Research Society Research Articles

Peer Review Statement

All papers published in this volume have been reviewed through processes administered by the Editors. Reviews were conducted by expert referees to the professional and scientific standards expected of a proceedings journal published by IOP Publishing.• Type of peer review: Single Anonymous• Conference submission management system: Morressier• Number of submissions received: 14• Number of submissions sent for review: 14• Number of submissions accepted: 14• Acceptance Rate (Submissions Accepted / Submissions Received × 100): 100• Average number of reviews per paper: 2• Total number of reviewers involved: 10• Contact person for queries: Name: Yan Hao Email: hy_cmrs@163.com Affiliation: Chinese Materials Research Society

168 Sustenance of Substantial Clinical Benefit in Adult Spinal Deformity Corrective Surgery Patients: A Minimum 5-Year Outcomes Analysis

INTRODUCTION: Clinical outcomes for adult spinal deformity patients has been extensively reported on, however factors associated with sustaining two year (2Y) substantial clinical benefit (SCB) till five year (5Y) remains unclear. METHODS: ASD patients fused from at least L1 to sacrum with 5Y postoperative data were included. Good Outcome(GO) was defined as: no reoperation, mechanical failure, proximal junctional failure(PJF) based on Lafage criteria, and [meeting either: (1) SCB for Oswestry Disability Index(ODI)(decrease of >18.8), or (2) ODI <15 and Scoliosis Research Society(SRS-22r) Total>4.5]. Multivariable analysis controlled for age, BMI, CCI, frailty, deformity, HRQLs, and surgical variations. RESULTS: 330 ASD patients were included. 42% achieved GO at 2Y(2+) while 47% at 5Y(5+) did. 71% of 2+ cohort attained 5+. In 2- cohort, 29% achieved 5+. Isolating 2+ cohort, assessing 5+ vs 5-: 5- had greater SVA deformity at 5Y (p < .05). Regaining the level of activity postoperatively was associated with 4x higher odds of maintaining GO from 2Y to 5Y (p < .05). The odds of achieving GO at 5Y in 2+ decreased by 47% for each additional comorbidity and decreased by 74% in those that had lower extremity paresthesias at BL (both p < .05). Decreased number of levels fused, decreased correction in SVA and increased correction in PI-LL to be predictive of sustaining 2Y GO till 5Y (all p < 0.05). CONCLUSIONS: Overall, 47% had substantial clinical benefit till 5Y. While 71% of patients at 2Y sustained good clinical outcome till 5Y, major contributors to its loss were adjacent segment changes and rod fracture. The odds of achieving SCB till 5Y decreased by nearly 50% for each additional comorbidity. Decreased levels fused along with decreased correction of SVA and increased correction in PI-LL were predictive of optimal sustaining of clinical outcomes.

Outcome of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society outcome questionnaire

Background Adolescent idiopathic scoliosis (AIS) is a structural deformity of the spine. Posterior deformity correction represents the gold standard of the surgical treatment of AIS. The fixation technique was shifted from hybrid fixation to the all pedicle screw construct, which could produce superior deformity correction. Patient-oriented outcome questionnaires have become an important measure of the success of surgical correction. This study was conducted to assess the outcome of all pedicle screw constructs in treating AIS using the Scoliosis Research Society (SRS)-24 outcome questionnaire. Patients and methods Seventy-nine AIS patients were included with a minimum 2-year follow-up. Clinical and radiographic measurements were evaluated at preoperative, postoperative, and final follow-up periods. Complications and results of the SRS-24 questionnaire were analyzed. Sex, Lenke classification, levels of the lowest instrumented vertebra, curve magnitude, and percentage of curve correction were correlated with the SRS-24 questionnaire results. Results There were 59 females and 20 males. The mean age of the patients was 14.2 ± 2.5 years. According to Lenke classification, the majority of the curves were type 1 (57 patients), followed by type 5 (11 patients), type 2 (six patients), type 3 (three patients), type 6 (two patients), and no type 4. The mean preoperative major curve Cobb angle was 59.3 ± 9.045° and the mean postoperative Cobb angle was 5.82 ± 5.932°. The average score for SRS-24 was 4.17. The mean preoperative pain score was 3.29, which improved to 4.30 after at least 2 years of follow-up (P˂0.005). Statistically significant improvement was seen in the general self-image, function from back condition, and level of activity. After surgery, the mean score for self-image was 4.19, and for function was 3.55. The postoperative function was the lowest, while the postoperative satisfaction score was the best of all domains, with a mean score of 4.55. About 90% of patients were satisfied with the results of their surgical correction. Magnitude of curve and amount of correction did not significantly alter the SRS scores. Conclusion All pedicle screw construct is an efficient and safe method in AIS correction. The surgical treatment in our AIS patients has resulted in a perceived benefit in all domains of SRS-24 questionnaire.

