasibility of accurate GRF and CoP estimation in diverse gait scenarios and support the potential for real-world applications. Future work will focus on sensor optimization and broader population validation. Full article

Background: Mid-shaft clavicle fracture fixation carries neurovascular injury risk. The purpose of this study was to compare bicortical compression and unicortical locked clavicle plate constructs biomechanically. Materials and Methods: Ten fourth-generation composite transverse mid-shaft clavicle osteotomy specimens were assigned to two groups, and each clavicle was fixed with an eight-hole second-generation 3.5 mm pelvic reconstruction plate placed superiorly. Group one included five fixed with bicortical compression screws and group two included five fixed with unicortical locking screws. All were tested on a four-axis servohydraulic testing frame in three modes: axial rotation, anterior/posterior bending, and cephalad/caudad bending. Results: Mean construct stiffness for AP bending was 1.255 ± 0.058 Nm/deg (group 1) and 1.442 ± 0.065 Nm/deg (group 2) (p = 0.001). Mean construct stiffness for axial rotation was 0.701 ± 0.08 Nm/deg (1) and 0.726 ± 0.03 Nm/deg (2) (p = 0.581). Mean construct stiffness for cephalad bending was 0.889 ± 0.064 Nm/deg (1) and 0.880 ± 0.044 Nm/deg (2) (p = 0.807). Mean construct stiffness for caudal bending was 2.523 ± 0.29 Nm/deg (1) and 2.774 ± 0.25 Nm/deg (2) (p = 0.182). Conclusions: With transverse mid-shaft clavicle fractures, unicortical locking fixation provided comparable rigidity to bicortical compression fixation in axial rotation, cephalad bending, and caudal bending; it provided greater rigidity in AP bending. Full article

Background and Objectives: Gait and posture alterations are reported in patients with diabetic foot. We evaluated whether gait and postural parameters are associated with a well-known parameter, e.g., glycated hemoglobin levels in blood, and the salivary markers 1,5-anhydro-D-glucitol (1,5-AG) and Advanced Glycation End-Products (AGEs) measured in saliva samples. Materials and Methods: Gait and postural impairment was assessed using a wearable inertial sensor, and the evaluation of balance/gait and risk of fall was determined by the Tinetti Scale and Downton Index, respectively. Glycemic control was measured by glycated hemoglobin concentration and fasting glycemia. The salivary concentration of 1,5-AG and AGEs was measured using an enzyme-linked immunosorbent assay. Results: Eighty-five patients were evaluated, revealing significant associations (p < 0.05) between salivary 1,5-AG and sway path displacement along the medio-lateral axis (rho = 0.365, p = 0.017) and sway area (rho = 0.334, p = 0.031) during tandem position tests with eyes closed. Salivary AGEs were significantly associated with sway path displacement along the anterior–posterior axis (rho = 0.419, p = 0.004) and medio-lateral axis (rho = 0.436, p = 0.002) in the tests performed with eyes closed, feet close together, and foam pads, as well as with sway area (rho = 0.387, p = 0.007). The concentration of HbA1c was significantly correlated with sway path displacement along the anterior–posterior axis in the tests performed with eyes closed, feet close together, and foam pads (rho = 0.236, p = 0.043), as well as with sway area (rho = −0.236, p = 0.043). A significant difference was observed in the salivary AGE concentration between patients with previous ulcers versus those without (p = 0.035). By applying Bonferroni correction for multiple comparisons, the associations remained significant (p < 0.05) for AGE concentration in saliva and postural instability parameters. Conclusions: The results suggest a link between salivary glycemic control biomarkers, in particular AGEs and postural changes in patients with diabetic foot, indicating a new interesting filed for further studies on fall risk. Full article

