BACKGROUND: Conventionally, neural transfer of the spinal accessory nerve to the suprascapular nerve for shoulder abduction in traumatic brachial plexus injury is performed via the anterior approach. However, important advantages of the posterior approach have made it an alternative option, such as the proximity of neural coaptation to the muscle to be reinnervated and negating the effects of a second injury to the suprascapular nerve.
METHODS: Retrospective data was collected from 30 patients with brachial plexus injury who underwent spinal accessory nerve to suprascapular nerve transfer over 4 years. There were 15 patients in the anterior-approach group (group A) and 15 in the posterior-approach group (group B). Functional outcome at the shoulder was measured as muscle power and active range of motion at 18 months, and data on patients\' satisfaction levels and surgeons\' perceptions was also collected.
RESULTS: No statistical difference was found in the muscle strength achieved in the 2 groups (P = 0.34), but significant recovery was found in the external rotation achieved by group B (P = 0.02). Statistical difference was insignificant in the 2 groups\' active range of motion during abduction and external rotation. The satisfaction index of patients was 86.7% in group B as compared to 68% in group A. Surgeons\' perspective showed a faster speed of suprascapular nerve exploration in the posterior approach, with better visibility of supraspinatus muscle contraction, and overall surgeons preferred the posterior approach.
CONCLUSIONS: External rotation at the shoulder is better via the posterior approach, but no difference in abduction was noted. Patients who underwent the posterior approach were more satisfied with the recovery, and surgeons preferred the posterior approach.

This pilot study assessed the feasibility of performing a randomized control trial (RCT) investigating injection with platelet-rich plasma (PRP) for dorsal wrist ganglion (DWG). Aspiration alone was compared with aspiration plus injection of PRP. Seventeen patients were enrolled. Nine patients received PRP and eight aspiration alone. Patients were followed up at 6 weeks and 1 year; recurrence of the ganglion and Patient Evaluation Measure scores were measured. At 6 weeks seven patients in the aspiration group had a recurrence and five in the PRP group, but by 1 year, this has increased to seven out of eight in the PRP group whereas in the aspiration group four had resolved leaving three out of eight patients with a ganglion still present. From the basis of our work an RCT would require a minimum of 46 patients per group; however, it is unlikely that PRP will be a panacea for ganglia. This is a Level II study.

UNASSIGNED: To compare the stability of the radius stabilized fractured parts by volar and dorsal planting based on modeling approach.
UNASSIGNED: Ten forearm models were created based on Computed Tomography (CT) Scan images by using of Mimics software. The distal part fracture of radius was induced in the models. The stress were developed and implanted in various parts of the bone and and their displacement were evaluated in volar and dorsal inserted implants.
UNASSIGNED: The results of this study showed that the stress developed in screws, implant and bony parts differed significantly between volar and dorsal plate conditions. The displacement of implant and bony parts in volar plating was more than dorsal plating (p=0.05). However, the screws displacement in dorsal plating significantly increased compared to volar plating.
UNASSIGNED: The stress developed in dorsal and volar implants is not too high to fail the structure. However, it seems that the irritation of soft tissue and tendon would be less in volar inserted implant than dorsal implant. It is recommended to use valor plating to be a good approach for stabilizing the distal part fracture of radius.

UNASSIGNED: In the absence of any exclusive classification for dorsal FJA, there is a lot of confusion while labelling grade 1 FJA in thoracic spine based on decreased FJ space.
UNASSIGNED: The purpose of this study was to know the facet joint space measurements in thoracic spine of asymptomatic and symptomatic participants and to comment whether the lower cut-off of 2 mm used in lumbar FJA classification can be safely applied in thoracic spine too.
UNASSIGNED: This cross-sectional study was done from December 1, 2018 to November 30, 2019. Patients above 18 years of age in this study who underwent CT thorax for causes unrelated to dorsal spinal pain were included. IBM SPSS Statistics v 26 was used for statistical analysis.
UNASSIGNED: We measured and analysed 1512 thoracic facet joints in 63 patients (30 females and 33 males) in both axial and sagittal plane on CT scan. Mean age of the entire sample was 59.19 ± 15.19 years, ranging from 33 to 97 years and a standard error of mean 1.365 years. Overall mean thoracic facet joint space was measured to be 1.270 mm ± 0.3416 mm, ranging from 0 to 3.1 mm and a standard error of mean 0.0088 mm and a variance of 0.117 mm. The median was 1.300 mm while mode was 1.1 mm.
UNASSIGNED: The popular lumbar FJA classification by Weishupt et al. cannot be applied in its present form in thoracic spine, without the modification in parameters of grade 1 FJA. The lower cut-off of normal thoracic facet joint space probably lies around 1 mm.

