Search Results (5,573)

Background: Soft tissue sarcomas are rare and highly heterogeneous malignant tumors, often asymptomatic in the early stages. Accurate diagnosis and reliable assessment of the risk of metastasis, classified as low, intermediate, or high, are therefore essential for effective clinical decision-making. However, the application of Artificial Intelligence (AI) approaches to these diseases is often limited by the small size and quality of available datasets, which can compromise model robustness and reliability. Methods: The use of formal methods, based on mathematical modeling and logical verification, can be an alternative to AI techniques. When integrated with radiomics, formal methods provide a structured and interpretable approach to support disease diagnosis. Results: The proposed methodology yielded encouraging results, in line with those reported in the literature. A process was conducted to extract several first- and second-order radiomic classes, which were then selected based on their significance. The resulting models were evaluated using standard performance metrics and obtained 80% accuracy, 83% precision, and 83% recall. Conclusion: The transparency of formal methods improves the interpretability of models and radiomic features, allowing new links with clinical practice to be discovered. The proposed approach is presented as a feasibility and proof-of-concept framework aimed at improving interpretability. Given the very small cohort size, performance metrics should be considered preliminary and descriptive, as they require validation on larger external datasets before any clinical applicability can be claimed. Full article

Hydrogels are endowed with exceptional hydrophilicity and biocompatibility by their network structure, while also exhibiting soft physical properties similar to living tissues, which renders them ideal biomaterials. Responsive hydrogels—particularly those constructed from multicomponent systems including proteins, polysaccharides, peptides, and polyphenols—have emerged as a frontier research focus owing to their tunable responsiveness and controllable functional properties. In this review, hydrogel response mechanisms were categorized according to pH, ionic strength, temperature, light, enzymes, and multi-stimuli interactions. Key preparation strategies, encompassing chemical, physical, and enzymatic crosslinking, were systematically introduced. The preparation of hydrogels from various food-grade matrices, such as polysaccharide-based, protein-based, peptide-based, and polyphenol-based systems, was also summarized, with emphasis placed on how their tailored structures govern functional performance. Furthermore, innovative applications of responsive hydrogels were highlighted, including targeted delivery of nutrients and bioactive substances (e.g., probiotics, anthocyanins, vitamins) in functional foods, smart packaging and sensing for real-time freshness monitoring of meat and fruits, food quality detection through colorimetric and photothermal sensors, and 4D food printing for personalized nutrition and dysphagia-friendly foods. Full article

Background: Floating barbed threads are commonly used for minimally invasive midface lifting and rely on mobile subcutaneous tissue for support, which may limit stability. Fixation is primarily achieved by barb engagement within the subcutaneous fat and fibrous septa of the retinacula cutis. Objectives: To describe an anatomically guided modification of the APTOS Excellence Visage Soft (PLLA/PCL) thread technique, positioning the terminal segment posterior to the zygomatic retaining ligament line with the aim to enhancing mechanical stability. This technical report presents the anatomical rationale, procedural steps, and illustrative clinical cases demonstrating feasibility. Methods: The modified technique uses a single-entry point at the superior zygomatic margin, with five threads per hemiface. After linear insertion, the cannula is rotated laterally and inferiorly to position the terminal barbs posterior to the zygomatic retaining ligament line, thereby transferring tensile load toward a more fixed anatomical structure. Representative cases were documented and are presented. Results: Illustrative cases showed immediate midface elevation with improved malar projection and softening of the nasolabial and mentolabial folds. Standardized 3D imaging and vector analysis demonstrated a superolateral pattern of soft tissue displacement along the intended vectors, consistent with the proposed fixed-anchorage concept. The procedure was well tolerated, with only mild and transient local effects observed. One illustrative case included photographic follow-up at 12 months, in which preservation of midface contour and malar projection was visually appreciable. Conclusions: Redirecting the terminal thread segment posterior to the zygomatic retaining ligament line is a feasible modification that may contribute to improved vector stability by engaging a fixed fascial structure. Observations—including one case with 12-month follow-up—support the anatomical plausibility of the approach, although controlled studies with objective endpoints are necessary to confirm long-term efficacy and reproducibility. Full article

