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Context: Early identification of incoming military personnel at elevated odds for bone stress injury (BSI) is important for the health and readiness of the US military. Design: Prospective cohort study. Methods: Knee kinematic data of the incoming US Military Academy cadets were collected while performing a jump-landing task (The Landing Error Scoring System) using a markerless motion capture system and depth camera. Data on incidence of lower-extremity injury, including BSI, were collected throughout the study period. Results: A total of 1905 participants (452 females, 23.7%) were examined for knee valgus and BSI status. A total of 50 BSI occurred during the study period (incidence proportion = 2.6%). The unadjusted odds ratio for BSI at initial contact was 1.03 (95% confidence interval [CI], 0.94–1.14; P =.49). Adjusted for sex, the odds ratio for BSI at initial contact was 0.97 (95% CI, 0.87–1.06; P =.47). At the instant of maximum knee-flexion angle, the unadjusted odds ratio was 1.06 (95% CI, 1.02–1.10; P =.01), and the odds ratio was 1.02 (95% CI, 0.98–1.07; P =.29) after adjusting for sex. This suggests that there was not a significant enough association for an increase in the odds of BSI based on either degree of knee valgus. Conclusions: Our results did not demonstrate an association between knee valgus angle data during a jump-landing task and future increased odds of BSI in a military training population. Further analysis is warranted, but the results suggests the association between kinematics and BSI cannot be effectively screened by knee valgus angle data in isolation. [ABSTRACT FROM AUTHOR]

Foreign body ingestion is a common clinical occurrence worldwide, with high morbidity in the pediatric population and in adult patients with intentional attempts. Coins and button battery ingestions are more common among children. Bone impaction and swallowed dentures are usually seen in older adults. While most ingested foreign bodies pass through the gastrointestinal tract spontaneously with no complications, some require endoscopic and/or surgical intervention. Complications such as pharyngoesophageal ulceration, perforation, stricture, and deep neck infection can develop without timely diagnosis and management. The purpose of this article is to familiarize radiologists with the imaging approach to assess for characteristics and impacted locations of ingested foreign bodies in the neck. [ABSTRACT FROM AUTHOR]

Background: Drug resistant (DR) osteoarticular TB (OATB) is a challenge in view of it being deep seated lesion and paucibacillary disease. Case definition, investigation protocol, treatment of proven DR and those cases where DR could not be demonstrated lacks clarity and evidence. Hence, a series of studies were conducted to develop an algorithm to investigate and treat therapeutically refractory disease (TRD) or presumptive drug resistance (PDR) cases of OATB. Patients and methods: 6 studies were conducted. Study one and two evaluated criteria to label TRD/PDR. Three subsequent studies were conducted where TDR/PDR or fresh cases of OATB cases were investigated by AFB smear, Bactec/liquid culture, histology and genotypic DST by CBNAAT & LPA. Sixth study was a retrospective evaluation of all DR cases treated for proven or clinical drug resistance (CDR). Results: Patient of bone/spine TB on ATT for 5 months or more show poor clinico-radiological treatment response as worsening of lesion, increased spinal deformity, persistent discharging sinus/ulcer, appearance of fresh lesion, recurrence of previous lesion, wound dehiscence of post-operative surgical scar cab labelled as PDR cases. These cases on histology ascertained TB and were proven DR on genotypic and phenotypic DST and are treated successfully. The patients of histologically ascertained TB and no/indeterminate phenotypic and genotypic DST were successfully treated as clinical drug resistance on MDR protocol. Conclusions: We described an algorithm. We must suspect PDR(TRD) based on criteria described. The tissue must be procured and submitted for AFB smear, histology and phenotypic and genotypic DST for diagnosis of TB. Genotypic and phenotypic DST will be useful to prove (90% instances) type of drug resistance. Remaining on strong clinical suspicion of DR and yet inconclusive on phenotypic/genotypic DST (<10%), may be treated as CDR as MDR. The adverse drug reactions and hepatic side-effects should be monitored diligently and these cases to be treated till healed status is demonstrated. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the optimal ratio of synthetic bone graft (SBG) material and platelet rich fibrin (PRF) mixed in a metal 3D-printed implant to enhance bone regeneration. Methods: Specialized titanium hollow implants (5 mm in diameter and 6 mm in height for rabbit; 6 mm in diameter and 5 mm in height for pig) were designed and manufactured using 3D printing technology. The implants were divided into three groups and filled with different bone graft combinations, namely (1) SBG alone; (2) PRF to SBG in 1:1 ratio; (3) PRF to SBG in 2:1 ratio. These three groups were replicated tightly into each bone defect in distal femurs of rabbits (nine implants, n = 3) and femoral shafts of pigs (fifteen implants, n = 5). Animal tissue sections were obtained after euthanasia at the 8th postoperative week. The rabbit specimens were stained with analine blue, while the pig specimens were stained with Masson–Goldner's trichrome stain to perform histologically examination. All titanium hollow implants were well anchored, except in fracture specimens (three in the rabbit and one fracture in the pig). Result: Rabbit specimens under analine blue staining showed that collagen tissue increased by about 20% and 40% in the 1:1 ratio group and the 2:1 ratio group, respectively. Masson–Goldner's trichrome stain results showed that new bone growth increased by 32% in the 1:1 ratio PRF to SBG, while − 8% in the 2:1 ratio group. Conclusion: This study demonstrated that placing a 1:1 ratio combination of PRF and SBG in a stabilized titanium 3D printed implant resulted in an optimal increase in bone growth. [ABSTRACT FROM AUTHOR]

Background: Osteonecrosis of the femoral head caused by glucocorticoids (GIONFH) is a significant issue resulting from prolonged or excessive clinical glucocorticoid use. Astaxanthin, an orange-red carotenoid present in marine organisms, has been the focus of this study to explore its impact and mechanism on osteoblast apoptosis induced by dexamethasone (Dex) and GIONFH. Methods: In this experiment, bioinformatic prediction, molecular docking and dynamics simulation, cytotoxicity assay, osteogenic differentiation, qRT-PCR analysis, terminal uridine nickend labeling (TUNEL) assay, determination of intracellular ROS, mitochondrial function assay, immunofluorescence, GIONFH rat model construction, micro-computed tomography (micro-CT) scans were performed. Results: Our research demonstrated that a low dose of astaxanthin was non-toxic to healthy osteoblasts and restored the osteogenic function of Dex-treated osteoblasts by reducing oxidative stress, mitochondrial dysfunction, and apoptosis. Furthermore, astaxanthin rescued the dysfunction in poor bone quality, bone metabolism and angiogenesis of GIONFH rats. The mechanism behind this involves astaxanthin counteracting Dex-induced osteogenic damage by activating the Nrf2 pathway. Conclusion: Astaxanthin shields osteoblasts from glucocorticoid-induced oxidative stress and mitochondrial dysfunction via Nrf2 pathway activation, making it a potential therapeutic agent for GIONFH treatment. [ABSTRACT FROM AUTHOR]

Simple Summary: Primary leiomyosarcoma of bone constitutes less than 0.7% of all primary malignant bone tumors. Currently, there is no consensus on whether therapeutic approaches should align with the biological characteristics seen in soft tissue leiomyosarcoma or be tailored to the bone location. The efficacy of perioperative chemotherapy for this rare tumor type remains uncertain. Our study aimed to assess various treatment modalities across multiple centers. Surgical intervention emerged as the most significant prognostic factor for patient survival in our analysis, with tumors situated axially, indicating poorer prognosis. A considerable portion of patients experienced secondary metastases. Additionally, the perioperative chemotherapy regimens administered did not correlate with enhanced survival outcomes. Hence, the efficacy of perioperative chemotherapy in bone leiomyosarcoma warrants further investigation, alongside the identification of appropriate agents for treatment. Primary leiomyosarcoma of bone (LMSoB) is extremely rare, comprising only <0.7% of primary malignant bone tumors, and is therefore considered an ultra-rare tumor entity. There is currently no consensus as to whether therapeutic strategies should be based on the biological characteristics of soft tissue leiomyosarcoma or on primary tumor localization in the bone. The use of perioperative chemotherapy and its effectiveness in this rare tumor entity remains unclear. We aimed to evaluate the impact of different treatment approaches in a multicenter setting with a total of 35 patients included. The 5-year overall survival (OS) was 74%. Patients with localized disease undergoing surgery had a significantly higher 5-year OS compared to patients who did not undergo surgical treatment (82% vs. 0%, p = 0.0015). Axial tumor localization was associated with worse event-free survival (EFS) probability (p < 0.001) and OS (p = 0.0082). A high proportion of our patients developed secondary metastases. Furthermore, the perioperative chemotherapy protocols applied to our patients were not associated with an improved EFS or OS. Therefore, the benefit of perioperative chemotherapy in LMSoB needs to be further investigated, and the choice of agents still needs to be clarified. [ABSTRACT FROM AUTHOR]

