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Heterotopic ossification (HO) is a pathological bone formation process caused by musculoskeletal trauma. HO is characterized by aberrant endochondral ossification and angiogenesis. Our previous studies have indicated that macrophage inflammation is involved in traumatic HO formation. In this study, we found that macrophage infiltration and TGF-β signaling activation are presented in human HO. Depletion of macrophages effectively suppressed traumatic HO formation in a HO mice model, and macrophage depletion significantly inhibited the activation of TGF-β/Smad2/3 signaling. In addition, the TGF-β blockade created by a neutralizing antibody impeded ectopic bone formation in vivo. Notably, endochondral ossification and angiogenesis are attenuated following macrophage depletion or TGF-β inhibition. Furthermore, our observations on macrophage polarization revealed that M2 macrophages, rather than M1 macrophages, play a critical role in supporting HO development by enhancing the osteogenic and chondrogenic differentiation of mesenchymal stem cells. Our findings on ectopic bone formation in HO patients and the mice model indicate that M2 macrophages are an important contributor for HO development, and that inhibition of M2 polarization or TGF-β activity may be a potential method of therapy for traumatic HO. [ABSTRACT FROM AUTHOR]

Genu recurvatum (knee hyperextension) is a common problem after stroke. It is important to promote the coordination between knee and ankle movements during gait; however, no study has investigated how multi-joint assistance affects genu recurvatum. We are developing a gait training technique that uses robotized knee-ankle-foot orthosis (KAFO) to assists the knee and ankle joints simultaneously. This report aimed to investigate the safety of robotized KAFO-assisted gait training (Experiment 1) and a clinical trial to treat genu recurvatum in a patient with stroke (Experiment 2). Six healthy participants and eight patients with chronic stroke participated in Experiment 1. They received robotized KAFO-assisted gait training for one or 10 sessions. One patient with chronic stroke participated in Experiment 2 to investigate the effect of robotized KAFO-assisted gait training on genu recurvatum. The patient received the training for 30 min/day for nine days. The robot consisted of KAFO and an attached actuator of four pneumatic artificial muscles. The assistance parameters were adjusted by therapists to prevent genu recurvatum during gait. In Experiment 2, we evaluated the knee joint angle during overground gait, Fugl-Meyer Assessment of lower extremity (FMA-LE), modified Ashworth scale (MAS), Gait Assessment and Intervention Tool (G.A.I.T.), 10-m gait speed test, and 6-min walk test (6MWT) before and after the intervention without the robot. All participants completed the training in both experiments safely. In Experiment 2, genu recurvatum, FMA-LE, MAS, G.A.I.T., and 6MWT improved after robotized KAFO-assisted gait training. The results indicated that the multi-joint assistance robot may be effective for genu recurvatum after stroke. [ABSTRACT FROM AUTHOR]

Copyright of SEMS-Journal is the property of Schwiez Zschr Sportmed Sporttraumatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Surgical resection is the primary treatment for advanced-stage heterotopic ossification (HO), with a high incidence of local recurrence reaching up to 50%. Postoperative radiotherapy (PORT) and indomethacin are commonly used prophylactic strategies following surgery. The study aims to assess the safety and effectiveness of PORT in advanced-stage HO patients having motor vehicle accidents (MVA). Methods: Medical records of patients having HO following MVA between 2006 and 2021 were retrospectively reviewed. Thirty-nine patients with advanced disease (35 had hip HO and 4 had elbow HO) were included in the study. Results: Excision of HO with joint preservation was performed for 82% of patients, while 18% had a joint replacement. Seven to 8 Gy radiation was given to all patients within 3 days postoperatively. A ninty seven percent of patients regained partially the movement range. The mean follow-up time was 74 months. Six patients had treatment failure, with only one having a recurrence of HO. The 8-year treatment failure-free rate (8-y TFFR) was 79.3±9%, and the 5-year HO failure-free rate (5y-HOFFR) was 97.2±3%. Acute side effects were experienced in 13% of patients but resolved without any consequences. Despite the relatively long follow-up time, we did not report any absolute infertility or secondary malignancies related to the radiation. The testicular mean calculated dose was 33±44 cGy, and the mean measured dose was 58±40 cGy. Of the 35 patients who received radiation to the pelvis, 26 were married, and all did not experience infertility post-treatment. Conclusion: PORT proved an effective and safe treatment for advanced-stage HO disease. The treatment failure is mainly related to surgical difficulties due to advanced disease. Treatment using a 3-dimensional or intensity-modulated radiation therapy is not associated with serious side effects like second malignancy or absolute infertility. [ABSTRACT FROM AUTHOR]

