Search Results (122)

Hamstring strain injuries (HSIs) are the most common time loss injury sustained in male Australian Football League (AFL) athletes, causing significant financial cost, time cost, and impaired team and individual performance. In a squad of 42 players, HSIs accounted for 4.86 new injuries sustained by players per club per AFL season in 2020. This is consistent with injury reporting over the last decade in AFL, despite best efforts to reduce the rate. This scoping review sought to firstly identify the reported hamstring injury prevention risk factors in elite AFL, discern the impact of these factors, and map the gaps in the current literature using a biopsychosocial understanding of injury prevention. The scoping review process was based on the Askey and O’Malley framework. Five relevant online databases (MEDLINE, Proquest, CINAHL, SPORTdiscuss, and EMBASE) were systematically searched using a series of Boolean and operator terms following the PRISMA-ScR protocol using the criteria: (1) assessing male professional/elite athletes in AFL; (2) written in English and peer-reviewed; (3) full text available; and (4) published after 2006. Only manuscripts that fit the search terms and inclusion criteria were retained in the scoping review. Following an initial search, 246 potential studies were identified, with 12 studies meeting the inclusion criteria after full-text screening. The risk factors examined were subclassified into modifiable and non-modifiable categories. Modifiable factors include high-speed running exposure, gluteus medius activation, eccentric hamstring strength, shorter bicep femoris fascicle length, use of interchange, and hamstring stiffness. Non-modifiable factors include previous history of HSI and limb injury, age, and size of injury on MRI. This scoping review highlights the need for continued monitoring of high-speed running volumes as rapid increases in completed distances present as a substantial risk factor. The modifiable mechanistic risk factors of eccentric hamstring strength and hamstring stiffness were identified as important components of player screening to reduce the risk of future HSI. Risk factors identified throughout will help develop comprehensive injury profiling for athletes. Further research is warranted to develop a holistic approach to injury profiling. Full article

Background: The coracohumeral ligament (CHL) is inserted in the coracoid process, from which it extends laterally and caudally, blending with the tendinous insertions of the subscapularis muscle and the supraspinatus muscle, with a third intermediate area between the muscles inserted between the humeral tubercles, and it contributes to the fibrous tunnel that engulfs the long head of the biceps tendon. Most previous studies mention insertions from the base of the coracoid process, but not from the tip, and some authors describe anterior and posterior columns. In contrast, others stress the existence of superficial and deep fascicles. Also, the relationship between the coracohumeral and the glenohumeral ligaments is unclear. Given the position of the CHL covering most of the rotator interval, and its role in the stability of the shoulder capsule and pathologies like frozen shoulder, a clear description of its fascicles in a plane-wise manner might be helpful for a selective surgical approach. Methods: We studied sixteen soft-embalmed shoulders to avoid misclassifying fascicles due to formalin-linked tissue amalgamation. Further histological assessment was performed on the two remaining non-embalmed shoulders. Results: In our sample, the coracohumeral ligament hung from the anterior and posterior edges of the coracoid process’ inferior surface, defining two columns that converged near the tip of the coracoid process. Both columns were formed by superficial and deep fascicles directed to different depths of the rotator cuff, usually via the rotator interval, fusing with the connective tissue around the muscles without direct distal attachments. We performed histological and morphometrical assessments, and we discuss clinical and biomechanical implications. Conclusions: The coracohumeral ligament contains four fascicles that fuse with the connective tissue of the shoulder joint, forming a double necklace around the subscapularis and supraspinatus. Therefore, its functions probably extend beyond simple vertical stabilization. Full article

