Search Results (49)

Background/Objectives: This study aimed to assess the potential of sternal morphometric parameters derived from multidetector computed tomography (MDCT) for sex estimation in a contemporary Greek population. A secondary objective was to develop and evaluate statistical and machine learning models based on these measurements for forensic identification. Methods: Sternal measurements were obtained from chest MDCT scans of 100 Greek adults (50 males, 50 females). Morphometric variables included total sternum length, surface area, angle, and index (SL, SSA, SA, and SI); manubrium length, width, thickness, and index (MBL, MBW, MBT, and MBI); sternal body length, width, thickness, and index (SBL, SBW, SBT, and SBI); and xiphoid process length and thickness (XPL and XPT). Logistic regression and a Random Forest classifier were applied to assess the predictive accuracy of these parameters. Results: Both models showed high classification performance. Logistic regression identified MBL and SBL as the most predictive variables, yielding 91% overall accuracy, with 92% sensitivity and 90% specificity. The Random Forest model achieved comparable results (91% accuracy, 88% sensitivity, 93% specificity), ranking SSA as the most influential feature. Conclusions: MDCT-derived sternal morphometry provides a reliable, non-invasive method for sex estimation. Parameters such as MBL, SBL, and SSA demonstrate strong discriminatory power and support the development of population-specific standards for forensic applications. Full article

Peripheral nerve injuries represent a significant challenge in legal medicine, and their proper management and evaluation are at the intersection of clinical medicine, anatomical science, and legal medicine. In this review, we aimed to integrate current knowledge about the anatomy, physiology, clinical management, and paraclinical assessment of peripheral nerve injuries, targeted explicitly for medical–legal practice. We conducted a comprehensive review of the medical–legal evaluation framework needed to evaluate peripheral nerve injuries, with particular emphasis on anatomical variations, imaging techniques, and methods to assess the timing of injury. Peripheral nerve injuries should be analyzed using a complex approach, which includes anatomical characteristics, variants, microanatomy, physiopathology, imaging, and other paraclinical evaluations. The analysis of causation and timing of injury should be heavily based on objective criteria and should be performed using a reproducible, objective, and scientifically based approach. Full article

It has been demonstrated that S100B actively participates in neuroinflammatory processes of different diseases of the central nervous system (CNS), such as experimental autoimmune encephalomyelitis (EAE), a recognized animal model for multiple sclerosis (MS). The inhibition of S100B activity using pentamidine and of S100B synthesis using arundic acid are able to determine an amelioration of the clinical and pathologic parameters of MS with milder and delayed symptoms. This study further goes in detail on the role of S100B, and in particular of astrocytic S100B, in these neuroinflammatory processes. To this aim, we used a model of S100B knockout (KO) mice. As expected, S100B protein levels were significantly reduced in the S100B KO mouse strain resulting in an amelioration of clinical and pathological parameters (clinical and morphological analyses). To dissect the potential mechanisms that could explain the role of S100B in the development of EAE, we sorted, cultured, and compared glial subpopulations (astrocytes, oligodendrocytes, and microglia) derived from S100B KO and wild type mice, through flow cytometric panels and ELISA. Glial cells were analyzed for proinflammatory molecules showing a significant reduction of TNFα protein in mice where S100B was silenced. To dissect the role of S100B in MS, we cultured astrocytes and microglial cells magnetically sorted and enriched from the brains of EAE-affected animals, both from KO and wild type animals. Both genetic silencing of S100B and pharmacological inhibition with S100B-targeting compounds demonstrated a direct impact on specific subpopulations of astrocytes (mainly), oligodendrocytes, and microglia. The present results further individuate astrocytic S100B as a key factor and as a potential therapeutic target for EAE neuroinflammatory processes. Full article

