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Topological materials have shown promising potential in the spintronics application due to their conspicuous efficiency of charge-to-spin conversion. Our research investigates the temperature-dependent spin–orbit torque (SOT) from sputtered WTex. We reveal a strong temperature dependence of SOT and realize the current-induced SOT switching of WTex with perpendicular magnetic anisotropy structure under a wide range of 12 K to room temperature. Our findings reveal the temperature dependence of sputtered WTex and may pave the way for the spintronics application of semimetals under cryogenic temperature. [ABSTRACT FROM AUTHOR]

Access to legal information is fundamental to access to justice. Yet accessibility refers not only to making legal documents available to the public, but also rendering legal information comprehensible to them. A vexing problem in bringing legal information to the public is how to turn formal legal documents such as legislation and judgments, which are often highly technical, to easily navigable and comprehensible knowledge to those without legal education. In this study, we formulate a three-step approach for bringing legal knowledge to laypersons, tackling the issues of navigability and comprehensibility. First, we translate selected sections of the law into snippets (called CLIC-pages), each being a small piece of article that focuses on explaining certain technical legal concept in layperson's terms. Second, we construct a Legal Question Bank, which is a collection of legal questions whose answers can be found in the CLIC-pages. Third, we design an interactive CLIC Recommender. Given a user's verbal description of a legal situation that requires a legal solution, CRec interprets the user's input and shortlists questions from the question bank that are most likely relevant to the given legal situation and recommends their corresponding CLIC pages where relevant legal knowledge can be found. In this paper we focus on the technical aspects of creating an LQB. We show how large-scale pre-trained language models, such as GPT-3, can be used to generate legal questions. We compare machine-generated questions against human-composed questions and find that MGQs are more scalable, cost-effective, and more diversified, while HCQs are more precise. We also show a prototype of CRec and illustrate through an example how our 3-step approach effectively brings relevant legal knowledge to the public. [ABSTRACT FROM AUTHOR]

The era of information and communication technology (ICT) has popularized adolescents' digital reading activities in their daily lives. Most prior studies focused on identifying significant factors that foster digital reading performance. Although educational quality is of great concern, it is crucial to consider the issue of educational equity in the digital world. Our study aims to unfold the mediating roles of ICT-related psychological needs between economic, social, and cultural status (ESCS) and digital reading performance. A multilevel mediation analysis was adopted for 36,490 students from six high-performing Asian regions participating in the Programme for International Student Assessment (PISA). The results indicated that perceived ICT autonomy significantly mediated the relationship in most Asian regions, while perceived ICT competence yielded mixed roles. Interestingly, the suppression effects were detected between ESCS, ICT in social interaction, and digital reading. Our research findings offer fresh insights into narrowing the digital divide in the online reading environment for adolescents. [ABSTRACT FROM AUTHOR]

