Medicine and Pharmacology

Abstract: Coaches often ask whether a muscle’s weekly sets should be spread over more days. The Weekly Net Stimulus model treats frequency as a major lever: each workout adds a stimulus with diminishing returns per set, and muscle is lost on each day outside a 48-hour post-workout window. I set out that model in testable form and compared it with an alternative fitted to 224 effects from 36 studies. Over about 10 weeks, doubling weekly sets from 6 to 12 added 1.7 percentage points of growth (95% interval 1.1 to 2.4), whereas moving 12 weekly sets from one session to three changed growth by +0.3 points (−1.6 to +2.1). Within studies, more frequent training differed from less frequent by +0.2 points (−1.3 to +1.7; 41 contrasts). Within the model’s recovery limits, once-weekly training at 9 sets gave 0.69 (−0.12 to 1.13) of the three-times-weekly gain, which does not exclude the predicted 0.14. Across all effects the ratio was 0.95 (0.44 to 1.39), which excludes the published model only if growth rises at least as steeply as the 0.4 power of its stimulus and swelling bias is under 1 point. Sessions above the recovery limits did not reduce growth (+1.4%, −0.3 to +3.2), although trials scanning 72 hours or more after training were too few to decide. On a ratio scale, most of the model’s predicted frequency effect comes from a daily loss that is calibrated, not measured. I state one prediction for a 12-month trial and provide a free calculator.

Abstract: Breath-by-breath gas exchange is required to characterise the oxygen uptake (V̇O₂) response at exercise onset, limiting repeated assessment outside the laboratory. In this single-centre study, 36 collegiate athletes completed an incremental cycling test and two 30-min constant-load tests at 60–70% of peak work rate, at least 7 days apart, while sweat lactate was recorded continuously from the upper arm with a wearable biosensor. We examined whether the time to peak sweat lactate (sLApeak time) was associated with two indices of that response — the phase 2 time constant (τ), a rate parameter, and the time to the software-defined end of phase 2 (fin2), a duration marker — and whether any association was reproduced on a separate day. sLApeak time showed moderate-to-strong correlations with fin2 at both tests (r = 0.63 and 0.69), stronger and more consistent than its correlations with τ (r = 0.44 and 0.32), and fin2 remained independently associated after adjustment for τ and peak V̇O₂. In contrast, sLApeak time was only weakly correlated with the accumulated oxygen deficit (r = 0.33 and 0.34). Continuous sweat lactate monitoring may therefore provide a field-deployable marker of the duration of the exercise-onset transition, rather than of its rate or its magnitude.

Abstract: Meissner corpuscles are specialized cutaneous mechanosensory end organs primarily located in the dermal papillae of human glabrous skin and specialized mucocutaneous territories. Traditionally regarded as rapidly adapting tactile receptors composed of a sensory axon surrounded by passive lamellar cells, current evidence supports a more complex organization in which the axon, terminal glial cells (TGCs), extracellular matrix, and endoneurial capsule form an integrated mechanosensory unit. This review provides an updated synthesis of the development, anatomical distribution, structural organization, molecular phenotype, mechanotransduction, functional neurobiology, aging, and pathological alterations of human Meissner corpuscles. Particular attention is given to the molecular identity of TGCs and to their emerging role as active components of corpuscular function. PIEZO2 remains the best-established mediator of primary mechanotransduction in the sensory axon, whereas human TGCs express several mechanosensing-associated proteins and experimental evidence suggests a potential glial contribution to corpuscular function. Human studies also demonstrate substantial regional and age-related variability in corpuscular density and phenotype. Importantly, Meissner corpuscles undergo quantitative, structural, immunophenotypic, and molecular alterations in a broad spectrum of peripheral and central neurological disorders. Recent evidence of disease-associated molecular pathology, including intracorpuscular phosphorylated TDP-43 in amyotrophic lateral sclerosis, further expands their potential relevance as accessible peripheral indicators of neurological disease. Finally, emerging three-dimensional imaging, tissue-clearing, spatial molecular profiling, functional imaging, and quantitative digital approaches provide new opportunities for investigating human corpuscular organization. Collectively, current evidence supports viewing the Meissner corpuscle as a dynamic neuro-glial mechanosensory organ whose biological and clinical significance extends beyond its classical role in discriminative touch.

