Head Deformity Research Articles

The PLAY bundle for head deformities: A NICU quality improvement project

BackgroundPremature infants in the Neonatal Intensive Care Unit (NICU) have a greater risk of head deformities and related complications. Numerous evidence-based interventions demonstrate successful prevention and treatment for head deformities with maximized success when combined. Local problemThere was no standardized policy to aid in the prevention, evaluation, and management of head deformities at a local children's hospital. Additionally, the Electronic Health Record (EHR) did not optimize head measurement documentation and documented asymmetrical head measurements did not prompt follow-up. MethodsAuthors developed a nurse-driven order set, or bundle, comprised of Positioning and PT/OT involvement, Learning, Assistive Devices, and You (PLAY) as part of a quality improvement project to reduce the progression of head deformities through education, prevention strategies, and earlier identification and treatment. Data collected for the first 13 weeks was under the current standard of care and data collected under the second 13 weeks was under the PLAY bundle. Results33 infants participated with 19 after PLAY Bundle implementation. Under the current standard of care, 34% of patients (n = 27) had plagiocephaly documentation while just 7% (n = 6) received a PT (Physical Therapist) consultation. Of the participants diagnosed with head deformities since PLAY Bundle implementation, biweekly head measurements improved in 58%, worsened in 20%, worsened then improved in 8%, and stayed the same in 20%. ConclusionsThe PLAY Bundle was successful in the earlier identification and intervention of head deformities. In addition, the PLAY Bundle highlighted the importance of repositioning intervention for head deformities.

A Modified 90-Degree Distal Chevron Metatarsal Osteotomy for Correcting Moderate Hallux Valgus Deformity.

Various modifications of distal chevron metatarsal osteotomy (DCMO) have been introduced for correcting moderate hallux valgus deformity; however, the amount of correction may be limited, and complications, such as the recurrence of the deformity and avascular necrosis of the metatarsal head, have been a problem. This study aimed to present a modified 90-degree DCMO technique that overcomes the previously reported shortcomings and to report a successful short-term radiographic outcome. Sixty-eight consecutive patients who underwent the operation with our modified DCMO technique and twenty-two consecutive patients with the conventional DCMO technique (control group) were retrospectively analyzed. The radiographic measurements were evaluated preoperatively, at two months post operation, and at the final follow-up. Both groups showed a significant correction of the hallux valgus angle, first-second intermetatarsal angle, distal metatarsal articular angle, and sesamoid position at the final follow-up, while the amount of correction was significantly greater in the modified DCMO group. In both groups, there were no cases of complications such as avascular necrosis of the metatarsal head, nonunion, and surgical site infection appearing throughout the follow-up period. Therefore, the modified 90-degree DCMO technique is effective and safe, which could serve as a favorable option to treat moderate hallux valgus deformity.

Modeling and analysis of transition-point disappearance in high-speed railway pantograph-catenary system

During the operation of high-speed railway, the transition-point disappearance phenomenon, which is caused by the deformation of pantograph head, poses a safety threat to the pantograph-catenary system. In this study, the analytical model for transition-point disappearance analysis is presented. The instantaneous profile, as well as the deformation process of the pantograph head under different contact force values and positions or different pantograph-head parameters can be solved using the model. Curve equation, force analysis, coordinate axis rotation, and few other methods are adopted to achieve simplified modeling. The proposed modeling method and analysis conclusion provide theoretical support for the permissible contact force range calculation and pantograph-head parameters optimization to prevent transition-point disappearance. The effectiveness of the proposed model is verified using both finite element simulation and experimental measurements. Finally, a case analysis for the prevention of transition-point disappearance is conducted, using pantographs with the models CX-GI and DSA250 as examples.

Medium-term Results After Femoral Head Resection and Subtrochanteric Valgus Osteotomy in Children and Adolescents With Neuromuscular Disorders.

