Search Results (22)

This report provides a concise selective representative overview of the predictor factors for progression in Idiopathic Scoliosis (IS). The Cobb angle method, rib hump deformity, imaging and advanced techniques for assessing skeletal maturity serve as key elements in evaluating prognostic factors for IS progression based on the patient’s age at diagnosis—particularly in Infantile Idiopathic Scoliosis (IIS), Juvenile Idiopathic Scoliosis (JIS), and Adolescent Idiopathic Scoliosis (AIS). The commonly used approaches for determining skeletal maturity include the assessment of the iliac apophysis and scoliosis curve deterioration, the Sanders skeletal maturity staging system, the distal radius and ulna (DRU) classification for predicting growth spurts and curve progression in IS, as well as the ossification of vertebral epiphyseal rings, the humeral head, and the calcaneal apophysis. Prognostic factors influencing IS progression are further discussed in relation to the patient’s age at onset—whether in infancy, childhood, or adolescence—as well as in both untreated and braced AIS patients. Additionally, the apical convex rib–vertebra angle in AIS is explored as an indicator of progression. Predictors for curve progression at skeletal maturity are outlined, along with various models for forecasting IS deterioration. Lastly, the Rib and Segmental Rib Index, a rib cage deformity parameter, is introduced as a predictor of scoliosis progression. In conclusion, this concise and selective overview of predictor factors for progression in IS highlights the current understanding of IS progression factors. It also introduces the Rib and Segmental Rib Index—a rib cage deformity parameter—as a predictor of IS progression. Full article

Background: Skeletal age estimation plays a fundamental role in orthopedic treatments. Since the most reliable methods are based on ionizing radiation, this study aimed to use machine learning techniques to explore a skeletal age assessment method not based on additional radiographies. Methods: Patients aged between 6 and 16 years old whose clinical records included orthopantomography, radiographs of the second phalanx of the third finger, and biometric data were enrolled for the study. The radiographs were analyzed to estimate the maturation degree of the left lower first premolars, the midpalatal suture, and the second phalanx of the third finger. Both an explicative data analysis and a multivariate analysis were performed. Results: The sample comprised 111 subjects. The multivariate analysis revealed an explanatory role for sex (p < 0.01) and chronological age (p < 0.01). The ordinal tool showed how the use of height (p = 0.02) and weight (p = 0.03) was explicative of skeletal age against a loss of statistical significance corresponding to the use of body mass index (p = 0.6). The median palatine suture (p = 0.01) was explicative. Conclusions: The combined evaluation of weight, height, sex, chronological age, and grade of maturation of the midpalate suture provides an explicative tool for assessing skeletal age without additional radiographic exams, besides a routine orthopantomography. Full article

This opinion article refers to the “double rib contour sign” and to the rib index (DRCS and RI), to their reliability study results in the chest radiographs of a control group and to their validity study results. These two parameters were introduced by the first author in this report. The introduction of the Segmental Rib Index (SRI) and its relation to spinal deformity is also discussed. The RI has been confirmed to be a strong surrogate for scoliometric readings in idiopathic scoliosis (IS). The clinical applications of the RI are analyzed for the following: (a) the documentation of deformity; (b) the assessment of physiotherapy outcomes (PSSEs); (c) the documentation of the outcomes of brace treatment; (d) the documentation of the pre- and post-operative assessment of thoracic deformity correction in different types of instrumentation; (e) its usage in prognosticating accelerated deterioration in skeletally mature adolescent idiopathic scoliosis (AIS) curves of 40–50 degrees; and (f) its usage in the recognition of the proper rib level for thoracoplasty/costoplasty. The emerging etiological–scoliogenic implications from the use of the DRCS and RI are described. The rotation of the trunk and vertebral bodies as interrelated, but distinct parameters are finally analyzed. Full article

