Research Articles (Anatomy)

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First permanent molar root canal configurations in a South African sample : a descriptive micro-computed tomographic report
Jonker, C.H.; Lambourn, G.; Van der Vyver, Petrus Jacobus; Theye, Charlotte E.G.; Foschi, F.; L'Abbe, Ericka Noelle; Oettlé, A.C. (South African Dental Association, 2025-06)
The aim of this paper was to describe root canal configurations using micro-CT in South African first molars. A segmentation process was followed on micro-focus X-ray computed tomography (micro-CT) scans of 101 maxillary and 86 mandibular first molars. Main and accessory root canal anatomy were considered to describe root canal configurations. Intra- and inter-observer reliability was determined using the unweighted Cohen's Kappa test. Intra- and inter-rater agreement was 93% for maxillary configurations; 92.9% and 86.2% respectively for mandibular configurations. The most common main canal configurations were: 3MxFM MB1DB1P1 (n = 33/93, 35.5%) and 2MDFM M1-2D1 (n = 8/84, 9.5%) (separate three-rooted maxillary and two-rooted mandibular respectively). The addition of accessory canals resulted in configurations that were mostly individualised with only a few notable similarities. A total of 97 unique configurations were found in maxillary teeth and 85 in mandibular teeth. In the separate three-rooted maxillary molars, the only similarities were 3MxFM MB1(A2) DB1(A1) P1 (n = 4/93, 4.3%) and 3MxFM MB1(A1) DB1(A1) P1 (n = 2/93, 2.2%). In two-rooted mandibular molars, only 2MDFM M1D1 (n = 2/84, 2.4%) was noted. Root canal configurations were found to be diverse and complex.
The role of angiogenesis in breast cancer and obesity : unravelling the connection
Sikuza, Yolo O.K.; Basson, Charlise; Oberholzer, Nanette; Ambele, Melvin Anyasi (Wiley, 2026-06)
Breast cancer remains one of the leading causes of cancer-related mortality amongst women worldwide, with rising incidence rates paralleling the global obesity epidemic. Obesity has been increasingly recognised as a risk factor for breast cancer, yet the molecular mechanisms underlying the association remain poorly understood. This review explores the role of angiogenesis as the central mechanism linking obesity to breast cancer progression. Angiogenesis is essential for both adipose tissue expansion and tumour growth. It is dysregulated in obesity and breast cancer, resulting in the formation of abnormal vasculature that perpetuates hypoxia and malignancy. Obesity contributes to this process through hypertrophic adipose tissue, altered adipokine profiles and elevated expression of proangiogenic factors, such as VEGF. These changes create a tumour microenvironment conducive to cancer progression, treatment resistance and poor clinical outcomes. Emerging evidence also implicates endothelial cells, pericytes and lipid metabolism in this interaction, suggesting novel therapeutic targets.
Toward a semiotic-Bayesian epistemology of skeletal trauma interpretation in forensic anthropology
Parra, Roberto C.; Crispino, Frank; Ubelaker, Douglas H.; Saravia-Yataco, Jose A.; Aranda, Claudia M.; Garizoain, Gonzalo; L'Abbe, Ericka Noelle; Martrille, Laurent; Condori, Lucio A.; Moraitis, Konstantinos; Baccino, Eric; Castellanos, Daniel; Luna, Leandro (Elsevier, 2026-11)
This article introduces a semiotic-Bayesian epistemological framework for the analysis and interpretation of skeletal trauma in forensic anthropology. The model integrates Peircean semiotics with probabilistic inference to provide a structured, reproducible approach to evaluating forensic evidence under conditions of uncertainty. Bone injuries are conceptualized as signs that maintain a causal relationship with the events that produced them; their interpretation begins with abductive reasoning, through which the forensic anthropologist formulates plausible hypotheses about the origin of the observed trauma. These hypotheses are subsequently organized through the abductive-deductive-inductive (ADI) cycle and formally evaluated using likelihood ratios (LR), derived from empirical frequency data reported in the published literature, to quantify the strength of the evidence. This proposal is illustrated through three forensic cases involving cranial blunt force trauma, cervicocephalic injuries associated with interpersonal violence, and close-range gunshot wounds. In each case, the framework enabled logical quantification of evidential weight, enhancing interpretive transparency, mitigating cognitive bias and facilitating communication within judicial contexts. The methodology proposed bridges qualitative, context-driven interpretation with quantitative rigor, thereby addressing longstanding epistemological challenges aligning anthropological practice with modern legal standards of admissibility, and highlighting the important role of the LR as a logically coherent and reproducible measure of strength. HIGHLIGHTS • A semiotic-Bayesian epistemology for bone trauma analysis in forensic anthropology is introduced. • The model formally integrates trace interpretation (semiotics) with probabilistic reasoning. • Likelihood ratios quantitatively express the strength of evidence for competing hypotheses. • The framework improves logical transparency, reduces cognitive bias, and ensures reproducibility.
