Spinal Curvature Research Articles

Intelligent Evaluation Method for Scoliosis at Home Using Back Photos Captured by Mobile Phones

The traditional scoliosis examination based on X-ray film is not suitable for large-scale screening, and it is also not suitable for dynamic evaluation during rehabilitation. Therefore, based on computer vision technology, this paper puts forward an evaluation method of scoliosis with different photos of the back taken by mobile phones, which involves three aspects: first, based on the key point detection model of YOLOv8, an algorithm for judging the type of spinal coronal curvature is proposed; second, an algorithm for evaluating the coronal plane of the spine based on the key points of the human back is proposed, aiming at quantifying the deviation degree of the spine in the coronal plane; third, the measurement algorithm of trunk rotation (ATR angle) based on multi-scale automatic peak detection (AMPD) is proposed, aiming at quantifying the deviation degree of the spine in sagittal plane. The public dataset and clinical paired data (mobile phone photo and X-ray) are used to test. The results show that this method has high accuracy and effectiveness in distinguishing the type of spinal curvature and evaluating the degree of deviation, which is higher than other deep learning algorithms.

Thoracic posture-related morphological changes in patients with pectus excavatum vs healthy controls.

Cases of severe pectus excavatum presenting with worsening cardiopulmonary symptoms in the upright position have been reported. However, the underlying mechanism remains unclear. We evaluated posture-related morphological changes of the thorax in patients with pectus excavatum. Chest morphology was evaluated preoperatively using upright and supine computed tomography in 21 patients with pectus excavatum and 35 healthy volunteers. The minimum anterior-posterior thoracic diameter, depression depth, and Haller index on horizontal sections, as well as the T6-12 plumb line distance on sagittal sections, were compared between the two positions. In patients with pectus excavatum (median age, 22 years; 18 males and 3 females), the minimum anterior-posterior diameter was smaller (4.5 vs 5.1 cm, P < 0.001) and the Haller index was greater (10.1 vs 6.4, P < 0.001) in the upright position than in the supine position. The T6-T12 plumb line distance was longer in the upright position (2.4 vs 0.8 cm, P < 0.001), while the depression depth showed no significant difference. Healthy volunteers exhibited similar changes. The degree of spinal curvature increased in the upright position due to the anterior shift of the lower thoracic vertebrae, resulting in a shorter anterior-posterior diameter, irrespective of chest wall deformity. One patient with dyspnoea only in the upright position exhibited compression of the right inferior pulmonary vein only on upright computed tomography. The minimum anterior-posterior diameter is shorter in the upright position. This may explain the worsening of cardiopulmonary symptoms in patients with severe pectus excavatum when in an upright position. UMIN000036438 https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041519.

Maternal Parity Effect on Spine Posture Changes and Back Pain During Pregnancy

Background: Pregnancy can significantly alter posture and stability, thereby affecting spine curvatures. A positive relationship between the number of full-term pregnancies and the prevalence of low back pain (LBP) has been reported previously. This study aimed to analyze the impact of pregnancy on spine posture and LBP. Methods: Thirty pregnant females who were nulliparous (Group 1, n = 15) or had one or two pregnancies (Group 2, n = 15) were examined using the photogrammetric method in the first, second, and third trimesters of pregnancy. Further, a correlation analysis was conducted among the body mass index (BMI), pain intensity (VAS scale), and spine posture parameters. Results: The parous groups did not differ significantly in the parameters of the spinal posture. The thoracic angle decreased in trimester II compared to trimester I (157.77° vs. 160.55°, p = 0.004), which, according to the measurement methodology used, means that the thoracic kyphosis curvature increased. BMI was associated with the angle of trunk inclination in trimester I in Group 1 (r = 0.54, p = 0.04), as well as with the thoracic angle in trimesters II and III in Group 2 (r = 0.54–0.62, p &lt; 0.05). A statistically significant correlation between pain intensity and spine posture parameters was more frequently observed in Group 2. Conclusions: Parity does not affect spine posture during pregnancy or pain intensity. The intensity of LBP was associated with spine posture changes during pregnancy, but the character of association differs between groups of parity. Alterations in spine posture should be monitored during pregnancy to prevent back pain.