Background/Objectives: The aim of this cross-sectional study was to establish if there is a relationship between body mass index (BMI) and skeletodental development in young obese patients in comparison with normal-weight patients. Methods: The sample consisted of 178 individuals (115 normal weight, 37 overweight and 26 obese), aged 6 to 16 years, with a mean biological age of 11.96 ± 2.44 years. Dental maturation (dental age) was determined by using Demerjian’s method; craniofacial growth pattern, skeletal and dental class were determined by using cephalometric measurements; skeletal maturation was determined by using Baccetti’s method. Data were statistically analyzed. Results: According to Demirjian’s method, the mean dental age of the overweight and obese subjects was significantly higher than that of the normal-weight subjects (p = 0.001 and p = 0.02, respectively). A higher rate of dental class III was detected in the overweight group (p = 0.002). Concerning cephalometric records, statistically significant differences (p = 0.018) were observed in the distribution of SNA and SNB values, higher values being found in obese subjects. No difference was detected in the distribution of the ANB angle between the groups. As regards craniofacial growth pattern, no significant differences were found between the groups. Children with obesity presented more advanced skeletal maturation, reaching statistically significant differences (p = 0.02), in comparison with the normal-weight subjects. Conclusions: In conclusion, obese children showed increased tooth and skeletal development in comparison to the normal-weight subjects. These findings may be of interest for orthodontists, who should consider weight status when performing orthodontic treatment in children and adolescents. Full article

This study aimed to predict the skeletal growth maturation using convolutional neural network-based deep learning methods using cervical vertebral maturation and the lower 2nd molar calcification level so that skeletal maturation can be detected from orthopantomography using multiclass classification. About 1200 cephalometric radiographs and 1200 OPGs were selected from patients seeking treatment in dental centers. The level of skeletal maturation was detected by CNN using the multiclass classification method, and each image was identified as a cervical vertebral maturation index (CVMI); meanwhile, the chronological age was estimated from the level of the 2nd molar calcification. The model’s final result demonstrates a high degree of accuracy with which each stage and gender can be predicted. Cervical vertebral maturation reported high accuracy in males (98%), while females showed high accuracy of 2nd molar calcification. CNN multiclass classification is an accurate method to detect the level of maturation, whether from cervical maturation or the calcification of the lower 2nd molar, and the calcification level of the lower 2nd molar is a reliable method to trust in the growth level, so the traditional OPG is enough for this purpose. Full article

Appropriate growth curves can reflect more sophisticated growth patterns of animals than body weight, and thus, the identification of genes and variants related to the growth curve parameter traits contributes to revealing the fine growth and development characteristics of livestock. However, the ability of single genome-wide association analysis (GWAS) and transcriptome analyses to identify valuable genes and variants is limited. In this study, based on genome and transcriptome data, the growth curve parameter traits of hybrid pigs were analyzed, and a set of genes and variants were identified. The Gompertz–Laird growth curve model was optimized to reveal the growth pattern of F₂ individuals of Duroc × Erhualian pigs over four time points. Five growth parameters were estimated, including initial body weight ${(W}_0)$, instantaneous growth rate per day (L), coefficient of relative growth or maturing index (k), body weight at inflection point ${(W}_i)$, and average growth rate (GR). These five parameters were subjected to a genome-wide association study, differential gene expression analysis, and weighted gene co-expression network analysis (WGCNA). In the study, 336 pigs were genotyped, and 39,494 SNP markers were used for each pig in the analysis. Thirty of these pigs were also included in the transcriptomics analysis. Based on genome and transcriptome data, the integrated analyses identified five putative SNPs (including INRA0056566 on chromosome X, DRGA0004151 on chromosome 3, INRA0056460 on chromosome X, H3GA0049324 on chromosome 17, and H3GA0037747 on chromosome 13) and 15 candidate genes (PDGFA, VEGFD, CSPP1, EFHC1, PIK3C3, ZZZ3, GCC2, MAPK14, ZPR1, ISG15, ANG, CEBPD, ZHX3, CTBP2, and MYNN). The functional analysis indicated that these candidate genes played important roles in cell division and differentiation, development and aging, and skeletal muscle and fat formation. Our results provide insight into the genetic mechanisms underlying the growth and development of hybrid pigs and offer a theoretical basis for genomic breeding. Full article