Background: Degenerative lumbar disease (DLD) affects older adults, causing lumbar degeneration and lower extremity dysfunction. The five-times sit-to-stand test (5xSTS) reveals kinematic changes associated with DLD. While marker-based motion capture systems detect these changes, their complexity limits clinical use. Markerless motion capture offers a portable alternative, yet its functional assessment applications in DLD remain underexplored. Thus, the aim of this study is to evaluate the reliability and validity of markerless motion capture for assessing functional tests in DLD patients. Methods: This study included 11 healthy individuals (mean age: 27.28 ± 6.92 years) and 10 with DLD (mean age: 70.00 ± 8.08 years). Participants performed the 5xSTS while being recorded by marker-based (VICON) and markerless (MediaPipe) systems using two synchronized cameras. Test–retest reliability was assessed over one week via the intraclass correlation coefficient (ICC). Concurrent validity and agreement between VICON and MediaPipe were evaluated via Pearson/Spearman correlation coefficients, systematic bias, and the root mean square error (RMSE). Movement time, joint excursions, and angular velocities were also analyzed and compared across two groups. Results: Both systems showed high test–retest reliability (ICC: 0.81–0.99) and strong correlations (r: 0.75–0.99). The highest RMSE was observed at the ankle in the anterior–posterior (A–P) direction in the DLD group (54.55 mm) and at the hip A–P axis in the control group (51.20 mm). The lowest RMSE was found at the knee medial–lateral (M–L) axis in the DLD group (7.88 mm) and at the ankle M–L axis in the control group (8.54 mm). Bias values ranged from 0.30 mm (hip vertical in control group) to +53.47 mm (ankle A–P in DLD group), with underestimation more common at the hip and overestimation at the ankle. The control group demonstrated a faster 5xSTS completion time (5.89 ± 0.69 s vs. 8.13 ± 1.96 s, p < 0.05), greater hip joint excursions during sit-to-stand (65.07 ± 25.94° vs. 38.13 ± 9.84°, p < 0.05) and stand-to-sit (62.56 ± 24.74° vs. 27.85 ± 11.45°, p < 0.05) tests, and higher angular velocities compared to the DLD group. Conclusion: MediaPipe markerless motion capture can quantify 3D kinematic changes in DLD patients during functional performance. It enables a clinical evaluation with minimal setup, offers potential for remote assessment, and accurately detects sagittal plane movement. The two-camera system provides 3D kinematic data comparable to multi-camera systems, suitable for home rehabilitation and assessment. Full article

Metallic implants in radiotherapy patients alter dose distributions due to their high density and unique composition, potentially compromising treatment precision. This study evaluates the effects of three metallic materials, Co-Cr-Mo alloy, titanium alloy, and stainless steel, on dose distribution across four radiotherapy modalities: 6 MV photons, 15 MeV electrons, 170 MeV protons, and very-high-energy electrons (100 and 150 MeV). Monte Carlo simulations in the TOol for PArticle Simulations Monte Carlo (TOPAS MC) generated percentage depth dose curves and dose profiles, with dosage data standardized to a reference point and uncertainties addressed via error propagation. Results revealed that the Co-Cr-Mo alloy produced the most significant alterations. For instance, at 100 MeV Very High Electron Energy (VHEE), the dose at a 15 cm depth was 34.57% lower than in water; 6 MV photons showed a 15.16% reduction, and the proton Bragg peak shifted 9.5 cm closer to the source. These pronounced changes along the central beam axis affected dose distributions anterior and posterior to the metal. A prostate cancer simulation further demonstrated considerable dose reduction with deeply embedded metallic implants. The findings underscore the critical impact of implant properties on radiotherapy dose distributions, emphasizing the need to integrate these factors into clinical protocols to improve dosimetric accuracy and treatment safety. Full article

The dorsomedial caudate–putamen (dmCPu), a key input structure of the basal ganglia, plays a crucial role in goal-directed behaviors and the transition to habits. The functional specialization of the dmCPu along its anteroposterior axis suggests that distinct prefrontal cortex (PFC) subregions may differentially contribute to these processes. However, the precise topographical organization of PFC and adjacent areas projections to the anterior and posterior dmCPu remains poorly understood. We employed retrograde tracing using Fluoro-Gold to map the projections from PFC subregions and adjacent areas to the anterior and posterior dmCPu in male Sprague Dawley rats. Histological verification and immunohistochemical labeling were conducted to confirm injection sites and neuronal labeling. Quantitative analyses were performed to assess the effects of injection site placement (anterior vs. posterior dmCPu), laterality (ipsilateral vs. contralateral), and cortical subregion on projection density. The posterior dmCPu received significantly higher projection densities than the anterior dmCPu, with a pronounced ipsilateral dominance across all cortical subregions. Among the subregions examined, the cingulate cortex exhibited the highest number of labeled neurons projecting to the dmCPu, with distinct patterns of connectivity between anterior and posterior injection sites. Notably, motor and somatosensory cortical projections were more prominent in the posterior dmCPu, whereas cingulate projections demonstrated robust anteroposterior and lateralized differences. These findings provide a comprehensive map of the topographical organization of cortical inputs to the dmCPu, highlighting differential connectivity patterns that may underlie distinct functional roles in goal-directed and habitual behaviors. This work advances our understanding of corticostriatal circuits and their relevance to adaptive behaviors and neuropsychiatric disorders. Full article

