Search Results (1,115)

Background: Breast cancer is the most common neoplasm in women. Despite effective treatments, sequelae such as decreased muscle strength, upper limb dysfunction, and tissue changes are common, highlighting the need for functional assessments during rehabilitation. This study analysed the morphofunctional profile of the upper limbs in breast cancer survivors, comparing muscle strength and ultrasound findings between groups with and without lymphoedema, as well as between ipsilateral and contralateral limbs. Methods: This cross-sectional study included female breast cancer survivors treated at an oncology physical therapy clinic. Muscle strength was measured using dynamometry (handgrip and arm flexor strength), and ultrasound assessed the thickness of the dermal–epidermal complex (DEC), subcutaneous tissue (SUB), and muscle (MT). Results: The upper limbs of 41 women were evaluated. No significant differences were observed between those with and without breast cancer-related lymphoedema (BCRL). When comparing the ipsilateral and contralateral limbs, significant reductions were observed in arm flexor strength (p < 0.001; 95% CI: −9.77 to −2.50), handgrip strength (p < 0.001; 95% CI: −4.10 to −1.22), and tissue thickness, with increased DEC thickness on the forearm (0.20 mm; p = 0.022) and arm flexors (0.25 mm; p < 0.001) of the ipsilateral limb. Conclusion: Significant differences in muscle strength and tissue structure between ipsilateral and contralateral limbs may reflect surgical and local pathophysiological effects. A trend toward reduced values for these parameters was also noted in limbs with BCRL, reinforcing the importance of future research to elucidate underlying mechanisms and guide more effective therapeutic strategies. Full article

This study aimed to determine the factors associated with the occurrence of the first-wave dominant follicle (DF) in the ovary ipsilateral to the corpus luteum (CL) in lactating dairy cows and dairy heifers. A total of 505 estruses were investigated (lactating dairy cows, n = 361; dairy heifers, n = 144). The locations of the preovulatory follicle (PF) and regressed CL were examined at the estrus, and the locations of the first-wave dominant follicle (DF) and newly formed CL were examined seven days after estrus using transrectal ultrasonography. Then, cows were classified into two groups: the first-wave DF in the ovary ipsilateral to the CL (IG) and the first-wave DF in the ovary contralateral to the CL (CG). To evaluate the factors which affect the occurrence of IG and CG, binominal logistic regression analysis was conducted; the location of the PF and regressing CL, season (warm: June–September; cool: October–May), live weight, days in milk at estrus, daily milk production, and body condition score were used as independent variables. The occurrence rate of IG was significantly higher when the PF was located contralateral to the regressing CL (lactating dairy cows, 63.4%; dairy heifers, 58.6%) rather than ipsilateral (lactating dairy cows, 44.9%; dairy heifers, 35.1%). The IG occurrence rate was significantly higher with an increase in daily milk production (<30 kg, 47.3%; 30–40 kg, 55.2%; >40 kg, 60.5%) in lactating dairy cows. In conclusion, the occurrence of IG was associated with relative locations of the PF and regressing CL in lactating dairy cows and dairy heifers and with the level of milk production in lactating dairy cows. Full article

Background/Objectives: Gastrin-releasing peptide receptor (GRPR) is overexpressed in breast cancer and might be used as a theranostics target. The expression of GRPR strongly correlates with estrogen receptor (ER) expression. Visualization of GRPR-expressing breast tumors might help to select the optimal treatment. Developing GRPR-specific probes for SPECT would permit imaging-guided therapy in regions with restricted access to PET facilities. In this first-in-human study, we evaluated the safety, biodistribution, and dosimetry of the [^99mTc]Tc-DB8 GRPR-antagonistic peptide. We also addressed the important issue of finding the optimal injected peptide mass. Methods: Fifteen female patients with ER-positive primary breast cancer were enrolled and divided into three cohorts receiving [^99mTc]Tc-DB8 (corresponding to three distinct doses of 40, 80, or 120 µg DB8) comprising five patients each. Additionally, four patients with ER-negative primary tumors were injected with 80 µg [^99mTc]Tc-DB8. The injected activity was 360 ± 70 MBq. Planar scintigraphy was performed after 2, 4, 6, and 24 h, and SPECT/CT scans followed planar imaging 2, 4, and 6 h after injection. Results: No adverse events were associated with [^99mTc]Tc-DB8 injections. The effective dose was 0.009–0.014 mSv/MBq. Primary tumors and all known lymph node metastases were visualized irrespective of injected peptide mass. The highest uptake in the ER-positive tumors was 2 h after injection of [^99mTc]Tc-DB8 at a 80 µg DB8 dose (SUV_max 5.3 ± 1.2). Injection of [^99mTc]Tc-DB8 with 80 µg DB8 provided significantly (p < 0.01) higher uptake in primary ER-positive breast cancer lesions than injection with 40 µg DB8 (SUV_max 2.0 ± 0.3) or 120 µg (SUV_max 3.2 ± 1.4). Tumor-to-contralateral breast ratio after injection of 80 μg was also significantly (p < 0.01, ANOVA test) higher than ratios after injection of other peptide masses. The uptake in ER-negative lesions was significantly lower (SUV_max 2.0 ± 0.3) than in ER-positive tumors. Conclusions: Imaging using [^99mTc]Tc-DB8 is safe, tolerable, and associated with low absorbed doses. The tumor uptake is dependent on the injected peptide mass. The injection of an optimal mass (80 µg) provides the highest uptake in ER-positive tumors. At optimal dosing, the uptake was significantly higher in ER-positive than in ER-negative lesions. Full article