1083 Investigating Quantitative Long-term Outcomes of Surgical Intervention in Patients With Adolescent Idiopathic Scoliosis and Cobb Angles Between 40 and 50 Degrees: A Retrospective Analysis of the Harms Study Group Scoliosis Outcomes Database Registry

INTRODUCTION: Many patients with Adolescent Idiopathic Scoliosis (AIS) are successfully managed with conservative methods, and when indicated, with additional surgical intervention. However, current evidence is limited in supporting therapeutic recommendations for AIS patients with Cobb angles between 40-50 degrees. METHODS: De-identified patient data was acquired with permission from the Harms Study Group. Patients 10-21 years old with AIS and 40-50-degree Cobb angles at the time of baseline data collection were grouped based on whether they received operative (op) or nonoperative (non-op) management. Baseline and 2-year follow-up Scoliosis Research Society 22-item questionnaire (SRS-22) scores were analyzed using two-tailed Student’s t-tests and Chi-square tests. Significance level was set to alpha = 0.05. RESULTS: A total of 919 patients were analyzed; 863 patients in the op group, and 56 patients in the non-op group. There was no significant difference between op and non-op groups in the distribution of spinal curvature locations at baseline (p = 0.52). The op and non-op groups were found to be significantly different in both average baseline (3.9 vs. 4.1, p = 0.002), and average 2-year follow-up (4.4 vs. 4.0, p < 0.001) SRS-22 scores. The average change in pairwise SRS-22 scores over the 2-year period also significantly differed between op (+0.5) and non-op (-0.1) groups (p < 0.001). CONCLUSIONS: Our results showed significantly higher 2-year follow-up average SRS-22 scores, as well as a markedly positive pairwise score change for the operative group, when compared to the non-operative group. This demonstrates better long-term outcomes amongst patients who underwent surgery rather than conservative management alone. Our study provides novel evidence that supports recommending surgical intervention for AIS patients with Cobb angles between 40-50 degrees.

Concurrent Validity and Reliability of Video-Based Approach to Assess Physical Function in Adults with Knee Osteoarthritis.

The aim of this study was to determine the concurrent validity and reliability of the Osteoarthritis Research Society International recommended performance-based tests delivered by video-based in adults with knee osteoarthritis. Thirty-two participants (aged 40 to 70 years; 15 men) undertook assessments of 4 performance-based tests via both video-based (real-time and recorded) and face-to-face approaches, on the same day. Outcome measures were performance-based test and the number of technical issues encountered. The performance-based tests included the 40-Meter Fast-Paced Walk Test (velocity, m/s), the 30-Second Chair Stand Test (number of repetitions), the Stair Climb Test (time, seconds), and the Timed "Up & Go" Test (TUG; time, seconds). The Bland-Altman limit of agreement measures, standard error of measurement (SEM), coefficient of variation (CV), minimal detectable changes (MDCs), and bias (mean difference) were employed to analyse the concurrent validity between video-based and face-to-face approaches of the performance-based tests. Reliability was measured using intraclass correlation coefficients (ICC), CV, and SEM. A high degree of concurrent validity for the TUG (bias = -0.22), the 30-Second Chair Stand Test (bias = -0.22), the Stair Climb Test (bias = -0.31), and the 40-Meter Fast-Paced Walk Test (bias = -0.06) was found. SEM and CV values were within the acceptable level for concurrent validity. There was a high degree of reliability demonstrated for all tests analysed. ICC measures ranged from 0.95 to 1.00 for intrarater reliability, and from 0.95 to 0.99 for interrater reliability. Video-based assessment of physical performance tests is a valid and reliable tool for measuring physical function among adults with knee osteoarthritis via Microsoft Teams (Microsoft Corp, Redmond, WA, USA). Video-based assessment is a promising public health tool to measure physical function in adults with knee osteoarthritis.

