Search Results (192)

Adipose tissue macrophages (ATMs) play important roles in the progression of obesity-related severe acute pancreatitis (SAP). This study aimed to investigate the alterations of autophagic flux within ATMs, as well as the possible regulatory mechanisms. Obese mice were induced via high-fat diets. SAP was triggered using caerulein and lipopolysaccharide. Inflammatory injuries within pancreatic and adipose tissue were assessed. Autophagic flux, along with the expression of autophagosome-located soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins, were examined in ATMs. RNA-sequencing was performed to identify the possible regulatory factor, which was further validated. The results showed that obesity exacerbated inflammatory injuries. ATMs in obesity-related SAP exhibited impaired autophagic flux characterized by reduced autophagosome–lysosome fusion. Expression of autophagosome-located SNARE proteins decreased in ATMs. RNA-sequencing identified Forkhead box as the differentially expressed transcription factor associated with autophagy. The expression and transcriptional activity of Forkhead box O1 (FoxO1) decreased. The inhibition of FoxO1 exacerbated SNARE proteins’ suppression and autophagic flux impairment, while the activation of FoxO1 showed the opposite effect. In conclusion, obesity-induced impaired autophagic flux and autophagosome–lysosome fusion in ATMs are potentially regulated via autophagosome-located SNARE proteins and the transcription factor FoxO1. The impaired autophagic flux in ATMs aggravated inflammatory injuries of obesity-related SAP. Full article

Study design: Trends in the utilization of Mandibulo-Maxillary Fixation (MMF) are shifting nowadays from tooth-borne devices over specialized screws to hybrid MMF devices. Hybrid MMF devices come in self-made Erich arch bar modifications and commercial hybrid MMF systems (CHMMFSs). Objective: We survey the available technical/clinical data. Hypothetically, the risk of tooth root damage by transalveolar screws is diminished by a targeting function of the screw holes/slots. Methods: We utilize a literature review and graphic displays to disclose parallels and dissimilarities in design and functionality with an in-depth look at the targeting properties. Results: Self-made hybrid arch bars have limitations to meet low-risk interradicular screw insertion sites. Technical/clinical information on CHMMFSs is unevenly distributed in favor of the SMARTLock System: positive outcome variables are increased speed of application/removal, the possibility to eliminate wiring and stick injuries and screw fixation with standoff of the embodiment along the attached gingiva. Inferred from the SMARTLock System, all four CHMMFs possess potential to effectively prevent tooth root injuries but are subject to their design features and targeting with the screw-receiving holes. The height profile and geometry shape of a CHMMFS may restrict three-dimensional spatial orientation and reach during placement. To bridge between interradicular spaces and tooth equators, where hooks or tie-up-cleats for intermaxillary cerclages should be ideally positioned under biomechanical aspects, can be problematic. The movability of their screw-receiving holes according to all six degrees of freedom differs. Conclusion: CHMMFSs allow simple immobilization of facial fractures involving dental occlusion. The performance in avoiding tooth root damage is a matter of design subtleties. Full article

Bioactive materials have recently shown potential in nerve repair and regeneration by promoting the growth of new cells, tissue repair, and restoring nerve function. These natural, synthetic, and hybrid materials offer a biomimetic structure, enhance cell attachment, and release bioactive molecules that promote the axonal extension of severed nerves. Scaffold-based preclinical studies have shown promising results on enhancing nerve repair; however, they are limited by the immune response and fabrication, scalability, and cost. Nevertheless, advances in manufacturing, including 3D bioprinting, and other strategies, such as gene editing by CRISPR, will overcome these shortcomings. The opportunity for the development of individualized approaches and specific treatment plans for each patient will also increase the effectiveness of bioactive materials for the treatment of nerve injuries. Combining bioactive materials with the neural interface can develop new reliable therapeutic solutions, particularly for neuroprosthetics. Finally, it is essential to stress a multidisciplinary focus, and future studies are needed to enhance the potential of bioactive materials for patients with nerve injuries and the field of regenerative medicine. Full article