Various salvage surgical procedures for painful hip dislocation in adolescent patients with cerebral palsy exist. To date, no significant differences among these surgical techniques have been described. In our institution the McHale procedure is the standard of care for painful chronically dislocated hips with or without deformity of the femoral head in patients with cerebral palsy. This study focuses on mid-term results after surgical treatment. Surgical reports and patient charts were analyzed retrospectively. All x-rays were evaluated and migration of the proximal femur and heterotopic ossification according to Brooker were recorded. In addition, we conducted a telephone interview with the caretakers with special reference to pain preoperatively and postoperatively and after implant removal, sitting tolerance, range of motion, mobility, quality of life, and personal hygiene. Fifty-two patients (65 hips) with a mean age of 13.5 ± 3.6 years (range: 4 to -20y) were included. Mean surgery time was 178.4 ± 63.4 minutes (range: 45 to 380min) and mean follow-up was 45.17 ± 30.6 months (range: 12 to 204mo). A significant difference between preoperative and postoperative pain levels was found, P<0.001. Personal hygiene (P=0.02) and quality of life (P=0.013) improved significantly. Eighty-five percent of the caregivers would have the surgery performed on their child again and 81% of the caregivers would recommend the surgery to others. The removal of implants leads to a significant improvement in pain (P=0.011). A total of 22 complications in 65 McHale procedures (33.9%) were related to the procedures. A significant reduction in pain and a significant improvement of hygiene as well as quality of life can be achieved with the McHale procedure in painful chronically dislocated hips in patients with cerebral palsy. Overall, the procedure is predominantly experienced as helpful by the caregivers and recommended to others. The removal of the implants improves pain significantly, but complications may occur in one third of the patients. IV.

Cleft lip and palate risk factors among otorhinolaryngology: Head and neck surgery patients in two hospitals.

Cleft lip and/or palate is the most prevalent type of head and neck deformity, accounting for 65% of cases. The occurrence of this condition is influenced by both genetic and environmental factors. Cleft defects are classified into 2 types: syndromic cleft lip and palate syndrome and non-syndromic cleft lip and palate syndrome. Cleft lip with or without cleft palate is the most common type of cleft defect, and the surgical repair is the primary treatment option for patients. Our study was a retrospective case-control study that included 132 cases of patients with cleft defects and 132 healthy babies without cleft defects serving as controls. Personal information, including the name, age, and origin of the participants, was collected. Additionally, we collected information on all potential risk factors, including medical history, daily habits, consanguinity between parents, and family history. Information was collected in Excel and analyzed using the Statistical Package for Social Sciences and a Chi-Square test was performed to determine the results and their relationship to cleft lip and palate. Our study identified various risk factors that have a significant association with cleft lip and palate with a P-value <5% in addition to factors that are not considered risk factors. Using relative risk analysis, we were able to rank the top 5 most significant and influential risk factors. The most impactful factor was not taking folic acid during pregnancy. The primary risk factors associated with cleft lip and palate include a family history of the condition, lack of folic acid supplementation, maternal age over 35 years, and high temperatures exceeding 39 °C. Consequently, we recommend that mothers who intend to conceive should take folic acid supplements at a dose of 0.4 to 0.8 mg during the initial trimester of pregnancy. Additionally, we advise careful monitoring of all risk factors, particularly during the first trimester of pregnancy.

Model test and finite element analysis results of a monopile in very dense sand under unidirectional horizontal cyclic loading

This study is carried out to understand the response of a monopile for a large (8–9 MW) offshore wind turbine located at a 45m water depth under lateral cyclic loading. Firstly, a 1g large-scale model pile test was performed in saturated very dense sand under numerous cycles of lateral loading, N=2000. The test results show that the lateral pile head displacement and rotation increase while the secant stiffness of pile decreases with increasing N. The numerical model was then validated by comparing the pile head displacement results of the test and the finite element (FE) model analysis. The soil was modelled using the UBC3D-PLM constitutive model to understand the development of the excess pore pressure ratio (EPPR) around the monopile. The FE analysis was performed cycle by cycle up to N=5 for a large diameter “XL monopile” with diameter D=9m and embedded length L=50m. The results showed that the EPPR around the monopile is insignificant. Furthermore, the effect of the number of loading cycles on the evolution of the EPPR, pile head deformation and pile head rotation are insignificant. In addition, a relatively high maximum pile head rotation accumulation θmax≅0.13° was obtained during cyclic loading.

