Search Results (405)

In veterinary education, many exercises are performed on animals. Palpating the mucosa of the Ruminoreticulum in ruminants is a necessary preparatory exercise for future surgery. However, there are legal and ethical obligations to reduce the use of animals and improve animal welfare. This can be achieved using 3D models and simulators. To allow students to practice palpating the goat’s forestomach, a simulator is being developed. The aim of the present study was to produce replicas of the mucosal surface of the Ruminoreticulum for the inner lining of this simulator. Two methods were applied and compared: 3D printing and surface casting. For 3D printing, computed tomography-based virtual templates were created and printed after appropriate post-processing. For the surface cast, a negative mold of the mucosal surfaces was created using epoxy resin. The positive mucosal cast was then created using silicone. The results showed a clear advantage of surface casting compared to 3D printing. The virtual templates and 3D prints lacked fine anatomical structures. In contrast, the surface casting method yielded detailed replicas of the mucosal surfaces of Rumen and Reticulum, including even finer anatomical structures. Since the silicone casts also allowed for haptic differentiation of mucosal formations, they can be considered a suitable inner lining for the planned simulator. Full article

Background/Objectives: Several methods have been proposed to assess lower limb-length discrepancies; however, none have demonstrated sufficient reliability and validity for diagnosing anatomical discrepancies (DA). Objectives: This study primarily aims to evaluate the accuracy of two traditional tests—the Modified Iliac Crests Palpation and Pelvimeter with Blocks test (ICPBL) and plantar pressure analysis—by comparing them with the gold standard telemetry (TE) method for diagnosing DA. The secondary objective is to assess the intra-rater reliability of these two tests and determine their potential applicability in clinical settings. Methods: Thirty subjects between the ages of 20 and 80 were enrolled in the present prospective, cross-sectional diagnostic accuracy pilot study; thirteen with a positive TE for DA of more than 3 mm were classified into the group with the condition DA, and 17 were classified into the group without the condition DA. Pelvic tilting and plantar pressures were evaluated. Results: The TE revealed a difference of 8.09 ± 3.24 mm between the short and long limbs, while subjects without DA had only a 0.41 mm difference (p < 0.001). Similarly, the Modified ICPBL test showed a 4.38 ± 2.10 mm difference in subjects with DA, compared to 0.51 ± 0.53 mm in those without DA (p < 0.001). Additionally, plantar pressure measurements supported these findings, with a difference of 5.17 ± 3.28 kg/cm² between the short and long limbs in subjects with DA, versus 2.28 ± 1.77 kg/cm² in subjects without DA (p < 0.05). The area under the receiver operating characteristic (ROC) curve was 0.783 (95% CI: 0.456–0.877) for plantar pressures and 1.000 (95% CI: 0.742–0.942) for the Modified ICPBL test. Conclusions: The Modified ICPBL and plantar pressure tests demonstrated high diagnostic accuracy within the sample studied, suggesting they are useful tools for supporting the diagnosis of DA. In this pilot study, the Modified ICPBL showed very high discriminative ability, while plantar pressure testing demonstrated moderate sensitivity. Both methods may serve as preliminary practical alternatives to telemetry TE, potentially reducing X-ray exposure; however, these results should be interpreted with caution due to the limited sample size and the specific clinical setting of this study. Full article

Background and Clinical Significance: This case report describes an unusual complication in an 8-year-old female patient undergoing ME (maxillary expansion) with a tooth-supported maxillary expander with the hyrax screw. Case presentation: After the 36th screw turn in the 5th week of treatment, the patient reported pressure and pain symptoms and the patient’s parents observed a bone elevation at the bridge of the nose. The patient was referred to for clinical examination which revealed a bilateral infraorbital hematoma and a movable, and highly sensitive, nasal area upon palpation. A cone-beam computed tomography (CBCT) scan confirmed a displaced nasal bone fracture. Conservative treatment was immediately initiated by reversing the hyrax screw four times, followed by ten additional turns over the next 7 days for a total of 14 back-turns. This procedure led to an immediate improvement in symptoms. An 8-week follow-up CBCT confirmed the physiological repositioning of the nasal bones and healing of the fracture. Conclusions: Although nasal bone fracture is a rare complication of ME, particularly in children, clinicians should be aware of this potential risk and remain vigilant for symptoms of high pressure and pain in the orbito-nasal area. If a nasal fracture is suspected during orthodontic treatment, the orthodontist should immediately cease screw activation. In selected cases, careful reversal of the screw, as described in this report, may be considered as a conservative treatment. Full article