Upright-posture motorcycle crashes against steel safety barriers (SSBs) often result in severe upper-body injuries due to the sharp upper edge of the rail. While solutions for sliding crashes on curves, called a ‘motorcyclist-friendly barrier’, are already implemented in practice, protective measures for upright-posture impacts remain underdeveloped. This study systematically reviews patents and patent applications addressing upper guardrail protection for motorcyclists. We identified and analysed a small number of existing innovations aimed at mitigating the consequences of upright crashes. The selected solutions were evaluated according to their technical design, ease of installation, potential for recycling, environmental compatibility, and expected costs. Our comparative analysis reveals that while some patents or patent applications offer promising features, such as flexible caps, bent plates, or modular attachments, none comprehensively address all safety, environmental, and economic requirements. The findings provide a basis for further development of motorcyclist-friendly SSB designs and suggest specific criteria that should be included in future guidelines and standard updates. Full article

Background: Burns in children represent a significant public health issue, as there is no single targeted dressing for the treatment of burn wounds in children. The alloplastic epidermal skin substitute is the dressing of choice for treating burns in children in our burn center. However, it sometimes occurs that the dressing separates from the wound too early, before the process of full re-epithelialization. The inflammatory phase of wound healing seems to be crucial for maintaining the adhesion of the dressing, and thus, changes in parameters such as leukocyte levels and protein changes are of clinical significance. The aim of our study is to find laboratory factors that could contribute to premature dressing separation. Methods: The documentation of 182 children treated for acute burns at a major Polish burn center in the years 2009–2023 was analyzed. A demographic analysis was performed to collect information. The group was split into the following two categories based on the condition of the dressing: “attached to the wound” and “detached from the wound”. Laboratory tests were collected on admission and with control tests 3–5 days after injury. Results: The results indicate that only a few of the parameters studied showed a statistically significant difference between the groups of patients in whom the dressing did or did not attach. The most pronounced relationship was found for the pre-treatment leukocyte level (leuk1). Statistical significance was also demonstrated for hemoglobin levels and changes in protein (protein_diff) and also glucose levels (glucose_diff). Conclusions: Our study shows that there are blood parameters (leukocyte, protein, and glucose levels) that influence the adhesion of the dressing. Unfortunately, there are no other studies on this topic in the literature, so it seems very important to expand research in this direction. Full article

Spinal cord injuries (SCI) often result in impaired motor functions. To quantify these impairments, swimming patterns were analyzed in individuals with SCI. Water provides a unique rehabilitation environment where buoyancy supports weight-bearing activities and can reveal deficits that might otherwise go unnoticed. Data were collected of 30 individuals with chronic, motor-incomplete SCI and 20 healthy controls during breaststroke swimming on a kickboard. Using eight wearable inertial sensors attached to the lower limbs, we captured detailed kinematic data. Spatiotemporal parameters were then calculated and compared between the two groups to assess differences in swimming patterns. An analysis of the parameters revealed significant differences in velocity (p < 0.001, ε² = 0.476) and distance per stroke (p < 0.001, ε² = 0.516), indicating decreased swimming speeds in individuals with SCI compared to controls. Furthermore, individuals with SCI demonstrated a reduced range of motion (RoM) in the ankle (p = 0.003, ε² = 0.516) and knee joints (p = 0.041, ε² = 0.142). The limited RoM likely contributes to the shorter distance covered per stroke. These observations underscore the impact of SCI on functional capabilities. The developed algorithm holds promise for enhancing the assessment of motor deficits after neurological injuries. Full article