Results of the Pediatric Shaft Femur Fracture Treated with Closed Rigid Lateral Trochanteric Entry Intramedullary Nail in North Indian Population

Objectives The femoral shaft fractures constitute 1.6% of the pediatric fractures. Intramedullary nailing is a common mode of fixation in older children and adolescents. The rigid intramedullary locking nail is a preferred choice over flexible nails in overweight patients and children older than 11 years of age. The adolescent age group with skeletal immaturity deserves special attention from the surgeons because of grave complications like avascular necrosis of the femur head and angular deformities. The aim of this study is to report the outcome of an adolescent femur shaft fracture treated with a rigid intramedullary interlocking nail in North Indian patients. Material and Methods This is a retrospective analysis performed by retrieving records of 19 patients. Patients with open fractures, polytrauma and neurovascular injuries were excluded. The preoperative and post-operative radiographic orthogonal views were analyzed to assess parameters like alignment, union and avascular necrosis (AVN). Results The mean age was 12.3 years. The mean follow-up was 1.5 years. The average time for union was 8 weeks. All the fractures were united in an acceptable alignment and rotation. There was no avascular necrosis, angular deformity and infection. The mean femur length discrepancy was 7 mm. Conclusion The rigid intramedullary interlocking nail is a valuable option for the fixation of femoral shaft fractures in an adolescent age group with a good union rate and minimal complications.

Legg–Calvé–Perthes disease presenting with osteoarthritis: Mechanisms of the development and prospects of conservative therapy using bisphosphonates

BACKGROUND: Aseptic necrosis of the femoral head in children remains a subject of great interest among specialists, despite its long history of study. The LeggCalvPerthes disease is the most common form of aseptic necrosis of the femoral head in children. The necrotic lesion in the femoral head results from the blockage of the arterial blood supply to the epiphysis, leading to its infarction. Some children experience a more aggressive disease course, with signs of osteoarthritis, which can result in the early development of coxarthrosis. Numerous publications have demonstrated the successful use of bisphosphonates in adult patients with aseptic necrosis of the femoral head.&#x0D; AIM: To generalize data on the use of bisphosphonates in children with the LeggCalvPerthes disease presenting with signs of osteoarthritis through the analysis of contemporary global literature.&#x0D; MATERIALS AND METHODS: A literature search was conducted in the open databases of PubMed, Science Direct, and Google Scholar, and the analysis depth spanned 20 years. The search terms used included LeggCalvPerthes disease, aseptic (avascular) necrosis of the femoral head, and bisphosphonates. The review encompassed the literature on bisphosphonates, their biological action, effectiveness of their use in patients with aseptic necrosis of the femoral head, and results of our research.&#x0D; RESULTS: Studies on the efficacy of bisphosphonates in children with LeggCalvPerthes disease are limited. Currently, the effect of bisphosphonates on disease course and outcome is unknown. Despite this, mechanisms of chronic inflammation are increasingly mentioned in the literature, which may directly or indirectly influence the clinical course and outcome of the disease. The key is the hyperactivity of osteoclasts in osteonecrosis. The experience of using bisphosphonates in adult patients with aseptic necrosis of the femoral head had positive results in preventing the progression of the deformity of femoral head deformity.&#x0D; CONCLUSIONS: Bisphosphonates are specific inhibitors of osteoclast activity, which has been used in many diseases. The results and inferences of using bisphosphonates in children with LeggCalvPerthes disease will lead to the formulation of a new treatment algorithm.

The influence of steel reinforcements on static rigidity of epoxy granite spindle head for dynamic performance enhancement of machining center: Experiments and finite element simulation

