Skeletal Injury Research Articles

Mesenchymal Stem Cell-derived Exosomes Affect Macrophage Phenotype: A Cell-free Strategy for the Treatment of Skeletal Muscle Disorders.

The process of tissue damage, repair, and regeneration in the skeletal muscle system involves complex inflammatory processes. Factors released in the inflammatory microenvironment can affect the phenotypic changes of macrophages, thereby changing the inflammatory process, making macrophages an important target for tissue repair treatment. Mesenchymal stem cells exert anti-inflammatory effects by regulating immune cells. In particular, exosomes secreted by mesenchymal stem cells have become a new cell-free treatment strategy due to their low tumorigenicity and immunogenicity. This article focuses on the mechanism of the effect of exosomes derived from mesenchymal stem cells on the phenotype of macrophages after skeletal muscle system injury and explores the possible mechanism of macrophages as potential therapeutic targets after tissue injury.

Skeletal Injuries and Their Pattern Following Mountaineering and Climbing Accidents in Iranian Athletes

The number of mountaineers and climbers has increased over the last few years. Considering the geographical features of Iran, this increase in the number of climbers is more significant in this country. Because of the importance of mountaineering injuries, a comprehensive survey of these injuries is needed. In this base, we designed a survey to investigate skeletal injuries in mountaineering accidents. This cross-sectional study was conducted on athletes from the Mountaineering Federation of Islamic Republic of the Iran (MFIRI) in 2015 and 2016. A total of 110 athletes were included using a simple random sampling method, and they were examined for any complications after skeletal injuries. Their medical records were reviewed. A total of 110 mountaineers completed the checklists, and 15 mountaineers reported a rock-climbing trauma and injury during 2015 and 2016. The most traumatic location was the lower extremities (46.7%). Additionally, most of trauma occurrences were in descent (80%) and times of day between noon and midnight (64.3%). The mean age of the mountaineers who had a trauma incidence was 37.95±8.76 years. Smoking was significantly different between the two groups. Skeletal injuries during mountaineering and rock climbing mostly affect the lower extremities, followed by the upper extremities and spine. There was no significant difference in age, sex or climbing equipment between the group who had an accident and the group who did not. In this study, there was a relationship between smoking cigarettes and an increased incidence of climbing accidents. Longitudinal studies with larger sample sizes are needed to evaluate this relationship.

Outcome of treatment of intra-articular distal end radius fractures by volar locking plate versus bridging external fixator augmented by single K-wire through radial styloid

Background: Distal radius fractures are common injuries occurring more frequently than any other fracture, and remain one of the most frequent skeletal injuries treated by orthopaedic or trauma surgeons. They are considered the most common fracture of the upper extremity. The use of percutaneous pin fixation, external fixation devices that permit distraction and palmar translation, low-profile internal fixation plates and implants, arthroscopically assisted reduction, and grafting techniques including bone-graft substitutes all have contributed to improving fracture stability and outcome. Methods: This is a prospective study consisting of 30 patients, who were treated with volar locking plate or K-wire augmented external fixation for intra-articular commented distal radius fractures (AO type C) at Rajendra institute of medical sciences between November 2020 and January 2023. The 15 patients were treated with open reduction using the volar approach and locking plate were used while 15 patients were treated with closed reduction under fluoroscopy, distraction with the external fixator (Joshi type external fixator) along with K-wire fixation for additional stability used. Result: The ORIF with plating group showed better functional outcomes in Green and O'Brien compared to ex fix group. The radiographic results in the ORIF group were more favorable than in the EF group. Conclusions: We found that both ORIF with plating and external fixation represent treatment choices for distal radius fractures. ORIF had better functional and radiological outcomes according to Green and O'Brien and Sarmiento scoring systems when compared to external fixation. ORIF had less incidence of complications compared with external fixation.

