The importance of the size of the trunk inclination angle in the early detection of scoliosis in children

Background Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature. Methods The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results In the age groups 6–9, 10–12 and 13–17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, significantly more frequent misdiagnoses (p < 0.05) were related to the lumbar and thoracolumbar (regions) sections of the spine in the groups aged 6–9 and 10–12 for ATI ≥ 7°; while no significant relationship was found at ATI ≥ 5°. For both ATI levels, the most frequent cases of mis- or undiagnosed scoliosis were observed among children with a Cobb angle of 10°-14° (p = 0.004). Conclusion A low predictive ATI value was demonstrated regarding scoliosis detection for the ATI 7° criterion in children aged 6–9 and 10–12 years, particularly for the lumbar and thoracolumbar locations. Adoption of the threshold of ATI 5° in screening tests for children aged 6–12 years, as well as for lower locations of scoliosis, may be more effective in the early detection of scoliosis. Trial registration. This study was approved by the Jan Dlugosz University in Czestochowa Ethics Committee KE-U/7/2021, and conducted under the Declaration of Helsinki.

The Effectiveness of Mobile-Learning in Teaching Corrective Exercises to Scoliosis Patients: A Quasi-Experimental Study

Background: Mobile-learning (M-learning) has recently provided new opportunities and facilitated patient education due to its attractiveness and ease of access. As a result, the present study aimed to design an application (app) and evaluate the effectiveness of M-learning in teaching CEx to patients suffering from scoliosis.Methods: This quasi-experimental study was fulfilled in two phases, namely, app design and educational intervention among scoliosis patients, and then reflections on the effectiveness of the app and educational intervention implementation concerned. Within the implementation step, the scoliosis patients referred to the rehabilitation center affiliated with Tabriz University of Medical Sciences, Tabriz, Iran, were divided into case and control groups upon imaging and grading their spine curvature. The effectiveness of the educational intervention was also assessed through the rate of recovery in spine curvature and users’ opinions and satisfaction with the app usability via the User Experience Questionnaire (UEQ). Results: In this sense, the accuracy index was equal to 100% based on physiotherapists’ approval. The level of satisfaction with the educational intervention in the case group with a mean value of 97% was also higher than that in the controls (88%). Moreover, the values ​​of the Cob angle change in the case group were significantly higher than that in the controls. Based on the analysis of the UEQ outcomes, the highest and the lowest levels of satisfaction among the users were associated with the “perspicuity” and “stimulation” dimensions of the app, respectively.Conclusion: Given that the new models of care are today mostly focused on the role of patients, moving toward patient self-management, the app designed here could be utilized as a model for developing broader similar systems and programs for treatment management, patient monitoring, emergency response, personalized health monitoring, and widespread access to health care information.

Transcriptome-Based Identification of Genes Responding to the Organophosphate Pesticide Phosmet in Danio rerio

Organophosphate pesticides (OPPs) are one of the most widely used insecticides. OPPs exert their neurotoxic effects by inhibiting acetylcholine esterase (AChE). Most of the gross developmental abnormalities observed in OPP-treated fish, on the other hand, may not be explained solely by AChE inhibition. To understand the overall molecular mechanisms involved in OPP toxicity, we used the zebrafish (ZF) model. We exposed ZF embryos to an OPP, phosmet, for 96 h, and then analyzed developmental abnormalities and performed whole transcriptome analysis. Phenotypic abnormalities, such as bradycardia, spine curvature, and growth retardation, were observed in phosmet-treated ZF (PTZF). Whole transcriptome analysis revealed 2190 differentially expressed genes (DEGs), with 822 and 1368 significantly up-and downregulated genes, respectively. System process and sensory and visual perception were among the top biological pathways affected by phosmet toxicity. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed significant enrichment of metabolic pathways, calcium signaling pathway, regulation of actin cytoskeleton, cardiac muscle contraction, drug metabolism–other enzymes, and phototransduction. Quantitative real-time PCR results of six DEGs agreed with the sequencing data expression profile trend. Our findings provide insights into the consequences of phosmet exposure in ZF, as well as an estimate of the potential risk of OPPs to off-target species.

Medical Multimedia Image Analysis of Scoliosis in Children Aged 3–7 Years Based on Adaptive Multiobjective Differential Evolution Algorithm

Scoliosis is mainly caused by the spinal column deviating from its centerline during the growth process. It usually occurs in children aged 3–7 years old. After a detailed analysis of the existing scoliosis detection methods, this paper compares and analyzes the advantages of using multimedia image processing technology to check scoliosis in children aged 3–7 years and uses an adaptive multiobjective differential evolution algorithm to perform scoliosis comprehensive testing. Finally, the experimental analysis shows that the adaptive multiobjective differential evolution algorithm is applied to scoliosis detection to analyze the characteristics of children's cervical spine curvature and the relationship between the cervical spine curvature and the scoliosis angle.