The zygomatic major and zygomatic minor muscles play a central role in facial expression, particularly in generating the smile, one of the most essential forms of human nonverbal communication. While their function is widely recognized, the anatomical variability in these muscles remains underexplored in both clinical and surgical settings. This review provides a comprehensive, interdisciplinary analysis of the zygomaticus musculature, integrating classical anatomical insights with recent advances in imaging, developmental biology, and artificial intelligence-based analysis. By examining data from cadaveric dissection, MRI, ultrasonography, and 3D photogrammetry, we identify key morphological differences with potential clinical relevance. A novel five-type morphological classification is proposed, based on differences in the number of muscle bellies (i.e., belly number), accessory structures, insertion patterns, and population-based variation. This classification aims to offer a more functionally relevant and clinically applicable framework for use in facial surgery, aesthetic procedures, and forensic reconstruction. By moving beyond the simplistic binary categorizations that have historically defined zygomaticus morphology, this review highlights the need for a personalized approach to facial anatomy, tailored to individual morphological variation. The proposed framework may assist in refining surgical planning, improving outcomes in facial reanimation, and enhancing diagnostic accuracy in both radiological assessment and preoperative planning. By moving beyond traditional binary categorizations, this review highlights the need for a personalized approach to facial anatomy, tailored to individual morphological variations. The proposed framework may assist in refining surgical planning, improving outcomes in facial reanimation, and advancing diagnostic precision in facial imaging. A total of 75 peer-reviewed articles were selected based on a targeted search in PubMed, Scopus, and Web of Science (1995–2024). Full article

Background: Sex estimation has been extensively investigated due to its importance for forensic science. Several anatomical structures of the human body have been used for this process. The human skull has important landmarks that can serve as reliable sex estimation predictors. Methods: In this study, orbital measurements from 92 dried skulls, comprising 35 males and 57 females, were utilized to develop a machine-learning-based classifier for sex estimation with potential applications in forensic science. The parameters evaluated included optic foramen height (OFH), optic foramen width (OFW), optic canal height (OCH), optic canal width (OCW), intraorbital distance (IOD), extraorbital distance (EOD), orbit height (OH), and orbit width (OW). Results: A Random Forest classifier was employed to analyze the data, achieving an overall test accuracy of 0.68. The model demonstrated a precision of 0.65, indicating a moderate level of false positives. The recall was 0.70, reflecting that 70% of the positive cases were correctly identified. The F1 score was calculated at 0.675, suggesting a balanced performance between precision and recall. The area under the curve (ROC AUC) score was also 0.72, indicating that the model can distinguish between classes. The most important features in the best subset were OW (0.2429), IOD (0.2059), EOD (0.1927), OFH (0.1798), and OFW (0.1787), highlighting their significant contributions to the model’s predictions. Conclusions: These findings suggest that orbital measurements could potentially serve as reliable predictors for automated sex estimation, contributing to advancements in forensic identification techniques Full article

Vulvovaginal candidiasis (VVC) is a prevalent women’s infection characterized by excessive inflammation and damage of the vaginal epithelium that, in its recurrent form (RVVC), causes more than three symptomatic episodes per year, impacting nearly 8% of women globally. Current antifungal treatments alleviate symptoms but often fail to restore the inflammatory homeostasis of mucosal tissue and prevent recurrences. α-Tocopherol (α-TOH) and garcinoic acid (GA), a vitamin E metabolite, with immunomodulatory properties, were investigated for the first time in vaginal epithelial cells exposed to C. albicans infection to assess their effects on inflammatory signaling parameters important to restore cellular homeostasis. For this purpose, the protein kinases MKK3/6, p38 stress kinase (SAPK), and ERK1/2 were studied together with c-Fos transcription factor and IL-6, IL-1α, and IL-1β secretion in A-431 vaginal epithelial cells pre-treated with GA or with α-TOH and then infected with C. albicans. GA, differently from α-TOH, significantly reduced the C. albicans-induced activation of p38-SAPK while increasing pro-survival MAPK ERK1/2 activity. This resulted in a significant reduction in the secretion levels of the inflammatory cytokines IL-6 and IL-1α, as well as IL-1β. Overall, our data indicate that GA holds potential for restoring the immuno-metabolic properties of the vaginal epithelium exposed to C. albicans infection, which may help to treat inflammatory symptoms in VVC/RVVC. Full article