Background: The prognosis of surgically treated subjects with early onset scoliosis (EOS) into adulthood has been lacking. We aimed to investigate the patients’ perspectives on satisfaction with surgical treatment. Methodology: We included all surgical candidates with EOS who had undergone index spinal surgery for scoliosis correction between 2009 and 2013. The minimum duration of postoperative follow-up was 10 years at the time of survey completion. Three questionnaires were used in this study, comprising the revised Scoliosis Research Society questionnaire (SRS-22r), the Patient-Reported Outcomes Measurement Information System (PROMIS-29), and the World Health Organization Quality of Life (WHOQOL-BREF). Measures of treatment satisfaction were retrieved from SRS-22r. Results: There were 29 participants who completed the survey, and thereby included in the study (i.e., a response rate of 43% and a dropout rate of 6%). Amongst them, 14, 11, and 4 individuals received posterior spinal fusion (PSF), magnetically controlled growing rods (MCGR), and traditional growing rods, respectively. The average duration after the index spinal surgery was 12.6 ± 2.2 years. Our findings revealed that self-image (across all treatment groups), sleep disruption (only in PSF), and social aspects (in both PSF and MCGR) were significantly worse when compared to the normative values. According to the multivariable linear regression model (R-square = 0.690, p <.001), an increase in SRS-22r mental health (p =.008) and PROMIS-29 social participation scores (p =.004) corresponded to 0.511 and 0.055 points increases in satisfaction. Every unit increase in PROMIS-29 fatigue (p =.043) and WHOQOL-BREF physical domain scores (p =.007) was in conjunction with 0.019 and 0.040 points decreases in satisfaction. SRS-22r self-image (p =.056) and WHOQOL-BREF environmental domain scores (p =.076) were included in the model but did not reach statistical significance. Conclusions: To improve the long term quality of life in surgical candidates with EOS, we demonstrated that mental health, social participation, fatigue, and physical health were significant factors associated with treatment satisfaction. Interestingly, demographic and radiographic parameters did not have a significant effect in our cohort. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether the new classification system published by Jordans et al for cesarean scar pregnancy (CSP) can guide management and treatment outcomes. Methods: A retrospective study of women diagnosed with CSP from October 2010 to December 2022 in a single tertiary center was performed. Sonographic records of these women were classified into three types according to the classification published by Jordans et al. Treatment outcomes were compared across each type of CSP. Results: The study included a total of 84 women, where 60 (71.4%), 17 (20.2%), and 7 (8.3%) of them were categorized into Type 1, 2, and 3 CSP, respectively. A total of 47 (55.9%) women were managed with methotrexate, 22 (26.2%) underwent surgical management of the CSP without removal of the Cesarean section (CS) niche, and 11 (13.1%) underwent surgery to remove the CSP and the CS niche. Overall treatment success rates for medical management and surgical management were 70 and 97%, respectively. Four women were managed expectantly and continued their pregnancies, among which three carried beyond 34 weeks and had good neonatal outcomes. Conclusions: The classification as published by Jordans et al is easily replicable and readily implemented clinically. Our findings show that a higher proportion of Type 1 and Type 2 CSP were treated successfully by a less invasive medical approach with a high success rate, whereas most Type 3 CSP required surgical resection to successfully remove the CSP and the CS niche. Prospective studies are required to confirm these findings and further validate the clinical utility of this nomenclature system. [ABSTRACT FROM AUTHOR]

Objectives: Telemedicine has been widely used during the COVID-19 pandemic. Among other health care professionals, Chinese medicine practitioners (CMPs) face practical challenges in providing telemedicine consultations. This study aims to explore CMPs' experience and perceptions of telemedicine service provision before and during the pandemic. Methods: A territory-wide cross-sectional online survey was conducted in Hong Kong between April and May 2022. A structured questionnaire with open-ended questions was used to investigate the provision of and perception on telemedicine service, as well as usability of telemedicine among CMPs. Results: A total of 195 CMPs participated the survey. Before COVID-19, 42% (81/195) had been providing telemedicine services, and the proportion doubled during COVID-19. CMPs in the private sector are the main providers. Mobile apps including WhatsApp, WeChat, and Zoom were commonly used for consultations (75%, 120/161). Barriers in providing telemedicine included inability of conducting physical examination on patients (69%, 134/195), legal and ethical concerns over medical negligence (61%, 118/195), and patients' incompetence on e-literacy (50%, 98/195). Respondents urged professional and regulatory bodies to provide an explicit clinical guideline that demonstrate best practice in traditional Chinese medicine telemedicine, and to clarify legal and ethical implications of such practice. Conclusions: CMPs demonstrated their competency in telemedicine, and most of them provided telemedicine during COVID-19. Development of appropriate guidelines on the provision of telemedicine would support CMPs to continue provision after the pandemic, whereas a user-friendly and comprehensive telemedicine e-platform would enhance quality of such service. Facilitating patients with lower e-literacy to access telemedicine is key to reduce disparities. [ABSTRACT FROM AUTHOR]