Abstract: Background/Objectives: Placental weight is a potential marker of placental efficiency and foetal growth, while maternal HIV infection may affect placental function and foetal development. This study evaluated associations between placental weight and neonatal anthropometric outcomes and examined the influence of maternal HIV status among term deliveries in Nnewi, Nigeria. Methods: This cross-sectional analytical study included 273 term singleton deliveries. Placental weight, umbilical cord length, neonatal birth weight, and neonatal length were measured using standardised procedures, and maternal HIV status was recorded. Pearson correlation and multivariable linear regression analyses were performed. Results: Mean placental weight was 0.64 ± 0.16 kg, birth weight 3.16 ± 0.61 kg, neonatal length 51.25 ± 5.72 cm, and umbilical cord length 58.58 ± 11.93 cm. Placental weight correlated positively with birth weight (r = 0.582, p < 0.001), neonatal length (r = 0.230, p < 0.001), and umbilical cord length (r = 0.180, p = 0.003). It inde-pendently predicted birth weight (β = 2.22, p < 0.001) and neonatal length (β = 7.21, p = 0.001). Conclusions: Maternal HIV status was not significantly associated with placental weight, umbilical cord length, or neonatal anthropometric outcomes. Placental weight, but not maternal HIV status, was associated with neonatal anthropometric outcomes among term deliveries.

Abstract: Female pelvic-floor support is a coupled biomechanical system involving the vagina, uterus, pelvic connective tissues, ligaments, levator ani, and pelvic boundaries. Published finite-element studies demonstrate that changes in intra-abdominal pressure (IAP), tissue impairment, and pelvic geometry alter stress and displacement patterns. This study proposes a constraint-modulated load-transfer framework in which pressure-induced deformation is redistributed through the interconnected pelvic support structures toward posterior pelvic boundaries. Within this framework, three metrics are defined: geometric Poisson’s ratio (νg), structural Poisson’s ratio (νs), and composite Poisson’s ratio (νc). The proposed composite Poisson’s ratio (νc) is introduced as a candidate system-level outcome measure rather than an established clinical or validated numerical biomarker. No new experimental or original finite-element simulation outputs are generated in this work; all interpretations draw upon previously-published literature. This manuscript integrates published biomechanical evidence with a proposed finite element (FE) validation protocol without claiming unsupported original numerical stress or displacement results.

Abstract: Molecular hydrogen (Н₂) belongs to a group of compounds capable of inhibiting free-radical processes at the cellular level, increasing antioxidant activity, enhancing metabolism, and restoring the structure of cell membranes. This study investigated the effect of molecular hydrogen on oxygen-dependent processes in the blood: blood oxygen transport, prooxidant-antioxidant balance, and the gasotransmitter system in vitro. The experiment was performed on male Wistar rats (n = 20). A gas mixture consisting of 98% air and 2% hydrogen was used for blood saturation. The blood was saturated for 5 minutes, then blood parameters were analyzed immediately after saturation, 30 minutes later, and 60 minutes later. Blood oxygen-transport parameters, gasotransmitter levels, lipid peroxidation products, and antioxidant system activity were determined in plasma and red blood cells. Results showed that incubating blood with hydrogen increases oxygen tension, blood oxygen saturation, and decreases hemoglobin's affinity for oxygen. The effect of H₂ on blood is accompanied by an increase in the concentration of gasotransmitters such as nitrogen monoxide and hydrogen sulfide and a decrease in the level of diene conjugates and malondialdehyde in plasma and red blood cells. This is due to stimulation of the antioxidant system, resulting in increased catalase activity and reduced glutathione levels.