Ensaya : an ensemble age model for prediction of chronological age in adolescents and young adults
Stenløkk, Kristina; Dahlberg, Pal Skage; Rolseth, Veslemoy; Bernitz, Herman; Gamieldien, Mohamed Yasin; Gholmieh, Mona Nahas; Robinson, Liam; Saade, Antoine; Uys, Andre; Bleka, Oyvind (Elsevier, 2027-01)
DNA methylation-based models for chronological age estimation have, for over a decade, been among the most important methods for age prediction in humans. While large-scale data have enabled the development of numerous models, their accuracy varies substantially depending on choice of machine learning algorithm, pre-processing pipeline, age range, tissue type, and population characteristics. Accurate age estimation in adolescents and young adults is particularly relevant in legal, investigational, and biomedical contexts. Here, we systematically evaluated blood-based DNA methylation age predictors in individuals aged 12–25 years and developed Ensaya (Ensemble age model for prediction of chronological age in adolescents and young adults), an ensemble model optimized for this age range. We assembled a validation dataset of 687 whole blood or peripheral blood mononuclear cell samples from 12 cohorts, profiled using Illumina 450 K, EPIC, and EPIC v2 arrays. We compared existing clocks and assessed robustness across cohorts, platforms, normalisation procedures, technical replicates, sex, and circadian timing. Among individual models, PAYA, cAge, and Garma showed the strongest performance and were combined into the Ensaya ensemble. In validation, Ensaya achieved improved accuracy, with a median absolute deviation of 0.79 years and a mean absolute error of 1.04 years, along with reduced age-dependent bias. It also demonstrated high technical reproducibility and stable performance across platforms and normalisation methods. These findings show that ensemble-based modelling improves age estimation in adolescents and young adults, supporting Ensaya as a practical blood-based predictor. HIGHLIGHTS • Systematic evaluation of blood-based epigenetic clocks for adolescents and young adults (12–25 years). • Combining estimates from existing clocks reduced age-dependent prediction bias. • Ensaya improves blood-based age prediction and showed a median absolute deviation of 0.79 years. • Performance remained stable across cohorts, array platforms, normalisation strategies, replicates, sex and circadian timing.
Assessing the cytotoxic effects of Group IX metal N-heterocyclic carbene complexes of iridium and rhodium on B16-F10 melanoma and non-cancerous RAW 264.7 cells
Van Vuuren, Estefan; Nadasen, Carolyn Courtney; Malan, F.P. (Frederick); Hlophe, Yvette Nkondo; Serem, June Cheptoo; Landman, Marile (Elsevier, 2026-09-15)
The development of highly effective and selective anticancer agents remains a central challenge in oncological research. Herein, we report a systematic evaluation of the anticancer activity of a series of rhodium- and iridium-based NHC (N-heterocyclic carbene) complexes (complexes 1, 3, 5–7), including the novel complex 3, as well as two imidazole-containing complexes (2 and 4). Their cytotoxic profiles were investigated against B16-F10 melanoma cells and benchmarked against non-cancerous RAW 264.7 macrophage cells to assess cancer selectivity. Cytotoxicity of complexes 1–7 was quantified using the crystal violet assay following exposure to 0.01 mM and 0.1 mM concentrations over 24, 48, and 72 h. Half-maximal inhibitory concentrations (IC50) were determined to establish comparative selectivity and potency indices. Mechanistic insight was further obtained through morphological assessment of treated cells at IC50 values using polarised light optical differential interference contrast (PlasDIC) microscopy. At 0.1 mM, all complexes induced a pronounced reduction in B16-F10 cell viability, with complexes 2 and 3 emerging as the most potent, achieving >90% inhibition after 72 h. Notably, early time-point IC50 values (24 h) revealed marked cytotoxicity in melanoma cells (complex 2: 0.04 mM; complex 3: 0.05 mM), while eliciting minimal effects in RAW 264.7 macrophages, indicating selective anti-cancer activity. Morphological analysis of B16-F10 cells demonstrated features consistent with both apoptosis (membrane blebbing, apoptotic bodies, nuclear fragmentation) and necrosis (cell swelling, debris). Cell cycle analysis demonstrated a general increase in the S phase in B16-F10 cells, indicative of replication stress or cell cycle arrest, whereas no significant changes were observed in RAW 264.7 cells. Collectively, complexes 2, 3, and 5, display a compelling combination of potency and selectivity towards B16-F10 melanoma cells, with reduced cytotoxicity towards non-cancerous RAW 264.7 cells. These results support the continued development of NHC-based metal complexes as promising selective anticancer agents and warrant further mechanistic and in vivo investigation. HIGHLIGHTS • Range of Rh and Ir metal complexes tested against B16F10 melanoma cells and non-cancerous RAW 264.7 macrophage cells with moderate activity (0.04–0.09 mM IC50) and high selectivity. • Morphological analysis of B16-F10 cells revealed both apoptotic (membrane blebbing, apoptotic bodies, nuclear fragmentation) and necrotic (cell swelling, debris) features. • Cell cycle analysis showed a general increase in S phase in B16-F10 cells and showed no significant changes in RAW 264.7 cells.
