Visual inputs evoke dynamic changes in the responses of visual neurons that evolve over both space and time. All visual experiences must somehow stem from stimulus-evoked spiking patterns in visual brain regions, but determining which neurons and periods of activity causally give rise to perception is one of the grand challenges in neuroscience. Targeted manipulations of neuronal activity while subjects perform sensory tasks have been indispensable for probing computations underlying perception. However, limits on the spatiotemporal precision of neuronal perturbations have constrained the scope of inquiry. Recent advances in optogenetic stimulation approaches have opened the door to augmenting neuronal activity on the spatiotemporal scales of visual computations. Applications of patterned optogenetic stimulation in behaving subjects have revealed many important insights into how different aspects of visual neuronal responses contribute to perception and ultimately behavior. First, we survey optical tools for precise optogenetic perturbations in mice and monkeys. Next, we discuss how patterned optogenetic experiments in behaving subjects have been used to causally test the neural mechanisms underlying perception. Last, we highlight a few key areas that we believe will be important for continued progress in this emerging research area.
The human claustrum is a small bilateral grey matter structure that is highly interconnected with cortical and subcortical regions. It has been implicated in different functions including sleep, multisensory integration, consciousness and attention, yet its exact function remains unclear. The primate claustrum is known to have distinct sensory regions, with the visual zone recently demonstrated in humans using high-resolution fMRI. In this study, we investigated stimulus properties that drive human visual claustrum activity. First, we tested the association of its response with various low- and mid-level physical stimulus features, including temporal and spatial contrast, color and motion. Second, we tested the association with subjective ratings of arousal, valence and interest. To compare the claustrum's responses with visual cortical regions, we performed the same analysis with the hV4 and hMT/V5+ complex. We found that the claustrum's visual response was associated with motion, as well as with arousal, interest and valence. The pattern of claustrum responses was similar to hMT/V5+. Given the well-established link between arousal and attentional allocation, as well as between saliency and motion, our results suggest that the visual claustrum may contribute to saliency detection and attention modulation during the sensory input.
Neuromorphic visual systems require optoelectronic synaptic devices capable of integrating optical sensing, memory, and processing. However, HfO2-based memristors still face challenges in simultaneously achieving stable resistive switching, efficient light-modulated synaptic plasticity, and device-level visual processing. Here, a sol-gel-derived Au/IGZO/HfO2/FTO heterojunction memristor is developed for optoelectronic synaptic emulation and neuromorphic visual applications. The IGZO/HfO2 heterointerface enables synergistic regulation of oxygen-vacancy-related defects, interfacial charge trapping/detrapping, and photogenerated carrier transport, leading to stable bipolar resistive switching and tunable optoelectronic synaptic behavior. The device emulates diverse synaptic functions, including short-term plasticity, long-term potentiation/depression, paired-pulse response, and learning-forgetting-relearning processes. Its excitatory postsynaptic current can be modulated by optical pulse width, power density, pulse number, and read voltage, with a minimum synaptic energy consumption of 11.925 nJ at 0.001 V under an optical pulse width of 0.5 s. Furthermore, a device-array-based feedback-circuit system enables adaptive image contrast enhancement, while neural network simulations achieve recognition accuracies of 97.94% for MNIST and 84.18% for Fashion-MNIST. These results demonstrate the potential of IGZO/HfO2 heterojunction memristors for low-power neuromorphic visual preprocessing and recognition.
A retrospective evaluation of the long-term visual recovery prediction in patients with diabetic macular edema (DME) following aflibercept treatment, based on spectral-domain optical coherence tomography (SD-OCT) parameters at one and four months post-treatment. This study involved 112 eyes of 112 DME patients which received at least one injection of aflibercept. SD-OCT parameters at 1 and 4 months post-aflibercept treatment-including central subfield thickness (CST), the continuity of external limiting membrane (ELM)/ellipsoid zone (EZ) and cone outer segment tip (COST), as well as the counts of retinal hyperreflective retinal foci (HRF), along with best-corrected visual acuity (BCVA) improvement at 12 months post-treatment-were analyzed. The correlation between SD-OCT parameters and BCVA improvement was evaluated using the chi-square or Wilcoxon test, and the predicted value of SD-OCT parameters was assessed via receiver operating characteristic (ROC) curve and binary logistic regression model. Twelve months after aflibercept treatment, BCVA was improved from 0.66 ± 0.46 to 0.48 ± 0.42 logMAR (p = 0.002). The SD-OCT parameters were significantly improved: CST was decreased from 397.05 ± 199.60 to 289.08 ± 119.39 μm; the affected eyes with damaged ELM/EZ and COST decreased from 46 (41.1%) and 71 (63.4%) to 31 (27.7%) and 43 (38.4%), respectively; the number of HRF decreased from 11.00 ± 11.38 to 8.03 ± 9.58. The AUC values for predicting BCVA gain of ≥ 5 letters at 12 months based on SD-OCT parameters at 1 and 4 months post-aflibercept treatment and their combination were 0.812, 0.824, and 0.873, respectively. Multivariate logistic analysis revealed that CST, ELM/EZ, COST, and HRF at 1 and 4 months were all independent predictors of long-term visual improvement outcomes. Intravitreal injection of aflibercept can effectively improve the vision and fundus structure of DME patients. Improvements in short- and medium-term CST, ELM/EZ, COST integrity, and HRF values are key physiological indicators for visual recovery.