Abstract: Background/Objectives: The arcade of Frohse (AF) is a potential site of compression of the deep branch of the radial nerve (DBRN). However, its direct spatial relationship with the nerve has not been systematically classified using reproducible macroscopic criteria. This study aimed to develop a macroscopic classification of the AF–DBRN relationship and to examine its morphometric correlates. Methods: Forty-two formalin-fixed upper limbs from 29 donors were examined. The AF–DBRN relationship was classified as type 0 (no direct contact), type 1 (direct contact without visible nerve deformation), or type 2 (direct contact with macroscopic DBRN deformation). Two observers independently classified all speci-mens. DBRN cross-sectional area (CSA) and the mediolateral-to-anteroposterior dimen-sion ratio (ML/AP ratio) were assessed at three levels relative to the AF. A cen-tral-to-proximal CSA ratio was calculated in 36 limbs. Results: Type 0 was identified in 12 limbs (28.6%), type 1 in 14 (33.3%), and type 2 in 16 (38.1%). Interobserver agreement was 92.9% (unweighted Cohen’s κ = 0.892; linearly weighted κ = 0.918). The cen-tral-to-proximal CSA ratio differed among relationship types (H(2) = 9.9; nominal p = 0.007), with the highest median observed in type 2. AF dimensions and position were not associated with relationship type. Conclusions: The proposed macroscopic classification demonstrated high interobserver agreement and provides a reproducible framework that complements conventional morphometric assessment of the AF and DBRN. It should be regarded as an anatomical rather than diagnostic classification but may support standar-dized reporting and future anatomical, imaging, biomechanical, and clinical studies.

Abstract: Background/Objectives: Subacromial impingement syndrome (SAIS) is the most prevalent musculoskeletal disorder of the shoulder, accounting for 44% to 65% of clin-ical presentations. This condition involves mechanical stress on the soft tissues within the subacromial space. This review aims to synthesize evidence on acromial, glenoid, and ligamentous variations to provide a framework for individualized surgical and rehabilitative strategies. Methods: A rigorous literature search was performed across PubMed, Embase, and Scopus. Eligibility was strictly limited to original re-search—including cross-sectional and retrospective designs—that evaluated demo-graphic and anatomic predictors such as age, sex, and hand dominance in relation to shoulder morphology. Results: Acromial morphology is classified using the Bigliani system into Type I (flat), Type II (curved), and Type III (hooked). Os acromiale, present in 7–15% of the population, causes dynamic narrowing of the subacromial space. Gle-noid dimensions exhibit significant sexual dimorphism and ethnic variability, while hand dominance typically increases retroversion on the dominant side. In gleno-humeral osteoarthritis, humeral head osteophytes ≥13 mm are strong predictors of ec-centric B2 glenoid morphology. Biomechanically, SAIS patients demonstrate excessive superior humeral translation (1.5–5 mm) and disrupted scapulothoracic kinematics, often exacerbated by slouched posture. Finally, recognizing congenital variants like the Buford complex is vital to avoid unnecessary surgical repairs. Conclusions: Shoulder pathology is multifactorial, arising from a convergence of static anatomical deviations and dynamic kinematic failures. The profound morphometric diversity between sexes and ethnicities necessitates patient-specific, individualized approaches to shoulder arthroplasty and rehabilitation.

Abstract: The extracellular signal-regulated kinase 1/2 (ERK1/2) cascade is a central effector of receptor tyrosine kinase-RAS-RAF-MEK signalling and a major therapeutic axis in oncology. Persistent ERK output supports cell-cycle progression, survival, invasion, angiogenesis and tumour-microenvironment remodelling, but pathway dependence is shaped by tumour lineage, driver class, co-mutations and feedback architecture. This narrative review uses a mechanism-first, lineage-specific framework to compare ERK-driven oncogenesis in melanoma, lung cancer and colorectal cancer and to explain why similar pathway alterations can produce different therapeutic responses. Resistance is organised into three interacting themes. Rapid adaptive resistance follows relief of negative feedback and receptor-RAS rebound. Acquired genetic resistance restores MAPK signalling through RAS activation, RAF dimerisation, BRAF amplification or splice variants, and MEK or ERK alterations. Tumours may also survive through parallel PI3K-AKT-mTOR signalling, lineage plasticity, drug-tolerant persister states and stromal support. The review further examines the context-dependent relationship between tumour-intrinsic ERK signalling, immune exclusion and T-cell function, which complicates combinations with immune checkpoint blockade. Clinical evidence supports BRAF-MEK combinations in molecularly selected cancers and combined BRAF-EGFR blockade in BRAF V600E colorectal cancer. RNA interference, CRISPR screening, single-cell and spatial profiling, and artificial-intelligence-assisted prediction are evaluated according to their translational maturity. The main conclusion is that durable ERK/MAPK control will require lineage-aware patient selection, longitudinal resistance monitoring, and mechanism-matched combination therapy rather than uniform pathway inhibition.