This paper examines the Nanatsu-dera manuscript of the Dafangguang Rulai Xingqi Weimizang Jing (RXWJ) through the lens of scribal practices, with a focus on variant characters (yitizi, 異體字) and textual transmission. As a “separately produced scripture” (bie sheng jing, 別生經), the RXWJ was not included in the woodblock-printed editions of the Chinese Buddhist canon, which limited its circulation and made manuscript copies—such as the Nanatsu-dera manuscript—critical for reconstructing its textual evolution, transmission, and scribal modifications. A detailed paleographic investigation reveals scribal variants, orthographic fluidity, and phonetic substitutions, illustrating both intentional adaptations and unintentional errors in textual transmission. Comparative analysis with Dunhuang fragments and the Taishō Canon further contextualizes these variations, shedding light on the interpretive challenges scribes and readers face. The findings suggest that the Nanatsu-dera manuscript underwent three stages of transmission: (1) it originated from the Fifty-Fascicle edition circulating in China, (2) it was used as a base text (diben, 底本) for manuscript copying in Japan, and (3) it was subsequently re-copied and preliminarily collated by Japanese scribes. By tracing scribal variants and textual transmission through a paleographic approach, this research underscores the critical role of manuscript culture in preserving texts outside the canonical tradition, offering new insights into the mechanisms of Buddhist textual transmission and adaptation in medieval East Asia. Full article

The detailed study of the morphology and morphometrics of the auditory ossicles in swine became a topic for investigation due to their resemblance to the human ear. The methods used in this study cover the typical macroscopical investigation of gross morphology: a detailed metrical and histological assessment through H&E standard protocol on auditory ossicles originating from eight pig fetuses originating from four distinctive sows. The ossicular assembly in the malleus, incus and stapes present in 66-day fetuses shows all the features generally described in swine. The malleus comprises two uneven laminae of mineralized hyaline cartilage and a medullary cavity. The areas of the head and neck show a high degree of vascularization. The incus has two similar cortical fascicles separated by a compartmentalized medullary cavity, with the highest degree of mineralization found at the distal part of the long process. Stapes show an early degree of mineralization at the level of the crura, lacking medullary cavities. The ossicular chain shows typical morphological elements, similar to adults, and from a dimensional perspective, our investigations point to an uneven degree of development of the ossicles, according to gestational age: the malleus and stapes reach almost 80% and the incus about 50–60% of their adult sizes. Full article

The Āgamas hold significant importance in the context of Old Uyghur Buddhism, as evidenced by the discovery of over 100 fragments of Old Uyghur translations from Turfan and Dunhuang. Of particular significance are the two fragments housed in the Berlin Turfan Collection, U 5464 and U 5501, which contain an Old Uyghur translation of the Chinese Saṃyuktāgama, inscribed on both sides of a repurposed Manichaean manuscript. These fragments correspond to the 22nd and 23rd fascicles of the Chinese source text. This study provides a comprehensive introduction and an edition of these two fragments, accompanied by a comparative analysis with a parallel Old Uyghur translation from Manuscript N, housed in Tokyo. The analysis reveals significant variations, particularly in translation strategies, suggesting the existence of multiple Old Uyghur versions of the text. Full article

Peripheral nerve injuries affect 13–23 per 100,000 people annually in the U.S. and often result in motor and sensory deficits. Microsurgical suture repair (SR) is the standard treatment but is technically challenging and associated with complications. Photochemical tissue bonding (PTB), which uses light and a photoactivated dye to bond collagenous tissues, offers a promising alternative. We compared PTB with commercially available collagen membranes for SR and PTB using cryopreserved human amnion (HAM) in a rat sciatic nerve transection model. In total, 75 Lewis rats underwent nerve repair with one of five methods: SR, PTB-HAM, PTB with commercial collagenous membranes (human amnion monolayer (AML), human amnion–chorion–amnion trilayer (ATL), or swine intestinal submucosa (SIS)). Functional recovery was assessed with walking tracks and the Static Sciatic Index (SSI) at days 30, 60, 90, and 120; histological evaluations at days 30 and 120 examined inflammation, axon density, and fascicle structure. No significant differences in SSI scores were found between groups, though PTB-AML and PTB-SIS improved over time. Histology showed inflammation at day 30 that decreased by day 120. Histomorphometry revealed similar axon regeneration across groups. These results suggest that PTB with commercial membranes is a viable alternative to SR. Full article