The Effectiveness of Mobile-Learning in Teaching Corrective Exercises to Scoliosis Patients: A Quasi-Experimental Study

Background Mobile-learning (M-learning) has recently provided new opportunities and facilitated patient education due to its attractiveness and ease of access. As a result, the present study aimed to design an application (app) and evaluate the effectiveness of M-learning in teaching CEx to patients suffering from scoliosis. Methods This quasi-experimental study was fulfilled in two phases, namely, app design and educational intervention among scoliosis patients, and then reflections on the effectiveness of the app and educational intervention implementation concerned. Within the implementation step, the scoliosis patients referred to the rehabilitation center affiliated with Tabriz University of Medical Sciences, Tabriz, Iran, were divided into case and control groups upon imaging and grading their spine curvature. The effectiveness of the educational intervention was also assessed through the rate of recovery in spine curvature and users’ opinions and satisfaction with the app usability via the User Experience Questionnaire (UEQ). Results In this sense, the accuracy index was equal to 100% based on physiotherapists’ approval. The level of satisfaction with the educational intervention in the case group with a mean value of 97% was also higher than that in the controls (88%). Moreover, the values ​​of the Cob angle change in the case group were significantly higher than that in the controls. Based on the analysis of the UEQ outcomes, the highest and the lowest levels of satisfaction among the users were associated with the “perspicuity” and “stimulation” dimensions of the app, respectively. Conclusion Given that the new models of care are today mostly focused on the role of patients, moving toward patient self-management, the app designed here could be utilized as a model for developing broader similar systems and programs for treatment management, patient monitoring, emergency response, personalized health monitoring, and widespread access to health care information.

Analysis of risk factors for C5 nerve root paralysis after posterior cervical decompression

Background C5 nerve root paralysis is a nonnegligible complication after posterior cervical spine surgery (PCSS). The cause of its occurrence remains controversial. The purpose of this study was to analyse the incidence of and risk factors for C5 nerve root paralysis after posterior cervical decompression. Methods We retrospectively analysed the clinical data of 640 patients who underwent PCSS in the Department of Orthopaedics, Affiliated Hospital of Qingdao University from September 2013 to September 2019. According to the status of C5 nerve root paralysis after surgery, all patients were divided into paralysis and normal groups. Univariate and multivariate analyses were used to determine the independent risk factors for C5 nerve root paralysis. A receiver operating characteristic (ROC) curve was used to demonstrate the discrimination of all independent risk factors. Results Multivariate logistic regression analysis revealed that male sex, preoperative cervical spine curvature, posterior longitudinal ligament ossification, and preoperative C4/5 spinal cord hyperintensity were independent risk factors for paralysis, whereas the width of the intervertebral foramina was an independent protective factor for paralysis. The area under the curve (AUC) values of the T2 signal change at C4-C5, sex, cervical foramina width, curvature and posterior longitudinal ligament ossification were 0.706, 0.633, 0.617, 0.637, and 0.569, respectively. Conclusions Male patients with C4-C5 intervertebral foramina stenosis, preoperative C4-C5 spinal cord T2 high signal, combined with OPLL, and higher preoperative cervical spine curvature are more likely to develop C5 nerve root paralysis after surgery. Among the above five risk factors, T2 hyperintensity change in C4-C5 exhibits the highest correlation with C5 paralysis and strong diagnostic power. It seems necessary to inform patients who have had cervical spine T2 hyperintensity before surgery of C5 nerve root paralysis after surgery, especially those with altered spinal cord T2 signals in the C4-C5 segment.

A Genomic Approach to Delineating the Occurrence of Scoliosis in Arthrogryposis Multiplex Congenita

Arthrogryposis multiplex congenita (AMC) describes a group of conditions characterized by the presence of non-progressive congenital contractures in multiple body areas. Scoliosis, defined as a coronal plane spine curvature of ≥10 degrees as measured radiographically, has been reported to occur in approximately 20% of children with AMC. To identify genes that are associated with both scoliosis as a clinical outcome and AMC, we first queried the DECIPHER database for copy number variations (CNVs). Upon query, we identified only two patients with both AMC and scoliosis (AMC-SC). The first patient contained CNVs in three genes (FBN2, MGF10, and PITX1), while the second case had a CNV in ZC4H2. Looking into small variants, using a combination of Human Phenotype Ontogeny and literature searching, 908 genes linked with scoliosis and 444 genes linked with AMC were identified. From these lists, 227 genes were associated with AMC-SC. Ingenuity Pathway Analysis (IPA) was performed on the final gene list to gain insight into the functional interactions of genes and various categories. To summarize, this group of genes encompasses a diverse group of cellular functions including transcription regulation, transmembrane receptor, growth factor, and ion channels. These results provide a focal point for further research using genomics and animal models to facilitate the identification of prognostic factors and therapeutic targets for AMC.