Background: Botulinum neurotoxin (BoNT) injection is an established therapy for limb spasticity and focal limb dystonia. Comparative benefits of injection guidance procedures have not been rigorously studied. Objectives: We compared 2 targeting techniques for onabotulinumtoxin‐A (onabotA) injection for the treatment of focal hand dystonia and upper limb spasticity: electrophysiologic guidance using electrical stimulation (E‐stim) and ultrasound (US). Methods: This was a 2‐center, randomized, crossover, assessor‐blinded trial. Participants with focal hand dystonia or upper limb spasticity, on stable onabotA therapy for at least 2 previous injection cycles, were randomly assigned to either E‐stim or US with crossover at 3 months. The primary outcome was improvement in dystonia or spasticity severity on a visual analog scale (VAS; 0–100) measured 1 month after each injection. The secondary outcome was participant discomfort assessed on a VAS. Repeated‐measures analysis of covariance was used with linear mixed‐model covariate selection. Results: A total of 19 participants (13 men) completed the study, 10 with upper limb spasticity and 9 with dystonia. Benefit was equivalent between the 2 techniques (VAS least‐square mean [LSmean] 51.5 mm with US and 53.1 with E‐stim). E‐stim was perceived as more uncomfortable by participants (VAS LSmean 34.5 vs. 19.9 for E‐stim and US, respectively). Procedure duration was similar with the 2 procedures. There were no serious adverse events related to either approach. Conclusions: US and E‐Stim localization guidance techniques provide equivalent efficacy in onabotA injections for spasticity and dystonia. US guidance injections are more comfortable for participants. Both techniques are effective guidance methods, with US potentially preferable based on participant comfort. [ABSTRACT FROM AUTHOR]

Background: Large calves are considered unattractive. Botulinum toxin type A (BoNT‐A), acting as a neurotoxin that reduces muscle contraction, is widely used in calf contouring. However, there lacks detailed anatomical data to guide clinical injection. Objectives: This study aims to use ultrasonography to provide depth information of the calf muscles and determine the morphological types of the gastrocnemius muscle. Methods: Ultrasound scanning was performed at six sites on 40 Chinese adults. A real‐time ultrasound scannerwas used to detect the depth of the gastrocnemius muscle and the soleus muscle. Results: The thickness of the gastrocnemius muscle and the soleus muscle was measured. The depth from the skin to the surface, the middle, and the bottom of the gastrocnemius muscle was measured. The morphology of gastrocnemius muscle was classified into four different types under ultrasound according to the muscle bulge pattern. Conclusion: This study took ultrasonic measurements of Asian calves to guide accurate and effective BoNT‐A injection in real clinical practice. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Crop Production & Processing is the property of Isfahan University of Technology, Faculty of Agricultural Engineering and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study assessed the bioaccumulation of metallic elements in sugar beet which is irrigated by the surface waters of Beht and Sebou rivers. The study focused on four supports: the bark, the pulp, molasses (raw sugar) and the leaves. Seven metal elements (Cd, Co, Cr, Cu, Ni, Pb and Zn) were analyzed by spectrometry emission coupled plasma (ICP). The obtained results showed that the levels of Cd in irrigating water exceeds the thresholds set by Moroccan standards. The concentrations of Cd and Cr in soil (0-15, 15-30cm) are higher than those set by the AFNOR and the contents of Cd, Cr, Cu and Ni in the supports of the beet exceed normal levels which are established by Kabata-Pendias and Mukherjee. Multivariate analysis (PCA) of average values of heavy metal says that the increase of variable induces the growth of the other, that is to say, there is a positive interaction between the elements for the physicochemical conditions of irrigation waters and agricultural soil collected. The obvious bioaccumulation of metallic elements which are identified in sugar beet are normally caused by the use of water surfaces of Beht and Sebou as sources of irrigation. [ABSTRACT FROM AUTHOR]

Gamma-ray bursts (GRBs) are known to have the most relativistic jets, with initial Lorentz factors in the order of a few hundreds. Many GRBs display an early X-ray light-curve plateau, which was not theoretically expected and therefore puzzled the community for many years. Here, we show that this observed signal is naturally obtained within the classical GRB fireball model, provided that the initial Lorentz factor is rather a few tens, and the expansion occurs into a medium-low density wind. The range of Lorentz factors in GRB jets is thus much wider than previously thought and bridges an observational gap between mildly relativistic jets inferred in active galactic nuclei, to highly relativistic jets deduced in few extreme GRBs. Furthermore, long GRB progenitors are either not Wolf-Rayet stars, or the wind properties during the final stellar evolution phase are different than at earlier times. Our model has predictions that can be tested to verify or reject it in the future, such as lack of GeV emission, lack of strong thermal component and long (few seconds) variability during the prompt phase characterizing plateau bursts. The origin of the plateau observed in the early X-ray light curves of gamma ray bursts (GRBs) is debated. Here, the authors show that the observed plateau can be explained within the classical GRB model by considering expanding shell with initial Lorentz factor of a few tens. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a sudden injury that causes damage to the brain. Rehabilitation therapies include specific training, such as attention process training (APT) programs using either standard or innovative approaches. The aim of this study is to evaluate the effects of a non-immersive virtual reality-based attention training to stimulate attention processes and mood in TBI patients. Thirty subjects with TBI were enrolled at the Neurorehabilitation Unit of the IRCCS Neurolesi Center and divided into either the Conventional Attention Process Training Group (C_APT: n = 15) or the Virtual-Based Attention Processes Training Group (VB_APT: n = 15), treated with the Virtual Reality Rehabilitation System (VRRS-Evo). All of the patients were evaluated with a specific psychometric battery before (T0) and after the end (T1) of each program. We found statistically significant differences between the two groups, in particular concerning global cognitive status (p < 0.02), attention processes (p < 0.03), depression symptoms (p < 0.04) and visual attention (p < 0.01). Experimental intragroup analysis showed great statistical significances in all psychometric tests, i.e., the Montreal Cognitive Assessment (p < 0.0006), Attention Matrices (p < 0.0007), the Hamilton Rating Scale-Depression (p < 0.004), the Trail Making Test-A (p < 0.0007), the Trail Making Test-B (p < 0.0007), and the Trail Making test-BA (p < 0.007). Our results suggest that non-immersive virtual reality may be a useful and effective approach for the attention processes recovery and mood of TBI patients, leading to better cognitive and behavioral outcomes. [ABSTRACT FROM AUTHOR]

