Disputes exist regarding the psychometric properties of the Oswestry Disability Index (ODI). The present study was to examine the reliability, validity, and dimensionality of a Chinese version of the ...ODI version 2.1 in a sample of 225 adult orthopedic outpatients with chronic low back pain mean age (SD): 40.7 (11.4) years.
We conducted reliability analysis, exploratory bifactor analysis, confirmatory factor analysis, and Mokken scale analysis of the ODI. To validate the ODI, we used the Short-Form 36 questionnaire (SF-36) and visual analog scale (VAS).
The reliability, and discriminant and construct validities of the ODI was good. The fit statistics of the unidimensional model of the ODI were inadequate. The ODI was a weak Mokken scale (H
= 0.31).
The ODI was a reliable and valid scale suitable for measurement of disability in patients with low back pain. But the ODI seemed to be multidimensional that was against the use of the raw score of the ODI as a measurement of disability.
Organic semiconductors demonstrate several advantages over conventional inorganic materials for novel electronic and optoelectronic applications, including molecularly tunable properties, ...flexibility, low‐cost, and facile device integration. However, before organic semiconductors can be used for the next‐generation devices, such as ultrafast photodetectors (PDs), it is necessary to develop new materials that feature both high mobility and ambient stability. Toward this goal, a highly stable PD based on the organic single crystal PtBr2(5,5′‐bis(CF3CH2OCH2)‐2,2′‐bpy) (or “Pt complex (1o)”) is demonstrated as the active semiconductor channel—a material that features a lamellar molecular structure and high‐quality, intraligand charge transfer. Benefitting from its unique crystal structure, the Pt‐complex (1o) device exhibits a field‐effect mobility of ≈0.45 cm2 V−1 s−1 without loss of significant performance under ambient conditions even after 40 days without encapsulation, as well as immersion in distilled water for a period of 24 h. Furthermore, the device features a maximum photoresponsivity of 1 × 103 A W−1, a detectivity of 1.1 × 1012 cm Hz1/2 W−1, and a record fast response/recovery time of 80/90 µs, which has never been previously achieved in other organic PDs. These findings strongly support and promote the use of the single‐crystal Pt complex (1o) in next‐generation organic optoelectronic devices.
A Pt‐complex‐based organic semiconductor is developed as the active channel and/or photoabsorption layer for high‐performance organic device applications. The Pt‐complex device displays a stable mobility (0.45 cm2 V−1 s−1), a remarkable photoresponsivity (1000 A W−1), and a record fast response/fall time (80/90 µs), demonstrating the highest combined efficiency and stability reported for an organic semiconductor.
Purpose
Observing across four comparative case organizations, the purpose of this paper is to identify two sources of contingency (i.e. construct and contextual contingency) for the relationship ...between knowledge heterogeneity and innovation.
Design/methodology/approach
The contingencies was explored by conducting a comparative case analyses with rich qualitative data extracted and interpreted from four case companies.
Findings
First, the construct contingency is examined by refining knowledge heterogeneity into three dimensions: domain, process, and context heterogeneity. Specifically, the author proposed that knowledge heterogeneity in domain is associated with innovation in an inverted U-shape, while heterogeneity in process and context dimensions both negatively influence innovation. Second, contextual contingency is studied. The author proposed that: trust positively moderates the relationship between knowledge heterogeneity and innovation; depending on the knowledge owner attributes, centralization positively or negatively moderates the relationship between heterogeneous knowledge and innovation; shared knowledge vision positively moderates the relationship between knowledge heterogeneity and innovation.
Originality/value
The influences of knowledge heterogeneity on innovation have yet been inconsistent. The present study set to reconcile such inconsistency with a solution of contingencies that intervene the heterogeneity-innovation relationship. These results offer useful references for future large-scaled, quantitative studies.
