Search Results (705)

Background: Previous research highlights the potential of Rolfing structural integration (SI)—a force-based mobilization of fascia—in modifying postural alignment and joint mobility. This retrospective cohort study builds upon prior work to explore the influence of SI on lower limb mobility, trunk symmetry, and respiratory thoracic expansion. Methods: We conducted a retrospective secondary analysis of data drawn from the archive of clinical records as in our previous publication. A total of 563 subjects (aged 18–60 years, BMI 19–29) who completed 10 SI sessions were included. Outcomes evaluated included passive hip flexion (right/left), passive knee flexion mobility (right/left), trunk length symmetry, and chest diameter at normal breath as well as in full inspiration. Wilcoxon signed-rank tests were used for statistical analysis. Results: All parameters showed statistically significant improvements post-intervention (p < 0.001), including increased thoracic expansion, enhanced trunk symmetry, and improved mobility in hip joint flexion and knee flexion. Conclusions: Ten sessions of SI were associated with statistically significant improvements in lower limb mobility, trunk symmetry, and respiratory thoracic mobility. These findings support the role of SI in addressing postural and mobility-related dysfunctions through fascia-oriented mobilization. Full article

Worker honey bees are crucial for colony stability and ecosystem pollination. However, the cross-scale aging features and underlying mechanisms in the Eastern honey bee (Apis cerana) remain poorly understood. This study systematically investigated age-related changes in A. cerana workers across youth (1~5 days post-emergence, dpe), middle age (29 dpe), and old age (50 dpe) through integrated morphological, ultrastructural, and transcriptomic analyses. With increasing age, the phenotypic deterioration in the old bees (OBs) was significant: the body color brightness decreased by 16.7% compared to the young bees (YBs) (p < 0.001), and the hair density of the head, thorax, and abdomen declined by 63.5%, 97.2%, and 91.5%, respectively (p < 0.0001). The wing wear index (WWI) increased to 96.7% (p < 0.0001). The locomotor performance declined sharply, with only 6.7% of the OBs successfully reaching the feeding platform within 15 s (p < 0.0001). Ultrastructural analysis revealed sensory organ abrasion, flattened thoracic bristles, thickened cuticle, and 90.4% increased mitochondrial damage (p < 0.0001). The autophagosomes showed dynamic changes, with 81.8% reduction versus those of mid-aged bees (MBs) (p < 0.001), which suggests that mitochondrial dysfunction and autophagy dysregulation may be the core driving factors behind aging. Transcriptomics identified 67 differentially expressed genes enriched in lifespan regulation, glutathione metabolism, and lysosomal pathways. Fifteen key aging-related genes were identified, such as major royal jelly protein 3 (MRJP3), synaptic vesicle glycoprotein 2A (SV2A), and apidermin 3 (APD3), whose expression dynamics have been shown to be closely related to nutritional metabolism, behavioral perception, and the decline of epidermal barrier function. This work establishes the first multidimensional aging evaluation system for A. cerana, providing critical insights into bee senescence mechanisms and colony health optimization. Full article

Objectives: Point-of-care ultrasound (POCUS) has become an integral part of emergency, intensive care, and perioperative medicine. However, the training and subsequent evaluation of POCUS users are still not standardized. The aim of the study was to develop and validate an assessment tool for POCUS users. Methods: After reviewing the existing literature and a multi-stage expert survey (Delphi method), consensus on twelve items for the assessment tool was reached. To validate the assessment tool, a group of volunteer doctors and medical students performed a POCUS examination using simple linear probe and more complex sector probe techniques. The examination was evaluated by two independent assessors using the created assessment tool. Then, four experts evaluated anonymized recordings of the examinations. We tested the reliability and validity, including internal consistency. Results: A total of 70 examinations were included. Of these, 19 examinations were carried out by physicians and 51 by medical students. A high inter-rater reliability (Cohen’s kappa 0.78 (linear weighted; SEM 0.37; p < 0.001) and Krippendorff’s alpha 0.895) was shown for the evaluation tool. To improve discriminative power and strengthen reliability, the assessment tool was modified using Cronbach’s alpha. Modification resulted in the removal of three items (patient positioning, ultrasound mode selection, and probe selection) from the tool. The mean values of instrument and expert ratings were now 2.62% apart (46.90% instrument vs. 44.29% expert). Pearson’s correlation coefficient between tool and expert ratings showed moderate to high validity (r = 0.69; p < 0.001). Conclusions: The new assessment tool is highly reliable and a valid tool for assessing POCUS skills. It holds strong potential for integration into medical education and training to objectify ultrasound skills. Further studies are required to investigate discriminatory power and transferability to other POCUS algorithms. Full article