The kinetics of formation and crystallization of Ln2Ti2O7 (Ln = Gd, Lu) pyrochlores from nanoparticulate precursors prepared via coprecipitation have been analyzed using X-ray diffraction, Raman spectroscopy, luminescence spectroscopy, scanning electron microscopy, calorimetry (differential scanning calorimetry (DSC)), mass spectrometry, and quantitative thermogravimetry (TG). The results demonstrate that the formation of the pyrochlores proceeds through crystallization of a nanoparticulate fluorite phase. The starting mixtures have been shown to consist in considerable measure of hydroxides and hydroxycarbonates, rather than of oxides. The first synthesis step at temperatures below 550–650°C is decomposition of the starting compounds to titanium oxide and lutetium (or gadolinium) dioxycarbonate. The second step is the synthesis of final compounds, also accompanied by CO2 release. Thus, "high-temperature" CO2 release makes it possible to visualize the synthesis kinetics. Specially designed experiments involving prolonged heat treatment at low temperatures (540 h at 550°C and 216 h at 700°C) have shown that Lu2Ti2O7 can be synthesized almost completely from starting mixtures even at 550°C. The high degree of conversion at 550°C has been confirmed by quantitative TG. Raman and luminescence spectroscopy results demonstrate that the disordered nanooxide synthesized at 550°C, with a crystallite size of 15 Å, has the fluorite structure. Prolonged heat treatment at 700°C was accompanied by an increase in crystallite size and a fluorite-to-pyrochlore phase transition. During heating of the starting precursor at a high rate, 10°C/min (DSC and TG), all of the processes were shifted to higher temperatures. The formation of the final Ln2Ti2O7 (Ln = Gd, Lu) pyrochlores through a nanoparticulate fluorite phase is characteristic of both systems. Thus, all of the Ln2M2O7 (M = Ti, Zr, Hf) 3+/4+ pyrochlores are formed as a result of an order–disorder transition from a nanoparticulate fluorite phase to a pyrochlore phase. [ABSTRACT FROM AUTHOR]

A significant fraction of massive stars move at speed through the interstellar medium of galaxies. After their death as core-collapse supernovae, a possible final evolutionary state is that of a fast-rotating magnetized neutron star, shaping its circumstellar medium into a pulsar wind nebula. Understanding the properties of pulsar wind nebulae requires knowledge of the evolutionary history of their massive progenitors. Using two-dimensional magnetohydrodynamical simulations, we demonstrate that, in the context of a runaway high-mass red-supergiant supernova progenitor, the morphology of its subsequent pulsar wind nebula is strongly affected by the wind of the defunct progenitor star pre-shaping the stellar surroundings throughout its entire past life. In particular, pulsar wind nebulae of obscured runaway massive stars harbour asymmetries as a function of the morphology of the progenitor's wind-blown cavity, inducing projected asymmetric up–down synchrotron emission. [ABSTRACT FROM AUTHOR]

The performance characteristics of solid oxide fuel cells operating at intermediate temperatures depend largely on the tailored properties of the electrolyte used in making these cells. The extensive properties like conductivity and stability have a direct correlation with the defect chemistry of the electrolyte material. Proton conductors are gaining momentum as plausible electrolytes for intermediate temperature solid oxide fuel cells (IT-SOFC). The replacement of electrolytes which conduct oxide ion (O 2 - ) by proton ion (H + ) largely enhances the performance in addition to decrease of cost of operation. But tailoring the oxide electrolytes for both high proton conductivity and chemical stability is a challenging task as they are antagonistic properties. This review discusses in detail the various electrolyte structures exhibiting proton conduction and also studies the effect of various dopants which alters the conductivity and stability of proton-conducting electrolytes for IT-SOFC. This review elaborates the mechanism of proton conduction in various oxides thereby providing a correlation between the structural and mechanistic features of the solid electrolytes. This review envisages to study the properties of proton-conducting electrolytes and aims to propose a framework that correlates the synthesis and properties of tailored electrolytes to the overall performance of the IT-SOFC for commercial applications. [ABSTRACT FROM AUTHOR]

Modes have steadily influenced the understanding of physical systems through time. At least since the prediction of the Casimir effect, they also play a very important role in Casimir physics and in the understanding of the different phenomena typical of this research field. At equilibrium modes provide a direct connection between the zero-point energy and the existence of irreducible fluctuations in a quantum system, offering an anatomic view into the physics of the interaction. In nonequilibrium systems, modes can be decisive to understand the behavior of quantum fluctuation-induced phenomena, highlighting key aspects which determine their strength and their functional dependence. In this article we review some recent studies and results that highlight how modes impact Casimir physics and the central role they play in shaping our understanding of this area of research. [ABSTRACT FROM AUTHOR]