Changes in spinal curve during dentistry studies measured with a Spinal Mouse device: A five-year prospective study.

Musculoskeletal disorders (MSDs) often arise and develop during dentistry studies. The most affected regions are related to the spine. Possible associations between spinal curve parameters and MSDs have not yet been investigated amongst dentistry students. This longitudinal observational study aimed to determine whether spinal curve changes during dentistry studies, analyse the relationship between objective findings and subjectively declared MSDs and compare spinal curve parameters with those published in the literature. Seventy-three dentistry students answered a questionnaire on MSDs, and were examined using the Spinal Mouse® device at the beginning, in the middle, and at the end of their 5-year study. The spinal curve exhibited a gender diversity in the lumbar lordosis angle, sacrum inclination, and thoracolumbar ratio. From the first to fifth study year, we observed an increase in the range of motions in the sagittal and frontal planes, an increase in the maximal extent of right lateral inclination, and a decrease in maximal left lateral inclination. Whole-spine backward inclination increased only in women, and forward sacral inclination decreased. No statistically significant relationships were found between the objective findings and subjectively declared MSDs. The spinal curve shape differed between men and women and changed during dentistry studies. No objective markers or predictors of MSDs were found amongst the dentistry students. These findings can serve as a benchmark for further studies on the association between MSDs and objective findings.

Interrelationships of cervical spine sagittal alignment and whole spinopelvic alignment under implications of musculoskeletal health among independent elderly women in Taiwan: A cross-sectional study.

Older women are at increased risk of spinal misalignment and its associated complications. This study investigated the influence of age, grip strength, and various sagittal spinal parameters on spinal alignment. The results indicate the need for comprehensive management strategies. This cross-sectional study included 200 older women who underwent bone health evaluations at the orthopedic department of a hospital. The study participants underwent dual-energy X-ray absorptiometry, grip strength measurement, and full-length spine radiography. Clinical and radiographic parameters were analyzed through Pearson correlation and linear regression analyses. Significant correlations were identified between grip strength and spinal parameters such as C7 slope and global tilt, indicating that muscle strength affects spinal alignment. Advanced age was associated with changes in sagittal spinal parameters, indicating that changes occur in body compensation over time. Furthermore, pelvic parameters such as pelvic tilt and sacral slope were significantly correlated with spinal curvature, indicating their critical roles in maintaining spinal stability. This study revealed the critical roles of muscle strength and pelvic alignment in the management of spinal health in older women with low bone mass. Targeted interventions for increasing muscle strength, correcting posture, and achieving hormonal balance can notably improve spinal stability and reduce the risk of associated complications. Longitudinal studies should be conducted to validate and refine the intervention strategies and to extend the study findings.

The efficacy of combined physiotherapeutic scoliosis-specific exercises and manual therapy in adolescent idiopathic scoliosis

