Search Results (45)

Background/Objectives: The stability of dual mobility (DM) total hip arthroplasty (THA) is often attributed to reduced impingement incidence and a superior range of motion (ROM) compared to the corresponding values when standard implants are used. However, few studies have directly explored this. Thus, the purpose of the present study was to compare the incidence of impingement and the range of motion between standard and DM acetabular cups, whose diameters are suited to the same patient anatomy. Methods: One standard and two DM implants were virtually implanted into a pelvis using a previously developed geometric model. Joint motions, which were representative of seven dislocation-prone activities of daily living (ADLs), as well as walking, were applied to each device type at a range of cup orientations (inclination/anteversion). Conclusions: There were no placement positions that avoided impingement across all seven ADLs, regardless of cup construct type. A similar impingement incidence and ROM were observed for standard and DM constructs, although the consequences of impingement are potentially more serious for DM devices (metal–metal contact) than for standard constructs (metal–polyethylene contact). This finding contradicts the common notion that DM-THAs have a reduced impingement incidence and superior ROM, instead suggesting that their stability may be attributed to alternative mechanisms, such as increased jump distance. Full article

Purpose: Image-guided radiotherapy (IGRT) has been widely implemented in the treatment of prostate cancer, offering a number of advantages regarding the precision of dose delivery. This study provides an overview of factors, clinical and physical alike, that increase treatment accuracy in prostate cancer radiotherapy in the context of IGRT. The following aspects are explored based on recent literature: the radiotherapy technique used in conjunction with IGRT, the type and frequency of IGRT, the impact of radiotherapy technique/IGRT on target dosimetry and organs at risk, the influence of IGRT on planning target volume margins, the impact of treatment time on dosimetric outcome and clinical outcomes using IGRT repositioning or an online adaptive plan. Methods: A systematic search of the literature was conducted within Pubmed/Medline databases to find relevant studies. Of the 152 articles fulfilling the initial search criteria, 79 were selected for final analysis. Results: The frequency of image guidance, the treatment regimen and the radiation technique are important factors that contribute to the optimization and personalization of the treatment plan. The daily anatomy and volume of the bladder and rectum can vary considerably, which can significantly impact the dosimetric effects on these organs. When used in conjunction with volumetric modulated arc therapy, IGRT allows for shaping the dose distribution to avoid nearby critical structures such as the bladder and rectum. Conclusions: Precise tumor targeting via IGRT can result in fewer geometric uncertainties, thereby improving treatment outcome both in terms of superior target coverage and sparing organs at risk. Full article

Background/Objectives: In short bowel syndrome adults (SBS), about 50% of patients on parenteral support (PS) are weaned off. However, micronutrient deficiency prevalence has never been studied in weaned patients. We aimed to assess the prevalence of micronutrient depletions and potential risk factors, more than a year after PS weaning. Methods: A retrospective study was conducted on our 161 weaned SBS patients between January 2011 and December 2021. Only 42 of them had an assessment of their plasma micronutrient status more than a year after PS weaning. Results: 40/42 patients had at least one micronutrient depletion, with an average of 4.0 ± 1.9 depletions per patient. Depletions in vitamins D, E, selenium, copper, and zinc were the most frequent, present for >50% of patients. In 75% of cases, patients depleted in vitamin B12 and D were already supplemented. Long-term proton pump inhibitor (PPI) use and duration on PS was associated with ≥ three depletions (p = 0.02). A daily mean of the total energy infused per week > 20 kcal/kg/day at the time of weaning was associated with more depletions (5.8 ± 1.6 vs. 3.7 ± 1.7 depletions, p = 0.02). Other factors (digestive anatomy, particularly SBS type, or associated chronic disease) were not predictive of depletion. Conclusions: Nearly all patients with SBS have at least one micronutrient depletion after PS withdrawal. This study suggests that a long-term monitoring of micronutrients status is needed for SBS patients weaned off PS. A larger-scale study would be necessary to generalize these results. Full article

The cerebellar peduncles (CPs) contain essential pathways connecting the cerebellum and other regions of the central nervous system, yet their role is often overlooked in daily medical practice. Individuals with the FMR1 premutation are at risk of developing fragile X-associated tremor/ataxia syndrome (FXTAS), a late-onset neurodegenerative disorder. The major clinical and radiological signs of FXTAS are cerebellar gait ataxia, intention tremor, and T2-weighted MRI hyperintensity of the middle cerebellar peduncle (MCP sign). Over the years, metabolic and structural abnormalities have also been described in the CPs of FMR1 premutation carriers, with some being associated with CGG repeat length and FMR1 mRNA levels. Evidence seems to associate the clinical disfunction observed in FXTAS with MCP abnormalities. However, other tracts within the different CPs may also contribute to the symptoms observed in FXTAS. By integrating imaging and pathological data, this review looks to enhance the understanding of the functional anatomy of the CPs and their involvement in different pathological entities, with special interest in premutation carriers and FXTAS. This review, therefore, aims to provide accessible knowledge on the subject of the CPs and their functional anatomy through detailed diagrams, offering a clearer understanding of their role in FMR1 premutation. Full article

