Pub Date : 2025-11-28DOI: 10.1016/j.aanat.2025.152757
Gloria Maria Hohenberger , Marco Johannes Maier , Michael Pretterklieber , Niels Hammer , Bettina Pretterklieber
Purpose
The common peroneal nerve (CPN) and the superficial peroneal nerve (SPN) are among the most commonly iatrogenically injured peripheral nerves. The aim of this study was to localize the division point of the CPN into the deep peroneal nerve (DPN) and SPN and the exit point of the SPN through the crural fascia in relation to the length of the fibula.
Methods
101 lower extremities were included in this given study. The distance between the apex of the fibular head and the distal tip of the lateral malleolus was defined as the fibular length (FL). Measurements were taken from the apex of the fibular head to the division site of the CPN and from the tip of the lateral malleolus and the perforation point of the SPN. Data were projected proportionally along the FL and analysed using Dirichlet regression models. The rationale behind this approach was to predict the location of these anatomical characteristics in a reliable manner. Due to variations of anatomical structures depending on body length (e.g., taller people tend to have longer fibulae), it is reasonable to assume that the CPN's/SPN's location may also vary proportionally and is not fixed in relation to the lateral malleolus.
Results
The mean FL was 37.2 cm (SD: 2.8; median: 36.9; range: 32.4–45.6; IQR: 3.6). The CPN’s division point was located at a mean of 3.3 cm (SD: 1.2; median: 3.2; range: 1.6 cm proximal to 8.2 cm distal to the tip; IQR: 1.3) distal to the apex of the fibular head, which corresponded to an interval between 3.9 % and 15.9 % of the FL, starting from the same landmark. The exit point of the SPN was at an average length of 17.1 cm (SD: 4.5; median: 17.1; range: 7–23.7; IQR: 7.9) proximal to the tip of the lateral malleolus, matching a proportional interval between 23.9 % and 69.0 % of the FL. Concerning the division point of the CPN, there was less precision (i.e., more variance) in females (p = .042) and right-sided specimens (p = .007), compared to male left-sided specimens. Regarding the SPN’s perforation point, compared to fixation with ethanol and left-sided specimens, the diversion point was higher in Thiel-specimens (p = .034) and the interaction (Thiel on the right side; p = .029).
Conclusion
The current results offer easily applicable data for intraoperative localisation of the peroneal nerve’s main portions at risk.
{"title":"Proportional localisation of the peroneal nerve along the fibula","authors":"Gloria Maria Hohenberger , Marco Johannes Maier , Michael Pretterklieber , Niels Hammer , Bettina Pretterklieber","doi":"10.1016/j.aanat.2025.152757","DOIUrl":"10.1016/j.aanat.2025.152757","url":null,"abstract":"<div><h3>Purpose</h3><div>The common peroneal nerve (CPN) and the superficial peroneal nerve (SPN) are among the most commonly iatrogenically injured peripheral nerves. The aim of this study was to localize the division point of the CPN into the deep peroneal nerve (DPN) and SPN and the exit point of the SPN through the crural fascia in relation to the length of the fibula.</div></div><div><h3>Methods</h3><div>101 lower extremities were included in this given study. The distance between the apex of the fibular head and the distal tip of the lateral malleolus was defined as the fibular length (FL). Measurements were taken from the apex of the fibular head to the division site of the CPN and from the tip of the lateral malleolus and the perforation point of the SPN. Data were projected proportionally along the FL and analysed using Dirichlet regression models. The rationale behind this approach was to predict the location of these anatomical characteristics in a reliable manner. Due to variations of anatomical structures depending on body length (e.g., taller people tend to have longer fibulae), it is reasonable to assume that the CPN's/SPN's location may also vary proportionally and is not fixed in relation to the lateral malleolus.</div></div><div><h3>Results</h3><div>The mean FL was 37.2 cm (SD: 2.8; median: 36.9; range: 32.4–45.6; IQR: 3.6). The CPN’s division point was located at a mean of 3.3 cm (SD: 1.2; median: 3.2; range: 1.6 cm proximal to 8.2 cm distal to the tip; IQR: 1.3) distal to the apex of the fibular head, which corresponded to an interval between 3.9 % and 15.9 % of the FL, starting from the same landmark. The exit point of the SPN was at an average length of 17.1 cm (SD: 4.5; median: 17.1; range: 7–23.7; IQR: 7.9) proximal to the tip of the lateral malleolus, matching a proportional interval between 23.9 % and 69.0 % of the FL. Concerning the division point of the CPN, there was less precision (i.e., more variance) in females (p = .042) and right-sided specimens (p = .007), compared to male left-sided specimens. Regarding the SPN’s perforation point, compared to fixation with ethanol and left-sided specimens, the diversion point was higher in Thiel-specimens (p = .034) and the interaction (Thiel on the right side; p = .029).</div></div><div><h3>Conclusion</h3><div>The current results offer easily applicable data for intraoperative localisation of the peroneal nerve’s main portions at risk.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"264 ","pages":"Article 152757"},"PeriodicalIF":1.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-28DOI: 10.1016/j.aanat.2025.152765
Qian Wu, Ying Wei, Zhenlong Zhao, Wenjia Cai, Jie Wu, Shiliang Cao, Na Yu, Tianhao Cong, Lili Peng, Yan Li, Shuqi Li, Ming’an Yu
Background
The in vivo lymphatic drainage pattern of the thyroid gland is a critical but poorly understood determinant of prognosis in papillary thyroid carcinoma (PTC), as conventional imaging cannot dynamically visualize these pathways. This study aimed to systematically characterize these patterns using lymphatic contrast-enhanced ultrasound (LCEUS).