Background: Anterior cruciate ligament reconstruction (ACLr) often leads to asymmetries between limbs, with variable return-to-performance rates in athletes. The single-leg countermovement jump (SLCMJ) is commonly used to assess postoperative knee function. However, limited research has explored deficits specifically during the unweighting phase of the jump. Methods: This study assessed 53 recreational athletes (11 females, 42 males) between 6 and 9 months post-ACLr using a dual force plate system (1000 Hz). Each participant performed three maximal-effort SLCMJs per limb. Outcome measures included jump height, negative peak velocity, minimum force, and center of mass (COM) displacement. Paired t-tests and Wilcoxon tests were used to compare the ACLr limb with the contralateral limb. Results: Compared to the healthy limb, the ACLr limb showed significantly lower negative peak velocity (−0.80 ± 0.40 m/s vs. −0.94 ± 0.40 m/s, p < 0.001), higher minimum force (36.75 ± 17.88 kg vs. 32.05 ± 17.25 kg, p < 0.001), and reduced COM displacement (−17.62 ± 6.25 cm vs. −19.73 ± 5.34 cm, p = 0.014). Eccentric phase duration did not differ significantly. Conclusions: Athletes post-ACLr demonstrate altered neuromuscular control during the early SLCMJ phase. These findings highlight the importance of rehabilitation strategies targeting eccentric strength and symmetry restoration. Full article

Optically pumped magnetometer OPM-MEG has the potential to replace the traditional low-temperature superconducting quantum interference device SQUID-MEG. Coherence analysis can be used to evaluate the functional connectivity and reflect the information transfer process between brain regions. In this paper, a finger tapping movement paradigm based on auditory cues was used to measure the functional signals of the brain using OPM-MEG, and the coherence between the primary motor cortex (M1) and the primary motor area (PM) was calculated and analyzed. The results demonstrated that the coherence of the three frequency bands of Alpha (8–13 Hz), Beta (13–30 Hz), and low Gamma (30–45 Hz) and the selected reference signal showed roughly the same position, the coherence strength and coherence range decreased from Alpha to low Gamma, and the coherence coefficient changed with time. It was inferred that the change in coherence indicated different neural patterns in the contralateral motor cortex, and these neural patterns also changed with time, thus reflecting the changes in the connection between different functional areas in the time-frequency domain. In summary, OPM-MEG has the ability to measure brain coherence during finger movements and can characterize connectivity between brain regions. Full article

Background: Prosthetic cementation using the biologically oriented preparation technique (BOPT) presents challenges in removing excess cement from the gingival sulcus, due to the absence of a finishing line and the impossibility of using absolute isolation with a rubber dam. This study aimed to evaluate the effectiveness of relative isolation using polytetrafluoroethylene (PTFE) tape in reducing cement retention during BOPT cementation. Methods: Fifteen 3D-printed resin models were created from an intraoral scan of a patient restored with BOPT in both upper central incisors. Each model included removable gingiva. Splinted polymethylmethacrylate (PMMA) provisional crowns were fabricated and cemented with temporary cement. One central incisor was isolated with PTFE (0.1 mm or 0.2 mm), while the contralateral tooth was left unisolated as a control. After debonding, digital scanning and volumetric analysis using root mean square (RMS) deviation were performed to quantify retained cement. Paired t-tests were applied to compare groups. Results: The mean RMS for the PTFE group was 0.1248 ± 0.0519 mm, compared to 0.1973 ± 0.0361 mm in the non-isolated group (p < 0.001). No significant difference was found between PTFE thicknesses of 0.1 mm and 0.2 mm (p = 0.388). Conclusions: PTFE tape is effective for relative isolation when rubber dam placement is not feasible in BOPT restorations. Further clinical studies are recommended to confirm these findings in vivo. Full article