Background/Objectives: In the broad and current context of antimicrobial resistance, antibiotic management and therapeutic surveillance are essential in hospitals. The present study (five-year retrospective, 2020–2024) aimed to analyze antibiotic consumption in relation to pathogens identified in a multidisciplinary hospital. Results: In terms of antibiotic consumption (overall 2020–2024), although initially Watch antibiotics were predominantly used, a decrease was observed in favor of Access class antibiotics (sharply increase from 2022 to 2023 and maximum in 2024). For Reserve antibiotics, only slight annual fluctuations were observed, but there was an important reduction in colistin consumption. The most used were cephalosporins (cefazolin, cefuroxime and ceftriaxone), carbapenems (meropenem and ertapenem), vancomycin and linezolid. Regarding pathogens, the most notable were: Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterococcus spp., Pseudomonas aeruginosa. Among the ESKAPE bacteria, Acinetobacter baumannii was the least frequent in our samples. ESKAPE bacteria predominantly colonized specimens from the respiratory tract, digestive tract, skin and soft tissue. Resistant strains were observed, mainly Methicillin-resistant Staphylococcus aureus (MRSA) and Extended-Spectrum Beta-Lactamase (ESBL) Klebsiella spp., but no alarming increases in number were recorded in the analyzed period. Methods: The analysis was carried out using tools recommended by the World Health Organisation (Access Watch Reserve antibiotics classification (AWaRe); Bacterial Priority Pathogen List (BBPL); Defined Daily Dose (DDD)), Average Annual Percent Change (AAPC) calculation and ESKAPE classification (bacteria group: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.). Conclusions: Relatively stable trends in bacterial isolates and resistant strains over five years (2020–2024) are consistent with effective antimicrobial stewardship practices. Full article

In regenerative medicine, three-dimensional (3D) printing provides precise spatial control over the fabrication of complex, biomimetic tissue constructs, enabling the production of architecturally defined and functionally tailored scaffolds. By enabling precise layer-by-layer deposition of cells, biomaterials, and bioactive compounds, 3D printing overcomes many limitations associated with conventional scaffold fabrication methods. This approach facilitates the development of tailored structures that mimic the mechanical, biological, and structural characteristics of native tissues, thereby enhancing cellular organization, proliferation, and differentiation. Extensive research in tissue engineering has led to the development of 3D-printed scaffolds for the regeneration of vascular, skin, bone, cartilage, and soft tissues. Advances in bioink formulations—including growth factor-loaded systems, decellularized extracellular matrix components, and natural and synthetic polymers—have further improved tissue-specific functionality. Moreover, multimaterial and multiscale printing strategies enable the fabrication of heterogeneous constructs with controlled porosity, mechanical gradients, and spatially regulated biological cues. Although vascularized tissue constructs remain a major challenge for clinical translation, recent bioprinting advancements have significantly accelerated progress in this area. Integration of computer-aided design with patient-specific imaging data has further strengthened the potential of 3D printing for personalized regenerative therapies. Despite these advances, challenges related to scalability, regulatory approval, and long-term functionality persist. Nevertheless, continued progress in printing technologies, biomaterials, and regulatory and standards frameworks is expected to drive the clinical adoption of 3D printing. Ultimately, 3D printing represents a transformative approach in tissue engineering, redefining strategies for functional tissue regeneration and translational regenerative medicine. Full article

Auditory Brain–Computer Interfaces (BCIs) constitute the vital intervention for profound sensorineural hearing loss where the auditory nerve is compromised, yet their clinical efficacy remains restricted by substantial biological bottlenecks and limited spectral resolution. This review critically examines the evolutionary paradigm of auditory restoration, tracing the transition from static physical replacement to dynamic biological symbiosis. We systematically analyze physiological barriers across cochlear, brainstem, and cortical levels, elucidating how rigid interfaces provoke chronic tissue responses and why linear encoding protocols fail in distorted central tonotopy. The article synthesizes emerging methodologies in material science, demonstrating how soft, bio-integrated electronics and biomimetic topologies effectively address mechanical impedance mismatches. Furthermore, the trajectory of neural encoding is evaluated, highlighting the paradigm shift from traditional envelope extraction to deep learning-driven non-linear mapping and adaptive closed-loop neuromodulation. Finally, the potential of high-resolution modulation techniques, including optogenetics and sonogenetics, alongside AI-facilitated intent perception for active listening, is assessed. It is concluded that future neuroprostheses must evolve into symbiotic systems capable of seamlessly integrating with neural plasticity to enable high-fidelity cognitive reconstruction. Full article