Infantile Fibrosarcoma is a malignant tumor of fibroblastic origin, typically found in early childhood, locally aggressive, and characterized by molecular alterations that activate tyrosine kinase signaling, primarily the ETV6::NTRK3 fusion. In recent years, a series of fusions different from the classic one have been described, including NTRK1, RAF1, and BRAF. In this paper, we present a case of IFS with a novel EVI5::BRAF fusion. We observed a spindle cell neoplasm growing in intertwined fascicles within a fibrous stroma, without the formation of an immature osteoid matrix. Weak and focal immunoreactivity for S100 was observed. SATB2 exhibited diffuse and intense staining, with focal expression of osteonectin and negativity for caldesmon, Smooth Muscle Actin, desmin, GFAP, SOX10, MelanA, panTRK, and HMB45. The Ki67 index was 7%, and the tumor harbored an EVI5::BRAF genetic fusion. To the best of our knowledge, the EVI5::BRAF fusion has not yet been described in BRAF fusions in IFS. Nevertheless, further studies are needed to define the prognostic features of these emerging BRAF sarcomas, along with new anti-BRAF therapeutic approaches. Full article

Background/Objectives: Intraneural tumors (INTs) pose a diagnostic challenge, owing to their varied origins within nerve fascicles and their wide spectrum, which includes both benign and malignant forms. Accurate diagnosis and management of these tumors depends upon the skills of the radiologist in identifying key imaging features and correlating them with the patient’s clinical symptoms and examination findings. Methods: This comprehensive review systematically analyzes the various imaging features in the diagnosis of intraneural tumors, ranging from basic MR to advanced MR imaging techniques such as MR neurography (MRN), diffusion tensor imaging (DTI), and dynamic contrast-enhanced (DCE) MRI. Results: The article emphasizes the differentiation of benign from malignant lesions using characteristic MRI features, such as the “target sign” and “split-fat sign” for tumor characterization. The role of advanced multiparametric MRI in improving biopsy planning, guiding surgical mapping, and enhancing post-treatment monitoring is also highlighted. The review also underlines the importance of common diagnostic pitfalls and highlights the need for a multi-disciplinary approach to achieve an accurate diagnosis, appropriate treatment strategy, and post-therapy surveillance planning. Conclusions: In this review, we illustrate the main imaging findings of intraneural tumors, focusing on specific MR imaging features that are crucial for an accurate diagnosis and the differentiation between benign and malignant lesions. Full article

Background and Objectives: This study investigates the effects of a five-week training program on the medial gastrocnemius muscle, comparing two approaches: blood flow restriction (BFR) training and normobaric hyperoxia (oxygen supplementation). It evaluates three strengthening modalities (dynamic, isometric, and the 3/7 method) analyzing their impact on maximal voluntary contraction (MVC), muscle architecture, and perceived exertion. Methods: A total of 36 young healthy participants (21 females, 15 males) were randomized into six subgroups (n = 6 each) based on the type of contraction and oxygen condition. Training sessions (three per week) were conducted for five weeks at 30% of MVC. Measurements of MVC, muscle circumference, pennation angle, fascicle length, and perceived exertion were taken at baseline (T0), mid-protocol (T1), and post-protocol (T2). Results: All groups demonstrated significant increases in MVC after five weeks, with no notable differences between BFR and oxygen conditions. Structural changes were observed in specific subgroups: the BFR-isometric group showed increased calf circumference (p < 0.05), and the 3/7 groups exhibited significant fascicle length gains (p < 0.05). Perceived exertion was consistently higher in BFR groups compared to oxygen supplementation, particularly in dynamic exercises. Conclusions: Both BFR and oxygen supplementation are effective in enhancing strength with light loads, though they elicit different structural and perceptual responses. Oxygen supplementation may be more comfortable and less strenuous, offering a viable alternative for populations unable to tolerate BFR. Future research should focus on optimizing training parameters and exploring applications tailored to specific athletic or clinical contexts. Full article