BackgroundAdolescent idiopathic scoliosis (AIS) is a pathological condition characterized by vertebral curvature and associated trunk deformities in adolescents. The clinical efficacy of conservative treatment in alleviating spinal curvature of AIS remains a topic of ongoing debate. The objective of this study was to investigate the impact of combined physiotherapeutic scoliosis-specific exercises (PSSE) and manual therapy (MT) on trunk deformity, spinal function, mobility, and mental health in patients with AIS.MethodsThirty-one participants who were diagnosed with AIS whose Cobb angle was between 10–45°were enrolled in the study. Participants in the intervention group received 50 min of PSSE combined with 10 min of MT, while the control group performed 50 min of PSSE as their home exercise program. Both treatments were implemented three times a week for four weeks. Cobb angle, spinal mobility, trunk morphology (vertebral rotation angle, apical deviation, pelvic obliquity distance and angle), movement capability, and quality of life (QOL) were assessed at baseline and post intervention. The treatment effects between the intervention and control groups were analyzed using a two-way repeated measures ANOVA.ResultsFollowing a 4-week treatment period, Cobb angle was significantly reduced from 21.58° to 18.58° in intervention group and increased from 18.00° at baseline and 19.14° post intervention in the control group. Significant improvements were also observed in spinal mobility, movement capability, quality of life, and some of the trunk morphology indices in the intervention group compared to baseline (p < 0.05). Improvements were significantly higher in the intervention group than the control group.ConclusionCombining PSSE and MT shows potential benefits in alleviating AIS symptoms and improving QOL. Further studies to substantiate these findings are warranted.Trial registrationThe trial was retrospectively registered in the Chinese Clinical Trial Registry (https://www.chictr.org.cn) with the registration number: ChiCTR2300071357, (Date: 12/05/2023).

ANALYSIS OF THE SPINAL CURVATURE IN RHYTHMIC GYMNASTICS ATHLETES OF DIFFERENT COMPETITIVE LEVELS AND WITH DIFFERENT POSTURES

Rhythmic gymnastics is characterized by high mobility demands on the spine, which can lead to structural changes and associated injuries or pain. The aim of this study is to assess and compare spinal posture in different positions, mobility, and pain perception among RG athletes. The sample consisted of 34 gymnasts (age: 14.18 ± 2.17) of grassroots and federation levels. Spinal posture and mobility were analyzed using the Spinal Mouse® system, along with pain perception (location and intensity) and body composition. Most gymnasts exhibited normal spinal curvature in both standing and sitting positions. Significant differences (p&lt;0.05) were only found in the sacral curve during extension. Regarding lumbar mobility, differences in sacral mobility from standing to extension were noted, with the federation-level gymnasts showing a greater tendency for hyperlordosis in extension. In terms of pain, the lumbar region was the most affected, with 32.4% of cases reporting pain. It was observed that gymnasts experiencing pain displayed more pronounced lumbar hyperlordosis in the standing position. A low but significant correlation was found between lumbar pain and its intensity (p=0.045), and a moderate correlation was observed between hip pain and pelvic tilt. The gymnasts demonstrated a greater tendency for lumbar hyperlordosis in the standing position and during the transition from standing to extension, which was more pronounced among federation-level gymnasts. Furthermore, there appears to be a stronger correlation between hyperlordosis and the occurrence of lumbar pain, as well as the intensity of pain.

Developmental Toxicity and Teratogenic Effects of Dicarboximide Fungicide Iprodione on Zebrafish (Danio rerio) Embryos

Iprodione (IDN) is a broad-spectrum fungicide used to treat various fungal infections in plants. Despite its extensive use, assessment of its toxicity in aquatic organisms remains incomplete. This study investigated the deleterious effects of IDN using zebrafish (ZF) as a model organism. ZF embryos, beginning at 2 h post-fertilization (hpf), were exposed to IDN (3.75–40 mg/L), and both mortality and deformities were assessed. The impact of IDN on mortality was concentration-dependent and significant from 14 mg/L. Importantly, IDN induced several deformities at sublethal concentrations, including abnormal somites, reduced retinal pigment accumulation, yolk sac edema, hatching failure, abnormal swim bladders, and spinal curvature. The EC50 values for IDN-induced deformities were 3.44 ± 0.74 to 21.42 ± 6.00 mg/L. The calculated teratogenic index values for all deformities were above 1, indicating that IDN is teratogenic to ZF. IDN-exposed ZF also displayed abnormalities in touch-evoked escape responses. IDN significantly affected heart rate and blood flow, and induced pericardial edema and hyperemia in a concentration-dependent manner, suggesting its influence on cardiac development and the function of ZF. In conclusion, these results suggest that IDN exerts toxic effects on ZF embryos, affecting mortality, development, and behavior.