Craniofacial development is a critical aspect of pediatric growth, influencing fields such as physical anthropology, pediatrics, forensic sciences, and clinical practice. Objectives: This study aimed to assess the trends in craniofacial measurements and indices in Latvian children aged 1–15. Methods: The anthropometrical measurements (head circumference, length, width, facial length, and width) were conducted on 375 children according to the guidelines by R. Martin, K. Saller, and J. Prīmanis at the Anthropology laboratory at the Institute of Anatomy and Anthropology, Rīga Stradiņš University. The cephalic index (CI) and the facial or prosopic index (PI) were calculated, allowing for a detailed examination of cranial and facial proportions. The data were analyzed using descriptive and inferential statistics, including the Pearson Chi-square test and the Spearman correlation coefficient. Results: The findings revealed a consistent increase in head circumference with age, with boys generally having slightly larger heads than girls. The boys and girls exhibited growth in head length and width, particularly noticeable between 1 and 2 years of age. Facial length and width increased with age, with boys typically having longer facial lengths and broader faces than girls. The most common cephalic index category is mesocephaly, which accounts for 52.85% of the population, followed by dolichocephaly at 32.94%. Brachycephaly and hyperbrachycephaly are less prevalent, representing 11.36% and 2.86% of the population. Regarding the facial index categories, hypereuryprosopic is the most prevalent, representing 45.54% of the population, closely followed by euryprosopic at 43.74%. Mesoprosopic is significantly less common, representing only 9.95%. The least common categories are leptoprosopic and hyperleptoprosopic, with prevalences of 0.64% and 0.12%, respectively. The indices analysis showed variations across age groups, with dolichocephaly being more common at younger ages and decreasing over time. Brachycephaly and hyperbrachycephaly remained relatively stable or decreased slightly with age, while mesocephaly displayed less variation. The relationship between the FI and CI in younger age groups was typically weak to moderate and inverse, with a significance level of p < 0.001 or p < 0.01. However, no meaningful correlation was observed in older children aged 14–15. Conclusions: This study provides valuable insights into the craniofacial development of Latvian children, highlighting the measurements, cranial and facial types, and their variations across age groups. Full article

Background/Objectives: Nasal morphology is a significant aspect of facial anatomy and is often used for forensic identification and aesthetic surgery. This study aims to compare nasal dimensions based on sex, facial index (FI), and nasal index (NI) using cone-beam computed tomography (CBCT) and 3D modeling. Methods: To observe differences in nasal dimensions by sex and analyze the relationships between facial shapes (FI) and nasal forms (NI), a total of 100 participants (50 males, 50 females) in their 20s were selected from Dankook University Dental Hospital. CBCT scans were performed, and 3D models were created using Mimics software (version 22.0). The measurement items included the alaria distance between (AL), the distance between N (nasion) and SN (subnasale), the distance between N (nasion) and PRN (pronasale), and the distance between SN (subnasale) and PRN (pronasale). A T-test was used for the sex-based analysis of the nasal dimensions, and the facial index- and nasal index-based nasal dimensions were analyzed using a one-way ANOVA with Scherffe’s post hoc test. Additionally, all the statistical analyses were performed using SPSS software (version 23.0). Results: The results indicated that males generally have larger nasal dimensions than females. Additionally, the mesoprosopic facial type (round face) showed the largest nasal dimensions in the FI classification, while the platyrrhine nasal type (broad and short nose) exhibited the largest dimensions in the NI classification. Conclusions: This study demonstrates that the nasal size varies significantly with sex, facial shape, and nasal form. The findings can contribute to forensic identification and provide valuable data for clinical practices in facial reconstruction and nasal surgery. Full article

A few cases of multiple sclerosis (MS) onset after COVID-19 vaccination have been reported, although the evidence is insufficient to establish causality. The aim of this study is to compare cases of newly diagnosed relapsing–remitting MS before and after the outbreak of the COVID-19 pandemic and the impact of COVID-19 vaccination. Potential environmental and genetic predisposing factors were also investigated, as well as clinical patterns. This is a single-centre retrospective cohort study including all patients who presented with relapsing–remitting MS onset between January 2018 and July 2022. Data on COVID-19 vaccination administration, dose, and type were collected. HLA-DRB1 genotyping was performed in three subgroups. A total of 266 patients received a new diagnosis of relapsing–remitting MS in our centre, 143 before the COVID-19 pandemic (until and including March 2020), and 123 during the COVID-19 era (from April 2020). The mean number of new MS onset cases per year was not different before and during the COVID-19 era and neither were baseline patients’ characteristics, type of onset, clinical recovery, or radiological patterns. Fourteen (11.4%) patients who subsequently received a new diagnosis of MS had a history of COVID-19 vaccination within one month before symptoms onset. Patients’ characteristics, type of onset, clinical recovery, and radiological patterns did not differ from those of patients with non-vaccine-related new diagnoses of MS. The allele frequencies of HLA-DRB1*15 were 17.6% and 22.2% in patients with non-vaccine-related disease onset before and during the COVID-19 era, respectively, while no case of HLA-DRB1*15 was identified among patients with a new diagnosis of MS post-COVID-19 vaccine. In contrast, HLA-DRB1*08+ or HLA-DRB1*10+ MS patients were present only in this subgroup. Although a causal link between COVID-19 vaccination and relapsing–remitting MS cannot be detected, it is interesting to note and speculate about the peculiarities and heterogeneities underlying disease mechanisms of MS, where the interactions of genetics and the environment could be crucial also for the follow-up and the evaluation of therapeutic options. Full article