Background/Objectives: the purpose of this study was to determine the contributions of mechanical, neural, morphological, and muscle quality factors on individual differences in the maximal ankle dorsiflexion range of motion (ROM). Methods: A sample of 41 university students performed passive-dorsiflexion and morphological measurements. In the passive-dorsiflexion measurement, while the ankle was passively dorsiflexed, maximal dorsiflexion ROM was measured in addition to passive torque at a given angle and muscle–tendon junction (MTJ) displacement during the last 13° as mechanical factors, and stretch tolerance and muscle activation were measured as neural factors. In morphological measurements, the cross-sectional area, muscle thickness, muscle fascicle length, and pennation angle were measured. In addition, the echo intensity was evaluated as muscle quality. Subjects were divided into three groups (flexible, moderate, and tight) using the value of the maximal dorsiflexion ROM. Results: Maximal dorsiflexion ROM and stretch tolerance were greater in the flexible group than those in the moderate and tight groups. MTJ displacement was smaller in the flexible group than those in the moderate and tight groups. Stepwise multiple regression analysis revealed that stretch tolerance and passive torque at a given angle were selected as parameters to explain the maximal dorsiflexion ROM (adjusted R² = 0.83). Conclusions: these results indicate that individual differences in maximal ankle dorsiflexion ROM are primarily related to mechanical and neural factors. Full article

Background: Damage to the upper trunk of the brachial plexus, often caused by high-energy trauma, leads to significant functional impairment of the upper limb. This injury primarily affects the C5 and C6 roots, resulting in paralysis of muscles critical for shoulder and elbow function. If spontaneous nerve regeneration does not occur within 3–6 months post-injury, surgical intervention, including nerve transfers, is recommended to restore function. Methods: This study evaluates long-term outcomes of nerve transfer surgeries performed between 2013 and 2023 on 16 adult patients with post-traumatic brachial plexus injuries. The most common cause of injury was motorcycle accidents. Nerve transfers targeted shoulder and elbow function restoration, including transfer of the accessory nerve to the suprascapular nerve, the radial nerve branch to the long or medial head of the triceps brachii to the axillary nerve, or the transfer of motor fascicles of the ulnar and median nerves (double Oberlin) to the brachialis and biceps brachii motor nerves. Results: Postoperative results showed varying degrees of functional recovery. In the shoulder, most patients achieved stabilization and partial restoration of active movement, with average flexion up to 92° and abduction up to 78°. In the elbow, full flexion with M4 strength was achieved in 64% of patients. In both the shoulder and the elbow, double nerve transfers yield better long-term outcomes than single transfers. Secondary procedures, such as tendon transfers, were required in some cases to improve limb strength. Conclusions: The study concludes that nerve transfers offer reliable outcomes in restoring upper limb function, although additional surgeries may be necessary in certain cases. Full article

This cross-sectional study examined gastrocnemius medialis fascicle length (FL) and anatomical cross-sectional area (ACSA) in female volleyball athletes aged 8–18 years, in an attempt to investigate morphological growth changes during childhood and adolescence. Methods: Eighty-nine athletes were assigned to five groups: 8–10, 10–12, 12–14, 14–16 and 16–18 years old. Height, body mass, leg and calf length were measured, and maturity offset was calculated from anthropometrics. FL and ACSA were assessed using ultrasonography. Results: FL was longer and ACSA was larger in the 12–14 y group compared with the 8–10 y group (4.31 ± 0.60 vs. 3.66 ± 0.40 cm, p = 0.008 and 13.08 ± 3.01 cm² vs. 9.98 ± 2.07 cm², p = 0.018, respectively). However, there were no differences in FL or ACSA among the groups aged between 12 and 18 years (p > 0.573 and p > 0.352). Notably the percentage increase in ACSA between the youngest (8–10 y) and the oldest group (16–18 y) was twofold greater than the percentage increase in FL (49% vs. 24%). Significant correlations were found between anthropometric characteristics FL and ACSA (r = 0.366–760, p < 0.001). Conclusions: These data indicate that there is a rapid increase in FL and ACSA from the age of 8 y until the age of 14 y, which is a crucial time frame for muscle growth. Full article