Morphological observation of occipital condyle position in Chinese skulls and potential clinical significance.

To study the anatomy of the Chinese occipital condyle and its position relative to the occipital foramen and skull. Measurements were taken from 106 adult Chinese skulls using a Cartesian coordinate system centered on the foramen magnum. Measurements included the longitudinal diameter of the foramen magnum, distances from various points on the occipital condyles to the foramen magnum and skull landmarks, and the occipital condyle classification index (OCI) and skull-occipital condyle classification index (SOCI). OCI categorized the position of the foramen magnum and occipital condyles into three groups: OCI ≤ 0.40 (3 cases, 2.83%), 0.40 < OCI ≤ 0.50 (75 cases, 70.75%), and OCI > 0.50 (28 cases, 26.42%). SOCI categorized the relationship between the skull and occipital condyles into two groups: 0.5 < SOCI ≤ 0.6 (49 cases, 46.23%) and 0.6 < SOCI ≤ 0.7 (57 cases, 53.77%). Four relationship types were identified based on specific measurements: Type I (23 cases, 21.70%), Type II (42 cases, 39.62%), Type III (4 cases, 3.77%), and Type IV (37 cases, 34.91%). Sagittal movement of the occipital condyle affects the cervical spine's curvature. Asymmetry between the occipital condyles and the foramen magnum may misalign the skull with the body's coronal plane.

Study on the relevant receptors based on dose-effect mechanism of yizhi weishu in jingjin theory

Yizhi weishu (the frequency of needling depending on the therapeutic effect) is one of the core items in the jingjin theory (muscle regions of meridians), but its relevant basic research is limited. On the basis of the preliminary research on jingjin theory and receptors, the article analyzes the association of thermoreceptor with "tendon spasm by cold and tendon flaccidity by heat, nociceptor with "patient's attention drawn by pain" and mechanoceptor with "spinal curvature, spastic or flaccid muscles and tendons, failure to erect". It is proposed that the dose-effect mechanism of jingjin therapy should be specially explored, aiming to provide the new approach to the modern research of yizhi weishu and support the development of the diagnosis and treatment system of TCM in jingjin diseases.

Gender Differences in the Relationship between Physical Activity, Postural Characteristics and Non-Specific Low Back Pain in Young Adults.

Background/Aim: University students are a particularly vulnerable population, as they spend increasing amounts of time sitting, which poses a major threat to their musculoskeletal health and posture. The aim of this cross-sectional study was to investigate gender differences in the relationships between physical activity (PA) and sedentary behavior, spinal curvatures and mobility, the endurance and balance of the trunk muscles, and the possible presence of non-specific low back pain (NS-LBP) in young adults aged 18-25 years. Methods: A total of 139 students completed all required tests. Results: Male students engaged in significantly more PA related to recreation, sports and leisure and were significantly more likely to be hyperkyphotic than female students. The more the male students participated in sports, the more pronounced the thoracic kyphosis. Female students had significantly more pronounced lumbar lordosis and anterior pelvic tilt that correlated with lumbar lordosis. Female students generally had significantly higher trunk extensor endurance and more balanced trunk musculature than males. NS-LBP correlated with PA in female students who generally had higher levels of NS-LBP than male students, with a statistically significant difference between those who practiced the most PA. Conclusions: Our results suggest that female students practice less PA and have pronounced lordosis and trunk extensor endurance, in contrast to males who practice more PA and have pronounced trunk flexor endurance and hyperkyphosis. Our findings suggest that more PA should be encouraged but implemented with caution and as an individualized gender-specific approach to prevent postural deformities and chronic musculoskeletal disorders, including NS-LBP.