The dental pulp chamber volume is a fundamental measurement in the field of endodontics, but also in forensic sciences, teaching and training, or tissue engineering. This study evaluates the precision of cone-beam computed tomography (CBCT) in comparison with computed micro-tomography (micro-CT) in evaluating the pulp chamber volume of the upper central incisors ex vivo. The intra-operator and inter-operator errors were evaluated, and the results for the two techniques were compared with those of a T-test for paired samples. The intra-operator and inter-operator errors were >0.05, indicating adequate reproducibility in each operator and no significant differences between their measurements. On the other hand, no significant differences between the two measurement techniques were found. The present results demonstrate that CBCT is a precise, feasible, and reproducible technique for the evaluation of the dental pulp chamber volume ex vivo. The results provided with this method are useful for different medical domains but also for the teaching and training of undergraduate and postgraduate students. Furthermore, the findings of this study carry significant clinical implications, as the accurate assessment of the pulp chamber volume is critical in the diagnosis and treatment of various endodontic conditions. The ability of CBCT to provide reliable 3D dental anatomy measurements can enhance the planning of endodontic treatments by allowing for a better understanding of the internal tooth morphology. Additionally, the precision and reproducibility of CBCT in assessing the pulp chamber volume can contribute to improved clinical outcomes and reduced complications during endodontic procedures. These findings further support the increasingly vital role of CBCT in modern clinical practice and underscore its value as an indispensable tool in the field of dentistry. Full article

Third molar extraction is the most common procedure in oral and maxillofacial surgery. Third molars are considered less functional than other teeth and are often extracted. Sometimes, they are also used for auto-transplantation for the benefit of oral rehabilitation. Since many biological factors are involved in this surgical approach, herein, we outline a review of the biological characteristics of medico-legal/forensic interest, in addition to presenting a successful clinical case. A scoping review of currently available research data (following the principles of PRISMA-ScR or the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) on third molar auto-transplantation was conducted by drawing upon the main databases (Scopus, PubMed, Google Scholar and LILACS) to evaluate biological and clinical characteristics possibly relatable to forensic issues. All the collected data were summarized and elaborated on for the purpose of this article. A patient underwent extraction of the right upper first molar and auto-transplantation of the unerupted ipsilateral third molar. Many biologic and clinical factors are involved in the success of this clinical procedure. Knowledge of third molar anatomy, of its development and viable surgical approaches are all essential elements; just as important are the treatment of the tooth before and after transplantation and the integrity of the periodontal ligament. Follow-up of the clinical case for 5 years made it possible to verify the stability of the procedure over time. Third molar auto-transplantation is feasible and cost-effective. However, the use of third molars as donor teeth in auto-transplantation may have medico-legal implications. The lack of official protocols and consistent evidence-based guidelines for operators still prevent such a procedure from becoming mainstream; therefore, it is viewed with suspicion by clinicians and patients, even though the biological factors herein detected point to a reasonably high degree of safety. The understanding of many specific biological and clinical factors involved in the stability of third molar auto-transplantation allows for a thorough understanding of the forensic implications relevant to clinical practice. Effective communication and information provision are therefore of utmost importance, in the interest of both patients and doctors. Full article

The S100B protein is abundant in the nervous system, mainly in astrocytes, and is also present in other districts. Among these, the adipose tissue is a site of concentration for the protein. In the light of consistent research showing some associations between S100B and adipose tissue in the context of obesity, metabolic disorders, and diabetes, this review tunes the possible role of S100B in the pathogenic processes of these disorders, which are known to involve the adipose tissue. The reported data suggest a role for adipose S100B in obesity/diabetes processes, thus putatively re-proposing the role played by astrocytic S100B in neuroinflammatory/neurodegenerative processes. Full article