In vitro culture longevity has long been a concern for disease modeling and drug testing when using contractable cells. The dynamic nature of certain cells, such as skeletal muscle, contributes to cell surface release, which limits the system’s ability to conduct long-term studies. This study hypothesized that regulating the extracellular matrix (ECM) dynamics should be able to prolong cell attachment on a culture surface. Human induced pluripotent stem cell (iPSC)-derived skeletal muscle (SKM) culture was utilized to test this hypothesis due to its forceful contractions in mature muscle culture, which can cause cell detachment. By specifically inhibiting matrix metalloproteinases (MMPs) that work to digest components of the ECM, it was shown that the SKM culture remained adhered for longer periods of time, up to 80 days. Functional testing of myofibers indicated that cells treated with the MMP inhibitors, tempol, and doxycycline, displayed a significantly reduced fatigue index, although the fidelity was not affected, while those treated with the MMP inducer, PMA, indicated a premature detachment and increased fatigue index. The MMP-modulating activity by the inhibitors and inducer was further validated by gel zymography analysis, where the MMP inhibitor showed minimally active MMPs, while the inducer-treated cells indicated high MMP activity. These data support the hypotheses that regulating the ECM dynamics can help maximize in vitro myotube longevity. This proof-of-principle strategy would benefit the modeling of diseases that require a long time to develop and the evaluation of chronic effects of potential therapeutics. Full article

Sarcopenia, a complex and debilitating condition characterized by progressive deterioration of skeletal muscle, is the primary cause of age-associated disability and significantly impacts healthspan in elderly patients. Despite its prevalence among the aging population, the underlying molecular mechanisms are still under investigation. The NLRP3 inflammasome is crucial in the innate immune response and has a significant impact on diseases related to inflammation and aging. Here, we investigated the expression of the NLRP3 inflammasome pathway and pro-inflammatory cytokines in skeletal muscle and peripheral blood of dependent and independent patients who underwent hip surgery. Patients were categorized into independent and dependent individuals based on their Barthel Index. The expression of NLRP3 inflammasome components was significantly upregulated in sarcopenic muscle from dependent patients, accompanied by higher levels of Caspase-1, IL-1β and IL-6. Among older dependent individuals with sarcopenia, there was a significant increase in the MYH3/MYH2 ratio, indicating a transcriptional shift in expression from mature to developmental myosin isoforms. Creatine kinase levels and senescence markers were also higher in dependent patients, altogether resembling dystrophic diseases and indicating muscle degeneration. In summary, we present evidence for the involvement of the NLRP3/ASC/NEK7/Caspase-1 inflammasome pathway with activation of pro-inflammatory SASP in the outcome of sarcopenia in the elderly. Full article

Cachexia syndrome, leading to reduced skeletal muscle and fat mass, is highly prevalent in cancer patients, resulting in further negative implications for these patients. To date, there is no approved therapy for cachexia syndrome. The objective of this study was to establish an in vitro model of cancer cachexia in mature human skeletal muscle myotubes, with the intention of exploiting the cell model to assess potential cachexia therapeutics, specifically cannabinoid related drugs. Having cultured and differentiated primary human muscle myoblasts to mature myotubes, we successfully established two cancer cachexia models using conditioned media (CM) from human colon adenocarcinoma (SW480) and from non-small-cell lung carcinoma (H1299) cultured cells. The cancer-CM-induced extensive myotube degeneration, demonstrated by a significant reduction in mature myotube diameter, which progressed over the period studied. Myotube degeneration is a characteristic feature of cancer cachexia and was used in this study as an index of cachexia. Expression of cannabinoid 1 and 2 receptors (CB₁R and CB₂R) was confirmed in the mature human skeletal muscle myotubes. Subsequently, the effect of cannabinoid compounds on this myotube degeneration were assessed. Tetrahydrocannabinol (THC), a partial CB₁R/CB₂R agonist, and JWH133, a selective CB₂R agonist, proved efficacious in protecting mature human myotubes from the deleterious effects of both (SW480 and H1299) cancer cachexia conditions. ART27.13, a full, peripherally selective CB₁R/CB₂R agonist, currently being trialled in cancer cachexia (IRAS ID 278450, REC 20/NE/0198), was also significantly protective against myotube degeneration in both (SW480 and H1299) cancer cachexia conditions. Furthermore, the addition of the CB₂R antagonist AM630, but not the CB₁R antagonist Rimonabant, abolished the protective effect of ART27.13. In short, we have established a convenient and robust in vitro model of cancer-induced human skeletal muscle cachexia. The data obtained using the model demonstrate the therapeutic potential of ART27.13 in cancer-induced cachexia prevention and provides evidence indicating that this effect is via CB₂R, and not CB₁R. Full article