(PM-24) TRANSLATION AND CULTURAL ADAPTATION OF THE KAROLINSKA INTERPERSONAL VIOLENCE SCALE INTO BRAZILIAN PORTUGUESE: A METHODOLOGICAL STUDY

Abstract Introduction Interpersonal violence is a global concern with significant implications for mental health and mortality. The Karolinska Institute in Sweden developed the Karolinska Interpersonal Violence Scale (KIVS), a semi-structured interview assessing interpersonal violence experiences as victims or aggressors across childhood and adulthood. Objective Our aim was to translate and culturally adapt the KIVS for use in the Brazilian population. Methods: The translation process involved ten stages based on The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. Back-translation was performed by a clinical psychologist unfamiliar with the original scale. The English versions were cross compared by the original instrument author. The consensus version underwent comprehension evaluation by eight participants, comprising four healthcare professionals and four patients from the AISEP - Excessive Sexual Drive and Prevention of Negative Outcomes Related with Sexual Behavior at Instituto de Psiquiatria of Hospital das Clínicas of São Paulo. A 5-point Likert scale assessed participant comprehension, with 80% agreement indicating successful equivalence. Sentences were revised until this consensus was achieved. The finalized translation, incorporating contextual revisions, underwent syntactic and spelling review. Results After application to eight participants (4 women and 4 men), 7 rated with the highest comprehension score (5.0), and 1 with 4.9. A final report documented the entire KIVS translation and validation process. Conclusion The translation and cultural adaptation of the KIVS into Brazilian Portuguese were successful. Minor adjustments were made to enhance comprehension without compromising meaning. This adaptation provides a valuable tool for assessing interpersonal violence in the Brazilian context, with implications for research and clinical practice. Financing FAPESP.

Evaluation of the changes in waistline asymmetry using digital photography in adolescents with idiopathic thoracolumbar/lumbar scoliosis after corrective surgery.

Waist line asymmetry is a major cosmetic concern in patients with adolescent idiopathic scoliosis (AIS). The primary surgical goal in patients with AIS is to correct spinal deformities and prevent further progression while maintaining global alignment. Additionally, an important objective of surgical treatment is to address physical appearance by reducing asymmetry. This study aimed to evaluate changes in waistline asymmetry using digital photographs in adolescents with thoracolumbar/lumbar (TL/L) scoliosis who underwent corrective surgery. We retrospectively analyzed the data of patients with Lenke types 5C and 6C AIS who underwent posterior fusion surgery with at least 2years of follow-up. Waist line asymmetry was assessed using digital photography. The waist angle ratio (WAR), waist height angle (WHA), and waistline depth ratio (WLDR) were measured pre- and postoperatively. Radiographic parameters and the revised 22-item Scoliosis Research Society Questionnaire (SRS-22r) were also evaluated. Forty-two patients (40 females and 2 males; 34 with type 5C and 8 with type 6C) were included in the study. The WAR, WHA, and WLDR significantly improved after surgery (0.873 → 0.977, - 2.0° → 1.4°, and 0.321 → 0.899, respectively). Every waistline parameter moderately correlated with the apical vertebral translation of the TL/L curve (WAR: r = - 0.398, WHA: r = - 0.442, and WLDR: r = - 0.692), whereas no correlations were observed with the TL/L curve magnitude. No correlations were observed between the photographic parameters and SRS-22r scores. Lateral displacement of the apical vertebra on the TL/L curve correlated with waistline asymmetry. Preoperative waistline asymmetry improved with scoliosis correction. Level 4.

Cardamonin inhibits osteogenic differentiation by downregulating Wnt/beta-catenin signaling and alleviates subchondral osteosclerosis in osteoarthritic mice.

