Just Noticeable Difference Research Articles

Identifying thresholds for meaningful improvements in NTDT-PRO scores to support conclusions about treatment benefit in clinical studies of patients with non-transfusion-dependent beta-thalassaemia: analysis of pooled data from a phase 2, double-blind, placebo-controlled, randomised trial

ObjectivesTo estimate thresholds for defining meaningful within-patient improvement from baseline to weeks 13–24 and interpreting meaningfulness of between-group difference for the non-transfusion-dependent beta-thalassaemia patient-reported outcome (NTDT-PRO) tiredness/weakness (T/W) and shortness...

Modification and Validation of the System Causability Scale Using AI-Based Therapeutic Recommendations for Urological Cancer Patients: A Basis for the Development of a Prospective Comparative Study

The integration of artificial intelligence, particularly Large Language Models (LLMs), has the potential to significantly enhance therapeutic decision-making in clinical oncology. Initial studies across various disciplines have demonstrated that LLM-based treatment recommendations can rival those of multidisciplinary tumor boards (MTBs); however, such data are currently lacking for urological cancers. This preparatory study establishes a robust methodological foundation for the forthcoming CONCORDIA trial, including the validation of the System Causability Scale (SCS) and its modified version (mSCS), as well as the selection of LLMs for urological cancer treatment recommendations based on recommendations from ChatGPT-4 and an MTB for 40 urological cancer scenarios. Both scales demonstrated strong validity, reliability (all aggregated Cohen’s K > 0.74), and internal consistency (all Cronbach’s Alpha > 0.9), with the mSCS showing superior reliability, internal consistency, and clinical applicability (p < 0.01). Two Delphi processes were used to define the LLMs to be tested in the CONCORDIA study (ChatGPT-4 and Claude 3.5 Sonnet) and to establish the acceptable non-inferiority margin for LLM recommendations compared to MTB recommendations. The forthcoming ethics-approved and registered CONCORDIA non-inferiority trial will require 110 urological cancer scenarios, with an mSCS difference threshold of 0.15, a Bonferroni corrected alpha of 0.025, and a beta of 0.1. Blinded mSCS assessments of MTB recommendations will then be compared to those of the LLMs. In summary, this work establishes the necessary prerequisites prior to initiating the CONCORDIA study and validates a modified score with high applicability and reliability for this and future trials.

A Bibliometric Review of Indoor Environment Quality Research and Its Effects on Occupant Productivity (2011–2023)

Over the past decade, there has been a growing recognition of the importance of indoor environmental quality (IEQ) in influencing occupant productivity. Researchers have studied various buildings, including offices, schools, hospitals, and residential settings, to understand the relationship between IEQ and productivity outcomes. Studies have taken a multifactorial approach, considering multiple aspects of IEQ. Evidence from the literature review suggests that the quality of the indoor environment is an essential factor that affects the productivity of building occupants, and it is one of the fundamental issues in the development of societies. This area of research requires the responsible participation of researchers at all levels, as there is significant scope to contribute to knowledge. Therefore, this study aims to conduct a bibliometric analysis of the published literature on indoor environmental quality and its impact on building occupant productivity through the scientific literature available from one of the largest and most famous academic databases, Scopus; the study was determined in 2011 to 2023. The search used differential thresholds for IEQ keywords affecting building occupant productivity. Three discrete queries were performed, resulting in approximately 3861 publications. These were filtered by reducing false positives and excluding publications irrelevant to the research topic. The final results were 72 publications. This study also used Excel and VOS viewer to analyse and create graphs and network visualisation maps to show the growth of publications and their types, active countries and institutions for recovered publications, international collaboration, author keywords, active journals, and citation analysis. This study can significantly advance our understanding of building occupant productivity and enhance quality of life and work. Evaluating the research outputs is essential for highlighting contributions to knowledge and global collaboration in this research area. The potential impact of this study is not just theoretical. It can shape the future of our built environments and the lives of those occupying them.