Methods
This prospective study enrolled 30 PTC patients. A microbubble contrast agent was injected into the tumor-bearing lobe. The origin, anatomical course, and terminal draining lymph nodes (LNs) of lymphatic vessels (LVs) were dynamically observed and quantitatively analyzed.
Results
Following injection, complete enhancement of the ipsilateral lobe was achieved in all cases. Contralateral communication was observed in 76.7 % (23/30) of patients. LVs originated evenly from all poles (P ≥ 0.05). The "Anterior to Carotid" course was the most prominent pathway for LVs (P < 0.05). Levels III and IV were the primary draining basins for LNs (P < 0.05). Notably, a significant right-sided predominance in the total number of draining LNs was identified (median 8.0 vs. 4.0; P = 0.005). No drainage to Level V was observed. No significant differences were found in patients with or without Hashimoto's thyroiditis.
Conclusion
LCEUS provides the first detailed, real-time map of thyroid lymphatic drainage, revealing a high incidence of contralateral communication and a previously uncharacterized right-sided anatomical predominance. These findings challenge conventional concepts of lymphatic compartmentalization and establish a novel methodology for lymphatic research.
甲状腺的体内淋巴引流模式是甲状腺乳头状癌(PTC)预后的一个关键但鲜为人知的决定因素,因为常规成像不能动态地显示这些途径。本研究旨在利用淋巴造影增强超声(LCEUS)系统地表征这些模式。方法本前瞻性研究纳入30例PTC患者。将微泡造影剂注入肿瘤叶。动态观察淋巴管(lv)的起源、解剖走向及末梢引流淋巴结(LNs),并进行定量分析。结果注射后,所有病例的同侧肺叶均得到完全增强。76.7 %(23/30)患者有对侧通信。LVs均匀地来自各极点(P ≥ 0.05)。颈动脉前段是LVs最主要的通路(P <; 0.05)。III级和IV级是LNs的主要排水流域(P <; 0.05)。值得注意的是,在引流LNs总数中发现了显著的右侧优势(中位数8.0 vs. 4.0; P = 0.005)。未见引流至V级。桥本甲状腺炎患者与非桥本甲状腺炎患者无显著差异。结论lceus提供了第一个详细的实时甲状腺淋巴引流图,揭示了对侧交通的高发生率和以前未发现的右侧解剖优势。这些发现挑战了淋巴区隔的传统概念,并为淋巴研究建立了一种新的方法。
{"title":"Characterization of thyroid lymphatic drainage on real-time contrast-enhanced ultrasound: A mapping study in vivo","authors":"Qian Wu, Ying Wei, Zhenlong Zhao, Wenjia Cai, Jie Wu, Shiliang Cao, Na Yu, Tianhao Cong, Lili Peng, Yan Li, Shuqi Li, Ming’an Yu","doi":"10.1016/j.aanat.2025.152765","DOIUrl":"10.1016/j.aanat.2025.152765","url":null,"abstract":"<div><h3>Background</h3><div>The in vivo lymphatic drainage pattern of the thyroid gland is a critical but poorly understood determinant of prognosis in papillary thyroid carcinoma (PTC), as conventional imaging cannot dynamically visualize these pathways. This study aimed to systematically characterize these patterns using lymphatic contrast-enhanced ultrasound (LCEUS).</div></div><div><h3>Methods</h3><div>This prospective study enrolled 30 PTC patients. A microbubble contrast agent was injected into the tumor-bearing lobe. The origin, anatomical course, and terminal draining lymph nodes (LNs) of lymphatic vessels (LVs) were dynamically observed and quantitatively analyzed.</div></div><div><h3>Results</h3><div>Following injection, complete enhancement of the ipsilateral lobe was achieved in all cases. Contralateral communication was observed in 76.7 % (23/30) of patients. LVs originated evenly from all poles (P ≥ 0.05). The \"Anterior to Carotid\" course was the most prominent pathway for LVs (P < 0.05). Levels III and IV were the primary draining basins for LNs (P < 0.05). Notably, a significant right-sided predominance in the total number of draining LNs was identified (median 8.0 vs. 4.0; P = 0.005). No drainage to Level V was observed. No significant differences were found in patients with or without Hashimoto's thyroiditis.</div></div><div><h3>Conclusion</h3><div>LCEUS provides the first detailed, real-time map of thyroid lymphatic drainage, revealing a high incidence of contralateral communication and a previously uncharacterized right-sided anatomical predominance. These findings challenge conventional concepts of lymphatic compartmentalization and establish a novel methodology for lymphatic research.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"264 ","pages":"Article 152765"},"PeriodicalIF":1.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-27DOI: 10.1016/j.aanat.2025.152756
Ehsanullah , Bakhtawar Maqbool , Muhammad Imran Arshad , Nagah M. Abourashed , Shafia Tehseen Gul
Background
The use of artificial intelligence (AI) also playing a significant role in veterinary medicine due to the changing pattern of diseases in terms of climatic changes and advances in treatment protocols. About 60 % of emerging human diseases are zoonotic mainly originating from animals, so the conventional diagnostic tools and traceability protocols are not fast enough, precise and lack of ability to handle large number of cases. Use of AI tools can make a big difference in diagnosis of diseases/problems through diagnostic images, predicting outbreaks through the data from previous records ultimately leading to improved monitoring of zoonotic diseases in terms of early warning systems for future outbreaks, multisectoral collaborations to improve the health of humans, animals and environments. In diagnosis, AI shows great effectiveness, like being able to spot more than 90 % of bone and joint issues in X-rays, predicting sickness in farm animals up to two to three days before they show symptoms, and even predicting animal diseases those can transmitted to humans up to weeks in advance by looking at data about the environment changes and animals’ movements. But adoption to these AI systems is still not common because of many reasons including scattered data, lack of understanding about algorithms, ethical issues, and unequal access to technology etc.
