Medialization has become like digitalization, rationalization, dynamization, globalization, pluralization, hybridization, and differentialization and is one of the buzzwords of modern Western industrialized societies,...Medialization has become like digitalization, rationalization, dynamization, globalization, pluralization, hybridization, and differentialization and is one of the buzzwords of modern Western industrialized societies, which are all together essentially responsible for structural change in communication. Medialization means the adaption of producers to media logics, media formats, and media routines ＆ workflows. There are consequently and logically influences because of the dynamic process of medialization to legal discourse and genres, law, media, and social power. It has to be discussed if the logics, data formats, and routines ＆ workflows of new media and information and communication technologies （ICTs） like social media are creating also a new generation of genres and novel form of legal discourses. Also, if social media will replace or complete old classic media （law of Riepl）, the question of the relevance of law concerning new ＆ social media has to be answered in close future. Lastly, if to the fore of social power, these new novel resources are actually framing for problem-based inquiries in law. There are big chances but also serious risks in cyberworld, their realities, and dangers. There actually exists an urgent call of action to theory building, development of methodologies, and empirical research.展开更多
Introduction:Unilateral vocal fold paralysis(ULVP)is characterized by the complete immobility of a single vocal fold which can cause significant health challenges,including voice impairment,difficulty swallowing,and a...Introduction:Unilateral vocal fold paralysis(ULVP)is characterized by the complete immobility of a single vocal fold which can cause significant health challenges,including voice impairment,difficulty swallowing,and a high risk of aspiration due to glottic incompetency.The aim of this study is to systematically review the effectiveness of laryngeal reinnervation(LR)and medialization thyroplasty(MT)in the treatment of ULVP.Materials and Methods:Medline,PubMed,Cochrane Library,OVID,Scopus,Springer Nature Journals,ScienceDirect,and Directory of Open Access Journals databases were searched.Restriction to non-English studies were applied.Studies were excluded if subjects had previous treatment for ULVP,if they had co-existing neuromuscular disease affecting the larynx,and if they had significant non-laryngeal speech abnormalitiesResults:Fifteen articles were reviewed,all conducted between 2003 and 2023.Among the 864 participants included,48 underwent LR,348 underwent MT,and the remaining 432 were in the comparison group,which involved injection laryngoplasty(IL),voice therapy(VT),placebo,and medialization with arytenoid adduction.Meta-analyses compared LR to MT and MT to alternative treatments,revealing a preference for MT.The comparison between LR and MT in the network meta-analysis yielded a mean difference of 0.33(95%CI:-11.79,12.6)favoring the MT group,ranking using SUCRA values highlighted that MT is the best treatment modality followed by LR.Discussion:The results of the network meta-analysis and the subgroup meta-analysis showed that MT is better than alternative treatments that were included in this study.Moreover,management modalities should be individualized to each patient as many factors are important and may affect the final outcomes.Conclusions:While the network meta-analysis indicates that MT may be more effective than alternative treatments for managing ULVP,the results should be interpreted with caution due to potential confounding factors.One notable limitation is the small sample size in the LR group.Despite these limitations,the findings contribute to the existing literature and can help guide future research on optimal interventions for the treatment of ULVP.展开更多
Objective: To review current literature and experience with Gore-Tex? implant extrusion following medialization thyroplasty, as well as to report the unique case of Gore-Tex? implant extrusion following revision media...Objective: To review current literature and experience with Gore-Tex? implant extrusion following medialization thyroplasty, as well as to report the unique case of Gore-Tex? implant extrusion following revision medialization thyroplasty.Methods: Review of existing literature and description of personal experience with unique case of Gore-Tex? implant extrusion following revision medialization thyroplasty.Results: Review of existing literature found no prior reported cases of Gore-Tex? implant extrusion following revision medialization thyroplasty. Risk factors for implant extrusion include the pressure of the implant on insertion and the inability to secure the implant. Cases of implant extrusion can be managed operatively via an endoscopic or via an external open approach.Conclusion: This is the first reported case of Gore-Tex? implant extrusion following revision medialization thyroplasty. Careful consideration should be given in revision medialization thyroplasty as additional implant material may cause increased pressure, a risk factor for implant extrusion.展开更多
Objective: To assess patient reported swallowing outcomes before and after injec-tion medialization laryngoplasty in patients with unilateral vocal fold immobility (UVFI). Methods: Case series with chart review of pat...Objective: To assess patient reported swallowing outcomes before and after injec-tion medialization laryngoplasty in patients with unilateral vocal fold immobility (UVFI). Methods: Case series with chart review of patients with UVFI who underwent injection media-lization laryngoplasty at a community laryngology practice by a single clinician between October 2015 and December 2017. Patient-reported validated surveys of swallowing impair-ment, Eating Assessment Tool (EAT-10), demographics, etiology and duration of symptoms were recorded before and after injection. A paired t test was done on EAT-10 surveys before and after IML to assess for statistical significance. Results: Twenty-one patients with UVFI and glottic insufficiency underwent IML between October 2015 and December 2017. Nineteen of 21 patients (90％) presented with dysphagia (EAT-10 ≥ 3). 76％ of patients with dysphagia reported improvement in swallowing function af-ter IML. The EAT-10 scores of UVFI patients with dysphagia before and after IML were 17.0 ± 14.0 and 4.2 ± 9.6, respectively (p = 0.004). Conclusions: Nearly all patients with UVFI and glottic insufficiency report associated dysphagia. Three fourths of these patients perceive improvement in their swallowing function after injection medialization laryngoplasty. Patients with idiopathic UVFI may have a more sus-tained improvement and those with severe preop dysphagia may not benefit. Further research is necessary to refine patient selection and to assess duration of improved swallowing function.展开更多
BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar k...BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.展开更多
The number and diversity of inhibitory neurons(INs)increased substantially during mammalian brain evolution.However,the generative mechanisms of the vast repertoire of human INs remain elusive.We performed spatial and...The number and diversity of inhibitory neurons(INs)increased substantially during mammalian brain evolution.However,the generative mechanisms of the vast repertoire of human INs remain elusive.We performed spatial and single-cell transcriptomics of human medial ganglionic eminence(hMGE),a pivotal source of cortical and subpallial INs,and built the trajectories of hMGE-derived cells during brain development.We identified spatiotemporally and molecularly segregated progenitor cell populations fated to produce distinct IN types.展开更多
AIM:To compare spontaneous brain regional activities between diabetic vitreous hemorrhage patients(DVHs)and healthy controls(HCs).METHODS:Thirty-two DVHs and 32 HCs were enrolled in this study.Baseline demographic and...AIM:To compare spontaneous brain regional activities between diabetic vitreous hemorrhage patients(DVHs)and healthy controls(HCs).METHODS:Thirty-two DVHs and 32 HCs were enrolled in this study.Baseline demographic and vision data were compared between groups using an independent sample t-test.Resting-state functional magnetic resonance imaging(rs-fMRI)was used in all participants.fMRI data was obtained and analyzed using MRIcro and SPM8 software.Fractional amplitude of low-frequency fluctuation(fALFF)technology was used to measure regional spontaneous brain activity,and sensitivity was tested using receiver operating characteristic curves(ROCs).The fALFF values were analyzed using REST software and two-sample t-tests were used to compare values between groups.Hospital anxiety and depression scale(HADS)score was assessed in DVHs and Pearson’s correlation was used to test relationships between mean fALFF value and both HADS score and duration of DVH.RESULTS:Except for the best-corrected visual acuity(BCVA)in both eyes,which showed a statistically significant difference(P<0.05),there were no statistically significant differences in the other indicators(P>0.05)between the HCs and DVHs group.Compared with controls,fALFF value was higher in DVH in cerebellum posterior lobe(CPL)and lower in right anterior cingulate cortex(ACC)and right medial orbitofrontal cortex(OFC).In DVH patients,mean fALFF value of CPL was positively correlated with HADS score and duration of diabetes.However,no such correlation was found,for right ACC or right medial OFC.DVH may lead to abnormal activities in certain brain regions related to visual control and mood.CONCLUSION:Visual impairment caused by DVH may lead to adjustment in regional visual brain activities and may be related to depression or reward system processing in some brain regions.展开更多
Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice ...Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice is brain region–specific,particularly involving the corticolimbic system,including the ventral tegmental area,nucleus accumbens,prefrontal cortex,amygdala,and hippocampus.Determining how brain-derived neurotrophic factor participates in stress processing in different brain regions will deepen our understanding of social stress psychopathology.In this review,we discuss the expression and regulation of brain-derived neurotrophic factor in stress-sensitive brain regions closely related to the pathophysiology of depression.We focused on associated molecular pathways and neural circuits,with special attention to the brain-derived neurotrophic factor–tropomyosin receptor kinase B signaling pathway and the ventral tegmental area–nucleus accumbens dopamine circuit.We determined that stress-induced alterations in brain-derived neurotrophic factor levels are likely related to the nature,severity,and duration of stress,especially in the above-mentioned brain regions of the corticolimbic system.Therefore,BDNF might be a biological indicator regulating stress-related processes in various brain regions.展开更多
BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomica...BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomical constraints in the periocular region.Precise diagnosis is essential to guide appropriate surgical management and prevent recurrence.CASE SUMMARY A 32-year-old female presented with a recurrent tumor in the medial canthus,previously diagnosed as a solitary fibrous tumor in an outside institution.After complete radiological and systemic workup,she was scheduled for a wide local excision followed by reconstruction after getting tumor clear margins on frozen section.Histopathology confirmed DFSP,characterized by storiform spindle cell proliferation,diffuse cluster of differentiation 34 positivity,and signal transducer and activator of transcription 6 negativity.CONCLUSION This case highlights the challenges in the diagnostic and surgical management of DFSP in periocular tumors.Comprehensive surgical excision with appropriate reconstruction is critical for achieving oncological control while preserving aesthetics and function.展开更多
The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency i...The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency in the brain that subsequently manifests as various motor and non-motor symptoms. This review aims to summarize the involvement of the globus pallidus in both motor and non-motor manifestations of Parkinson's disease. The firing activities of parvalbumin neurons in the medial globus pallidus, including both the firing rate and pattern, exhibit strong correlations with the bradykinesia and rigidity associated with Parkinson's disease. Increased beta oscillations, which are highly correlated with bradykinesia and rigidity, are regulated by the lateral globus pallidus. Furthermore,bradykinesia and rigidity are strongly linked to the loss of dopaminergic projections within the cortical-basal ganglia-thalamocortical loop. Resting tremors are attributed to the transmission of pathological signals from the basal ganglia through the motor cortex to the cerebellum-ventral intermediate nucleus circuit. The cortico–striato–pallidal loop is responsible for mediating pallidi-associated sleep disorders. Medication and deep brain stimulation are the primary therapeutic strategies addressing the globus pallidus in Parkinson's disease. Medication is the primary treatment for motor symptoms in the early stages of Parkinson's disease, while deep brain stimulation has been clinically proven to be effective in alleviating symptoms in patients with advanced Parkinson's disease,particularly for the movement disorders caused by levodopa. Deep brain stimulation targeting the globus pallidus internus can improve motor function in patients with tremordominant and non-tremor-dominant Parkinson's disease, while deep brain stimulation targeting the globus pallidus externus can alter the temporal pattern of neural activity throughout the basal ganglia–thalamus network. Therefore, the composition of the globus pallidus neurons, the neurotransmitters that act on them, their electrical activity,and the neural circuits they form can guide the search for new multi-target drugs to treat Parkinson's disease in clinical practice. Examining the potential intra-nuclear and neural circuit mechanisms of deep brain stimulation associated with the globus pallidus can facilitate the management of both motor and non-motor symptoms while minimizing the side effects caused by deep brain stimulation.展开更多