Coherence and Intensity Statistical Mapping of Earthquake Affected Areas using Sentinel-1 Images

Abstract. The January 1, 2024, Noto Peninsula earthquake left many devastated areas. Right after the event, aerial photography provided the initial assessment but covered only specific areas. Satellite images with optical sensors that are freely available are limited by spatial resolution and oftentimes covered by cloud. The Sentinel-1 Synthetic Aperture Radar (SAR) due to its all-weather sensing capability proved to be useful in mapping the extent of the affected areas. This study mapped Wajima City where earthquake aftereffects were severe as reported using coherence and intensity mapping. Pre- and post-event images were used to rapidly identify affected areas. Based on the result, taking the coherence of one pre- and one post-event images can give an impression of wide earthquake damage. The coherence of two post-event images compared with two pre-event images provides a better estimate of affected areas. Taking multiple pre- and post- event images improved the map because the large variation of the intensity is minimized through time-series averaging. Using a simple RGB composite, the affected areas were mapped. Threshold mapping was also used to extract collapsed buildings/houses using a training dataset. The mean coherence difference and mean intensity difference between pre- and post-event images were the two variables used. The computed minimum threshold for the mean coherence difference was 0.35. However, the average not the minimum of the mean intensity difference of 3.0 was used as initial value. Using mean coherence difference>=0.35 gave a high accurate prediction of collapsed buildings at 73.47% but also has false identification of 30.95%. To negate the overprediction, the mean intensity difference<=4.0 was integrated. The result lowered the overprediction to 20.75% but also lowered the accuracy to 64.97%. This assessment was only conducted in the fire-razed morning market in Wajima City.

Brief Report: Prognostic impact of adjuvant immunotherapy in patients with resectable non-small cell lung cancer following neoadjuvant chemoimmunotherapy

ObjectiveThe potential survival benefits of adjuvant immunotherapy for resectable non-small cell lung cancer (NSCLC) following neoadjuvant chemoimmunotherapy, as well as the optimal number of adjuvant immunotherapy cycles, remain uncertain. This study aims to evaluate the prognostic impact of adjuvant immunotherapy and determine the optimal number of cycles. MethodsA total of 438 patients who received neoadjuvant chemoimmunotherapy between August 2019 and June 2022 across four hospitals were enrolled in this study, with a median follow-up time of 31.3 months. Recurrence-free survival (RFS) and overall survival (OS) were estimated using Kaplan-Meier methods and tested by log-rank test. Unstratified Cox proportional hazards models were fitted to the subgroups. ResultsIn this multi-center cohort, 29.7% of patients (n=130) achieved a pathologic complete response (pCR). Patients who received adjuvant immunotherapy experienced significant survival benefits compared to those who did not (RFS: hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.41-0.98, P = 0.037; OS: HR 0.27, 95% CI 0.13-0.57, P < 0.001). Subgroup analyses showed that patients with a squamous histologic type, positive PD-L1 expression, and those with a major pathologic response (MPR) particularly benefited from adjuvant immunotherapy. Additionally, we found that six cycles of adjuvant immunotherapy served as a threshold for better prognostic differentiation, suggesting that six or more cycles may be more beneficial. ConclusionsOur study demonstrated that the addition of adjuvant immunotherapy to neoadjuvant chemoimmunotherapy is significantly associated with improved RFS and OS in patients with resectable NSCLC. We also identified that six cycles of adjuvant immunotherapy may be the optimal regimen for these patients.

Synthetic medial meniscus implant demonstrates high reoperation rates: Patients who retain implant or require implant exchange show improvement in post meniscectomy knee pain and clinical function