The association between aerobic capacity and spinal curvature and mobility in young soccer players

BackgroundThere is a lot of research in terms of injuries and performance in football and nowadays aerobic capacity, spinal posture and mobility have been taken into consideration separately in terms of performance. Considering from a biomechanical perspective, we thought spinal curvature and mobility may affect aerobic performance and investigated the relationship between them. Research questionDo young soccer players' segmental spinal curvature and mobility affect their aerobic capacity and maximal exercise performance? MethodsThirty-four young league players (mean age 16.56 ±1.11 years) were evaluated pre-season. Spinal assessments in the sagittal plane with a non-invasive, computer-assisted electromechanical device and aerobic capacity assessment with a cardiopulmonary exercise-testing device were applied. The relationship between spinal postural variables with aerobic capacity was done by Pearson correlation analysis, and simple linear regression analysis was used to estimate the effect of spinal curvature and mobility on aerobic performance. ResultsVarious parameters of aerobic performance were related to spinal curvature and mobility. Maximal oxygen uptake (VO2max) and maximal heart rate (HRmax) were negatively correlated with thoracic angle (r=-0.343, p=0.047 and r=-0.344, p=0.046; respectively). Thoracic angle was also associated with tidal volume (VT) and VO2/HR (r=-0.347, p=0.044 and r=-0.348, p=0.044; respectively). Higher thoracic mobility caused to reach the anaerobic threshold (VAT) earlier (r=-0.368, p=0.032), at a lower speed (r=-0.367, p=0.033). In other segments, lumbar mobility was negatively correlated with VT at VAT (r=-0.346; p=0.045), while spinal inclination with HR at VAT (r=-0.387, p=0.024). SignificanceAlthough it is within physiological ranges, increased spinal curvature and mobility are associated with a decrease in aerobic capacity in young soccer players. Spinal curvature and mobility especially in the thoracic region may affect the aerobic performance of a soccer player. The trainers should consider spinal alignment for not only the technical and tactical but also the general performance of the soccer player.

Changes in the Centers of Rotation in Different Prosthetic Segments Following Continuous Two-Level Cervical Disc Replacement: A Retrospective Study

To observe the short-term to medium-term therapeutic effects and radiological outcomes of adjacent 2-level cervical spondylosis treated with artificial cervical disc replacement (ACDR) using Mobi-C and Bryan discs. To observe changes and discrepancies in the flexion-extension centers of rotation (FE-COR) of different ACDR segments. Twenty-four patients undergoing 2-level (C4/5 and C5/6) ACDR were analyzed retrospectively (11 patients in the Mobi-C group and 13 patients in the Bryan group). Clinical outcomes were assessed using modified Japanese Orthopedic Association score, Neck Disability Index, and visual analog scale. Preoperative and 2years' follow-up radiographs were collected to compare total cervical spine curvature (C2-C7) range of motion (ROM), upper and lower ACDR segmental ROM, and the operated adjacent segmental ROM. The FE-COR of the ACDR segment was measured using the mid-plumb line method. The degree of disc degeneration in the adjacent segment was observed. At the 2years' follow-up, in both group, the modified Japanese Orthopedic Association score increased significantly, and the Neck Disability Index and neck and upper extremity visual analog scale scores decreased significantly compared with preoperative (P<0.05). There were no significant statistical differences in postoperative scores between the 2 groups (P > 0.05). The overall cervical ROM, the upper and lower segmental ROM at the 2years' follow-up showed no significant statistical differences compared with the preoperative period (P > 0.05). There was no statistically significant difference in the adjacent segmental ROMs compared with the preoperative period (P > 0.05). Furthermore, the statistical analysis revealed no significant differences in the measurements of the ROM at each time points between the Mobi-C Group and the Bryan Group (P > 0.05). There was no significant difference in the preoperative FE-COR-X (indicating the horizontal position of the point in the coordinate system) and FE-COR-Y (indicating the vertical position of the point in the coordinate system) of upper or lower ACDR segments between the 2 groups (P > 0.05). At the 2years' follow-up, there were significant differences both in FE-COR-X and FE-COR-Y between the 2 groups (P < 0.05). For the Mobi-C group, in both the upper and lower segment, the FE-COR-X significantly increased compared with preoperative (P < 0.05), while the FE-COR-Y decreased compared with preoperative (P < 0.05). For the Bryan group, no significant changes were observed in the upper or lower segment in both FE-COR-X and FE-COR-Y compared with preoperative (P > 0.05). Fourty-eight adjacent segments (24 superior and 24 inferior segments) were included in the studies of adjacent segment disease. Four segments showed imaging adjacent segment disease (4/48, 8.33%) in 4 patients, of which 2 were mild and 2 were moderate according to the grading criteria. Among them, 2 were from the Mobi-C group and 2 were from the Bryan group. No severe imaging degeneration was observed. In continuous 2-level cervical ACDR surgery, both Mobi-C and Bryan artificial cervical discs achieved satisfactory clinical outcomes in the short to medium term postoperatively. The FE-COR exhibited different trends of change. In the Mobi-C group, the FE-COR for both upper and lower segments shifted anteriorly and inferiorly, whereas in the Bryan group, whether upper or lower, the FE-COR remained closer to the preoperative state. The changes in FE-COR did not significantly affect the short-term to medium-term clinical outcomes postoperatively.