Cyclic GMP–phosphodiesterase type 5 (PDE5) inhibition has been shown to counteract maladaptive cardiac changes triggered by diabetes in some but not all studies. We performed a single-center, 20-week, double-blind, randomized, placebo-controlled trial (NCT01803828) to assess sex differences in cardiac remodeling after PDE5 inhibition in patients with diabetic cardiomyopathy. A total of 122 men and women (45 to 80 years) with long-duration (>3 years) and well-controlled type 2 diabetes mellitus (T2DM; HbA1c < 86 mmol/mol) were selected according to echocardiographic signs of cardiac remodeling. Patients were randomly assigned (1:1) to placebo or oral tadalafil (20 mg, once daily). The primary outcome was to evaluate sex differences in cardiac torsion change. Secondary outcomes were changes in cardiovascular, metabolic, immune, and renal function. At 20 weeks, the treatment-by-sex interaction documented an improvement in cardiac torsion (−3.40°, −5.96; −0.84, P = 0.011) and fiber shortening (−1.19%, −2.24; −0.14, P = 0.027) in men but not women. The primary outcome could not be explained by differences in cGMP concentrations or tadalafil pharmacodynamics. In both sexes, tadalafil improved hsa-miR-199-5p expression, biomarkers of cardiovascular remodeling, albuminuria, renal artery resistive index, and circulating Klotho concentrations. Immune cell profiling revealed an improvement in low-grade chronic inflammation: Classic CD14++CD16− monocytes reduced, and Tie2+ monocytes increased. Nine patients (14.5%) had minor adverse reactions after tadalafil administration. Continuous PDE5 inhibition could offer a strategy to target cardiorenal complications of T2DM, with sex- and tissue-specific responses. Further studies are needed to confirm Klotho and hsa-miR-199-5p as markers for T2DM complications. Conditional cardioprotection: Phosphodiesterase 5 (PDE5) inhibition has been shown to have inconsistent cardioprotective effects. Here, Pofi et al. conducted a small phase 4 trial to assess sex differences in cardiac remodeling in patients with diabetes and diabetic cardiomyopathy treated with the PDE5 inhibitor tadalafil. They observed an improvement in cardiac shortening and torsion in men but not women, whereas circulating has-miR-199-5p was reduced and Klotho increased with treatment in both sexes. Certain populations of monocytes were also altered with treatment. Results highlight the importance of considering sex-specific differences in treatment response. [ABSTRACT FROM AUTHOR]

The functional interdependence of nerves and blood vessels is a well-established concept during tissue morphogenesis, yet the role of neurovascular coupling in proper and aberrant tissue repair is an emerging field of interest. Here, we sought to define the regulatory relationship of peripheral nerves on vasculature in a severe extremity trauma model in mice, which results in aberrant cell fate and heterotopic ossification (HO). First, a high spatial degree of neurovascular congruency was observed to exist within extremity injury associated heterotopic ossification. Vascular and perivascular cells demonstrate characteristic responses to injury, as assessed by single cell RNA sequencing. This vascular response to injury was blunted in neurectomized mice, including a decrease in endothelial proliferation and type H vessel formation, and a downregulation of key transcriptional networks associated with angiogenesis. Independent mechanisms to chemically or genetically inhibit axonal ingrowth led to similar deficits in HO site angiogenesis, a reduction in type H vessels, and heterotopic bone formation. Finally, a combination of single cell transcriptomic approaches within the dorsal root ganglia identified key neural-derived angiogenic paracrine factors that may mediate neuron-to-vascular signaling in HO. These data provide further understanding of nerve-to-vessel crosstalk in traumatized soft tissues, which may reflect a key determinant of mesenchymal progenitor cell fate after injury. [ABSTRACT FROM AUTHOR]

Afterglow radiation in gamma-ray bursts (GRB), extending from the radio band to GeV energies, is produced as a result of the interaction between the relativistic jet and the ambient medium. Although in general the origin of the emission is robustly identified as synchrotron radiation from the shock-accelerated electrons, many aspects remain poorly constrained, such as the role of inverse Compton emission, the particle acceleration mechanism, the properties of the environment and of the GRB jet itself. The extension of the afterglow emission into the TeV band has been discussed and theorized for years, but has eluded for a long time the observations. Recently, the Cherenkov telescopes, MAGIC and H.E.S.S., have unequivocally proven that afterglow radiation is also produced above 100 GeV, up to at least a few TeV. The accessibility of the TeV spectral window will largely improve with the upcoming facility CTA (the Cherenkov Telescope Array). In this review article, we first revise the current model for afterglow emission in GRBs, its limitations and open issues. Then, we describe the recent detections of very high energy emission from GRBs and the origin of this radiation. Implications on the understanding of afterglow radiation and constraints on the physics of the involved processes will be deeply investigated, demonstrating how future observations, especially by the CTA Observatory, are expected to give a key contribution in improving our comprehension of such elusive sources. [ABSTRACT FROM AUTHOR]

