Search Results (311)

Background: Bone health in youth is influenced by both modifiable factors, such as nutrition and physical activity, and non-modifiable factors, such as biological maturation and heredity. Understanding how these elements interact to predict body composition may enhance the effectiveness of early interventions. Importantly, the integration of both supervised and unsupervised machine learning models enables a data-driven exploration of complex relationships, allowing for accurate prediction and subgroup discovery. Methods: This cross-sectional study examined 94 male athletes during the developmental period. Anthropometric, performance, and nutritional data were collected, and bone parameters were assessed using dual-energy X-ray absorptiometry (DXA). Three supervised machine learning models (Random Forest, Gradient Boosting, and Support Vector Regression) were trained to predict Total Body-Less Head (TBLH) values. Nested cross-validation assessed model performance. Unsupervised clustering (K-Means) was also applied to identify dietary intake profiles (calcium, protein, vitamin D). SHAP analysis was used for model interpretability. Results: The Random Forest model yielded the best predictive performance (R² = 0.71, RMSE = 0.057). Weight, height, and handgrip strength were the most influential predictors. Clustering analysis revealed two distinct nutritional profiles; however, t-tests showed no significant differences in TBLH or regional BMD between the clusters. Conclusions: Machine learning, both supervised for accurate prediction and unsupervised for nutritional subgroup discovery, provides a robust, interpretable framework for assessing adolescent bone health. While dietary intake clusters did not align with significant differences in bone parameters, this finding underscores the multifactorial nature of skeletal development and highlights areas for further exploration. Full article

Background: The hyoid bone is a key anatomical structure involved in the functional coordination of the stomatognathic system. Although its position may vary in response to masticatory patterns, its relationship with functional occlusion remains insufficiently studied in orthodontics. Objective: This pilot study aimed to explore the association between masticatory type and hyoid bone position and to assess the clinical utility of the Functional Masticatory Angle of Planas (AFMP) in classifying masticatory patterns. Materials and Methods: A descriptive, observational, cross-sectional study was conducted with 18 patients. Right and left AFMPs were measured using standardized intraoral photographs, and hyoid bone position was assessed via panoramic radiographs, classified as either aligned or displaced. Measurements were repeated to assess intraobserver reliability. Results: In most cases, hyoid bone elevation occurred on the same side as the smaller AFMP, suggesting a possible adaptive response to unilateral masticatory dominance. High intraobserver agreement was confirmed for both AFMP and hyoid measurements. Conclusions: The findings suggest a potential relationship between functional masticatory asymmetry and hyoid bone position. While further studies with larger samples are needed, the AFMP appears to be a promising tool for evaluating functional occlusion in relation to craniofacial dynamics. Full article

Background: Calcium is essential for maintaining bone health, facilitating muscle contractions, regulating body temperature, and supporting aerobic metabolism. While the relationship between physical activity and calcium metabolism is well established, the impact of calcium intake on cardiorespiratory fitness (CRF) remains underexplored. The main aim of this study was to assess the effects of calcium intake on CRF and the mediation effect of calcium intake on the relationship between vigorous physical activity participation and CRF. Methods: Analyses were performed on a sample of 576 adult participants (257 males and 319 females) from the Quebec Family Study (QFS) for whom data were available for calcium intake, CRF, and body composition. The effects of calcium intake on CRF and body composition were analyzed by comparing subjects classified into sex-specific tertiles of calcium intake using general linear mixed models. Pearson correlations were also used to document the associations between calcium intake, CRF, and body composition. A mediation analysis was used to determine the effect of calcium intake as a mediator of the association between vigorous physical activity and CRF. Results: The comparison of calcium-based tertiles revealed that low calcium consumers had lower CRF, especially in males. In both males and females, correlation analysis showed that calcium intake was positively associated (p < 0.05) with CRF. Mediation analyses revealed that calcium intake explains an insignificant fraction of the physical activity–CRF relationship. Between-tertile comparisons showed reduced body fat and increased fat-free mass levels when increasing calcium intake, although some of these effects were not statistically significant. Conclusions: The results of this study suggest that low calcium intake is associated with reduced aerobic capacity in adult males and females. While the positive relationship observed between calcium and aerobic fitness aligns with calcium’s known physiological roles, further research is needed to clarify the exact mechanisms by which this micronutrient may influence aerobic capacity. Full article