Effects of High-Velocity Spinal Manipulation on Quality of Life, Pain and Spinal Curvature in Children with Idiopathic Scoliosis: A Systematic Review.

Scoliosis is a condition that involves deformation of the spine in the coronal plane and commonly appears in childhood or adolescence, significantly limiting a person's life. The cause is multifactorial, and treatment aims to improve the spinal curvature, prevent major pathologies, and enhance aesthetics. The objective of this review was to determine whether high-velocity low-amplitude (HVLA) spinal manipulation is more effective than other treatments for children with idiopathic scoliosis (IS). The PubMed, Web of Science, Scopus and PEDro databases were searched for both clinical trials and cohort studies. Methodological quality was assessed via the PEDro scale (for clinical trials) and the Newcastle-Ottawa scale (for observational studies). The protocol of this systematic review was registered in PROSPERO (CRD42024532442). Five studies were selected for review. The results indicated moderate improvements in pain and the Cobb angle and limited improvements in quality of life. HVLA spinal manipulation does not seem to have significant effects on reducing spinal deformity in IS patients, nor does it significantly impact quality of life. However, this therapy may have significant effects on reducing pain in these patients.

Correlation between sagittal balance and thoracolumbar elastic energy parameters in 42 spines subject to spondylolisthesis or spinal stenosis and 21 normal spines

The curvature of the lumbar spine plays a critical role in maintaining spinal function, stability, weight distribution, and load transfer. We have developed a mathematical model of the lumbar spine curve by introducing a novel mechanism: minimization of the elastic bending energy of the spine with respect to two biomechanical parameters: dimensionless lumbosacral spinal curvature cLS and dimensionless curvature increment along the spine CI. While most of the biomechanical studies focus on a particular segment of the spine, the distinction of the presented model is that it describes the shape of the thoracolumbar spine by considering it as a whole (non-locally) and thus includes interactions between the different spinal levels in a holistic approach. From radiographs, we have assessed standard geometrical parameters: lumbar lordosis LL, pelvic incidence PI, pelvic tilt PT, sacral slope ψ0 and sagittal balance parameter SB = sagittal vertical axis (SVA)/sacrum-bicoxofemoral distance (SFD) of 42 patients with lumbar spinal stenosis (SS) or degenerative spondylolisthesis (SL) and 21 radiologically normal subjects. SB statistically significantly correlated with model parameters cL5 (r = −0.34, p = 0.009) and −CI (r = 0.33, p = 0.012) but not with standard geometrical parameters. A statistically significant difference with sufficient statistical power between the patients and the normal groups was obtained for cLS, CI, and SB but not for standard geometrical parameters. The model provides a possibility to predict changes in the thoracolumbar spine shape in surgery planning and in assessment of different spine pathologies.