Abstract: Hydrogen (H₂) is fermented by the intestinal microbiota, transferred to the blood according to the pressure gradient, and exhaled. Since H₂ is not produced or metabolized in human cells, alveolar H₂ saturates the entire human body, including cellular organelles such as mitochondria, owing to gas exchange in the lungs. The electron transport chain comprises a series of redox enzymes in the mitochondria of human cells that drive adenosine triphosphate (ATP) synthesis. The catalytic activity of electron-transport enzymes is optimized at certain electrochemical potentials, as is the hydrogen ion activity (pH). However, the human body is an aqueous solution, which must be electrically neutral. Membrane potentials exist between the inside and outside of human cells because of the unequal distribution of ions across the membrane. The single-electrode potential can only be assessed relative to that of another electrode (a reference electrode). We measured the electrochemical potentials relative to a standard hydrogen electrode (SHE), and found that H₂ partial pressure was a fundamental factor affecting the SHE, pH, and a reversible hydrogen electrode (RHE). The H₂ partial pressure is not a unit in the human body, therefore, breath H₂ is an external variable of the redox environment in the human body.

Abstract: Chronic pain arises from complex interactions between peripheral and central nervous system structures that process nociceptive information and integrate it with sensory, autonomic, endocrine, emotional, and cognitive functions. Numerous neuroactive substances, including classical neurotransmitters, neuropeptides, hormones, neurotrophic factors, endocannabinoids, and endogenous opioids, participate in these processes. These substances are produced by specific anatomical structures and, in turn, act upon the same or other structures, thereby creating highly interconnected networks of reciprocal modulation. This review examines the actions of individual neuromodulators on pain-related anatomical structures throughout the nervous system, including primary afferents, spinal cord circuits, brainstem nuclei, hypothalamic systems, basal ganglia, limbic structures, and cortical regions. Particular emphasis is placed on the divergence of modulator actions, whereby a single substance influences multiple neural structures and functions, and on the converse principle of convergence, according to which individual structures receive inputs from numerous modulatory systems. The review covers hypothalamic hormones and peptides, monoamines, neuropeptides, neurotrophic factors, ion channels, and major excitatory and inhibitory neurotransmitter systems. The available evidence indicates that chronic pain is associated with widespread alterations in many anatomical and functional structures, although such changes do not necessarily constitute the primary cause of chronic pain. Instead, pain states emerge from dynamic interactions among multiple neuronal populations, signaling molecules, and physiological systems whose contributions vary according to disease state, internal bodily conditions, and environmental influences. By emphasizing both the divergence and convergence of neuromodulatory actions, this review highlights the extraordinary complexity of nociceptive networks and argues that chronic pain cannot be adequately explained by single mechanisms or isolated “key” processes. Rather, chronic pain appears to arise from the collective behavior of highly interconnected and adaptive neural systems.

Abstract: Introduction: The superficial palmar branch of the radial artery (SPBRA) typically originates 10 to 20 mm proximal to the distal wrist crease, before the radial artery winds around the carpal bones toward the dorsum of the hand. From its origin, the SPBRA courses along the palmar aspect of the hand, traverses the fibers of the thenar muscles, and anastomoses with the ulnar artery to form the superficial palmar arch. Anatomical variations of this branch are described in the literature; given its potential as a vascular pedicle for thenar flaps in the reconstruction of distal finger and hand injuries, knowledge of its morphology is indispensable for surgical safety. Objective: To report a proximal origin of the SPBRA and discuss its possible clinical and surgical implications. Case Report: During routine dissection, an anatomical variation in the origin of the SPBRA was identified in a right forearm disarticulated at the elbow level. The radial artery followed its usual course in the anterior forearm until it prematurely emitted the SPBRA in the distal third, 61.05 mm proximal to the wrist joint, characterizing a high origin compared to the pattern described in the literature. The branch directed itself obliquely in a distal and medial direction, penetrated the fibers of the abductor pollicis brevis muscle, and, after this intramuscular segment, anastomosed with the ulnar artery to form the superficial palmar arch. The total length of the SPBRA was 92.68 mm. Conclusion: The high origin of the SPBRA is a rare anatomical variation of great clinical relevance, the recognition of which is fundamental in planning surgical and reconstructive procedures of the hand, especially in the design of thenar flaps. In addition to corroborating previous literature findings, the present study contributes an unprecedented measurement of the distance between the high origin of the branch and the wrist joint, providing relevant data for the anatomical characterization of this variation.