Vitamin D is a fat-soluble steroid hormone that was initially known only for regulating calcium and phosphorus levels and maintaining bone health. However, it was later discovered that many organs express vitamin D metabolizing enzymes and have a ligand for vitamin D, which regulates the expression of an extensive assortment of genes. As a result, vitamin D is indispensable for the proper function of organs, and its deficiency is believed to be a critical factor in symptoms and disorders such as cardiovascular diseases, autoimmune diseases, and cancers. The significance of vitamin D in reproductive tissues was recognized later, and studies have revealed its crucial role in male and female fertility, as well as proper reproductive function during pregnancy. Vitamin D deficiency has been identified as a risk factor for infertility, gonadal cancers, pregnancy complications, polycystic ovary syndrome, and endometriosis. However, data investigating the association between vitamin D levels and reproductive disorders, including endometriosis, have encountered inconsistencies. Therefore, the present study aims to review existing research on the effect of vitamin D on proper reproductive function, and the role of deficiency in reproductive diseases and specifically focuses on endometriosis. [ABSTRACT FROM AUTHOR]

Summary: Sheehan's syndrome (SS) is a rare but well-characterized cause of hypopituitarism. Data on skeletal health is limited and on microarchitecture is lacking in SS patients. Purpose: We aimed to explore skeletal health in SS with bone mineral density (BMD), turnover, and microarchitecture. Methods: Thirty-five patients with SS on stable replacement therapy for respective hormone deficiencies and 35 age- and BMI-matched controls were recruited. Hormonal profile and bone turnover markers (BTMs) were measured using electrochemiluminescence assay. Areal BMD and trabecular bone score were evaluated using DXA. Bone microarchitecture was assessed using a second-generation high-resolution peripheral quantitative computed tomography. Results: The mean age of the patients was 45.5 ± 9.3 years with a lag of 8.3 ± 7.2 years prior to diagnosis. Patients were on glucocorticoid (94%), levothyroxine (94%), and estrogen–progestin replacement (58%). None had received prior growth hormone (GH) replacement. BTMs (P1NP and CTX) were not significantly different between patients and controls. Osteoporosis (26% vs. 16%, p = 0.01) and osteopenia (52% vs. 39%, p = 0.007) at the lumbar spine and femoral neck (osteoporosis, 23% vs. 10%, p = 0.001; osteopenia, 58% vs. 29%, p = 0.001) were present in greater proportion in SS patients than matched controls. Bone microarchitecture analysis revealed significantly lower cortical volumetric BMD (vBMD) (p = 0.02) at the tibia, with relative preservation of the other parameters. Conclusion: Low areal BMD (aBMD) is highly prevalent in SS as compared to age- and BMI-matched controls. However, there were no significant differences in bone microarchitectural measurements, except for tibial cortical vBMD, which was lower in adequately treated SS patients. [ABSTRACT FROM AUTHOR]

Summary: Non-pharmacological therapies, such as whole-food interventions, are gaining interest as potential approaches to prevent and/or treat low bone mineral density (BMD) in postmenopausal women. Previously, prune consumption preserved two-dimensional BMD at the total hip. Here we demonstrate that prune consumption preserved three-dimensional BMD and estimated strength at the tibia. Purpose: Dietary consumption of prunes has favorable impacts on areal bone mineral density (aBMD); however, more research is necessary to understand the influence on volumetric BMD (vBMD), bone geometry, and estimated bone strength. Methods: This investigation was a single center, parallel arm 12-month randomized controlled trial (RCT; NCT02822378) to evaluate the effects of 50 g and 100 g of prunes vs. a Control group on vBMD, bone geometry, and estimated strength of the radius and tibia via peripheral quantitative computed tomography (pQCT) in postmenopausal women. Women (age 62.1 ± 5.0yrs) were randomized into Control (n = 78), 50 g Prune (n = 79), or 100 g Prune (n = 78) groups. General linear mixed effects (LME) modeling was used to assess changes over time and percent change from baseline was compared between groups. Results: The most notable effects were observed at the 14% diaphyseal tibia in the Pooled (50 g + 100 g) Prune group, in which group × time interactions were observed for cortical vBMD (p = 0.012) and estimated bone strength (SSI; p = 0.024); all of which decreased in the Control vs. no change in the Pooled Prune group from baseline to 12 months/post. Conclusion: Prune consumption for 12 months preserved cortical bone structure and estimated bone strength at the weight-bearing tibia in postmenopausal women. [ABSTRACT FROM AUTHOR]

Very little literature currently exists prescribing which maceration method to use when preparing infant human remains, resulting in bone quality that is suitable for forensic anthropological analysis. The aim of the study was to test five maceration methods to determine which is most suitable for infant remains for forensic anthropological analysis. The sample included five neonate pig carcasses (Sus scrofa domesticus), ranging between one to three days old. Five maceration methods were tested on the pig carcasses (one pig per maceration method) to determine their effectiveness. The methods included invertebrate maceration by meal worms, chemical maceration by bleach, chemical maceration by borax solution, enzymatic maceration by laundry detergent and sodium carbonate solution, and chemical maceration by sodium hypochlorite. A scoring method was created to assess the effectiveness of each maceration method. Invertebrate maceration and chemical maceration using bleach were the least successful methods of maceration (total maceration score = 8 respectively). Chemical maceration using borax and chemical maceration using sodium hypochlorite achieved complete maceration of the skeletal remains; however, they both resulted in artifacts that are unsuitable for forensic analysis (total maceration score = 14 respectively). Enzymatic maceration using laundry detergent and sodium carbonate was the most successful method (total maceration score = 17). The detergent technique subsequently successfully macerated all five sets of infant human remains. This study has validated that the enzymatic maceration technique using laundry detergent and sodium carbonate can be used to effectively macerate the remains of infant skeletal remains for forensic anthropological analysis. [ABSTRACT FROM AUTHOR]

• Environmental impacts of AD, Py, ADCo-Py and ADCo-INC were compared. • High environmental burden from pretreatment was mitigated by co-processing. • The most significant environmental burdens in each system were AP, ETP and GWP. • Co-processing of AD with Py demonstrated the highest environmental benefit. • Poor waste source separation can be partially mitigated by co-processing systems. This research conducted an environmental life cycle assessment (LCA) to evaluate an anaerobic digestion-co-pyrolysis (ADCo-Py) system in which pyrolysis was added to traditional food waste (FW) anaerobic digestion (AD) systems to treat the solid fraction and impurities separated from FW. The solid fraction, including impurities such as wooden chopsticks, plastics, eggshells, and bones, is usually incinerated, while pyrolysis can be a viable alternative to optimize FW treatment. The environmental impact of ADCo-Py was compared with stand-alone AD, pyrolysis, and ADCo-INC (AD with incineration of separated solids). The results indicated that both ADCo-Py (−1.726 kg CO 2 -Eq/kg FW) and ADCo-INC (−1.535 kg CO 2 -Eq/kg FW) outperform stand-alone AD (−0.855 kg CO 2 -Eq/kg FW) and pyrolysis (−0.181 kg CO 2 -Eq/kg FW) in mitigating global warming potential (GWP). Additionally, pretreatments were found to have the most significant influence on GWP, ecotoxicity potential (ETP), and acidification potential (AP). The two-step pretreatment in ADCo-Py, including the separation of solids and drying, significantly improved the environmental sustainability of the system when compared with standalone pyrolysis. [ABSTRACT FROM AUTHOR]

In January 1940, the Wehrmacht had only a two-month supply of torpedo oil, an irreplaceable lubricant derived solely from the feet and shinbones of slaughtered cattle. The Wehrmacht resolved this shortage by appointing the man responsible for its supply during the First World War: Alfons Knetsch. This case study shows not only the importance of knowledge transfer from one war to the other but also how competing industrial interests shaped Nazi recycling policy and how an efficient, vigorously managed recycling organization could buy time for the research and development of substitutes, overcoming seemingly impossible raw material bottlenecks. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of resveratrol (RES) on the prevention of medication‐related osteonecrosis of the jaws (MRONJ) in ovariectomized (OVX) rats treated with zoledronate (ZOL). Fifty rats were distributed in five groups: SHAM (n = 10): non‐ovariectomy + placebo; OVX (n = 10):ovariectomy + placebo; OVX + RES (n = 10):ovariectomy + resveratrol; OVX + ZOL (n = 10):ovariectomy + placebo + zoledronate; and OVX + RES + ZOL (n = 10):ovariectomy + resveratrol + zoledronate. The mandibles left sides were analyzed with micro‐CT, histomorphometry, and immunohistochemistry. On the right side, bone markers gene expression was analyzed by qPCR. ZOL increased the percentage of necrotic bone and reduced the neo‐formed bone compared to groups not receiving ZOL (p < 0.05). RES impacted the tissue healing pattern in OVX + ZOL + RES, reduced inflammatory cell infiltrate, and improved bone formation in the extraction site. Osteoblasts, alkaline phosphatase (ALP)‐, and osteocalcin (OCN)‐immunoreactive cells were lower in OVX‐ZOL than in SHAM, OVX, and OVX‐RES. The OXV‐ZOL‐RES had fewer osteoblasts and ALP‐ and OCN‐cells than the SHAM and OVX‐RES. The tartrate‐resistant acid phosphatase (TRAP)‐positive cells were reduced in the presence of ZOL (p < 0.05), while the TRAP mRNA levels increased with ZOL treatment, with or without resveratrol, compared with the other groups (p < 0.05). RES alone increased superoxide dismutase levels compared to OVX + ZOL and OVX + ZOL + RES (p < 0.05). In conclusion, resveratrol reduced the tissue impairment severity induced by ZOL; however, it could not prevent the occurrence of MRONJ. [ABSTRACT FROM AUTHOR]