Background/Objectives: The mental foramen (MF) constitutes a passage for mental nerves and vessels, and it is a crucial anatomical landmark in the body of the mandible. The accessory mental foramen (AMF) is a small, addable foramen proximate to the MF, and it is mainly located posteriorly. The AMF is a rare anatomical variation in human mandibles that must be taken into consideration throughout dental and surgical operations. We aimed to assess the incidence and perform morphological and morphometric analyses of AMFs in the human dry mandibles of the Greek population, in addition to a relevant systematic review and meta-analysis of global data. Methods: We studied 114 human adult dry mandibles of unknown gender and age available from the Laboratory of Anatomy, Medical School, Democritus University of Thrace, Greece. We used the search term “accessory mental foramen” in the PubMed, Scopus, and Google Scholar databases to detect all publications of the last 50 years reporting the prevalence and morphology of AMFs in dry mandibles; the search ended on 13 January 2025. Quality assessments were performed using the relevant Joanna Briggs Institute tool. Data were synthesized with the random-effects REML model after Freeman–Tukey double arcsine transformationusing STATA 18. No external funding was received. The PROSPERO CRD is 42025638135. Results: According to our data, the MF was present in all observed mandibles, and it was bilateral. Nine AMFs (five right/four left; five round/four oval; six posterior/three anterior to the MF) were found in seven mandibles (five single and two double), and all were unilateral. AMFs presented a mean diameter of 0.96 ± 0.43 mm and mean distances of 4.12 ± 2.15 mm from the MF, 12.68 ± 4.10 mm from the alveolar ridge, and 11.92 ± 1.57 mm from the lower border of the mandible. Furthermore, 27 publications were included in the meta-analysis; the combined AMF prevalence was 6.1% (95% CI: 4.8–7.6%; I² 60%), the combined mean vertical axis was 1.18 ± 0.61 mm, and the combined mean distance from the MF was 3.64 ± 2.29 mm. Bilateral AMFs were detected in 2.1% of AMF cases. An oval shape was described in 37.3% of AMFs. No publication bias was detected. Conclusions: AMFs are not considered rare, and they are occasionally bilateral or even multiple in number. Moreover, they demonstrate considerable variation regarding their size, shape, anddistance from the MF, alveolar ridge, and lower border of the mandible. Dental surgeons must be aware of AMFs’ anatomical variations during surgical and anesthetic planning in order to effectively prevent or mitigate the risk of postoperative complications, such as pain, anesthesia, injury, and other adverse outcomes. Full article

Objectives: The aim of this study was to compare the radiographic results, mechanical complications, and clinical outcomes between anterior and posterior lumbar interbody fusion at L5–S1 (ALIF51 and PLIF51 groups, respectively) using a matched cohort of patients undergoing long fusion for adult spinal deformity (ASD). Methods: Patients who underwent hybrid surgery of ≥5-level fusion to the pelvis with a minimum follow-up duration of 2 years were included. The baseline characteristics of the groups were controlled using a propensity score matching analysis. The radiographic results, mechanical complications such as proximal junctional kyphosis/failure and metal failure, and clinical outcomes were compared between the groups. Results: In total, 79 patients were assigned to each group with comparable baseline data, except for a higher frequency of anterior column realignment procedures in the PLIF51 group than in the ALIF51 group (49.4% vs. 31.6%). At the last follow-up, L5–S1 segmental lordosis (SL) was significantly greater in the ALIF51 group than in the PLIF51 group (12.1° vs. 7.3°, p < 0.001). The final C7–sagittal vertical axis (SVA) was significantly smaller in the ALIF51 group than in the PLIF51 group (25.4 mm vs. 35.5 mm, p = 0.032). However, other global sagittal parameters were comparable between the groups. The mechanical complication rates, including metal failure at L5–S1, and the final clinical outcomes were comparable between the groups. Conclusions: ALIF51 has modest advantages over PLIF51 in terms of better restoring L5–S1 SL and C7–SVA with avoiding more invasive procedures above the L5–S1 levels. Other sagittal parameters, mechanical complication rates, and clinical outcomes did not differ between the groups. Full article