Peptide delivery in the management of diabetes : exploring bioinspired nanoarchitectures using stimuli-responsive materials and supramolecular depots
Abdullahi, Aliyu Dantani; Ibrahim, Mohammed Auwal; Serem, June Cheptoo (Elsevier, 2026-08-10)
Peptide therapeutics such as insulin and glucagon-like peptide-1 (GLP-1) analogues are central to diabetes management but remain constrained by rapid enzymatic degradation, poor epithelial permeability and short systemic half-life. Bioinspired nanoarchitectures have emerged as promising strategies to address these challenges by mimicking biological membranes, extracellular matrices and supramolecular peptide assemblies to enhance peptide stability, absorption and pharmacokinetic control. This review synthesised advances in membrane-mimetic lipid nanocarriers, polymer-based systems, peptide-driven self-assembling depots and stimuli-responsive nanoarchitectures. Lipid-inspired systems including hydrophobic ion-paired exenatide lipid nanocarriers achieved oral bioavailability of 16.3–27.9%. Comparably, polymer-based systems incorporating adaptive electrostatic or stimuli-responsive designs such as charge-switchable PCB122/INS nanoparticles coated capsules, enabled oral insulin bioavailability approaching ∼27%, translating into sustained glucose lowering effects in vivo. In addition, a polymeric D-PLA-PEG stereocomplex nanoassembly enabled ultra-long insulin release for up to 16 weeks following a single subcutaneous administration, maintaining controlled blood glucose levels in type 1 diabetic models. Peptide-driven supramolecular systems such as GLP-1 nanofibre hydrogels and cassette-assembled peptides demonstrated sustained glycaemic control lasting weeks to over 40 days in preclinical models. Interestingly, emerging glucose-responsive platforms including glucose oxidase-integrated hydrogels and ROS-responsive polymersomes, further enabled closed-loop insulin release with polymersomes releasing > 90% insulin under hyperglycaemic conditions. Importantly, several nanoarchitectures also supported cell-based therapies such as biomimetic pancreatic constructs combining stem-cell-derived islet cells with peptide-loaded nanomatrices to restore glycaemic regulation in type 1 diabetes models. Overall, these bioinspired platforms illustrate how nanomedicine can integrate barrier penetration, pharmacokinetic control and stimuli-responsive release to advance next-generation peptide delivery strategies for diabetes therapy. HIGHLIGHTS • Bioinspired nanoarchitectures improve peptide stability and delivery. • Lipid and polymeric systems enhance oral peptide bioavailability. • Self-assembling depots enable sustained peptide release. • Glucose-responsive platforms provide on-demand insulin release. • Biomimetic nanomatrices support cell-based diabetes therapies.
Computed tomography as a solution to skeletal collection limitations : exploring cranial variation in the South African population
Kruger, Gabriele Christa; Jantz, Richard L.; L'Abbe, Ericka Noelle (Springer, 2026)
Skeletal collections have provided the foundation for forensic anthropology in South Africa, offering invaluable reference material for developing and testing identification methods. However, these collections remain limited in both size and representativeness. Many are historically biased, restricted by donation practices, and unable to reflect the demographic and biological diversity of the country’s modern population. Indian South Africans, in particular, are notably absent due to cultural and religious beliefs that discourage body donation. This study explores the use of computed tomography (CT) as an alternative to overcome these limitations. A total of 408 high-resolution head CT scans representing Black, Coloured, Indian, and White South Africans were analysed using inter-landmark distances and geometric morphometrics. Measurement repeatability was high, with both intra- and inter-observer errors falling well within accepted forensic thresholds (< 2 mm; <3.5%). Significant population-level differences in cranial form were identified (p < 0.01). Black South Africans were consistently the most clearly differentiated group, while Coloured and Indian South Africans showed the greatest overlap, reflecting shared population affinity and historical admixture. Cross-validated classification accuracies ranged between 62% and 64%, indicating that both linear and shape-based analyses can capture relevant cranial variation. These results confirm that CT-derived data are reliable for examining cranial variation within contemporary South African samples and provide access to larger and more diverse datasets than traditional skeletal collections. This study establishes the first cranial reference data incorporating Indian South Africans and demonstrates how CT scanning can support the development of inclusive, population-specific standards for forensic anthropology in South Africa.