Aim: The combination of dynapenia (age-related muscle weakness) and obesity is referred to as dynapenic obesity. We examined the associations between dynapenic obesity and cortical bone thickness and trabecular bone density. Methods: The participants were 797 community-dwelling postmenopausal women (with an average age of 62.5 years) who were stratified into normopenia without obesity, dynapenia without obesity (dynapenia), normopenia with obesity (obesity) and dynapenia with obesity (dynapenia obesity) groups based on their grip strength and body fat percentage. Cortical bone thickness and trabecular bone density were measured using ultrasonic bone densitometry. The participants were further divided into those with low cortical bone thickness and low trabecular bone density. Logistic regression analysis was used to identify associated factors. Results: Individuals with dynapenia (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.16-2.68), obesity (OR 2.46, 95% CI 1.62-3.75) and dynapenic obesity (OR 4.07, 95% CI 2.44-6.79) all significantly increased the odds of low cortical bone thickness. Conversely, the odds of low trabecular bone density were significantly lower in the obesity group (OR 0.65, 95% CI 0.43-0.99) and dynapenic obesity group (OR 0.60, 95% CI 0.37-0.97). Conclusions: Dynapenic obesity was found to be associated with cortical bone thinning that might compromise bone health. Postmenopausal women with dynapenic obesity might need to be closely monitored for preserving bone health. [ABSTRACT FROM AUTHOR]

Charcot neuroarthropathy is a complicated phenomenon with the potential to cause significant deformity, morbidity, and mortality. Costs associated with Charcot-related complications are substantial, with thousands of amputations occurring annually. The purpose of this study was to retrospectively review a single surgeon's experience and record the 10-year mortality rate among patients after Charcot reconstruction at a single institution between 2007 and 2013. Lower-extremity limb salvage is crucial to reduce the burden of Charcot neuroarthropathy. This article provides an example of the potential long-term success of reconstruction surgery for this condition. [ABSTRACT FROM AUTHOR]

Objective: Anorexia nervosa is associated with low bone mineral density (BMD) and deficits in bone microarchitecture and strength. Low BMD is common in atypical anorexia nervosa, in which criteria for anorexia nervosa are met except for low weight. We investigated whether women with atypical anorexia nervosa have deficits in bone microarchitecture and estimated strength at the peripheral skeleton. Method: Measures of BMD and microarchitecture were obtained in 28 women with atypical anorexia nervosa and 27 controls, aged 21–46 years. Results: Mean tibial volumetric BMD, cortical thickness, and failure load were lower, and radial trabecular number and separation impaired, in atypical anorexia nervosa versus controls (p <.05). Adjusting for weight, deficits in tibial cortical bone variables persisted (p <.05). Women with atypical anorexia nervosa and amenorrhea had lower volumetric BMD and deficits in microarchitecture and failure load versus those with eumenorrhea and controls. Those with a history of overweight/obesity or fracture had deficits in bone microarchitecture versus controls. Tibial deficits were particularly marked. Less lean mass and longer disease duration were associated with deficits in high‐resolution peripheral quantitative computed tomography (HR‐pQCT) variables in atypical anorexia nervosa. Discussion: Women with atypical anorexia nervosa have lower volumetric BMD and deficits in bone microarchitecture and strength at the peripheral skeleton versus controls, independent of weight, and particularly at the tibia. Women with atypical anorexia nervosa and amenorrhea, less lean mass, longer disease duration, history of overweight/obesity, or fracture history may be at higher risk. This is salient as deficits in HR‐pQCT variables are associated with increased fracture risk. Public Significance: Atypical anorexia nervosa is a psychiatric disorder in which psychological criteria for anorexia nervosa are met despite weight being in the normal range. We demonstrate that despite weight in the normal range, women with atypical anorexia nervosa have impaired bone density, structure, and strength compared to healthy controls. Whether this translates to an increased risk of incident fracture in this population requires further investigation. [ABSTRACT FROM AUTHOR]

Hydroxyapatite (HAp) is observed as a mineral deposition on bones and in teeth enamel and hence serves as an ideal model or as a component for orthopaedic and dental implants. Synthetic HAp has been synthesized on a lab scale for several decades to mimic the naturally occurring HAp based on its chemical and crystallographic nature. There are several methods for synthesis of HAp available in the literature, amongst which the following are a few examples: dry methods which include the solid-state method and mechano-chemical method, wet methods which include chemical precipitation and sol–gel method, and methods which use high-temperature such as combustion method and pyrolysis method. However, more economical and better yield-giving methods produce HAp with controlled morphology for its potential use in biomedical applications. One such method that exploits Schiff base ligands to form chelating complexes with calcium and phosphate precursors and protect generated HAp nuclei is recent ongoing research for the preparation of HAp. This review presents the synthesis of HAp using a wide array of methods, with the recent HAp using novel methods compared to the traditional synthesis of HAp. [ABSTRACT FROM AUTHOR]

Background: Ilizarov external fixation has become the treatment of choice for infected non-union of tibia. Varying degrees of bone loss and different strategies of treatment in the published reports make comparing outcomes difficult. This study hopes to bridge this gap in the literature by focussing exclusively on bone transport in patients with bone loss of 5 cm or more. Methodology: This is a prospective case series conducted at a tertiary level orthopaedic speciality hospital. Outcomes are measured by Association of the Study and Application of Method of Ilizarov (ASAMI) bony scores, ASAMI functional scores, Lengthening Index and by assessing complications encountered. Results: There were 49 patients in this study with an average of 9.57 cm bone gap. Among these, 29 patients had a bone gap of 5–10 cm and 20 patients had a bone gap of ≥ 11 cm. According to the ASAMI bony score, 42 patients had excellent or good outcomes with two fair results and five poor results. The ASAMI functional scores were 45 excellent to good outcomes, four fair and no poor results or failures. Fixed flexion deformity of the knee of more than 5°, ankle stiffness and soft tissue interposition were significantly more frequent in those with bone gap of ≥ 11 cm. Trifocal transport and bone grafting at docking significantly improved the lengthening index. Conclusion: Even massive bone defects of 11 cm or more can be reliably healed by bone transport using Ilizarov external fixation, but with a significantly higher rate of complications. Level of evidence: Level IV. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to quantitatively investigate airborne particle load in the operating room during endoscopic or microscopic epitympanectomy or mastoidectomy. Method: In the transcanal endoscopic ear surgery group, drilling was performed underwater. A particle counter was used to measure the particle load before, during and after drilling during transcanal endoscopic ear surgery or microscopic ear surgery. The device counted the numbers of airborne particles of 0.3, 0.5 or 1.0 μm in diameter. Results: The particle load during drilling was significantly higher in the microscopic ear surgery group (n = 5) than in the transcanal endoscopic ear surgery group (n = 11) for all particle sizes (p < 0.01). In the transcanal endoscopic ear surgery group, no significant differences among the particle load observed before, during and after drilling were seen for any of the particle sizes. Conclusion: Bone dissection carries a lower risk of airborne infection if it is performed using the endoscopic underwater drilling technique. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral osteoarthritis (PFJOA) is a subtype of knee OA, which is one of the main causes of anterior knee pain. The current study found an increased prevalence of OA in postmenopausal women, called postmenopausal OA. Therefore, we designed the ovariectomized rat model of patella baja-induced PFJOA. Alendronate (ALN) inhibits osteoclast-mediated bone loss, and has been reported the favorable result of a potential intervention option of OA treatment. However, the potential effects of ALN treatment on PFJOA in the ovariectomized rat model are unknown and need further investigation prior to exploration in the clinical research setting. In this study, the effects of ALN on articular cartilage degradation and subchondral bone microstructure were assessed in the ovariectomized PFJOA rat model for 10 weeks. Methods: Patella baja and estrogen withdrawal were induced by patellar ligament shortening (PLS) and bilateral ovariectmomy surgeries in 3-month-old female Sprague–Dawley rats, respectively. Rats were randomly divided into five groups (n = 8): Sham + V; OVX + V, Sham + PLS + V, OVX + PLS + V, OVX + PLS + ALN (ALN: 70 μg/kg/week). Radiography was performed to evaluate patellar height ratios, and the progression of PFJOA was assessed by macroscopic and microscopic analyses, immunohistochemistry and micro-computed tomography (micro-CT). Results: Our results found that the patella baja model prepared by PLS can successfully cause degeneration of articular cartilage and subchondral bone, resulting in changes of PFJOA. OVX caused a decrease in estrogen levels in rats, which aggravated the joint degeneration caused by PFJOA. Early application of ALN can delay the degenerative changes of articular cartilage and subchondral bone microstructure in castrated PFJOA rat to a certain extent, improve and maintain the micrometabolism and structural changes of cartilage and subchondral bone. Conclusion: The early application of ALN can delay the destruction of articular cartilage and subchondral bone microstructure in castrated PFJOA rat to a certain extent. [ABSTRACT FROM AUTHOR]