The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial ...The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella.Despite this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion.The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial.This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.展开更多
Dear Editor,The importance of the medial entorhinal cortex(MEC)for memory and spatial navigation has been shown repeatedly in many species,including mice and humans[1,2].It is,therefore,not surprising that the connect...Dear Editor,The importance of the medial entorhinal cortex(MEC)for memory and spatial navigation has been shown repeatedly in many species,including mice and humans[1,2].It is,therefore,not surprising that the connectivity of this structure has been studied extensively over the past century,mainly using a range of anterograde and retrograde anatomical tracers[3].展开更多
Previous studies have identified two group-level processes,neural representations of interracial between-group difference and intraracial within-group similarity,that contribute to the racial categorization of faces.W...Previous studies have identified two group-level processes,neural representations of interracial between-group difference and intraracial within-group similarity,that contribute to the racial categorization of faces.What remains unclear is how the brain tracks race-related information that varies across different faces as an individual-level neural process involved in race perception.In three studies,we recorded functional MRI signals when Chinese adults performed different tasks on morphed faces in which proportions of pixels contributing to perceived racial identity(Asian vs White)and expression(pain vs neutral)varied independently.We found that,during a pain expression judgment task,tracking other-race and same-race-related information in perceived faces recruited the ventral occipitotemporal cortices and medial prefrontal/anterior temporal cortices,respectively.However,neural tracking of race-related information tended to be weakened during explicit race judgments on perceived faces.During a donation task,the medial prefrontal activity also tracked race-related information that distinguished between two perceived faces for altruistic decision-making and encoded the Euclidean distance between the two faces that predicted decision-making speeds.Our findings revealed task-dependent neural mechanisms underlying the tracking of race-related information during face perception and altruistic decision-making.展开更多
BACKGROUND Multiple sclerosis(MS)is known to affect many sensory systems,yet most auditory research in MS has focused on the afferent pathways,with relatively few studies examining efferent function.The brainstem is a...BACKGROUND Multiple sclerosis(MS)is known to affect many sensory systems,yet most auditory research in MS has focused on the afferent pathways,with relatively few studies examining efferent function.The brainstem is a common site for MS plaques,and the medial olivocochlear(MOC)system is located in the superior olivary complex(SOC)of the brainstem.The cochlear nuclei are also involved in the MOC reflex arc.Additionally,the temporal cortex can modulate the SOC and cochlear nucleus,so lesions in the brainstem or temporal cortex may affect the MOC reflex in MS.AIM To investigate efferent auditory system activity in patients with multiple sclerosis via the MOC reflex.METHODS The study included 50 patients with MS and 50 healthy controls.Patients with MS were divided into three subgroups according to cranial magnetic resonance imaging findings:Patients with brainstem lesions(Group 1,n=20);patients with temporal cortex lesions without brainstem involvement(Group 2,n=20);and patients without any lesions in the brainstem or temporal cortex(Group 3,n=10).Tympanometry,acoustic stapedial reflex thresholds,pure-tone audiometry,and transientevoked otoacoustic emission(TEOAE)tests(with and without contralateral noise)were performed for all participants.RESULTS There was no significant difference in pure-tone hearing thresholds or baseline TEOAE amplitudes between the MS and control groups,indicating normal cochlear function in patients with MS;however,MOC reflex suppression was significantly reduced in patients with MS compared to controls(P=0.021).In particular,Group 1(MS with brainstem lesions)showed the lowest mean suppression values,which was significantly lower than that of Group 2 and the control group(P=0.002).By contrast,Group 2 and Group 3 did not significantly differ from controls.Additionally,patients with MS exhibited a sex difference in MOC function:Male patients had significantly lower suppression compared to female patients both within Group 1 and in the MS group as a whole.CONCLUSION The findings indicate that the efferent auditory system(specifically the MOC reflex)is affected by MS.MOC reflex activity was most significantly decreased in patients with MS with brainstem lesions,while temporal cortex lesions alone did not appear to notably impair the MOC reflex.Diminished MOC activity may underlie various auditory difficulties in patients with MS(e.g.,hearing in noise),and loss of efferent suppression could contribute to symptoms such as hyperacusis or tinnitus in this population.Further studies are needed to better understand the relationship between MOC dysfunction and auditory symptoms in MS,as well as the potential diagnostic value of MOC testing in MS.展开更多