Engineering functional tissues of clinically relevant size (in mm-scale) in vitro is still a challenge in tissue engineering due to low oxygen diffusion and lack of vascularization. To address these limitations, a perfusion bioreactor was used to generate contractile engineered muscles of a 3 mm-thickness and a 8 mm-diameter. This study aimed to upscale the process to 50 mm in diameter by combining murine skeletal myoblasts (SkMbs) with human adipose-derived stromal vascular fraction (SVF) cells, providing high neuro-vascular potential in vivo. SkMbs were cultured on a type-I-collagen scaffold with (co-culture) or without (monoculture) SVF. Large-scale muscle-like tissue showed an increase in the maturation index over time (49.18 ± 1.63% and 76.63 ± 1.22%, at 9 and 11 days, respectively) and a similar force of contraction in mono- (43.4 ± 2.28 µN) or co-cultured (47.6 ± 4.7 µN) tissues. Four weeks after implantation in subcutaneous pockets of nude rats, the vessel length density within the constructs was significantly higher in SVF co-cultured tissues (5.03 ± 0.29 mm/mm²) compared to monocultured tissues (3.68 ± 0.32 mm/mm²) (p < 0.005). Although no mature neuromuscular junctions were present, nerve-like structures were predominantly observed in the engineered tissues co-cultured with SVF cells. This study demonstrates that SVF cells can support both in vivo vascularization and innervation of contractile muscle-like tissues, making significant progress towards clinical translation. Full article

Many observations have demonstrated great heterogeneity in the magnitude of the response to the physical exercise stimulus. Only a few studies have investigated the effects of high-intensity interval training (HIIT) on the prevalence of non-responders (NRs) in adolescents while considering health-related fitness measurements and other co-variables. Therefore, the aim of the current work was twofold: (1) to assess the effects of ten weeks of school-based HIIT on the prevalence of responders (Rs) and NRs for body composition, resting blood pressure (BP), cardiorespiratory and musculoskeletal fitness, and (2) to assess the relationship of this prevalence with sex, body mass category, and biological maturation status, while estimating the likelihood of a response. Adolescents aged 16 years (n = 73) were included in the study. Waist-to-hip ratio, body fat percentage (BFP), skeletal muscle mass (SMM), BP, cardiorespiratory fitness (CRF), and musculoskeletal fitness were the primary outcomes. Co-variables included sex, body mass index (BMI), and maturity offset. The percentages of the Rs and NRs were analyzed based on changes (Δ) between post-intervention and pre-intervention values. The typical error (TE) method was used to identify Rs and NRs. Results showed a variation in the relative size of changes (% of changes) depending on the variable and sex. The greatest changes were observed in females’ abdomen muscle strength (Δ% = 23.89%), and the difference from that of males (Δ% = 5.98%) was statistically significant (p < 0.001) with very large effect size of (Cohen’s d = 0.941). Similar significant differences in relative changes were observed in body composition, but in the reverse direction. Males gained more from HIIT in the decrease in the body fat percentage (Δ% = −8.24%) and increase in skeletal muscle mass (Δ% = 3.38%) comparing to females (Δ% = 0.46, p = 0.040 and Δ% = 1.06%, p = 0.007, respectively). Effect size for body fat was small (Cohen’s d = 0.469), and for skeletal muscle mass it was moderate (Cohen’s d = −0.659). The results also showed positive significant differences in the prevalence of Rs compared to NRs in BFP, SMM, systolic BP (SBP), diastolic BP (DBP), CRF, and abdominal muscular strength (ABS) (p = 0.047, p = 0.047, p < 0.001, p = 0.003, p = 0.014, and p = 0.014, respectively). The effect was greatest and largest for SBP (Cohen’s ω = 0.67). Sex was related to the prevalence of Rs for ABS and close to significance for SMM. More males than females benefited from HIIT in SMM (p = 0.058), but more females than males had ABS benefits (p = 0.050). Males were more likely (2.5-fold) to be Rs than females in SMM. BMI was not related to the prevalence of Rs and NRs. Biological maturation was related to the prevalence of Rs and NRs in SMM (p = 0.036) and SBP (p = 0.016). In SBP, 100% of the early matured derived benefit from HIIT, but the effect size was small (Cramer’s V = 0.27). Those who maturated later were more likely (almost 70%) to be Rs. Thus, the HIIT program introduced to a typical physical education (PE) lesson can be considered partially effective. Therefore, there is a need to continue the search for an optimal and effective program for all health-related parameters. The close relationship between analyzed values and sex and biological maturation, but not BMI, indicates that the intervention programs should be tailored specifically for males and females. Full article