Osteoarthritis (OA) is a common degenerative joint disease, and subchondral osteosclerosis is an important pathological change that occurs in its late stages. Cardamonin (CD) is a natural flavonoid isolated from Alpinia katsumadai that has anti-inflammatory activity. The objectives of this study were to investigate the therapeutic effects and potential mechanism of CD in regulating OA subchondral osteosclerosis at in vivo and in vitro settings. Eight-week-old male C57BL/6J mice were randomly divided into four groups: sham operation, anterior cruciate ligament transection (ACLT)-induced OA model, low-dose and high-dose CD treated ACLT-OA model groups. Histological assessment and immunohistochemical examinations for chondrocyte metabolism-related markers metalloproteinase-13, ADAMTS-4, Col II, and Sox-9 were performed. Microcomputed tomography was used to assess the sclerosis indicators in subchondral bone. Further, MC3T3-E1 (a mouse calvarial preosteoblast cell line) cells were treated with various concentrations of CD to reveal the influence and potential molecular pathways of CD in osteogenic differentiations. Animal studies suggested that CD alleviated the pathological changes in OA mice such as maintaining integrity and increasing the thickness of hyaline cartilage, decreasing the thickness of calcified cartilage, decreasing the Osteoarthritis Research Society International score, regulating articular cartilage metabolism, and inhibiting subchondral osteosclerosis. In vitro investigation indicated that CD inhibited alkaline phosphatase expression and production of calcium nodules during osteogenic differentiation of MC3T3-E1 cells. In addition, CD inhibited the expression of osteogenic differentiation-related indicators and Wnt/β-catenin pathway-related proteins. In conclusion, CD inhibits osteogenic differentiation by downregulating Wnt/β-catenin signaling and alleviating subchondral osteosclerosis in a mouse model of OA.

Translation, Cultural Adaption, and Linguistic Validation of the Norwegian Wound-QoL Questionnaire

Background and Purpose:A sound translation is complex but necessary to provide a valid patient-reported questionnaire. The aim of this study was therefore to translate, culturally adapt, and linguistically validate the 17-item Wound-Quality of Life (Wound-QoL) questionnaire from English to Norwegian.Methods:For translation and cultural adaption of the Wound-QoL, we followed the methods described by the ISPOR—The Professional Society for Health Economics and Outcomes Research (formerly, the International Society for Pharmacoeconomics and Outcome Research), Messaging Application Programming Interface Research Institute, and recommendations from literature reviews.Results:Differences in the language semantics and syntax caused challenges in the translation. The cognitive debriefing interviews revealed some irrelevant items related to personal preferences.Conclusions:This study provides a questionnaire that can improve the quality of clinical care and promote research and valuable knowledge to other researchers translating the Wound-QoL and similar questionnaires.

Impact of COVID-19 Pandemic on Psychosocial Attributes of Indian Families Bearing Child With Down Syndrome: A Survey by Trisomy 21 Research Society (T21RS), Indian Chapter.

Impact of COVID-19 Pandemic on Psychosocial Attributes of Indian Families Bearing Child With Down Syndrome: A Survey by Trisomy 21 Research Society (T21RS), Indian Chapter.

Measuring gender in elementary school-aged children in the United States: Promising practices and barriers to moving beyond the binary.

How gender identity is assessed directly shapes how students are supported in elementary schools in the United States. Despite the existence of gender diversity, calls for more inclusive science, and recommendations from national research associations and societies to incorporate and emphasize the voices of individuals with diverse gender identities, most studies exploring gender disparities in education have relied heavily on the assumption of a gender binary. As a result, the omission of diverse gender identities from educational research in the elementary years is troubling. To address this area of need, the current article summarizes the opportunities for and constraints surrounding inclusive evaluation of gender identity in the elementary school years. We begin with a brief review of common methods used to assess gender identities for children in elementary school, including the strengths and limitations of each. We next contextualize these measures by outlining the current state-level barriers to including diverse gender identities in assessments of gender. In highlighting the best available practices and the structural systems of oppression realized through state-level policies that perpetuate an inability to represent student voices across the gender spectrum, we conclude with a call to action to inspire the evolution of best practices in the service of all students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The BMP7-Derived Peptide p[63-82] Reduces Cartilage Degeneration in the Rat ACLT-pMMx Model for Posttraumatic Osteoarthritis.