PurposeThe purpose of this study was to evaluate the clinical outcomes in the use of a synthetic medial meniscus implant in patients symptomatic after medial meniscectomy and not responsive to other treatment methods. and not responded to non-operative treatment. MethodsThis single-arm, multicenter, prospective study enrolled subjects between ages 30-75 with post-meniscectomy pain. Changes from baseline to 24-months were measured in the pain subscale of the knee injury and osteoarthritis outcome score (KOOS) and in KOOS overall (average of all five subscales) in patients that had received a medial meniscus implant. Success was a 20-point improvement at 24-months, reoperation rates, and implant failures were recorded. VAS, IKDC, and WOMET scores were also measured. ResultsOf the 115 treated patients 3 (2.6%) were either lost to follow-up or missed the 24-month visit, 48 (43%) patients had at least one subsequent surgery, 12 (10.7%) had the implant permanently removed. Of the remaining 100 patients, the mean KOOS pain improved 28.4 points at 24 months (P <0.001), and mean KOOS overall improved 28.3 points (P < 0.001). Seventy-six percent of subjects had mean scores for KOOS pain above the minimal clinically important difference (MCID) threshold, and 72% of subjects met or exceeded this threshold for KOOS overall. There were 29 patients (25.9%) who underwent implant exchange. The 24-month clinical outcomes were similar between subjects who had an implant exchange and patients who did not have any subsequent implant procedure (P < 0.2). ConclusionThe synthetic medial meniscus demonstrates high reoperation and failure rates. Patients who retained the implant or required implant exchange showed significantly improved pain, function, and quality of life at 24-month follow-up in patients symptomatic following partial medial meniscectomy and failed non-operative management. The high reoperation rate is a concern, and further evaluation is needed to determine any contributing factors.

Time Required to Achieve Clinically Significant Outcomes After Anteroinferior Arthroscopic Capsular Release for Shoulder Adhesive Capsulitis.

The specific time required to reach clinically significant outcomes for patient-reported outcome measures (PROMs) after arthroscopic capsular release (ACR) for the treatment of shoulder adhesive capsulitis remains unknown. To determine the time required to achieve the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) score thresholds after ACR for visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons score (ASES), Single Assessment Numeric Evaluation (SANE), and Constant score and to identify patient factors associated with delayed achievement of these clinical benchmarks. Case series; Level of evidence, 4. A prospective analysis was performed of patients who underwent ACR for the treatment of idiopathic shoulder adhesive capsulitis between October 2019 and October2020. Patients completed PROMs preoperatively and at 1, 2, 4, 6, and 12 months postoperatively. Threshold values for MCID and PASS were obtained from previous literature for the VAS, ASES, SANE, and Constant scores. A total of 73 patients were included (mean age, 55.5 ± 9.3 years; body mass index [BMI], 26.6 ± 4.6 kg/m2). By 1-year follow-up, the cumulative percentage of patients achieving the MCID and PASS for VAS, ASES, SANE, and Constant scores was 98.6%, 100%, 100%, and 98.6%, and 95.8%, 91.7%, 98.6%, and 84.9%, respectively. The median time required to reach the MCID thresholds for VAS, ASES, SANE, and Constant scores was 1, 1, 2, and 1 month, respectively. The median time required to reach the PASS thresholds for VAS, ASES, SANE, and Constant scores was 4, 4, 4, and 2 months, respectively. Factors associated with delayed achievement of MCID for SANE included higher BMI (hazard ratio [HR], 0.94; 95% CI, 0.88-0.99) and diabetes (HR, 0.49; 95% CI, 0.2-0.99). Age was associated with delayed achievement of the PASS for VAS. Most patients undergoing ACR achieved clinically significant outcomes within a 4-month timeframe. The majority of patients reached MCID thresholds on outcome measures within 1 to 2 months and achieved satisfactory symptom states within 2 to 4 months postoperatively. By delineating the timeline of patient-perceived benefits, these results provide useful data to set appropriate expectations, guide rehabilitation, and optimize outcomes after ACR.

A Vibrotactile Belt for Measuring Vibrotactile Acuities on the Human Torso Using Coin Motors

Accurate measurement of the vibrotactile acuities of the human torso is the key to designing effective torso-worn vibrotactile displays for healthcare applications such as navigation aids for visually impaired persons. Although efforts have been made to measure vibrotactile acuities, there remains a lack of systematic studies addressing the spatial, temporal, and intensity-related aspects of vibrotactile sensitivity on the human torso. In this work, a torso-worn vibrotactile belt consisting of two crossed coin motor arrays was designed and a psychophysical study was carried out to measure the spatial, temporal, and intensity-related vibrotactile acuities of a set of human subjects wearing the designed belt. The objective parameters of vibrational intensity and the timing latency of the coin motor were also determined before measuring the vibrotactile acuities. The experimental results indicated that the tested coin motor was able to generate a median number of five and six available just-noticeable differences in intensity and duration, respectively. Among the four parameters of vibrational intensity, the perceived intensity was the most relevant to vibrational displacement. The spatial acuities measured as the degree of two-point spatial thresholds (TPTs) showed less individual difference than the distance TPTs. The results from the current work provide valuable guidance for the design of a comfortable torso-worn vibrotactile display using coin motors.