Machine tool structures are subjected to continuous distortions and unwanted vibrations during machining. The structures should have excellent static and dynamic properties to minimize the adverse effects due to vibration. Cast iron is generally used as a structural material for machine tools owing to its higher structural rigidity and moderate damping properties. The lack of desired dynamic properties results in poor surface finish of the machined components. Epoxy granite is a resin mineral-based composite found to provide superior damping ability but it has lesser material stiffness. Steel reinforcements are more appropriate to enhance the static rigidity of epoxy granite structures. The cast iron spindle head of the vertical machining center is considered for the present study. Static structural analysis has been performed by finite element analysis and the results are considered as a benchmark for the design of epoxy granite spindle head. Multiple design configurations of steel reinforcements are evolved through topology optimization to achieve improved stiffness with a higher damping ratio. A model which exhibited higher stiffness with minimum steel has been proposed for fabrication. A 1:2 scaled model of the proposed configuration has been fabricated using epoxy granite. Experimental modal analysis and numerical static analyses have been carried out and the results are compared to those of cast iron spindle head. A significant reduction in mass and deformation of the epoxy granite spindle head by 22% and 57%, respectively, was observed compared to that of cast iron spindle head.

Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg-Calvé-Perthes.

Legg-Calvé-Perthes disease is a self-limiting disorder that develops in children following interruption of the blood supply to the capital femoral epiphysis. This review outlines the current knowledge on the epidemiology, natural evolution, clinical spectrum, and management of the disease. The literature pertaining to these aspects of the disease were studied and summarized in this review. Epidemiological studies suggest that environmental factors contribute to the causation of the disease. Incidence rates monitored over time indicate that the incidence of Legg-Calvé-Perthes disease is declining. The natural evolution followed on sequential plain radiographs enables division of the disease into Stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV. Reversible deformation of the capital occurs in Stages Ia-IIa simply on standing while irreversible deformation may occur in Stages IIb and IIIa. Treatment of Legg-Calvé-Perthes disease in Stages Ia-IIa aims to prevent the femoral head from getting deformed by containment and avoidance of weight-bearing. In Stages IIb and IIIa, treatment aims to remedy the effects of early irreversible deformation of the femoral head. In Stage IIIb and IV, treatment is directed to correcting the altered shape of the femoral head. The impression that these treatment methods are helpful is based on poor quality evidence. There is an urgent need to undertake Level I studies to establish the efficacy of currently treatment. level V.

Cytotoxicity Effects of Azithromycin and Curative of Garlic on Sperm Mortality and Testicular Tissue of Albino Male Rats

The current study aimed to identify the adverse effects of azithromycin drug and the protective role of garlic in cytotoxicity tests that included sperm deformation and histological changes in testes tissue of male albino rats. Twenty-four mature male rat animals (Rattus norvegicus) were used in the present study, their age was (2.5 – 3) months, and their weight ranged from 148 to 280 gm they were divided into four groups as follows:&#x0D; The first group was the control group contained four rats and was administered distilled water only. In contrast, the second group containing four rats was administered garlic at 480 mg/kg body weight. The third group included eight rats, was administered Azithromycin at the dose of 500 mg/kg body weight. The fourth group contained eight rats, and Azithromycin was administrated at 500 mg/k mg+ garlic at 480 mg/kg body weight. The groups were treated with Azithromycin and garlic daily. The results recorded a significant increase (p≥0.05) in sperm head and tail deformation rate in the group administered Azithromycin + garlic compared with the control groups that were administrated distilled water and garlic. Furthermore, the results reported a significant decrease (p≥0.05) in sperm head and tail deformation rates in the group administered Azithromycin + garlic compared with the only Azithromycin administered group. Moreover, the study indicated histological changes in testes tissue included degenerative changes represented by depletion of the spermatogonial cells (some seminiferous tubules appeared with one or two layers of spermatogonia) in the group that was administered Azithromycin compared with the control group, which was administered distilled water and garlic. In addition, the study indicated slight histological changes in testes tissue compared with standard testes architecture, somniferous tubules with the maturation of spermatogony, and sperms inside the lumen in groups administered Azithromycin and garlic compared with control groups, which were administered distilled water and garlic Finally, the findings showed a reduction in histological changes in testes tissue in the group that was administered azithromycin+garlic compared with the group that was administered Azithromycin only..