Evaluating the safe application of the Bridging Infix method for anterior pelvic fixation in relation to neighbouring anatomical structures
Van Schalkwyk, Jerolize; Keough, Natalie; Naicker, Jade; Strydom, Sven; Snyckers, Christian H.; Masenge, Andries; Mogale, Nkhensani (Elsevier, 2026-04)
BACKGROUND : Numerous techniques for anterior pelvic fixation exist, however, a novel minimally invasive subcutaneous technique, the Bridging Infix, has been proposed. Although, little is known regarding the risk of injury to anatomical structures in close proximity to the modified implant site. The current study aimed to assess the implant’s proximity to adjacent anatomical structures and palpable bony landmarks to ensure secure and safe fixation. METHODS : An anatomical study was conducted using 50 formalin-fixed cadavers and two fresh-frozen specimens. Dissections were performed to identify and measure the distances between the Bridging Infix implant and critical anatomical structures, including the iliohypogastric nerve, ilioinguinal nerve, superficial epigastric vessels, superficial circumflex iliac vessels, spermatic cord, and the femoral neurovascular bundle. Measurements were also taken between these anatomical structures and relevant bony landmarks. RESULTS : When the Bridging Infix was applied following accepted technical guidelines, no surrounding anatomical structures were compromised. The ilioinguinal and iliohypogastric nerves were shielded by the abdominal muscles and located, on average, 48.96 (SD ± 20.65, range: 10.21–85.26) mm and 31.55 (SD ± 14.45, range:7.42–72.89) mm from the anterior superior iliac spine (ASIS), respectively. The spermatic cord showed no signs of compression by the implant. The superficial epigastric vessels occasionally passed through the medial window field area, while the superficial circumflex iliac vessels were found near the ASIS and lateral window. Nevertheless, vessels can be easily cauterized or ligated when necessary, underscoring the importance of surgeons being familiar with these anatomical relations. In this case, the femoral vessels were positioned deep to the implant, with no gross evidence of direct contact or compression. CONCLUSION : Anatomical structures initially considered to be at risk during the placement of the Bridging Infix were observed to lie at an adequate distance from the fixation point, without macroscopic evidence of implant-related compression. Further studies are required to clinically validate these findings. HIGHLIGHTS • No anatomical structures were injured during the Bridging Infix proving it is a minimally invasive technique. • Requires surgical expertise, layer-by-layer dissection, full musculature retraction to avoid IHN and IIN injury. • Compression of the spermatic cord and femoral vessels was not observed. • Further quantitative analysis should be conducted to confirm findings and assess potential risks under varying conditions.
Fibre bundle morphology and aponeuroses of the soleus muscle in neonatal anatomical donors : a three-dimensional modelling study
Cronjé, Jessica Yvonne; Van Schoor, Albert-Neels; Uys, Andre; Yu, Paula JiaoJia; Tran, John; Mirjalili, S. Ali (Elsevier, 2026-08)
BACKGROUND : Changes in architectural parameters, including alterations in contractile and connective tissue elements, can impact the plantarflexion function of the soleus muscle in gait. To date, no architectural data or quantified observations of volumetric neonatal soleus fibre bundles could be found in the literature. The purpose of this study was therefore to document the musculoaponeurotic and musculotendinous structures of the neonatal soleus muscle by employing a serial digitization-dissection and three-dimensional modelling protocol. METHODS : Both the left and right soleus of four neonatal anatomical donors were serially dissected, each muscle fibre was digitized (MicroScribe® Digitizer), and the whole volume of fibre bundles modelled in Autodesk Maya®. RESULTS : Connective tissue footprint similarities and apparent differences in architectural parameters between adult and neonatal soleus muscles, and their individual structural partitions (marginal, posterior, and anterior) were noted. Whole muscle architectural parameters for the neonatal soleus suggest that the anterior partition contributes more during force-generation, while the posterior partition has relatively greater force-generating capacity. CONCLUSIONS : This study provides the first three-dimensional, whole-volume characterization of the neonatal soleus muscle, demonstrating that its marginal, posterior, and anterior partitions are structurally and architecturally distinct at birth. These findings establish a normative baseline for neonatal soleus architecture and indicate that regional specialization for force generation and excursion is intrinsically present prior to gait, forming the foundation for subsequent postnatal functional adaptation. HIGHLIGHTS • Architecturally distinct partitions of neonatal soleus show functional distinctions. • Neonatal soleus functional parameter key differences to adult soleus. • Soleus stability function as a developmental adaptation to weight-bearing. • Neuromuscular partitioning of the soleus observed from birth. • Post-weight-bearing functional development inferred by neuromuscular partitioning.