Conclusions
As climate change speeds up the spread of diseases from animals to humans, AI is becoming a crucial tool for reaching health goals that affect both people and animals. But this will happen only if AI is used fairly and responsibly. This summary shows that working together across different fields is important to combine new technology with expert knowledge from vets. The goal is to use AI to support, not take over, what doctors do, and to make advanced care available to everyone around the world.
{"title":"Role of artificial intelligence in veterinary anatomical diagnostics and zoonotic disease monitoring","authors":"Ehsanullah , Bakhtawar Maqbool , Muhammad Imran Arshad , Nagah M. Abourashed , Shafia Tehseen Gul","doi":"10.1016/j.aanat.2025.152756","DOIUrl":"10.1016/j.aanat.2025.152756","url":null,"abstract":"<div><h3>Background</h3><div>The use of artificial intelligence (AI) also playing a significant role in veterinary medicine due to the changing pattern of diseases in terms of climatic changes and advances in treatment protocols. About 60 % of emerging human diseases are zoonotic mainly originating from animals, so the conventional diagnostic tools and traceability protocols are not fast enough, precise and lack of ability to handle large number of cases. Use of AI tools can make a big difference in diagnosis of diseases/problems through diagnostic images, predicting outbreaks through the data from previous records ultimately leading to improved monitoring of zoonotic diseases in terms of early warning systems for future outbreaks, multisectoral collaborations to improve the health of humans, animals and environments. In diagnosis, AI shows great effectiveness, like being able to spot more than 90 % of bone and joint issues in X-rays, predicting sickness in farm animals up to two to three days before they show symptoms, and even predicting animal diseases those can transmitted to humans up to weeks in advance by looking at data about the environment changes and animals’ movements. But adoption to these AI systems is still not common because of many reasons including scattered data, lack of understanding about algorithms, ethical issues, and unequal access to technology etc.</div></div><div><h3>Conclusions</h3><div>As climate change speeds up the spread of diseases from animals to humans, AI is becoming a crucial tool for reaching health goals that affect both people and animals. But this will happen only if AI is used fairly and responsibly. This summary shows that working together across different fields is important to combine new technology with expert knowledge from vets. The goal is to use AI to support, not take over, what doctors do, and to make advanced care available to everyone around the world.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"264 ","pages":"Article 152756"},"PeriodicalIF":1.7,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-27DOI: 10.1016/j.aanat.2025.152755
Nicole Gumprecht , Anna Weber , Christoph Bourauel , Istabrak Dörsam
Here we evaluated the retention of two implant-supported overdenture attachment systems - Locator and CM-LOC - on edentulous mandibular models. We compared the retention force between these systems based on implant number and position, addressing complications like loss of retention and ease of denture removal. Implants were placed in various configurations (two, three or four implants) and two attachment systems were tested using different retention inserts. Locator system generally provided higher pull-off forces than the CM-LOC system, especially with the red and transparent inserts. However, the CM-LOC system showed less complications, such as loss of retention element. In terms of axial and non-axial pull-off tests, Locator system performed better than the CM-LOC system, particularly in the non-axial direction, which closely reflects real-life conditions. The results showed that implant angulation and choice of attachment system were critical factors influencing resulting retention forces. Overall, the study concluded that while the Locator system achieved high retention forces, the CM-LOC system had less complications and might be a better option for patients with difficulties in denture removal.
{"title":"Investigation of the pull-off forces for implant-supported overdentures with two resilient attachment systems","authors":"Nicole Gumprecht , Anna Weber , Christoph Bourauel , Istabrak Dörsam","doi":"10.1016/j.aanat.2025.152755","DOIUrl":"10.1016/j.aanat.2025.152755","url":null,"abstract":"<div><div>Here we evaluated the retention of two implant-supported overdenture attachment systems - Locator and CM-LOC - on edentulous mandibular models. We compared the retention force between these systems based on implant number and position, addressing complications like loss of retention and ease of denture removal. Implants were placed in various configurations (two, three or four implants) and two attachment systems were tested using different retention inserts. Locator system generally provided higher pull-off forces than the CM-LOC system, especially with the red and transparent inserts. However, the CM-LOC system showed less complications, such as loss of retention element. In terms of axial and non-axial pull-off tests, Locator system performed better than the CM-LOC system, particularly in the non-axial direction, which closely reflects real-life conditions. The results showed that implant angulation and choice of attachment system were critical factors influencing resulting retention forces. Overall, the study concluded that while the Locator system achieved high retention forces, the CM-LOC system had less complications and might be a better option for patients with difficulties in denture removal.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"264 ","pages":"Article 152755"},"PeriodicalIF":1.7,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.aanat.2025.152754
Grzegorz Fibiger , Katarzyna Majka , Jonasz Tempski , Miłosz Czeliński , Jakub Obrzut , Maksymilian Osiowski , Aleksander Osiowski , Szymon Matejuk , Tetiana Tkachuk , Tomasz Kozioł , Dominik Taterra , Jerzy A. Walocha , Przemysław Pękala , Wojciech Fibiger
Background
Sesamoid bones are small, tendon-embedded bones in the hand, which play a role in reducing friction and redirecting tendon forces. Their variable presence highlights the need for detailed anatomical knowledge, particularly for radiologists and orthopedic specialists diagnosing conditions in this region. Given their significance in both diagnostic and surgical contexts, an updated meta-analysis on this issue is highly important.
