Search Results (247)

Background: This study aims to evaluate the functional improvement, pain reduction, and esthetic outcomes including scar satisfaction and donor-site morbidity following autogenous dermal-fat graft reconstruction for temporomandibular joint (TMJ) ankylosis. Methods: This retrospective clinical study included 12 adults with TMJ ankylosis treated surgically with autogenous dermal fat graft reconstruction. Outcomes measured included pre- and postoperative maximum mouth opening (MMO), pain intensity via the Visual Analog Scale (VAS) at postoperative day 2, week 1, and month 6, and scar-satisfaction scores. Changes in functional and esthetic outcomes over time and the correlation between preoperative mouth opening and postoperative pain were analyzed using appropriate parametric or non parametric tests and correlation analyses. Results: Mean MMO significantly improved from 8.17 ± 6.72 mm to 29.58 ± 5.68 mm (p = 0.002). Mean VAS pain scores declined steadily from 5.50 ± 1.88 at day 2 to 1.50 ± 1.73 at 6 months (p < 0.001). A strong negative correlation was found between preoperative MMO and postoperative pain at all intervals (p < 0.001), indicating that more severe preoperative restriction is associated with higher postoperative pain. Esthetic satisfaction was high (patients: 2.08 ± 1.38; surgeons: 1.58 ± 1.00), and donor-site morbidity was minimal. No re-ankylosis occurred during the 36-month mean follow-up. Conclusions: Autogenous dermal fat grafting for TMJ ankylosis provided favorable functional recovery, esthetic outcomes, and manageable donor site morbidity. Analysis suggests that restricted preoperative mouth opening is associated with greater postoperative pain, supporting perioperative analgesia and physiotherapy for patients. Full article

Background: Severe burn injuries are associated with prolonged consequent wound healing, substantial symptoms burden, and delayed, sometimes incomplete, functional recovery. Photobiomodulation using Multiwave Locked System (MLS) LASER therapy has been proposed as an adjunctive intervention to support tissue repair and thereby improve rehabilitation outcomes, but related clinical evidence in burn populations remains limited. Materials and Methods: This comparative study included 65 patients with severe burn injuries, of whom 35 were prospectively treated with adjunctive MLS LASER therapy, in addition to standard care, and 30 retrospectively identified patients, who received standard care alone, served as controls. The primary outcome was the time until complete epithelialization, while secondary outcomes included: reduction in wound surface, pain intensity, pruritus severity, scar quality, and functional improvements. Assessments were performed at baseline and after a standardized follow-up period of up to 20 days. Results: Patients treated with MLS LASER therapy achieved complete epithelialization significantly earlier than controls (median 40 vs. 73 days, p < 0.001) and demonstrated greater wound area reduction (median 434 vs. 137 cm², p = 0.0012). In multivariable analyses adjusted for burn extent, burn depth, age, and diabetes mellitus, considered as factors worsening evolution, MLS LASER therapy remained independently associated with shorter time to epithelialization and greater reduction in wound dimension. Significant improvements favoring the MLS group were also observed regarding pain, pruritus, scar quality, and functional outcomes, all assessed using specific evaluation tools (p < 0.001). Conclusions: Adjunctive MLS LASER therapy appears to be associated with improved wound healing dynamics and enhanced rehabilitation outcomes in patients with severe burn injuries. These findings should be interpreted with caution given the study limitations, including the non-randomized design and relatively small sample size. MLS LASER therapy may represent a promising adjunctive option in the conservative management of burn injuries; however, further prospective randomized studies are required to confirm these results and to define optimal treatment protocols. Full article