Background: Periprosthetic joint infection (PJI) is a severe complication following megaprosthetic reconstruction in musculoskeletal oncology. This study aimed to evaluate outcomes of different surgical strategies for PJI in lower-limb megaprostheses and identify factors associated with treatment failure. Methods: We performed a retrospective cohort study of 29 consecutive patients treated for PJI after oncologic megaprosthetic reconstruction. Reinfection was analyzed using cumulative incidence functions (CIFs) with death treated as a competing event. Overall survival was assessed using Kaplan–Meier analysis. Univariable cause-specific Cox regression was performed for exploratory risk-factor analysis. Results: Among 29 patients, coagulase-negative staphylococci and Staphylococcus aureus were the most frequently isolated pathogens, and difficult-to-treat organisms were identified in a substantial proportion of cases. In patients managed with two-stage revision, the cumulative incidence of reinfection was 15% (95% CI: 0–30%) at 1 year and 30% (95% CI: 10–50%) at 2 and 5 years. In the DAIR cohort, the cumulative incidence of reinfection was 25% (95% CI: 0–62.5%) at 1 and 2 years and 37.5% (95% CI: 12.2–75%) at 3 years. Positive reimplantation cultures occurred in 38% of cases and were strongly associated with subsequent treatment failure. Polymicrobial infections were present in 27.5% of cases. Amputation was required in 17.2% of patients, often due to multidrug-resistant organisms or poor soft tissue. Conclusions: Two-stage revision remains the most effective strategy for PJI management in megaprostheses. DAIR may control acute infection but is suboptimal for definitive treatment. Individualized, multidisciplinary approaches are essential to improve outcomes in this high-risk population. Full article

Shoulder spasticity is a common consequence of upper motor neuron lesions and may be associated with soft tissue contractures, limiting functional recovery. While both cryoneurolysis and tendon lengthening procedures are used individually in refractory cases, their combined effect has not been clearly established. It is consequently necessary to assess the efficacy of combining cryoneurolysis and percutaneous pectoral tenotomy in reducing shoulder spasticity and improving passive range of motion in patients with refractory shoulder spasticity and contracture. This retrospective, single-centre cohort study included 15 adults (≥19 years) with chronic shoulder spasticity and clinically confirmed musculotendinous contracture, previously treated with botulinum toxin injections without sufficient functional response, and free of pharmacological effects (last injection >4 months prior). All patients underwent cryoneurolysis targeting motor branches to the pectoral muscles. Outcomes included Modified Ashworth Scale (MAS) and shoulder Passive Range Of Motion (PROM). The combined approach provided significant improvements in spasticity severity for shoulder flexion (p < 0.01) and abduction (p < 0.01), and significant improvements in maximum PROM for shoulder flexion (p < 0.0001) and abduction (p < 0.0001). Combining cryoneurolysis and pectoral tenotomy appears feasible, safe, and clinically beneficial in selected patients with both spasticity and tendon contracture. Cryoneurolysis addresses the neural component, while tenotomy may restore mechanical excursion. This sequential diagnostic and therapeutic approach may enhance personalized management of mixed spastic–contracture shoulder limitations and could be applicable to other joints. Full article

Accurate identification of anatomical landmarks on three-dimensional (3D) pelvic surface scans is essential for musculoskeletal assessment, yet manual procedures remain limited by operator dependence and soft tissue variability. This study presents a fully automated deep learning pipeline for localizing anatomical landmarks on the posterior pelvic region from raw 3D point cloud data. The pipeline integrates three modules: PelvicROINet for extracting the region of interest, PelvicAlignNet for rotation correction to standardize posture, and PelvicLandmarkNet for localizing six anatomical landmarks including the bilateral posterior superior iliac spines, bilateral iliac crests, L1, and L4. The models were trained independently with task-specific annotations and combined sequentially during inference. Under a subject-level split evaluation setting, the fully integrated system achieved a median error of 11.25 mm, demonstrating consistent localization performance across unseen subjects. Compared with manual landmark marking, the automated measurements showed improved within-visit repeatability, with reduced variability and higher intraclass correlation coefficients. The entire inference process required approximately three seconds per scan, supporting near real-time clinical applicability. These results indicate that the proposed modular framework enhances numerical consistency and robustness in surface-based pelvic landmark assessment and provides a scalable foundation for AI-assisted musculoskeletal evaluation and longitudinal monitoring. Full article