Methods
A large-scale search through the major databases was conducted with no date or language restrictions to determine and pool all available and relevant data. Anatomical Quality Assessment Tool was used to assess the quality of included studies.
Results
A total of 29 studies were included (n = 15011 hands). The prevalence of sesamoid bone at 1st metacarpophalangeal joint (MCP) was 99.85 % (95 %CI: 99.7–99.95), 2nd MCP was 39.49 % (95 %CI: 35.31–43.76), 3rd was 1.74 % (95 %CI: 1.24–2.32), 4th was 0.64 % (95 %CI: 0.38–0.96), 5th 52.22 % (95 %CI: 45.36–59.04) and 1st interphalangeal joint was 48.03 % (95 %CI: 37.00–59.16). Our analysis showed that in total of 0.09 % of hands (95 %CI: 0.01–0.22) no sesamoid bones were found. Furthermore, no significant differences in balance could be found when comparing the left (0.30 %, 95 %CI: 0.00–0.81) and the right (0.13 %, 95 %CI: 0.00–0.36) hand.
Conclusion
Understanding sesamoid bones variability might be crucial for anatomical insight and clinical diagnosis, particularly in orthopedics or radiology.
{"title":"Prevalence, variability, and clinical anatomy of the sesamoid bones of the hand: A systematic review and meta-analysis","authors":"Grzegorz Fibiger , Katarzyna Majka , Jonasz Tempski , Miłosz Czeliński , Jakub Obrzut , Maksymilian Osiowski , Aleksander Osiowski , Szymon Matejuk , Tetiana Tkachuk , Tomasz Kozioł , Dominik Taterra , Jerzy A. Walocha , Przemysław Pękala , Wojciech Fibiger","doi":"10.1016/j.aanat.2025.152754","DOIUrl":"10.1016/j.aanat.2025.152754","url":null,"abstract":"<div><h3>Background</h3><div>Sesamoid bones are small, tendon-embedded bones in the hand, which play a role in reducing friction and redirecting tendon forces. Their variable presence highlights the need for detailed anatomical knowledge, particularly for radiologists and orthopedic specialists diagnosing conditions in this region. Given their significance in both diagnostic and surgical contexts, an updated meta-analysis on this issue is highly important.</div></div><div><h3>Methods</h3><div>A large-scale search through the major databases was conducted with no date or language restrictions to determine and pool all available and relevant data. Anatomical Quality Assessment Tool was used to assess the quality of included studies.</div></div><div><h3>Results</h3><div>A total of 29 studies were included (n = 15011 hands). The prevalence of sesamoid bone at 1st metacarpophalangeal joint (MCP) was 99.85 % (95 %CI: 99.7–99.95), 2nd MCP was 39.49 % (95 %CI: 35.31–43.76), 3rd was 1.74 % (95 %CI: 1.24–2.32), 4th was 0.64 % (95 %CI: 0.38–0.96), 5th 52.22 % (95 %CI: 45.36–59.04) and 1st interphalangeal joint was 48.03 % (95 %CI: 37.00–59.16). Our analysis showed that in total of 0.09 % of hands (95 %CI: 0.01–0.22) no sesamoid bones were found. Furthermore, no significant differences in balance could be found when comparing the left (0.30 %, 95 %CI: 0.00–0.81) and the right (0.13 %, 95 %CI: 0.00–0.36) hand.</div></div><div><h3>Conclusion</h3><div>Understanding sesamoid bones variability might be crucial for anatomical insight and clinical diagnosis, particularly in orthopedics or radiology.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152754"},"PeriodicalIF":1.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-17DOI: 10.1016/j.aanat.2025.152753
S. Varadinkova , E. Matalova , J. Frampton , M. Clarke , B. Vesela , P. Bartos , H. Lesot , Oralova V
The Rank-Rankl-Opg axis is a fundamental regulatory triad in bone development and remodelling. While extensively studied, novel modulators of this system continue to emerge, with the transcription factor Myb recently gaining attention due to its unexpected presence and physiological significance in tooth and bone, beyond its well-established role in haematopoiesis. To establish a baseline for normal development, we first elucidated the developmental dynamics of Rankl and Opg expression during prenatal mandibular development and osteocytogenesis in wild-type mice within distinct morphological regions of the developing mandible (incisor, diastema, molar), revealing intricate temporal expression patterns. Building upon this foundational understanding, we then investigated the hitherto uncharacterized impact of Myb deficiency on Rankl and Opg expression at their survival limit (prenatal day 15), using Myb knock-out mice. We observed a significant and region-specific upregulation of both Rankl and Opg expression in the molar region of Myb-deficient mandibles, as assessed by qPCR. Intriguingly, increased expression of both genes was also evident in the incisor region, while no significant changes were noted within the diastema. In contrast, Rank expression remained unaffected across all three segments. To confirm the reciprocal effect of Myb, we demonstrated that its overexpression in mandibular micromasses reciprocally altered Rankl and Opg expression. By confronting the established developmental dynamics with the effects of Myb deficiency and Myb’s own expression pattern, we provide compelling evidence for a potent and direct influence of Myb on Rankl and Opg regulation, particularly prominent in the molar region. The observed temporal peaks of Myb and Rankl expression at the osteoblast-osteocyte transition further suggest broader, pivotal roles for Myb in osteogenesis. Our findings unravel Myb as a critical orchestrator of the Rank-Rankl-Opg system in craniofacial bone development, opening new avenues for understanding bone dysregulation.