Humans and animals have a fundamental ability to use experiences and environmental information to organize behavior.It often happens that humans and animals make decisions and prepare actions under uncertain situation...Humans and animals have a fundamental ability to use experiences and environmental information to organize behavior.It often happens that humans and animals make decisions and prepare actions under uncertain situations.Uncertainty would significantly affect the state of animals’minds,but may not be reflected in behavior.How to“read animals’mind state”under different situations is a challenge.Here,we report that neuronal activity in the medial prefrontal cortex(mPFC)of rats can reflect the environmental uncertainty when the task situation changes from certain to uncertain.Rats were trained to perform behavioral tasks under certain and uncertain situations.Under certain situations,rats were required to simply repeat two nose-poking actions that each triggered short auditory tone feedback(single-task situation).Whereas under the uncertain situation,the feedback could randomly be either the previous tone or a short musical rhythm.No additional action was required upon the music feedback,and the same secondary nose-poking action was required upon the tone feedback(dual-task situation);therefore,the coming task was uncertain before action initiation.We recorded single-unit activity from the mPFC when the rats were performing the tasks.We found that in the dual task,when uncertainty was introduced,many mPFC neurons were actively engaged in dealing with the uncertainty before the task initiation,suggesting that the rats could be aware of the task situation change and encode the information in the mPFC before the action of task initiation.展开更多
Anxiety disorder is a major symptom of autism spectrum disorder(ASD)with a comorbidity rate of~40%.However,the neural mechanisms of the emergence of anxiety in ASD remain unclear.In our study,we found that hyperactivi...Anxiety disorder is a major symptom of autism spectrum disorder(ASD)with a comorbidity rate of~40%.However,the neural mechanisms of the emergence of anxiety in ASD remain unclear.In our study,we found that hyperactivity of basolateral amygdala(BLA)pyramidal neurons(PNs)in Shank3 InsG3680 knock-in(InsG3680+/+)mice is involved in the development of anxiety.Electrophysiological results also showed increased excitatory input and decreased inhibitory input in BLA PNs.Chemogenetic inhibition of the excitability of PNs in the BLA rescued the anxiety phenotype of InsG3680+/+mice.Further study found that the diminished control of the BLA by medial prefrontal cortex(mPFC)and optogenetic activation of the mPFC-BLA pathway also had a rescue effect,which increased the feedforward inhibition of the BLA.Taken together,our results suggest that hyperactivity of the BLA and alteration of the mPFC-BLA circuitry are involved in anxiety in InsG3680+/+mice.展开更多
Transradial access (TRA) has emerged as the preferred vascular access route forcoronary angiography and percutaneous coronary interventions due to itssuperior safety profile compared to transfemoral access. However, i...Transradial access (TRA) has emerged as the preferred vascular access route forcoronary angiography and percutaneous coronary interventions due to itssuperior safety profile compared to transfemoral access. However, its widespreadadoption raises concerns regarding structural alterations in the radial artery,which may impact long-term vascular health and future procedural feasibility.TRA is associated with histopathologic changes in the arterial wall, such asintimal injury and hyperplasia, medial remodeling and adventitial inflammation,collectively contributing to radial artery remodeling. Moreover, TRA can inducechanges in radial artery lumen diameter driven by an inflammatory response dueto arterial puncture and mechanical friction during the procedure. Nonetheless, amore clinically significant consequence is radial artery occlusion, which is influencedby various procedural and patient-related factors. Strategies to minimizeremodeling include meticulous pre-procedural ultrasound assessment to ensureappropriate sheath-to-artery size matching, periprocedural pharmacologicalinterventions and implementation of patent hemostasis techniques. This reviewsynthesizes current knowledge regarding the mechanisms, clinical implications,and preventive strategies related to radial artery remodeling following TRA. Further research is needed toelucidate the long-term consequences of radial artery remodeling and to refine preventive strategies for preservingradial artery patency and its suitability for future interventions.展开更多
The present paper addresses two issues pertaining to the use of virtual reality(VR).One issue pertains to the equipment utilized.VR technology can be classified into two main categories:Immersive and non-immersive.The...The present paper addresses two issues pertaining to the use of virtual reality(VR).One issue pertains to the equipment utilized.VR technology can be classified into two main categories:Immersive and non-immersive.The immersive type of technology necessitates the use of substantial equipment,yet it is demonstrably efficacious.Furthermore,the efficacy of this approach is enhanced when combined with relaxation and biofeedback techniques.The other issue is that the efficacy of this approach is diminished when applied to chronic pain,in comparison to acute pain.The relief of chronic pain is a challenging endeavor due to the diminished functionality of the medial prefrontal cortex(mPFC)within the default mode network.Given the close relationship between the mPFC and the reward system dopamine,it is essential to develop a program that activates the reward system dopamine through the use of VR technology.展开更多
Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can...Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can significantly contribute to emotional disabilities and mental disorders,including panic disorder,phobias,social anxiety disorder,and post-traumatic stress disorder(PTSD).展开更多
BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical...BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.展开更多
文摘Medialization has become like digitalization, rationalization, dynamization, globalization, pluralization, hybridization, and differentialization and is one of the buzzwords of modern Western industrialized societies, which are all together essentially responsible for structural change in communication. Medialization means the adaption of producers to media logics, media formats, and media routines ＆ workflows. There are consequently and logically influences because of the dynamic process of medialization to legal discourse and genres, law, media, and social power. It has to be discussed if the logics, data formats, and routines ＆ workflows of new media and information and communication technologies （ICTs） like social media are creating also a new generation of genres and novel form of legal discourses. Also, if social media will replace or complete old classic media （law of Riepl）, the question of the relevance of law concerning new ＆ social media has to be answered in close future. Lastly, if to the fore of social power, these new novel resources are actually framing for problem-based inquiries in law. There are big chances but also serious risks in cyberworld, their realities, and dangers. There actually exists an urgent call of action to theory building, development of methodologies, and empirical research.