Regional anaesthesia of the equine anogenital tract is limited to local infiltration, extradural, blind palpation and nerve stimulator-guided techniques which risk iatrogenic damage, recumbency and ataxia. This study aimed to describe and assess the feasibility of transcutaneous ultrasound-guided (USG) pudendal nerve staining in equine cadavers. An initial pilot phase used two fresh equine cadavers and one standing unsedated horse to image the intrapelvic anatomy using ultrasound. One fixed equine cadaver specimen was also dissected to identify the pudendal nerve and refine the dissection approach. The main study of six fresh equine cadavers used ultrasound to identify the landmarks of pelvic brim, pelvic urethra, rectum and semimembranosus musculature. Bilateral USG injection of 15 mL of methylene blue dye was performed, followed by anatomical dissection. The pudendal nerve was stained in 41.7% of injections, with an average staining length of 8.26 cm. Landmarks guiding dye injection were reliably imaged in all cadavers. Imaging of the pudendal nerve was not possible. Staining of the sciatic nerve did not occur. Transcutaneous USG pudendal nerve staining with methylene blue dye (15 mL) is possible in equine cadavers. However, this technique cannot be currently recommended. Further refinement in cadavers is necessary to improve the staining success rate. Full article

Background: Lipomas are common benign subcutaneous neoplasms treated surgically for cosmetic or symptomatic reasons. The minimal one-third incision and four-step (MOTIF) technique provides reliable excision with minimal scarring, but smaller proportional incisions remain unstudied. This study evaluates the minimal one-quarter incision and four-step (MOQIF) technique. Methods: Retrospective review of 82 patients undergoing MOQIF excision of histologically confirmed subcutaneous lipomas by a single surgeon from July 2024–December 2025 was done. Lipomas were stratified by maximum diameter: small-intermediate (<5 cm) and large (≥5 cm). MOQIF used a one-quarter incision of the lipoma’s long axis determined by preoperative ultrasound measurement and palpation with four steps: hydro dissection preserving superficial subcutaneous tissue, superficial dissection, staged deep dissection with selective cautery of fibrovascular septa, and intact mass delivery. Outcomes included excision length, postoperative complications, Vancouver Scar Scale (VSS) scores, recurrence, and subjective treatment satisfaction of patients. Results: Mean lipoma size was 6.8 ± 2.0 cm (75.6% ≥5 cm). All lipomas were completely excised through 1.69 ± 0.49 cm incisions (ratio 0.25). Complications were low: seroma 10.98% (16.7% vs. 9.4%, p = 0.404), hematoma 7.3% (11.1% vs. 6.3%, p = 0.608), with no infections, nerve injuries, or recurrences at a mean 8.9-month follow-up. VSS scores were equivalent between groups (0.83 vs. 1.06; p = 0.438) and overall patient satisfaction was high (3.54 ± 0.53 (2–4)). Conclusions: MOQIF achieves complete lipoma excision through one-quarter incisions with safety and cosmetic outcomes across lipoma sizes, demonstrating feasibility through standardized technique refinement and careful case selection. Full article