Neural tissue injuries, including spinal cord damage and neurodegenerative diseases, pose a major clinical challenge due to the central nervous system’s limited regenerative capacity. Current treatments focus on stabilization and symptom management rather than functional restoration. Tissue engineering offers new therapeutic perspectives, particularly through the combination of electrospun nanofibrous scaffolds and mesenchymal stem cells (MSCs). Electrospun fibers mimic the neural extracellular matrix, providing topographical and mechanical cues that enhance MSC adhesion, viability, and neural differentiation. MSCs are multipotent stem cells with robust paracrine and immunomodulatory activity, capable of supporting regeneration and, under proper stimuli, acquiring neural-like phenotypes. This systematic review, following the PRISMA 2020 method, analyzes 77 selected articles from the last ten years to assess the potential of electrospun biopolymer scaffolds for MSC-mediated neural repair. We critically examine the scaffold’s composition (synthetic and natural polymers), fiber architecture (alignment and diameter), structural and mechanical properties (porosity and stiffness), and biofunctionalization strategies. The influence of MSC tissue sources (bone marrow, adipose, and dental pulp) on neural differentiation outcomes is also discussed. The results of a literature search show both in vitro and in vivo enhanced neural marker expression, neurite extension, and functional recovery when MSCs are seeded onto optimized electrospun scaffolds. Therefore, integrating stem cell therapy with advanced biomaterials offers a promising route to bridge the gap between neural injury and functional regeneration. Full article

Background: Orthodontically driven osteogenesis (ODO) is a surgical tunnel modification of periodontally accelerated osteogenic orthodontics (PAOO), combining selective corticotomy with bone grafting in sequential and/or segmental fashion. This is a minimally invasive approach that enhances periodontal health and allows orthodontic tooth movement beyond the original alveolar envelope. Considering the lack of long-term three-dimensional data on orthodontically driven osteogenesis (ODO), this study aims to quantitatively assess the long-term stability of alveolar bone and buccal cortical thickness following ODO, using CBCT imaging. The null hypothesis is that ODO does not result in significant changes in alveolar bone volume or cortical thickness over a seven-year follow-up period. Methods: Twenty patients (13 females, 7 males; mean age 27.4 ± 5.3 years) who had undergone orthodontically driven osteogenesis (ODO) using a minimally invasive tunnel approach and segmental corticotomy protocol followed by clear aligner therapy were retrospectively evaluated. The mean follow-up period after treatment was 7 years (range: 5–15 years). Cone beam computed tomography (CBCT) scans were obtained at one year postoperatively (T1) and again at the long-term follow-up visit (T2). Buccal bone thickness measurements were taken at standardized levels (3 mm, 5 mm, and 7 mm apical to the cementoenamel junction) and compared between T1 and T2 to evaluate bone stability over time. In addition, histologic evaluation of the previously grafted area was performed in two patients: one sample was collected during an alveolar ridge augmentation procedure six months after ODO, and the other during orthognathic surgery eight months after ODO. The samples were analyzed to assess new bone formation and integration of graft material. Results: Radiographic analysis showed long term stability of the new bone support. Histologic examination showed newly formed lamellar and reticular bone. Bone marrow showed no inflammatory infiltration, and bone particles were still detectable but incorporated in the newly created bone. Conclusions: Based on these findings, ODO appears to be a promising technique that could induce stable bone osteogenesis. A larger cohort study can enhance the evidence of these promising results to popularize this technique. Full article

Background: Angioimmunoblastic T-cell lymphoma (AITL) and peripheral T-cell lymphomas (PTCL), not otherwise specified (NOS), share overlapping histology and T-follicular helper (TFH) biology but often show divergent outcomes and treatment needs. The clinical significance of KMT2A rearrangement (KMT2A-r) in nodal PTCL remains undefined. We aimed to investigate the clinicogenomic features and prognostic impact of KMT2A-r in AITL and PTCL-NOS. Methods: We retrospectively analyzed consecutive patients diagnosed with AITL or PTCL-NOS between 2021 and 2024 at two centers. All patients underwent 523-gene DNA/RNA next-generation sequencing. Gene co-variation and diagnostic splits were summarized using network and decision-tree analyses. Results: Overall, 37 patients were included (AITL: 14; PTCL-NOS: 23), with similar baseline clinical characteristics. In AITL, TFH markers were more frequently expressed, and RHOA mutations were enriched. KMT2A-r occurred in 24% of cases without histology-specific enrichment. AITL showed better 2-year overall survival (OS) than PTCL-NOS (70.7% vs. 38.8%; p = 0.040) but similar progression-free survival (PFS). Univariate analysis revealed that KMT2A-r, lactate dehydrogenase elevation, and bone-marrow involvement predicted inferior PFS (Hazard ratio for KMT2A-r: 2.56). Median PFS was 5.9 versus 12.5 months in the KMT2A-r and non-KMT2A-r groups, respectively (p = 0.039). Brentuximab vedotin (BV) plus cyclophosphamide, doxorubicin, and prednisone did not significantly improve OS or PFS overall; however, exploratory analysis indicated improved PFS in the KMT2A-r subset. Conclusions: KMT2A-r delineates an adverse-risk biology in nodal PTCL, aligns with non-TFH genomic hubs and markers of tumor burden, and may serve as a stratifier and hypothesis-generating target for BV-based strategies. Full article