Osteoarthritis (OA) is characterized by articular cartilage erosion, pathological subchondral bone changes, and signs of synovial inflammation and pain. We previously identified p[63-82], a bone morphogenetic protein 7 (BMP7)-derived bioactive peptide that attenuates structural cartilage degeneration in the rat medial meniscal tear-model for posttraumatic OA. This study aimed to evaluate the cartilage erosion-attenuating activity of p[63-82] in a different preclinical model for OA (anterior cruciate ligament transection-partial medial meniscectomy [anterior cruciate ligament transection (ACLT)-pMMx]). The disease-modifying action of the p[63-82] was followed-up in this model for 5 and 10 weeks. Skeletally mature male Lewis rats underwent ACLT-pMMx surgery. Rats received weekly intra-articular injections with either saline or 500 ng p[63-82]. Five and 10 weeks postsurgery, rats were sacrificed, and subchondral bone characteristics were determined using microcomputed tomography (µCT). Histopathological evaluation of cartilage degradation and Osteoarthritis Research Society International (OARSI)-scoring was performed following Safranin-O/Fast Green staining. Pain-related behavior was measured by incapacitance testing and footprint analysis. Histopathological evaluation at 5 and 10 weeks postsurgery showed reduced cartilage degeneration and a significantly reduced OARSI score, whereas no significant changes in subchondral bone characteristics were found in the p[63-82]-treated rats compared to the saline-treated rats. ACLT-pMMx-induced imbalance of static weightbearing capacity in the p[63-82] group was significantly improved compared to the saline-treated rats at weeks 5 postsurgery. Footprint analysis scores in the p[63-82]-treated rats demonstrated improvement at week 10 postsurgery. Weekly intra-articular injections of p[63-82] in the rat ACLT-pMMx posttraumatic OA model resulted in reduced degenerative cartilage changes and induced functional improvement in static weightbearing capacity during follow-up.

Glaucocalyxin A delays the progression of OA by inhibiting NF-κB and MAPK signaling pathways

BackgroundOsteoarthritis (OA) is a common degenerative joint condition marked by inflammation and cartilage breakdown. Currently, there is a dearth of treatment medications that can clearly slow the course of OA. Glaucocalyxin A (GLA) is a diterpene chemical identified and extracted from Rabdosia japonica with antithrombotic, anticoagulant, anti-tumor, anti-inflammatory, anti-oxidant, and other pharmacological properties. Previous research has linked inflammation to abnormalities in the homeostasis of the extracellular matrix (ECM). Although GLA has been shown to have anti-inflammatory qualities, its effects on the progression of OA are unknown. As a result, the goal of this study was to see if GLA could slow the course of OA.MethodsATDC5 cells were stimulated by IL-1β to create an inflammatory chondrocyte damage model. Quantitative polymerase chain reaction, Western Blot, high-density culture, and immunofluorescence were used to detect the expression levels of associated gene phenotypes. We also created a mouse model of OA induced by destabilization of the medial meniscus (DMM) instability, and GLA was administered intraperitoneally once every two days for eight weeks. Mice knee specimens were stained with hematoxylin–eosin, Safranin O/fast green, and immunohistochemical, and the Osteoarthritis Research Society International grade system and Mankin’s score were used to assess the protective effect of GLA on cartilage.ResultsIn vitro and in vivo, we explored the effects and molecular processes of GLA as a therapy for OA. The findings demonstrated that GLA might reduce the expression of associated inflammatory mediators and protect the ECM by inhibiting the NF-κB and MAPK signaling pathways. Animal research revealed that GLA could protect against the DMM-induced OA model mice by stabilizing ECM.ConclusionTaken together, our findings show that GLA has a protective impact on cartilage throughout OA progression, implying that GLA could be employed as a possible therapeutic agent for OA, thus giving a new therapeutic method for the treatment of OA.

Do Caregivers and Patients With Early-Onset Scoliosis Share the Same Perspective on Health-Related Quality of Life? A Comparison of 24-item Early-Onset Scoliosis Questionnaire and 22-item Scoliosis Research Society Questionnaire Scores.