Background: Cleft lip and/or palate (CLP) is a common craniofacial malformation with aesthetic, functional, and psychosocial impacts. Although surgical repair is performed early in life, scar tissue formation may intensify maxillary deformities. Presurgical orthopedic interventions have therefore been introduced to optimize anatomical conditions prior to surgery. This scoping review aimed to systematically map presurgical orthopedic approaches described in the literature for patients with CLP. Methods: A Scoping Review was conducted in accordance with PRISMA-ScR guidelines. The protocol was registered in the Open Science Framework. Searches were performed in PubMed, Embase, Web of Science, and Cochrane databases without language or date restrictions. Two independent reviewers assessed the articles and extracted data. Results: A total of 207 studies were included, with a predominance of case series, case reports, and cohort studies, reflecting a generally low level of evidence. Nasoalveolar molding (NAM) was the most frequently reported intervention, while other appliances such as the Hotz plate and Latham device were considerably less represented. Across studies, reported outcomes included reduction of the alveolar cleft, improved nasal symmetry, and facilitation of feeding; however, variability in protocols and outcome measures limited comparability. Conclusions: The available evidence is heterogeneous and largely based on observational designs, which restricts definitive conclusions regarding the comparative effectiveness of presurgical orthopedic approaches. The predominance of NAM in the literature may reflect clinical preference rather than superior evidence, highlighting the need for standardized protocols and higher-quality studies. Full article

Background: Age-related macular degeneration (AMD) is the primary cause of severe visual acuity loss in individuals over 60 with increasing prevalence. Currently, no effective treatments exist for geographic atrophy and macular scarring, highlighting the need for visual rehabilitation in these patients. Microperimetry offers functional assessment at any AMD stage and employs fixation training to help patients utilize the most effective retinal areas for vision. Methods: A prospective study involving 25 patients (50 eyes) aged 67 to 90. The MAIA II microperimeter assessed scotoma size and location, retinal sensitivity, macular integrity, fixation parameters (P1, P2, 63%BCEA, 95%BCEA), fixation stability, and preferred retinal locus. Quality of life was evaluated using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). A subgroup with inactive AMD-related macular changes, either bilateral geographic atrophy (13 patients, 26 eyes) or bilateral scarring (12 patients, 24 eyes), was identified, all exhibiting bilateral absolute central scotomas of at least 2 degrees. Each patient completed 10 fixation training sessions with a microperimeter, training the eye with better acuity weekly. One-week post-training, a functional assessment was performed on both trained and untrained eyes. Results: Fixation training significantly improved best corrected visual acuity (BCVA) in trained eyes (mean change −0.14 logMAR, p < 0.001, large effect size) and also in fellow untrained eyes (−0.16 logMAR, p < 0.001). BNVA improved from 2.25 to 1.86 in trained eyes (p < 0.001) and from 2.96 to 2.76 in untrained eyes (p = 0.004). Fixation stability parameters improved significantly, including increases in P1 and P2 and reductions in Bivariate Contour Ellipse Area (BCEA). Quality of life measured using the NEI-VFQ-25 questionnaire improved significantly in 9 of 11 domains. Conclusions: Microperimetry may be a valuable tool for assessing visual function in AMD patients. Fixation training with the MAIA II microperimeter is both safe and effective for vision rehabilitation in those with geographic atrophy and macular scarring. Full article