We present a deep learning-based approach for accurate bone segmentation directly from routine T1-weighted MRI scans, with the goal of enabling MRI-only virtual surgical planning in head and neck oncology. Current workflows rely on CT for bone modeling and MRI for tumor delineation, introducing challenges related to image registration, radiation exposure, and resource use. To address this, we trained a deep neural network using CT-based segmentations of the mandible, cranium, and inferior alveolar nerve as ground truth. A dataset of 100 patients with paired CT and MRI scans was collected. MRI scans were resampled to the voxel size of CT, and corresponding CT segmentations were rigidly aligned to MRI. The model was trained on 80 cases and evaluated on 20 cases using Dice similarity coefficient, Intersection over Union (IoU), precision, and recall. The network achieved a mean Dice of 0.86 (SD ± 0.03), IoU of 0.76 (SD ± 0.05), and both precision and recall of 0.86 (SD ± 0.05). Surface deviation analysis between CT- and MRI-derived bone models showed a median deviation of 0.21 mm (IQR 0.05) for the mandible and 0.30 mm (IQR 0.05) for the cranium. These results demonstrate that accurate CT-like bone models can be derived from standard MRI, supporting the feasibility of MRI-only surgical planning. Full article

Poly(lactic acid) (PLA) and poly(ether-ether ketone) (PEEK) are widely recognized for their biocompatibility and processability in orthopaedic applications. However, PLA suffers from brittleness and limited thermal and mechanical stability, while PEEK, despite its better strength, does not fully replicate the mechanical and tribological performance of natural bone. This study explores the enhancement of structural and tribological properties in PLA- and PEEK-based composites reinforced with short glass fibres (S-GF) via additive manufacturing. Microstructural analysis confirms uniform GF dispersion within both polymer matrices, with no evidence of agglomeration, fibre pull-out, or interfacial debonding, suggesting strong fibre–matrix adhesion. The incorporation of GF significantly improved mechanical performance: microhardness increased by 38.3% in PLA and 36.3% in PEEK composites, while tensile strength increased by 25.1% and 13.4%, respectively, compared to plain polymers. These enhancements are attributed to effective stress transfer enabled by uniform fibre distribution and strong interfacial bonding. Tribological tests further demonstrate enhanced wear resistance, reduce damage propagation, and improved surface integrity under micro-scratching. These findings highlight the potential of GF-reinforced PLA and PEEK composites as high-performance materials for load-bearing biomedical applications, offering a balanced combination of mechanical strength and wear resistance aligned with the functional requirements of bioimplants. Full article

Background: Patellofemoral instability arises from the interplay between trochlear morphology and malalignment of the extensor vector. Although each factor is individually well described, their combined mechanical effects have not been quantified within a single finite element framework. Objective: To investigate how lateral trochlear inclination (LTI) and tibial tuberosity position interact to influence patellofemoral contact mechanics and stability across clinically relevant knee flexion angles. Methods: A subject-specific finite element model of the femur–patella–tibia complex was reconstructed from high-resolution CT data. Cortical and cancellous bone, patellar cartilage, the MPFL, and patellar tendon were included. Three trochlear morphologies were simulated (LTI = 15°, 10°, 5°) under native alignment (Case A) and after 10 mm lateral tibial tuberosity translation (Case B). Flexion at 30°, 60°, and 90° was imposed via solver-applied tibial displacement. Primary outcomes were contact pressure, contact area, MPFL stress, and lateral patellar translation. Instability was defined as >5 mm lateral translation or >50% reduction in contact area, consistent with the biomechanical literature. Model convergence (<5% variation) and validation against cadaveric pressure data were performed; a sensitivity analysis tested material property variation (±15%). Results: The native model reproduced peak pressures (3.6 MPa at 60°) within 9% of experimental benchmarks. Decreasing LTI enlarged the contact patch and lowered mean pressures (−18%) but increased MPFL stress (+37%). Tibial tuberosity lateralisation reduced mean pressures further (−25%), yet, when combined with shallow trochlear slopes (≤8°), produced >5 mm lateral patellar translation and near-complete loss of cartilage contact by 60°, simulating lateral dislocation. Sensitivity testing confirmed robustness to material property uncertainty. Conclusions: Shallow trochlear inclination dissipates articular load but destabilises the patella, an effect magnified by tibial tuberosity lateralisation. While these findings highlight thresholds at which stability may be compromised, they derive from a single-subject model and should be interpreted as hypothesis-generating rather than prescriptive. Broader validation across multiple geometries and loading conditions is required before clinical translation. Full article