Amid high-profile food scares, health concerns and threats of information imperfection and asymmetry, the Chinese pork industry faces increasing demands from consumers for assurances regarding ...quality and production methods in both the domestic and export markets. Using a real choice experiment (RCE), 316 consumers in Wuxi, located in China's Jiangsu Province, were randomly surveyed to examine the impact of various factors (e.g., traceability, lean meat essence testing, animal welfare, appearance, and price) on consumers' preference and willingness to pay (WTP) for pork products. A random parameter logit model was estimated, and the results show that having a traceable code is the second important factor after price for consumers, corresponding to a WTP of 4.76 yuan per catty, followed by a bright red appearance, a national stocking density standard of animal welfare, and detected no lean meat essence, corresponding to a WTP of more than 2 yuan per catty. In addition, there is a complementary interrelationship between a traceable code and a bright red appearance, detected no lean meat essence, and a national stocking density standard of animal welfare. The results concerning the latent class model (LCM) indicate that 56.9% of consumers are "quality-focused" consumers who are willing to pay a high price for traceable code, detected no lean meat essence, a national stocking density standard of animal welfare, and bright red appearance attributes. A further 28.1% are "price-sensitive" consumers who pay significant attention to the price, and the price that they pay for each product is meagre. The consumers with "preference combination attributes" attach greater value to interaction attributes, such as a traceable code combined with detected no lean meat essence or a bright red appearance and detected no lean meat essence combined with a national stocking density standard of animal welfare or a bright red appearance, accounting for 15% of consumers. The government should improve the traceability system, increase the intensity of lean meat essence testing, promote the welfare level of pigs, and promote public education and publicity on pork quality and safety attributes. Meanwhile, enterprises can formulate "differentiated" pork products, according to different consumer groups, and appropriately increase prices, according to production costs, in order to meet the requirements for pork quality and safety for consumers.
Purpose
This study aims to determine whether outcomes following vertebroplasty with high viscosity cement are superior to low viscosity cement and non-inferior to kyphoplasty in the setting of ...vertebral compression fractures.
Methods
We searched for randomized controlled trials and cohort studies assessing cement leakage rate in adult patients with VCFs who underwent vertebroplasty with high (HVCV) or low viscosity cement (LVCV) augmentation, or kyphoplasty (KP) in PubMed, Embase, Ovid, The Cochrane Library, and Web of Science from inception up to December 2019. Two authors extracted data and appraised risk of bias. We performed pairwise meta-analyses in R to compare differences between three treatments and network meta-analysis using frequentist random-effects models for indirect comparison. We used P-score to rate the overall certainty of evidence. The primary outcome was cement leakage rate.
Results
Five RCTs and eight cohort studies with 840 patients and a total of 1280 vertebral bodies were included in the systematic review and network meta-analysis. Compared to LVCV, the relative risk for cement leakage following HVCV and KP was 0.42 (95% CI 0.28–0.61) and 0.83 (95% CI 0.40–1.68), respectively. Our pooled results suggested that HVCV (P-score = 0.99) was better than KP (P-score = 0.36) in cement leakage rate.
Conclusions
The present network meta-analysis demonstrated that HVCV may be associated with lower risk of cement leakage among patients with VCFs as compared to other augmentation techniques. Future prospective studies will validate the findings of this analysis and further elucidate the risk of symptomatic cement leakage.
No previous study has investigated the associations of depression, anxiety, and insomnia at baseline with disability at a five-year follow-up point among outpatients with chronic low back pain ...(CLBP). The study aimed to simultaneously compare the associations of depression, anxiety, and sleep quality at baseline with disability at a 5-year follow-up point among patients with CLBP.
Two-hundred and twenty-five subjects with CLBP were enrolled at baseline, and 111 subjects participated at the five-year follow-up point. At follow-up, the Oswestry Disability Index (ODI) and total months of disability (TMOD) over the past five years were used as the indices of disability. The depression (HADS-D) and anxiety (HADS-A) subscales of the Hospital Anxiety and Depression Scale and the Insomnia Severity Index (ISI) were used to assess depression, anxiety, and insomnia at baseline and follow-up. Multiple linear regression was employed to test the associations.
The scores of the HADS-D, HADS-A, and ISI were correlated with the ODI at the same time points (both at baseline and follow-up). A greater severity on the HADS-D, an older age, and associated leg symptoms at baseline were independently associated with a greater ODI at follow-up. A greater severity on the HADS-A and fewer educational years at baseline were independently associated with a longer TMOD. The associations of the HADS-D and HADS-A at baseline with disability at follow-up were greater than that of the ISI at baseline, based on the regression models.
Greater severities of depression and anxiety at baseline were significantly associated with greater disability at the five-year follow-up point. The associations of depression and anxiety at baseline with disability at the long-term follow-up point might be greater than that of insomnia at baseline.