Introduction: Women wear exterior breast support for most of the day. A female’s breast tissue and skin affect the comfort of the ADLs, exercise, health, and work environments. Understanding the breast tissue’s normal anatomy and mechanical and material properties is related to a woman’s daily health and quality of life outcomes. Considering the importance and impact of female breasts throughout one’s lifespan, additional research is needed to address the research gaps to provide solutions to improve daily lives and clinical interventions. Breast stability and behavior are dependent on its internal mechanical properties and applied external forces. Objective: To evaluate the current knowledge and research gaps on the adult female breast tissue’s anatomy, the factors that impact its growth and development, variations among racial populations, the internal and external mechanical properties of the tissue, and the factors employed to evaluate the pathology risk. Review sections: The review sections are as follows: 3. Anatomy of Breast, 4. Effects of Age and Stages of Breast Development, 5. Breast Skin, and 6. Breast Tissue Mechanics. Conclusions: Numerous research gaps have been identified within the field of female breasts. Full article

Avian diseases, especially coccidiosis, represent a significant threat to poultry production, demanding research into the use of herbal supplements in birds’ diets. So, the aim of this study was to assess the efficacy of selected herbal components in mitigating coccidiosis in broilers and to examine their overall impact on the productivity traits of broilers. A 35-day feeding trial was conducted with 1200 male ROSS 308 broiler chickens in two poultry facilities, one non-infected, using either usual coccidiostats (UC⁻) or 500 g/t herbal additive (consisting of Holarrhena antidysenterica, Ficus religiosa, Berberis aristata, Allium sativum, Embelia ribes, and Azadirachta indica; HA⁻) and the other intentionally exposed to Eimeria via drinking water at 7 days old, with corresponding control and experimental groups (UC⁺ and HA⁺). Dietary interventions significantly influenced broiler chicken body weight (BW) and average daily gain (ADG) throughout the trial, notably on day 21, with UC⁺ treatment yielding the highest values. Herbal supplements did not affect the feed conversion ratio (FCR) or liveability. Under infection, litter dry matter (DM) content differences were notable on days 14 and 21, favouring herbal additive treatments (HA⁻ and HA⁺). Herbal supplements also impacted Eimeria presence in the duodenum and jejunum on day 21, with notable differences between treatments. Despite several limitations, the study reveals that herbal additions may effectively manage Eimeria infection and enhance litter quality in broiler production, since control treatments demonstrated improved development and anatomy. Full article

The rhesus monkey (Macaca mulatta) is a non-human primate with a genome that is 93.5% identical to that of humans. Both species, therefore, have numerous phenotypical similarities in common. Consequently, this non-human primate is regularly studied in biomedical research. Not only does the rhesus monkey play an important role as an animal model for studying human disease, but it is also often featured in zoos, and there are substantial feral populations that live in Asia. Since they are exploited as research subjects, their appropriate housing and husbandry and the validation of obtained research data benefit from the comprehension of the rhesus monkey anatomy. Unexpectedly, the number of anatomical documents on the rhesus monkey are largely outnumbered by publications on the anatomy of domestic animals. In addition, the limited number of available anatomical books and atlases are, unfortunately, outdated, e.g., by presenting black-and-white photographs and using archaic nomenclature, or failing to cover the in-depth anatomy of various anatomical systems. Since state-of-the-art data on the rhesus monkey anatomy are requested by biomedical researchers and veterinarians responsible for the daily care of these captive animals, the present study describes the musculature of the foot of the rhesus monkey. It builds on a recently published manuscript on the topographical anatomy of the pelvic limb of this non-human primate. Full-color anatomical (stereomicroscopic) photographs are taken during layer-by-layer dissections of the feet of three rhesus monkeys. All the muscles, from the superficial to the deepest layer, are described using veterinary anatomical nomenclature and annotated on multipaneled figures. Although the foot musculature of the rhesus monkey largely parallels that of its human counterparts, the small number of dissimilarities should be recognized when extrapolating these research data. In addition, a solid understanding of the rhesus monkey anatomy by veterinarians can be valuable during medical interventions, such as surgery for foot injuries. Full article