Evaluation of relevant anatomy for cervical erector spinae plane block using paediatric computed tomography scans
Nel, Adri; Van Schoor, Albert-Neels; Farhana Ebrahim; Bösenberg, Adrian T.; Govender, Sabashnee (Korean Association of Anatomists, 2026-06)
The primary aim of this study was to provide foundational anatomical knowledge that may be valuable when performing a cervical erector spinae plane block (ESPB) with or without ultrasound guidance in a paediatric sample. This included measuring the distance from the spinous process to the tip of the transverse process at the C6 and C7 vertebral levels, the depth from the skin to the most medial points of the erector spinae muscle, and the most posterior points of the sternocleidomastoid muscle at the C6 and C7 vertebral levels. Ninety axial computed tomography (CT) images were randomly selected from the database of radiographic images at the Department of Radiology, Steve Biko Academic Hospital. The age and sex of the patients were recorded. The 90 axial CT scans consisted of 30 scans for each of the age groups defined by the American Medical Association, i.e., neonates (age range: 0-2 months), infants (age range: 2 months-2 years), and children (age range: 2-12 years). Gridlines were placed over the tips of the left and right transverse processes to ensure that points were perpendicular to the structure, and various measurements were taken bilaterally. Significant differences were observed between the majority of the measurements for the different age groups. Statistically significant differences were observed between the measurements for males and females in some instances. These results provide pediatric anesthesiologists with useful anatomical reference data when performing a cervical ESPB at vertebral level C6 or C7, particularly where ultrasound guidance is not available.
Anatomy of the sural nerve in a sample of South African human adult cadavers
Harangee, Jayshree; Venter, Gerda (Korean Association of Anatomists, 2026-03-31)
The sural nerve (SN) is a sensory nerve in the lower limb with notable variability in its origin, course, and branching patterns. This variability has important implications for diagnostic procedures, nerve grafting, and surgical planning, yet it remains underexplored in Southern African populations. This cadaveric study examined 90 lower limbs from 45 embalmed adult human cadavers (24 males, 21 females) at the University of Pretoria in South Africa. Each specimen was assessed for SN formation type, anatomical location, and morphometric data, including its contributing branches (medial sural cutaneous nerve [MSCN] and lateral sural cutaneous nerve [LSCN]). Measurements were recorded, and bilateral symmetry and sex-based differences were analyzed. Four SN formation types were identified, with Type 1 (union of MSCN and LSCN) being most common (62.2%). Formation most frequently occurred in the middle third of the leg (38.9%), although distribution across the middle, lower, and ankle levels was more evenly spread than in other populations. Bilateral symmetry in SN formation was seen in only 40% of cadavers. The average SN length was 100.1 mm and the mean distance from the lateral malleolus was 27.2 mm. This study confirms high anatomical variability of the SN among South African cadavers, and understanding such variation is crucial for clinicians performing nerve grafting or procedures in the distal leg. These findings may enhance surgical planning and education by emphasizing region-specific anatomical variation.
Anatomical evaluation of the greater occipital nerve block using embalmed neonatal cadavers
Prigge, Lané; Ayres, Amelia; Bosenberg, Adrian T.; Van Schoor, Albert-Neels (AOSIS, 2026-06-27)
BACKGROUND : The greater occipital nerve block is indicated for pain relief in children undergoing, among others, posterior fossa craniotomies. This nerve, which arises from the C2 spinal nerve, travels alongside the occipital artery and provides sensation to the posterior scalp. AIM : The aim of this study was to anatomically determine the location of the greater occipital nerve and accompanying occipital artery, as it travels through the hiatus in the trapezius muscle aponeurosis, in the occipital region, in embalmed neonatal cadavers. SETTING : Study was conducted at the Department of Anatomy, University of Pretoria, South Africa. METHODS : Following ethical approval, the greater occipital nerve and occipital artery were bilaterally dissected and exposed in 35 embalmed neonatal cadavers from the Department of Anatomy at the University of Pretoria. The distance between the external occipital protuberance, the rudimentary mastoid process and the greater occipital nerve was measured, while the relationship between the neurovascular structures was observed. RESULTS : The greater occipital nerves were found to be on average 19.85 mm ± 4.70 mm from the external occipital protuberance in neonates, while the external occipital protuberance and rudimentary mastoid process are 42.55 mm ± 8.46 mm apart. In 77.3% of the specimens, the greater occipital nerve was located medial to the occipital artery, while in the remaining cases, the artery lies between the cutaneous branches of the greater occipital nerve at the trapezius muscle hiatus. CONCLUSION : In this neonatal sample, the greater occipital nerve is located at the approximate mid-point of the line between the external occipital protuberance and rudimentary mastoid process. CONTRIBUTION : Careful aspiration is recommended, because the greater occipital nerve is not always located medial to the occipital artery.