Technique of tension band wiring in patella fracture management-our experience

: Fractures of the patella account for about 1% of all skeletal injuries. Displaced patella fractures often result in disruption of the extensor mechanism of the knee. Open reduction and internal fixation is the recommended treatment to restore the extensor mechanism Tension band wiring (TBW) technique using K-wires and stainless steel wires is the most commonly used. The purpose of this study is to study surgical outcome of patella fractures treated with, tension band wiring (TBW) technique and functional outcome of patella fractures treated with TBW technique. It is a Retrospective study of 21 patients carried out from July 2019 to February 2021 admitted to orthopedic ward at our institution. All patients underwent same surgical technique and similar postoperative and physiotherapy protocol. Bostman scoring system was used to perform functional assessment.: In our study there were 14 males and 7 females. Fracture union was achieved in all patients. The mean bostman score was 26.54 at the final follow up.we had 4 complications 1 superficial infection of the surgical wound, 1 knee stiffness and 2 cases of symptomatic implant. We had 8 excellent, 9 good and 4 satisfactory result.: Tension band wiring technique for transverse patella fractures can be a very good option with effective fixation method and relatively easy surgical procedure.

Multiple injuries and injury recidivism in Milan over 2,000 years

Injury recidivism is a clinical term defined as the recurrence of traumatic injuries from temporally distinct events, whereas multiple injuries correspond to skeletal injuries to more than one body region. The analysis of these dynamics can lead to a better understanding of the individual’s way of life and social environment. The present investigation examines the rates of multiple injuries, and in particular their distribution according to sex and age-at-death, as well as their association with stress markers, among 200 skeletons from Milan covering four historical periods (roman, medieval, modern, and contemporary eras), equally divided between sexes. In addition, injury recidivism was investigated in the sample and three cases were identified and detailed as case studies. As a result, multiple injuries were more frequent in the Medieval period (41%), followed by the Contemporary (25%), Roman (19%) and Modern eras (15%). Statistical analyses showed a significant association between multiples injuries and male sex, but not with age-at-death or stress markers. The three cases of recidivism included one female from the modern era and two males from the Medieval period. The analysis of the injuries and their recurrence permitted to improve our understanding of the individuals’ social environment and hypothesize on their causes (accidents/occupational work, and interpersonal violence).

Features of damage to the ribs by a blade with a defective tip

Stab wounds are a common injury in the practice of a forensic pathologist. Such damage often occurs in domestic conditions, for example, in the kitchen during a quarrel, where knives are always at hand. The young, able-bodied portions of the population are frequent victims, which makes the problem socially significant.
 Knives that have been used for a long time are rarely in perfect condition; operational defects occur on them. For example, repeated sharpening results in the rounding of the tip of the blade. Moreover, during operation, the tip of the blade can bend or even break off. However, before studying the effects of such blades on flat bones, studying the history of this issue, to familiarize with the work of other scientists, is necessary.
 In the literature review, authors of studies on stab-cut injuries focused more on damage to the skin and clothing. Morphological features of skeletal bone injuries and the possibility of identification studies on them until the XXI century were described poorly.
 To improve the forensic medical diagnosis of rib injuries caused by blades with point defects based on the study of a complex of morphological features, experimental studies on cadaveric materials are necessary.

Compartment Syndrome and Its Validation in Skeletal Injuries

Background Compartment syndrome, a potential limb-threatening condition in acute traumatic situations following different modalities of injury, may lead to irreversible damage or even life risk later. Its differential time-bound clinical presentation with added observer bias on available invasive and noninvasive diagnostic modalities influences the decision-making and undue delay for early intervention toward limb salvage procedure. Results Thirty-two patients were included in our study with mean age of 36; males (18; 56.3%) were more injured than females (14; 43.8%) and left limb (17; 53.1%) was more involved than right (15; 46.9%). Mean calf muscle measurement of total injured limb with relation to immediate time was 39.9 cm, after 1 hour was 40.69 cm, after 2 hours was 41.06 cm, and after 3 hours was 41.40 cm; 95% confidence interval was found to be statistically significant. Three patients (9%) underwent emergency decompression fasciotomy, with an average mean of 41.4 cm for injured limbs against 38.5 cm in control limb. Conclusions Compartment syndrome is an acute emergency with potential irreversible damage when undiagnosed. Bias on diagnosis evolves around observer skills and clinical invasive and noninvasive methods, with differential statistical results pertaining to its decision-making for emergency fasciotomy.