Background: Duloxetine, a serotonin–norepinephrine reuptake inhibitor, is widely used both preoperatively and postoperatively in patients with neuropathic low back pain. This study aimed to determine the impact of duloxetine administration on posterolateral spinal fusion in rats and to evaluate the dose-dependent relationship of this effect. Methods: A pre-established rat model for posterolateral spinal fusion was employed, and four equal groups were formed, each undergoing posterolateral spinal fusion surgery. Except for the control group, the other groups received duloxetine postoperatively starting on day 1 at doses of 30 mg/kg/day, 60 mg/kg/day, and 120 mg/kg/day for six weeks. All rats were sacrificed after six weeks. Fusion status was assessed using manual palpation, radiological examination with plain radiography, and histopathological evaluation. Results: No significant differences were observed between groups in manual palpation scoring or radiological scoring. Histopathological evaluations of new bone formation also showed no significant differences between groups. The number of inflammatory cells was found to be higher in the control group compared to the low- and moderate-dose duloxetine groups (p = 0.012). Neovascularization scores were slightly higher in the control group compared to the duloxetine-treated groups (p = 0.048). Conclusions: In this experimental rat model of posterolateral spinal fusion, duloxetine administration was associated with reduced inflammatory cell infiltration and mildly decreased neovascularization on histopathological evaluation. However, these histological differences did not translate into measurable differences in fusion outcomes, as assessed by manual palpation, radiological scoring, or new bone formation. Overall, postoperative duloxetine treatment did not demonstrate a detrimental effect on spinal fusion success, suggesting that its use for neuropathic pain management may be biologically applicable with respect to fusion healing in this animal model. Full article

Background: Pelvic floor muscle dysfunction (PFD) is common during pregnancy. To counteract pregnancy-associated PFD, women require sufficient knowledge and structured guidance on correct pelvic floor muscle (PFM) contraction to improve PFM perception and functional control. Identifying pregnant women who are unable to perform correct PFM contraction despite structured teaching may allow early referral for rehabilitative measures. Objective: At measurement stage 1, this study aims to investigate the influence of structured PFM teaching on pregnant women’s ability to perform targeted PFM contraction (tPFMC-A), assess PFM strength, and describe possible early PFD symptoms. Material and Methods: “pelviTrust” is a two-arm randomized, controlled longitudinal study and has been conducted in the Department of Midwifery Science, University of Tuebingen since February 2023. The study sample comprised 221 healthy pregnant women with singleton pregnancy at 18–22 weeks of gestation. The intervention group (IG; n = 113) (69 nulliparous, 40 primiparous and four biparous) completed the validated German Pelvic Floor Questionnaire for Pregnant and Postpartum Women (GPFQppw) and received individualized midwife-led teaching on PFM anatomy, functional activation and PFM-friendly behaviour, followed by visual inspection and vaginal palpation. Objective-targeted PFMC ability (tPFMC-A) and PFM strength (modified Oxford Scale) were compared with self-assessed ability. The control group (n = 101) (61 nulliparous, 38 primiparous, and two biparous) receives routine prenatal and postnatal care and completes the GPFQppw. The present analysis focuses exclusively on the IG at T1. Results: At T1, 88% of the 113 women in the IG believed they could contract their PFM, but only 68% demonstrated a correct tPFMC-A on visual inspection. Following structured teaching with individualized feedback, 97% achieved correct PFM contraction while 2.7% still had deficits. The median PFM strength was three on the modified Oxford Scale (interquartile range: 3–4). Stress urinary incontinence and flatulence were the most frequently reported symptoms. Primiparous and multiparous women reported urinary incontinence and descensus symptoms more often than nulliparous women (p < 0.001). Conclusions: At the first prenatal assessment, pregnant women often overestimate their ability to contract their PFM correctly. A structured, midwife-led PFM teaching improves objectively assessed PFM contraction ability and may be integrated into routine antenatal care to support PFM health in pregnant women. Full article

Background: The mother’s bond with her newborn is important for the child’s development and their relationship. Midwives are well placed to witness first-hand the beginning of this relationship. Objectives: This study examined, based on mothers’ perceptions, the contribution of midwives to the development of the bond with their baby from pregnancy to the first postnatal months. Methods: We conducted a descriptive qualitative interpretative study in Quebec, Canada (from 2022 to 2025), with 10 primiparous mothers who were cared for by midwives in a model of continuity of care, and gave birth in a birth center, at home, or in a hospital. Semi-structured retrospective interviews were conducted between two and four months after childbirth, and were complemented by interviews with two midwives. Results: Most participants developed a bond with their baby during pregnancy. They discussed their midwifery care and what they felt were significant elements in the development of their bond with the baby. Midwives encouraged them to develop this bond through their approach and various means: letting them feel the fetus during palpation, talking to it, encouraging mothers to do the same, and reinforcing the bond throughout pregnancy. The birth and first moments after birth were also key moments for promoting contact between mother and baby. Midwives were also creative in promoting bonding in more difficult situations, such as when a transfer to the hospital for delivery was needed. Conclusions: Midwives play an important role in initiating and developing the mother–child bond during pregnancy, especially if they practice within a model of relational continuity. Full article