文摘Introduction:Unilateral vocal fold paralysis(ULVP)is characterized by the complete immobility of a single vocal fold which can cause significant health challenges,including voice impairment,difficulty swallowing,and a high risk of aspiration due to glottic incompetency.The aim of this study is to systematically review the effectiveness of laryngeal reinnervation(LR)and medialization thyroplasty(MT)in the treatment of ULVP.Materials and Methods:Medline,PubMed,Cochrane Library,OVID,Scopus,Springer Nature Journals,ScienceDirect,and Directory of Open Access Journals databases were searched.Restriction to non-English studies were applied.Studies were excluded if subjects had previous treatment for ULVP,if they had co-existing neuromuscular disease affecting the larynx,and if they had significant non-laryngeal speech abnormalitiesResults:Fifteen articles were reviewed,all conducted between 2003 and 2023.Among the 864 participants included,48 underwent LR,348 underwent MT,and the remaining 432 were in the comparison group,which involved injection laryngoplasty(IL),voice therapy(VT),placebo,and medialization with arytenoid adduction.Meta-analyses compared LR to MT and MT to alternative treatments,revealing a preference for MT.The comparison between LR and MT in the network meta-analysis yielded a mean difference of 0.33(95%CI:-11.79,12.6)favoring the MT group,ranking using SUCRA values highlighted that MT is the best treatment modality followed by LR.Discussion:The results of the network meta-analysis and the subgroup meta-analysis showed that MT is better than alternative treatments that were included in this study.Moreover,management modalities should be individualized to each patient as many factors are important and may affect the final outcomes.Conclusions:While the network meta-analysis indicates that MT may be more effective than alternative treatments for managing ULVP,the results should be interpreted with caution due to potential confounding factors.One notable limitation is the small sample size in the LR group.Despite these limitations,the findings contribute to the existing literature and can help guide future research on optimal interventions for the treatment of ULVP.
文摘Objective: To review current literature and experience with Gore-Tex? implant extrusion following medialization thyroplasty, as well as to report the unique case of Gore-Tex? implant extrusion following revision medialization thyroplasty.Methods: Review of existing literature and description of personal experience with unique case of Gore-Tex? implant extrusion following revision medialization thyroplasty.Results: Review of existing literature found no prior reported cases of Gore-Tex? implant extrusion following revision medialization thyroplasty. Risk factors for implant extrusion include the pressure of the implant on insertion and the inability to secure the implant. Cases of implant extrusion can be managed operatively via an endoscopic or via an external open approach.Conclusion: This is the first reported case of Gore-Tex? implant extrusion following revision medialization thyroplasty. Careful consideration should be given in revision medialization thyroplasty as additional implant material may cause increased pressure, a risk factor for implant extrusion.
文摘Objective: To assess patient reported swallowing outcomes before and after injec-tion medialization laryngoplasty in patients with unilateral vocal fold immobility (UVFI). Methods: Case series with chart review of patients with UVFI who underwent injection media-lization laryngoplasty at a community laryngology practice by a single clinician between October 2015 and December 2017. Patient-reported validated surveys of swallowing impair-ment, Eating Assessment Tool (EAT-10), demographics, etiology and duration of symptoms were recorded before and after injection. A paired t test was done on EAT-10 surveys before and after IML to assess for statistical significance. Results: Twenty-one patients with UVFI and glottic insufficiency underwent IML between October 2015 and December 2017. Nineteen of 21 patients (90％) presented with dysphagia (EAT-10 ≥ 3). 76％ of patients with dysphagia reported improvement in swallowing function af-ter IML. The EAT-10 scores of UVFI patients with dysphagia before and after IML were 17.0 ± 14.0 and 4.2 ± 9.6, respectively (p = 0.004). Conclusions: Nearly all patients with UVFI and glottic insufficiency report associated dysphagia. Three fourths of these patients perceive improvement in their swallowing function after injection medialization laryngoplasty. Patients with idiopathic UVFI may have a more sus-tained improvement and those with severe preop dysphagia may not benefit. Further research is necessary to refine patient selection and to assess duration of improved swallowing function.