A new artificial intelligence program for the automatic evaluation of scoliosis on frontal spinal radiographs: Accuracy, advantages and limitations

BACKGROUND: Scoliosis is one of the most common spinal deformations that are usually diagnosed on frontal radiographs using Cobb’s method. Automatic measurement methods based on artificial intelligence can overcome many drawbacks of the usual method and can significantly save radiologist’s time. AIM: To analyze the accuracy, advantages, and disadvantages of a newly developed artificial intelligence program for the automatic diagnosis of scoliosis and measurement of Cobb’s angle on frontal radiographs. MATERIALS AND METHODS: In total, 114 digital radiographs were used to test the agreement of Cobb’s angle measurements between the new automatic method and the radiologist using the Bland–Altman method on Microsoft Excel. A limited clinical accuracy test was also conducted using 120 radiographs. The accuracy of the system in defining the scoliosis grade was evaluated by sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve. RESULTS: The agreement of Cobb’s angle measurement between the system and the radiologist’s calculation was found mostly in grade 1 and 2 scoliosis. Only 2.8% of the results showed a clinically significant angle variability of 5°. The diagnostic accuracy metrics of the limited clinical trial in City Mariinsky Hospital (Saint Petersburg, Russia) also proved the reliability of the system, with a sensitivity of 0.97, specificity of 0.88, accuracy (general validity) of 0.93, and area under the receiver operating characteristic curve of 0.93. CONCLUSION: Overall, the artificial intelligence program can automatically and accurately define the scoliosis grade and measure the angles of spinal curvatures on frontal radiographs.

A New ‘Stockholm Syndrome’: Physical Impairment and Hospital Confinement as Post-Holocaust Sequelae in Ilona Karmel’s Stephania

Ilona Karmel was a Holocaust victim. She endured diseases, Nazi ‘madness’, and imprisonment in the Krakow Ghetto and in concentration camps in Poland and Germany. At the end of World War II, she was abandoned to die by the retreating German enemy. Nevertheless, Victory Day in 1945 saw the beginning of another period of infirmity and confinement for Karmel, who was hospitalized in Sweden to treat leg injuries she had suffered by the Nazis. This essay, bringing together disability and Holocaust studies, explores harrowing post-Shoah sequelae in Karmel’s life, as reflected in Stephania (1953). To recover her sense of self after the bloodletting and to make visible physical impairment in her novel, Karmel creates the fictional Stephania: A Polish patient with spinal curvature worsened during wartime captivity who seeks medical treatment in Stockholm, all the while refusing to accept her body’s disfigurement. This article examines how disability and voluntary hospital confinement are portrayed in the novel Stephania and connected with Holocaust trauma. Despite memories of pain and incarceration invading their minds as survivors, Karmel and her creation Stephania inescapably must come to terms with their respective postwar impairments, heal from their emotional wounds, and cling to life during and beyond their convalescences.

Preliminary Investigation into the Association between Scoliosis and Hypoxia: A Retrospective Cohort Study on the Impact of Eliminating Hypoxic Factors on Scoliosis Outcomes.

This study delves into the implications of adenoidectomy for scoliosis progression, investigating the intricate nexus of hypoxia, spinal curvature, and surgical intervention. With adenoidectomy being a common procedure for addressing pediatric sleep-disordered breathing, this research study explores its potential impact on spinal health. Employing a retrospective cohort design, this study gathered data from patients who underwent adenoidectomy, including those with scoliosis, between January 2017 and March 2023. Initial and follow-up evaluations involved clinical and radiological assessments, notably measuring the Cobb angle to quantify spinal curvature. This study enrolled 218 patients under 10 years old. Among them, 18 exhibited Cobb angles of 10° or more, with a mean Cobb angle of 12.8°. In the follow-up evaluation, 83% of patients with initial Cobb angles of 10° or more were reached out to, along with 84.6% of those with Cobb angles below 10°. The postoperative follow-up revealed a notable decrease in Cobb angles for most patients, particularly those with an initial Cobb angle exceeding 10°. This study underscores the potential connection between adenoidectomy, hypoxia, and scoliosis regression, highlighting the importance of early intervention for scoliosis management. Despite certain limitations, this investigation lays the foundation for future research involving larger patient cohorts and multifaceted analyses. The observed interactions between airway function, hypoxia, and spinal health open avenues for refining clinical strategies in scoliosis treatment.