{"title":"Impact of Myb deficiency on Rankl/Opg expression within the developing mouse mandible","authors":"S. Varadinkova , E. Matalova , J. Frampton , M. Clarke , B. Vesela , P. Bartos , H. Lesot , Oralova V","doi":"10.1016/j.aanat.2025.152753","DOIUrl":"10.1016/j.aanat.2025.152753","url":null,"abstract":"<div><div>The Rank-Rankl-Opg axis is a fundamental regulatory triad in bone development and remodelling. While extensively studied, novel modulators of this system continue to emerge, with the transcription factor Myb recently gaining attention due to its unexpected presence and physiological significance in tooth and bone, beyond its well-established role in haematopoiesis. To establish a baseline for normal development, we first elucidated the developmental dynamics of <em>Rankl</em> and <em>Opg</em> expression during prenatal mandibular development and osteocytogenesis in wild-type mice within distinct morphological regions of the developing mandible (incisor, diastema, molar), revealing intricate temporal expression patterns. Building upon this foundational understanding, we then investigated the hitherto uncharacterized impact of Myb deficiency on <em>Rankl</em> and <em>Opg</em> expression at their survival limit (prenatal day 15), using Myb knock-out mice. We observed a significant and region-specific upregulation of both <em>Rankl</em> and <em>Opg</em> expression in the molar region of Myb-deficient mandibles, as assessed by qPCR. Intriguingly, increased expression of both genes was also evident in the incisor region, while no significant changes were noted within the diastema. In contrast, <em>Rank</em> expression remained unaffected across all three segments. To confirm the reciprocal effect of Myb, we demonstrated that its overexpression in mandibular micromasses reciprocally altered <em>Rankl</em> and <em>Opg</em> expression. By confronting the established developmental dynamics with the effects of Myb deficiency and Myb’s own expression pattern, we provide compelling evidence for a potent and direct influence of Myb on <em>Rankl</em> and <em>Opg</em> regulation, particularly prominent in the molar region. The observed temporal peaks of Myb and Rankl expression at the osteoblast-osteocyte transition further suggest broader, pivotal roles for Myb in osteogenesis. Our findings unravel Myb as a critical orchestrator of the Rank-Rankl-Opg system in craniofacial bone development, opening new avenues for understanding bone dysregulation.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152753"},"PeriodicalIF":1.7,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1016/j.aanat.2025.152752
Adrian Balcerzak , George Triantafyllou , Fotis Demetriou , Maria Piagkou , Łukasz Olewnik
Background
The hepatic artery (HA) system is essential for the arterial supply of the liver and other abdominal organs. Understanding its anatomical variations is crucial for anatomists, radiologists, and surgeons, particularly in the context of abdominal surgeries and preoperative imaging. While two most recognized classification systems - Michels’ and Hiatt’s - describe these variants, a comprehensive meta-analysis covering the entire hepatic arterial system is lacking.
Methods
This systematic review and meta-analysis followed PRISMA 2020 guidelines and Evidence-based Anatomy Workgroup protocols. A thorough literature search was conducted across major databases, including PubMed, Scopus, Web of Science, and Google Scholar. Studies reporting the prevalence of HA variants were included, and pooled prevalence was calculated using random-effects models. Subgroup analyses were performed based on geographic distribution and study type.
Results
Eighty-five studies with a total of 47,732 patients were included. Typical HA anatomy was identified in 69.96 % (95 % CI: 66.78–73.05) of cases, while 30.04 % exhibited variant anatomy. The most common variation involved the right hepatic artery (RHA) with a pooled prevalence of 11.38 % (95 % CI: 9.45–13.45). Significant differences were observed between populations and study types, with European populations and cadaveric studies showing higher prevalence rates for certain variants.
Conclusions
HA variability is common phenomenon, with approximately one-third of individuals presenting deviations from the typical anatomy. These findings are crucial for surgical planning and risk mitigation in invasive procedures, particularly those involving the hepatobiliary region. Future research should aim to refine classification systems, address heterogeneity, and include gender-specific and morphometric data to enhance anatomical understanding.