The Catalytic Degradation of the Inflammatory Drug Diclofenac Sodium in Water by Fe2+/Persulfate, Fe2+/Peroxymonosulfate and Fe2+/H2O2 Processes: A Comparative Analysis

Diclofenac sodium was extensively used for treating arthritis, osteoarthritis and skeletal muscular injuries, which ultimately caused troubles for aquatic organisms as well as human beings. In this study, homogeneous catalytic advanced oxidation processes, including Fe2+/persulfate, Fe2+/peroxymonosulfate and Fe2+/H2O2, were used for the degradation of diclofenac sodium in water, without using UV-C light. About 89, 82 and 54% DCF sodium was decomposed by Fe2+/persulfate, Fe2+/peroxymonosulfate and Fe2+/H2O2, respectively, in 60 min. The degradation of diclofenac sodium followed the pseudo first-order kinetics, in all cases. The degradation efficiency of diclofenac sodium was significantly affected in the presence of various anions, such as NO3−, HCO3− and SO42−. The mineralization studies revealed 62, 45 and 32% total carbon removal by Fe2+/persulfate, Fe2+/peroxymonosulfate and Fe2+/H2O2, respectively, in 60 min. In addition, the degradation byproducts of diclofenac sodium were determined by FTIR analysis. The results revealed that the Fe2+/oxidant system, particularly Fe2+/persulfate, was a promising technology for the elimination of toxic pharmaceuticals, such as diclofenac sodium, from the water environment.

A Review of Three Decades of Research Dedicated to Making Equine Bones Stronger: Implications for Horses and Humans

Much research has been conducted in an attempt to decrease skeletal injuries in athletic horses. The objective of this literature review is to compile the findings of over three decades of research in this area, make practical recommendations, and describe how research can develop over the years. An initial study investigating the role of bioavailable silicon in the diets of horses in race training produced the unexpected finding of decreased bone mineral content of the third metacarpus subsequent to the onset of training. Further studies revealed this decrease to be associated with stall housing eliminating high-speed exercise, leading to disuse osteopenia. Only relatively short sprints (between 50 and 82 m) were necessary to maintain bone strength and as few as one sprint per week provided the needed stimuli. Endurance exercise without speed fails to elicit the same benefits to bone. Proper nutrition is also required for optimal bone health, but without the right exercise, strong bone cannot be maintained. Several pharmaceuticals may have unintended consequences capable of impairing bone health. Many of the factors influencing bone health in horses also exist in humans including a sedentary lifestyle, improper nutrition, and pharmaceutical side-effects.

The Effect of Early Movements of Swollen Lymph Nodes Caused by COVID-19/ Vaccine of COVID-19 on Recovery

Background: The swelling of the lymph nodes may raise some concerns and anxiety for people after getting the vaccination, especially for COVID-19. Many women seek medical attention for the enlarged lymph node due to the known relationship between lymph nodes and breast cancer. This research is intended to enrich the data of the most recent COVID-19 pandemic and the vaccines that were developed shortly after. The aim is to see if there is an effect of early movement of the swollen axillary lymph nodes caused by the COVID-19 vaccination and to enrich the data of the most recent COVID-19 pandemic and its developed vaccines shortly after.
 Methods: A voluntary survey was used to collect data from recently vaccinated individuals. Data were analyzed for associations between early movement and resolution of lymphadenopathy.
 Results: 32 (20.38%) of 157 participants reported swelling of axillary lymph nodes that resulted from COVID-19 vaccination. Duration of swelling ranged from 1 to more than two weeks. The early movement did not show a statistically significant reduction in the course of swelling.
 Conclusion: Early movement of areas affected with lymph node enlargement, whether active or passive, does not seem to cause additional side effects. The effect of early action seems comparable to rest (see Fig.), although it may lessen erythema due to improved circulation, just like the newer concept of early movement after a skeletal injury has a better outcome than merely resting, which was the older method of recovery. However, the current data is limited to support the benefit of such a concept.