Thermal Effect of the Back Radiation from Disk to Head after Laser Heating in HAMR

In a heat-assisted magnetic recording, the thermal effect of the head/disk interface has an important influence on the stability of the recording data. In this paper, we will discuss the thermal radiation from the disk, more specifically, the magnetic recording layer, which is at high temperature after laser heating, to the magnetic head, which is at room temperature. The radiative heat flux can be represented by the Poynting vector. In the near-field band, an effective way to obtain the electromagnetic fields is to solve the Maxwell’s equations combined with fluctuational electrodynamics. The near-field back radiation between specific head and disk material is calculated by the fluctuation-volume-current method. The radiative heat energy will induce the thermal deformation of the magnetic head, which will be discussed by the simulation, laying the foundation for adjusting and controlling the flying status.

Facial feature fusion convolutional neural network for driver fatigue detection

Driver fatigue detection is critical for preventing traffic accidents. However, in real driving scenarios, low-quality input situations often occur due to occlusion, large-turn head deformation, and inconsistent eye states, which introduce noise and degrade the performance of single-stream networks. To address this, we propose a multi-stream facial feature fusion convolution neural network (FFF–CNN) that enhances performance on low-quality inputs. The FFF-CNN includes a global face stream and two local eye streams, with feature fusion used for eye state classification. To facilitate feature fusion, we implemented two preprocessing modules, the feature attention module (FAM) and the stream interaction module (SIM). FAM emphasizes important features in the global face stream, while SIM corrects information from the two local eye streams. The proposed FFF-CNN achieved good performance on both our dataset and the public Closed Eyes in the Wild (CEW) dataset. Compared to single-stream networks, the FFF-CNN improved performance by 4.95% and 4.27% on our dataset and the CEW dataset, respectively. Furthermore, it achieved state-of-the-art performance on the CEW dataset with an accuracy of 98.35%. The effectiveness of the proposed FAM and SIM has been verified by experiments. Notably, our experimental results show that the proposed FFF-CNN effectively improved fatigue detection performance on low-quality input, approaching the performance on normal situations.

Revisiting the Cephalic Index: The Origin, Purpose, and Current Applicability—A Narrative Review

ABSTRACT Introduction Cephalometry is the measurement and study of the proportions of the head and face, and infant skull deformities have been the subject of many clinical studies over the last 30 years. Clinical protocols to document change are especially critical during periods of growth and development, but reference values and norms are lacking for infants, especially in the first year after birth. Discussion Key publications were reviewed by the authors to provide a narrative review of the 1) origin of the cephalic index (CI), 2) adaptations of the measure over time, 3) anatomical landmarks and alignments used, 4) clinical tools, 5) necessary considerations for different ethnic, sex, and cultural influences, 6) value and limitations of CI measurements, and 7) appropriate use of the CI in the documentation of infant skull deformities. The CI calculation has remained constant since the 1840s, although the cranial shape classifications have changed many times over the years. Conclusions Used in isolation, the two-dimensional (2D) and linear nature of the CI fails to describe the magnitude of the three-dimensional (3D) head deformity. However, the CI can and should be used in conjunction with other 2D and 3D measurements to provide a more detailed description and understanding of the entire cranial deformity. For today's cranial clinicians and allied health care professionals, the commonly referenced CI chart fails to reflect 1) the natural skull changes noted with supine sleeping infants, and 2) the cultural diversity of the infant population currently treated. Although the CI provides information about one of the most obvious features of the dysmorphology, clinicians must also document and report other distinct features such as frontal flattening or bossing, parietal shape or involvement, sloping, displacement, and/or posterior asymmetry. Clinical Relevance The CI should be used in conjunction with other 2D and 3D anthropometric measurements to provide a more detailed assessment of the entire cranial deformity. The CI results should be discussed with the medical team along with a complete review of other 2D and 3D measurements to determine the best course of action for orthotic treatment or nontreatment of the head shape.

Novel variants in DNAH6 cause male infertility associated with multiple morphological abnormalities of the sperm flagella (MMAF) and ICSI outcomes.