To investigate the chemical and visual compatibility of dexmedetomidine injection with 44 secondary intravenous (IV) drugs and six 2-in-1 parenteral nutrition (PN) solutions used in neonatal intensive care unit settings. Dexmedetomidine (1 or 4 µg/mL) was mixed 1:1 with each secondary IV drug or PN solution to simulate Y-site co-administration. Visual compatibility was evaluated for 4 hours and chemical compatibility was determined from dexmedetomidine concentrations using a validated high performance liquid chromatography (HPLC) assay. Absorption/adsorption loss of dexmedetomidine was evaluated in three syringe filters and one in-line filter. Dexmedetomidine injection was visually compatible with all 44 secondary IV drugs and six PN solutions tested, and chemically compatible with 42 drugs. Due to interference by nine secondary drugs in the HPLC analyses of dexmedetomidine at 1 µg/mL, compatibility tests were conducted at a higher concentration of 4 µg/mL against ampicillin, benzylpenicillin, flucloxacillin, hydrocortisone, ibuprofen, indometacin and rifampicin, and the combinations were found to be chemically compatible. However, dexmedetomidine 4 µg/mL was chemically incompatible with ibuprofen lysine injection. Results for cloxacillin were inconclusive due to unresolved interference in the HPLC assay. Modest absorption/adsorption loss of dexmedetomidine (<20%) occurred in the first millilitre of filtrate with clinically relevant filters. Dexmedetomidine injection was chemically and visually compatible with 42 secondary IV drugs and six PN solutions for up to 4 hours. Dexmedetomidine injection should not be combined via Y-site administration with ibuprofen lysine injection. Due to inconclusive results, combining dexmedetomidine and cloxacillin injections via Y-site administration is not recommended.
Acidic carboxylated biomolecules play a pivotal role in regulating the nucleation and growth of inorganic crystals during biomineralization, yet their dynamic behavior throughout the crystallization process remains elusive due to technical limitations in tracking. Herein, we report a biomimetic strategy using carboxylated gold nanoclusters (Au NCs) as carboxylated biomolecules mimics, leveraging their high electron density and fluorescence to visualize brushite (dicalcium phosphate dihydrate, DCPD) mineralization under acidic conditions. Rod-shaped DCPD forms at pH 5.0, while plate-like DCPD is observed at pH 6.5. The carboxyl groups of Au NCs bind to Ca2+ ions, inducing the aggregation of calcium phosphate liquid-like precursor and their subsequent transformation into DCPD. High-resolution transmission electron microscopy (HRTEM) reveals that Au NCs are uniformly dispersed in the initial liquid-like precursor and gradually excluded to the crystal edges during crystallization. Fluorescence microscopy further confirms the localization of Au NCs along the DCPD crystal edges. This work elucidates the mechanism by which carboxylated Au NCs modulate DCPD crystal growth and provides a promising visualizable tool for probing calcium phosphate crystallization pathways. Moreover, it expands the design of biomimetic mineralization regulators and offers valuable insights for fundamental research on crystal growth control.