{"title":"The hepatic arterial system variations: A systematic review with meta-analysis","authors":"Adrian Balcerzak , George Triantafyllou , Fotis Demetriou , Maria Piagkou , Łukasz Olewnik","doi":"10.1016/j.aanat.2025.152752","DOIUrl":"10.1016/j.aanat.2025.152752","url":null,"abstract":"<div><h3>Background</h3><div>The hepatic artery (HA) system is essential for the arterial supply of the liver and other abdominal organs. Understanding its anatomical variations is crucial for anatomists, radiologists, and surgeons, particularly in the context of abdominal surgeries and preoperative imaging. While two most recognized classification systems - Michels’ and Hiatt’s - describe these variants, a comprehensive meta-analysis covering the entire hepatic arterial system is lacking.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis followed PRISMA 2020 guidelines and Evidence-based Anatomy Workgroup protocols. A thorough literature search was conducted across major databases, including PubMed, Scopus, Web of Science, and Google Scholar. Studies reporting the prevalence of HA variants were included, and pooled prevalence was calculated using random-effects models. Subgroup analyses were performed based on geographic distribution and study type.</div></div><div><h3>Results</h3><div>Eighty-five studies with a total of 47,732 patients were included. Typical HA anatomy was identified in 69.96 % (95 % CI: 66.78–73.05) of cases, while 30.04 % exhibited variant anatomy. The most common variation involved the right hepatic artery (RHA) with a pooled prevalence of 11.38 % (95 % CI: 9.45–13.45). Significant differences were observed between populations and study types, with European populations and cadaveric studies showing higher prevalence rates for certain variants.</div></div><div><h3>Conclusions</h3><div>HA variability is common phenomenon, with approximately one-third of individuals presenting deviations from the typical anatomy. These findings are crucial for surgical planning and risk mitigation in invasive procedures, particularly those involving the hepatobiliary region. Future research should aim to refine classification systems, address heterogeneity, and include gender-specific and morphometric data to enhance anatomical understanding.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152752"},"PeriodicalIF":1.7,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.aanat.2025.152750
Anna Kanewska, Wataru Yano, Yuto Fujimitsu, Masataka Ito
Objective
The juxta-oral organ (JOO) is a bilateral organ located in the lateral walls of the oral cavity and has close connection with the buccal nerve. While it is described mainly in mammals, some studies have reported the existence of JOO in other classes. The aim of this study was to re-analyze the existence of JOO in the domestic chicken using newly available methods.
Materials and methods
Fertilized chicken eggs were incubated at 38°C from day 0 of fertilization. At least 3 embryos of each stage were sampled at embryonic day 8 (E 8), E 8.5, E 9, E 10, E 11, E 12, E 13 as well as two E 20 embryos, and serial tissue sections were analyzed. The morphology was studied in hematoxylin-eosin (HE) stained sections, and immunohistochemical staining (IHC) for cytokeratin 6 A (CK6A) and neuron-specific class III beta-tubulin (TUJ1) was performed for the detection of epithelial and neuronal structures, respectively. Chick embryos at E 11 – E 20 were also stained for α-smooth muscle actin (SMA) to detect myoepithelial cells. In addition, one E 20 chicken embryo was analyzed by micro-computer tomography.
Results
At E 8, epithelial thickening at the buccal fold was observed. From E 9, an epithelial structure was budding from the angle of the beak cavity in a posterior direction, with further elongation at E 10 and branching at E 11. Acini-like structure was observed from E 12 and E 13, developing into a glandular structure in E 20. The epithelial structure was positive for CK6A and had a close relationship with TUJ1-positive nerve fibers. The topographic relationship was confirmed in the micro-CT analysis. Epithelial budding with subsequent formation of submandibular, maxillary and sublingual salivary glands was also observed in HE-stained serial sections from stage E 9.
Conclusion
We identified the observed glandular structure at the buccal fold to be glandula angularis oris (GAO). As there were no other epithelial structures in this area, we concluded that JOO did not exist in the chickens.
{"title":"Re-examination of the juxta-oral organ in domestic chicken (Gallus gallus domesticus) using immunohistochemistry and micro-computer tomography techniques","authors":"Anna Kanewska, Wataru Yano, Yuto Fujimitsu, Masataka Ito","doi":"10.1016/j.aanat.2025.152750","DOIUrl":"10.1016/j.aanat.2025.152750","url":null,"abstract":"<div><h3>Objective</h3><div>The juxta-oral organ (JOO) is a bilateral organ located in the lateral walls of the oral cavity and has close connection with the buccal nerve. While it is described mainly in mammals, some studies have reported the existence of JOO in other classes. The aim of this study was to re-analyze the existence of JOO in the domestic chicken using newly available methods.</div></div><div><h3>Materials and methods</h3><div>Fertilized chicken eggs were incubated at 38°C from day 0 of fertilization. At least 3 embryos of each stage were sampled at embryonic day 8 (E 8), E 8.5, E 9, E 10, E 11, E 12, E 13 as well as two E 20 embryos, and serial tissue sections were analyzed. The morphology was studied in hematoxylin-eosin (HE) stained sections, and immunohistochemical staining (IHC) for cytokeratin 6 A (CK6A) and neuron-specific class III beta-tubulin (TUJ1) was performed for the detection of epithelial and neuronal structures, respectively. Chick embryos at E 11 – E 20 were also stained for α-smooth muscle actin (SMA) to detect myoepithelial cells. In addition, one E 20 chicken embryo was analyzed by micro-computer tomography.</div></div><div><h3>Results</h3><div>At E 8, epithelial thickening at the buccal fold was observed. From E 9, an epithelial structure was budding from the angle of the beak cavity in a posterior direction, with further elongation at E 10 and branching at E 11. Acini-like structure was observed from E 12 and E 13, developing into a glandular structure in E 20. The epithelial structure was positive for CK6A and had a close relationship with TUJ1-positive nerve fibers. The topographic relationship was confirmed in the micro-CT analysis. Epithelial budding with subsequent formation of submandibular, maxillary and sublingual salivary glands was also observed in HE-stained serial sections from stage E 9.</div></div><div><h3>Conclusion</h3><div>We identified the observed glandular structure at the buccal fold to be glandula angularis oris (GAO). As there were no other epithelial structures in this area, we concluded that JOO did not exist in the chickens.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152750"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-29DOI: 10.1016/j.aanat.2025.152751
Xianyi He , Yichen Gao , Haiyin Wan , Xia Wang , Jie Shen , Yun He , Junliang Chen
Background
Dental mesenchymal stem cells are seed cells for oral and maxillofacial bone tissue engineering. The aim of this study was to compare the biological characteristics of gingival mesenchymal stem cells (GMSCs), periodontal ligament stem cells (PDLSCs), and dental follicle stem cells (DFSCs), and to evaluate the effects of their corresponding conditioned medium (CM) on the biological characteristics of bone marrow mesenchymal stem cells (BMSCs). The findings may expound a theoretical foundation for the development of treatments for oral and maxillofacial bone defects.