Some of the earliest members of the archosaur-lineage (i.e., non-archosauriform archosauromorphs) are characterised by an extremely elongated neck. Recent fossil discoveries from the Guanling Formation (Middle Triassic) of southern China have revealed a dramatic increase in the known ecomorphological diversity of these extremely long-necked archosauromorphs, including the fully marine and viviparous Dinocephalosaurus orientalis. These recent discoveries merit a reinvestigation of enigmatic Triassic diapsid fossils from contemporaneous European deposits housed in historical collections. Here, we provide a redescription of Trachelosaurus fischeri, represented by a single, disarticulated specimen first described in 1918. Due to its unique morphology, which includes short, bifurcating cervical ribs, and a high presacral vertebral count, this taxon has been referred to either as a "protorosaurian" archosauromorph or a sauropterygian. Our revision clearly shows that Trachelosaurus represents the first unambiguous Dinocephalosaurus-like archosauromorph known from outside the Guanling Formation. Our finding has important systematic implications. Trachelosauridae Abel, 1919 represents the senior synonym for the recently identified Dinocephalosauridae Spiekman, Fraser and Scheyer, 2021. Based on our phylogenetic analyses, which employ two extensive datasets, we also corroborate previous findings that tanystropheids and trachelosaurids represent two families within a larger monophyletic group among non-crocopodan archosauromorphs, which is here named Tanysauria (clade nov.). Trachelosauridae is minimally composed of Trachelosaurus fischeri, Dinocephalosaurus orientalis, Pectodens zhenyuensis, and Austronaga minuta, but one of our analyses also found a probably taxonomically broader clade that may also include Gracilicollum latens and Fuyuansaurus acutirostris. Trachelosaurus fischeri considerably expands the known spatial and temporal range of Trachelosauridae to the earliest Anisian and the Central European Basin. Our findings add to the growing evidence for the presence of a diverse group of fully marine reptiles during the Middle Triassic among Tanysauria. These trachelosaurids possess flipper-like limbs, high vertebral counts, and elongate necks, thus superficially resembling long-necked Jurassic and Cretaceous plesiosaurs in some regards. [ABSTRACT FROM AUTHOR]

Obesity and diabetes mellitus are prevalent metabolic disorders that have a detrimental impact on overall health. In this regard, there is now a clear link between these metabolic disorders and compromised bone health. Interestingly, both obesity and diabetes lead to elevated risk of bone fracture which is independent of effects on bone mineral density (BMD). In this regard, gastrointestinal (GIT)-derived peptide hormones and their related long-acting analogues, some of which are already clinically approved for diabetes and/or obesity, also seem to possess positive effects on bone remodelling and microarchitecture to reduce bone fracture risk. Specifically, the incretin peptides, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), as well as glucagon-like peptide-2 (GLP-2), exert key direct and/or indirect benefits on bone metabolism. This review aims to provide an initial appraisal of the relationship between obesity, diabetes and bone, with a focus on the positive impact of these GIT-derived peptide hormones for bone health in obesity/diabetes. Brief discussion of related peptides such as parathyroid hormone, leptin, calcitonin and growth hormone is also included. Taken together, drugs engineered to promote GIP, GLP-1 and GLP-2 receptor signalling may have potential to offer therapeutic promise for improving bone health in obesity and diabetes. Plain Language Summary: Impact of peptides from the gut on bone health in obesity and diabetes mellitus Obesity and related type 2 diabetes (T2D) are prevalent diseases. Unfortunately, there is now a clear link between obesity and related T2D and poor bone health, leading to increased bone fracture risk. However, we know that peptides derived from the gut following a meal can possess positive effects on bone health and reduce bone fracture risk. These peptides are called glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2) and glucose-dependent insulinotropic polypeptide (GIP). Moreover, some of these peptides, GLP-1 and GIP, are already being used to treat obesity and T2D, whilst GLP-2 is used to treat people with short bowel syndrome. In other words, drugs that mimic the action of GLP-1, GLP-2 and GIP are available for human use. This current review article aims to provide an initial appraisal of the relationship between obesity, diabetes and bone health, with a focus on the positive impact of peptide hormones like GLP-1, GLP-2 and GIP for bone health in obesity/diabetes. The take home message is that drugs engineered to promote GIP, GLP-1 and GLP-2 action may have potential to offer therapeutic promise for improving bone health in obesity and diabetes. [ABSTRACT FROM AUTHOR]

Background: Reverse Shoulder Arthroplasties (RSA) have become a primary choice for improving shoulder function and pain. However, the biomechanical failure mechanism of the humeral component is still unclear. The present study reports a novel protocol for microstructural imaging of the entire humerus implant under load before and after fracture. Methods: A humerus specimen was obtained from a 75-year-old male donor. An expert surgeon implanted the specimen with a commonly used RSA implant (Aequalis reversed II, Stryker Orthopaedics, USA) and surgical procedure. The physiological glenohumeral contact force that maximized the distal implant migration was selected from a public repository (orthoload.com). Imaging and concomitant mechanical testing were performed using a large-volume micro-CT scanner (Nikon XT H 225 ST) and a custom-made compressive stage. Both when intact and once implanted, the specimen was tested under a pre-load and by imposing a constant deformation causing a physiological reaction load (650 N, 10 degrees adducted). The deformation of the implanted specimen was then increased up to fracture, which was identified by a sudden drop of the reaction force, and the specimen was then re-scanned. Results: The specimen's stiffness decreased from 874 N/mm to 464 N/mm after implantation, producing movements of the bone-implant interface consistent with the implant's long-term stability reported in the literature. The micro-CT images displayed fracture of the tuberosity, caused by a combined compression and circumferential tension, induced by the distal migration of the implant. Conclusion: The developed protocol offers detailed information on implant mechanics under load relative to intact conditions and fracture, providing insights into the failure mechanics of RSA implants. This protocol can be used to inform future implant design and surgical technique improvements. [ABSTRACT FROM AUTHOR]

Background: Taxonomic ambiguity still exists in ariid catfish species identification. Morphological similarities occur in ariid catfishes which lead to misidentification of the species. To overcome this taxonomic ambiguity osteology is one of the effective integrated taxonomic tools for species discrimination. From this study, we provide an osteotaxonomic key for the field identification of ariid catfish species. Methods: The fish samples were cleaned and washed with the freshwater put into the sample for 1% potassium hydroxide solution (KOH). Then fish samples were allowed for alkali digestion of muscle in the solution for 24-48 hours depending on the condition of the specimen. After the completion of the muscle digestion process, Alizarin S dye was used for staining the fish bones. Result: The present paper deals with a comparative study of the five Ariidae family species discussed, they are Arius arius (Hamilton, 1822), Plicofollis layardi (Gunther, 1866), Netuma thalassina (Ruppell, 1837), Nemapteryx caelata (Valenciennes, 1840) and Osteogeneiosus militaris (Linnaeus, 1758). The osteological portions used for this study like premaxillary, dentary, neurocranium, otolith, vertebral and caudal bone. The aforementioned osteological portions made the important primitive characters that will be used to differentiate the species. [ABSTRACT FROM AUTHOR]

3'-Phosphoadenosine 5'-phosphosulfate synthase 2 (PAPSS2) deficiency is a rare disorder due to biallelic pathogenic variants in the PAPSS2 gene. This disorder was first described in 1998 by Ahmad et al. and Faiyaz ul Haque et al. To date, 79 patients with PAPSS2 deficiency have been reported. The main reported features of these patients are related to bone abnormalities and clinical/biochemical androgen excess. Disproportionate short stature and symptoms associated with spondylar skeletal dysplasia are the most common clinical features that require clinical attention. Androgen excess has been described much less commonly. This review summarizes the currently published clinical, molecular, and biochemical features of patients with PAPSS2 deficiency. [ABSTRACT FROM AUTHOR]