Soft pneumatic actuators/robotics have received significant interest in the medical and health fields, due to their intrinsic elasticity and simple control strategies for enabling desired interactions. However, current soft hand pneumatic exoskeletons often exhibit uniform deformation, mismatch the profile of the interacting objects, and seldom quantify the assistive effects during activities of daily life (ADL), such as extension angle and predicted joint stiffness. The lack of quantification poses challenges to the effective and sustainable advancement of rehabilitation technology. This paper introduces the design, modeling, and testing of pneumatic bioinspired segmented composite proprioceptive bending actuators (SCPBAs) for hand rehabilitation in ADL tasks. Inspired by human finger anatomy, the actuator’s soft-joint–rigid-bone segmented structure provides a superior fit compared to continuous structures in traditional fiber-reinforced actuators (FRAs). A quasi-static model is established to predict the bending angles based on geometric parameters. Quantitative evaluations of predicted joint stiffness and extension angle utilizing proprioceptive bending are performed. Additionally, a soft under-actuated hand exoskeleton equipped with SCPBAs demonstrates their potential in ADL rehabilitation scenarios. Full article

Device-assisted left atrial appendage exclusion plays a crucial role in the prevention of fatal ischemic complications in patients with atrial fibrillation and contraindications to anticoagulation treatment. Various devices with different safety profiles and device-related complications are available in daily practice to perform this procedure. In this review, the anatomy, physiology, and functions of the left atrial appendage were detailed, and all available devices used for epicardial and endocardial exclusion of the left atrial appendage and their clinical outcomes were discussed. Future research should aim to further investigate the long-term effects of left atrial appendage exclusion on body homeostasis, blood coagulation, and cardiac function. Full article

Background and Objectives: The Fontan procedure, a palliative surgery for univentricular heart physiology, often reduces exercise capacity and quality of life. This study aimed to evaluate the impact of cardiac rehabilitation (CR) on improving outcomes in Fontan patients to inform evidence-based care. Materials and Methods: Fontan patients aged 8–30 participated in a structured CR program for at least three months. The program included weekly aerobic and resistance training sessions with educational and nutritional guidance. Baseline and post-CR assessments included cardiac function, fitness, daily activity, and health-related quality of life (HRQOL). Results: The cohort included ten Fontan patients, of whom six had a right systemic ventricle. CR significantly improved cardiorespiratory fitness, as seen in VO2 max (from 27.92 ± 5.15 to 34.69 ± 1.14 mL/kg/min, p = 0.0089) and percent predicted VO2 (from 0.67 ± 0.18 to 0.90 ± 0.02, p = 0.005). VCO2 increased by +8.68 ± 8.59 mL/kg/min but did not reach statistical significance (p = 0.05). Most haemodynamic and ventilatory parameters showed no significant improvement. All the SF-36 questionnaire domains showed significant HRQOL gains (p < 0.001). High adherence (85–93%), no adverse events, and reduced NT-proBNP levels supported the program’s safety. Conclusions: This study’s findings have important implications for the care of Fontan patients. CR significantly improved exercise capacity and HRQOL in Fontan patients across various anatomies, particularly in the right systemic ventricle. Integrating physical conditioning into standard care could reduce long-term morbidity and mortality; however, further research is needed to refine the protocols and confirm sustained benefits. Full article

The spine community is continuously adding to its armamentarium of intraoperative techniques for visualization and instrumentation of the spine. Recently, three-dimensional printed spine models were introduced for use in preoperative planning, surgical simulation, and intraoperative guidance. We present a 14-year old African male with congenital kyphoscoliosis, small stature, an obvious gibbus deformity and coronal imbalance, who underwent a three-staged posterior surgical correction procedure, during which a 3D-printed spine biomodel was utilized for better appreciation of his complex spinal deformity patho-anatomy. During the first stage of the procedure, he developed diminished lower extremity motor strength bilaterally and bowel/bladder control, but, following his third stage procedure and with focused rehabilitation efforts, he has regained full control of his bowel and bladder function, and is able to ambulate and perform activities of daily living independently, albeit still requiring intermittent walking support with a single forearm crutch due to residual left leg weakness. The 3D spine biomodel functioned successfully as a valuable tool and surrogate anatomic blueprint for the surgeons, enabling adequate appreciation of the complex bony anatomy which could not be easily resolved on the conventionally available imaging modalities, intraoperative navigation or robotic platform. Theoretically, up to $2900 USD in savings, translated from the mean estimated time saved per procedure with the use 3D-printed spine models has been proposed in some studies. Therefore, 3D-printed spine models have utility in complex spinal deformity correction surgery. Full article