Variations in the dynein axonemal heavy chain gene, dynein axonemal heavy chain 6 ( DNAH6 ), lead to multiple morphological abnormalities of the flagella. Recent studies have reported that these deficiencies may result in sperm head deformation. However, whether DNAH6 is also involved in human acrosome biogenesis remains unknown. The purpose of this study was to investigate DNAH6 gene variants and their potential functions in the formation of defective sperm heads and flagella. Whole-exome sequencing was performed on a cohort of 375 patients with asthenoteratozoospermia from the First Affiliated Hospital of Anhui Medical University (Hefei, China). Hematoxylin and eosin staining, scanning electron microscopy, and transmission electron microscopy were performed to analyze the sperm morphology and ultrastructure. Immunofluorescence staining and Western blot analysis were conducted to examine the effects of genetic variants. We identified three novel deleterious variants in DNAH6 among three unrelated families. The absence of inner dynein arms and radial spokes was observed in the sperm of patients with DNAH6 variants. Additionally, deficiencies in the acrosome, abnormal chromatin compaction, and vacuole-containing sperm heads were observed in these patients with DNAH6 variants. The decreased levels of the component proteins in these defective structures were further confirmed in sperm from patients with DNAH6 variants using Western blot. After intracytoplasmic sperm injection (ICSI) treatment, the partner of one patient with a DNAH6 variant achieved successful pregnancy. Overall, novel variants in DNAH6 genes that contribute to defects in the sperm head and flagella were identified, and the findings indicated ICSI as an effective clinical treatment for such patients.

Two-Step Spin Forming of Thin-Walled Heads with Lateral Normal Flanged Holes

A thin-walled head with a lateral normal flanged hole is a key part of a propellant tank, and its low-cost and high-precision forming process is very challenging. In this paper, a two-step method is proposed to preform the head via marginal-restraint mandrel-free spinning and then to realize the flanging of the lateral normal hole using a punching–spinning method. Finite element analysis of round-hole punching–spinning flanging shows that the larger the thinning ratio and the roller fillet radius, the lower the rebound and contour rise amount; the larger the feed ratio, the lower the rebound and the higher the contour rise amount. Further study on the effects of round-hole punching–spinning flanging on the secondary deformation of thin-walled heads shows that the deformation of the head in the area around the flanging hole is less severe than that of the flat blank, and the deformation in the circumferential direction is different from that in the busbar direction. Finally, it is verified through experiments that the two-step method can realize the spin forming of thin-walled heads with lateral normal flanged holes.

How Myopia and Glaucoma Influence the Biomechanical Susceptibility of the Optic Nerve Head.

The purpose of this study was to assess optic nerve head (ONH) deformations following acute intraocular pressure (IOP) elevations and horizontal eye movements in control eyes, highly myopic (HM) eyes, HM eyes with glaucoma (HMG), and eyes with pathologic myopia (PM) alone or PM with staphyloma (PM+S). We studied 282 eyes, comprising of 99 controls (between +2.75 and -2.75 diopters), 51 HM (< -5 diopters), 35 HMG, 21 PM, and 75 PM+S eyes. For each eye, we imaged the ONH using spectral-domain optical coherence tomography (OCT) under the following conditions: (1) primary gaze, (2) 20 degrees adduction, (3) 20 degrees abduction, and (4) primary gaze with acute IOP elevation (to ∼35 mm Hg) achieved through ophthalmodynamometry. We then computed IOP- and gaze-induced ONH displacements and effective strains. Effective strains were compared across groups. Under IOP elevation, we found that HM eyes exhibited significantly lower strains (3.9 ± 2.4%) than PM eyes (6.9 ± 5.0%, P < 0.001), HMG eyes (4.7 ± 1.8%, P = 0.04), and PM+S eyes (7.0 ± 5.2%, P < 0.001). Under adduction, we found that HM eyes exhibited significantly lower strains (4.8% ± 2.7%) than PM+S eyes (6.0 ± 3.1%, P = 0.02). We also found that eyes with higher axial length were associated with higher strains. Our study revealed that eyes with HMG experienced significantly greater strains under IOP compared to eyes with HM. Furthermore, eyes with PM+S had the highest strains on the ONH of all groups.