Background/Objectives: The incidence of pediatric pathological scars (PPS) has been gradually increasing due to various causes, highlighting the need for accurate scar assessment to monitor disease progression and therapeutic efficacy. Vancouver Scar Scale (VSS) and other scar evaluation systems are relatively subjective evaluation methods that rely on physicians’ or patients’ own judgment. By contrast, when comparing different scar scale evaluation methods, a three-dimensional (3D) camera and dermoscopy may provide relatively objective measurable parameters to avoid possible subjective bias created by the observers. This study aimed to compare the utility of traditional VSS evaluation with that of 3D cameras and dermoscopy in PPS evaluation. Methods: A total of 35 pediatric patients (aged 0–18 years) with PPS were involved, and their scars were assessed via the VSS, dermoscopy, and the Antera 3D^® system. In addition, a subset of 18 patients (36 scar regions) was also evaluated for therapeutic efficacy after 3–6 months of treatment. Briefly, VSS scores were blindly evaluated by two independent dermatologists under standardized conditions. Quantitative assessment was also performed using dermoscopy and the Antera 3D^® system. The former quantified chromatic parameters (pigmentation: L*, vascularity: a*, green value); the latter captured multispectral 3D images to analyze volume, pigmentation, and erythema. Data are presented as means ± standard deviation and analyzed using paired-sample t tests (one-tailed), the Wilcoxon signed-rank test, and standardized response means (SRMs) to assess therapeutic sensitivity, while baseline variability was evaluated using the standard deviation and coefficient of variation (CV). Results: The results showed that Antera 3D^® detected significant reductions in pigmentation (p < 0.01, SRM = −0.46), vascularity (p < 0.001, SRM = −0.59), and volume (p < 0.0001, SRM = −0.83), while dermoscopy indicated similar moderate improvements in vascularity (Green value: p < 0.001, SRM = 0.57; a*: p < 0.0001, SRM = −0.68) and pigmentation (L*: p < 0.0001, SRM = 0.48) after treatments. VSS showed significant gains in pliability (p < 0.0001, SRM = −1.13), height (p < 0.01, SRM = −0.54), and overall impression (p < 0.0001, SRM = −0.86), but minimal changes in pigmentation (p > 0.05, SRM = 0) or vascularity (p > 0.05, SRM = −0.21). At baseline, Antera 3D^® showed the greatest variability in pigmentation (CV 43.41%) and volume (CV 91.21%), followed by VSS in vascularity (CV 52.95%), pliability (CV 34.05%), and overall impression (CV 31.76%). Dermoscopy presented the lowest variability, indicating limited discriminative power. Conclusions: In conclusion, Antera 3D^® offers an objective, sensitive, and spatially precise approach for PPS assessment and may provide additional quantitative information for evaluating subtle and early changes alongside traditional scar assessment scales. Its integration into clinical practice will enhance treatment monitoring and support more accurate timing of therapeutic interventions. Full article

Corneal fibrosis, clinically referred to as corneal scarring, disrupts the normal architecture and transparency of the cornea and remains a major cause of visual impairment worldwide. Although corneal transplantation can restore vision, its effectiveness is constrained by limited accessibility, donor tissue shortages, and the risk of allograft rejection. Treatments with human corneal stromal stem cells (hCSSCs) have demonstrated scarless healing in preclinical models of acute corneal injury. Here, we report that hCSSCs also modulated pre-existing corneal opacities. We established a reproducible in vivo model of chronic corneal opacity. Given that scar severity varies among corneas even after identical injuries, we developed a non-invasive, image-based method to quantify opacity volume longitudinally in individual corneas. Using this approach, we evaluated the scar-reducing potential of three hCSSC batches previously shown to inhibit acute scarring. Following cell treatment, the pre-existing opacity volumes gradually decreased. In vitro, hCSSCs exposed to pro-inflammatory stimulus exhibited increased metalloproteinase (MMP) activity relative to tissue inhibitor of metalloproteinase (TIMP), as indicated by an elevated MMP2/TIMP2 ratio. This shift may promote matrix remodeling and scar resolution. Overall, our findings provide proof-of-concept for hCSSC-based therapy as a strategy to reduce established corneal scarring and restore corneal transparency. Full article

Background and Objectives: Pulmonary fibrosis (PF) is an interstitial lung disease that leads to death and is characterized by excessive collagen deposition and tissue scarring. Bleomycin (BLM) is widely used to induce PF in rodent models, closely resembling human idiopathic pulmonary fibrosis. Ivermectin, a broad-spectrum antiparasitic agent, has recently attracted interest due to its reported anti-inflammatory and antifibrotic effects. The beneficial effects of ivermectin to treat PF may be attributed to suppressing the NLRP3 inflammasome. Ivermectin can cause acute toxicity, including convulsions, when overdosed in animals. In humans, it may induce neurological disorders, particularly in individuals with mutations in the ABCB1 gene. This study aimed to investigate the potential protective role of ivermectin against BLM-induced PF in rats. Materials and Methods: Forty adult male albino rats were randomly allocated into four groups (n = 10 each): control, ivermectin-treated (0.6 mg/kg, orally on days 0, 1, 7, and 8), BLM-treated (single intratracheal dose of 5 mg/kg), and BLM- and ivermectin-treated. Lung tissues were collected for histopathological analysis and Mallory trichrome staining to assess collagen deposition. Mast cell (MC) infiltration was assessed using toluidine blue. Immunohistochemistry for α-SMA and Ki-67 was used to evaluate myofibroblast and cell proliferation. Oxidative stress parameters, including serum total antioxidant capacity, lung glutathione and lung nitric oxide were measured. Results: Ivermectin treatment markedly attenuated BLM-induced lung fibrosis, showing reduced collagen accumulation, restoration of alveolar architecture, and decreased inflammatory cell infiltration. Immunohistochemical evaluation revealed decreased expression of α-SMA and Ki-67, while biochemical analyses demonstrated improved oxidative stress markers. Conclusions: Ivermectin significantly mitigates BLM-induced pulmonary fibrosis in rats through modulation of inflammation, suppression of myofibroblast proliferation, and reduction in oxidative stress and collagen deposition. These findings highlight ivermectin as a potential candidate for the management of fibrotic lung diseases, warranting further mechanistic and clinical investigations. Full article