Background/Objectives: SMARCA4-deficient or SMARCA4-mutated cancers are rare but highly aggressive tumors with poor differentiation, resistance to conventional treatments, and limited clinical guidance. While thoracic SMARCA4-deficient undifferentiated tumors are relatively well described, the full spectrum of SMARCA4-altered cancers across different organs and their therapeutic responses remains poorly understood. This study aimed to systematically review published case reports and case series to clarify the clinical characteristics, molecular features, treatment patterns, and survival outcomes of SMARCA4-altered malignancies. Methods: We conducted a systematic review of case reports and case series published between 2015 and 2025 using PubMed, Embase, and Web of Science. Eligible studies included adult patients with immunohistochemically or genetically confirmed SMARCA4-deficient or SMARCA4-mutated tumors. Key clinical, pathological, molecular, therapeutic, and outcome-related data were extracted. Descriptive statistics were used, and exploratory subgroup analyses were performed based on tumor type and treatment modality. The review protocol was registered in PROSPERO (CRD420251088805). Results: A total of 109 studies reporting 160 individual patients were included. Most tumors arose in the thorax (40.0%), followed by gastrointestinal (17.5%) and gynecologic sites (15.6%). The median age was 58 years, with a male predominance (70.0%) and frequent smoking history (44.4%). Platinum-based chemotherapy was administered in 62.5% of cases, and immune checkpoint inhibitors (ICIs) were used in 25.6%. Among ICI-treated patients, partial responses or stable disease were observed in 80.5%. The median progression-free survival (PFS) was 4.0 months, and the median overall survival (OS) was 5.0 months. Conclusions: SMARCA4-altered cancers are clinically and molecularly diverse but uniformly aggressive, with limited therapeutic benefit from conventional chemotherapy. Immune checkpoint inhibitors may offer improved outcomes in select patients, particularly those with thoracic tumors. Early molecular profiling, rare tumor registries, and biomarker-driven trials are crucial for guiding future treatment strategies. Full article

Background and Objectives: The hypothesis that fascial thickness variability may serve as a biomarker for low back pain (LBP) requires a clear understanding of typical thickness values in both LBP and non-LBP populations—an area still lacking in the literature. This narrative review aims to define reference values and patterns of variability for the superficial fascia, deep fascia, and subcutaneous tissue in individuals with and without LBP. Methods: A literature search was conducted in PubMed and ScienceDirect using keywords such as superficial fascia, deep fascia, thoracolumbar, subcutaneous fat, back pain, lumbar, thorax, and thickness. Inclusion criteria focused on human studies with proper identification of the relevant soft tissue structures. A total of 21 studies, published up to February 2024, met the inclusion criteria and were analyzed. Results: The review revealed notable intra- and inter-study variability in the thickness of the investigated structures. In LBP populations, both deep fascia and subcutaneous tissues were generally equal to or thicker than in controls (non-LBP), whereas consistent data on superficial fascia thickness remain limited. Age, sex, and anatomical location were discussed as potential influencing factors. Conclusions: These findings support the establishment of reference thickness values for subcutaneous and fascial tissues and encourage further investigation into their structural and functional roles in LBP. The observed variability may offer a basis for patient- and site-specific assessment and intervention strategies. Full article