Background: The lumbopelvic region plays a pivotal role in enabling various functional activities. This study quantified and compared the kinematic changes between healthy individuals and patients with recurrent low back pain (LBP) in both rested and fatigued states to gain insight into the kinematic adaptation and mechanisms underlying kinematic variations that occur in the presence of these factors. Methods: Participants were divided into two groups: the LBP (n = 23) and healthy control groups (n = 19). Dynamic lumbopelvic measurements were taken using a biplane radiography image system while the participants performed weight-bearing forward-backward bending before and after fatigue. All lumbopelvic kinematics were described as the three-dimensional motion of the vertebra relative to the pelvis and were measured at normalized time intervals from maximum extension to approximately 45° of flexion. Results: Repetitive lifting- and lowering-induced fatigue significantly affected lumbopelvic kinematics in the anterior/posterior translation (mm) and rotation around the z-axis in both healthy individuals and patients with LBP (p < 0.05). In healthy individuals, significant differences occurred in approximately 13–83% of the forward-backward bending cycle (0–100%), whereas, in patients with LBP, significant differences mainly occurred in 61–93% of the cycle (p < 0.01). Conclusions: The lumbopelvic kinematic changes observed in both LBP patients and healthy individuals after fatigue may indicate protective compensation or vulnerability and could play a role in LBP dysfunction. Full article

A new species of Asian horned toad, Boulenophrys, is described from Yongzhou City, Hunan Province, China. The species is a phylogenetically sister to B. yunkaiensis, based on 16S rRNA and COI genes. The new species differs from its congeners, possessing the following combination of characters: (1) moderate body size: SVL 37.6–40.2 mm (38.9 ± 1.3, n = 7) in adult males and SVL 41.8–45.9 mm (43.6 ± 2.1, n = 3) in adult females; (2) tympanum boundary clear: TD/ED 0.48–0.57 in males and 0.47–0.57 in females; (3) the presence of a small horn-like tubercle at the edge of the upper eyelid; (4) vomerine ridge present and vomerine teeth absent; (5) margin of tongue rounded, not notched posteriorly; (6) rough dorsal skin: a discontinuous “V”-shaped ridge with two discontinuous dorsolateral ridges on two sides on the back, dense tubercles on the skin of the ventral surface of the dorsal shank and thigh, and spiny tubercles surrounding the cloaca; (7) slender hindlimbs with heels overlapping when the flexed hindlimbs are held at right angles to the body axis; tibio-tarsal articulation reaching forward between anterior margin of tympanum and posterior corner of eye when leg stretched forward; (8) relative finger length IV < II < I < III, with a subarticular tubercle present at the base of each finger; (9) distinct supernumerary tubercles below the base of I and II toes; (10) toes without lateral fringes and with rudimentary webbing (webbing formula: I1 − 1-II1 − 2-III2 − 3IV3- − 2V). Full article

Objective: To describe the relationship between bilateral electrical activity in the biceps femoris and the variation of triaxial acceleration in three 50 m sprints. Methods: Biceps femoris muscle activation and acceleration in the anterior–posterior, mediolateral, and superior–inferior axes were measured in three 50 m sprints in nine national-level sprinters. Results: There was significant asymmetry between both legs, and the variations between axes were significant between the anterior–posterior with respect to the lateral and superior–inferior, and between the lateral and superior–inferior (p < 0.05). Conclusions: Increased biceps femoris activation during running increases speed regardless of asymmetry in force application. In the maintenance of horizontal velocity, acceleration of the anterior–posterior axis is the most relevant and depends on the flexion-extension muscle actions contained in the lateral axis. Full article