文摘BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.
文摘The number and diversity of inhibitory neurons(INs)increased substantially during mammalian brain evolution.However,the generative mechanisms of the vast repertoire of human INs remain elusive.We performed spatial and single-cell transcriptomics of human medial ganglionic eminence(hMGE),a pivotal source of cortical and subpallial INs,and built the trajectories of hMGE-derived cells during brain development.We identified spatiotemporally and molecularly segregated progenitor cell populations fated to produce distinct IN types.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Zhejiang Traditional Chinese Medicine Science and Technology Plan Project(No.2025ZR172).
文摘AIM:To compare spontaneous brain regional activities between diabetic vitreous hemorrhage patients(DVHs)and healthy controls(HCs).METHODS:Thirty-two DVHs and 32 HCs were enrolled in this study.Baseline demographic and vision data were compared between groups using an independent sample t-test.Resting-state functional magnetic resonance imaging(rs-fMRI)was used in all participants.fMRI data was obtained and analyzed using MRIcro and SPM8 software.Fractional amplitude of low-frequency fluctuation(fALFF)technology was used to measure regional spontaneous brain activity,and sensitivity was tested using receiver operating characteristic curves(ROCs).The fALFF values were analyzed using REST software and two-sample t-tests were used to compare values between groups.Hospital anxiety and depression scale(HADS)score was assessed in DVHs and Pearson’s correlation was used to test relationships between mean fALFF value and both HADS score and duration of DVH.RESULTS:Except for the best-corrected visual acuity(BCVA)in both eyes,which showed a statistically significant difference(P<0.05),there were no statistically significant differences in the other indicators(P>0.05)between the HCs and DVHs group.Compared with controls,fALFF value was higher in DVH in cerebellum posterior lobe(CPL)and lower in right anterior cingulate cortex(ACC)and right medial orbitofrontal cortex(OFC).In DVH patients,mean fALFF value of CPL was positively correlated with HADS score and duration of diabetes.However,no such correlation was found,for right ACC or right medial OFC.DVH may lead to abnormal activities in certain brain regions related to visual control and mood.CONCLUSION:Visual impairment caused by DVH may lead to adjustment in regional visual brain activities and may be related to depression or reward system processing in some brain regions.
基金supported financially by the National Natural Science Foundation of China,No.82071272(to YZ).
文摘Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice is brain region–specific,particularly involving the corticolimbic system,including the ventral tegmental area,nucleus accumbens,prefrontal cortex,amygdala,and hippocampus.Determining how brain-derived neurotrophic factor participates in stress processing in different brain regions will deepen our understanding of social stress psychopathology.In this review,we discuss the expression and regulation of brain-derived neurotrophic factor in stress-sensitive brain regions closely related to the pathophysiology of depression.We focused on associated molecular pathways and neural circuits,with special attention to the brain-derived neurotrophic factor–tropomyosin receptor kinase B signaling pathway and the ventral tegmental area–nucleus accumbens dopamine circuit.We determined that stress-induced alterations in brain-derived neurotrophic factor levels are likely related to the nature,severity,and duration of stress,especially in the above-mentioned brain regions of the corticolimbic system.Therefore,BDNF might be a biological indicator regulating stress-related processes in various brain regions.
文摘BACKGROUND Dermatofibrosarcoma protuberans(DFSP)is a rare,low-grade,locally aggressive cutaneous sarcoma.DFSP in the periocular region is exceedingly rare,leading to diagnostic and surgical challenges due to anatomical constraints in the periocular region.Precise diagnosis is essential to guide appropriate surgical management and prevent recurrence.CASE SUMMARY A 32-year-old female presented with a recurrent tumor in the medial canthus,previously diagnosed as a solitary fibrous tumor in an outside institution.After complete radiological and systemic workup,she was scheduled for a wide local excision followed by reconstruction after getting tumor clear margins on frozen section.Histopathology confirmed DFSP,characterized by storiform spindle cell proliferation,diffuse cluster of differentiation 34 positivity,and signal transducer and activator of transcription 6 negativity.CONCLUSION This case highlights the challenges in the diagnostic and surgical management of DFSP in periocular tumors.Comprehensive surgical excision with appropriate reconstruction is critical for achieving oncological control while preserving aesthetics and function.