Nerve growth factor (NGF) signalling affects spermatogenesis and mature sperm traits. In this paper, we aimed to evaluate the distribution and the role of NGF and its receptors (p75^NTR and TrKA) on the reproductive apparatus (testis and epididymis) and sperm of fertile men (F) and men with different pathologies, namely varicocele (V) and urogenital infections (UGIs). We collected semen samples from 21 individuals (31–40 years old) subdivided as follows: V (n = 7), UGIs (n = 7), and F (n = 7). We submitted the semen samples to bacteriological analysis, leucocyte identification, and analysis of sperm parameters (concentration, motility, morphology, and viability). We determined the seminal plasma levels of NGF, interleukin 1β (IL-1β), and F₂-isoprostanes (F₂-IsoPs), and the gene and protein expression of NGF receptors on sperm. We also used immunofluorescence to examine NGF receptors on ejaculated sperm, testis, and epididymis. As expected, fertile men showed better sperm parameters as well as lower levels of NGF, F_2-IsoPs, and IL-1β compared with men with infertility. Notably, in normal sperm, p75^NTR and TrKA were localised throughout the entire tail. TrKA was also found in the post-acrosomal sheath. This localisation appeared different in patients with infertility: in particular, there was a strong p75^NTR signal in the midpiece and the cytoplasmic residue or coiled tails of altered ejaculated sperm. In line with these findings, NGF receptors were intensely expressed in the epididymis and interstitial tissue of the testis. These data suggest the distinctive involvement of NGF and its receptors in the physiology of sperm from fertile men and men with infertility, indicating a possible role for new targeted treatment strategies. Full article

Hypertrophic scars (HTSs) are pathological structures resulting from chronic inflammation during the wound healing process, particularly in complex injuries like burns. The aim of this work is to propose Biofiber PF (biodegradable fiber loaded with Pirfenidone 1.5 w/w), an electrospun advanced dressing, as a solution for HTSs treatment in complex wounds. Biofiber has a 3-day antifibrotic action to modulate the fibrotic process and enhance physiological healing. Its electrospun structure consists of regular well-interconnected Poly-L-lactide-co-poly-ε-caprolactone (PLA-PCL) fibers (size 2.83 ± 0.46 µm) loaded with Pirfenidone (PF, 1.5% w/w), an antifibrotic agent. The textured matrix promotes the exudate balance through mild hydrophobic wettability behavior (109.3 ± 2.3°), and an appropriate equilibrium between the absorbency % (610.2 ± 171.54%) and the moisture vapor transmission rate (0.027 ± 0.036 g/min). Through its finer mechanical properties, Biofiber PF is conformable to the wound area, promoting movement and tissue oxygenation. These features also enhance the excellent elongation (>500%) and tenacity, both in dry and wet conditions. The ancillary antifibrotic action of PF on hypertrophic scar fibroblast (HSF) for 3 days downregulates the cell proliferation over time and modulates the gene expression of transforming growth factor β1 (TGF-β1) and α-smooth muscle actin (α-SMA) at 48–72 h. After 6 days of treatment, a decrement of α-SMA protein levels was detected, proving the potential of biofiber as a valid therapeutic treatment for HTSs in an established wound healing process. Full article

Untreated early childhood caries (ECC) is a global public health concern. In the short term, untreated ECC can lead to pain, infection, and disrupted sleep, among other issues. In the long term, it is associated with poor oral health in later life, increased risk of caries in permanent teeth, and adverse effects on physical and psychological development. There may be a link between untreated ECC and adverse cognitive and neurodevelopmental outcomes in young children, although the exact pathways are not fully understood. One possible pathway is through the relationship between mastication and brain stimulation. Impaired masticatory function due to ECC can affect the hippocampus, a key region responsible for memory and learning. Furthermore, untreated ECC can cause chronic inflammation, leading to the release of pro-inflammatory cytokines that may damage the brain. Sleep disturbances resulting from ECC-related pain and discomfort can also impact brain development and cognitive functioning. Additionally, frequent use of antibiotics and analgesics to address ECC-related infections can disrupt the gut microbiome, potentially affecting the brain through the gut–brain axis. Untreated ECC can cause nutritional deficiencies and elevated nutritional risk, and can further hinder brain development. Addressing ECC comprehensively with early childhood health initiatives can help mitigate potential long-term consequences and promote optimal brain development in young children. Full article