Spinal cord injury (SCI) is a debilitating condition that results from a culmination of acute and chronic damage to neural tissue, specifically the myelin sheath, thus impacting neurons’ abilities to synergistically perform their physiological roles. This review explores the molecular underpinnings of myelination, demyelination, and remyelination, emphasizing the role of oligodendrocyte progenitor cells (OPCs), astrocytes, and microglia in physiological, and pathophysiological, healing. Furthermore, we link these processes with emerging therapeutic strategies currently under investigation in animal and human models, underscoring areas of translational medicine that remain underutilized. The goal of this review is to provide a framework for developing more advanced interventions to restore function and improve outcomes for individuals with SCI.

Dreams have arguably been a source of creative insight for millennia. The specific assertion that dreams during rapid eye movement (REM) sleep promote creative problem-solving, however, has only anecdotal support, lacking strong empirical support from rigorous studies. Experimental manipulations of dream content have been confounded by waking components, such that any boost in creative problem-solving could be attributable to waking cognition rather than sleep cognition. Likewise, correlational evidence cannot unequivocally establish that dreams cause insights. Evidence that memory reactivation during sleep promotes creative problem-solving is also insufficient for implicating dreaming per se. Better methods for directly manipulating REM-sleep dreaming are needed. Here, we studied individuals who frequently have lucid dreams—realizing they are dreaming while still asleep. Participants slept after failing to solve several puzzles that had unique soundtracks, and they were instructed to continue working on a puzzle if they heard its soundtrack in a dream. Half of the soundtracks were played during REM sleep to reactivate memories of corresponding puzzles, with the goal of biasing dreams to connect with those specific puzzles versus the remaining puzzles. Those sound cues reliably increased dreaming about the associated puzzles. Furthermore, a post-hoc analysis showed that, for participants with an increase in cue-related dreaming, cues boosted later puzzle-solving. We thus expanded on a well-known phenomenon, that sounds can be incorporated into dreams and can change dream content, by substantiating experimental procedures to align dreams with the search for creative answers to specific challenges. Results highlight that REM dreams can contribute to next-day problem solving.

Diabetes mellitus (DM) is highly prevalent among patients undergoing foot and ankle surgery and is associated with substantially increased perioperative and postoperative risk. This narrative review synthesizes the current literature on optimization of DM patients undergoing foot and ankle surgery. Complications of chronic hyperglycemia, including neuropathy and peripheral vascular disease, make the foot and ankle particularly vulnerable to ulceration, infection, and deformity, contributing to high rates of both operations and postoperative complications such as surgical site infection and readmission. Glycemic control and obesity are modifiable predictors of surgical outcomes and represent key targets for preoperative optimization. Lifestyle modification and pharmacologic therapy play central roles in DM optimization. Traditional agents such as metformin, sulfonylureas, thiazolidinediones, and dipeptidyl peptidase-4 inhibitors remain foundational therapies, while newer therapies such as sodium–glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 (GLP-1) agonists offer meaningful improvements to glycemic control and weight loss. Pharmacologic regimens must be individualized, and many agents require careful perioperative management. Despite advances in medical therapy, high-quality evidence specific to foot and ankle surgery remains limited. Future research should focus on developing procedure- and agent-specific guidelines to reduce the substantial clinical and economic burden of DM in foot and ankle surgical patients.

» Cervical disc arthroplasty (CDA) offers a potential alternative for patients with degenerative disc disease, improving long-term outcomes such as preserved range of motion, decreased incidence of adjacent segment degeneration, and lower morbidity. » CDA offers potential advantages over anterior cervical discectomy and fusion in regard to length of stay, cost, and routine discharge, but the motion-preserving design may introduce novel complications and failure modalities that are poorly understood. » Complications of CDA may include heterotopic ossification, decreased range of motion, persistent or worsening pain, unintended fusion, and permanent neurologic deficit. » Preventing CDA failures begins with careful recognition of contraindications such as cervical instability, osteoporosis or osteopenia, previous surgery at the surgical level(s), and extensive facet joint arthropathy. » Complication profiles associated with CDAs vary in accord with device characteristics, highlighting a potential need for matching prosthesis design with patient-specific factors.