Background: The optimal revascularization strategy for patients with left main coronary artery (LMCA) disease has been repeatedly addressed in randomized controlled trials (RCTs), although outcomes from real-life clinical studies are still poorly investigated. Objectives: This retrospective study aimed to assess the complete 5-year outcomes for individuals with multivessel coronary artery disease (MVD) involving LMCA disease treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) as recommended by a local HT. Methods: From 2016 to 2019, 176 Heart Team (HT) meetings were held. Primary and secondary endpoints of 267 patients with MVD involving LMCA disease qualified either for CABG or PCI (109 and 158 patients, respectively) with subsequent optimal medical therapy (OMT) were assessed. The primary endpoint of the study was as an overall mortality, while secondary endpoints contained major adverse cardiac and cerebrovascular events (MACCE)—specifically, stroke, myocardial infarction (MI), repeat revascularization (RR), and the individual components of MACCE. Results: At 5 years, we found no significant difference in overall mortality between the both cohorts (22.9%-CABG vs. 24.7%-PCI, p = 0.74). The rate of MI was higher in patients treated percutaneously (7.3% vs. 15.8% for PCI, p = 0.04), while the incidence of stroke was higher in patients who underwent CABG (3.8% vs. 11.0% for CABG, p = 0.02). A MACCE occurrence was higher in PCI cohort (77.2% vs. 55.0%, p < 0.001), mainly driven by higher rates of RR was higher in patients treated percutaneously (32.9% vs. 13.8%, p < 0.001). Conclusions: For patients with LMCA disease, neither CABG nor PCI following HT decisions showed overwhelming superiority in real-life clinical practice: occurrence of all-cause death was similar, rates of MACCE, MI, and repeat revascularization advocated CABG, while incidence of strokes favored PCI. Full article

This study presents the development and the mechanical and clinical characterization of a flexible biodegradable chitosan–glycerol–graphite composite strain sensor for real-time respiratory monitoring, where the main material, chitosan, is derived and extracted from Tenebrio Molitor larvae shells. Chitosan was extracted using a sustainable, low-impact protocol and processed into a stretchable and flexible film through glycerol plasticization and graphite integration, forming a conductive biocomposite. The sensor, fabricated in a straight-line geometry to ensure uniform strain distribution and signal stability, was evaluated for its mechanical and electrical performance under cyclic loading. Results demonstrate linearity, repeatability, and responsiveness to strain variations in the stain sensor during mechanical characterization and performance, ranging from 1 to 15%, with minimal hysteresis and fast recovery times. The device reliably captured respiratory cycles during normal breathing across three different areas of measurement: the sternum, lower ribs, and diaphragm. The strain sensor also identified distinct breathing patterns, including eupnea, tachypnea, bradypnea, apnea, and Kussmaul respiration, showing the capability to sense respiratory cycles during pathological situations. Compared to conventional monitoring systems, the sensor offers superior skin conformity, better adhesion, comfort, and improved signal quality without the need for invasive procedures or complex instrumentation. Its low-cost, biocompatible design holds strong potential for wearable healthcare applications, particularly in continuous respiratory tracking, sleep disorder diagnostics, and home-based patient monitoring. Future work will focus on wireless integration, environmental durability, and clinical validation. Full article

The two closely related Oriental species of the genus Rhynocoris, R. costalis (Stål, 1867) and R. fuscipes (Fabricius, 1787), exhibit remarkable morphological similarity, particularly in their overall red and black body coloration, including the head, thorax, and abdomen. Based on the examination of type specimens and non-type material collected from various localities of southern China, we found these two congeners were misidentified in many previous publications. Due to the restricted distribution and limited population size of R. fuscipes in China, most taxonomic, biological, and biocontrol studies conducted under the name Harpactor fuscipes or Rhynocoris fuscipes should be instead attributed to R. costalis. To address this confusion regarding these two species, the present study clarifies the taxonomic status of the two controversial species—R. costalis and R. fuscipes. Additionally, a new species, Rhynocoris minutus Liu, Zhao & Cai sp. nov., collected from southwestern China, is described and illustrated. A key to the 13 species in Rhynocoris currently recorded in China is provided. Full article