Лечение детей с множественными повреждениями костей, образующих локтевой сустав

Introduction Diagnosis and treatment of children with multiple injuries of the bones that form the elbow joint is a relevant problem in pediatric traumatology. Due to the high variability of the cases encountered, it is necessary to differentiate the volume, timing and sequence of surgical interventions, as well as the duration of fixation of the injured limb with immobilizing means. The aim of the work was to study the dependence of long-term anatomical and functional treatment results in children with multiple fractures around the elbow joint on the type of injury. Materials and methods The medical records of 82 pediatric patients with multiple injuries of the bones forming the elbow joint were studied. The patients involed in the study were divided into two groups. Group 1 were patients with multiple fractures of the bones that make up the elbow joint (35 children), and group 2 were patients with intra-articular fractures of the distal end of the humerus and fracture-dislocations of the forearm bones in the elbow joint (47 children). The results were evaluated using the DASH questionnaire and the Broberg-Morrey rating scale. Results In the first group of patients with multiple fractures of the bones that make up the elbow joint, the anatomical and functional results of treatment were significantly better, and the process of restoring the function of the elbow joint was shorter. The treatment results of patients in the second group largely depended on the severity of the injuries. The use of the Ilizarov method with rational arrangements of the apparatus enables to preserve the function of the elbow joint in the course of transosseous osteosynthesis. In hybrid fixation (the use of pins and apparatus or plaster immobilization and apparatus), patients frequently developed immobilization contracture of the elbow joint and the anatomical and functional results turned out to be worse, since the fixed elbow joint needed long-term rehabilitation. Discussion Multiple injuries of the bones of the elbow joint are highly variable. The treatment of patients with multiple injuries of the elbow joint remains a difficult clinical task, partly because there is no differentiated approach to rehabilitation measures depending on the nature of the injury, and, accordingly, a rational approach to the treatment of this group of patients has not been developed. Due to the fact that most dislocations are usually associated with fractures, accurate diagnosis of the severity of injuries and rational surgical intervention in terms of timing and volume are necessary to achieve good anatomical and functional results. Conclusion Accurate and timely diagnosis of skeletal injuries of the elbow joint and rational determination of treatment tactics are of great importance in pediatric emergency traumatology. They determine the anatomical and functional outcomes of rehabilitation.

Preparation and characterization of hydroxyapatite nanoparticles doped with nickel, tin, and molybdate ions for their antimicrobial effects

Background Hydroxyapatite (HAp) nanoparticles doped with some ions have shown anticancer and antibacterial properties and are of great interest for the development of new biomedical applications. Therefore, the present study aimed to investigate the preparation and in vitro characterization of HAp nanoparticles doped with (Ni2+), tin (Sn2+), molybdate (Mo3+) ions for prevention of infections specially in bone tissue engineering. Methods HAp and HAp nanocrystal powders doped with nickel (Ni2+), tin (Sn2+), molybdate ions (Mo3+) with concentrations of 500, 1000, and 2000 ppm were prepared by the sol-gel method using a combination of calcium nitrate and phosphorous pentoxide as chemical reagents. The nanoparticles were characterized by FT-IR, XRD, EDAX and SEM. Their antimicrobial effect was studied by disk diffusion method on two types of bacteria: Pseudomonas aeruginosa and Staphylococcus aureus. Results FT-IR and XRD tests confirmed the formation of HAp nanoparticles. SEM images showed the morphology and nanostructure of HAp and Ni@HAp. Ni@HAp showed significantly more antimicrobial effects than the other two ions on S. aureus. EDAX confirmed the presence of Ni2+ ions in the Ni@HAp structure and the element map also showed very good dispersion of elements in both HAp and Ni@HAp structures. Conclusions HAp nanoparticles doped with nickel ions may be considered as a promising antibacterial treatment in bone tissue engineering and repairing of skeletal injuries contaminated with S. aureus.