Sodium Fluoride Exposure Induces Developmental Toxicity and Cardiotoxicity in Zebrafish Embryos.

Fluorosis is a worldwide public health problem, in which the heart is an important target organ. However, studies on its toxicological mechanism in embryonic development are limited. This study assessed the toxicity of sodium fluoride (NaF) toward zebrafish embryos. We determined the mortality, hatching rate, phenotypic malformation, heart function, and morphology of zebrafish embryos after exposure to NaF. Subsequently, the molecular mechanism was revealed using high-throughput RNA sequencing analysis. The expression levels of key genes for heart development were detected using quantitative real-time reverse transcription PCR. The 50% lethal concentration (LC50) value of NaF toward zebrafish embryos at 96h post-fertilization was 335.75mg/L. When the concentration of NaF was higher than 200mg/L, severe deformities, such as pericardial edema, yolk sac edema, spine curvature, shortened body length, reduced head area, and eye area, were observed. The heart rate of the embryos exposed to NaF decreased in a dose-dependent fashion. The distance between the sinus venosus and bulbus arteriosus was significantly increased in the NaF-exposed group compared with that in the control group. The stroke volume and cardiac output decreased significantly in the NaF groups. Compared with the control group, the expression levels of Gata4, Tbx5a, Hand2, Tnnt2c, Nppa, and Myh6 were significantly increased in the NaF-treated group. Through transcriptome sequencing, 1354 differentially expressed genes (DEGs) were detected in the NaF (200mg/L) treated groups, including 1253 upregulated genes and 101 downregulated genes. Gene ontology functional analysis and Kyoto Encyclopedia of Genes and Genomes pathway analyses of the DEGs showed that cardiac-related pathways, such as actin cytoskeleton regulation, Jak-Stat, PI3k-Akt, and Ras, were activated in the NaF-exposed group. This study revealed the underlying mechanism of fluoride-induced cardiac morphological and functional abnormalities and provides clues for the clinical prevention and treatment of fluorosis.

AXIAL DEFORMATION OF SPINEBIO-TENSEGRITY MODELAT DIFFERENT DEPLOYABLE SCHEMES

The study presents the axial deformation of a spine bio-tensegrity model through a shape change strategy with different deployment schemes. The spine bio-tensegrity model mimics the total height, tapered form and natural curvature of a human spine. Three deployable schemes S1-S3 with a different combination of cables at alterable and fixed lengths (at the lower, middle and upper part of the model, respectively) were investigated to achieve a series of axial displacements at 200 mm, 400 mm and 600 mm in the z-direction. The shape change algorithm was developed to optimise the forced elongation of cables, incorporating an objective function designed for monitored nodes in the system to reach their prescribed targets during the optimisation process. Sequential quadratic programming was employed to solve a nonlinear optimisation problem in the shape change analysis involving inequality constraints. The efficiency of the deployable schemes was evaluated based on the deformed shapes, convergence curve and axial forces of the spine bio-tensegrity model. The finding shows in addition to axial deformation, the model in deployment scheme S1 preserves the slenderness characteristic of the spine. In contrast, the model exhibits excessive expansion in the thoracic region in schemes S2 and S3. Greater total computational steps in deployment scheme S3, followed by S2 and S1, reveal that the active cables set near the monitored nodes allow the model to sense and act faster to reach their targets. The study contributes to understanding the structural behaviour and deployment strategy for a structure mimicking a biological system.