Background: Positive identification is at the forefront of tasks for forensic practitioners when a set of remains is discovered. Standard means of identification include fingerprints, dental, and DNA analyses; however, additional methods are utilized by forensic practitioners to identify remains when these primary methods of identification are not applicable. Comparative radiography has become a frequently employed approach for positive identification, specifically focused on individualizing characteristics evident in human skeletal variation. Regions that display wide ranges of morphological variation within the human skeleton include the cranium as well as the thorax. With regard to the cranium specifically, paranasal sinuses have been recognized as unique features and are valuable for identification purposes. Objectives: This paper explores the basic information of the anatomy and development, range of variation, and the importance of paranasal sinuses in forensic contexts. Results: This article discusses how practitioners can best use the morphological information contained in the paranasal sinuses and how to compare the antemortem and postmortem datasets involving different imaging modalities for positive identification purposes, in order to provide practical concepts that may assist in cases where paranasal sinuses may be used for forensic human identification. Conclusions: Understanding the development of paranasal sinuses, the imaging techniques applied for their visualization, as well as the principles of identification, is key to conducting proper antemortem vs. postmortem comparisons and effectively utilizing paranasal sinuses in forensic identification contexts. Full article

Background/Objectives: Nutraceuticals containing milk fat globule membranes (MFGMs) and extracellular vesicles (EVs) are purported to abate age-related metabolic dysfunction due to their richness in milk sphingolipids. As such, nutraceuticals offer a compelling strategy to improve metabolic health through dietary means, especially for elderly persons who are unable to adhere to common therapeutic interventions. To address this, we examined the effects of supplementing aged sedentary rats with an MFGM/EV-rich concentrate. Methods/Results: In a 25-week study, 89-week-old male rats received either a milk sphingolipid-rich MFGM/EV concentrate or a control supplement. Analysis of metabolic health using a battery of tests, including MS^ALL lipidomics of plasma, liver, and other peripheral tissues, revealed that MFGM/EV supplementation promotes accretion of unique sphingolipid signatures, ameliorates ceramide biomarkers predictive of cardiovascular death, and has a general lipid-lowering effect. At the functional level, we find that these health-promoting effects are linked to increased lipoprotein particle turnover, showcased by reduced levels of triglyceride-rich particles, as well as a metabolically healthier liver, assessed using whole-body lipidomic flux analysis. Conclusions: Altogether, our work unveils that MFGM/EV-containing food holds a potential for ameliorating age-related metabolic dysfunction in elderly individuals. Full article

Colorectal surgery has undergone significant advances over the past few decades, driven by the evolution of minimally invasive techniques, particularly laparoscopy and robotics. While laparoscopy is widely recognized for its short-term benefits and oncological safety, the increasing adoption of robot-assisted surgery (RAS) has generated considerable debate regarding its clinical benefits, economic implications, and overall impact on patient outcomes. This narrative review synthesizes the existing evidence, highlighting the clinical and economic aspects of RAS in colorectal surgery, while exploring areas for future research. The findings suggest that RAS offers potential technical advantages, including increased precision, three-dimensional visualization, and improved ergonomics, particularly in anatomically complex scenarios such as low rectal resections. Still, its superiority over laparoscopy remains inconclusive and current evidence is mixed. For colon cancer, meta-analyses and analyses of large cohorts suggest lower conversion rates and faster recovery with RAS, although data are mostly retrospective and lack long-term oncological endpoints. In rectal cancer, emerging evidence from randomized controlled trials demonstrates improved short-term outcomes. Additionally, the recently published three-year results of the REAL trial are the first to demonstrate enhanced oncological outcomes following RAS. However, findings remain inconsistent due to methodological heterogeneity, the absence of patient stratification, and limited data on long-term survival and cost-effectiveness. The available evidence indicates that RAS may offer advantages in selected patient populations, particularly for anatomically complex procedures. Yet, its overall utility remains uncertain. Future studies should emphasize high-quality randomized trials, stratified subgroup analyses, and standardized economic evaluations to better define the role of RAS in colorectal surgery. Full article