The 1st Joint Ectopic Calcification Meeting (JECM) was held in Nancy, France on 24–26 September 2025. In response to the growing need for unified scientific dialogue on soft tissue ectopic calcification, the Joint Ectopic Calcification Meeting (JECM) brought together the communities of INTEC, ISSEC, BBC, iSCCa, and the PXE Budapest meeting. This initiative emerged from concerns over fragmentation in the field, with multiple smaller meetings diluting collaborative potential. By consolidating efforts, JECM aims to foster interdisciplinary exchange, highlight cutting-edge research, and build a flagship event for the ectopic calcification community. With over 100 participants, the inaugural meeting in Nancy marks a promising step toward a more integrated and dynamic future for the field. The abstracts of this year’s meeting oral and poster presentations are collected in this conference paper, with permission from the corresponding authors. Full article

Background: Vascular injury after total knee arthroplasty (TKA) is rare but may be limb-threatening. Popliteal artery branch pseudoaneurysm is an uncommon complication that can present with nonspecific symptoms, potentially mimicking postoperative hematoma, infection, or deep venous thrombosis (DVT). Case presentation: A 79-year-old man underwent primary left TKA for advanced osteoarthritis (OA). Seven months later, he sustained a low-energy fall closed reduction and bracing were implemented. Due to recurrent episodes of instability with spontaneous self-reduction, a constrained revision TKA (R-TKA) was performed. Eighteen days after revision, the patient was readmitted because of persistent pain-related functional impairment. Duplex Doppler ultrasonography revealed a partially thrombosed pseudoaneurysm measuring 33 × 37 mm arising from a popliteal/genicular branch. Computed tomography angiography (CTA) confirmed a partially thrombosed pseudoaneurysm with a contrast-filled component within a larger periarticular fluid collection. This suggested a second, smaller pseudoaneurysm along the feeding vessel; hemarthrosis and soft-tissue edema were also present. After multidisciplinary evaluation, selective catheter angiography via left common femoral access was performed, and the injured branch was occluded using coil embolization combined with n-butyl cyanoacrylate tissue adhesive. Completion angiography demonstrated successful exclusion of the pseudoaneurysm without complications. Conclusions: Delayed pseudoaneurysm of a popliteal artery branch should be considered after revision TKA in patients with atypical swelling, hemarthrosis, or disproportionate pain. Duplex ultrasound and CTA are complementary diagnostic tools, and endovascular embolization provides a minimally invasive, effective, and low-morbidity treatment option when the lesion involves a branch vessel. Full article

Background: Inguinoscrotal sarcomas are a rare sarcoma subtype. The treatment of choice is radical inguinal orchiectomy with wide local resection of the surrounding soft tissues. However, consensus regarding prognostic factors is lacking. We present our experience at a referral sarcoma center concerning the management, oncologic results, and prognostic factors pertaining to this disease. Methods: We conducted a retrospective analysis of patients who underwent surgery for inguinoscrotal sarcomas between 2005 and 2023 at a sarcoma referral hospital. Results: The study included 39 patients. The most frequent histology was liposarcoma. Seven patients required surgical reconstruction with a microvascularized free flap. Four patients presented major postoperative complications. Mean follow-up was 46 months. Overall survival rates were 97.4%, 81.7%, and 64.8% at one, three, and five years. High-grade tumors were correlated with worse overall and disease-free survival. Conclusions: The chance finding of a sarcoma in the inguinal region poses a diagnostic and therapeutic dilemma when considering options for treatment with curative intent. Vascular and muscle resection followed by vascular and/or free flap reconstruction may be necessary to achieve complete surgical resections; therefore, a multidisciplinary approach is needed. A preoperative biopsy should be performed to establish the histological grade, which may be the main prognostic factor. Full article