The vegetal polyphenol curcumin displays beneficial effects against skeletal muscle derangement induced by oxidative stress, disuse or aging. Since oxidative stress and inflammation are involved in the progression of muscle dystrophy, the effects of curcumin administration were investigated in the diaphragm of mdx mice injected intraperitoneally or subcutaneously with curcumin for 4–12–24 weeks. Curcumin treatment independently of the way and duration of administration (i) ameliorated myofiber maturation index without affecting myofiber necrosis, inflammation and degree of fibrosis; (ii) counteracted the decrease in type 2X and 2B fiber percentage; (iii) increased about 30% both twitch and tetanic tensions of diaphragm strips; (iv) reduced myosin nitrotyrosination and tropomyosin oxidation; (v) acted on two opposite nNOS regulators by decreasing active AMP-Kinase and increasing SERCA1 protein levels, the latter effect being detectable also in myotube cultures from mdx satellite cells. Interestingly, increased contractility, decreased myosin nitrotyrosination and SERCA1 upregulation were also detectable in the mdx diaphragm after a 4-week administration of the NOS inhibitor 7-Nitroindazole, and were not improved further by a combined treatment. In conclusion, curcumin has beneficial effects on the dystrophic muscle, mechanistically acting for the containment of a deregulated nNOS activity. Full article

Accurately estimating and predicting chronological age from some anthropometric characteristics of an individual without an identity document can be crucial in the context of a growing number of forced migrants. In the related literature, the prediction of chronological age mostly relies upon the use of a single predictor, which is usually represented by a dental/skeletal maturity index, or multiple independent ordinal predictor (stage of maturation). This paper is the first attempt to combine a robust method to predict chronological age, such as Bayesian calibration, and the use of multiple continuous indices as predictors. The combination of these two aspects becomes possible due to the implementation of a complex statistical tool as the copula. Comparing the forecasts from our copula-based method with predictions from an independent model and two single predictor models, we showed that the accuracy increased. Full article

Hip dysplasia (HD) is a frequent cause of hip pain in skeletally mature patients and may lead to osteoarthritis (OA). An accurate and early diagnosis may postpone, reduce or even prevent the onset of OA and ultimately hip arthroplasty at a young age. The overall aim of this study was to assess the reliability of an algorithm, designed to read pelvic anterior-posterior (AP) radiographs and to estimate the agreement between the algorithm and human readers for measuring (i) lateral center edge angle of Wiberg (LCEA) and (ii) Acetabular index angle (AIA). The algorithm was based on deep-learning models developed using a modified U-net architecture and ResNet 34. The newly developed algorithm was found to be highly reliable when identifying the anatomical landmarks used for measuring LCEA and AIA in pelvic radiographs, thus offering highly consistent measurement outputs. The study showed that manual identification of the same landmarks made by five specialist readers were subject to variance and the level of agreement between the algorithm and human readers was consequently poor with mean measured differences from 0.37 to 9.56° for right LCEA measurements. The algorithm displayed the highest agreement with the senior orthopedic surgeon. With further development, the algorithm may be a good alternative to humans when screening for HD. Full article

The health benefits of physical activity (PA) are widely recognized; however, biological maturation contributions are a subject that has been little studied, which is why the aim of this study was to analyze the effect of a six-week training program at moderate-intensity on the muscular strength and aerobic capacity in children between nine and 13 years (13 ± 1.0 years) according to their maturation state. Twenty-six schoolchildren (15 girls) participated in a six-week physical exercise program based on aerobic/anaerobic capacity and coordination skills. Maximal oxygen uptake (VO₂max), trunk-lift, push-ups, curl-ups, and handgrip strength (both hands) were measured as response variables. Body mass index (BMI), skeletal maturity indicator (SMI), peak height velocity (PHV), age on peak height velocity (APHV) and sex were considered as covariates. The results of VO₂max, push-ups, curl-ups, and handgrip strength were higher after the exercise program in the whole group (p < 0.05). The VO₂max showed a greater increase in the normal-weight than in the overweight-obesity children (p = 0.001). Higher results in dominant handgrip strength were observed in girls (p = 0.003). The PHV before intervention presented a positive correlation with the dominant handgrip strength in all kids (r = 0.70, p = 0.001). As a conclusion, the six-week training program improved the physical fitness of children independent of the maturation state. Somatic maturation increases the physical abilities in schoolchildren. Full article