Background: Microbial communities of insects have distinct roles for their respective hosts. For the black fly (Diptera: Simuliidae), an important vector and ecological indicator, the representative microbiota from the different body regions are not known. Here, we investigated the microbial composition and diversity of the head, thorax, and abdomen of wild-caught Simulium vanluni. Methods: Adult Simulium vanluni were surface-sterilized and dissected into head, thorax, and abdomen. For each body region, 20 individuals were pooled into one sample with six replicates per region. DNA was extracted and sequenced using the 16S rRNA amplification method to assess for possible microbial diversity. Data were analyzed using MicrobiomeAnalyst, where we calculated alpha diversity, beta diversity, and tested compositional differences using PERMANOVA. Results: Across 17 pooled samples, three core genera, Wolbachia (78.33%), Rickettsia (9.74%), and Acinetobacter (9.20%), accounted for more than 97% of the 16S rRNA sequencing reads. Head communities were compositionally distinct compared to the thorax and abdomen (PERMANOVA, p < 0.05). Heads were nearly monodominated by Wolbachia (95–97%), exhibiting significantly lower diversity and evenness compared to other body regions. In contrast, the thoracic and abdominal communities were more even, where thoraces were enriched with Acinetobacter (19.16%) relative to Rickettsia (10.85%), while abdomens harbored higher Rickettsia (10.96%) than Acinetobacter (5.68%). Collectively, the near-monodominance of Wolbachia in heads and inverse abundances of Acinetobacter and Rickettsia in thoraces and abdomens suggest possible anatomical niche partitioning or competition exclusion of microbiota across body regions. Conclusions: Our findings reveal fine-scale anatomical niche partitioning in S. vanluni microbiota, with the heads being almost exclusively colonized by Wolbachia, while the thoracic and abdominal niche regions exhibit distinct enrichment patterns for Acinetobacter and Rickettsia. These spatially distinct microbial distributions suggest potential functional specialization across anatomical regions of S. vanluni. Full article

Introduction: Acute Myeloid Leukemia (AML) is a hematologic malignancy characterized by the clonal expansion of myeloid progenitors. While it primarily affects the bone marrow, extramedullary relapse occurs in 3–5% of cases, and it is linked to poor prognosis. Central nervous system (CNS) involvement presents diagnostic challenges due to nonspecific symptoms. CNS manifestations include leptomeningeal dissemination, nerve infiltration, parenchymal lesions, and myeloid sarcoma, occurring at any disease stage and frequently asymptomatic. Methods: A 62-year-old man with a recent history of AML in remission presented with diplopia and aching paresthesias in the left periorbital region spreading to the left frontal area. The diagnostic workup included neurological and hematological evaluation, lumbar puncture, brain CT, brain magnetic resonance imaging (MRI) with contrast, and dermatological evaluation with skin biopsy due to the appearance of nodular skin lesions on the abdomen and thorax. Results: Neurological evaluation showed hypoesthesia in the left mandibular region, consistent with left trigeminal nerve involvement, extending to the periorbital and frontal areas, and impaired adduction of the left eye with divergent strabismus in the primary position due to left oculomotor nerve palsy. Brain MRI showed an equivocal thickening of the left oculomotor nerve without enhancement. Cerebrospinal fluid (CSF) analysis initially showed elevated protein (47 mg/dL) with negative cytology; a repeat lumbar puncture one week later detected leukemic cells. Skin biopsy revealed cutaneous AML localization. A diagnosis of AML relapse with CNS and cutaneous localization was made. Salvage therapy with FLAG-IDA-VEN (fludarabine, cytarabine, idarubicin, venetoclax) and intrathecal methotrexate, cytarabine, and dexamethasone was started. Subsequent lumbar punctures were negative for leukemic cells. Due to high-risk status and extramedullary disease, the patient underwent allogeneic hematopoietic stem cell transplantation. Post-transplant aplasia was complicated by septic shock; the patient succumbed to an invasive fungal infection. Conclusions: This case illustrates the diagnostic complexity and poor prognosis of extramedullary AML relapse involving the CNS. Early recognition of neurological signs, including cranial nerve dysfunction, is crucial for timely diagnosis and management. Although initial investigations were negative, further analyses—including repeated CSF examinations and skin biopsy—led to the identification of leukemic involvement. Although neuroleukemiosis cannot be confirmed without nerve biopsy, the combination of clinical presentation, neuroimaging, and CSF data strongly supports the diagnosis of extramedullary relapse of AML. Multidisciplinary evaluation remains essential for detecting extramedullary relapse. Despite treatment achieving CSF clearance, the prognosis remains unfavorable, underscoring the need for vigilant clinical suspicion in hematologic patients presenting with neurological symptoms. Full article