Epidemiological analysis has revealed key insights into the frequency, severity, and circumstances surrounding subway-to-pedestrian incidents; however, there remains a lack of available impact test data specific to this impact type that can be used in modelling and countermeasure design studies. To address this gap, nine controlled impact tests were conducted using a cylindrical headform to derive force–penetration relationships for foam, as well as foam encased in 1 mm aluminium or 3 mm ABS shells. These relationships were validated in MADYMO multibody simulations. Building on a previous multibody computational study of subway-to-pedestrian collisions this research evaluates three passive countermeasure designs using a reduced simulation test matrix: three impact velocities (8, 10, and 12 m/s) and a trough depth of 0.75 m. In subway collisions, due to the essential rigidity of a subway front relative to a pedestrian, it is the pedestrian stiffness characteristics that primarily dictate the contact dynamics, as opposed to a combined effective stiffness. However, the introduction of energy-absorbing countermeasures alters this interaction. Results indicate that modular energy-absorbing panels attached to the train front significantly reduced the Head Injury Criterion (HIC) (by 90%) in the primary impact and pedestrian-to-wheel contact risk (by 58%), with greater effectiveness when a larger frontal area was covered. However, reducing primary impact severity alone did not substantially lower total fatal injury risk. A rail-guard design, used in combination with frontal panels, reduced secondary impact severity and led to the largest overall reduction in fatal injuries. This improvement came with an expected increase in hospitalisation-level outcomes, such as limb trauma, reflecting a shift from fatal to survivable injuries. These findings demonstrate that meaningful reductions in fatalities are achievable, even with just 0.5 m of available space on the train front. While further development is needed, this study supports the conclusion that subway-to-pedestrian fatalities are preventable. Full article

Platelet activation processes begin when injury to blood vessels exposes the subendothelial matrix, leading platelets to attach to it, where they become activated and exert their hemostatic function. Excessive platelet aggregation is associated with thrombotic disorders such as arterial thrombosis. To manage such diseases, medications that inhibit thrombosis are continuously sought, despite potential drawbacks that include hemorrhage. This study described the development of a novel peptide-based vaccine that targets the purinergic ADP P2Y₁ receptor (abbreviated EL2Vac) and its pharmacological characterization. Thus, we designed and developed an EL2Vac that targets the ligand-binding domain of the P2Y₁ receptor protein, which is located in its second extracellular loop (EL2). We then evaluated the vaccine’s ability to trigger an immune response (antibody production) in immunized mice, modulate platelet function, its antithrombotic activity, and any effects on hemostasis, by employing a thrombosis model and the tail bleeding time assay. Results showed significant levels of antibody production in mice treated with EL2Vac, in comparison with the random peptide vaccine control (EL2rVac), which persisted at least up to six months post vaccination. Moreover, we observed significant inhibition of the ADP-induced aggregation response in platelets from EL2Vac-treated mice, relative to those from EL2rVac controls. This inhibition was selective for ADP, as other agonists, such as the thromboxane A₂ receptor (TPR) agonist U46619 or high-dose collagen, had no detectable effect on aggregation. As for its capacity to protect against thrombosis, our data showed a significant delay in the occlusion time of the EL2Vac mice when compared with the random peptide control vaccine, which was also observed (at least) six months post vaccination. Interestingly, EL2Vac did not appear to prolong the tail bleeding time, supporting the notion that it is devoid of a bleeding diathesis. As a conclusion, this study documents the design and evaluation of a novel peptide-based vaccine, EL2Vac, which appears to selectively target the P2Y₁ receptor and protect against thrombus formation without impairing hemostasis. Thus, EL2Vac may provide a promising clinical option to treat thromboembolic disorders. Full article

Background and objectives: Iatrogenic injury to the external iliac vein is a rare surgical complication during kidney transplantation. It can compromise the use of the vein for anastomosis and adversely affect venous return from the ipsilateral lower extremity. Case presentation: We present an innovative salvage technique for addressing iatrogenic injuries to the external iliac vein occurring during its dissection from the surrounding tissues. This approach involves the attachment of an allograft renal vein to the distal segment of the divided external iliac vein using end-to-end anastomosis, while the proximal segment is anastomosed to the allograft renal vein using an end-to-side technique. Early postoperative ultrasound evaluations indicated sufficient venous return from both the transplanted kidney and the lower extremity. A recent follow-up, 12 years post-transplantation, confirmed sustained vascularization and venous return from the allograft. Conclusions: The described technique provides an effective solution for managing significant external iliac vein injuries during kidney transplant procedures. It facilitates the salvage of the vein for anastomosis with the allograft in the ipsilateral iliac fossa without the need for vascular tissue replacement or altering the anastomosis site. Full article