That's Not a Hybrid: How to Distinguish Patterns ofAdmixture and Isolation By Distance.

Describing naturally occurring genetic variation is a fundamental goal of molecular phylogeography and population genetics. Popular methods for this task include STRUCTURE, a model-based algorithm that assigns individuals to genetic clusters, and principal component analysis (PCA), a parameter-free method. The ability of STRUCTURE to infer mixed ancestry makes it popular for documenting natural hybridisation, which is of considerable interest to evolutionary biologists, given that such systems provide a window into the speciation process. Yet, STRUCTURE can produce misleading results when its underlying assumptions are violated, like when genetic variation is distributed continuously across geographic space. To test the ability of STRUCTURE and PCA to accurately distinguish admixture from continuous variation, we use forward-time simulations to generate population genetic data under three demographic scenarios: two involving admixture and one with isolation by distance (IBD). STRUCTURE and PCA alone cannot distinguish admixture from IBD, but complementing these analyses with triangle plots, which visualise hybrid index against interclass heterozygosity, provides more accurate inference of demographic history, especially in cases of recent admixture. We demonstrate that triangle plots are robust to missing data, while STRUCTURE and PCA are not, and show that setting a low allele frequency difference threshold for ancestry-informative marker (AIM) identification can accurately characterise the relationship between hybrid index and interclass heterozygosity across demographic histories of admixture and range expansion. While STRUCTURE and PCA provide useful summaries of genetic variation, results should be paired with triangle plots before admixture is inferred.

LiqD: Dynamic Liquid Level Detection under Containers

Abstract. In daily life and industrial production, it is crucial to accurately detect changes in liquid level in containers. Traditional contact measurement methods have some limitations, while emerging non-contact image processing technology shows good application prospects. This paper proposes a container dynamic liquid level detection model based on U-Net. This model uses the SAM model to generate an initial data set, and then evaluates and filters out high-quality pseudo-label images through the semi-supervised framework to build an exclusive data set. The model uses U-Net to extract masking images of containers from the data set, and uses morphological processing to compensate for masking defects. Subsequently, the model calculates the grayscale difference between adjacent video frame images at the same position, segments the liquid level change area by setting a difference threshold, and finally uses a lightweight neural network to classify the liquid level state and achieves the accuracy of 91.39%. This approach not only mitigates the impact of intricate surroundings, but also reduces the demand for training data, showing strong robustness and versatility. A large number of experimental results show that the proposed model can effectively detect the dynamic liquid level changes of the liquid in the container, providing a novel and efficient solution for related fields.

A quantitative equation for umami evaluation of food and condiments based on the Weber-Fechner law

Here, a quantitative equation for Overall Umami Strength (OUS) in foods and condiments, based on sensory evaluation, was defined using the Weber-Fechner law. Sensory evaluation was conducted utilizing objective questions grounded in triangulation tests and paired comparisons to accurately determine the absolute and difference thresholds for monosodium glutamate (MSG). These thresholds were employed to define various levels of umami strength, which facilitated the creation of an umami sensory difference strength curve. Subsequently, the OUS equation was constructed through a well-fitting function, represented as “OUS=9.6828×log10(CMSG)+34.8” (R2 = 0.996). Once the relative MSG concentration of the sample is determined, it can be converted into the OUS value under the thresholds scale mentioned above for quantification. To validate this quantitative equation, multiple samples, including fish, mushrooms, and soy sauce, were evaluated using the paired comparison test to obtain relative MSG concentration. The OUS value calculated by relative MSG concentration was compared with the existing method to verify its correctness and effectiveness. The results demonstrate that both foods and condiments, even from different species origins, can be reliably quantified for overall umami intensity using the proposed sensory quantitative equation.

Machine learning reveals dynamic controls of soil nitrous oxide emissions from diverse long-term cropping systems.