Effects of seated whole-body vibration on the lumbar spine : a Sprague-Dawley animal model
König, Anya; Kat, Cor-Jacques; Myburgh, Jolandie; Keough, Natalie; Oberholzer, Hester Magdalena; Myburgh, Jolandie (Elsevier, 2026-05)
Seated whole-body vibration (WBV) is often experienced by individuals, most commonly as vehicle occupants. Understanding the long-term health implications of WBV is crucial for assessing human well-being. This study investigates the effect of seated WBV on bone and intervertebral disc (IVD) properties in the lumbar spine using a novel seated Sprague-Dawley rat model. Ten-week-old male Sprague-Dawley rats (n = 24) were used. The experimental group (EG, n = 18) were exposed to WBV in a seated position using a custom designed seated rat vibration apparatus. Control group one (C1, n = 3) were placed in a stationary capsule, while control group two (C2, n = 3) remained in their cages throughout the study. X-ray images were taken weekly to track changes in IVD thickness (also termed IVD height in humans) and lumbar spine superior- and inferior endplate (SEP and IEP) bone mineral density (BMD) during the 8-week period. The applied WBV resulted in significant differences in both the SEP BMD and IVD thickness of the Sprague-Dawley rat lumbar spine towards the end of the test. No notable changes in IEP BMD were observed. The findings align with existing literature on the biological effects of WBV on the lumbar spine, emphasizing the importance of understanding the relationship between seated WBV and lumbar spine BMD and IVD thickness. The novel animal model enables research into understanding this relationship and the relationship between exposure and rest periods, particularly to identify optimal exposure-rest ratios that minimize harmful effects on the spine.
The anatomical spread of a simulated ultrasound-guided erector spinae fascial plane block in the cervical region in neonatal cadavers observed through cone beam computed tomography scans
Nel, Adri; Van Schoor, Albert-Neels; Uys, Andre; Bosenberg, Adrian; Govender-Davies, Sabashnee (AOSIS, 2026-05-06)
BACKGROUND : The erector spinae plane block (ESPB), a novel anaesthetic technique, has been shown to be a safer alternative to neuraxial and paravertebral blocks in adults. The exact mechanism of action of the ESPB in the cervical region – performed at the C6 and C7 vertebral levels – remains unclear in both adult and paediatric patients. AIM : The aim of this study was to determine the spread of a simulated cervical ESPB in a neonatal sample and to translate the clinical relevance of the anatomical findings for anaesthesia providers. SETTING : Study was conducted at the Department of Anatomy, Faculty of Health Sciences, University of Pretoria, South Africa. METHODS : Nine fresh-frozen low-normal birth weight neonatal cadavers were injected with contrast medium (0.1 mL/kg) at both C6 (anterior tubercle of the transverse process) and C7 (transverse process) vertebral levels. The ultrasound-guided injections were done with the cadavers in a prone position, utilising a 5 cm 22G Tuohy needle. Following the injections, cone-beam computed tomography scans were performed using the Planmeca G7 scanner, operated with Romexis software (version 6.4.5.136; Planmeca, Helsinki, Finland). RESULTS : Twelve simulated blocks were performed; seven at C6 and five at C7. The contrast medium spread most consistently between the C5 and C7 levels when performing the simulation at the C6 vertebral level and between C6 and T1 when performing the simulation at the C7 vertebral level. CONCLUSION : The study results suggest that the cervical ESPB may be a promising regional anaesthesia technique for neonates and infants undergoing procedures involving the cervical spine or upper limbs. CONTRIBUTION : This study offers valuable anatomical insights into the cervical ESPB in a neonatal cadaveric sample, demonstrating the consistent spread of the contrast medium across the C5–C7 dermatomes, with additional, less consistent spread observed from C2 to T1.
A robust forensic reasoning to estimate the minimum number of individuals : the certain exclusion
Knecht, Siam; Biehler-Gomez, Lucie; Krüger, Gabriele Christa; Liebenberg, Leandi; Ouladsine, Mustapha; Cattaneo, Cristina; Roman, Christophe; Adalian, Pascal (Springer, 2026-06)
Estimating the Minimum Number of Individuals (MNI) in commingled skeletal assemblages is a core task in forensic and archaeological anthropology. Traditional methods, based on the frequency of lateralized elements, often suffer from underestimation due to fragmentation and morphological similarity. This study introduces a new MNI estimation method grounded in the principle of certain exclusion (with a 99% confidence interval), which focuses on detecting osteometric incompatibilities between elements rather than identifying matches. We developed linear regression models based on a large international dataset (n = 2,969 individuals) to generate 99% prediction intervals between long bone measurements. A recursive protocol, termed Allometric Research by Exclusion (RAE), was implemented to isolate bones that cannot belong to the same individual. The method was validated via bootstrap simulations using independent samples from the Milano and Pretoria Bone collections. Across all assemblages, the exclusion-based MNI estimates were consistently higher than those obtained by frequency-based methods, and more closely approximated the real number of individuals. This trend was especially clear in small to mid-sized assemblages, where precise MNI estimation is most critical. The exclusion method offers a statistically grounded, replicable, and conservative approach to MNI estimation. Its integration into forensic and archaeological workflows may enhance the accuracy and defensibility of population reconstruction in complex contexts.