BACKGROUND: The assessment of gait function is important for stroke rehabilitation. Gait function of patients with stroke often depends on the type of orthosis. There are however few gait assessments that assess the type of orthosis. OBJECTIVE: The purpose of this study was to investigate the reliability and validity of our newly developed Ambulation Independence Measure (AIM), which assesses the gait function, type of orthoses and physical assistance, for acute stroke patients. METHODS: A total of 73 acute stroke patients participated in this prospective study. The AIM discriminates 7 levels of gait ability on the basis of the amount of physical assistance required and orthoses that are used during walking. Interrater reliability, concurrent validity with the Functional Ambulation Category (FAC) and predictive validity were examined. RESULTS: The weighted kappas of AIM at the start of gait training (baseline) and discharge were 0.990 and 0.978, respectively. The AIM scores were significantly correlated with the FAC scores at both baseline (r = 0.808) and discharge (r = 0.934). Multiple regression analyses showed that the AIM at baseline was a stronger predictor of the FAC at discharge (R2 = 0.80). CONCLUSIONS: The AIM has excellent reliability, concurrent validity, predictive validity, and good responsiveness in acute stroke patients. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Ankara Training & Research Hospital is the property of Medical Journal of Ankara Training & Research Hospital and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We studied niobium nitride (NbN)-based π-junctions with a diluted ferromagnetic Pd89Ni11 interlayer (NbN/PdNi/NbN junctions). In the NbN/PdNi/NbN junctions with various PdNi thicknesses, we observed a non-monotonic dependence of the critical currents on PdNi thickness, indicating the effects of the exchange interaction on the superconducting order parameter. From theoretical fitting of the experimental data, we found that the NbN/PdNi/NbN junctions showed a significantly smaller degree of spin-flip scattering in the PdNi interlayer than in the CuNi interlayer of NbN/CuNi/NbN junctions reported previously. The weak spin-flip scattering leads to a longer decay length of the Josephson critical current, so the critical currents were observed over a wide range of PdNi thicknesses (10–40 nm). We also fabricated superconducting quantum interference devices (SQUIDs) including the NbN/PdNi/NbN junction, using a PdNi thickness in which the π-state was expected. A half-flux-quantum shift, as evidence of the π-state, was observed in the magnetic field-dependent critical currents of the SQUIDs. This result represents an important step towards the practical application of NbN-based π-Josephson junctions. [ABSTRACT FROM AUTHOR]

The recent multi-messenger and multi-wavelength observations of gamma-ray bursts (GRBs) have encouraged renewed interest in these energetic events. In spite of the substantial amount of data accumulated during the past few decades, the nature of the prompt emission remains an unsolved puzzle. We present an overview of the leading models for their prompt emission phase, focusing on the perspective opened by future missions. [ABSTRACT FROM AUTHOR]

Abstract: Genet F, Autret K, Schnitzler A, Lautridou C, Bernuz B, Denormandie P, Allieu Y, Parratte B. Motor branch of extensor carpi radialis longus: anatomic localization. Objective: To identify extensor carpi radialis longus (ECRL) motor nerve coordinates in relation to anatomic surface landmarks. Design: Descriptive study. Setting: Anatomy institute of a school of medicine in Paris, France. Cadavers: Fresh adult cadaver upper limbs (N=20). Intervention: Anatomic dissection of upper limbs. Main Outcome Measures: Three measurements (mm) were taken of the position of the ECRL motor branch: the distance between the lateral epicondyle and the emergence of the ECRL branch along the forearm axis, the branch depth, and the ratio between the distance corresponding to the nerve depth and the intercondylar distance. Results: The radial nerves of 4 men and 6 women (age range 59–80y) were identified between the brachioradialis and the ECRL and traced proximally to the lateral epicondyle. The injection point was between the lateral epicondyle posteriorly and the wrist extensor group anteriorly. Direction was perpendicular to the axis of the forearm. Mean depth was 35.6mm (minimal value: 24.0; maximal value: 58.0; SD=9mm). Ratio between nerve depth and intercondylar distance was .46 (.37; .53±.05). Conclusions: The ECRL motor nerve branch is easy to reach using specified landmarks. Selective motor nerve block of the ECRL branch should be considered in the clinical assessment to test the capacity of the extensor carpi radialis brevis to extend the wrist alone and to assess the command and overactivity of antagonists before surgery. [Copyright &y& Elsevier]

Neurogenic heterotopic ossifications (NHOs) form in periarticular muscles after severe spinal cord (SCI) and traumatic brain injuries. The pathogenesis of NHO is poorly understood with no effective preventive treatment. The only curative treatment remains surgical resection of pathological NHOs. In a mouse model of SCI‐induced NHO that involves a transection of the spinal cord combined with a muscle injury, a differential gene expression analysis revealed that genes involved in inflammation such as interleukin‐1β (IL‐1β) were overexpressed in muscles developing NHO. Using mice knocked‐out for the gene encoding IL‐1 receptor (IL1R1) and neutralizing antibodies for IL‐1α and IL‐1β, we show that IL‐1 signaling contributes to NHO development after SCI in mice. Interestingly, other proteins involved in inflammation that were also overexpressed in muscles developing NHO, such as colony‐stimulating factor‐1, tumor necrosis factor, or C‐C chemokine ligand‐2, did not promote NHO development. Finally, using NHO biopsies from SCI and TBI patients, we show that IL‐1β is expressed by CD68+ macrophages. IL‐1α and IL‐1β produced by activated human monocytes promote calcium mineralization and RUNX2 expression in fibro‐adipogenic progenitors isolated from muscles surrounding NHOs. Altogether, these data suggest that interleukin‐1 promotes NHO development in both humans and mice. © 2021 American Society for Bone and Mineral Research (ASBMR). [ABSTRACT FROM AUTHOR]