The 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) is validated in patients with early onset scoliosis (EOS) aged 0 to 18 years and the 22-item Scoliosis Research Society (SRS-22) questionnaire is validated in idiopathic scoliosis patients 10 years and older. EOSQ-24 is completed by the caregiver and SRS-22 is completed by the patient. A prior study comparing patient-reported outcome measures completed by older pediatric patients and their parents showed a low level of agreement. Our purpose was to compare EOSQ-24 and SRS-22 scores completed at the same time point and at subsequent time points, in patients aged 5 to 18 years with idiopathic or congenital EOS without developmental delay. This was a multicenter retrospective study. We identified pairs of EOSQ-24 and SRS-22 completed on the same day or within 6 months. Some patients had multiple pairs of surveys over time. EOSQ-24 and SRS-22 questions were matched and domain scores for Pain, Function, Mental Health, and Satisfaction were compared. Patients with a change in treatment between surveys were excluded. Pearson correlation coefficients ( r ) were used to compare domain scores, with r ≥0.7 indicating a strong relationship. There were 228 patient-caregiver dyads who completed 411 pairs of EOSQ-24 and SRS-22 on the same day. A strong correlation was found only for the Pain domain ( r =0.77). Function, Mental Health, and Satisfaction domains had positive but not strong correlations ( r = 0.58, r = 0.50, r = 0.41, respectively). Subanalysis based on age also showed a strong correlation only for Pain. There were 76 patient-caregiver dyads who completed 134 pairs of surveys with SRS-22 completed within 6 months after an EOSQ-24. All domains demonstrated a positive but not strong correlation, with Pain showing the highest correlation ( r = 0.64). EOSQ-24 and SRS-22 had a strong correlation only for Pain when completed at the same time point. EOSQ-24 and SRS-22 completed within 6 months lacked a strong correlation for all domains. Our findings suggest that parents and children with EOS may not share the same perspective on their health. Self-reported questionnaires should be used when possible to assess health-related quality of life in older children and adolescents with EOS who are developmentally neurotypical. Level III-diagnostic.

Current and future glyphosate use in European agriculture

AbstractThere has been a longstanding and contentious debate about the future of glyphosate use in the European Union (EU). In November 2023, the European Commission approved the renewal of the use registration for glyphosate for a further 10 years. Nevertheless, the EU Farm to Fork strategy calls for a 50% reduction in pesticide use by 2030. In November 2022, the European Weed Research Society organised a 2 day workshop to identify critical glyphosate uses in current EU cropping systems and to review the availability of glyphosate alternatives. Workshop participants identified four current, critical uses in EU cropping systems; control and management of perennial weeds, weed control in conservation agriculture, vegetation management in tree and vine crops and herbicide resistance management. There are few herbicide alternatives that provide effective, economic, broad‐spectrum control of weeds, particularly perennial weeds. Mechanical weed control, and in particular, soil cultivation is the most obvious glyphosate alternative. However, this is not possible in conservation agriculture systems and, in general, increased soil cultivation has negative impacts for soil health. Emerging technologies for precision weed control can enable more targeted use of glyphosate, greatly reducing use rates. These technologies also facilitate the use and development of alternative targeted physical weed control (e.g. tillage, lasers, electricity), reducing the energy and environmental costs of these approaches. In tree crops, the use of organic and inorganic mulches can reduce the need for glyphosate use. In general, reduced use of glyphosate will require an even greater focus on integrated weed management to reduce weed establishment in agroecosystems, increase weed management diversity and limit the use of alternative resistance‐prone herbicides.

The validation of Chinese version of workplace PERMA-profiler and the association between workplace well-being and fatigue

BackgroundWell-being is an important issue in workplace. One of these assessment tools of well-being, Workplace PERMA Profiler, is based on Seligman’s five dimensions well-being. Prolonged fatigue may last for a long time, leading a great impact on both employees and enterprises. However, rare studies about the association between well-being and fatigue had been investigated. Our aim is to establish the Chinese version Profiler, and to discovery the association between workplace well-being and fatigue.MethodsThe Chinese version was established according to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) task force guidelines. In the study, researchers employed simple random sampling by approaching individuals undergoing health checkups or receiving workplace health services, inviting them to participate in a questionnaire-based interview. Prolonged Fatigue was evaluated by Checklist Individual Strength (CIS). The reliability was evaluated by Cronbach’s alphas, Intra-class Correlation Coefficients (ICCs), and measurement errors. Moreover, confirmatory factor analysis and correlational analyses were assessed for the validity.ResultsThe analyses included 312 Chinese workers. Cronbach’s alphas of the Chinese version ranged from 0.69 to 0.93, while the ICC ranged from 0.70 to 0.92. The 5-factor model of confirmatory factor analysis revealed a nearly appropriate fit (χ2 (82) = 346.560, Comparative Fit Index [CFI] = 0.887, Tucker-Lewis Index [TLI] = 0.855, Root Mean Square Error of Approximation [RMSEA] = 0.114, Standardized Root Mean Square Residual [SRMR] = 0.060). Moreover, the CIS and its four dimensions were significantly and negatively associated with the Positive Emotion, while they are positively associated with Engagement dimension except CIS-Motivation dimension.ConclusionThe Chinese version Workplace PERMA-Profiler indicate nice reliability and validity. Furthermore, all CIS dimensions were negatively influenced by Positive Emotion, while commonly positively associated with Engagement.