Abstract: Background/Objectives: The supraclavicular foramen (SCF) is a rare anatomical variant formed when a branch of the supraclavicular nerve traverses the clavicle through a complete transclavicular canal. Published studies differ substantially in study material, denominators, and reporting of side-specific and bilateral data, so bilateral anatomy is often synthesized as if pairing were irrelevant. This study aimed to describe SCF in a Greek osteological sample and to apply a meta-analytic framework distinguishing per-clavicle prevalence, marginal laterality, paired laterality, and separately observed bilateral prevalence. Methods: We examined 115 dry clavicles of Greek origin for SCF frequency, size, and topography. Measurements were obtained independently by two observers using stainless-steel wires and digital calipers, with inter-rater agreement assessed by intraclass correlation coefficients. A systematic review and meta-analysis were then conducted according to PRISMA 2020. Quantitative synthesis included pooled per-clavicle prevalence, conventional marginal left-versus-right comparison, and feasibility-based paired laterality analysis under explicit dependence assumptions when bilateral information was incomplete. Observed bilateral prevalence was analyzed separately using only studies with directly reported body-level bilateral counts. Study quality was assessed using AQUA and CATAM. Results: Complete transclavicular canals, identified by paired supraclavicular foramina representing entrance and exit openings, were present in 3/115 clavicles (2.4%), with a mean patency diameter of 1.5 ± 0.8 mm and a mean relative acromial position of 0.44 ± 0.12. Inter-rater reliability was excellent. Pooled per-clavicle prevalence was 2.2% (95% CI: 1.4–3.0%; I² = 71%). Conventional marginal laterality showed significant left-sided predominance (OR = 1.76, 95% CI: 1.16–2.66; I² = 0%), while feasibility-based paired laterality yielded a stronger effect (paired OR = 2.26, 95% CI: 1.30–3.94). The main observed bilateral-prevalence model yielded 0.95% (95% CI: 0.33–2.70%). Minor small-study effects were suggested by the Doi/LFK framework. Conclusions: SCF is an uncommon developmental variant with consistent left-sided predominance. Bilateral anatomical variants should not be synthesized as if all observations were unpaired; separating per-clavicle prevalence, marginal laterality, paired laterality, and observed bilateral prevalence provides a more transparent and biologically meaningful synthesis.

Abstract: The proven involvement of sinuvertebral nerve (SVN) in discogenic low-back pain and the demonstration that its blockade has been effective in reducing the intensity and frequency of diffuse low back pain have led to an increase in publications related to the characterization of this nerve. However, there is a huge disparity in the observations resulting from the studies carried out, probably due to the technical difficulty of accessing this structure. In the last years the number of studies in large samples has increased but some important data in relation to nature of sinuvertebral nerve remain unpublished. We studied 100 vertebral column segments between L1 and L5, corresponding to both sides of 10 adult cadavers donated to the Body Donation Center and Dissection Rooms of the Complutense University of Madrid. All levels were carefully dissected to study sinuvertebral nerve origins and some samples of SVN were selected to routinely paraffin-embedded and serially sectioned with a Minot-type microtome at a 7µm thickness. Immediately after dewaxing following the standard histology lab protocols, sections from selected SVN (well-preserved morphology and histologic condition) were subjected to an immunohistochemical protocol to detect CGRP-IH, and VIP-IH. Data analysis was performed using IBM SPSS Statistics version 27 and RStudio. The SVN was observed with a single branch (pattern I) in 82 cases (85.4%) and with two branches (pattern II) at the same level in 14 cases (14.6%).Statistical differences were not found in relation to vertebral levels, side or sex. All sinuvertebral nerve samples that underwent immunohistochemical study were positive for CGRP and VIP, demonstrating the sympathetic nature of the nerve (VIP+) and its nociceptive component (CGRP+). This study confirms the neurochemistry profile of the SVN thanks due to the realization of the immunochemistry characterization directly in the SVN, not in its innervated structures. This information supports the usage of the SVN blocking from a pathophysiological point of view for diagnostic and treatment techniques (e.g., Percutaneous Transforaminal Endoscopic Radiofrequency Ablation of the SVN) in discogenic lumbar pain.