Evidence on prophylactic radiotherapy (RT) in hip heterotopic ossification (HO) is sparse and conflicting. The aim of this literature review was to collect and summarize the available data on RT efficacy in preventing hip HO. The results of this review show that RT is effective in the prevention of hip HO, albeit with large variability across series. Effective prophylactic RT requires optimal treatment fields and time intervals with surgery. On the contrary, there is no clear evidence on the optimal timing (post-operative versus pre-operative RT). Comparisons between prophylactic RT and use of non-steroidal antiinflammatory drugs showed conflicting results, although most were in favor of RT. In conclusion, RT is an established prophylactic treatment for hip HO. However, optimal dose, technique and timing remain unclear, as does the usefulness of combining RT with drugs. [ABSTRACT FROM AUTHOR]

To investigate the effect of muscle selection for botulinum neurotoxin A (BoNT-A) treatment on spasticity in patients with post-stroke elbow flexor muscle over-activity. Chronic stroke patients with a deforming spastic paresis in the upper limb (elbow flexion with forearm pronation) who were injected BoNT-A into at least one of elbow flexor muscles (brachialis, brachioradialis, and biceps brachii) were included in this prospective observational study. The main outcome measure was spasticity angle by Tardieu Scale recorded at pre-treatment and week 4 after treatment. Three muscle selection groups with sufficient sample size for statistical analysis were able to be created; brachialis (n = 14), biceps brachii (n = 21), and brachialis plus brachioradialis (n = 11). Although there was a significant improvement in spasticity angle within all groups over time (p < 0.05), the change in spasticity angle was not different between the groups (p > 0.05 for each pairwise comparison). However, the magnitude of the change in spasticity angle was larger in the groups in which brachialis was preferred. In stroke patients with a spontaneous spastic posture of elbow flexion and forearm pronation, targeting brachialis for BoNT-A injection seems more effective in reducing the severity of spasticity. NCT04036981 [ABSTRACT FROM AUTHOR]

The cells of origin of neurogenic heterotopic ossifications (NHOs), which develop frequently in the periarticular muscles following spinal cord injuries (SCIs) and traumatic brain injuries, remain unclear because skeletal muscle harbors two progenitor cell populations: satellite cells (SCs), which are myogenic, and fibroadipogenic progenitors (FAPs), which are mesenchymal. Lineage-tracing experiments using the Cre recombinase/LoxP system were performed in two mouse strains with the fluorescent protein ZsGreen specifically expressed in either SCs or FAPs in skeletal muscles under the control of the Pax7 or Prrx1 gene promoter, respectively. These experiments demonstrate that following muscle injury, SCI causes the upregulation of PDGFRα expression on FAPs but not SCs and the failure of SCs to regenerate myofibers in the injured muscle, with reduced apoptosis and continued proliferation of muscle resident FAPs enabling their osteogenic differentiation into NHOs. No cells expressing ZsGreen under the Prrx1 promoter were detected in the blood after injury, suggesting that the cells of origin of NHOs are locally derived from the injured muscle. We validated these findings using human NHO biopsies. PDGFRα+ mesenchymal cells isolated from the muscle surrounding NHO biopsies could develop ectopic human bones when transplanted into immunocompromised mice, whereas CD56+ myogenic cells had a much lower potential. Therefore, NHO is a pathology of the injured muscle in which SCI reprograms FAPs to undergo uncontrolled proliferation and differentiation into osteoblasts. [ABSTRACT FROM AUTHOR]

Objective : In spinal cord injury (SCI), heterotopic ossification is a frequent secondary complication, commonly associated with limited range of motion of affected joints, which could lead to secondary disability in activities of daily living. Additionally, heterotopic ossifications might challenge the effect of regeneration-promoting therapies on neurological and functional recovery. This study evaluated the impact of heterotopic ossification on clinical recovery within the first year after SCI. Methods : The study was conducted as a monocentric longitudinal paired cohort study. Recruitment was based on consecutive sampling in the framework of the European Multicenter about Spinal Cord Injury (EMSCI). Recovery profiles were determined using standardized neurological and functional clinical assessments within the 1st year following SCI. All study participants underwent at least two comprehensive standardized neurological and functional clinical examinations according to the International Standards for Neurological Classification of SCI and the Spinal Cord Independence Measure, respectively. Data regarding the diagnosis and treatment of heterotopic ossification were obtained by reviewing the patient medical records. The most similar "digital twin" from the entire EMSCI database were matched in terms of age, acute neurological and functional status to each individual with SCI, and heterotopic ossification. Results : Out of 25 participants diagnosed with heterotopic ossification, 13 individuals were enrolled and matched to control individuals. Most individuals presented with motor complete injury (75%). Ossifications were most frequently located at the hip joints (92%) and mainly occurred within the first 3 months after SCI. Individuals with heterotopic ossification achieved around 40% less functional improvement over time compared to their matched counterparts, whereas neurological recovery was not altered in individuals with SCI and heterotopic ossification. Conclusion : Heterotopic ossification—a common complication of SCI—unfavorably affects functional recovery, which in the end is most relevant for the best possible degree of independence in activities of daily living. Upon presentation with heterotopic ossification, neurological improvement achieved through potential restorative therapies might not translate into clinically meaningful functional improvement. Diagnostic algorithms and effective early prevention/treatment options for heterotopic ossification need to be established to ensure the best possible functional outcome. Clinical Trial Registration : NCT01571531 (https://clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