Soil nitrous oxide (N2O) emissions exhibit high variability in intensively managed cropping systems, which challenges our ability to understand their complex interactions with controlling factors. We leveraged 17 years (2003-2019) of measurements at the Kellogg Biological Station Long-Term Ecological Research (LTER)/Long-Term Agroecosystem Research (LTAR) site to better understand the controls of N2O emissions in four corn-soybean-winter wheat rotations employing conventional, no-till, reduced input, and biologically based/organic inputs. We used a random forest machine learning model to predict daily N2O fluxes, trained separately for each system with 70% of observations, using variables such as crop species, daily air temperature, cumulative 2-day precipitation, water-filled pore space, and soil nitrate and ammonium concentrations. The model explained 29%-42% of daily N2O flux variability in the test data, with greater predictability for the corn phase in each system. The long-term rotations showed different controlling factors and threshold conditions influencing N2O emissions. In the conventional system, the model identified ammonium (>15 kg N ha-1) and daily air temperature (>23°C) as the most influential variables; in the no-till system, climate variables such as precipitation and air temperature were important variables. In low-input and organic systems, where red clover (Trifolium repens L.; before corn) and cereal rye (Secale cereale L.; before soybean) cover crops were integrated, nitrate was the predominant predictor of N2O emissions, followed by precipitation and air temperature. In low-input and biologically based systems, red clover residues increased soil nitrogen availability to influence N2O emissions. Long-term data facilitated machine learning for predicting N2O emissions in response to differential controls and threshold responses to management, environmental, and biogeochemical drivers.

Content adaptive JND profile by leveraging HVS inspired channel modeling and perception oriented energy allocation optimization

The existing just noticeable difference (JND) models consider the effects of various covariates, however, they rarely account for the fusion relationship between the covariates, i.e., they lack a holistic understanding of the mechanisms of visual perception and disregarding the significant impact of energy consumption on visual perception. In fact, visual perception is no exception to the rule that nerve activities and energy supply are inextricably linked. Based on this insight, this paper proposes a novel JND estimation model employing content-adaptive energy allocation. Primarily, the information theory is applied to the visual perception system by conceptualizing human visual system (HVS) as an information communication framework. Then, leveraging the relationship between energy consumption and information perception, this paper quantitatively measures the HVS energy consumption as uniform metric to describe the complicated and heterogeneous HVS perception process, and then construct JND model by fusing low-level and Semantic-level features. Numerous simulation results verify that the proposed JND model is significantly competitive with other frontier models and highly compatible with HVS.

Safety and efficacy of adipose-derived mesenchymal stem cell therapy in elderly Parkinson's disease patients: an intermediate-size expanded access program

ObjectiveThis intermediate-size expanded access program aimed to evaluate safety and clinical efficacy of multiple intravenous infusions of autologous, Hope Biosciences adipose-derived mesenchymal stem cell (HB-adMSC) therapy in elderly patients with Parkinson's disease (PD). MethodsTen eligible participants (aged 76–95 years) received six intravenous infusions each with 200MM autologous HB-adMSCs over 18 weeks, with the end of study (EOS) at week 26. Safety was assessed through adverse events (AEs) and serious adverse events (SAEs). Efficacy was measured through improvements in both motor and non-motor symptoms, utilizing scales including Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts I-IV, Parkinson's Disease Questionnaire-39 (PDQ-39), Parkinson's disease Fatigue Scale (PFS-16), Patient Health Questionnaire-9 (PHQ-9), and Visual Analog Scale (VAS). Analysis employed paired t-tests and Minimal Clinically Important Difference (MCID) thresholds for the patient-reported outcomes. ResultsMost AEs (37 out of 46) were mild in severity, with 5 SAEs reported, none attributed to the drug. No deaths occurred. Despite lack of statistical significance across the efficacy endpoints, modest yet clinically meaningful improvements with effect size > 0.3 were observed in several secondary efficacy endpoints (MDS-UPDRS part I & III, PDQ-39, and PHQ-9) at the EOS, nearing or surpassing the established MCID values. ConclusionsThe administration of autologous 200MM HB-adMSCs was found to be safe and well-tolerated in the elderly PD population. Although not achieving statistical significance, modest clinical improvements were noted across multiple secondary endpoints. These findings underscore the safety profile of the treatment in elderly patients and highlight the importance of evaluating clinical relevance alongside statistical measures for meaningful patient outcomes. Further investigation with a larger, randomized, placebo-controlled design is warranted to validate these observations.

