(1) Background: Whey protein (WP) in combination with resistance training (RT) is beneficial in improving sarcopenic obesity and its damaging effects in older adults, while the difference between men and women should be considered while interpreting results. This review aims to investigate WP’s efficacy on postmenopausal women with or without RT; (2) Material and Methods: We searched electronic databases including PubMed, EMBASE, and the Cochrane Library from inception to August 2021 for randomized controlled trials that included comparison groups to evaluate WP’s efficacy in women aged 55 years and above. The outcomes included body composition, muscular strength, functional capacity, and dietary intake. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to estimate the effect of WP. We also performed subgroup analysis with or without RT; (3) Results: We included 14 studies in the systematic review and 10 studies in the meta-analysis. Subgroup analyses showed RT was a major confounder for muscle strength, lean mass, and dietary protein intake (PI). In the RT subgroup, WP supplementation had a significant positive effect on biceps curl strength (BC) (SMD: 0.6805, 95% CI: 0.176, 1.185, I²: 0%), and lower limb lean-mass (LLLM) (SMD: 1.103, 95% CI: 0.632, 1.574, I²: 14%). In the subgroup without RT, a significant negative effect on PI (SMD: −0.4225, 95% CI: −0.774, −0.071, I²: 47%) was observed, while no significant effect on muscle strength or lean mass was revealed. WP supplementation did not show a significantly different effect on fat mass or body weight loss in both the subgroups; (4) Conclusions: In postmenopausal women, WP supplementation only in combination with RT enhances BC and LLLM compared to placebo controls. Without RT, WP has no significant benefit on muscle strength or lean mass.

Primary bone lymphoma (PBL) comprises less than 5% of all malignant bone tumors and almost 7% of all extranodal lymphomas. Only 1.7% of all PBLs have been reported to involve the vertebrae. In our case, osteomyelitis was accidentally found during surgery, which might have resulted in the rapid collapse of vertebral body. This is the first report on primary lymphoma of the vertebrae with superimposed osteomyelitis in the English literature to the best of our knowledge. The patient reported here received anterior vertebrectomy and posterior interbody fusion with instrumentation for spinal instability. Tumor mass and the necrotic debris were removed. After the procedure, the patient received treatment with antibiotics and six cycles of chemotherapy. This case reminds us the possibility of hematologic seeding of bacteria in the tissue, especially with tumor necrosis. We suggest percutaneous needle aspiration for pathology and culture before making a decision whether or not to proceed with surgical decompression for fear of missing the occult bacterial infection.

Background: Electroencephalography (EEG) has been widely used to measure brain activity, but its potential to generate accurate images from neural signals remains a challenge. Most EEG-decoding research has focused on tasks such as motor imagery, emotion recognition, and brain wave classification, which involve EEG signal analysis and classification. Some studies have explored the correlation between EEG and images, primarily focusing on EEG-image pair classification or transformation. However, EEG-based image generation remains underexplored. Objective: The primary goal of this study was to extend EEG-based classification to image generation, addressing the limitations of previous methods and unlocking the full potential of EEG for image synthesis. To achieve more meaningful EEG-to-image generation, we developed a novel framework, Neural-Cognitive Multimodal EEG-Informed Image (NECOMIMI), which was specifically designed to generate images directly from EEG signals. Methods: We developed a 2-stage NECOMIMI method, which integrated the novel Neural Encoding Representation Vectorizer (NERV) EEG encoder that we designed with a diffusion-based generative model. The Category-Based Assessment Table (CAT) score was introduced to evaluate the semantic quality of EEG-generated images. In addition, the ThingsEEG dataset was used to validate and benchmark the CAT score, providing a standardized measure for assessing EEG-to-image generation performance. Results: The NERV EEG encoder achieved state-of-the-art performance in several zero-shot classification tasks, with an average accuracy of 94.8% (SD 1.7%) in the 2-way task and 86.8% (SD 3.4%) in the 4-way task, outperforming models such as Natural Image Contrast EEG, Multimodal Similarity-Keeping Contrastive Learning, and Adaptive Thinking Mapper ShallowNet. This highlighted its superiority as a feature extraction tool for EEG signals. In a 1-stage image generation framework, EEG embeddings often resulted in abstract or generalized images such as landscapes instead of specific objects. Our proposed 2-stage NECOMIMI architecture effectively extracted semantic information from noisy EEG signals, showing its ability to capture and represent underlying concepts derived from brain wave activity. We further conducted a perturbation study to test whether the model overly depended on visual cortex EEG signals for scene-based image generation. The perturbation of visual cortex EEG channels led to a notable increase in Fréchet inception distance scores, suggesting that our model relied heavily on posterior brain signals to generate semantically coherent images. Conclusions: NECOMIMI demonstrated the potential of EEG-to-image generation, revealing the challenges of translating noisy EEG data into accurate visual representations. The novel NERV EEG encoder for multimodal contrastive learning reached state-of-the-art performance both on n-way zero-shot and EEG-informed image generation. The introduction of the CAT score provided a new evaluation metric, paving the way for future research to refine generative models. In addition, this study highlighted the significant clinical potential of EEG-to-image generation, particularly in enhancing brain-machine interface systems and improving quality of life for individuals with motor impairments.

Proper placement of suture anchors is an important step in Bankart repair as improper placement can lead to failure. Concern surrounding suture anchor placement inspired the use navigation systems in shoulder arthroscopy. We aimed to demonstrate the technological advantage of using the O-arm (Medtronic Navigation, Denver, CO, USA) image guidance system to provide real-time images during portal and anchor placements in shoulder arthroscopy. Consecutive patients (from July to October 2014) who were admitted for arthroscopic capsulolabral repair surgeries were included. Ten patients were randomly enrolled in the navigation group and 10 in the traditional group. The glenoid was divided into four zones, and the penetration rates in each zone were compared between the two groups. In zone III, the most inferior region of the glenoid, the penetration rate was 40.9% in the traditional group and 15.7% in the navigation group (P = 0.077), demonstrating a trend toward improved accuracy of anchor placement with the aid of the navigation system; however, this was not statistically significant. Average surgical time in the navigation and traditional groups was 177.6±40.2 and 117.7±17.6 mins, respectively. American Shoulder and Elbow Surgeons Shoulder Scores showed no difference before and 6 months after surgery. This pilot study showed a trend toward decreased penetration rate in O-arm-navigated capsulolabral repair surgeries and decreased risks of implant misplacement; however, possibly due to the small sample size, the difference was not statistically significant. Further large-scale studies are needed to confirm the possible benefit of the navigation system. Even with the use of navigation systems, there were still some penetrations in zone III of the glenoid. This penetration may be attributed to the micro-motion of the acromioclavicular joint. Although the navigation group showed a significant increase in surgical time, with improvements in instrument design, O-arm-navigated arthroscopy will gain popularity in clinical practice.

Case: A 17-year-old adolescent boy with a history of right elbow septic arthritis and osteomyelitis in infancy presented with elbow contracture. He underwent modified Outerbridge-Kashiwagi procedure and radial shortening osteotomy, guided by a 3-dimensional (3D)–printed patient-specific model for preoperative planning and intraoperative reference. At 2 years 8 months postoperatively, range of motion improved by 40° in flexion-extension and 60° in rotation. Transient posterior interosseous nerve (PIN) palsy resolved within 6 months. Conclusion: Infantile elbow infection may cause functional impairment. 3D-assisted modified Outerbridge-Kashiwagi procedure improved motion. Surgeons should be cautious of PIN injury during proximal radius surgery.