Refinement of the Bayesian probabilistic framework for forensic adult age-at-death estimation using dentin translucency in intact-single rooted teeth
Parra, Roberto C.; Garizoain, Gonzalo; Aranda, Claudia M.; L'Abbe, Ericka Noelle; Marques, Carina; Gualdi-Russo, Emanuela; Caldas, Ines; Giannotti, Pablo Sebastian; Mansegosa, Daniela; Ubelaker, Douglas H.; Rodriguez, Pablo A.; Adserias-Garriga, Joe; Pinto, Paulo Henrique Viana; Moraitis, Konstantinos; Zorba, Eleni; Escalante-Florez, Karen; Mishra, Manusmrati; Condori, Lucio A.; Bertrand, Benoit; Moyano, Glicerio Alberto Rosas; Flores, Carmen Hernandez; Retana-Milan, Fernando; Rivera, Claudia; Peccerelli, Freddy; Da Silva, Ricardo Henrique Alves; Baccino, Eric; Luna, Leandro H. (Elsevier, 2026-08)
This study refines a Bayesian probabilistic framework for adult age-at-death estimation based on root dentin translucency (RDT). Model comparison using the Bayesian Information Criterion demonstrated that a univariate model relying solely on RDT was the most parsimonious and efficient, achieving an R² of 63.60%. The framework was validated through entirely external samples: a Peruvian case study, and samples from Brazil (N = 247), the UK (N = 113), and Guatemala (N = 302). Bayesian updating using data from the Forensic International Dental Database (FIDB; N = 4522) substantially increased the strength of the evidence, with Likelihood Ratios rising from a mean of 2160 to nearly 10,000, elevating the inference to a level of very strong support and extremely strong support. Results confirmed the inter-population stability of the model and its capacity to mitigate the characteristic trajectory effect of overestimation in young adults and underestimation in older adults. This approach provides a transparent, robust, and globally applicable tool for forensic anthropology, successfully balancing statistical rigor with practical utility. Furthermore, it establishes a foundational platform, named BayAD, that enables the future integration of additional skeletal traits within an age-at-death estimation framework. HIGHLIGHTS • A simplified Bayesian model using Root Dentin Translucency is efficient for age estimation. • The model shows high inter-population robustness across geographically diverse samples. • Bayesian updating with reference data increases evidentiary strength by more than fourfold. • The approach mitigates systematic bias of over- and underestimation at age extremes. • It provides a platform for integrating multi-trait skeletal evidence.
The therapeutic potential of polyphenols for targeting methylglyoxal and the associated glycation pathways : a review
Ndalane, Refilwe Joy; Ntuli, Sunday; Oberholzer, Hester Magdalena; Bester, Megan Jean; Serem, June Cheptoo (Elsevier, 2026-06)
Methylglyoxal (MGO) is a highly reactive α-dicarbonyl compound and a major reactive carbonyl species (RCS), implicated in glycation and associated diseases. MGO readily reacts with protein nucleophilic sites, leading to the formation of advanced glycation end products (AGEs), that activate pro-inflammatory signalling pathways, induce oxidative stress, causing cellular dysfunction leading to cell death. Although endogenous detoxification systems, such as the glyoxalase pathway and aldehyde dehydrogenase, play a key role in neutralising MGO, under pathological conditions, these mechanisms are often not sufficient. The synthetic AGE inhibitor, aminoguanidine, effectively reduces MGO and AGE accumulation but due to safety concerns further clinical studies were terminated. Consequently, polyphenols have emerged as promising alternatives due to their safety profile and ability to trap MGO; up- and down-regulate associated antioxidant and inflammatory respectively. This review provides evidence-based insights on the trapping potential of polyphenols, effectively reduce the effects of MGO, and includes the mechanisms of interaction and the associated pathways. The MGO-trapping and pathway regulation by polyphenols is a novel and possibly an effective approach to prevent or reduce RCS-induced adverse effects thereby promoting metabolic health.