Background: Bone vibrator (BV) stimulation applied to skin sites on the body elicits hearing by soft tissue conduction (STC). However, BV stimulation to sites far from the ear requires the delivery of higher-intensity stimulus vibrations to achieve threshold, which can then induce hearing by air conduction (AC) contamination. This problem limits the study of STC thresholds at sites more distant from the ear. Objective: To overcome this problem, we evaluated the possibility of delivering STC vibratory stimuli to body sites in a water bath, based on the different acoustic impedances between air and water, which produces a 30 dB reduction in transmission from water to air. Methods: A standard clinical BV delivered vibration stimuli (tonal and speech stimuli) applied directly to two body sites: finger and foot. BV and body sites were immersed in a water bath. One control involved both stimulation site and BV both in water, but not in contact. In an additional control, the BV was in the bath, while the stimulation site was out of the bath. Results: STC hearing of both pure tones and speech could be elicited at stimulus intensities below those induced by control stimulation (body site and BV both in water, but not in contact; BV in bath, stimulation site out of bath). STC thresholds at the finger site were lower than those at the foot. Conclusions: The current results suggest that water-immersion method enables study of STC hearing in response to higher-intensity vibrational stimuli, and at body sites more distant from the ear, without contamination by AC hearing. Full article

Additive manufacturing (AM) offers new opportunities for biomedical device design; however, its translation to soft-tissue reinforcement remains challenging, particularly in pelvic organ prolapse (POP) applications requiring mechanical performance and tissue compatibility. In this study, a hybrid AM approach combining melt electrowriting (MEW) and controlled post-processing was developed to fabricate biodegradable poly(ε-caprolactone) (PCL) cog threads for minimally invasive pelvic reinforcement. This integrated fabrication workflow enables the precise deposition of microscale fibers via MEW followed by localized mechanical modification, offering a versatile platform for tailoring graft architecture and anchoring geometry. Smooth filaments were first produced via MEW and subsequently post-processed to introduce barbs for mechanical anchorage. The resulting structures were mechanically characterized through uniaxial tensile testing and evaluated as reinforcement elements in ex vivo sow vaginal tissue using ball burst testing. The MEW-fabricated cog threads increased the ultimate load of vaginal tissue from 83 ± 20 N (control) to 126 ± 15 N, corresponding to a 51.8% improvement (p = 0.0477). Compared with commercial PCL cog threads reported in the literature (177.0 ± 5.4 N), the reinforced specimens achieved approximately 71% of the benchmark load. Owing to their intermediate stiffness profile, the MEW-fabricated cog threads reduced mechanical mismatch with soft tissue compared to high-stiffness commercial alternatives. These findings demonstrate the feasibility of hybrid MEW-based additive manufacturing strategies for engineering mechanically compatible, application-driven soft-tissue reinforcement systems. Full article

Background/Objectives: Breast morphology is commonly described using volume, projection, and ptosis, whereas proportional relationships within the breast footprint are less frequently quantified. Routine clinical measurements describe the apparent or clinically measured breast footprint rather than the fixed anatomical footprint. This exploratory study examines how body mass index and thoracic width are associated with the clinically measured horizontal and vertical dimensions of the breast footprint and introduces the height-to-base-width (H/B) ratio as a simple descriptive index. Methods: Anthropometric measurements from 50 women undergoing aesthetic breast surgery were retrospectively analyzed. Breast base width and breast height were obtained using standardized upright clinical measurements. BMI was used as a surrogate of adiposity, while thoracic circumference measured at the inframammary fold (band size) served as a proxy for thoracic frame size. Associations were examined using Spearman correlation and multivariable regression. Results: BMI showed a strong positive association with clinically measured breast base width (ρ = 0.691, p < 0.001) but only a weak association with breast height (ρ = 0.327, p = 0.0777). Thoracic width was inversely associated with the H/B ratio (ρ = −0.549, p = 0.002). Multivariable analysis identified BMI as the principal determinant of measured base width, whereas vertical footprint dimensions showed limited responsiveness to BMI variation. Conclusions: Higher BMI was associated with horizontal expansion of the measured breast footprint, while vertical dimensions remained comparatively stable. These findings reflect soft-tissue redistribution and measurement-dependent footprint appearance rather than alteration of the underlying anatomical footprint. The H/B ratio emerges as a potential descriptive index for apparent footprint proportions, meriting further investigation and prospective validation. Full article