Injuries associated with mechanical chest compressions and active decompressions after out-of-hospital cardiac arrest: A subgroup analysis of non-survivors from a randomized study

BackgroundBoth skeletal and visceral injuries are reported after cardiopulmonary resuscitation (CPR). This subgroup analysis of a randomized clinical study describes/compares autopsy documented injury patterns caused by two mechanical, piston-based chest compression devices: standard LUCAS® 2 (control) and LUCAS® 2 with active decompression (AD, intervention) in non-survivors with out-of-hospital cardiac arrest (CA). MethodWe compared injuries documented by autopsies (medical/forensic) after control and intervention CPR based on written relatives consent to use patients’ data. The pathologists were blinded for the device used. The cause of CA and injuries reported were based on a prespecified study autopsy template. We used Pearson's chi-squared testand logistic regression analysis with an alpha level of 0.05. Results221 patients were included in the main study (April 2015–April 2017) and 207 did not survive. Of these, 114 (55%, 64 control and 50 intervention) underwent medical (N = 73) or forensic (N = 41) autopsy. The cause of CA was cardiac 53%, respiratory 17%, overdose/intoxication 14%, ruptured aorta 10%, neurological 1%, and other 5%. There were no differences between control and intervention in the incidence of rib fractures (67% vs 72%; p-value = 0.58), or sternal fractures (44% vs 48%; p-value = 0.65), respectively. The most frequent non-skeletal complication was bleeding (26% of all patients) and intrathoracic was the most common location. Ten of the 114 patients had internal organ injuries, where lungs were most affected. ConclusionIn non-survivors of OHCA patients, the most frequent cause of cardiac arrest was cardiogenic. Skeletal and non-skeletal fractures/injuries were found in both control and intervention groups. Bleeding was the most common non-skeletal complication. Internal organ injuries were rare.

Developments in the epidemiology and surgical management of patella fractures in Germany

BackgroundPatella fractures account for approximately 1% of all skeletal injuries. Treatment options are vast and no definitive conclusion on what option is the most beneficial could be made so far. Plate osteosynthesis appears to gain in importance. We aim to give insight into the more recent trends and developments as well as establish the epidemiology of patella fractures in Germany by analysing treatment and epidemiological data from a national database.MethodsAnonymised data was retrieved form a national database. In the period of 2006 to 2020, all patients with patella fractures as defined in ICD-10 GM as their main diagnosis, who were treated in a German hospital were included. Patients were divided into subgroups based on gender and age. Age groups were created in 10-year intervals from 20 years old up to 80 years old with one group each encompassing all those above the age of 80 years old and below 20 years old and younger. Linear regression was performed were possible to determine statistical significance of possible trends.ResultsA total of 151,435 patellar fractures were reported. 95,221 surgical interventions were performed. Women were about 1.5 times more likely to suffer from patella fracture than men. The relative number of surgical interventions rose from about 50% in 2006 to 75% in 2020. Most surgical interventions are performed in those over the age of 50. The incidence of complex fractures and plate osteosynthesis has significantly increased throughout the analysed period.ConclusionsWe found a clear trend for surgical treatment in Germany with an increase in surgical procedures. We could also show that this ratio is age-related, making it more likely for younger patients in the age groups from 0 to 70 years old to receive surgical treatment for their patella fracture.

Mangled Extremity Severity Score in the Assessment of Extremity Injuries - Is it Reliable?

The mangled extremity severity score (MESS) was established 28years ago to decide performing an amputation in cases of limb trauma. It assigns points for 4 aspects of the injury: the extent of soft tissue and skeletal injury, limb ischemia and ischemic duration, shock, and age. A score of 7 or higher indicates that primary amputation is required. Thirty-one patients with MESS scores of 7 to 8 underwent limb salvage surgeries, with 13 limbs being saved and 18 limbs being amputated. Upper extremities trauma had a salvage rate of 62.5%, whereas lower extremity trauma had a salvage rate of 20%. MESS is not a sensitive predictor of amputation in upper limb trauma, but it is useful in lower limb injuries.