Background: The shoulder joint is the most commonly dislocated joint in the human body, and the recurrence rate exceeds 50% after nonsurgical treatment. Although surgical treatment reduces the recurrence rate, there is controversy regarding the optimal surgical approach. Previous studies suggest that the Latarjet procedure yields favourable outcomes for specific populations at risk of recurrence, such as competitive athletes with significant glenoid defects. However, most of the existing related research consists of nonrandomized controlled trials with small sample sizes, and there is a lack of strong evidence regarding the efficacy and safety of the Latarjet procedure. Methods: The PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched. Athletes with ≥ 20% glenoid defects were selected for inclusion. The following data were extracted: general patient information, instability rates, return to sports (RTS) rates, imaging features (graft positioning rate and graft healing rate), functional assessments [Rowe score, Athletic Shoulder Outcome Scoring System(ASOSS), visual analogue scale (VAS), forward flexion function, and external rotation function], and complications. Results: After excluding suspected duplicate cases, a total of 5 studies were included in this meta-analysis. The studies involved a total of 255 patients, including 237 males (93%) and 18 females (7%). The average age at the time of surgery was 25.4 ± 8.5 years. All the studies had a minimum follow-up period of 2 years, with an average follow-up time of 48.7 ± 18.9 months. The pooled rate of return to sport (RTS) was 94.3% (95% CI: 87.3%, 98.8%), and 86.1% (95% CI: 78.2%, 92.5%) of patients returned to their preoperative level of activity. The pooled redislocation rate was 1.1% (95% CI: 0%, 3.8%). Regarding the imaging results, the combined graft retention rate was 92.1% (95% CI: 88.1%, 95.5%), and the graft healing rate was 92.1% (95% CI: 88%, 95.4%). Postoperative functional evaluation revealed that the combined Rowe score, ASOSS score, and VAS score were 93.7 ± 6.5 points, 88.5 ± 4.4 points, and 1.1 ± 10 points, respectively. The forward flexion and external rotation angles were 170.9 ± 6.9 degrees and 65.6 ± 4.5 degrees, respectively. After excluding one study with unclear complications, the combined complication rate was 9.4% (95% CI: 1.0%, 23.6%). Conclusion: For athletes with shoulder instability and a total of ≥ 20% glenoid bone defects, the Latarjet procedure can achieve excellent functional outcomes, with the majority of patients returning to preoperative levels of sports activity. This procedure also leads to a low recurrence rate. Therefore, the Latarjet procedure has been proven to be a safe and effective treatment. [ABSTRACT FROM AUTHOR]

Purpose: Three-dimensional (3D) printing is highly dependent on printing process parameters for achieving high mechanical strength. It is a time-consuming and expensive operation to experiment with different printing settings. The current study aims to propose a regression-based machine learning model to predict the mechanical behavior of ulna bone plates. Design/methodology/approach: The bone plates were formed using fused deposition modeling (FDM) technique, with printing attributes being varied. The machine learning models such as linear regression, AdaBoost regression, gradient boosting regression (GBR), random forest, decision trees and k-nearest neighbors were trained for predicting tensile strength and flexural strength. Model performance was assessed using root mean square error (RMSE), coefficient of determination (R2) and mean absolute error (MAE). Findings: Traditional experimentation with various settings is both time-consuming and expensive, emphasizing the need for alternative approaches. Among the models tested, GBR model demonstrated the best performance in predicting both tensile and flexural strength and achieved the lowest RMSE, highest R2 and lowest MAE, which are 1.4778 ± 0.4336 MPa, 0.9213 ± 0.0589 and 1.2555 ± 0.3799 MPa, respectively, and 3.0337 ± 0.3725 MPa, 0.9269 ± 0.0293 and 2.3815 ± 0.2915 MPa, respectively. The findings open up opportunities for doctors and surgeons to use GBR as a reliable tool for fabricating patient-specific bone plates, without the need for extensive trial experiments. Research limitations/implications: The current study is limited to the usage of a few models. Other machine learning-based models can be used for prediction-based study. Originality/value: This study uses machine learning to predict the mechanical properties of FDM-based distal ulna bone plate, replacing traditional design of experiments methods with machine learning to streamline the production of orthopedic implants. It helps medical professionals, such as physicians and surgeons, make informed decisions when fabricating customized bone plates for their patients while reducing the need for time-consuming experimentation, thereby addressing a common limitation of 3D printing medical implants. [ABSTRACT FROM AUTHOR]

The recreational use of cannabis products has risen considerably worldwide over the past decade. As the cannabis legal market grows, a critical challenge has been to make substantiated claims about the benefits and adverse health problems triggered by cannabis exposure. Despite accumulating evidence from animal studies demonstrating the role of cannabinoids on bone metabolism, there are conflicting results in clinical literature regarding their effects on bone health outcomes. We undertook a systematic review to assess the evidence for the safety of cannabis use on bone health. We searched the databases MEDLINE, EMBASE, Cochrane Library, and Web of Science up to March 2023 for studies evaluating the effect of the recreational use of cannabis on the bone mineral density (BMD) of adults. Among the 2620 studies reviewed, three cross-sectional studies and one randomized controlled trial comprised 4032 participants from 18 to 60 years who met the inclusion criteria. Two studies showed that cannabis exposure decreased BMD, while the other 2 indicated no alteration. Despite the different study designs, the included studies showed a low risk of bias according to the Joanna Briggs Institute tool. Eligible studies present differences in cannabis products, administration routes, and exposure determination. Further longitudinal research is needed to establish multiple clinical predictors associated with potentially negative consequences of cannabis exposure, especially in vulnerable populations such as elderly individuals. [ABSTRACT FROM AUTHOR]

The negative effect of caponization on the structural, geometric and mechanical parameters of femur and tibia has been shown in a few studies. Nevertheless, its influence on tibia bone microarchitecture is still largely unknown. Therefore, this study aimed to assess the effect of castration on the microstructural parameters of the trabecular and compact bone of tibia bone in crossbred chickens. The experiment involved 96 roosters derived from crossing Yellowleg Partridge hens ( Z ˙ -33) and Rhode Island Red cockerels (R-11) fattened until the 16th, 20th and 24th week of life. Animals were randomly divided into 2 groups of 48 each. Group I (control) consisted of intact roosters and group II (experimental) consisted of birds subjected to caponization at the 8th week of age. The castration surgery had no influence on some properties within compact bone such as osteon diameter On.Dm, osteon perimeter On.Pm, osteon area On.Ar, osteocyte lacunar number Ot.Lc.N, osteon bone area On.B.Ar, osteon wall thickness On.W.Th as well as thick-mature collagen content in all analyzed age groups of animals. Nevertheless, our results demonstrate that castration caused a decrease of Haversian canal area Hc.Ar, osteocyte lacunar area Ot.Lc.Ar and osteocyte lacunar porosity Ot.Lc.Po among the 16-week-old birds, decrease of Haversian canal perimeter Hc.Pm and increase of fraction of bone area On.B.Ar/On.Ar among 16- and 24-week-old individuals and also an increase of osteocyte lacunar density Ot.Lc.Dn in the osteons of the oldest roosters. Additionally, some microstructural parameters of trabecular bone show the negative effect of caponization. The youngest 16-week-old capons were characterized by thinnin the trabecular in the epiphysis part of tibia. Moreover, in the case of 24-week-old, there is an increase in the trabecular separation Tb.Sp with simultaneous decrease of trabecular number Tb.N compared to roosters, which may suggest the increase of the bone resorption among the oldest individuals. The increased bone turnover in the epiphysis part of the tibia bone also indicates changes in the collagen fibers distribution, where among 20-week-old animals there is a decrease in the content of immature thin collagen fibers with simultaneous increase in the content of mature thick collagen fibers. Furthermore, among the oldest 24-week-old individuals we can observe the increased thick-to-thin collagen ratio, which may be a sign of slowing down in bone formation. [ABSTRACT FROM AUTHOR]

Diets can influence the body's acid–base status because specific food components yield acids, bases, or neither when metabolized. Animal-sourced foods yield acids and plant-sourced food, particularly fruits and vegetables, generally yield bases when metabolized. Modern diets proportionately contain more animal-sourced than plant-sourced foods, are, thereby, generally net acid-producing, and so constitute an ongoing acid challenge. Acid accumulation severe enough to reduce serum bicarbonate concentration, i.e., manifesting as chronic metabolic acidosis, the most extreme end of the continuum of "acid stress", harms bones and muscles and appears to enhance the progression of chronic kidney disease (CKD). Progressive acid accumulation that does not achieve the threshold amount necessary to cause chronic metabolic acidosis also appears to have deleterious effects. Specifically, identifiable acid retention without reduced serum bicarbonate concentration, which, in this review, we will call "covert acidosis", appears to cause kidney injury and exacerbate CKD progression. Furthermore, the chronic engagement of mechanisms to mitigate the ongoing acid challenge of modern diets also appears to threaten health, including kidney health. This review describes the full continuum of "acid stress" to which modern diets contribute and the mechanisms by which acid stress challenges health. Ongoing research will develop clinically useful tools to identify stages of acid stress earlier than metabolic acidosis and determine if dietary acid reduction lowers or eliminates the threats to health that these diets appear to cause. [ABSTRACT FROM AUTHOR]