Site-specific fluorescent tagging enables visualization of protein conformational changes and molecular interactions on native biological assemblies. Using the HIV-1 envelope (Env) glycoprotein as an example, this protocol details a site-specific dual-fluorophore tagging strategy suitable for downstream single-molecule Förster resonance energy transfer (smFRET) studies. Genetic code expansion via amber (TAG stop codon) suppression, combined with click chemistry, offers a minimally invasive route to such labeling. However, the sequential incorporation of noncanonical amino acids (ncAAs) at two introduced amber codons often faces low efficiency and off-target readthrough at naturally occurring amber sites in the viral genome. To mitigate these technical constraints, the methods employ an engineered "intact amber-free HIV-1 provirus" in which endogenous TAG codons in essential viral genes are replaced with TAA. This design allows precise incorporation of ncAA trans-cyclooct-2-en-L-lysine (TCO*A) exclusively at two engineered amber sites within Env during virion production in HEK293T cells, followed by labeling via strain-promoted inverse electron-demand Diels-Alder cycloaddition with tetrazine-conjugated fluorophores. The method supports site-specific dual-click labeling for smFRET analysis and single-site labeling for live-cell imaging. The methods presented here provide stepwise procedures for click-chemistry labeling and visualization of Env on intact virions and can be easily adapted for single- or dual-site biorthogonal tagging of other viral and cellular proteins.
The durability of platinum (Pt) electrocatalysts in electrochemical energy conversion is fundamentally challenged by surface oxidation and dissolution during electrochemical operation. Although Pt surface oxidation has commonly been discussed in terms of a "place exchange" mechanism between Pt and oxygen, atomic-scale insight into its potential-dependent progression has remained limited. Herein, we directly visualize atomic electrooxidation and dissolution of {111}-terminated surfaces of octahedral Pt nanoparticles by employing ex situ differential-phase-contrast scanning transmission electron microscopy combined with online inductively coupled-plasma mass spectroscopy and density functional theory calculations. We reveal the atomistic structural evolution of the {111} nanoparticle surface with progressively increasing electrode potentials (0.8-1.5 V), from the initial lattice expansion induced by adsorbed oxygen, to vacancy-induced formation of two-dimensional, lattice-contracted PtOx monolayers, and finally to a dimensional transition to three-dimensional PtO2 growth. Furthermore, we demonstrate how the potential cycling protocols (triangular versus square wave cycling) decisively control the final oxide's dimensionality (multilayer versus single layer) and stability. These atomic-scale insights establish how electrochemical conditions dictate Pt oxidation pathways and atomistic structural evolution, providing a mechanistic basis for understanding and improving the durability of Pt-based electrocatalysts.
Early detection of pancreatic fluid leakage is essential after pancreaticojejunostomy, a surgical procedure connecting the pancreas to the jejunum, typically performed during pancreaticoduodenectomy, as delays in identifying the leakage can lead to severe postoperative complications. Here, we present a starch-based aerogel that enables simple and visual detection of leakage through amylase-triggered structural degradation. The aerogel's highly porous network accelerates liquid diffusion and enzymatic hydrolysis, producing a clear degradation response correlated with enzyme concentration. However, native starch aerogels lack wet stability and rapidly disintegrate in aqueous environments. To address this, cellulose nanofibers (CNFs) were incorporated as a reinforcing scaffold, enhancing mechanical integrity in hydrated conditions without hindering enzymatic accessibility. The resulting starch-CNF aerogel remained stable under normal postoperative amylase levels (∼100 U/L) but degraded rapidly under leakage-associated conditions (>300 U/L). This material offers a low-cost, biocompatible, and easily deployable platform suitable for integration into standard drainage systems, enabling rapid bedside assessment of pancreatic fluid leakage.
Despite the widespread use of visual analog scales (VASs), their psychophysical and psychometric properties for rating dysarthria remain largely untested. Using a scale whose measurement properties, reliability, and validity are unknown undermines the comparison of findings across studies and clinical contexts. Therefore, we investigated these properties of VAS using samples of hypokinetic dysarthria. Thirty-seven nonexperts and three dysarthria experts evaluated 85 speech samples from individuals with Parkinson's disease and healthy controls on overall severity, reduced loudness, articulatory imprecision, short rushes of speech, and monotony. Listeners used VAS and direct magnitude estimation (DME), which is an established ratio-level scale, to complete the ratings. To determine measurement level, we assessed the relationship between VAS and DME; for inter- and intrarater reliability, we calculated intraclass correlation coefficients for both scales, and for criterion validity for both scales, we applied Spearman's correlations to the nonexpert and expert ratings. VAS ratings showed strong linear relationships with DME for overall severity, reduced loudness, short rushes of speech, and monotony. Inter- and intrarater reliability values were good to excellent for VAS and significantly higher than those for DME. Criterion validity was strong to very strong for both scales across all features. Compared to experts, nonexperts provided significantly higher VAS and DME scores; however, the effect sizes of the between-listeners group differences were small. VAS is a reliable and valid ratio-level scale for assessing prothetic features of hypokinetic dysarthria including overall severity, reduced loudness, and short rushes of speech. For metathetic dimensions such as monotony, a linear relation between VAS and DME does not indicate that the VAS functions as a ratio scale since linearity is expected for both interval- and ratio-scaled judgments. More work is needed to address the feature-specific variations and establish additional psychometric properties of VAS, such as sensitivity and specificity.