Methods
GMSCs, PDLSCs, and DFSCs were isolated and cultured from the same donors to compare their proliferation, migration, chondrogenic and osteogenic differentiation potentials. CM derived from each stem cell type were obtained through serum-free culture. Transwell assays, alkaline phosphatase staining, Alizarin Red staining, western blotting, quantitative real-time polymerase chain reaction, and immunofluorescence were carried out to evaluate the effects of the different CM on the osteogenic differentiation and migration abilities of BMSCs.
Results
This study demonstrated that GMSCs, PDLSCs, and DFSCs exhibited similar morphologies. The proliferation and migration potentials of GMSCs and DFSCs were significantly higher than those of PDLSCs. DFSCs also showed the highest osteogenic and chondrogenic differentiation capability. In addition, DFSC-CM significantly promoted the osteogenic differentiation and migration abilities of BMSCs compared with PDLSC-CM and GMSC-CM.
Conclusions
DFSCs are promising candidate for maxillofacial bone regeneration due to their robust regenerative properties. DFSC-CM, as a cell-free therapeutic, could overcome limitations of direct stem cell transplantation by leveraging paracrine signaling. This study provides a foundation for clinical applications, such as combining DFSC-CM with biomaterials to enhance bone defect repair.
{"title":"Comparative study on biological characteristics of dental mesenchymal stem cells isolated from gingiva, periodontal ligament, and dental follicle and their derived conditioned medium","authors":"Xianyi He , Yichen Gao , Haiyin Wan , Xia Wang , Jie Shen , Yun He , Junliang Chen","doi":"10.1016/j.aanat.2025.152751","DOIUrl":"10.1016/j.aanat.2025.152751","url":null,"abstract":"<div><h3>Background</h3><div>Dental mesenchymal stem cells are seed cells for oral and maxillofacial bone tissue engineering. The aim of this study was to compare the biological characteristics of gingival mesenchymal stem cells (GMSCs), periodontal ligament stem cells (PDLSCs), and dental follicle stem cells (DFSCs), and to evaluate the effects of their corresponding conditioned medium (CM) on the biological characteristics of bone marrow mesenchymal stem cells (BMSCs). The findings may expound a theoretical foundation for the development of treatments for oral and maxillofacial bone defects.</div></div><div><h3>Methods</h3><div>GMSCs, PDLSCs, and DFSCs were isolated and cultured from the same donors to compare their proliferation, migration, chondrogenic and osteogenic differentiation potentials. CM derived from each stem cell type were obtained through serum-free culture. Transwell assays, alkaline phosphatase staining, Alizarin Red staining, western blotting, quantitative real-time polymerase chain reaction, and immunofluorescence were carried out to evaluate the effects of the different CM on the osteogenic differentiation and migration abilities of BMSCs.</div></div><div><h3>Results</h3><div>This study demonstrated that GMSCs, PDLSCs, and DFSCs exhibited similar morphologies. The proliferation and migration potentials of GMSCs and DFSCs were significantly higher than those of PDLSCs. DFSCs also showed the highest osteogenic and chondrogenic differentiation capability. In addition, DFSC-CM significantly promoted the osteogenic differentiation and migration abilities of BMSCs compared with PDLSC-CM and GMSC-CM.</div></div><div><h3>Conclusions</h3><div>DFSCs are promising candidate for maxillofacial bone regeneration due to their robust regenerative properties. DFSC-CM, as a cell-free therapeutic, could overcome limitations of direct stem cell transplantation by leveraging paracrine signaling. This study provides a foundation for clinical applications, such as combining DFSC-CM with biomaterials to enhance bone defect repair.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152751"},"PeriodicalIF":1.7,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-27DOI: 10.1016/j.aanat.2025.152749
Colton P. Lane , Milena Douglas , Matthew Mckoy , Jonathan Rozeboom , Eshwar S. Karupakula , Harsh C. Patel , Kianna P. Ruble , Rosemary Josenkoski , Samuel Ryabov , Jasmine Zhai , Alexander Rich , Ainsley Durning , Cole McNeil , Georgianna Miller , Dominik Valdez , Timothy L. Campbell , Terrence B. Ritzman , Heather F. Smith , Leigha M. Lynch
<div><div>Coronary artery and cardiac venous drainage patterns exhibit substantial anatomical variability, which can impact surgical planning and patient outcomes. While each system's variation has been studied independently, little is known about potential correlations between arterial supply and venous drainage of the heart. This study investigates coronary artery dominance and cardiac venous drainage dominance in a sample of 167 adult human cadaveric donors to better understand their prevalence and potential relationship. Coronary artery dominance was assessed based on the origin of the posterior interventricular artery (PIA), and cardiac venous drainage dominance was classified by examining the association of the great and middle cardiac veins to the apex of the heart. Among 165 hearts evaluated for arterial dominance, 81.21 % were right dominant, 12.73 % left dominant, and 6.06 % codominant. Of 80 hearts scored for cardiac venous dominance, 48.75 % were middle vein dominant (MVD), 6.25 % great vein dominant (GVD), and 45.00 % intermediate type (IM). No significant differences in dominance patterns were found between sexes or age at death. Additionally, analysis of 78 hearts with both arterial and venous structures showed no significant correlation between coronary artery dominance and venous drainage dominance. These findings confirm prior prevalence reports, underscore the anatomical variability in cardiac vasculature, and suggest that arterial and venous dominance patterns may develop independently. Understanding this variation is crucial for improving clinical outcomes in cardiac interventions.