The impact of smoking on patient-reported outcomes following lumbar decompression: an analysis of the Quality Outcomes Database.

Smoking has been shown to negatively impact spinal health, as well as the outcomes of spinal fusion. Published reports show conflicting data regarding whether smoking negatively impacts patient outcomes following lumbar decompression. The objective of this study was to investigate whether smoking affects the outcomes of patients undergoing lumbar decompression for spinal stenosis or herniated disc. The Quality Outcomes Database was queried for patients with spinal stenosis or lumbar disc herniation who underwent one- or two-level lumbar decompression without fusion. All patients had preoperative and 12-month outcome measures and were divided into groups of nonsmokers and current smokers. Outcomes were compared between the two groups, as well as the percentage of patients reaching the minimal clinically important difference (MCID) threshold for numeric rating scale (NRS) back and leg pain scores and the Oswestry Disability Index (ODI). Of 17,271 patients, 14,233 were nonsmokers and 3038 were current smokers. Smokers had worse baseline NRS back and leg pain, ODI, and EQ-5D scores and experienced slightly less improvement in all measures following lumbar decompression (p ≤ 0.009), although changes were largely similar, and a high percentage of patients achieved the MCID thresholds for NRS back pain (78% nonsmokers vs 75% smokers), NRS leg pain (79% nonsmokers vs 73% smokers), and ODI (74% nonsmokers vs 68% smokers). Comparison of propensity-matched cohorts did not identify any difference in outcomes in smokers versus nonsmokers. In patients undergoing lumbar decompression for spinal stenosis or herniated disc, smokers demonstrated slightly less improvement in outcomes compared with nonsmokers, and a high proportion of both groups achieved meaningful improvement with surgery. While smoking cessation should be strongly encouraged in all patients, lumbar decompression procedures for spinal stenosis and herniated disc should not be denied to smokers.

Neighborhood Socioeconomic Disadvantage May Influence 1-Year Patient-Reported Outcome Measures After Total Hip Arthroplasty

BackgroundThe impact of socioeconomic status on achievement of clinically relevant patient-reported outcome measure (PROM) improvements and satisfaction after total hip arthroplasty (THA) is unknown. Area Deprivation Index (ADI) is a metric that can be used as a proxy for a patient’s neighborhood socioeconomic status. This study aimed to assess the association between ADI and failure to achieve: (1) clinically relevant improvements in PROMs; and (2) self-reported satisfaction at 1 year following THA. MethodsA prospective cohort of 7,506 patients who underwent primary unilateral THA from January 2016 to July 2021 was included. The ADI was stratified into quintiles based on their distribution in our sample. Multivariable logistic regression models were created to investigate the effect of ADI on 1-year PROMs. The included PROMs were the Hip Disability and Osteoarthritis Outcome Score (HOOS) Pain, Physical Function Shortform (PS), and Joint Replacement (JR). Clinically relevant improvements were assessed through minimal clinically important difference and patient acceptable symptom state threshold achievement. ResultsThere was no significant association between ADI and failure to achieve minimal clinically important difference for HOOS pain (P = 0.42), PS (P = 0.91), or JR (P = 0.20). However, higher ADI scores were independently associated with increased odds of failing to achieve patient acceptable symptom state for HOOS Pain (P = 0.002), PS (P = 0.003), and JR (P = 0.017). The ADI was not associated with failure to achieve patient satisfaction at 1 year (P = 0.93). ConclusionsGreater neighborhood socioeconomic disadvantage was associated with decreased odds of achieving clinically relevant improvement in patient-perceived symptomatic state, but not associated with patients’ perception of their overall pain and function 1 year after THA. Targeted interventions to address access and care pathways for low socioeconomic status patients may present an opportunity to improve patient-perceived outcomes following THA. Level of EvidenceLevel III.

Preoperative patient-reported outcome measures predict minimal clinically important difference and patient-acceptable symptomatic state following arthroscopic Bankart repair.