Recently, onychectomy, the “declaw” surgery in which all or part of the distal phalanges are removed, has been shown to have significant effects on the forearm muscles of felids. While this surgery should clearly affect the limb muscles (especially those that insert on the removed or modified bone), these effects have not been studied beyond felids or in the hindlimb. To that end, we herein evaluated the muscle architecture of a kinkajou (Potos flavus) that was declawed on all four of its limbs and compared its anatomy to that of intact specimens and the felid findings. As expected, some of the declawed kinkajou’s muscles were substantially different from those of the intact specimens, and as was seen in felids, its digital muscles appear to have been weaker. However, unlike in the felids, the declawed kinkajou had relatively larger forearm muscles. Also, contrary to expectation, the leg muscles of the declawed kinkajou were not substantially different, perhaps reflecting important differences in limb use. Future analyses should examine this anatomy in other declawed kinkajou specimens and also look at the effects of this surgery in other taxa, for instance, non-arboreal relatives of the kinkajou as well as other arboreal taxa. Full article

The Nordic hamstring exercise (NHE) is effective at decreasing hamstring strain injury risk. Limited information is available on the in vivo mechanics of the bicep femoris long head (BF_LH) during the NHE. Therefore, the purpose of this study was to observe kinematic, neuromuscular and in-vivo mechanics of the BF_LH during the NHE. Thirteen participants (24.7 ± 3.7 years, 79.56 ± 7.89 kg, 177.40 ± 12.54 cm) performed three repetitions of the NHE at three horizontal planes (0°, 20° and −20°). Dynamic ultrasound of the dominant limb BF_LH, surface electromyography (sEMG) of the contralateral hamstrings and sagittal plane motion data were simultaneously collected. Repeated measures analysis of variance with Bonferroni post hoc corrections were used on the in vivo mechanics and the kinematic and sEMG changes in performance of the NHE. Likely differences in ultrasound waveforms for the BF_LH were determined. Significant and meaningful differences in kinematics and in vivo mechanics between NHE variations were observed. Non-significant differences were observed in sEMG measures between variations. Changes to the NHE performance angle manipulates the lever arm, increasing or decreasing the amount of force required by the hamstrings at any given muscle length, potentially changing the adaptive response when training at different planes and providing logical progressions ore regressions of the NHE. All NHE variations result in a similar magnitude of fascicle lengthening, which may indicate similar positive adaptations from the utilization of any variation. Full article

Prior to training, many athletes perform different soft-tissue preparation protocols. Many of these protocols involve stretching, foam rolling, and/or percussion massage. Many of these modalities have been studied, but not as a group to observe muscle alterations and differences in males and females. In total, 40 (20 males, 20 females) participants performed five minutes of static stretching, foam rolling, and percussion massage. Pre- and post-isometric leg strength, muscle activation and ultrasound assessments (cross-sectional area, echo intensity, pennation angle, fascicle length, and muscle thickness) were taken. The results indicate that there is no significant difference among modalities, and that they do not significantly alter any muscle characteristic or improve performance. There is a significant difference in size between males and female, with males having larger muscle and greater pennation angles than females. This allows males to generate significantly more muscle force. However, they both respond similarly to each modality. In conclusion, the muscle response to static stretching, foam rolling, and percussion massage do not differ among modalities and do not contribute to an increase or decrease in maximal isometric knee extension with similar effects between males and females. Full article