The mammalian heart rapidly loses regenerative capacity after birth and responds to myocardial infarction (MI) with scar formation and development of interstitial fibrosis. Cardiac fibroblasts orchestrate extracellular matrix (ECM) remodeling and cell–cell communication during development and injury; however, how fibroblast heterogeneity and fibroblast communication networks differ between regenerative neonatal and non-regenerative adult hearts remains incompletely defined. We performed scRNA-seq analysis on metabolically active CD45⁻/CD31⁻ nonmyocyte cells from the left ventricles of normal neonatal (P3) and adult (P84) mice to probe heterogeneity in a cardiac fibroblast-enriched population. We identified five transcriptionally distinct cardiac fibroblast subclusters (CF0-CF4) demonstrating different distributions across ages, including an adult-enriched immune/complement-associated program (CF0); an ECM structural-associated program present across ages (CF1); and neonatal-enriched contractile/ECM-remodeling (CF2), Wnt-modulating matrix-regulatory (CF3), and proliferative (CF4) programs. Matrisome category scoring revealed age-dependent divergence in ECM programs: neonatal fibroblasts showed higher enrichment of core matrisome components (particularly collagens and proteoglycans), whereas adult fibroblasts were relatively enriched for matrisome-associated categories, including ECM regulators and secreted factors. Ligand–receptor inference using CellChat demonstrated a broad reduction in fibroblast–fibroblast interaction strength and information flow in adult networks, and adult-enriched signaling was dominated by immune/chemotactic pathways. Finally, projection of subcluster marker programs onto an independent bulk RNA-seq dataset of cardiac fibroblasts 3 days after MI revealed that adult injury partially recapitulates neonatal-associated programs, including activation of the contractile/ECM-remodeling program (CF2) and robust induction of a cell-cycle-associated program (CF4), but lacks an additional neonatal-specific injury program associated with the Wnt-modulating subset (CF3), which was weakly induced or absent in adults. This cardiac fibroblast-enriched single-cell study defines age-dependent fibroblast states, ECM specialization, and communication network architecture that distinguish regenerative neonatal from non-regenerative adult hearts. It also provides a framework to interpret divergent stromal responses after MI and to prioritize fibroblast programs for regenerative and anti-fibrotic strategies. Full article

Background: Acne scars remain a very common complaint in dermatology practices. Even though many treatment options are available, proper treatment remains a challenge. Complex treatment methods that are based on the synergy effect are the ones that result in better effects and patient satisfaction. Methods: Three healthy female patients with a total of 106 atrophic acne scars were recruited to the split-face study with placebo control, where a series of three microneedling procedures in monthly intervals combined with 5% retinyl palmitate-loaded oleogel was compared to the same microneedling protocol with placebo. Patients’ quality of life was measured using the Dermatology Life Quality Index (DLQI) and Skindex-29 questionnaires. Patients’ satisfaction with treatment and intensity of post-procedure symptoms were assessed as well. Results: In clinical evaluation, a modest effect was observed regarding the reduction in atrophic acne scars, whereas moderate-to-marked improvement in acne scar reduction was noted by the patients. Additionally, mild to marked improvement was noted by patients regarding skin quality, moisture level, elasticity, and skin tone. No significant side effects were noted. All the above resulted in good patient satisfaction with the treatment, and willingness to repeat the procedures again. No significant differences regarding acne scar reduction, treatment-related symptoms, and skin quality improvement were noted between active substance and placebo-treated sides of the face. Conclusions: Microneedling remains a key method in the therapeutic arsenal for acne scarring. By combining it with 5% retinyl palmitate-loaded oleogel modest effects can be noted after a series of three procedures, with good overall treatment tolerability and patients’ satisfaction. Full article