Study on the mechanism of cross-linked hyaluronic acid-dexamethasone hydrogelin post-traumatic osteoarthritis

Objective: To explore the mechanism of cross-linked hyaluronic acid-dexamethasone hydrogel (cHA-Dex) in inhibiting chondrocyte apoptosis and alleviating early post-traumatic osteoarthritis (PTOA). Methods: To generate PTOA model, anterior cruciate ligament transection (ACLT)was performed on SD rats (n=70), and the sham surgery group (n=70) was set as control. The changes in inflammatory indicators such as interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-3 (MMP-3), and matrix metalloproteinase-13 (MMP-13) in the joint lavage fluid were measured at different time points (1-14 days, 5 rats at each time point) after surgery. The cHA-Dex (0.5 mg/ml) hydrogel (experimental group, n=70) and ordinary low-molecular-weight hyaluronic acid (HA) hydrogel premixed with Dex, that was, HA-Dex (0.5 mg/ml) hydrogel (control group, n=70) were injected into the joint cavity of PTOA rats, and the release amount and cumulative release amount of Dex in the joint fluid of rats at each time point(1-14 days, 5 rats at each time point) were detected to reveal the release mechanism of cHA-Dex hydrogel. The cartilage of knee joint of patients with osteoarthritis (OA) who underwent knee arthroplasty in the Second Hospital of Shanxi Medical University from January 2020 to December 2022 was taken for in vitro tissue block culture (Outbridge score=1 or 2,n=18). After the cartilage tissue block was treated with cHA-Dex hydrogel premixed with 0.1, 0.2, and 0.5 mg/ml Dex, the mRNA expression levels of IL-1β, IL-6, TNF-α, MMP-3, and MMP-13 in the articular cartilage tissue block were detected. OA chondrocytes were isolated from cartilage samples using enzymatic hydrolysis and cultured in vitro (n=18). Chondrocytes were divided into 4 groups: saline, cHA hydrogel, Dex (0.5 mg/ml), and cHA-Dex (0.5 mg/ml) hydrogel group. The effects of different interventions on chondrocyte proliferation and apoptosis were tested. Results: The Osteoarthritis Research Society International (OARSI) score of safranine O-solid green staining in PTOA group was 3.34±0.35, and it was 1.17±0.21 in Sham group(P=0.010). The Meachim score of knee joint osteophytes in PTOA rats was significantly higher than that in the Sham group (2.66±0.41 vs 0.22±0.17, P=0.010), indicating PTOA model in rat was established successfully. The cHA-Dex hydrogel, which corresponded to the peak changes of inflammatory factors in the joints of PTOA rats in the early stage, was also released in the early stage and sustained-released in the late stage. After the OA articular cartilage tissue block was treated with cHA-Dex hydrogel premixed with 0.1, 0.2, and 0.5 mg/ml Dex, the mRNA expression levels of IL-1 β, IL-6, TNF-α, MMP-3, and MMP-13 in the tissue block were reduced significantly (all P<0.05) and in a dose-dependent manner. Compared with Dex (0.5 mg/ml) alone group, the apoptosis rate of cHA-Dex (0.5 mg/ml) hydrogel group was significantly reduced (0.60±0.07 vs 6.63±0.98, P=0.010).Compared with the normal saline or the cHA hydrogel alone group, the cHA-Dex (0.5 mg/ml) hydrogel group had significant cell proliferation, and the difference at each time point were all significant statistically (all P<0.05). Conclusion: For the early inflammation of PTOA, cHA-Dex hydrogel can not only inhibit cartilage inflammation, but also reverse the increased apoptosis and decreased proliferation rate of chondrocytes caused by Dex, and finally alleviate the progress of PTOA by releasing Dex.