Limb deformities have a close pathological link with peripheral nerve injuries; however, there is currently a lack of analysis and summary of research trends in this field aimed at elucidating the close relationship between limb deformities and peripheral nerve repair. Based on the Web of Science Core Collection database, this study retrieved 897 articles published between 2001 and 2025. A bibliometric analysis using CiteSpace and VOSviewer was therefore conducted to comprehensively map the research landscape, hotspots, and evolving trends in this field, revealing a sustained annual upward trend in research output. The University of Washington (UW, Seattle) was the institution with the most publications and the greatest impact. The Journal of Pediatric Orthopaedics was the journal with the most publications, while the Journal of Bone and Joint Surgery-American Volume was the journal with the greatest academic impact. Keyword analysis identified two major clusters of interest: diabetic peripheral neuropathy and foot deformities, involving studies on Charcot neuroarthropathy, diabetic foot ulcers, and amputation prevention; and birth-related brachial plexus palsy and its secondary shoulder and elbow deformities, focusing on functional reconstruction strategies such as tendon transfer and osteotomy. Burst keyword analysis revealed a clear shift in the research focus. From 2003 to 2013 (the early period), studies primarily focused on single-site functional impairments and conservative treatments (such as botulinum toxin). From 2014 to 2025 (the recent period), the focus shifted toward investigating "prevalence" and "risk factors," as well as conducting in-depth studies on "reconstructive" surgery, diabetic foot ulcers, and molecular mutation mechanisms. Current research in this field focuses on the bidirectional relationship between "malformations" and "nerves," exploring how nerve injuries cause malformations and investigating secondary nerve compression and damage following malformations. Peripheral neuropathies, such as diabetic peripheral neuropathy, Charcot-Marie-Tooth disease, and obstetric brachial plexus palsy, are the key direct or indirect causes of specific limb deformities (such as foot deformities, talipes, and forearm supination deformities). Research on the mechanical effects of deformities on nerves focuses on how skeletal deformities (such as elbow valgus/varus or knee valgus) result in or exacerbate nerve entrapment syndromes (such as ulnar nerve or common peroneal nerve injuries) through abnormal biomechanical mechanisms (such as excessive traction or dynamic compression). During surgeries for correcting complex deformities, the use of intraoperative nerve monitoring provides real-time early warning to avoid iatrogenic brachial plexus injuries and ensure patient safety, which has become a prominent technical focus. Previous studies have established the criteria for early monitoring of shoulder deformities and Mallet functional assessment following obstetric paralysis. Research over the past 5 years has focused on the mechanisms by which deformities exert mechanical effects on nerves, as well as the application of precision surgical techniques and intraoperative nerve monitoring. Surgical repair strategies for cubital tunnel syndrome and ulnar nerve palsy-induced claw hand are also among the key clinical areas of interest. Overall, these findings indicate that research on limb deformities associated with peripheral neuropathy and injury repair has evolved into two major research domains, focusing on nerve repair for deformities caused by diabetic peripheral neuropathy and limb deformities resulting from obstetric paralysis. Current research trends are moving toward precision, minimally invasive approaches, and multidimensional efficacy assessments. Future research should deepen the understanding of the "deformity-nerve" interaction mechanisms, focus on early warning systems, intraoperative nerve monitoring, and individualized functional reconstruction, and thereby improve patient outcomes and surgical safety.
The incentive spirometer (IS) promotes lung expansion, but its physiological effects remain unclear. We hypothesized that the low-cost Asepto syringe could be a viable alternative. This study compared the different number of IS balls and Asepto syringe in healthy volunteers, evaluating their impacts on tidal volume (Vt), end-expiratory lung volume (EELV), regional ventilation distribution, lung homogeneity, and dynamic lung strain. In this prospective crossover pilot trial, healthy volunteers were randomly assigned to start with either the Asepto syringe or incentive spirometer. All participants used both devices, and lung function was assessed using Electrical Impedance Tomography. The study included 24 participants (63%female). Vital signs remained stable post-intervention. Three-ball IS produced the highest Vt in mL: 1,868 [1313-2392], followed by the Asepto syringe 1,264 [770-1728], 2-ball IS 1,231 [942-1629] and 1-ball IS 920 [624-1591] compared to Vt at baseline (p<0.0001). The 1- and 2-ball IS improved EELV in mL (439 [251-908] and 496 [117-767], respectively, p<0.001) with a higher number of breaths achieving target per minute. All devices increased dorsal ventilation compared to baseline (p=0.048). Although dynamic lung strain from IS and Asepto syringe was higher than baseline (p<0.0001), all values were below threshold of potential lung injury. For promoting lung expansion in healthy volunteers, the Asepto syringe might be an alternative to employing an incentive spirometer. One-or two-ball IS improved EELV and adherence. Effects in patients with lung disease warrant further study.