</div></div><div><h3>Purpose</h3><div>This study investigates coronary artery dominance and cardiac venous drainage dominance in a sample of 167 adult human cadaveric donors to better understand their prevalence and potential relationship.</div></div><div><h3>Methods</h3><div>Coronary artery dominance was assessed based on the origin of the posterior interventricular artery (PIA), and cardiac venous drainage dominance was classified by examining the association of the great and middle cardiac veins to the apex of the heart.</div></div><div><h3>Results</h3><div>Among 167 hearts evaluated for arterial dominance, 81.21 % were right dominant, 12.73 % left dominant, and 6.06 % codominant. Of 80 hearts scored for cardiac venous dominance, 48.75 % were middle vein dominant (MVD), 6.25 % great vein dominant (GVD), and 45.00 % intermediate type (IM). No significant differences in dominance patterns were found between sexes (artery p = 0.45; vein p = 0.43) or age at death (artery p = 0.43, vein=0.48). Additionally, analysis of 78 hearts with both arterial and venous structures showed no significant correlation between coronary artery dominance and venous drainage dominance (p = 0.39).</div></div><div><h3>Implications</h3><div>These findings confirm prior prevalence reports, underscore the anatomical variability in cardiac vasculature, and suggest that arteria
{"title":"Anatomical variation in the external vasculature of the human heart: A cadaveric investigation of dominance in coronary artery branching and cardiac venous drainage","authors":"Colton P. Lane , Milena Douglas , Matthew Mckoy , Jonathan Rozeboom , Eshwar S. Karupakula , Harsh C. Patel , Kianna P. Ruble , Rosemary Josenkoski , Samuel Ryabov , Jasmine Zhai , Alexander Rich , Ainsley Durning , Cole McNeil , Georgianna Miller , Dominik Valdez , Timothy L. Campbell , Terrence B. Ritzman , Heather F. Smith , Leigha M. Lynch","doi":"10.1016/j.aanat.2025.152749","DOIUrl":"10.1016/j.aanat.2025.152749","url":null,"abstract":"<div><div>Coronary artery and cardiac venous drainage patterns exhibit substantial anatomical variability, which can impact surgical planning and patient outcomes. While each system's variation has been studied independently, little is known about potential correlations between arterial supply and venous drainage of the heart. This study investigates coronary artery dominance and cardiac venous drainage dominance in a sample of 167 adult human cadaveric donors to better understand their prevalence and potential relationship. Coronary artery dominance was assessed based on the origin of the posterior interventricular artery (PIA), and cardiac venous drainage dominance was classified by examining the association of the great and middle cardiac veins to the apex of the heart. Among 165 hearts evaluated for arterial dominance, 81.21 % were right dominant, 12.73 % left dominant, and 6.06 % codominant. Of 80 hearts scored for cardiac venous dominance, 48.75 % were middle vein dominant (MVD), 6.25 % great vein dominant (GVD), and 45.00 % intermediate type (IM). No significant differences in dominance patterns were found between sexes or age at death. Additionally, analysis of 78 hearts with both arterial and venous structures showed no significant correlation between coronary artery dominance and venous drainage dominance. These findings confirm prior prevalence reports, underscore the anatomical variability in cardiac vasculature, and suggest that arterial and venous dominance patterns may develop independently. Understanding this variation is crucial for improving clinical outcomes in cardiac interventions.</div></div><div><h3>Purpose</h3><div>This study investigates coronary artery dominance and cardiac venous drainage dominance in a sample of 167 adult human cadaveric donors to better understand their prevalence and potential relationship.</div></div><div><h3>Methods</h3><div>Coronary artery dominance was assessed based on the origin of the posterior interventricular artery (PIA), and cardiac venous drainage dominance was classified by examining the association of the great and middle cardiac veins to the apex of the heart.</div></div><div><h3>Results</h3><div>Among 167 hearts evaluated for arterial dominance, 81.21 % were right dominant, 12.73 % left dominant, and 6.06 % codominant. Of 80 hearts scored for cardiac venous dominance, 48.75 % were middle vein dominant (MVD), 6.25 % great vein dominant (GVD), and 45.00 % intermediate type (IM). No significant differences in dominance patterns were found between sexes (artery p = 0.45; vein p = 0.43) or age at death (artery p = 0.43, vein=0.48). Additionally, analysis of 78 hearts with both arterial and venous structures showed no significant correlation between coronary artery dominance and venous drainage dominance (p = 0.39).</div></div><div><h3>Implications</h3><div>These findings confirm prior prevalence reports, underscore the anatomical variability in cardiac vasculature, and suggest that arteria","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"263 ","pages":"Article 152749"},"PeriodicalIF":1.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}