Accurate estimation of Body Carcass Fat (BCF) is essential for evaluating the physiological condition of ewes. Traditional assessment via Body Condition Score (BCS) through palpation is inaccurate and subjective. BCF can now be predicted more precisely using objective measurements. This study presents a comparative analysis of eight machine learning (ML) models for predicting BCF in Coopworth ewes, using weight and RGB-image-based body measurements. Four non-linear regression methods and four neural network architectures were evaluated using a dataset of 74 ewes with 13 independent variables. The dataset was partitioned into training (52 ewes), validation (11 ewes), and testing (11 ewes) sets. The Gradient Boosting Regression achieved the highest predictive accuracy with an R² value of 0.9434 using body weight and width, followed by Ensemble Neural Network (R² = 0.9371) using body weight. The findings demonstrate the effectiveness of the Gradient Boosting Regression, Ensemble Neural Network and Random Forest tree-based approaches for morphometric prediction tasks in biological applications. BCF values obtained from image analysis were validated against those derived from computerized tomography (CT), considered the gold standard. These findings highlight the potential of image-guided, ML-driven models for objective, non-invasive, cost-effective assessment of ewe body composition in modern livestock systems. Full article

Introduction: Distal intracapsular minimally invasive osteotomies (DICMOs) for central metatarsals are described as intracapsular procedures; however, neither their intracapsular location throughout the entire cut nor the optimal anatomical position for their execution have been fully validated. The aim of this study was to assess the geometric position of the DICMO osteotomy in the central metatarsals (third and fourth) and quantify associated anatomical damage when performed under three different guidance modalities: anatomical palpation, fluoroscopic control, and ultrasound guidance. Material and methods: An experimental cadaveric study was conducted using 29 fresh specimens (11 males, 18 females), contributing a total of 58 central metatarsals (third and fourth). All specimens underwent a DICMO-type metatarsal osteotomy. Osteotomies were randomly allocated to three intervention groups: (1) ultrasound (n = 20), (2) fluoroscopy (n = 19), and (3) anatomical guidance (n = 19). Metatarsal length, the distance between the osteotomy line and the articular surface, and post-dissection soft-tissue damage were recorded. Results: After dissection, all osteotomies were confirmed to be intracapsular. A constant proportional relationship was identified between osteotomy location and metatarsal length: distance to the joint line = 0.239 × metatarsal length. This relationship was independent of the guidance technique used. Only one iatrogenic lesion was observed: an articular cartilage injury of a third metatarsal in the anatomical-guidance group. Conclusions: The optimal position for DICMO osteotomy placement is approximately 24% of the total distal metatarsal length. This ensures an intracapsular trajectory and may contribute to intrinsic osteotomy stability. Image guidance—either fluoroscopy or ultrasound—appears essential to optimize outcomes and prevent avoidable anatomical damage. Full article