Background/Objectives: The implementation of polygenic scores (PGSs) and multifactorial risk assessments (MFRAs) has the potential to enhance breast cancer risk stratification, particularly in carriers of moderate-penetrance pathogenic variants (PVs), whose risk profiles often remain unclear if testing is limited to monogenic risk factors. Methods: To enhance breast cancer risk stratification, we included the BCAC313 polygenic score, together with MFRA, for carriers of moderate-penetrance pathogenic variants (PVs) during routine diagnostics and assessed its effect on the classification of patients’ risk categories in a real-world cohort at our center in its first year of implementation. Seventeen carriers with PVs in moderate-risk breast cancer genes were included in this study. Thirteen of them qualified for analysis for a full MFRA, including PGS, according to ancestry estimation and clinical criteria. The MFRA was performed using the CanRisk tool, which incorporates clinical, lifestyle, familial, and genetic data, including the BCAC313 score. Results: PGS z-scores were significantly higher in breast cancer patients compared to the unaffected control cohort (p = 0.016). The MFRA, including PGS, increased risk estimates for contralateral breast cancer in seven of eight patients with breast cancer and for primary breast cancer in three of five healthy carriers, compared to the risk conferred by the MFRA and moderate-penetrance pathogenic variant alone. Risk estimates varied widely, demonstrating the value of MFRA in personalized care. In five cases, one with a CHEK2-PV and four with an ATM-PV, the modified risk assessment contributed to the surgical decision for a prophylactic mastectomy. Conclusions: The MFRA, including PGS, provides the clinically meaningful refinement of breast cancer risk estimates in individuals with moderate-risk PVs. Personalized risk predictions can inform clinical management and support decision-making, which highlights the utility of this approach in clinical practice. Full article

Background/Objectives: This study aimed to prospectively assess the incidence of retinal embolization and to evaluate the vascular and structural changes in the retina and choroid in 52 patients with asymptomatic severe carotid artery disease who underwent carotid artery revascularization. Methods: In our study, 35 patients underwent carotid endarterectomy (CEA) and 17 underwent carotid artery stenting (CAS). Biomicroscopy, fundoscopy, optical coherence tomography (OCT), and OCT-angiography (OCTA) were performed at baseline and 1 month after revascularization. Results: The subfoveal choroidal thickness (SFCT), peripapillary choroidal thickness inferior to the optic nerve head (ppCTi), total overall average retinal vascular density (rVDtot), and total overall average choriocapillaris vascular density (ccVDtot) of the eyes ipsilateral to the operated carotid artery increased significantly after revascularization, whereas a statistically significant increase was also found in the SFCT, rVDtot, and ccVDtot of the contralateral eyes in the overall cohort. Comparing the two study groups, we found that the SFCT, superior and inferior peripapillary choroidal thicknesses (ppCTs, ppCTi), rVDtot, and ccVDtot increased in both groups after revascularization, but significantly only in the CEA group. Furthermore, the temporal choriocapillaris vascular density (ccVDt) increased significantly after revascularization in both groups to a similar degree. Conclusions: Carotid artery revascularization led to a statistically significant increase in retinal and choroidal vascular densities, which indicates significantly improved ocular perfusion. The analysis of the findings of the two study groups suggests the superiority of CEA in terms of improving ocular perfusion in asymptomatic severe carotid artery disease. The rate of retinal embolization was similar in both surgical groups. Full article

Background: prostate fusion biopsies are key in the diagnosis of prostate cancer (PCa); however, the fusion imaging system is not always user-friendly or reliable. The aim of this study was to assess the feasibility, accuracy, and effectiveness of transperineal fusion biopsies performed with a novel fusion imaging device equipped with AI-driven auto-contouring. Methods: data from 148 patients who underwent MRI-targeted and systematic prostate fusion biopsy with UroFusion (Esaote) were prospectively collected. All biopsies were performed in-office, under local anaesthesia. Results: cancer detection rate was 64% overall and 56% for clinically significant PCa (csPCa, ISUP ≥ 2). PCa was detected in 35%, 65% and 84% of lesions scored as PI-RADS 3, 4 and 5, respectively. Outfield positive systematic cores were found in the contralateral lobe in one third of cases. Median device-time to obtain fusion imaging was 5 min and median biopsy duration was 15 min. Median difference in volume estimation between ultrasound and MRI auto-contouring was only 1 cc. Detection rate did not differ between experienced and novice, supervised users. Conclusions: in this initial prospective experience, fusion biopsies performed with UroFusion AI-driven auto-contouring system appeared time-efficient, accurate, well tolerated, and user-friendly, with comparable outcomes between experienced and novice users. Systematic biopsies remain highly recommended given the non-negligible rates of positive outfield cores. Full article