The objective is to compare the safety and efficacy of dual-axis rotational coronary angiography (DARCA) with standard coronary angiography (SA). We performed a systematic review and meta-analysis comparing the efficacy of coronary lesions visualization and safety endpoints for patients with suspected coronary artery disease undergoing DARCA and SA. We searched PubMed, Google Scholar, and Cochrane databases for head-to-head trials. Mean differences (MD) with 95% confidence intervals (CI) were pooled with a random-effects model with a Paule-Mendel estimator using RStudio software. Three studies corresponding to 128 patients met the inclusion criteria. 128 (100%) patients underwent both DARCA and SA. Compared with SA, DARCA had no significant diagnostic accuracy difference for coronary lesion visualization (MD = -0.19 lesions per patient; 95% CI = [-0.52; 0.15]; p = 0.28) but was associated with a substantially lower contrast dose used (MD = -16.77 cm3; 95% CI = [-26.00; -7.55]; p < 0.01) and radiation exposure (MD = -11.89 Gycm2; 95% CI = [-17.09; -6.65]; p < 0.01). In the meta-analysis, DARCA had no significant difference in coronary lesion visualization and lower contrast and radiation used compared with SA. Nuestro objetivo fue el de comparar la seguridad y eficacia de la angiografía coronaria rotacional de doble eje (DARCA) con la angiografía coronaria estándar (AS). Realizamos una revisión sistemática y un metanálisis comparando la eficacia de la visualización de lesiones coronarias y los criterios de valoración de seguridad para pacientes con sospecha de enfermedad coronaria (CAD) sometidos a DARCA y AS. Buscamos ensayos comparativos en PubMed, Google Scholar y bases de datos Cochrane. Las diferencias de medias (DM) con intervalos de confianza (IC) del 95% se agruparon con un modelo de efectos aleatorios con un estimador de Paule-Mendel utilizando el software RStudio. Tres estudios correspondientes a 128 pacientes cumplieron los criterios de inclusión. 128 (100%) pacientes se sometieron tanto a DARCA como a AS. En comparación con la angiografía asistida por sonda, la DARCA no mostró una diferencia significativa en la precisión diagnóstica para la visualización de lesiones coronarias (MD -0,19 lesiones por paciente; IC del 95% [−0.52; 0.15]; p = 0.28), pero se asoció con una dosis de contraste utilizada sustancialmente menor (MD = −16.77 cm3; IC del 95% = [−26.00; −7.55]; p < 0.01) y una exposición a la radiación (MD = −11.89 Gycm2; IC del 95% = [−17.09; −6.65]; p < 0.01). En el metanálisis, la DARCA no mostró una diferencia significativa en la visualización de lesiones coronarias y se utilizó un contraste y una radiación menores en comparación con la angiografía asistida por sonda.