Background: n-3 PUFA derived from marine sources, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), exhibit potential for breast cancer prevention. In contrast, higher dietary intakes of n-6 PUFA, such as linoleic acid (LA), have been implicated in promoting mammary tumourigenesis. However, there is a need for further exploration into how n-3 PUFA influence breast cancer development in comparison to different amounts and sources of LA. Objective: The purpose of this study was to compare the effects of n-3 PUFA-enriched diets versus n-6 PUFA diets differing in LA content, including corn oil (50% LA) and safflower oil (70% LA), on mammary tumour development in a HER2+ breast cancer model. Methods: Using the HER2+ breast cancer MMTV-neu(ndl)YD5 transgenic mouse model, this study determined the effects of: (1) 10% w/w corn oil (CO, n-6 PUFA, n = 14), (2) 10% w/w safflower oil (SO, n-6 PUFA, n = 14), (3) 3% w/w menhaden oil + 7% w/w CO (3% FO 7% CO, n-3 PUFA, n = 12), and (4) 3% w/w menhaden oil + 7% w/w SO (3% FO 7% SO, n-3 PUFA, n = 14) on puberty onset, tumour incidence, tumour volume, and tumour number in utero until 20 weeks of age. Results: Mice fed the n-3 PUFA-enriched diets showed a lower trajectory of tumour development compared to the n-6 PUFA diets, although the differences for palpated tumour volume and number over time reached significance only between the 10% CO and 3% FO 7% CO groups. This suggests that high LA content in CO may represent a threshold for promoting tumour growth whereby further LA content marginally influences additional tumour development. Exposure to the CO n-6 PUFA diet further resulted in earlier onset of puberty compared to the n-3 PUFA-enriched diet containing CO. To investigate the underlying mechanisms, a qPCR analysis of mammary glands and tumour tissue revealed that the n-3 PUFA diets downregulated the expression of pro-tumourigenic immune markers, including CD206 and F4/80 in the mammary glands and the cannabinoid receptor CB2 in tumours, compared to the n-6 PUFA diets. Conclusions: These findings indicate that the presence of dietary n-3 PUFA plays a key role in modulating mammary tumour development, which may be further influenced by the underlying n-6 PUFA background. The associated changes in immune markers suggest that n-3 PUFA exert anticancer effects in part by shifting the tumour immune microenvironment toward an anti-tumour phenotype and modulating cannabinoid receptor signalling. Collectively, this work informs future human studies investigating the role of dietary fat composition in breast cancer risk. Full article

Robotic-assisted surgery (RAS) provides enhanced dexterity and visualisation but remains constrained by the absence of clinically meaningful palpation and haptic feedback. This perspective examines palpation sensing in RAS from an engineering and system-integration standpoint, identifying the lack of tactile information as a major contributor to increased cognitive load, prolonged training, and risk of tissue injury. Recent advances in force, tactile, vibroacoustic, audio, and optical sensor technologies enable quantitative assessment of tissue mechanical properties and often exceed human tactile sensitivity. However, clinical translation is limited by challenges in sensor miniaturisation, sterilisation, robustness and integration and the absence of standardised evaluation metrics. The integration of artificial intelligence and multimodal sensor fusion with intra-operative imaging and augmented visualisation is highlighted as a key strategy to compensate for sensor limitations and biological variability. Dedicated robotic palpation devices and wireless or magnetically coupled probes are discussed as promising transitional solutions. Overall, the restoration of palpation sensing is presented as a prerequisite for improving safety and efficiency and enabling higher levels of autonomy in future RAS platforms. Full article

Accurate identification and characterization of subcutaneous tumors are essential for improving breast tumor detection and treatment. This study introduces an innovative Tactile-Sensation Imaging System (TSIS) designed, implemented, and tested to detect and characterize subcutaneous inclusions simulating breast tumors. The system employs a multilayered polydimethylsiloxane (PDMS) optical waveguide that mimics the tactile structure of the human fingertip. By introducing light at a critical angle, the design enables continuous total internal reflection (TIR) within the flexible, transparent waveguide. When external pressure is applied, deformation of the contact area causes light scattering, which is recorded using a high-definition camera and processed as tactile images. Analysis of these images allows estimation of inclusion characteristics such as size, depth, and mechanical properties, including Young’s modulus. Analytical modeling and numerical simulations validated the optical performance of the waveguide, while experimental evaluations using realistic tissue phantoms confirmed the system’s ability to accurately detect and quantify embedded inclusions. The results demonstrated reliable estimations of inclusion dimensions, depths, and stiffness, verifying the system’s sensitivity and precision. The TSIS offers a noninvasive, portable, and cost-efficient solution for quantitative breast tumor assessment, bridging the gap between manual palpation and advanced imaging, with future enhancements aimed at improving resolution and diagnostic accuracy. Full article