Abstract: The cavernous sinus remains one of the most anatomically complex and surgically challenging regions of the skull base because of its intimate relationships with the internal carotid artery and multiple cranial nerves. Detailed microsurgical anatomical knowledge is essential for safe skull base and parasellar surgery. A stepwise microsurgical cadaveric dissection of the cavernous sinus was performed on six adult formalinfixed specimens using a standard pterional extradural approach under magnification with a Leica operating microscope. Progressive extradural and interdural dissections were carried out to expose the lateral wall of the cavernous sinus, cranial nerves III, IV, V1, V2, and VI, the intracavernous internal carotid artery, and the principal surgical triangles of the cavernous sinus. The dissection demonstrated the multilayered interdural architecture of the lateral wall and allowed identification of the interdural cleavage plane extending from the superior orbital fissure to Meckel’s cave. Cranial nerves III, IV, V1, and V2 were identified within the lateral wall, whereas the abducens nerve coursed medially within the venous compartment adjacent to the cavernous internal carotid artery. Parkinson’s triangle and the anteromedial and infratrochlear corridors provided useful operative windows to the intracavernous compartment. Stepwise cadaveric dissection remains an effective educational tool for understanding the microsurgical anatomy of the cavernous sinus and improving operative orientation during skull base procedures.

Abstract: Anabolic-androgenic steroids (AAS), such as ND, are commonly used to enhance physical performance and muscle mass. However, its abuse has been associated with numerous adverse health effects, particularly on the hippocampus, affecting learning, working memory, and cognitive functions. The current study aims to investigate the potential effects of ND, aerobic exercise, resistance exercise, and the combination of ND with aerobic or resistance exercise on memory and cognitive functions. Moreover, the study aims to explore the possible underlying mechanisms of changes in memory and cognitive function. Adult male rats were divided into four groups: control (GI), only ND-treated (GII), only exercise (GIIIa & GIIIb), and combined exercise + ND-treated (GIVa & GIVb). Exercise included aerobic treadmill training and ladder-climbing modalities for 8 weeks, either alone or with ND. Cognitive function was evaluated using the Modified Barnes Maze and T-maze tests. Hippocampal integrity was assessed through oxidative stress markers, serum brain-derived neurotrophic factor (BDNF) levels, hippocampal nerve growth factor (NGF) expression, and histological examination. ND significantly impaired spatial learning and memory, increased oxidative stress, lowered serum BDNF levels, and reduced NGF expression in the hippocampus. Exercise markedly attenuated these harmful effects. Aerobic exercise gave the most pronounced improvements. It restored cognitive function, enhanced antioxidant defenses, increased serum BDNF levels, increased hippocampal NGF expression, and preserved hippocampal structure. Resistance training also had neuroprotective effects, but to a lesser extent than aerobic exercise. In brief, both aerobic and anaerobic exercise have been shown to exert protective effects against ND-induced neurotoxicity by enhancing antioxidant defenses and promoting neuronal integrity. The monitored neuroprotective benefits suggest that physical exercise could serve as a possible non-pharmacological approach to prevent or decrease cognitive impairments associated with anabolic steroid abuse.