We analyzed the prognostic value of an interim [18F]FDG PET/CT performed after cycle 3 of [177Lu]Lu-PSMA-617 ([177Lu]Lu-PSMA) for patients undergoing therapy for metastatic castration-resistant prostate cancer (mCRPC). Methods: We retrospectively reviewed the data of patients with mCRPC in the ProsTIC Registry (NCT04769817) receiving [177Lu]Lu-PSMA who underwent [18F]FDG PET/CT at both baseline and after cycle 3. Parameters included visual response assessment (progression vs. no progression) and metabolic tumor volume (MTV) (≥20% increase vs. <20% increase or any decrease). Outcomes were measured against reductions of 50% or greater in prostate-specific antigen (PSA) levels (PSA-50) by Fisher exact test and time-to-event outcomes. PSA progression-free survival (PFS) and overall survival (OS) were defined relative to cycle 3, using Kaplan-Meier estimation. Results: Thirty-four patients (median age, 72 y; interquartile range, 66-77 y) were eligible for study inclusion. Their median PSA was 58 ng/mL (interquartile range, 17-176 ng/mL) before treatment. All patients had prior treatment with androgen receptor pathway inhibitors, and 33 had received at least 1 line of chemotherapy. Visual progression on interim [18F]FDG PET was observed in 18 patients (53%) and was associated with shorter median PFS after cycle 3 (1.2 mo; 95% CI, 0.7-2.0) compared with those patients without visual progression (5.2 mo; 95% CI, 3.6-7.0) (P = 0.0005) and lower achievement of PSA-50 (28% vs. 75%, P = 0.015). Median OS did not significantly differ between those with and without visual progression (10.3 mo; 95% CI, 6.1-17.1 mo vs. 16.4 mo; 95% CI, 10.5-21.4 mo, respectively) (P = 0.090). An increase of at least 20% in MTV was observed in 11 patients (32%) who, when compared with those whose MTV increased or decreased by less than 20%, had a shorter median PFS (0.7 mo; 95% CI, 0.6-1.4 mo vs. 4.9 mo; 95% CI, 2.2-6.6 mo; P < 0.0001) and OS (10.8 mo; 95% CI, 2.1-17.1 mo vs. 16.4 mo; 95% CI, 10.3-20.1 mo; P = 0.069) and lower PSA-50 response (9.1% vs. 70%, P = 0.002). Conclusion: Visual and quantified changes on interim [18F]FDG PET appeared prognostic for PFS in patients undergoing [177Lu]Lu-PSMA therapy and correlated with PSA response. Further studies are needed to determine whether [18F]FDG PET could serve as an independent biomarker to guide treatment intensification or de-escalation, including treatment pauses.
To compare the therapeutic effects of different electrical stimulation modalities combined with rehabilitation training on lower limb function improvement in patients following anterior cruciate ligament reconstruction. PubMed, Embase, Web of Science, Scopus, and CNKI databases were systematically searched from inception to March 2, 2026, and a meta-analysis was subsequently conducted to evaluate the included studies (PROSPERO registration number: CRD420261364272). A total of 11 randomized controlled trials involving 629 patients were included. Traditional meta-analysis showed that electrical stimulation combined with rehabilitation training was significantly superior to rehabilitation training alone in Visual Analog Scale (SMD = -0.596, 95% CI -0.990 to -0.202) and range of motion (SMD = 0.716, 95% CI 0.138 to 1.294), but showed no significant difference in International Knee Documentation Committee (MD = 1.931, 95% CI -3.663 to 7.526, P = 0.499). Network meta-analysis revealed that neuromuscular electrical stimulation significantly improved Visual Analog Scale (SMD = -0.837, 95% CI -1.420 to -0.254) and range of motion (SMD = 1.274, 95% CI 0.927 to 1.622) compared with rehabilitation alone, and was superior to transcutaneous electrical nerve stimulation in range of motion (SMD = -1.185, 95% CI -1.717 to -0.653). The surface under the cumulative ranking curve results indicated that neuromuscular electrical stimulation ranked first for Visual Analog Scale (92.5%) and range of motion (99.9%). No significant difference was found compared with rehabilitation alone for International Knee Documentation Committee scores (P > 0.05). Electrical stimulation combined with rehabilitation training can effectively improve Visual Analog Scale and range of motion after anterior cruciate ligament reconstruction, with neuromuscular electrical stimulation demonstrating the optimal effect, although its improvement on International Knee Documentation Committee was limited. Based on the current evidence, rehabilitation training combined with neuromuscular electrical stimulation is recommended as an adjunctive treatment protocol.
To evaluate the feasibility and image quality of dynamic 3-T magnetic resonance imaging (MRI) for visualizing and quantifying peroneal tendon motion during active dorsiflexion and plantarflexion. This prospective pilot study was approved by the Swedish Ethical Review Authority (Dnr 2020-00029). Asymptomatic adults without prior ankle trauma underwent dynamic ankle MRI at 3 T using a balanced fast field-echo sequence (axial at the lateral malleolus) during active dorsiflexion/plantarflexion. Three musculoskeletal radiologists rated five image-quality criteria (five-point Likert); agreement was quantified with Gwet's AC2 and Fleiss' κ. The highest-rated sequence was analyzed. One musculoskeletal radiologist manually segmented the peroneus longus and peroneus brevis tendons; Euclidean centroid distance was computed per frame. For intra-rater analysis, an independent person randomly selected three volunteers; segmentation was repeated after 1 month, and reliability was assessed with the intraclass correlation coefficient (ICC) (2,1). Ten volunteers aged 36.6 ± 7.8 years (mean ± stasndard deviation) were included. Tendon motion was visualized in all volunteers with good image quality (median 4; mean 4.04-4.10). Agreement was strongest for retinaculum visibility and ability to follow tendon motion (AC2 = 0.621 and 0.557, respectively). Centroid distance increased in dorsiflexion and decreased in plantarflexion (excursion 2.95-4.83 mm). Intra-rater reliability was good (ICC = 0.85; 95% confidence interval 0.723-0.922; p < 0.001). Dynamic MRI enabled reproducible, high-quality visualization and quantification of peroneal tendon motion during active ankle movement and warrants evaluation in suspected peroneal tendon instability. Dynamic real-time 3-T MRI enables visualization and quantitative tracking of peroneal tendon motion during active ankle movement, and may complement static imaging in future studies of suspected peroneal tendon instability. Real-time 3-T MRI showed peroneal tendon motion in all volunteers. Image quality was consistently good for tracking tendons during ankle movement. Centroid-to-centroid distance between tendons was highly repeatable over time.