Background: Prolonged manual wheelchair usage often leads to musculoskeletal disorders in the upper body of individuals with spinal cord injury (SCI) due to repetitive, unidirectional movements. To mitigate these issues, targeted exercise of the back muscles—particularly those involving pulling movements of the arms and shoulders—is recommended. Therefore, this study aimed to develop a detachable, two-way propulsion system for manual wheelchairs, enabling propulsion through both pushing forward and pulling backward on the wheelchair pushrims. Methods: The propulsion system was engineered using a planetary gear train to facilitate dual-direction propulsion. Specifically, the planetary gear reverses the rotational direction, allowing the wheelchair to advance forward even when users pull the pushrims backward. Thus, the wheelchair can move forward through either pushing forward or pulling backward actions. Results: A prototype of the proposed system was fabricated using 3D printing technology and its functionality was verified. The prototype successfully demonstrated the two-way propulsion capability and the operation of the attachment mechanism. Additionally, the pilot test confirmed that an individual with SCI was able to propel a manual wheelchair equipped with the two-way propulsion system using both propulsion methods and switch between the methods independently while maintaining stability and safety throughout the test. Conclusion: The developed detachable two-way propulsion system shows significant promise as both a mobility aid and an exercise device, potentially reducing musculoskeletal complications among individuals with SCI who regularly utilize manual wheelchairs. Full article

Background/Objectives: Colonoscopies have some limitations that result in a miss rate detection of polyps. Microwave imaging has been demonstrated to detect colorectal polyps based on their dielectric properties in synthetic phantoms, ex vivo tissues and in vivo animal models. This study aims to evaluate, for the first time, the feasibility, safety and performance of microwave-based colonoscopy for diagnosis of polyps in real-time explorations in humans. Methods: This was a single-center, prospective, observational study. Patients referred for diagnostic colonoscopy were explored with a device with microwave antennas which was attached to the tip of a standard colonoscope. The primary outcomes were rate of cecal intubation, adverse events, mural injuries and performance metrics for the detection of polyps. Secondary outcomes were the following: patients’ subjective feedback, procedural time and perception of difficulty according to the endoscopist. Results: Fifteen patients were enrolled. Cecal intubation rate was 100%, with a mean time of 12.7 ± 4.9 min (range 4–22). Use of the device did not affect the endoscopic image, and polypectomy was successfully performed in all cases. In on scale from zero (not difficult) to four (very difficult), the maneuverability during the insertion was considered ≤2 in the 86.7% (13/15) of colonoscopies. Only 16 incidents were reported in 14 patients: 11 (67%) superficial hematomas, 2 minor rectal bleedings, 1 anal fissure, 1 rhinorrhea and 1 headache. Most of the patients (94%) reported no discomfort or minimal discomfort before discharge (Gloucester score 1 and 2, respectively). In the six patients with 23 polyps used for the performance analysis, the sensitivity and specificity were 86.9% and 72.0%, respectively. Conclusions: microwave-based colonoscopy is safe and feasible and has the potential to detect polyps in real colonoscopies. Full article

Corpectomy is the surgical procedure of resecting a vertebral body or a part of it in order to decompress neural structures. Corpectomy is performed in patients with degenerative disease or cancer and following injury to the spine. We present a case of multilevel corpectomy in a female patient with massive degenerative disease associated with rheumatoid arthritis, combined with cervical myelopathy and osteoporosis. We present the case of a female patient who underwent C4-C5-C6 corpectomy and spinal stabilisation with a Cervical 3D Expandable cage and a cervical plate attached to the C3-C7 bodies. The rheumatoid arthritis caused degenerative changes, which, combined with the impact of environmental conditions and the patient’s postural defects, led to a pathological profile of the spine along the vertical and transverse axis, manifesting clinically as a cervical myelopathy with its characteristic neurological symptoms. Pre-operative imaging studies revealed a critical stenosis of the spinal canal. This report showcases an effective surgical technique for severe degenerative disease bearing an increased risk of tetraplegia that could be brought on by even a minor injury to the cervical spine in the presence of this kind of pathology. Multilevel cervical corpectomy can be an effective method for treating spinal canal stenosis to prevent the onset of neurological deficits. This procedure requires careful diagnostic work-up, surgical planning and an interdisciplinary approach, especially in patients with co-morbidities. Full article