Insects’ body coloration may be indirectly influenced by their host plants. Perina nuda (Lepidoptera: Lymantriidae), commonly known as the Banyan Tussock Moth and a serious pest of banyan trees (Ficus spp.) in southern China, exhibits light body coloration during its first- to third-instar stages, with its coloration progressively darkening as it matures, but little is known of the relationship between larval body coloration and host plants. To address this gap, we examined the R (red), G (green), B (blue), and L (lightness) values of the head, dorsal thorax and abdomen, stripe, dorsal mid-line, and tail of larvae fed on different hosts and host endogenous substance by using quantitative image analysis and chemical determination. Our results revealed that larval body coloration exhibited conserved ontogenetic patterns but varied significantly with host species, developmental age, and anatomical region. Redundancy analysis identified chlorophyll-b as the dominant driver, strongly associating with dorsal thorax–abdomen pigmentation. Flavonoids exhibited subthreshold significance, correlating with darker dorsal mid-line coloration, while nutrients (sugars, proteins) showed negligible effects. Linear regression revealed weak but significant links between leaf and larval body coloration in specific body regions. These findings demonstrate that host plant endogenous substances play a critical role in shaping larval body coloration. This study provides a foundation for understanding the ecological and biochemical mechanisms underlying insect pigmentation, with implications for adaptive evolution and pest management strategies. Full article

Background/Objectives: Infantile hemangioma (IH) is a common vascular tumor in neonates, influenced by multiple prenatal and perinatal factors. This study aimed to identify risk factors in both infants and mothers, assess their link to clinical characteristics and severity, and evaluate treatment outcomes when systemic propranolol therapy was administered. Methods: We conducted a retrospective observational study analyzing 43 infants under 12 months, including 11 neonates (<28 days) diagnosed with IH. Maternal and neonatal factors, diagnostic timelines, clinical presentation, and treatment efficacy were examined. Data analysis included descriptive statistics, focusing on gestational age, birth weight, Apgar scores, and the Infantile Hemangioma Referral Score (IHReS). Results: The study found a female predominance and a correlation between IH and pre-term birth (50%) and low birth weight (<2760 g, 51.16%). Maternal anemia (23%) and gestational hypertension (9%) were present in the cohort, but no statistical association with IH severity was found. A significant number (44.18%) were diagnosed within the first two weeks postpartum. The IHReS was inversely correlated with Apgar scores, with newborns scoring above 8 having a lower IHReS. Treatment with propranolol (1–3 mg/kg/day) was highly effective, resulting in significant lesion regression in most patients. Mild complications included sleep disturbances (12%) and diarrhea (9%). The most affected areas were the face/eyelid (32.55%), limbs (18.6%), and anterior thorax. Additionally, 42% of cases had an IHReS above 4, with multiple hemangiomas increasing severity. Conclusions: IH was common in pre-term and low-birth-weight infants, whereas the maternal comorbidities observed in this small cohort did not show a definitive association, underscoring the need for controlled studies. Early diagnosis, risk stratification, and timely propranolol therapy are crucial in achieving favorable outcomes. Further research is needed to assess long-term effects and evaluate risks of treatment rebound. Full article