Background: Botulinum toxin (BoNT) injection is the most commonly performed procedure in cosmetic surgery. However, blind injection is unable to take individual anatomical variations into consideration, which is the main contributing factor to complications. Ultrasound (US) imaging was introduced to reduce complications and improve effects. This article will review uses of US in aesthetic BoNT injection. Method: A systematic electronic search was performed using the PubMed, MEDLINE, Web of science. Search terms were set to focus on aesthetic BoNT injection. Two independent reviewers subsequently reviewed the resultant articles based on strict inclusion and exclusion criteria. Selected manuscripts were analysed and grouped by procedure categories. Clinical cases were all performed by one plastic surgeon in our department. Results: The search finally retained 24 articles. Five procedural categories were identified, including masseter (n = 16), frontalis (n = 2), glabella complex (n = 2), trapezius (n=1), and gastrocnemius (n = 3). US imaging is practical and instructive for pre-operative assessments as in needle-type selection, injection point localization and depth setting, as well as post-operative follow-ups regarding injection feedback (for instance, the extent of muscle volume decreases). What's more, ultrasound-guided injection makes needle trajectory visualized so as for the needle to reach the target muscle in avoidance of potential damage to neurovascular bundle, gland or adjacent muscle. Conclusion: Muscles, such as masseter, frontalis, glabella complex, trapezius and gastrocnemius, and their adjacent structures can be well visualized using US, and as such, US can be a useful tool for a variety of pre-operative, intra-operative and post-operative procedures. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

In the present work, preceramic nanocrystallite barium cerate (BaCeO3) was successfully synthesized using the hydrazine-nitrate combustion method. Using carbon-free hydrazine (N2H4) as fuel significantly reduced the formation of carbonate by-products. Subsequent annealing of combustion products in the air atmosphere at temperatures in the range of 500–1000 °С yielded preceramic powders based on chemically and phase-pure BaCeO3. Characterization of the as-received powders was performed by X-ray diffraction, energy-dispersive X-ray spectroscopy (EDXS), scanning electron microscopy (SEM), simultaneous thermal analysis (DTA-TGA) and adsorption-structural analysis (N2, 77 K). Thermophysical properties of the sample annealed at 1000 °С were investigated using laser flash analysis (LFA) in the temperature interval of 1000 °С. As a result of a comprehensive study, the sequence of chemical and phase transformations that lead to the formation of barium cerate with a rhombic structure (Pnma, a = 6.2145 Å, b = 8.7776 Å, c = 6.2337 Å) during the thermal processing of combustion products was investigated. It was established that the average size of the obtained nanocrystals is 38 ± 3 nm and that they form micron-sized agglomerates with a specific surface area of the powder of 4.8 m2/g. It was shown that the sintered sample of barium cerate is characterized by thermal diffusivity values of 0.28 to 0.20 mm2/s and thermal conductivity values of 0.41–0.35 W/mK, depending on temperature. These results, given the impact of porosity on the sample (~40%), show very good agreement with the thermophysical characteristics of densely sintered ceramics based on BaCeO3—a solid oxide electrolyte SOFC. Consequently, the proposed method of hydrazine-nitrate synthesis of barium cerate presents itself as a promising approach to obtaining preceramic powders and ceramics in the area of solid oxide fuel cells. Highlights: Novel hydrazine-nitrate combustion route was proposed to synthesize BaCeO3 nanopowder. Thermal treatment of combustion products leads to chemically and phase pure BaCeO3. Crystallite size and its aggregation outperform those for conventional approaches. Thermophysical performance of BaCeO3 powders makes it promising for SOFC ceramics. [ABSTRACT FROM AUTHOR]

Objective: to provide a comparative characterization of the prevalence of polymorphic variants of cytokine genes in plasma cell myeloma (PCM) patients suffered after the Chornobyl disaster and patients who were in contact with ionizing radiation within the natural radiation background, based on comparison with population controls to determine their contribution as genetic markers of disease risk. Materials and methods. Molecular genetic studies of polymorphism of cytokine genes (TNF-α, TGF-β1, IL-6, IL-10, IFN-γ) and complex frequency analysis of occurrence in three-, four-, and five-locus combinations of their allelic variants as prognostic markers of the risks of plasma cell myeloma was carried out in 102 patients - 56 victims of the Chornobyl nuclear power plant accident and 46 patients irradiated within the limits of the natural radiation background, in comparison with the control group (364 practically healthy people, residents of the Central geno-geographical region of Ukraine). Results. The same probable increase in the prevalence of the TGF-β genotype codon10 T/T of the TGF-β1 gene was established in the groups of patients irradiated after the Chornobyl NPP accident and non-irradiated patients. In patients with plasma cell myeloma a protective effect for IL-10 -1082 A/G and an association with the risk of disease occurrence for IL-10 -1082 G/G were determined. Conclusion. Probable difference in the frequency of the TGF-β1 genotype codon10 T/T of the TGF-β1 gene in the observed groups relative to the control group provides grounds for considering this single-nucleotide polymorphism of the TGF-β1 gene as an immunogenetic factor of predisposition to the development of PCM independent of exogenous factors. The study of the contribution of multigene combinations of «gene-gene» interaction indicates their role in the mechanisms of plasma cell myeloma occurrence and confirms the presence of an additive interaction. [ABSTRACT FROM AUTHOR]