Background/Objectives: Meniscus injuries represent a critical challenge in orthopedic medicine due to the limited self-healing capacity of the tissue. This study presents the development and characterization of polycaprolactone/graphene oxide (PCL/GO) scaffolds fabricated using 3D bioprinting technology for meniscus cartilage regeneration. Methods: GO was incorporated at varying concentrations (1%, 3%, 5% w/w) to enhance the bioactivity, mechanical, thermal, and rheological properties of PCL scaffolds. Results: Rheological analyses revealed that GO significantly improved the storage modulus (G’) from 36.1 Pa to 97.1 Pa and the yield shear stress from 97.2 Pa to 507.1 Pa, demonstrating enhanced elasticity and flow resistance. Mechanical testing showed that scaffolds with 1% GO achieved an optimal balance, with an elastic modulus of 614 MPa and ultimate tensile strength of 46.3 MPa, closely mimicking the native meniscus’s mechanical behavior. FTIR analysis confirmed the successful integration of GO into the PCL matrix without disrupting its chemical integrity, while DSC analysis indicated improved thermal stability, with increases in melting temperatures. SEM analysis demonstrated a roughened surface morphology conducive to cellular adhesion and proliferation. Fluorescence microscopy using DAPI staining revealed enhanced cell attachment and regular nuclear distribution on PCL/GO scaffolds, particularly at lower GO concentrations. Antibacterial assays exhibited larger inhibition zones against E. coli and S. aureus, while cytotoxicity tests confirmed the biocompatibility of the PCL/GO scaffolds with fibroblast cells. Conclusions: This study highlights the potential of PCL/GO 3D-printed scaffolds as biofunctional platforms for meniscus tissue engineering, combining favorable mechanical, rheological, biological, and antibacterial properties. Full article

A20/Tnfaip3, an early NF-κB response gene and key negative regulator of NF-κB signaling, suppresses proinflammatory responses. Its ubiquitinase and deubiquitinase activities mediate proteasomal degradation within the NF-κB pathway. This study investigated the involvement of A20 signaling alterations in podocytes in the development of kidney injury. The phenotypes of A20Δpodocyte (podocyte-specific knockout of A20) mice were compared with those of control mice at 6 months of age to identify spontaneous changes in kidney function. A20Δpodocyte mice presented elevated serum urea nitrogen and creatinine levels, along with increased accumulation of inflammatory cells—neutrophils and macrophages—within the glomeruli. Additionally, A20Δpodocyte mice displayed significant podocyte loss. Ultrastructural analysis of A20 podocyte-knockout mouse glomeruli revealed hypocellularity of the glomerular tuft, expansion of the extracellular matrix, podocytopenia associated with foot process effacement, karyopyknosis, micronuclei, and podocyte detachment. In addition to podocyte death, we also observed damage to intracapillary endothelial cells with vacuolation of the cytoplasm and condensation of nuclear chromatin. A20 expression downregulation and CRISPR-Cas9 genome editing targeting A20 in a podocyte cell line confirmed these findings in vitro, highlighting the significant contribution of A20 activity in podocytes to glomerular injury pathogenesis. Finally, we analyzed TNFAIP3 transcription levels alongside genes involved in apoptosis, anoikis, NF-κB regulation, and cell attachment in glomerular and tubular compartments of kidney biopsies of patients with various renal diseases. Full article

This paper provides information about (a) 15 wildfire-related accidents that took place during 12 wildfires due to eruptive fire behavior in the 1982–2016 period and (b) six additional cases of “chimney effect” and “flame attachment” occurrence that caused no deaths or injuries, in the 2007–2019 period, in Greece. The work is based on (i) detailed documentation and reconstruction of wildfire behavior and spread, (ii) coupling of wildfire behavior with geospatial data and analysis, (iii) location information and field evidence for firefighter and citizen fatalities, and (iv) events surrounding those fatal accidents. These are matched with corresponding weather and fuel information, creating a rather complete picture of the conditions that entail a great risk to firefighters and citizens. The objectives of our effort are (a) to identify the common elements present in these cases and extract conclusions about the common denominators that may lead to fatal or near-fatal firefighter accidents, (b) to discuss how the findings compare with similar accidents in other countries, and (c) to develop clear messages for firefighters and citizens to help improve their safety. Full article