While digital finance and renewable energy consumption (REC) are two timely issues, it remains unclear whether the former affects the latter, especially in developing economies. This paper examines ...the impact of digital finance on China’s REC between 2011 and 2018 and explores the underlying mechanisms. Results show that digital finance, along with its coverage breadth and usage depth, significantly improved REC in China and that digital finance in the area of credit has had the most significant impact. Additionally, the results show that loan scale and income level are the main mediation variables, through which digital finance affects REC. The findings also suggest that economic growth and technological progress have increased REC in China, while carbon dioxide emissions have had no meaningful effect on this consumption. The results further indicate that policymakers must pay close attention to the role of digital finance when formulating policies on REC. To promote REC and environmental sustainability, developing economies like China should strengthen the breadth and depth of digital finance development, focus on the influence channels of digital finance, and promote economic growth and technological progress.
Background context
Postoperative symptomatic epidural hematoma (SEH) is a serious complication of lumbar spine surgery. Despite its rarity, this uncommon complication may result in devastating ...neurological sequelae, including lower limb weakness.
Purpose
A retrospective study was made to identify possible risk factors of postoperative spinal epidural hematoma by reviewing the clinical cases of this rare complication and analyzing the postoperative evaluations of patients.
Methods
From 2002 to 2010, out of 15,562 who underwent lumbar decompression procedure with/without instrumentation, 25 patients required reoperation for epidural hematoma after the initial spinal surgery. For the control group, another 75 patients were randomly selected from the pool of patients who received lumbar decompression surgery during the same period of time. The medical records of preoperative, intraoperative and postoperative factors were collected to determine possible risk factors by comparing between the cases and controls, and the postoperative evaluations of muscle power, intractable pain, saddle anesthesia, time to detection and time to evacuation were analyzed to find if there is any significant relation within the case group. Mann–Whitney
U
test, two-sample
t
test,
χ
2
test and Fisher’s exact test were used for statistical analysis.
Results
The incidence of postoperative symptomatic epidural hematoma is 0.16 %. After the initial procedure, 20 (80 %) patients developed progressive decrease in muscle power (MP ≤ 3), 14 (56 %) patients had intractable pain (VAS ≥ 7), and 19 (76 %) patients had saddle anesthesia. Preoperative diastolic blood pressure, intraoperative use of gelfoam for dura coverage and postoperative drain output were statistically significant risk factors (
p
< 0.01). Within the SEH case group, postoperative symptom of decreased muscle power had significant relation with blood loss, laminectomy level and fusion level (
p
= 0.016, 0.021, 0.010). If the symptom of decreased muscle power or perianal anesthesia was not improved after hematoma evacuation, there was a tendency for permanent leg weakness after 1-year follow-up (
p
= 0.001, 0.003).
Conclusions
The findings suggest that preoperative diastolic blood pressure, intraoperative use of gelfoam for dura coverage and postoperative drain output are risk factors for symptomatic epidural hematoma after lumbar decompression surgery. Major blood loss and multilevel surgical procedure could result in poor recovery of muscle power. After spine decompression surgery, early detection and evacuation of hematoma are the key to avoid neurologic deterioration and have better clinical outcomes.
Approximately 45% of metastatic colorectal cancer (mCRC) patients with wild-type KRAS exon 2 are resistant to cetuximab treatment. We set out to identify additional genetic markers that might predict ...the response to cetuximab treatment. Fifty-three wild-type KRAS exon 2 mCRC patients were treated with cetuximab/irinotecan-based chemotherapy as a first- or third-line therapy. The mutational statuses of 10 EGFR pathway genes were analyzed in primary tumors using next-generation sequencing. BRAF, PIK3CA, KRAS (exons 3 and 4), NRAS, PTEN, and AKT1 mutations were detected in 6, 6, 5, 4, 1, and 1 patient, respectively. Four of the BRAF mutations were non-V600 variants. Four tumors harbored multiple co-existing (complex) mutations. All patients with BRAF mutations or complex mutation patterns were cetuximab non-responders. All patients but one harboring KRAS, NRAS, or BRAF mutations were non-responders. Mutations in any one of these three genes were associated with a poor response rate (7.1%) and reduced survival (PFS = 8.0 months) compared to wild-type patients (74.4% and 11.6 months). Our data suggest that KRAS, NRAS, and BRAF mutations predict response to cetuximab treatment in mCRC patients.
To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgery.
Patients who underwent elective spine surgeries at our hospital between January ...2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed.
Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressively worsening. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer.
Spine surgeons should be highly alert to these risk factors of postoperative perforated peptic ulcers inpatients who has history of peptic ulcer, large amount ofintraoperative blood loss and abnormal high serum amylase level after elective spine surgery. Early diagnosis and emergent surgical intervention promote better outcomes.
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