Background: POP (pelvic organ prolapse) involves the descent of one or more pelvic organs downwards with or without protrusion from the vaginal opening, caused by the relaxation and weakening of ligaments, connective tissue, and pelvic muscles. Such an outcome negatively impacts the quality of life. The gold standard procedure for repairing apical compartment prolapse is colposacropexy (CS) to secure the anterior and posterior walls of the vagina to the anterior longitudinal sacral ligament, located anteriorly to the sacral promontory, using a mesh. Several surgical approaches are feasible. Laparotomic or minimally invasive methods, including laparoscopic or robotic ones, can restore the horizontal axis of the vagina and typically involve concomitant hysterectomy. Methods: This study is based on 80 patients who underwent CS at Palermo’s Ospedali Riuniti Villa Sofia-Cervello from 2019 to 2023. Women aged 35–85 at the time of surgery were divided into two groups: 40 patients underwent mini-laparoscopic surgery, and 40 patients underwent robotic surgery. The following parameters were accounted for: demographic data (initials of name and surname, age), preoperative clinical diagnosis, date of surgery, surgical procedure performed, estimated intraoperative blood loss, duration of surgical intervention, length of hospital stay, postoperative pain assessed at 24 h using the VAS scale, and any complications occurring in the postoperative period. Mini-laparoscopic CS (Minilap) and robotic CS (Rob) were then compared in terms of outcomes. Results: In the Minilap group, 11 patients out of 40 had a preoperative diagnosis of vaginal vault prolapse. The average age in this group was 61.6. Five of these patients had isolated cystocele, while the rest presented vaginal stump prolapse linked to cystocele, rectocele, or both. The remaining 29 patients in the Minilap group had a preoperative diagnosis of uterovaginal prolapse, also associated with cystocele, rectocele, or both, or isolated in nine cases. In the Rob group (average age: 60.1), 13 patients were diagnosed with vaginal prolapse (isolated or associated with cystocele), while the remaining 27 had a diagnosis of uterovaginal prolapse. In the Minilap group, the average procedure duration was 123.3 min, shorter than the Rob group (160.1 min). Conclusions: The data collected throughout this prospective study point to the mini-laparoscopic approach as being preferable over the robotic one in terms of surgical procedure length, intraoperative blood loss, postoperative pain, and aesthetic outcome. Hospital stay duration and post operative complication rates were similar for both groups. The innovative and ever-progressing nature of such procedures calls for novel standards prioritizing patient care as well as medicolegal viability. Full article

Objective: The aim of the present study is to identify a more reliable reference point in three-dimensional cephalometric analysis to replace the Porion point used in two-dimensional analysis, enhancing the accuracy of assessments. Methods: The methodology assessed potential alternative landmarks for three-dimensional cephalometric analysis. Utilizing a segmenting technique, anatomical landmarks were accurately pinpointed from the external acoustic meatus of 26 Cone Beam Computed Tomography (CBCT) scans. These landmarks were chosen for their clear and unambiguous detectability. To assess reproducibility, each landmark was replicated twice with a one-week interval by a master’s student. Reproducibility was quantitatively evaluated by analyzing the absolute difference per axis. Results: Five possible candidate landmarks were identified: the most anterior, posterior, superior, and inferior points of the external acoustic meatus (EAM) and a notch delineating the epitympanic recess. The reproducibility of pinpointing these landmarks ranged from 0.56 mm to 2.2 mm. The absolute mean differences between measurements were 0.46 mm (SD 0.75) for the most anterior point, 0.36 mm (SD 0.44) for the most posterior point, 0.25 mm (SD 0.26) for the most superior point, 1.11 mm (SD 1.03) for the most inferior point, and 0.78 mm (SD 0.57) for the epitympanic notch. Conclusions: The most superior point of the EAM might successfully replace the Porion as an anatomical reference. Full article

Falls are considered a significant cause of disability, pain, and premature deaths in older adults, often due to sedentary lifestyles and various risk factors. Combining immersive virtual reality (IVR) with physical exercise, or exergames, enhances motivation and personalizes training, effectively preventing falls by improving strength and balance in older people. IVR technology may increase the ecological validity of the assessments. The main goal of our study was to assess the feasibility of using a KAVE-based VR platform combining simulations of Levadas and a cable car to perform a balanced assessment and profiling of the older adult population for high risk of falls and the related user experience. A VR-based platform using a Wii balance board and a CAVE was developed to assess balance and physical fitness. Validated by the Biodex Balance System (BBS), 25 older adults participated in this study. The usability and presence were measured through the System Usability Scale and ITC-SOPI questionnaires, respectively. The IVR system showed a high presence and a good usability score of 75. Significant effects were found in the maximum excursion of the centre of pressure (COP) on the anterior–posterior axis during the cable car simulation (CCS), correlating with BBS metrics. Multiple discriminative analysis models and the support vector machine classified fall risk with moderate to high accuracy, precision, and recall. The system accurately identified all high-risk participants using the leave-one-out method. This study suggests that an IVR-based platform based on simulations with high ecological validity can be used to assess physical fitness and identify individuals at a higher risk of falls. Full article