基金supported by the National Natural Science Foundation of China,No.31771143 (to QZ)Shanghai Municipal Science and Technology Major Project,ZJ Lab+1 种基金Shanghai Center for Brain Science and Brain-Inspired Technology,No.2018SHZDZX01 (to LC)Shanghai Zhou Liangfu Medical Development Foundation “Brain Science and Brain Diseases Youth Innovation Program”(to ZQ)。
文摘The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency in the brain that subsequently manifests as various motor and non-motor symptoms. This review aims to summarize the involvement of the globus pallidus in both motor and non-motor manifestations of Parkinson's disease. The firing activities of parvalbumin neurons in the medial globus pallidus, including both the firing rate and pattern, exhibit strong correlations with the bradykinesia and rigidity associated with Parkinson's disease. Increased beta oscillations, which are highly correlated with bradykinesia and rigidity, are regulated by the lateral globus pallidus. Furthermore,bradykinesia and rigidity are strongly linked to the loss of dopaminergic projections within the cortical-basal ganglia-thalamocortical loop. Resting tremors are attributed to the transmission of pathological signals from the basal ganglia through the motor cortex to the cerebellum-ventral intermediate nucleus circuit. The cortico–striato–pallidal loop is responsible for mediating pallidi-associated sleep disorders. Medication and deep brain stimulation are the primary therapeutic strategies addressing the globus pallidus in Parkinson's disease. Medication is the primary treatment for motor symptoms in the early stages of Parkinson's disease, while deep brain stimulation has been clinically proven to be effective in alleviating symptoms in patients with advanced Parkinson's disease,particularly for the movement disorders caused by levodopa. Deep brain stimulation targeting the globus pallidus internus can improve motor function in patients with tremordominant and non-tremor-dominant Parkinson's disease, while deep brain stimulation targeting the globus pallidus externus can alter the temporal pattern of neural activity throughout the basal ganglia–thalamus network. Therefore, the composition of the globus pallidus neurons, the neurotransmitters that act on them, their electrical activity,and the neural circuits they form can guide the search for new multi-target drugs to treat Parkinson's disease in clinical practice. Examining the potential intra-nuclear and neural circuit mechanisms of deep brain stimulation associated with the globus pallidus can facilitate the management of both motor and non-motor symptoms while minimizing the side effects caused by deep brain stimulation.
文摘The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when required.The medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the patella.Despite this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of flexion.The clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still controversial.This editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.
文摘Dear Editor,The importance of the medial entorhinal cortex(MEC)for memory and spatial navigation has been shown repeatedly in many species,including mice and humans[1,2].It is,therefore,not surprising that the connectivity of this structure has been studied extensively over the past century,mainly using a range of anterograde and retrograde anatomical tracers[3].
基金supported by the National Natural Science Foundation of China(32230043 and 32371092)the Ministry of Science and Technology of China(2019YFA0707103)+1 种基金Das Chinesisch-Deutsche Zentrum für Wissenschaftsförderung(M-0093)the High-performance Computing Platform of Peking University.
文摘Previous studies have identified two group-level processes,neural representations of interracial between-group difference and intraracial within-group similarity,that contribute to the racial categorization of faces.What remains unclear is how the brain tracks race-related information that varies across different faces as an individual-level neural process involved in race perception.In three studies,we recorded functional MRI signals when Chinese adults performed different tasks on morphed faces in which proportions of pixels contributing to perceived racial identity(Asian vs White)and expression(pain vs neutral)varied independently.We found that,during a pain expression judgment task,tracking other-race and same-race-related information in perceived faces recruited the ventral occipitotemporal cortices and medial prefrontal/anterior temporal cortices,respectively.However,neural tracking of race-related information tended to be weakened during explicit race judgments on perceived faces.During a donation task,the medial prefrontal activity also tracked race-related information that distinguished between two perceived faces for altruistic decision-making and encoded the Euclidean distance between the two faces that predicted decision-making speeds.Our findings revealed task-dependent neural mechanisms underlying the tracking of race-related information during face perception and altruistic decision-making.
文摘BACKGROUND Multiple sclerosis(MS)is known to affect many sensory systems,yet most auditory research in MS has focused on the afferent pathways,with relatively few studies examining efferent function.The brainstem is a common site for MS plaques,and the medial olivocochlear(MOC)system is located in the superior olivary complex(SOC)of the brainstem.The cochlear nuclei are also involved in the MOC reflex arc.Additionally,the temporal cortex can modulate the SOC and cochlear nucleus,so lesions in the brainstem or temporal cortex may affect the MOC reflex in MS.AIM To investigate efferent auditory system activity in patients with multiple sclerosis via the MOC reflex.METHODS The study included 50 patients with MS and 50 healthy controls.Patients with MS were divided into three subgroups according to cranial magnetic resonance imaging findings:Patients with brainstem lesions(Group 1,n=20);patients with temporal cortex lesions without brainstem involvement(Group 2,n=20);and patients without any lesions in the brainstem or temporal cortex(Group 3,n=10).Tympanometry,acoustic stapedial reflex thresholds,pure-tone audiometry,and transientevoked otoacoustic emission(TEOAE)tests(with and without contralateral noise)were performed for all participants.RESULTS There was no significant difference in pure-tone hearing thresholds or baseline TEOAE amplitudes between the MS and control groups,indicating normal cochlear function in patients with MS;however,MOC reflex suppression was significantly reduced in patients with MS compared to controls(P=0.021).In particular,Group 1(MS with brainstem lesions)showed the lowest mean suppression values,which was significantly lower than that of Group 2 and the control group(P=0.002).By contrast,Group 2 and Group 3 did not significantly differ from controls.Additionally,patients with MS exhibited a sex difference in MOC function:Male patients had significantly lower suppression compared to female patients both within Group 1 and in the MS group as a whole.CONCLUSION The findings indicate that the efferent auditory system(specifically the MOC reflex)is affected by MS.MOC reflex activity was most significantly decreased in patients with MS with brainstem lesions,while temporal cortex lesions alone did not appear to notably impair the MOC reflex.Diminished MOC activity may underlie various auditory difficulties in patients with MS(e.g.,hearing in noise),and loss of efferent suppression could contribute to symptoms such as hyperacusis or tinnitus in this population.Further studies are needed to better understand the relationship between MOC dysfunction and auditory symptoms in MS,as well as the potential diagnostic value of MOC testing in MS.