Tularemia is caused by the highly infectious bacterium Francisella tularensis , which is recognized as a Tier 1 bioterrorism agent. Tularemia has a range of recognized clinical manifestations, but fewer than 20 bone or joint infections from 6 countries have been reported in the literature to date. This series includes 13 cases of F. tularensis septic arthritis or osteomyelitis in the United States during 2004–2023 and describes exposures, clinical presentation, diagnosis, and outcomes for this rare but severe form of tularemia. Clinicians should consider F. tularensis in patients with compatible exposures or a history of joint replacement or immunosuppression. [ABSTRACT FROM AUTHOR]

Purpose: Polyethylene particles produced from metal-backed tibial (MBT) implants are understood to contribute to bone loss and component loosening. This, along with advanced surgical techniques, improved materials and increasing costs, has renewed interest in all-polyethylene tibias (APTs). We investigated peri-APT bone mineral density (BMD) in patients, expecting to find no differences between two post-operative values. Methods: Patients over 65 years, with BMI ≤ 37.5 kg/m2 and no previous joint replacements were recruited to have computer-navigated total knee arthroplasty using an APT. The study cohort (n = 27) had mean age of 71.9 (SD 4.35) and BMI of 31.2 (SD 3.8). The BMD examinations were performed 6 weeks and 18 months post-operatively. Six regions of interest (ROI) were identified on anterior/posterior and lateral dual-energy X-ray absorptiometry scans. For each ROI, BMD relative differences (RDs) were determined between limbs and RDs at the two time points were compared. Results: No differences were found between the RDs for any ROI. No revisions or complications were reported. At 18 months post-operatively, 79.2% of the cohort were very satisfied or satisfied with the outcome of their surgery and Oxford Knee Scores improved significantly compared to pre-operatively (p < 0.001). Mean knee range of motion was 102° (SD 10.7°), and mean leg alignment was 2.0° valgus (1–6°valgus). Conclusion: Results from BMD analysis suggest that implants were well fixated without compromising function. We believe that using APTs with computer navigation is a viable cheaper option to MBTs for patients who are less active, have lower BMI and good bone quality. [ABSTRACT FROM AUTHOR]

We have studied the effects of individual and combined treatment of insulin (I) and naringin (NAR) on the bone structure and biomechanical properties of femurs from streptozotocin (STZ)-induced diabetic rats. Male Wistar rats were divided into five groups: (1) controls, (2) STZ-induced diabetic rats, (3) STZ-induced diabetic rats treated with I, (4) STZ-induced diabetic rats treated with NAR, and (5) STZ-induced diabetic rats treated with I + NAR. Bone mineral density (BMD), bone histomorphometry, biomechanical testing, and bone biomarker expressions were accomplished in femur of all animals, as well as serum biochemical analyses. The combined treatment of I + NAR increased the body weight and the femur BMD from STZ-induced diabetic rats. The bone biomechanical properties and the bone morphology of the femurs from STZ-induced diabetic rats were also improved by the combined treatment. The increased number of osteoclasts in STZ-induced diabetic rats was partially prevented by I, NAR, or I + NAR. NAR or I + NAR completely blocked the decrease in the number of osteocalcin (+) cells in the femur from STZ-induced diabetic rats. RUNX family transcription factor 2 immunostaining was much lower in STZ-induced diabetic rats than in control animals; the combination of I + NAR totally blocked this effect. The combined treatment not only ameliorated bone quality and function, but also normalized the variables related to glucose metabolism. Therefore, the combination of I + NAR might be a better therapeutic strategy than the individual I or NAR administration to reduce bone complications in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Graves' disease increases bone resorption in hyperthyroidism, leading to elevated serum calcium levels and a negative bone balance. Thymic hyperplasia is observed in some Graves' disease patients. What's more, there have been a few reports of increased serum calcium and severe osteoporosis induced by Graves' disease with thymic hyperplasia. It remains unclear whether Graves' disease with thymic hyperplasia is associated with higher serum calcium levels. Our study aimed to investigate the possibility of elevated serum calcium levels and aggravated bone mobilization in Graves' disease patients with thymic hyperplasia. Methods: Newly diagnosed and untreated patients with Graves' disease (n = 96) were enrolled. They were divided into two groups based on the incidental detection of thymic hyperplasia during imaging. Albumin, alkaline phosphatase, calcium, free triiodothyronine, free thyroxine, thyroid-stimulating hormone, and thyrotrophin receptor antibody (TRAb) were measured, and a computerized tomography of the chest was obtained. Results: Patients with Graves' disease who had thymic hyperplasia were notably younger (P=0.018) and exhibited higher serum calcium levels (P=0.001) compared to those with Graves' disease without thymic hyperplasia. In the multiple regression analysis, thymic hyperplasia, TRAb, and female gender were significant variables associated with elevated serum calcium levels in patients with Graves' disease, collectively accounting for 31.7% of the variation in serum calcium. Conclusions: Graves' disease patients with thymic hyperplasia showed higher serum calcium levels. thymic hyperplasia, TRAb, and female gender were found to be correlated with increased serum calcium levels in Graves' disease, suggesting a potential association between thymic hyperplasia and bone mobilization in Graves' disease. [ABSTRACT FROM AUTHOR]

To verify the reliability and accuracy of wall thickness ratio analysis to determine the degree of bone healing, fracture models were established with 6 beagles. X-ray, micro-CT, and CT scans were performed at 24 weeks. The healthy side and the affected side were used to simulate the three-dimensional geometric model after internal fixation, and the mesh was divided. The mean and median CT wall thickness values were obtained through the wall thickness analysis. X-ray, CT, micro-CT, and gross appearance were used to determine the degree of bone healing, which was compared with wall thickness analysis. There was a positive correlation between the average CT value and the median wall thickness. The correlation coefficient analysis of the median wall thickness ratio (R2) and healing index ratio (R3) showed a positive correlation. The results of the wall thickness ratio (R2) and the healing index ratio (R3) were used to determine bone healing, and the results were consistent with the results of the actual mechanical test and image analysis. The results of wall thickness ratio analysis were significantly correlated with the degree of bone healing. This method is simple, rapid, and practical to analyze and judge the degree of bone healing. [ABSTRACT FROM AUTHOR]

Background: Osteoking has been used for fracture therapy with a satisfying clinical efficacy. However, its therapeutic properties and the underlying mechanisms remain elusive. Method: A bone defect rat model was established to evaluate the pharmacological effects of Osteoking by the dynamic observation of X-ray, micro-CT and histopathologic examination. Transcriptome profiling was performed to identify bone defect-related genes and Osteoking effective targets. Then, a "disease-related gene–drug target" interaction network was constructed and a list of key network targets were screened, which were experimentally verified. Results: Osteoking effectively promoted bone defect repair in rats by accelerating the repair of cortical bone and the growth of trabeculae. Histopathologically, the bone defect rats displayed lower histopathologic scores in cortical bone, cancellous bone and bone connection than normal controls. In contrast, Osteoking exerted a favorable effect with a dose-dependent manner. The abnormal serum levels of bone turnover markers, bone growth factors and bone metabolism-related biochemical indexes in bone defect rats were also reversed by Osteoking treatment. Following the transcriptome-based network investigation, we hypothesized that osteoking might attenuate the levels of ZBP1–STAT1–PKR–MLKL-mediated necroptosis involved into bone defect. Experimentally, the expression levels of ZBP1, STAT1, PKR and the hallmark inflammatory cytokines for the end of necroptosis were distinctly elevated in bone defect rats, but were all effectively reversed by Osteoking treatment, which were also suppressed the activities of RIPK1, RIPK3 and MLKL in bone tissue supernatants. Conclusions: Osteoking may promote bone formation and bone defect repair by regulating ZBP1–STAT1–PKR axis, leading to inhibit RIPK1/RIPK3/MLKL activation-mediated necroptosis. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, we demonstrate that miR-19a promotes the progression of bone invasion of pituitary adenoma and reveal the specific mechanism. miR-19a is released from pituitary adenoma cells into the tumor microenvironment and enters the osteoclasts to exert its effects. miR-19a reduces cylindromatosis (CYLD) expression, thereby preventing the K63 deubiquitination of tumor necrosis factor receptor-associated factor 6 (TRAF6). k63 ubiquitinated TRAF6 acts as a key downstream node of RANK and can activate downstream NF-кB and mitogen-activated protein kinase (MAPK) pathways to promote osteoclastogenesis. Through a combination of molecular biology and cytology, as well as in vivo experiments, we verified the specific mechanism by which miR-19a promotes bone invasion in pituitary tumors. Background: The presence of bone invasion in aggressive pituitary adenoma (PA) was found in our previous study, suggesting that PA cells may be involved in the process of osteoclastogenesis. miR-19a (as a key member of the miR-17-92 cluster) has been reported to activate the nuclear factor-кB (NF-кB) pathway and promote inflammation, which could be involved in the process of the bone invasion of pituitary adenoma. Methods: In this work, FISH was applied to detect miR-19a distribution in tissues from patients with PA. A model of bone invasion in PA was established, GH3 cells were transfected with miR-19a mimic, and the grade of osteoclastosis was detected by HE staining. qPCR was performed to determine the expression of miR-19a throughout the course of RANKL-induced osteoclastogenesis. After transfected with a miR-19a mimic, BMMs were treated with RANKL for the indicated time, and the osteoclast marker genes were detected by qPCR and Western Blot. Pit formation and F-actin ring assay were used to evaluate the function of osteoclast. The TargetScan database and GSEA were used to find the potential downstream of miR-19a, which was verified by Co-IP, Western Blot, and EMSA. Results: Here, we found that miR-19a expression levels were significantly correlated with the bone invasion of PA, both in clinical samples and animal models. The osteoclast formation prior to bone resorption was dramatically enhanced by miR-19, which was mediated by decreased cylindromatosis (CYLD) expression, increasing the K63 ubiquitination of tumor necrosis factor receptor-associated factor 6 (TRAF6). Consequently, miR-19a promotes osteoclastogenesis by the activation of the downstream NF-кB and mitogen-activated protein kinase (MAPK) pathways. Conclusions: To summarize, the results of this study indicate that PA-derived miR-19a promotes osteoclastogenesis by inhibiting CYLD expression and enhancing the activation of the NF-кB and MAPK pathways. [ABSTRACT FROM AUTHOR]