The aims of this study were to validate the minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) thresholds for Western Ontario Shoulder Instability Index (WOSI), Rowe score, American Shoulder and Elbow Surgeons (ASES), and visual analogue scale (VAS) scores following arthroscopic Bankart repair, and to identify preoperative threshold values of these scores that could predict the achievement of MCID and PASS. A retrospective review was conducted on 131 consecutive patients with anterior shoulder instability who underwent arthroscopic Bankart repair between January 2020 and January 2023. Inclusion criteria required at least one episode of shoulder instability and a minimum follow-up period of 12 months. Preoperative and one-year postoperative scores were assessed. MCID and PASS were estimated using distribution-based and anchor-based methods, respectively. Receiver operating characteristic curve analysis determined preoperative patient-reported outcome measure thresholds predictive of achieving MCID and PASS. MCID thresholds were determined as 169.6, 6.8, 7.2, and 1.1 for WOSI, Rowe, ASES, and VAS, respectively. PASS thresholds were calculated as ≤ 480, ≥ 80, ≥ 87, and ≤ 1 for WOSI, Rowe, ASES, and VAS, respectively. Preoperative thresholds of ≥ 760 (WOSI) and ≤ 50 (Rowe) predicted achieving MCID for WOSI score (p < 0.001). Preoperative thresholds of ≤ 60 (ASES) and ≥ 2 (VAS) predicted achieving MCID for VAS score (p < 0.001). A preoperative threshold of ≥ 40 (Rowe) predicted achieving PASS for Rowe score (p = 0.005). Preoperative thresholds of ≥ 50 (ASES; p = 0.002) and ≤ 2 (VAS; p < 0.001) predicted achieving PASS for the ASES score. Preoperative thresholds of ≥ 43 (ASES; p = 0.046) and ≤ 4 (VAS; p = 0.024) predicted achieving PASS for the VAS. This study defined MCID and PASS values for WOSI, Rowe, ASES, and VAS scores in patients undergoing arthroscopic Bankart repair. Higher preoperative functional scores may reduce the likelihood of achieving MCID but increase the likelihood of achieving the PASS. These findings provide valuable guidance for surgeons to counsel patients realistically regarding their expectations.

Incidence of revision surgery and patient-reported outcomes within 5 years of the index procedure for grade 1 spondylolisthesis: an analysis from the Quality Outcomes Database spondylolisthesis data.

Some patients treated surgically for grade 1 spondylolisthesis require revision surgery. Outcomes after revision surgery are not well studied. The objective of this study was to determine how revision surgery impacts patient-reported outcomes (PROs) in patients undergoing decompression only or decompression and fusion (D+F) for grade 1 spondylolisthesis within 5 years of the index surgery. Patients in the 12 highest Quality Outcomes Database (QOD) enrolling sites with a diagnosis of grade 1 spondylolisthesis were identified and the incidence of revision surgery between the decompression-only and D+F patients were compared. PROs were compared between cohorts requiring revision surgery versus a single index procedure. Of 608 patients enrolled, 409 had complete 5-year data available for this study. Eleven (13.3%) of 83 patients underwent revision in the decompression-only group as well as 32 (9.8%) of 326 in the D+F group. For the entire cohort, patients requiring revision had significantly worse PROs at 5 years: Oswestry Disability Index (ODI) 27.4 versus 19.4, p = 0.008; numeric rating scale for back pain (NRS-BP) 4.1 versus 3.0, p = 0.013; and NRS for leg pain (NRS-LP) 3.4 versus 2.1, p = 0.029. In the decompression-only group, the change in 5-year PROs was not impacted by revision status: ODI 31.9 versus 24.2, p = 0.287; NRS-BP 1.9 versus 2.9, p = 0.325; and NRS-LP 6.2 versus 3.7, p = 0.011. In the D+F group, the change in 5-year PROs was diminished if patients required revision: ODI 19.1 versus 29.1, p = 0.001; NRS-BP 3.0 versus 4.0, p = 0.170; and NRS-LP 2.3 versus 4.6, p = 0.001. The most common reasons for reoperation within 5 years in the decompression-only group were repeat decompression and instability, whereas in the D+F group the most common reason was adjacent-segment disease. The need for revision resulted in modestly diminished benefit compared with patients with no revisions. These differences were greater in the fusion cohort compared with the decompression-only cohort. The mean PRO improvement still far exceeded minimal clinically important difference thresholds for all measures for patients who underwent a revision surgery.