Mapping out the axillary nerve : a cadaveric study
Lottino, Bronwyn; Naicker, Jade; Hohmann, Erik; Mogale, Nkhensani (Elsevier, 2026-04)
INTRODUCTION : The axillary nerve is a crucial peripheral branch arising from the posterior cord of the brachial plexus. It provides both motor and sensory innervation to the shoulder girdle, enabling essential movements such as abduction and external rotation—functions that are crucial for daily activities and various athletic movements. Despite its significance, detailed documentation of the axillary nerve's branching patterns remains limited. This study aimed to examine the branching configurations of the axillary nerve in a South African cadaveric sample. MATERIALS AND METHODS : Thirty adult cadavers (15 females and 15 males) were examined. To minimise the risk of damaging the axillary nerve during dissection, key surface anatomy landmarks—including the acromion and coracoid process—were identified and marked, enabling accurate location of the nerve as it traversed the deltoid muscle. Dissection followed established protocols, involving careful incision and reflection of the deltoid and pectoral muscles to expose the axillary nerve and associated neurovascular structures. RESULTS : The study identified and classified four distinct axillary nerve branching patterns. Type 1, in which the nerve branches before entering the quadrangular space, was observed in 16.67% of cases. Type 2, characterized by branching within the quadrangular space, was noted in 18.33%. Type 3, where branching occurred after exiting the quadrangular space, was observed in 25.00%. Type 4, a combination of the previous three patterns, was the most prevalent, occurring in 40.00% of specimens. No significant differences were observed between the left and right shoulders regarding branching pattern (p = 0.9998). However, a significant difference was found in the overall distribution of branching types across all categories (p = 0.01299). CONCLUSION : These findings suggest that the axillary nerve does not exhibit a definitive branching pattern, highlighting the anatomical complexity and variability of this structure. This underscores the need for a more nuanced and comprehensive classification system when analyzing the axillary nerve morphology. HIGHLIGHTS • Four distinct axillary nerve branching patterns were identified, refining the anatomical framework for clinical use. • Mixed branching pattern (Type 4) was the most common (40.00 %), highlighting significant morphological variability. • No sex-based differences observed; significant variation found in the branching pattern between left and right sides.
Constructing mathematical models from small data sets : cell-viability model of melanoma under inhibition by MAZ-51
Anguelov, Roumen; Basson, Charlise; Bipath, Priyesh; Hlophe, Yvette Nkondo; Nadasen, Carolyn Courtney; Phiri, Avulundiah Edwin; Serem, June Cheptoo (EDP Sciences, 2026-01)
The synthetic indolinone derivative MAZ-51 is a selective inhibitor of vascular endothelial growth factor receptor 3 (VEGFR-3), a tyrosine kinase receptor essential for lymphangiogenesis and tumor progression. By competing with adenosine triphosphate (ATP) for VEGFR-3 binding, MAZ-51 blocks VEGF-C activity, thereby suppressing melanoma cell proliferation and promoting apoptosis. In this study, we employ mathematical modelling to quantify the inhibitory effects of MAZ-51 on the growth of B16-F10 melanoma cells. Cell viability is modeled as a function of both treatment duration and inhibitor concentration, providing a dynamic framework for assessing therapeutic efficacy. Our approach addresses a central challenge in mathematical biology: developing models that remain interpretable and predictive despite limited and variable data. By integrating biological insight with experimental data, we derive a parsimonious model that avoids overparameterization and yields biologically meaningful parameters. The model allows straightforward computation of pharmacological measures such as the half-maximal inhibitory concentration (IC50) and provides deeper insight into the growth rate reduction of melanoma cells under VEGFR-3 inhibition. This work highlights the utility of mathematical modelling in elucidating drug action mechanisms and in quantitatively evaluating targeted cancer therapies.
Variations in the length and anatomy of the common iliac vessels and their clinical consideration during anterior pelvic approaches
Cronjé, Jessica Yvonne; Naicker, Jade; Matshidza, Steven; Tshabalala, Zithulele Nkosinathi; Mogale, Nkhensani (Elsevier, 2026-06)
The bifurcation and confluence of the common iliac vessels and their course are critical considerations for safe surgical acetabular fracture repair. Anatomical variations in the expected placement of these vessels have been associated with intraoperative complications, including hemorrhage. The purpose of this study was therefore to define vertebral levels of bifurcation and confluence of the common iliac vessels and trace their passage across the quadrilateral plate, a surgically significant landmark. The findings revealed 57% and 11% of bifurcation and confluence, respectively, were located at vertebral levels higher than the commonly reported level of L4. Variations were also more common than previous reports, with the current study observing cases of absent common iliac veins and aberrant communicating veins. The course trajectories revealed 10.6% of the study sample would have been predisposed to surgical complications involving the common iliac vessels. HIGHLIGHTS • The findings revealed 57% and 11% of bifurcation and confluence were located at higher vertebral levels. • The course trajectories revealed 10.6% of the sample is predisposed to complications involving the common iliac vessels. • The lengths of the vessels can extend more than 10 cm into the pelvis and may intercept the quadrilateral plate. • Patient demographics like age and sex influence the anatomy and morphology of these vessels.

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