The 2023 Guidelines for the management and treatment of glucocorticoid-induced osteoporosis

IntroductionAlthough synthetic glucocorticoids (GCs) are commonly used to treat autoimmune and other diseases, GC induced osteoporosis (GIOP) which accounts for 25% of the adverse reactions, causes fractures in 30–50% of patients, and markedly decreases their quality of life. In 2014, the Japanese Society for Bone and Mineral Research (JSBMR) published the revised guidelines for the management and treatment of steroid-induced osteoporosis, providing the treatment criteria based on scores of risk factors, including previous fractures, age, GC doses, and bone mineral density, for patients aged ≥18 years who are receiving GC therapy or scheduled to receive GC therapy for ≥3 months.Materials and methodsThe Committee on the revision of the guidelines for the management and treatment of GIOP of the JSBMR prepared 17 clinical questions (CQs) according to the GRADE approach and revised the guidelines for the management and treatment of GIOP through systematic reviews and consensus conferences using the Delphi method.ResultsBisphosphonates (oral and injectable formulations), anti-RANKL antibody teriparatide, eldecalcitol, or selective estrogen receptor modulators are recommended for patients who has received or scheduled for GC therapy with risk factor scores of ≥3. It is recommended that osteoporosis medication is started concomitantly with the GC therapy for the prevention of fragility fractures in elderly patients.ConclusionThe 2023 guidelines for the management and treatment of GIOP was developed through systematic reviews and consensus conferences using the Delphi method.

Translation and Cross-Cultural Adaptation into French of the Harris Hip Score and the Modified Harris Hip Score.

The objective of this study was to develop a cross-cultural adaptation and translation into French of the original Harris Hip Score (HHS) and the modified Harris Hip Score (mHHS). The translation and cultural-adaptation of the questionnaire were performed following a 10-step process as recommended by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). During the cognitive debriefing, each item of the questionnaire has been rated between 1 and 10 according to the comprehension level of 8 patients who underwent total hip arthroplasty. The cross-cultural adaptation process required the modification of the walking distance item by converting the number of blocks into meters but also in walking time (minutes). All the different steps have been performed without any other important changes on the translated questionnaire which has been found highly understandable by interviewed patients (9.6 ± 1.1). This study successfully reports the French version development of the original HHS (HHS-Fr) and its modified patient-reported version (mHHS-Fr), thereby providing to clinicians a standardised version for the evaluation of French-speaking patients suffering from hip osteoarthritis.

Shoulder balance in Lenke type 2 adolescent idiopathic scoliosis: correlations among radiological indices, cosmetic indices, and patient-reported outcomes.

The aim of this study was to investigate the correlation between radiological indices of shoulder balance (SB) and cosmetic indices of shoulder deformity in patients with Lenke type 2 adolescent idiopathic scoliosis (AIS) and to determine the extent to which patient-reported outcomes (PROs) correlate with these measurements. Current management decisions and outcomes for SB in AIS are primarily based on radiological measurements. It is crucial to understand how these radiological parameters and cosmetic indices relate to patient satisfaction. The authors analyzed the preoperative radiological and photographic indices of SB, along with PROs, in patients with Lenke type 2 AIS. Lateral SB parameters included the radiological shoulder height (RSH) and clavicle angle, while medial SB parameters included the first rib angle and T1 tilt angle. Photographic indices included the shoulder height angle (SHA), axilla height angle (AHA), and the left/right trapezius angle (LRTA) ratio. The authors assessed the self-image, mental health, and total score domains of the Korean version of the 22-item Scoliosis Research Society questionnaire. In their analysis of Lenke type 2 patients, the authors found that correlation coefficients between radiological measurements and photographic indices ranged from -0.25 to 0.47, among which only lateral SB including clavicle angle and RSH showed a significant correlation with anterior and posterior photographic indices. No statistically significant correlations were found between radiological measurements and PROs. Anterior photographic indices including SHA and AHA significantly correlated with all three PROs (p < 0.05). Radiological shoulder parameters did not accurately reflect the perceived SB. Anterior photographic indices were reliable for evaluating clinical SB in patients with Lenke type 2 AIS and correlated with PROs. Spine surgeons may benefit from paying more attention to anterior photographic indices when making surgical decisions regarding clinical SB.