Monte Carlo Path Tracing (MCPT) provides highly realistic visualization of biomedical volumes, but its computational cost limits real-time interaction. The Advanced Realistic Rendering Technique (AR²T) adapts MCPT to enable interactive exploration through coarse images generated at low sample counts. This study explores the application of deep learning models for denoising in the early iterations of the AR²T to enable higher-quality interaction with biomedical data. We evaluate five deep learning architectures, both pre-trained and trained from scratch, in terms of denoising performance. A comprehensive evaluation framework, combining metrics such as PSNR and SSIM for image fidelity and tPSNR and LDR-FLIP for temporal and perceptual consistency, highlights that models trained from scratch on domain-specific data outperform pre-trained models. Our findings challenge the conventional reliance on large, diverse datasets and emphasize the importance of domain-specific training for biomedical imaging. Furthermore, subjective clinical assessments through expert evaluations underscore the significance of aligning objective metrics with clinical relevance, highlighting the potential of the proposed approach for improving interactive visualization for analysis of bones, joints, and vessels in clinical and research environments. Full article

Background/Objectives: Multi-scenario calculational methods have been used to evaluate proton teletherapy plan robustness but few studies have been performed to determine the accuracy of these calculational methods. This study evaluates a multi-scenario method by comparing calculations to measurements made in phantoms that simulate the effects of possible uncertainties. Methods: Plans were made using four phantoms in which the delivered dose was highly sensitive to positional and penetration uncertainties. The effects of alignment and penetration uncertainties on the dose distributions of each of those phantoms were simulated by performing calculations using nine different uncertainty scenarios and comparing the calculations to measurements with induced physical alignment displacements. Measured dose distributions were obtained by exposing films placed inside the phantoms and extracting multiple linear profiles. The maximum and minimum doses obtained for each of the calculational scenarios were compared with the measured dose profiles. In addition, comparisons of DVHs for nominal and uncertainty scenarios were performed. Results: The results showed that, under the influence of uncertainties, the minimum dose for the four phantoms decreased by more than 20 Gy, the V_95% coverage fluctuated by more than 10%, but the maximum dose parameter changed by less than 5 Gy. This was expected, as no margins for uncertainties were applied around the targets. The envelope bounded by the maximum and minimum possible calculated doses contained most of the measurements, although the shapes of the dose profiles displayed some mismatches for wedge and head phantoms. There were a few points where the measured maximum dose for bone and lung slab phantom cases was slightly higher than the maximum dose calculated from the nine scenarios. Conclusions: This study demonstrates that a nine-scenario method can adequately evaluate the robustness of simple mono-directional plans containing heterogeneities. Full article

Osteoblastogenesis plays a critical role in bone repair. Insulin and insulin-mimetic compounds, such as vanadium (IV) oxide acetylacetonate (VAC), have been reported to enhance bone healing in various models. This study aimed to evaluate the effects of vanadium compounds, VAC and vanadium (IV) oxide sulfate (VOSO₄), on osteoblast proliferation and function. MC3T3-E1 pre-osteoblast cells were treated with insulin, ascorbic acid, and varying concentrations of VAC or VOSO₄, and samples were collected at multiple time points over 21 days. We assessed cell proliferation, functional markers, and gene and protein expression. Our findings demonstrate that both VAC and VOSO₄ stimulate MC3T3-E1 proliferation, increase calcium and proteoglycan deposition, and enhance phosphorylation of Protein Kinase B (Akt) over time. Gene expression analysis revealed that VAC treatment upregulated RUNX2, BGLAP, and TWIST2 at Day 7 compared to controls, with sustained expression patterns observed at Day 10. These results align with existing literature, supporting that VAC and VOSO₄ promote osteoblastogenesis and may serve as effective adjuvants to accelerate bone regeneration during fracture healing. Full article