ZnMgAl layered double hydroxides (LDHs) were synthesised via coprecipitation, and oleic acid and stearic acid were grafted onto their surfaces via dehydration condensation to obtain two nano-lubricant additives, OA-ZnMgAl LDH and SA-ZnMgAl LDH. These surface modifications significantly improved the dispersion stability of ZnMgAl LDH in lubricating oil. Tribological tests showed that, at their respective optimal concentrations for friction reduction or wear resistance, ZnMgAl LDH, OA-ZnMgAl LDH, and SA-ZnMgAl LDH reduced the coefficient of friction by 3%, 20%, and 16%, and decreased the wear scar diameter by 7%, 9%, and 14%, respectively, compared with the base oil (XMP-Mobil 320). To clarify the lubrication mechanism, the wear morphology and chemical composition were analysed using 3D optical profilometry, X-ray photoelectron spectroscopy, scanning electron microscopy, and FIB-SEM. The results indicate that LDHs react with the steel surface under load and shear to form a multilayer protective film consisting of an inner oxide layer and an outer graphite layer, preventing direct contact between friction pairs. In addition, the rolling and filling effects of partially unreacted LDHs further reduce friction and wear. Full article

Molybdenum disulfide (MoS₂)-based composite systems are widely used as solid lubricating coatings. However, further optimization towards lower friction and higher wear resistance remains necessary to meet the extreme operating conditions and high reliability requirements of next-generation aerospace equipment. This study investigated the tribological performance of MoS₂/epoxy composite coatings by comparing the effects of individual and combined additions of nano nickel (Ni) and magnesium silicate hydroxide (MSH). The coating preparation process adopted in this study is the bonding method. Experimental results showed that, under a load of 2 N and a rotational speed of 500 r/min, the coating containing 0.3 g Ni and 0.1 g MSH (labeled W03Ni01MSH) achieved a 22% reduction in wear scar width compared to the coating with only Ni, demonstrating a distinct synergistic effect. This is attributed to the complementary roles of the two additives: Ni promotes the formation of flaky wear debris, facilitating rapid formation and stabilization of a transfer film, thereby reducing friction; MSH enhances the load carrying capacity of the coating and suppresses wear propagation, thereby improving wear resistance. Furthermore, this composite coating exhibited optimal performance under the conditions of 500 r/min and 2 N. The results of this study significantly improved the friction-reducing and wear-resistant properties of the MoS₂/epoxy composite coating. This provides a new strategy for the formulation design of high-performance solid lubricating coatings. Full article

In order to prepare alkyl-functionalized reduced graphene oxide more simply, economically and environmentally, we adopt a two-step method of first reduction and then surface grafting. Graphite oxide (GtO) is first exfoliated to thermally-reduced graphene oxide (TRGO) and then, in a heat-induced solid-state reaction, converted to lauryl-functionalized TRGO (LTRGO). During the second step, lauryl radicals generated from the decomposition of lauroyl peroxide (LPO) open the epoxide rings on TRGO, covalently grafting the alkyl chains. The average water contact angle of LTRGO is 135.5°, and it disperses stably in base oil without surfactants or other additives. Four-ball test results show when the dosage of LTRGO is 75 mg/L, the average friction coefficient and wear scar diameter of the Formosa Plastics base oil (100 N) are decreased by 20.8% and 15.4%, respectively. The morphology and element analysis after ball-on-disk friction tests showed that the stable LTRGO physical friction adsorption film and metal oxide friction chemical reaction film could be formed between the friction pairs, thus reducing the friction wear. Full article