Background: Mental foramen is a small foramen situated in anterolateral aspect of the body of the mandible. Normally, mental foramen is located below the interval between the premolars. It transmits mental nerve, artery and vein. Mental nerve is a branch of inferior alveolar nerve which supplies sensation to lower lip and the labial mucosa and lower canines and premolars. The most useful injection for anaesthetising the mandibular teeth is the inferior alveolar nerve block. Any foramen in addition to mental foramen in the body of the mandible is known as accessory mental foramen. Accessory mental foramen transmits the accessory branch of mental nerve. Materials and methods: The mandibles which were used for our study were procured from the Department of Anatomy, Siddhartha Medical College (Govt), Vijayawada over a period of 6 years. About 70 adult dry South Indian mandibles, irrespective of age and sex, with either all the teeth intact or with preserved alveolar margins, were used for our study. The bones with gross pathological deformities were excluded from our study. The number, shape and the orientation of the MF were determined by a visual examination. The shape of mental foramen in dry human adults was analyzed by visual examination of the both sides of the mandible. Result: The present study showed that the position of mental foramen from symphysis menti and posterior border of ramus of mandible was more on right side than left side and found to be insignificant while position of mental foramen from inferior border of body of mandible was more on left side than right side and found to be insignificant for right side while significant for left side. The shape of mental foramen on right side was found to be Oval shape - 65.7% and round shape - 34.3% while on left side Oval shape-71.4% and round shape - 28.6%. Conclusion: Hence, mental foramen plays a pivotal role in performing major facial surgeries and is an important landmark for several facial procedures performed. [ABSTRACT FROM AUTHOR]

Social scientists know how crucial it is to identify the bodies of the men, women and children who have died at sea or on land, or have been buried in mass burial grounds, and how consequential it is to engage (or not) in some form of ritual, of memorialization. If some scholars have focused on locating and numbering those victims, others have used forensic science to identify the bodies so that the families can get them back, engage in mourning and continue to live. Others, still, interrogate the lost objects of the death-bound migration. This essay will focus on a novel that deals with the exhumation and identification of bones in a civil war context. In Michael Ondaatje's Anil's Ghost, Sri Lankan-born and North American-educated Anil Tissera goes back to Sri Lanka as a forensic anthropologist. She is sent by a human rights group to investigate mass burials during the Civil War and genocide of the Sri Lankan Tamils, thus returning from her diasporic abode after 15 years. In Anil's forensic search for identification, with bones being literally unearthed, what does the literary text perform for those lost or unidentified bodies that could not be accomplished otherwise? What kind of engagement does it offer? Using the angle of forensics and its Latin etymology, this essay will formulate the hypothesis that the literary text enables justice to be delivered in an open court of law (forensis). Moving beyond the stigmatization of the unritual, it will probe the fraught relationship between literature and forensics, investigating the possibility that the narrative, its staging of the unidentified body of the dead, and our relationship to it, could create a public space to be shared by all (forum). [ABSTRACT FROM AUTHOR]

We present a reduced order model for efficient nonlinear homogenization of bones, accounting for strength difference effects and containing some well‐known plasticity models (like von Mises or Drucker‐Prager) as special cases. The reduced order homogenization is done by using a cluster‐based model order reduction technique, called cluster‐based nonuniform transformation field analysis. For an offline phase, a space–time decomposition is performed on the mesoscopic plastic strain fields, while a clustering analysis is employed for a spatial decomposition of the mesoscale RVE model. A volumetric‐deviatoric split is additionally introduced to capture the enriched characteristics of the mesoscopic plastic strain fields. For an online analysis, the reduced order model is formulated in a unified minimization problem, which is compatible with a large variety of material models. Both cortical and trabecular bones are considered for numerical experiments. Compared to conventional FE‐based RVE computations, the developed reduced order model renders a considerable acceleration rate beyond 103, while maintaining a sufficient accuracy level. [ABSTRACT FROM AUTHOR]

This work evaluated the influence of vitamin A on performance, organ weight, and bone and skin characteristics in broilers (Cobb 500) at 21 and 42 days of age. A total of 1920 chickens were distributed in a randomised design, considering six vitamin A supplementation levels (0, 6000, 16,000, 26,000, 36,000, and 46,000 IU kg−1), with 16 replicates and 20 chickens per experimental unit, established due to rising the range of vitamin levels observed in the literature to evaluate the effect of vitamin A on broilers. At 22 days, half of the replicates from each treatment continued receiving the initial diet, and the other eight repetitions received diets without vitamin A (0 IU kg−1) until 42 days. The level of vitamin A influenced feed intake (FI) and body weight gain (BWG) until 21 days for all treatments. Broilers at 21 days of age had a more significant BWG at a vitamin A supplementation level of 28,209 IU kg−1. At 42 days, vitamin A influenced the BWG and FI of broilers at treatments that were not supplemented after 21 days. Treatments supplemented up to 42 days showed quadratic responses to vitamin A for BWG, FI, and feed conversion. The vitamin A levels influenced the relative weights of the small intestine, pancreas, gizzard, abdominal fat, Seedor index, and breaking strength at 42 days, where the adequate supplementation of vitamin A improved these characteristics in broilers. Vitamin A supplementation from 22 to 42 days old did not affect broiler performance. An increased BWG was obtained when vitamin A supplementation occurred until 42 days, with supplementation of 29,375 IU kg−1 and a lower response of feed conversion with the addition of 27,775 IU kg−1. [ABSTRACT FROM AUTHOR]

Rice is the primary staple food for half of the world's population but is low in lysine content. Previously, we developed transgenic rice with enhanced free lysine content in rice seeds (lysine-rich rice), which was shown safe for consumption and improved the growth in rats. However, the effects of lysine-rich rice on skeletal growth and development remained unknown. In this study, we hypothesized that lysine-rich rice improved skeletal growth and development in weaning rats. Male weaning Sprague–Dawley rats received lysine-rich rice (HFL) diet, wild-type rice (WT) diet, or wild-type rice with various contents of lysine supplementation diet for 70 days. Bone microarchitectures were examined by microcomputed tomography, bone strength was investigated by mechanical test, and dynamics of bone growth were examined by histomorphometric analysis. In addition, we explored the molecular mechanism of lysine and skeletal growth through biochemical testing of growth hormone, bone turnover marker, and amino acid content of rat serum analysis, as well as in a cell culture system. Results indicated that the HFL diet improved rats' bone growth, strength, and microarchitecture compared with the WT diet group. In addition, the HFL diet increased the serum essential amino acids, growth hormone (insulin-like growth factor-1), and bone formation marker concentrations. The cell culture model showed that lysine deficiency reduced insulin-like growth factor-1 and Osterix expression, Akt/mammalian target of rapamycin signaling, and matrix mineralization, and inhibited osteoblast differentiation associated with bone growth. Our findings showed that lysine-rich rice improved skeletal growth and development in weaning rats. A further increase of rice lysine content is highly desirable to fully optimize bone growth and development. A rat-feeding study was performed. Bone strength and quality were then assessed, and the molecular mechanism for bone growth was evaluated. Lysine-rich rice diets improved the growth of rats. Lysine induced serum IGF-1 expression and activated the downstream signaling pathway. The active signaling and higher intracellular amino acid pool led to subsequent bone formation. Abbreviations: CT, computed tomography; IGF-1, insulin-like growth factor-1; mTOR, mammalian target of rapamycin; SD, Sprague–Dawley. [Display omitted] [ABSTRACT FROM AUTHOR]