Introduction: The Ankle Lunge Test (ALT) is a reliable method of measuring weight bearing ankle dorsiflexion range, a key component of gait, in healthy ankles and a range of musculoskeletal conditions. The aim of this study is to evaluate the reliability and concurrent validity of the ALT in people with stroke and investigate whether change in ALT is observed following treatment of spasticity with Botulinum Toxin. Methodology: Repeated Measure Design: Forty stroke survivors were recruited for reliability testing. Twenty three stroke survivors were evaluated with the ALT before and after treatment of the lower limb with Botulinum Toxin. Measurement with the ALT was performed for all participants. For the reliability group, two physiotherapists evaluated the ALT on Day 1 and one therapist re‐evaluated the ALT one to 5 days later. For the change evaluation group, the ALT was tested prior to and six to eight weeks after intervention. Other measures evaluated were velocity, the Functional Ambulation Category, Timed Up and Go and the Modified Tardieu Scale. Results: Intra‐rater, inter‐rater and test‐retest reliability yielded intra‐class correlation coefficients at or above 0.92. Moderate correlations were found between the ALT and velocity r = 0.605 (p < 0.01), the Timed Up and Go r = −0.598 (p < 0.01) and the Functional Ambulation Category r = 0.380 (p < 0.05). Following intervention with Botulinum Toxin, there was significant (p < 0.02) improvement in the ALT; pre‐median 20 mm (IQR −25 to 35) to post‐median 21 mm (IQR 0 to 40) and the Timed Up and Go; pre‐median 21.40 s (IQR 13.43 to 28.82) to post‐median 20.08 s (IQR 14.06 to 28.47). Conclusion/Significance: The ALT is a reliable and valid measure which may be applied in clinical practice to evaluate change in weight bearing ankle dorsiflexion in people with stroke. [ABSTRACT FROM AUTHOR]

Muscle activities of the elbow flexors, especially the brachialis muscle (BR), have been measured with intramuscular electromyography (EMG) using the fine-wire electrodes. It remains unclear whether BR activity can be assessed using surface EMG. The purpose of this study was to compare the EMG patterns of the BR activity recorded during elbow flexion using surface and fine-wire electrodes and to determine whether surface EMG can accurately measure the BR activity. Six healthy men were asked to perform two tasks—a maximum isometric voluntary contractions (MVICs) task and an isotonic elbow-flexion task without lifting any weight. The surface and intramuscular EMG were simultaneously recorded from the BR and the long and short heads of the biceps brachii muscle (BBLH and BBSH, respectively). The locations of the muscles were identified and marked under ultrasonographic guidance. The peak cross-correlation coefficients between the EMG signals during the MVICs task were calculated. For the isotonic elbow-flexion task, the EMG patterns for activities of each muscle were compared between the surface and the fine-wire electrodes. All cross-correlation coefficients between the surface EMG signals from the muscles were lower than 0.3. Furthermore, the EMG patterns of the BR activity were not significantly different between the surface and the fine-wire electrodes. The BR has different EMG pattern from the BBLH and the BBSH. The BR activity, conventionally measured with intramuscular EMG, can be accurately accessed with surface EMG during elbow flexion performed without lifting any weight, independent from the BBLH and BBSH activities. [ABSTRACT FROM AUTHOR]

Background: Neurogenic heterotopic ossification (NHO) is a frequent complication, often involving the hip. The functional impact may require surgical management and pre-surgical imaging assessment is necessary, usually by computed tomography (CT). We aimed to compare the performances of magnetic resonance imaging (MRI) and CT for bone assessment on pre-surgical imaging of the heterotopic ossifications and their features in NHO of the hip. Methods: This single-center prospective preliminary study included all patients who underwent surgery for NHO with joint limitation from July 2019 to March 2020. All patients had a CT after biphasic iodinated solution injection and an MRI including T1-weighted, STIR and ZTE sequences. Standardized reports were completed for both exams for each patient, evaluating location, implantation and fragmentation of NHO, relation to the joint capsule and bone mineralization, then were compared. Results: Seven patients from 32 to 70 years old (mean = 50.2 ± 17.2 years) were evaluated. NHO were bilateral in 2 patients, for a total of nine hips: six right hips and three left hips. Observed concordance rates between MRI and CT were, respectively, 94.4% for location, 100% for circumferential extension, 87.3% for implantation 88.9% for fragmentation, 77.8% for relation to the joint capsule and 66.7% for bone mineralization. It was 100% for femoral neck fracture and osteonecrosis of the femoral head. Conclusion: This preliminary study suggests that pre-surgical MRI imaging should be considered as effective as CT for bone assessment of NHO and their features. Trial registration: ClinicalTrials.gov, NCT03832556. Registered February 6, 2019, https://clinicaltrials.gov/ct2/show/NCT03832556. [ABSTRACT FROM AUTHOR]