Attention is a major cognitive function that allows the individuals to focus selectively on a discrete stimulus while ignoring others. Visual information could be driven endogenously, when the goals or desires are voluntary, or exogenously, in response to salient visual events in the environment. Since subjects with attention deficit hyperactivity disorder (ADHD) show heightened distractibility during activities that require significant attentional engagement, we hypothesized that they may be more severely impaired in their ability to perform endogenous tasks than controls. To elicit endogenous and exogenous shifts of attention, we thus used a modified version of Posner\'s cueing task. We compared oculomotor performance measured by an eye tracker in a group of 31 children with ADHD (mean age = 9.1 ± 1.3 years) and age-, sex-, and IQ-matched typically developing children. Endogenous and exogenous conditions were explored in three distinct visual sub-conditions (valid, invalid, and neutral). We found that children with ADHD showed longer latency during endogenous conditions compared to TD children in invalid sub-conditions. They also performed more errors than controls, during the endogenous task in neutral sub-conditions and during exogenous task in neutral and invalid sub-conditions. Our study suggests that children with ADHD may allocate their attention resource toward the detection of exogenous targets with a deficit in their ability to perform endogenous task. We suggest also that they have a difficulty in the engagement of the inhibitory control system particularly during voluntary saccade performance. This could result from impaired interactions between the ventral and dorsal attention networks as well as in the frontal eye field, although neuroimaging studies are necessary to validate this hypothesis in the ADHD population.

An important innate immune response in Drosophila melanogaster is the production of antimicrobial peptides (AMPs). Expression of AMP genes is mediated by the Toll and immune deficiency (IMD) pathways via NF-κB transcription factors Dorsal, DIF and Relish. Dorsal and DIF act downstream of the Toll pathway, whereas Relish acts in the IMD pathway. Dorsal and DIF are held inactive in the cytoplasm by the IκB protein Cactus, while Relish contains an IκB-like inhibitory domain at the C-terminus. NF-κB factors normally form homodimers and heterodimers to regulate gene expression, but formation of heterodimers between Relish and DIF or Dorsal and the specificity and activity of the three NF-κB homodimers and heterodimers are not well understood. In this study, we compared the activity of Rel homology domains (RHDs) of Dorsal, DIF and Relish in activation of Drosophila AMP gene promoters, demonstrated that Relish-RHD (Rel-RHD) interacted with both Dorsal-RHD and DIF-RHD, Relish-N interacted with DIF and Dorsal, and overexpression of individual RHD and co-expression of any two RHDs activated the activity of AMP gene promoters to various levels, suggesting formation of homodimers and heterodimers among Dorsal, DIF and Relish. Rel-RHD homodimers were stronger activators than heterodimers of Rel-RHD with either DIF-RHD or Dorsal-RHD, while DIF-RHD-Dorsal-RHD heterodimers were stronger activators than either DIF-RHD or Dorsal-RHD homodimers in activation of AMP gene promoters. We also identified the nucleotides at the 6th and 8th positions of the 3\' half-sites of the κB motifs that are important for the specificity and activity of NF-κB transcription factors.

OBJECTIVE: Carpometacarpal (CMC) joint subluxations of the fifth finger are rare injuries and are notoriously difficult to diagnose due to severe swelling and overlapping of bones on radiographs. Various radiographic studies have been suggested to identify these injuries. We hypothesize that there will be no difference between various oblique radiographs for detection of a fifth finger CMC subluxation.
METHODS: Using 4 cadaveric specimens, we took radiographs at various angles (0°, 30°, 45°, and 60°) with the fifth metacarpal in anatomic position, subluxated 25% and 50% dorsally. Radiology and orthopedic residents, fellows, and attending physicians viewed each image to determine whether a subluxation was present. Data were analyzed using area under the receiver operating curve, sensitivity, and specificity.
RESULTS: A total of 36 responses were obtained from 9 radiologists (4 residents, 3 fellows, 2 attendings) and 27 orthopedic surgeons (16 residents, 8 fellows, 3 attendings). Radiographs taken at 60° were more sensitive and specific (Sn 85, Sp 60) than at 0° (Sn 64, Sp 33), 30° (Sn 84, Sp 47), or 45° (Sn 80, Sp 49). Area under the receiver operating curve was also higher for 60° (0.87) than 0° (0.59), 30° (0.75), and 45° (0.75).
CONCLUSIONS: Sensitivity, specificity, and area under the receiver operating curve were highest for 60° radiographs. We recommend obtaining radiographs of the hand in 60° of pronation from the lateral if there is suspicion for a fifth CMC subluxation or dislocation.
CONCLUSIONS: This study suggests a simple radiographic view to enhance the diagnosis of fifth CMC subluxations.