Context Poor diet quality and unhealthy dietary patterns have been linked to poor bone health, yet few studies have investigated the role of diet quality in bone health in pediatric populations. Objective This systematic review aims to assess the available evidence on the association between diet quality and bone health markers in children and adolescents. Data Sources The PubMed, Scopus, and Virtual Health Library databases were searched electronically from October to November 2022, without any restrictions on date or language. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist was used to assess the quality of the studies. Data Extraction Published observational studies in children and adolescents (ages 2 to 19 years) that investigated the association between diet quality and bone health were eligible for inclusion. Two researchers independently analyzed and selected all articles using the Rayyan app. Initially, 965 papers were identified. A total of 12 observational studies qualified, including 8 cross-sectional and 4 longitudinal studies. The sample comprised 7130 individuals aged 3 to 17.9 years, representing both sexes. Bone health was evaluated by measures of bone mineral density and bone mineral content. Data Analysis Seven studies (58.3%) showed significant associations between diet quality and bone health markers, all of which evaluated diet quality by identifying dietary patterns. Diet quality as evaluated by all dietary indexes was not associated with bone health markers. Conclusions Adherence to a healthy diet may benefit bone health in children and adolescents. These findings emphasize the importance of developing effective public health policies that encourage healthy eating habits from childhood to preserve bone health. Longitudinal research using a specific tool to assess diet quality in relation to bone health is warranted. Future studies should also measure bone-regulating hormones and markers of bone turnover. Systematic Review Registration PROSPERO registration no. CRD42022368610. [ABSTRACT FROM AUTHOR]

Background: Periosteum-mediated bone regeneration (PMBR) is a recognized method for mandibular reconstruction. Despite its unpredictable nature and the limited degree to which it is understood, it does not share the concerns of developmental changes to donor and recipient tissues that other treatment options do. The definitive role of the periosteum in bone regeneration in any mammal remains largely unexplored. The purpose of this study was to identify the genetic determinants of PMBR in mammals through a systematic review. Methods: Our search methodology was designed in accordance with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. We conducted a quality assessment of each publication, and evaluated the differences in gene expression between days 7 and 15. Results: A total of four studies satisfied the inclusion criteria. The subjects and tissues examined in these studies were Wistar rat calvaria in two studies, mini-pigs in one study, and calves and mice in one study. Three out of the four studies achieved the necessary quality score of = 3. Gene expression analysis showed increased activity of genes responsible for angiogenesis, cytokine activities, and immune-inflammatory responses on day 7. Additionally, genes related to skeletal development and signaling pathways were upregulated on day 15. Conclusions: The results suggest that skeletal morphogenesis is regulated by genes associated with skeletal development, and the gene expression patterns of PMBR may be characterized by specific pathways. [ABSTRACT FROM AUTHOR]

Background: Excess reactive oxygen species generated by NADPH oxidase 2 (Nox2) in response to ethanol exposure mediate aspects of skeletal toxicity including increased osteoclast differentiation and activity. Because perturbation of chondrocyte differentiation in the growth plate by ethanol could be prevented by dietary antioxidants, we hypothesized that Nox2 in the growth plate was involved in ethanol‐associated reductions in longitudinal bone growth. Methods: Nox2 conditional knockout mice were generated, where the essential catalytic subunit of Nox2, cytochrome B‐245 beta chain (Cybb), is deleted in chondrocytes using a Cre‐Lox model with Cre expressed from the collagen 2a1 promoter (Col2a1‐Cre). Wild‐type and Cre‐Lox mice were fed an ethanol Lieber‐DeCarli‐based diet or pair‐fed a control diet for 8 weeks. Results: Ethanol treatment significantly reduced the number of proliferating chondrocytes in the growth plate, enhanced bone marrow adiposity, shortened femurs, reduced body length, reduced cortical bone volume, and decreased mRNA levels of a number of osteoblast and chondrocyte genes. Conditional knockout of Nox2 enzymatic activity in chondrocytes did not consistently prevent any ethanol effects. Rather, knockout mice had fewer proliferating chondrocytes than wild‐type mice in both the ethanol‐ and control‐fed animals. Additional analysis of tibia samples from Nox4 knockout mice showed that loss of Nox4 activity also reduced the number of proliferating chondrocytes and altered chondrocyte size in the growth plate. Conclusions: Although Nox enzymatic activity regulates growth plate development, ethanol‐associated disruption of the growth plate morphology is independent of ethanol‐mediated increases in Nox2 activity. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff repair is a common orthopaedic procedure, yet the rate of failure to heal after surgery is high. Repair site rupture is due to poor tendon-to-bone healing and lack of regeneration of the native fibrocartilaginous enthesis. During development, the enthesis is formed and mineralized by a pool of progenitors activated by hedgehog signaling. Furthermore, hedgehog signaling drives regenerative enthesis healing in young animals, in contrast to older animals, in which enthesis injuries heal via fibrovascular scar and without participation of hedgehog signaling. Hypothesis: Hedgehog activation improves tendon-to-bone healing in an animal model of rotator cuff repair. Study Design: Controlled laboratory study. Methods: A total of 78 adult Sprague-Dawley rats were used. Supraspinatus tendon injury and repair were completed bilaterally, with microsphere-encapsulated hedgehog agonist administered to right shoulders and control microspheres administered to left shoulders. Animals were sacrificed after 3, 14, 28, or 56 days. Gene expression and histological, biomechanical, and bone morphometric analyses were conducted. Results: At 3 days, hedgehog signaling pathway genes Gli1 (1.70; P =.029) and Smo (2.06; P =.0173), as well as Runx2 (1.69; P =.0386), a transcription factor of osteogenesis, were upregulated in treated relative to control repairs. At 14 days, transcription factors of tenogenesis, Scx (4.00; P =.041), and chondrogenesis, Sox9 (2.95; P =.010), and mineralized fibrocartilage genes Col2 (3.18; P =.031) and Colx (1.85; P =.006), were upregulated in treated relative to control repairs. Treatment promoted fibrocartilage formation at the healing interface by 28 days, with improvements in tendon-bone maturity, organization, and continuity. Treatment led to improved biomechanical properties. The material property strength (2.43 vs 1.89 N/m2; P =.046) and the structural property work to failure (29.01 vs 18.09 mJ; P =.030) were increased in treated relative to control repairs at 28 days and 56 days, respectively. Treatment had a marginal effect on bone morphometry underlying the repair. Trabecular thickness (0.08 vs 0.07 mm; P =.035) was increased at 28 days. Conclusion: Hedgehog agonist treatment activated hedgehog signaling at the tendon-to-bone repair site and prompted increased mineralized fibrocartilage production. This extracellular matrix production and mineralization resulted in improved biomechanical properties, demonstrating the therapeutic potential of hedgehog agonism for improving tendon-to-bone healing after rotator cuff repair. Clinical Relevance: This study demonstrates the therapeutic potential of hedgehog agonist treatment for improving tendon-to-bone healing after rotator cuff injury and repair. [ABSTRACT FROM AUTHOR]

Background: Currently, two classification systems, namely Stephens and Sanders, based on axial CT images, and Zwipp and Rammelt, which consider deformities, are used for calcaneus malunions. Existing classifications have limitations due to their pure anatomical basis, and the complexity of the problem, involving both bone and soft tissues. As a solution, the senior author proposed a novel ADIENS classification system for calcaneal malunion, based on pain generators. This study aimed to introduce and evaluate the inter- and intra-observer reliability of a new classification system for calcaneal malunions. Methods: This retrospective cohort study included adult cases with post-traumatic calcaneus malunion. Three experienced foot and ankle surgeon volunteers underwent training session on the classification system, which classifies malunions based on A arthritis, D deformity, E exostosis, I implant issues, N nerve issues, and S soft tissue issues. Post-training, two rounds of classification exercises were conducted. Inter-rater and intra-rater agreements were determined using Gwet's AC coefficient. Results: Out of 15 cases, 6 were of Stephen and Sanders types, and 8 were of Zwipp and Rammelt types, the rest fell out of these classifications. Inter-rater agreement for ADEINS classification was noted to be 'very good' for all six domains. Intra-observer agreements were 'very good' for four out of six domains of classification and 'fair' for two domains of classification. Conclusion: Pain generators-based new ADEINS classification has demonstrated good intra- and inter-observer reliability and seemed user-friendly. However, results need to be replicated in a larger, multicentric cohort before wider clinical applicability. Level of Evidence: Level IV, retrospective study. [ABSTRACT FROM AUTHOR]