Use of Computed Tomography in Evaluation and Management of Shell Fracture in a Red Eared Slider Turtle ( Trachemys scripta elegans) A Case report

Traumatic lesions of the shell are common problems in chelonians. Lesions of the shell vary in severity from a simple superficial abrasion (with a loss of the external skin layer and exposure of the bone) to complicated fractures of the carapace with exposure of internal organs of the coelom and injury of the soft tissues (Barten, 2006). In most shell or skeletal injuries in the turtle, plain radiographic data do not reveal the extent of complex fractures due to superimposed bone structures (Abou-Madi et al., 2002). In Comparison with conventional radiography, computed tomography (CT) allows better distinction of specific tissue densities and discrete changes in organ size, shape, margin, contour and position (Gaudron et al., 2001). Computed tomography is a non-invasive, cross-sectional diagnostic imaging technique that offers significant advantages for detection of pathologies in chelonians, and is ideal for diagnosing skeletal and soft tissue abnormalities (Gumpenberger and Henninger, 2001). The aim of the present work was to evaluate the three dimensional computed tomography (CT) for clinical examination of shell lesions in a red eared slider turtle.

Sulforaphane protects microvascular endothelial cells in lower limb ischemia/reperfusion injury mice.

Background: Microvascular damage is a key pathological factor in acute lower limb ischemia/reperfusion (I/R) injury. Current evidence suggests that sulforaphane (SFN) protects tissue from I/R injury. However, the role of SFN in acute lower limb I/R injury remains elusive. This study aimed to investigate the role and potential mechanism of SFN in I/R-related microvascular damage in the limb. Methods: Limb viability was evaluated by laser Doppler imaging, tissue edema analysis and histological analysis. Western blotting and immunofluorescence were applied to analyze the levels of apoptosis, oxidative stress, autophagy, transcription factor EB (TFEB) activity and mucolipin 1 (MCOLN1)-calcineurin signaling pathway. Results: SFN administration significantly ameliorated I/R-induced hypoperfusion, tissue edema, skeletal muscle fiber injury and endothelial cell (EC) damage in the limb. Pharmacological inhibition of NFE2L2 (nuclear factor, erythroid 2 like 2) reversed the anti-oxidation and anti-apoptosis effects of SFN on ECs. Additionally, silencing of TFEB by interfering RNA abolished the SFN-induced autophagy restoration, anti-oxidant response and anti-apoptosis effects on ECs. Furthermore, silencing of MCOLN1 by interfering RNA and pharmacological inhibition of calcineurin inhibited the activity of TFEB induced by SFN, demonstrating that SFN regulates the activity of TFEB through the MCOLN1-calcineurin signaling pathway. Conclusion: SFN protects microvascular ECs against I/R injury by TFEB-mediated autophagy restoration and anti-oxidant response.

FGF2 Alleviates Microvascular Ischemia-Reperfusion Injury by KLF2-mediated Ferroptosis Inhibition and Antioxidant Responses.

An essential pathogenic element of acute limb ischemia/reperfusion (I/R) injury is microvascular dysfunction. The majority of studies indicates that fibroblast growth factor 2 (FGF2) exhibits protective properties in cases of acute I/R injury. Albeit its specific role in the context of acute limb I/R injury is yet unknown. An impressive post-reperfusion increase in FGF2 expression was seen in a mouse model of hind limb I/R, followed by a decline to baseline levels, suggesting a key role for FGF2 in limb survivability. FGF2 appeared to reduce I/R-induced hypoperfusion, tissue edema, skeletal muscle fiber injury, as well as microvascular endothelial cells (ECs) damage within the limb, according to assessments of limb vitality, Western blotting, and immunofluorescence results. The bioinformatics analysis of RNA-sequencing revealed that ferroptosis played a key role in FGF2-facilitated limb preservation. Pharmacological inhibition of NFE2L2 prevented ECs from being affected by FGF2's anti-oxidative and anti-ferroptosis activities. Additionally, silencing of kruppel-like factor 2 (KLF2) by interfering RNA eliminated the antioxidant and anti-ferroptosis effects of FGF2 on ECs. Further research revealed that the AMPK-HDAC5 signal pathway is the mechanism via which FGF2 regulates KLF2 activity. Data from luciferase assays demonstrated that overexpression of HDAC5 prevented KLF2 from becoming activated by FGF2. Collectively, FGF2 protects microvascular ECs from I/R injury by KLF2-mediated ferroptosis inhibition and antioxidant responses.