Blue light is a physiological component of visible light, essential for daytime vision and circadian synchronization. There is no evidence supporting the routine use of blue-blocking glasses for preventive or therapeutic purposes. The most effective strategies are based on light hygiene, reduction of nocturnal exposure, and patient education. Strengthening scientific communication is necessary to counter misinformation and maintain an evidence-based ophthalmological discourse. Blue light has been associated with potential effects on visual function, sleep, and circadian physiology, although clinical evidence remains heterogeneous. In recent years, dissemination of claims unsupported by clinical evidence regarding spectral filters for preventive purposes has increased. The aim of this review was to critically analyze the available scientific evidence on the visual, circadian, and systemic effects of blue light and contrast it with messages disseminated through media and social networks. A narrative review of the literature published between 2009 and 2025 was conducted using PubMed, Scopus, and the Cochrane Library, prioritizing human studies and institutional position statements relevant to ophthalmological practice. Available systematic reviews and controlled trials indicate that blue-filtering lenses do not provide clinically meaningful improvements in visual acuity or symptoms of digital eye strain, and show small and inconsistent effects on sleep-related outcomes. Under typical viewing conditions, screen light exposure remains well below levels associated with photochemical retinal damage in experimental models. Therefore, current evidence does not support the routine preventive or therapeutic use of blue-blocking glasses. The most effective strategies rely on light hygiene, reduction of nocturnal light exposure, and patient education.
Transmission electron microscopy (TEM), together with Thioflavin T (ThT) fluorescence assays, is widely used to visualize amyloid fibrils and to characterize the kinetics of amyloid formation. However, discrepancies between ThT fluorescence data and TEM observations are sometimes reported, which may arise from limitations in fibril visualization by TEM. In particular, TEM imaging can be strongly influenced by the sample loading procedure on the grid, which governs fibril deposition and retention. In this work, five different grid preparation methods were compared to evaluate their efficiency in detecting and visualizing human islet amyloid polypeptide (hIAPP) fibrils, which are present in 95% of patients with type 2 diabetes mellitus. The methods were assessed based on detection speed, morphological representation, fibril abundance and grid contamination. The two best-performing methods were further evaluated for detecting early hIAPP aggregates and subsequently applied to another amyloid forming protein, namely amyloid-β 42 (Aβ42), which is involved in Alzheimer's disease. Among the tested approaches, method 2 (a droplet-deposition protocol) and method 3 (a centrifugation-based loading protocol) provided the most efficient fibril detection and morphological representation. Method 2 was identified as the best compromise between rapid detection, experimental simplicity, and low grid contamination, and was further tested under different buffer conditions. Overall, this comparative study demonstrated that variations in grid preparation protocols can significantly influence TEM observations and provide practical guidance for selecting optimal conditions for amyloid fibril imaging depending on experimental objectives.