Abstract: Objective: To study the effect of weight loss on the levels of vaspin, insulin, lipid profile and anthropometric indices in obese females participating in a low-energy dietary regimen combined with aerobic exercise. Materials and methods: This prospective observational study included 256 adult females aged (20-50) years were divided into 192 obese females with BMI ≥30 kg/m² and 64 normal weight females, with BMI 18.5-24.9 kg/m² as obese and control group respectively. The obese females were subgroups based on duration of dietary regimen as: Group I (3 months), Group II (6 months), and Group III (> 6 months). Each group consisted of 64 obese females and followed a low-calorie diet of 1200 to 1500 calories/day, combined with aerobic exercise training for 30 min/day all over the study period. Body mass index and waist circumference were measured post-weight loss. Serum vaspin, insulin, glucose levels, and lipid profiles were measured and analyzed statistically. Results: Baseline comparison revealed that body weight, waist circumference, BMI, vaspin, insulin, glucose, triglycerides, total cholesterol, and LDL of obese group were significantly increased compared to controls (P ≤ 0.05). Low-energy diet and aerobic exercise led to significant decrease in body weight, waist circumference, BMI, vaspin, insulin, glucose, especially with longer period of dietary regimen. Lipid profile showed improvement attitude but without statistical significance. BMI was positively correlated with most studied parameters and negatively correlated with HDL. Conclusions: Low-calorie diet accompanied with aerobic exercise were associated with body mass index, vaspin, insulin, and lipid profile level. Dieting and weight reduction, especially in longer periods, particularly for six months or more than six months, appear to normalize these parameters toward control values and improve metabolic status.

Abstract: Objective: Thyroid cartilage calcification and glucose metabolism may vary with age and gender. This study aimed to investigate the role of [18F]-sodium fluoride ([18F]NaF) and 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) PET/CT for the evaluation of physiological molecular calcification and glucose metabolism of thyroid cartilage with age. Methods: This retrospective study analyzed [18F]NaF and [¹⁸F]FDG PET/CT images from the CAMONA study (NCT01724749). Regions of interest were placed around the thyroid cartilage on CT images using OsiriX software. The mean standardized uptake value (SUVmean) was measured for [¹⁸F]NaF and [¹⁸F]FDG PET/CT images. Pearson correlation coefficients were calculated to evaluate the effects of aging on the uptake of [¹⁸F]NaF and ^[18F]FDG in the thyroid cartilage. Results: A total of 127 healthy subjects (65 females and 62 males) with a mean age of 48.46±14.13 (range 21–75) years for [¹⁸F]NaF PET/CT and a total of 114 healthy subjects (52 females and 63 males) with a mean age of 49.05±14.29 (range 21–75) years for [¹⁸F]FDG PET/CT were included. A significant positive correlation was observed between age and SUVmean of [¹⁸F]NaF in the thyroid cartilage (r=0.18, p=0.04). This result indicates that molecular calcification of this cartilage increases with aging. However, the correlation between age and SUVmean of [¹⁸F]FDG in the thyroid cartilage was not statistically significant (r=-0.09 p=0.31). Conclusion: This study presents a novel methodology for the determination of molecular calcification and glucose metabolism of laryngeal cartilage using [¹⁸F]NaF and [¹⁸F]FDG PET/CT. Molecular calcification of thyroid cartilage was found to increase with age, whereas glucose metabolism did not show a statistically significant correlation with age.

Abstract: The heel-strike (HS) paradigm of human gait originates from 19th-century chronophotographic studies conducted on Georges Demeny, a gymnasium instructor whose performed, exaggerated gait was never representative of natural locomotion. A compounding martial bias further normalised HS through military marching drill. A multi-disciplinary convergent argument analysis is conducted, integrating philological, zoological, anatomical, biomechanical, neurological and socioeconomic lines of evidence. All seven lines of argument support a forefoot-first model in which the centre of mass (CoM) leads the movement, stabilisers control equilibrium proactively, and the Triceps surae works in continuous eccentric mode---its natural functional state. Heel-strike generates impact forces up to 700 N with an ascending braking vector, under-recruits Gluteus maximus, progressively impoverishes plantar mechanoreceptors, and transmits repeated microtraumatic impulses up to the brain. Natural human gait is organised around forefoot contact, progressive CoM advance, and continuous eccentric stabiliser activity. The proposed model rediscovers lightness: a dance with gravity rather than a war against it. The HS paradigm is a culturally conditioned artefact with measurable pathological consequences.

Abstract: Traumatic tracheal injuries and congenital defects can be life threatening. Regenerating the trachea through tissue engineered scaffolds has emerged as an innovative alternative to traditional therapies. At present time, challenges in tracheal regeneration preclude clinical adoption, such as revascularization and promotion of favorable paracrine and immune signaling responses. This review summarizes current advances in tracheal regeneration and highlights key biological and engineering barriers to address to achieve functional tracheal regeneration.