Background: The aim of this observational preliminary study is to detect any changes in body mass, muscle strength and characteristics of the pectoralis major muscle in women who have undergone breast surgery treatments. Methods: Instrumental assessments, completed before surgery and after 60 and 120 days, included sonoelastography, dynamometric examination and surface electromyography (sEMG) of the pectoralis major muscle, hand grip test, body bioimpedance analysis; the DASH (Disability of the Arm, Shoulder and Hand) questionnaire and pain assessment using the NRS (Numerical Rating Scale). Results: An initial increase in weight and fat mass was observed, followed by a reduction related to the resumption of physical activity stimulated by physiotherapy and medical support. The IC (intracellular)/EC (extracellular) ratio showed an increase in extracellular fluids in the final phase, indicative of possible water retention and early oedema. Muscle strength and DASH scores showed a functional decline, which may be explained by reduced physical activity and the direct involvement of the pectoral muscle in surgical and radiotherapy procedures. Sonoelastography showed color variations suggestive of changes in tissue stiffness, useful for distinguishing between reinforcement processes and possible scarring. Conclusions: This multidimensional approach can be useful in the early monitoring of some tissue alterations (i.e., fat mass) as an aid to define personalized rehabilitation protocols for women who have undergone breast surgery. Full article

Background: Keloids are fibroproliferative scars with a prominent vascular component, and pulsed dye laser (PDL) is an established treatment, but objective imaging biomarkers of response are lacking. Objective: To evaluate whether dynamic optical coherence tomography (D-OCT) can provide quantitative, depth-resolved monitoring of keloid vascular remodeling under PDL and to explore candidate metrics for hypothesis-generating assessment in future studies. Methods: We conducted a prospective single-case pilot, hypothesis-generating study of a thoracic keloid treated with three sessions of 595 nm PDL, acquiring D-OCT scans at baseline and approximately 30, 60, and 90 days over a standardized 4 × 4 mm region of interest at 0.15, 0.30, and 0.50 mm depths. Primary D-OCT metrics included vascular en-face area, vessel length density, junction density, and mean vessel caliber. Results: The superficial layer (0.15 mm) showed an almost complete collapse of vascular signal (area −88% vs. baseline), the intermediate layer at 0.30 mm exhibited a sustained ~39% reduction in vascular area with parallel decreases in length and caliber at stable branching, and the deep layer at 0.50 mm showed modest area changes with longer but thinner vessels. These depth-resolved changes were consistent with clinical improvement in Vancouver Scar Scale and POSAS scores. Conclusions: D-OCT yielded quantitative, clinically interpretable vascular metrics that align with the expected effects of PDL in this single patient. In this patient, the percentage reduction in vascular area at 0.30 mm by week 8 emerged as a candidate quantitative metric for response monitoring; thresholds in the order of ≥25% could be tested prospectively as hypothesis-generating cut-offs in future controlled and reliability-tested studies, but are not proposed here as validated clinical criteria. Full article

Social acceleration and recurrent structural shocks increase habitus–field mismatch, yet similar exposure does not produce uniform trajectories of daily well-being or suicidal distress. This paper asks how comparable structural strain can generate divergent, path-dependent outcomes and why suicidal vulnerability may persist after objective conditions improve. We develop a theory-building, concept-driven framework that integrates Bourdieu’s practice theory with social and behavioural scholarship on stress, anomie, and despair, and conceptualises these dynamics as social hysteresis. The regime-based model specifies two ideal-typical response orientations through which mismatch can stabilise: an anomic regime marked by shame, withdrawal, and inwardly directed harm, and a radicalising regime marked by grievance framing, moral indignation, and organised participation, without implying violent extremism. Represented through hysteresis loops, the framework implies multistability, asymmetric switching thresholds, and scarring, providing a mechanism for persistence and non-linearity in distress trajectories. The model derives testable expectations for longitudinal panel and experience-sampling designs and suggests that prevention and intervention design should combine reductions in mismatch with relational and institutional infrastructures that facilitate regime shifts and reopen the space of possibles. Full article