Pediatric elbow fractures and dislocations have always been a challenge from a diagnostic and therapeutic point of view, primarily due to the complex nature of the pediatric elbow, especially its developmental anatomy. They must be diagnosed and treated on time to prevent numerous complications with long-term consequences. With the development of radiology and pediatric surgery and orthopedics, as well as the development of modern osteosynthesis materials, concerning current scientific and professional knowledge, the outcomes are getting better, with fewer acute and chronic complications. This comprehensive review aims to provide clinicians current knowledge about pediatric elbow fractures and dislocations so that in daily practice they have as few doubts as possible with the best possible treatment outcomes. Full article

Auditory impairment stands as a pervasive global issue, exerting significant effects on individuals’ daily functioning and interpersonal engagements. Cochlear implants (CIs) have risen as a cutting-edge solution for severe to profound hearing loss, directly stimulating the auditory nerve with electrical signals. The success of CI procedures hinges on precise pre-operative planning and post-operative evaluation, highlighting the significance of advanced three-dimensional (3D) inner ear reconstruction software. Accurate pre-operative imaging is vital for identifying anatomical landmarks and assessing cochlear deformities. Tools like 3D Slicer, Amira and OTOPLAN provide detailed depictions of cochlear anatomy, aiding surgeons in simulating implantation scenarios and refining surgical approaches. Post-operative scans play a crucial role in detecting complications and ensuring CI longevity. Despite technological advancements, challenges such as standardization and optimization persist. This review explores the role of 3D inner ear reconstruction software in patient selection, surgical planning, and post-operative assessment, tracing its evolution and emphasizing features like image segmentation and virtual simulation. It addresses software limitations and proposes solutions, advocating for their integration into clinical practice. Ultimately, this review underscores the impact of 3D inner ear reconstruction software on cochlear implantation, connecting innovation with precision medicine. Full article

Loss of hand functions, often manifesting in the form of weakness or spasticity from conditions like stroke or multiple sclerosis, poses challenges in performing activities of daily living (ADLs). The broad area of rehabilitation robotics provides the tools and knowledge necessary for implementing efficient restorative therapies. These therapies aim to improve hand functionality with minimal therapist intervention. However, the human hand evolved for various precision and power gripping tasks, with its intricate anatomy featuring a large number of degrees of freedom—up to 31—which hinder its modeling in many rehabilitation scenarios. In the process of designing prosthetic devices, instrumented gloves, and rehabilitation devices, there is a clear need to obtain simplified rehabilitation-oriented hand models without compromising their representativeness across the population. This is where the concept of kinematic reduction, focusing on specific grasps, becomes essential. Thus, the objective of this study is to uncover the intra-finger dependencies during finger flexion/extension by analyzing a comprehensive database containing recorded trajectories for 23 different functional movements related to ADLs, involving 77 test subjects. The initial phase involves data wrangling, followed by correlation analysis aimed at selecting 116 dependency-movement relationships across all grasps. A regularized generalized linear model is then applied to select uncorrelated predictors, while a linear mixed-effect model, with reductions based on both predictor significance and effect size, is used for modeling the dependencies. As a final step, agglomerative clustering of models is performed to further facilitate flexibility in tradeoffs in hand model accuracy/reduction, allowing the modeling of finger flexion extensions using 5–15 degrees of freedom only. Full article

With the rapid increase in computer processing capacity over the past two decades, machine learning techniques have been applied in many sectors of daily life. Machine learning in therapeutic settings is also gaining popularity. We analysed current studies on machine learning in robotic urologic surgery. We searched PubMed/Medline and Google Scholar up to December 2023. Search terms included “urologic surgery”, “artificial intelligence”, “machine learning”, “neural network”, “automation”, and “robotic surgery”. Automatic preoperative imaging, intraoperative anatomy matching, and bleeding prediction has been a major focus. Early artificial intelligence (AI) therapeutic outcomes are promising. Robot-assisted surgery provides precise telemetry data and a cutting-edge viewing console to analyse and improve AI integration in surgery. Machine learning enhances surgical skill feedback, procedure effectiveness, surgical guidance, and postoperative prediction. Tension-sensors on robotic arms and augmented reality can improve surgery. This provides real-time organ motion monitoring, improving precision and accuracy. As datasets develop and electronic health records are used more and more, these technologies will become more effective and useful. AI in robotic surgery is intended to improve surgical training and experience. Both seek precision to improve surgical care. AI in ‘’master–slave’’ robotic surgery offers the detailed, step-by-step examination of autonomous robotic treatments. Full article