Background/Objectives: During alveolar cleft grafting, the use of autogenous cancellous bone harvested from the iliac crest is still considered the gold standard. Due to the risk of donor-site morbidity and excessive graft resorption, alternative grafting materials (e.g., intraoral bone, xenografts) are being tested. The aim of this study was to compare the efficacy of using an autologous tooth-derived graft material and iliac crest cancellous bone in the reconstruction of the alveolar cleft in patients with a unilateral cleft lip and palate. Methods: A total of 21 patients with a unilateral cleft lip and palate, who underwent alveolar bone grafting between 2020 and 2023 were included in the study. In 11 cases, the donor site was the iliac crest; in the rest of the cases, deciduous teeth were harvested, processed, and used as an autologous particulate graft material for alveolar reconstruction. The mean follow-up time was 30.0 months, CBCT scans were taken, and the results were compared based on the ranking system published by Stasiak et al. Results: The Wilcoxon signed-rank test showed that the amount of bone on the cleft side was significantly less than that on the contralateral non-cleft side (ATB: p = 0.002, iliac crest: p = 0.005). The Mann–Whitney U test showed that there were no significant differences in bone quantity on the cleft side between the two groups (U = 47.5, p = 0.617). Conclusions: The use of ATB might be a feasible alternative to autologous bone during alveolar cleft reconstruction. This type of graft shows long-term stability, which is comparable to the bone harvested from the iliac crest. Full article

Upper extremity amputations significantly impact an individual’s physical capabilities, psychosocial well-being, and overall quality of life. The level at which an amputation is performed influences residual limb function, prosthetic compatibility, and long-term patient satisfaction. While surgical guidelines traditionally emphasize maximal limb preservation, prosthetists often advocate for amputation sites that optimize prosthetic fit and function, highlighting the need for a collaborative approach. This review examines the discrepancies between surgical and prosthetic recommendations for optimal amputation levels, from digit amputations to shoulder disarticulations, and explores their implications for prosthetic design, functionality, and patient outcomes. Various prosthetic options, including passive functional, body-powered, myoelectric, and hybrid devices, offer distinct advantages and limitations based on the level of amputation. Prosthetists emphasize the importance of residual limb length, not only for mechanical efficiency but also for achieving symmetry with the contralateral limb, minimizing discomfort, and enhancing control. Additionally, emerging technologies such as targeted muscle reinnervation (TMR) and advanced myoelectric prostheses are reshaping rehabilitation strategies, further underscoring the need for precise amputation planning. By integrating insights from both surgical and prosthetic perspectives, this review highlights the necessity of a multidisciplinary approach involving surgeons, prosthetists, rehabilitation specialists, and patients in the decision-making process. A greater emphasis on preoperative planning and interprofessional collaboration can improve prosthetic outcomes, reduce device rejection rates, and ultimately enhance the functional independence and well-being of individuals with upper extremity amputations. Full article

Background: Ischemic preconditioning (IPC) is a non-invasive, time-efficient strategy that has been shown to acutely enhance athletic performance. The present study examined the effects of 5 min of IPC on vertical and horizontal jump performance. A secondary aim was to explore the associations between outcomes of the 5-Hop (5-H) test and drop jump performance, in order to provide further evidence supporting the validity of the 5-H test for assessing reactive strength characteristics in trained jumpers. Methods: Twelve trained track and field jumpers (nine males, three females, age: 23.2 ± 2.9 years; height: 1.76 ± 0.07 m; body mass: 71.5 ± 8.0 kg) completed two conditions: an IPC condition applied to one leg and a control condition applied to the contralateral leg. In the first week, one leg was assigned to IPC and the other to the control condition, while in the second week, the conditions for each leg were reversed. Vertical single-leg performance was evaluated by drop jump (DJ) height, ground contact time, and reactive strength index (RSI). Horizontal jump performance was assessed by a five-hop (5-H) test during which total distance (TD), total time (TT), and reactive hopping index (RHI) were obtained. Results: Compared to the control condition, IPC enhanced DJ height (+ 3.6%) and RSI (+ 7.8%) (p < 0.05, g = 0.16 and 0.32, respectively) and reduced contact time (−4.4% p < 0.05, g = 0.41). Also, IPC resulted in significant improvements in TD (+ 4.1%) and RHI (+ 3.9%) during the 5-H test (p < 0.05, g = 0.32 and 0.42, respectively), while TT remained unchanged. Conclusions: A single cycle of IPC acutely improved vertical and horizontal jump performance and reactive strength indices in trained jumpers. These findings support the use of IPC as a practical, time-efficient method to enhance neuromuscular performance in explosive tasks. Full article