基金supported by the National Natural Science Foundation of China(32060199,32360197,31971035,and 31771182)the Jiangxi Province Natural Science Foundation(20224ACB206016).
文摘Humans and animals have a fundamental ability to use experiences and environmental information to organize behavior.It often happens that humans and animals make decisions and prepare actions under uncertain situations.Uncertainty would significantly affect the state of animals’minds,but may not be reflected in behavior.How to“read animals’mind state”under different situations is a challenge.Here,we report that neuronal activity in the medial prefrontal cortex(mPFC)of rats can reflect the environmental uncertainty when the task situation changes from certain to uncertain.Rats were trained to perform behavioral tasks under certain and uncertain situations.Under certain situations,rats were required to simply repeat two nose-poking actions that each triggered short auditory tone feedback(single-task situation).Whereas under the uncertain situation,the feedback could randomly be either the previous tone or a short musical rhythm.No additional action was required upon the music feedback,and the same secondary nose-poking action was required upon the tone feedback(dual-task situation);therefore,the coming task was uncertain before action initiation.We recorded single-unit activity from the mPFC when the rats were performing the tasks.We found that in the dual task,when uncertainty was introduced,many mPFC neurons were actively engaged in dealing with the uncertainty before the task initiation,suggesting that the rats could be aware of the task situation change and encode the information in the mPFC before the action of task initiation.
基金supported by grants from the National Natural Science Foundation of China(31970902,U22A20306,and 3192010300)the Municipal Administration of Hospitals Incubating Program(PZ2023009)+1 种基金the Key-Area R&D Program of Guangdong Province(2019B030335001)the Autism Research Special Fund of Zhejiang Foundation for Disabled Persons(2022003).
文摘Anxiety disorder is a major symptom of autism spectrum disorder(ASD)with a comorbidity rate of~40%.However,the neural mechanisms of the emergence of anxiety in ASD remain unclear.In our study,we found that hyperactivity of basolateral amygdala(BLA)pyramidal neurons(PNs)in Shank3 InsG3680 knock-in(InsG3680+/+)mice is involved in the development of anxiety.Electrophysiological results also showed increased excitatory input and decreased inhibitory input in BLA PNs.Chemogenetic inhibition of the excitability of PNs in the BLA rescued the anxiety phenotype of InsG3680+/+mice.Further study found that the diminished control of the BLA by medial prefrontal cortex(mPFC)and optogenetic activation of the mPFC-BLA pathway also had a rescue effect,which increased the feedforward inhibition of the BLA.Taken together,our results suggest that hyperactivity of the BLA and alteration of the mPFC-BLA circuitry are involved in anxiety in InsG3680+/+mice.
文摘Transradial access (TRA) has emerged as the preferred vascular access route forcoronary angiography and percutaneous coronary interventions due to itssuperior safety profile compared to transfemoral access. However, its widespreadadoption raises concerns regarding structural alterations in the radial artery,which may impact long-term vascular health and future procedural feasibility.TRA is associated with histopathologic changes in the arterial wall, such asintimal injury and hyperplasia, medial remodeling and adventitial inflammation,collectively contributing to radial artery remodeling. Moreover, TRA can inducechanges in radial artery lumen diameter driven by an inflammatory response dueto arterial puncture and mechanical friction during the procedure. Nonetheless, amore clinically significant consequence is radial artery occlusion, which is influencedby various procedural and patient-related factors. Strategies to minimizeremodeling include meticulous pre-procedural ultrasound assessment to ensureappropriate sheath-to-artery size matching, periprocedural pharmacologicalinterventions and implementation of patent hemostasis techniques. This reviewsynthesizes current knowledge regarding the mechanisms, clinical implications,and preventive strategies related to radial artery remodeling following TRA. Further research is needed toelucidate the long-term consequences of radial artery remodeling and to refine preventive strategies for preservingradial artery patency and its suitability for future interventions.
文摘The present paper addresses two issues pertaining to the use of virtual reality(VR).One issue pertains to the equipment utilized.VR technology can be classified into two main categories:Immersive and non-immersive.The immersive type of technology necessitates the use of substantial equipment,yet it is demonstrably efficacious.Furthermore,the efficacy of this approach is enhanced when combined with relaxation and biofeedback techniques.The other issue is that the efficacy of this approach is diminished when applied to chronic pain,in comparison to acute pain.The relief of chronic pain is a challenging endeavor due to the diminished functionality of the medial prefrontal cortex(mPFC)within the default mode network.Given the close relationship between the mPFC and the reward system dopamine,it is essential to develop a program that activates the reward system dopamine through the use of VR technology.
文摘Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can significantly contribute to emotional disabilities and mental disorders,including panic disorder,phobias,social anxiety disorder,and post-traumatic stress disorder(PTSD).
文摘BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.