Soil contamination with heavy metals often resulting from industrial activities and wastewater discharge is a major ecological problem. Bone meal, a by-product of the agri-food industry, is a promising material for remediating soils affected by heavy metal pollution. Bone meal, rich in phosphorus, calcium, and other essential minerals, provides advantages both in immobilizing inorganic pollutants and in improving soil fertility. This study explores the potential of bone meal as an ecological and sustainable solution for the retention of zinc from soils polluted with wastewater. This study analyzes the physicochemical properties of bone meal, the mechanisms of its interaction with metal ions through adsorption processes as revealed by equilibrium and kinetic studies, and its effects on plant germination. The results indicate a maximum adsorption capacity of 2375.33 mg/kg at pH = 6, according to the Langmuir model, while the pseudo-second-order kinetic model showed a coefficient of R² > 0.99, confirming the chemical nature of the adsorption. At pH 12, the retention capacity increased to 2937.53 mg/kg; however, parameter instability suggests interference from precipitation phenomena. At pH 12, zinc retention is dominated by precipitation (Zn(OH)₂ and Zn–phosphates), which invalidates the Langmuir assumptions; accordingly, the Freundlich isotherm provides a more adequate description. Germination tests revealed species-specific responses to Zn contamination and bone meal amendment. In untreated contaminated soil, germination rates were 84% for cress, 42% for wheat, and 50% for mustard. Relative to the soil + bone meal treatment (100% performance), the extent of inhibition reached 19–21% in cress, 24–29% in wheat, and 12% in mustard. Bone meal mitigated Zn-induced inhibition most effectively in wheat (+31% vs. soil; +40% vs. control), followed by cress (+23–27%) and mustard (+14%), highlighting its species-dependent ameliorative potential. Thus, the experimental results confirm bone meal’s capacity to reduce the mobility of zinc ions and improve the quality of the agricultural substrate. By transforming an animal waste product into a material with agronomic value, this study supports the integration of bone meal into modern soil remediation strategies, aligned with the principles of bioeconomy and sustainable development. Full article

Background. Orthodontic extrusion (OE), or forced eruption, is a conservative technique used to recover teeth affected by coronal fractures, traumatic intrusions, or severe caries. It involves applying light, continuous forces to induce vertical tooth movement, promoting tissue remodeling through periodontal ligament stimulation. Materials and Methods. This narrative review included studies investigating OE as a therapeutic approach for the management of deep or subgingival carious lesions, traumatic dental injuries (such as intrusion or fracture), or for alveolar ridge augmentation in implant site development. OE is typically performed using fixed appliances such as the straight-wire system or, in selected cases, clear aligners. Forces between 30 and 100 g per tooth are applied, depending on the clinical situation. In some protocols, OE is combined with fiberotomy to minimize gingival and bone migration. Results. Studies show that OE leads to significant vertical movement and increases in buccal bone height and interproximal septa. It enhances bone volume in targeted sites, making it valuable in implant site development. Compared to surgical crown lengthening, OE better preserves periodontal tissues and improves esthetics. Conclusions. In this narrative review is analized how OE is effective for managing traumatic intrusions and compromised periodontal sites, particularly when paired with early endodontic treatment. It reduces the risks of ankylosis and root resorption while avoiding invasive procedures like grafting. Although clear aligners may limit axial tooth movement, OE remains a minimally invasive, cost-effective alternative in both restorative and implant dentistry. Full article

Background/Objectives: The diagnosis of prosthetic joint infection remains difficult. Microbiological cultures frequently have false-positive and false-negative results. This study investigates whether rapid nanopore sequencing can be used to aid the identification of bacteria causing prosthetic joint infection for more timely identification and treatment. Methods: Nineteen patients who had revision surgery following total joint arthroplasty were included in this study. Of these, 15 patients had an infected joint arthroplasty. All patients had joint fluid aspirated at the time of revision surgery. The DNA was extracted from these fluid aspirates, and rapid nanopore sequencing was performed using the MinION device from Oxford Nanopore Technologies. The sequencing data was trimmed to improve quality and filtered to remove human reads using bioinformatic tools. Genomic sequence classification was performed using the Basic Local Alignment Search Tool. The results were filtered by read length and sequence identity score. The European Bone and Joint Infection Society criteria were used as a standard to identify infected and not infected patients. Confusion tables were used to calculate accuracy and F1 score based on this criteria and the nanopore sequencing results. Results: Microbiological cultures and nanopore sequencing had an accuracy of 68% and 74%, respectively. However, combining both results predicted infection accurately in 94% of cases (F1 score 96%). Conclusions: Nanopore sequencing has the potential to aid identification of bacteria causing prosthetic joint infection and may be useful as a supplementary diagnostic tool. Full article