Interleukin-6 receptor blockade improves bone healing following ischemic osteonecrosis in adolescent mice

ObjectiveJuvenile ischemic osteonecrosis (JIO) of the femoral head is one of the most serious hip disorders causing a permanent deformity of the femoral head in childhood. We recently reported that interleukin 6 (IL-6) is significantly increased in the hip synovial fluid of patients with JIO and that articular chondrocytes are primary source of IL-6. Adolescent JIO is particularly challenging to treat and has poor outcome. This study determined if IL-6 receptor blockade prevents bone loss and improves the bone healing in adolescent JIO. MethodAdolescent mice (12-week-old) surgically induced with JIO were treated with either saline or MR16-1, an IL-6 receptor blocker. ResultsMicro-CT assessment showed significantly increased bone volume (p ​< ​0.001, Cohen's d ​= ​2.0) and trabecular bone thickness (p ​< ​0.001, d ​= ​2.3) after the MR16-1 treatment. Histomorphometric assessment showed significantly increased osteoblast number (p ​< ​0.01, d ​= ​2.3), bone formation rate (p ​< ​0.01, d ​= ​4.3), and mineral apposition rate (p ​< ​0.01, d ​= ​4.1) after the MR16-1 treatment. The number of osteoclasts was unchanged. Histologic assessment showed significantly increased revascularization (p ​< ​0.01) and restoration of the necrotic marrow with new hematopoietic bone marrow (p ​< ​0.01). Vascular endothelial growth factor (VEGF) expression was increased in the revascularized area and the articular cartilage, and in the cultured chondrocytes treated with IL-6 receptor inhibitor. ConclusionIL-6 blockade in adolescent mice with JIO enhanced bone formation and revascularization. The findings suggest IL-6 receptor blocker as a potential medical therapy for adolescent JIO.

Преднамеренная искусственная деформация у населения позднесарматского времени (палеопатологический аспект)

Introduction. Intentional artificial head deformation is one of the most striking features of the late Sarmatian nomads from the Eastern European steppes. For quite a long time, archaeologists and anthropologists tried to solve the issues associated with this custom’s emergence and existence in the population of the 2nd – 4 th centuries AD. Later, the question of the deforming structure’s impact on the normal life of a person became a separate research line for the phenomenon of artificial cranial deformation in the late Sarmatians. Methods and materials. 155 craniums of sexually mature late Sarmatian populations (2nd – 4th centuries AD) originating from under the burial mounds in the territory of the Lower Volga region were the material for the study. Comparison of pathological conditions occurrence between the deformed and undeformed skull groups was carried out using nonparametric tests: Pearson’s chi-squared test (χ2) and Fisher’s exact test. Results. Comparative analysis of pathological conditions occurrence on deformed and undeformed skulls in late Sarmatian time has shown that the only deviation in which the compared series differ significantly is temporomandibular joint arthritis. Discussion. The frequency and degree of articular disease development in late Sarmatians with intentional artificial head deformities increase with age. The age-related variability of arthrotic changes in the mandibular joint area indicates the involutionary nature of this condition. At the same time, the absence of statistical differences between age groups in the distribution frequencies of this pathology and its wide distribution in young individuals under 35 years of age suggest that artificial skull deformation is one of the factors stimulating its development. Conclusions. Degenerative changes in the temporomandibular joint area are a statistically more widespread pathology in deformed skulls. The absence of gender differences between the deformed and undeformed skulls in the late Sarmatians, as well as the groups of pathologies associated with diet and the degree of negative factors impacting the natural and social environment, indicates that this custom in the late Sarmatian society did not carry the function of gender or social differentiation. The use of a modifying structure for deliberate artificial cranial deformation is quite compatible with normal human life, and its use did not subsequently lead to the development of serious skull and brain pathologies.

Children’s orthopaedics

The August 2023 Children’s orthopaedics Roundup360 looks at: DDH: What can patients expect after open reduction?; Femoral head deformity associated with hip displacement in non-ambulatory cerebral palsy; Bony hip reconstruction for displaced hips in patients with cerebral palsy: is postoperative immobilization indicated?; Opioid re-prescriptions after ACL reconstruction in adolescents are associated with subsequent opioid use disorder; Normative femoral and tibial lengths in a modern population of USA children; Retrospective analysis of associated anomalies in 636 patients with operatively treated congenital scoliosis; Radiological hip shape and patient-reported outcome measures in healed Perthes’ disease; Significantly displaced adolescent posterior sternoclavicular joint injuries.