Necrostatin-1 prevents skeletal muscle ischemia reperfusion injury by regulating Bok-mediated apoptosis.

Receptor interacting serine/threonine kinase 1 (RIPK1) mediates apoptosis by regulating the classic proapoptotic effectors Bcl-2-associated X protein (Bax) and Bcl-2 homologous antagonist/killer (Bak). Although Bcl-2-related ovarian killer (Bok) is structurally similar to Bak and Bax, it is unclear whether it mediates apoptosis in skeletal muscle ischemia reperfusion (IR) injury. We hypothesized that by regulating Bok-mediated apoptosis, inhibiting RIPK1 with necrostatin-1 would reduce skeletal muscle IR injury. Rats were randomized into four groups: sham (SM), IR, IR treated with necrostatin-1 (NI), or vehicle dimethyl sulfoxide (DI). For the IR group, the right femoral artery was clamped for 4 hours and then reperfused for 4 hours, and for the NI and DI groups, necrostatin-1 (1.65 mg/kg) and the equal volume of dimethyl sulfoxide were intraperitoneally administered prior to IR induction. The structural damage of muscle tissue and protein expression of Bok, Bcl-2, and cleaved caspase-3 were investigated, and apoptotic cells were identified with terminal dUTP nick-end labeling (TUNEL) staining. In vitro, human skeletal muscle cells (HSMCs) were exposed to 6 hours of oxygen-glucose deprivation followed by normoxia for 6 hours to establish an oxygen-glucose deprivation/reoxygenation (OGD/R) model. To determine the role of Bok, cell viability, lactate dehydrogenase (LDH) release, and flow cytometry were examined to demonstrate the effects of necrostatin-1 and Bok knockdown on the OGD/R insult of HSMCs. Necrostatin-1 pretreatment markedly reduced IR-induced muscle damage and RIPK1, Bok, and cleaved caspase-3 expression, whereas upregualted Bcl-2 expression (p < 0.05). Furthermore, necrostatin-1 prevented mitochondrial damage and decreased TUNEL-positive muscle cells (p < 0.05). In vitro, HSMCs treated with necrostatin-1 showed reduced Bok expression, increased cell viability, and reduced LDH release in response to OGD/R (p < 0.05), and Bok knockdown significantly blunted the OGD/R insult in HSMCs. Necrostatin-1 prevents skeletal muscle from IR injury by regulating Bok-mediated apoptosis.

Evaluating Skeletal Trauma and Forensic Anthropology for Medicolegal Investigations: A Systematic Review

Background: Skeletal trauma analysis is crucial in the area of forensic anthropology for locating and analyzingwounds in human remains. For the evaluation and recording of bone injuries, a number of techniques and methodshave been developed over the years, including ocular examination and cutting-edge imaging modalities. In orderto determine the approaches used in diagnosing bone trauma, the goal of this systematic review is to criticallystudy the body of current research. The goal of this study is to draw attention to the advantages, disadvantages,and recent technological developments of these techniques.Aim: This study thoroughly examines the examination of skeletal trauma and the function of forensic anthropologyin medicolegal cases, finding knowledge gaps and outlining potential directions for future research.Method: To find relevant studies released within a certain timeframe, a thorough search across the largest scientificdatabases was carried out. Studies on the assessment of skeletal trauma and the use of forensic anthropology inmedicolegal cases were also included. For methodological rigor, quality, and applicability, the chosen papersunderwent careful evaluation. According to the particular approaches and procedures used in assessing skeletaltrauma and the contributions of forensic anthropology to the field, data were retrieved, synthesized, and classified.Conclusion: This systematic study examines several approaches for assessing skeletal injuries in medicolegalinvestigations, stressing their benefits and drawbacks as well as the function of forensic anthropology. For thisdiscipline to improve accuracy and validity, advancements, established standards, and cutting-edge technologyare essential.