Preoperative Osteoporosis Is Associated With Increased Health Care Utilization and Compromised Pain and Function Improvement After Primary Total Hip Arthroplasty: A Prospective Cohort Analysis

BackgroundOsteoporosis (OP) has been linked to complications after total hip arthroplasty (THA), but its impact on health care utilization and patient-reported outcomes remains unclear. This study aimed to evaluate the association between: 1) pre-THA OP and health care utilization as well as patient-reported pain and function outcome measures; and 2) dual energy X-ray absorptiometry (DEXA) scan-based T-scores and the aforementioned outcomes. MethodsA retrospective analysis of prospectively collected data of primary THA (2015 to 2018) was performed (n = 5,321) from a validated academic institutional database of a large North American tertiary health care system; of which 4,074 (76.6%) completed 1-year follow-up. Outcomes included prolonged length of stay [LOS] > three days, discharge disposition, 90-day readmission, and 1-year reoperation, as well as Hip Disability and Osteoarthritis Outcome Score (HOOS]) Pain, HOOS-function (PS), and minimal clinically important difference thresholds (MCID), and satisfaction. ResultsThe prevalence of OP pre-THA was 56.9%, of which 39.8% were not prescribed OP medications and 15.3% had a DEXA scan. Compared to those who did not have OP, those who had OP were independently associated with higher odds of prolonged LOS, nonhome discharge, 90-day readmission, and 1-year reoperation (P < 0.005). Furthermore, they had significantly higher odds of failing to achieve MCID (odds ratio: 1.41 (95% confidence interval: 1.06 to 1.89)) for HOOS-PS and satisfaction (odds ratio: 1.5 (95% confidence interval: 1.16 to 1.93)) at one year. Higher T-scores were associated with lower odds of prolonged LOS, nonhome discharge, failure to achieve MCID in HOOS-Pain, and HOOS-PS. ConclusionsOver half of patients had OP; however, only 15.3% of patients had a DEXA scan before THA. Patients who had OP were at higher risk of prolonged LOS, nonhome discharge, 90-day readmission, and 1-year reoperation in addition to poor pain/function improvement and dissatisfaction one year after THA.

Differences between uncapping and removal behaviors in Apis cerana from the perspective of long non-coding RNAs

BackgroundHygienic behavior, a specialized form of immune response evolved in social insects, plays a crucial role in safeguarding colonies from disease spread. In honeybee colonies, such behavior typically entails the dual steps of uncapping and removal of unhealthy and deceased brood. Although in recent years, numerous studies have examined the development of hygienic behavior, the mechanisms underlying the division in the performance of uncapping and removal have yet to be sufficiently elucidated. In this regard, long non-coding RNAs (lncRNAs) have been evidenced to be engaged in regulating the physiological activities of honeybees; however, whether lncRNAs are likewise involved in the uncapping and removal tasks has not been clarified.ResultsIn this study, the strong hygienic Apis cerana worker bees were used and the processes of uncapping and removal behaviors in three colonies were assayed with freeze-killed brood in the field. We then sequenced the antennal RNAs of honeybees to identify differentially expressed lncRNAs and performed lncRNA-mRNA association analysis to establish the differences between uncapping and removal. We detected 1,323 differentially expressed lncRNAs in the antennae, and the findings of lncRNA-mRNA association analyses revealed that the target genes of differentially expressed lncRNAs between uncapping and removal worker bees were predominantly linked to response to stimulus, receptor activity, and synapse. Notably, among the lncRNAs enriched in cellular response to stimulus, XR_001766094.2 was exclusively expressed in the uncapping worker bees. Based on these findings, we hypothesize that XR_001766094.2 plays a key role in distinguishing uncapping from removal behaviors by responding to external stimulus, thereby suggesting that the division of hygienic behaviors is governed by differential thresholds of responsiveness to environmental cues.ConclusionWe characterized differences in the uncapping and removal behaviors of worker bees from a perspective of lncRNAs. Uncapping bees may be equipped with a more rapid stimulatory response and more acute olfactory sensitivity, contributing to the rapid hygienic behavior in honeybee colonies. Our results thus establish a foundation for potential lncRNA-mediated gene expression regulation in hygienic behavior.