Chronic ankle instability (CAI) is a common consequence of lateral ankle sprain and is characterized by recurrent episodes of giving way and impaired neuromuscular control. Neuromuscular control impairments (such as decreased postural stability and delayed muscle responses) are dominant during reduced vision. However, the neural mechanisms underlying impaired sensorimotor integration under reduced vision remain unclear. As a key structure involved in sensorimotor processing, the role of the cerebellum during vision-related neuromuscular control impairments has not been well defined. (1) Are there any differences in cerebellar activation across different visual conditions in patients with CAI compared with a control group? (2) Are there any associations between vision-related cortical activation changes and static and dynamic neuromuscular control deficits in patients with CAI? This cross-sectional study enrolled physically active adults with unilateral CAI and control participants matched for age, sex, and activity level. Between May and September 2025, a total of 55 individuals were screened. Of these, 64% (35 of 55) were considered eligible based on the inclusion criteria, consisting of 57% (20 of 35) in the CAI group (nine females, mean ± SD age 28 ± 7 years) and 43% (15 of 35) in the control group (eight females, mean age 25 ± 4 years). To assess cerebellar activation and its relation to neuromuscular control, all participants underwent task-based functional MRI (fMRI) and laboratory-based neuromuscular assessments. During fMRI, participants performed repetitive ankle dorsiflexion and plantarflexion movements using an MRI-compatible device under alternating eyes-open and eyes-closed conditions in a block design. Neuromuscular control was assessed during single-leg stance and a sudden ankle inversion (trapdoor) task. Postural stability was quantified using the Romberg ratio derived from center-of-pressure measures. Dynamic neuromuscular response was evaluated by peroneal reaction time using surface EMG synchronized with motion capture. Ankle function and perceived instability were assessed using questionnaires (Cumberland Ankle Instability Tool [CAIT], Foot and Ankle Ability Measure [FAAM], and Ankle Ligament Reconstruction-Return to Sport After Injury [ALR-RSI] tool). Whole-brain analyses were conducted to identify between-group differences in vision-related activation (eyes closed minus eyes open) using a general linear model with Gaussian random field correction. Clusters greater than 50 voxels were considered to be the minimum clinically important difference. Correlation analyses were performed to examine associations between neural activation patterns, neuromuscular outcomes, and clinical measures, with age and sex included as covariates. Compared with controls, individuals with CAI demonstrated reduced activation when eyes changed from open to closed in bilateral cerebellar regions including lobule VI (left hemisphere: cluster size 156 voxels, group mean difference -25.1 [95% confidence interval (CI) -40.1 to -10.1]; p < 0.001; right hemisphere: cluster size 153 voxels, group mean difference -21.7 [95% CI -36.3 to -7.6]), vermis VI (cluster size 51, group mean difference -26.6 voxels [95% CI -44.8 to -8.4]), and crus I (cluster size 112 voxels, group mean difference -21.9 [95% CI -35.8 to -8.1]), as well as in the left fusiform gyrus (cluster size 54 voxels, group mean difference -18.1 [95% CI -29.3 to -6.8]). Correlation analyses revealed that reduced activation in cerebellar and fusiform gyrus in both eyes-open and eyes-closed states was moderately associated with delayed peroneal reaction time in both visual conditions (eyes open: r = -0.38; p = 0.03; eyes closed: r = -0.40; p = 0.02) and worse self-reported ankle stability and function, as measured by the CAIT (r = 0.34; p = 0.046) and ALR-RSI (r = 0.38; p = 0.02). No correlations were observed between cerebellar activation and Romberg ratio. Patients with CAI demonstrated reduced cerebellar activation across visual conditions, which was associated with delayed dynamic muscle responses and worse perceived ankle stability. These findings suggest that patients with CAI had vision-related central activation strategies, such as reduced cerebellar activation when eyes were closed compared with controls. Such neural alterations were associated with decreased neuromuscular control and diminished ankle function. These vision-specific central alterations may be important in designing future interventions aimed at enhancing central sensorimotor integration.
This study examined whether elite Taekwondo athletes invest additional time to make better decisions under uncertainty by using a perception-action coupling task with temporal occlusion. Eighteen elite and 18 amateur Taekwondo athletes completed an embodied choice task in which they observed an opponent's kicking action and executed a corresponding motor response. Three temporal occlusion levels were used to manipulate the amount of visual information available (T1, T2, and T3). Reaction time, prediction accuracy, and decision confidence were analyzed using linear mixed-effects models. Descriptive results showed that amateurs became slightly faster from T1 to T3, whereas elites were slower at T1 but fastest at T3. Elites also showed substantial improvements in prediction accuracy and decision confidence as visual information increased, whereas amateurs showed only modest changes in accuracy and a gradual decline in confidence. The linear mixed-effects models revealed significant effects of group, occlusion level, and their interaction for reaction time and prediction accuracy, and a significant Group × Occlusion interaction for decision confidence. These findings suggest that elite Taekwondo athletes do not simply react faster; rather, they strategically delay their responses under high uncertainty and respond more efficiently once decisive kinematic cues become available. The results support the applicability of the embodied choice framework to one-to-one combat sports and highlight the importance of training perceptual timing and anticipatory skill in Taekwondo.