Background: Pancreatic cancer (PC) is expected to be the second leading cause of cancer-related death by 2030. Surgical resection with R0 margins remains the only available treatment capable of improving the overall survival of the patients; thus, appropriate characterization of pancreatic tumors is mandatory for the correct assessment of PC resectability. Despite advances in pancreatic surgery, POPF remains a frequent and dreaded complication that impacts the morbidity and mortality of PC patients, entailing both clinical and economic consequences. Soft pancreatic texture is known as an independent risk factor for POPF occurrence in pancreatic surgery. Intraoperative exploration of the pancreas is most frequently assessed subjectively, through the surgeon’s palpation. Intraoperative elastography is a modern ultrasound technique suitable to replace the surgeon’s intraoperative palpation to better evaluate pancreatic lesions, pancreatic texture, and improve surgical management. Thus, intraoperative elastography could provide quantifiable and reproducible information in pancreatic parenchyma characterization. Real-time intraoperative assessment of pancreatic texture through an objective method could improve surgical decisions. This systematic review analyzes the role of intraoperative elastography in differentiating benign from malignant pancreatic tumors and the efficacy of this technique in the assessment of pancreatic texture as a predictor of postoperative pancreatic fistula (POPF). Methods: We conducted a comprehensive systematic literature research on PubMed, Google Scholar, Scopus, Web of Science, Embase and Cochrane Library Database using PRISMA framework guided by the words “intraoperative elastography” or “intraoperative elasticity imaging” or “intraoperative shear wave elastography” or “intraoperative strain elastography” and “pancreatic cancer” or “pancreatic neoplasm” or “pancreatic adenocarcinoma” or “pancreatic tumor” or “pancreatic fistula” or “postoperative pancreatic fistula” or “pancreatic leak”. Articles that were listed between 2000 and 2025 and written in the English language were screened for potentially relevant articles. The primary outcome was to evaluate the use of intraoperative elastography in differentiating between benign and malignant lesions of the pancreas. The second outcome was to assess the role of intraoperative elastography in the evaluation of pancreatic texture as a predictive factor for the occurrence of postoperative pancreatic fistula. Results: From a total of 17 publications, 2 scientific articles were considered relevant for the role of intraoperative elastography in differentiating benign from malignant pancreatic lesions, while 4 articles analyzed the role of intraoperative pancreatic elastography as a predictor of postoperative pancreatic fistula (POPF). Based on the results, detection of pancreatic cancer through intraoperative SWE is possible at cut-off values of 3 m/s and 28.7 kPa, and values of 2.2 m/s or less obtained after intraoperative elastography of the pancreas are considered an independent risk factor for POPF in pancreatic surgery. Reported cut-off values should, however, be interpreted as exploratory and should represent a starting point for further studies aimed at validating their clinical implementation. Conclusions: Intraoperative elastography can be a promising tool in pancreatic tumor characterization and could differentiate between benign and malignant pancreatic tumors and predict the risk of POPF, but further prospective studies are required before cut-off values can be routinely applied in clinical practice. Full article

Background/Objectives: Cellulite is a common aesthetic condition in women, traditionally assessed using visual inspection and palpation-based scales that are inherently subjective. Therefore, image-based methods that may support standardized severity grading are of growing interest. To evaluate infrared thermography as an imaging-based method for grading cellulite severity and to perform methodological validation of a newly developed thermographic classification scale by comparing it with clinical palpation and anthropometric parameters. Methods: This retrospective, non-interventional study analyzed anonymized clinical and thermographic data from 81 women with clinically assessed cellulite. Cellulite severity was evaluated using the Nürnberger–Müller palpation scale and a newly developed five-point thermographic scale based on skin surface temperature differentials and histogram pattern analysis. The associations between the assessment methods were evaluated using ordinal statistical measures, and agreement was assessed using weighted Cohen’s kappa statistics. Results: Thermographic grading demonstrated high agreement with palpation-based assessment, with a percentage agreement of 93.8% and an almost perfect agreement based on weighted Cohen’s κ. A strong ordinal association was observed between the methods. Thermography consistently classified a subset of cases as one grade higher compared with palpation. No statistically significant associations were observed between thermographic grade and body mass index or waist-to-hip ratio. Conclusions: Infrared thermography enables image-based grading of cellulite severity and shows a strong concordance with established palpation scales. The proposed thermographic classification provides preliminary methodological validation of an imaging-based grading approach. Further multicenter studies involving multiple assessors and diverse populations are required to assess reproducibility, specificity, and potential clinical applicability. Full article