Background: Melasma is an acquired hyperpigmentation disorder with multifactorial etiologies and limited response to conventional therapies. Recent evidence suggests that Botulinum Toxin A (BoNT-A) may modulate ultraviolet (UV)-induced pigmentation and offer therapeutic benefits. Objective: We sought to evaluate the efficacy and safety of two intradermal dilutions of Letibotulinum toxin A (LetiBoNT-A) in Thai patients with melasma. Methods: In this randomized, double-blind, split-face study, 30 participants aged 32–62 years received a single intradermal injection of LetiBoNT-A, with 20 units administered per cheek. A 1:5 dilution was injected on one side of the face, and a 1:10 dilution was injected on the contralateral side. Outcomes were evaluated over a 6-month period using the Hemi-modified Melasma Area and Severity Index (Hemi-mMASI), VISIA^® brown spot analysis, and quantitative assessments of skin texture. Results: Both dilutions significantly improved Hemi-mMASI scores (1:5, p = 0.043; 1:10, p = 0.002) and brown spots (1:5, p = 0.002; 1:10, p < 0.001). The 1:10 dilution showed earlier and more sustained improvements. Subgroup analysis revealed greater reductions in Hemi-mMASI scores among patients with telangiectatic melasma, particularly with the 1:10 dilution, though they were not statistically significant. Additionally, the 1:10 dilution significantly reduced pore volume, pore area, and sebum levels. One case of transient facial asymmetry was reported with the 1:5 dilution. Conclusions: LetiBoNT-A is a safe and effective adjunct in melasma treatment. The 1:10 dilution offered superior clinical outcomes. Full article

Background/Objectives: Early and accurate prediction of stroke severity is crucial for optimizing guided therapeutic decisions and improving outcomes. This study investigates the predictive value of lesion size and functional connectivity for neurological deficits, assessed by the National Institutes of Health Stroke Scale (NIHSS score), in patients with acute or subacute subcortical ischemic stroke. Methods: Forty-four patients (mean age: 68.11 years, 23 male, and admission NIHSS score 4.30 points) underwent high-resolution anatomical and resting-state functional Magnetic Resonance Imaging (rs-fMRI) within seven days of stroke onset. Lesion size was volumetrically quantified, while functional connectivity within the motor, default mode, and frontoparietal networks was analyzed using seed-based correlation methods. Multiple linear regression and cross-validation were applied to develop predictive models for stroke severity. Results: Our results showed that lesion size explained 48% of the variance in NIHSS scores (R² = 0.48, cross-validated R² = 0.49). Functional connectivity metrics alone were less predictive but enhanced model performance when combined with lesion size (achieving an R² = 0.71, cross-validated R² = 0.73). Additionally, left hemisphere connectivity features were particularly informative, as models based on left-hemispheric connectivity outperformed those using right-hemispheric or bilateral predictors. This suggests that the inclusion of contralateral hemisphere data did not enhance, and in some configurations, slightly reduced, model performance—potentially due to lateralized functional organization and lesion distribution in our cohort. Conclusions: The findings highlight lesion size as a reliable early marker of stroke severity and underscore the complementary value of functional connectivity analysis. Integrating rs-fMRI into clinical stroke imaging protocols offers a potential approach for refining prognostic models. Future research efforts should prioritize establishing this approach in larger cohorts and analyzing additional biomarkers to improve predictive models, advancing personalized therapeutic strategies for stroke management. Full article

The research aims to compare the dynamic visual acuity (DVA) in myopic adults wearing spectacles prescribed to 0.05D and 0.25D steps. This double-blind, randomized, self-control study included 40 myopic participants aged 18–40. The participants were randomly assigned to receive spectacles with one 0.05D step lens and the contralateral lens of 0.25D step. The monocular horizontal and vertical motion DVA at 20 and 40 degrees per second (dps) was measured. The DVA was compared between eyes with 0.25D and 0.05D step lenses and further analyzed by eye dominance and test sequence. The result demonstrated no significant difference in DVA between two eyes with 0.25D or 0.05D step lenses at 20 and 40 dps horizontal and vertical motion test (p > 0.05, respectively). When the eye with a 0.25D step lens was the dominant eye (p = 0.004) or measured secondly (p = 0.002), it outperformed the contralateral eye with a 0.05D step lens in the 40 dps horizontal motion test. In conclusion, the horizontal and vertical motion DVA of the eye with 0.05D step lens spectacles was comparable to that of contralateral eyes corrected with 0.25D step lens. Full article