Background and aims: Despite evidence that patients living with cancer who continue to smoke after diagnosis are at higher risk for all‐cause mortality and reduced treatment efficacy, many cancer patients continue to smoke. This protocol is for a study to test the effectiveness of a self‐determination theory‐based intervention (quit immediately or progressively) plus instant messaging (WhatsApp or WeChat) to help smokers with cancer to quit smoking. Design: This will be a multi‐centre, two‐arm (1:1), single‐blind, pragmatic, individually randomized controlled trial. Setting: Taking part will be specialist outpatient clinics in five major hospitals in different location‐based clusters in Hong Kong. Participants: The sample will include 1448 Chinese smokers living with cancer attending medical follow‐ups at outpatient clinics. Interventions: The intervention group will receive brief advice (approximately 5–8 minutes) from research nurses in the outpatient clinics and then be invited to choose their own quit schedules (immediate or progressive). During the first 6‐month follow‐up period they will receive instant messaging with smoking cessation advice once per week for the first 3 months, and thereafter approximately once per month. They will also receive four videos, and those opting to quit progressively will receive a smoking reduction leaflet. The control group will also receive brief advice but be advised to quit immediately, and instant messaging with general health advice during the first 6‐month follow‐up period using the same schedule as the intervention group. Participants in both groups will receive smoking cessation leaflets. Measurements The primary outcome is biochemically validated smoking abstinence at 6 months, as confirmed by saliva cotinine level and carbon monoxide level in expired air. Secondary outcomes include biochemically validated smoking abstinence at 12 months, self‐reported 7‐day point prevalence of smoking abstinence at 6 and 12 months, self‐reported ≥ 50% reduction of cigarette consumption at 6 and 12 months and quality of life at 6 and 12 months. All time‐points for outcomes measures are set after randomization. Comments The results could inform research, policymaking and health‐care professionals regarding smoking cessation for patients living with cancer, and therefore have important implications for clinical practice and health enhancement. [ABSTRACT FROM AUTHOR]

Background and aims: Despite evidence that patients living with cancer who continue to smoke after diagnosis are at higher risk for all-cause mortality and reduced treatment efficacy, many cancer patients continue to smoke. This protocol is for a study to test the effectiveness of a self-determination theory-based intervention (quit immediately or progressively) plus instant messaging (WhatsApp or WeChat) to help smokers with cancer to quit smoking. Design: This will be a multi-centre, two-arm (1:1), single-blind, pragmatic, individually randomized controlled trial. Setting: Taking part will be specialist outpatient clinics in five major hospitals in different location-based clusters in Hong Kong. Participants: The sample will include 1448 Chinese smokers living with cancer attending medical follow-ups at outpatient clinics. Interventions: The intervention group will receive brief advice (approximately 5-- 8 minutes) from research nurses in the outpatient clinics and then be invited to choose their own quit schedules (immediate or progressive). During the first 6-month follow-up period they will receive instant messaging with smoking cessation advice once per week for the first 3 months, and thereafter approximately once per month. They will also receive four videos, and those opting to quit progressively will receive a smoking reduction leaflet. The control group will also receive brief advice but be advised to quit immediately, and instant messaging with general health advice during the first 6-month follow-up period using the same schedule as the intervention group. Participants in both groups will receive smoking cessation leaflets. Measurements: The primary outcome is biochemically validated smoking abstinence at 6 months, as confirmed by saliva cotinine level and carbon monoxide level in expired air. Secondary outcomes include biochemically validated smoking abstinence at 12 months, self-reported 7-day point prevalence of smoking abstinence at 6 and 12 months, selfreported ≥ 50% reduction of cigarette consumption at 6 and 12 months and quality of life at 6 and 12 months. All time-points for outcomes measures are set after randomization. Comments: The results could inform research, policymaking and health-care professionals regarding smoking cessation for patients living with cancer, and therefore have important implications for clinical practice and health enhancement. [ABSTRACT FROM AUTHOR]

Mediation, moderation, and moderated mediation are common in behavioral research models. Several tools are available for estimating indirect effects, conditional effects, and conditional indirect effects and forming their confidence intervals. However, there are no simple-to-use tools that can appropriately form the bootstrapping confidence interval for standardized conditional indirect effects. Moreover, some tools are restricted to a limited type of models. We developed an R package, manymome, which can be used to estimate and form confidence intervals for indirect effects, conditional effects, and conditional indirect effects, standardized or not, using a two-step approach: model parameters are estimated either by structural equation modeling using lavaan or by a set of linear regression models using lm, and then the coefficients are used to compute the requested effects and form confidence intervals. It can be used when there are missing data if the model is fitted by structural equation modeling. There are only a few limitations on some aspects of a model, and no inherent limitations on the number of predictors, the number of independent variables, or the number of moderators and mediators. The goal is to have a tool that allows researchers to focus on model fitting first and worry about estimating the effects later. The use of the model is illustrated using a few numerical examples, and the limitations of the package are discussed. [ABSTRACT FROM AUTHOR]

This article explores the relationship between cognitive impairment and functional limitations in individuals with haemophilia in Hong Kong. The study reveals that patients who experience difficulties with memory, attention, and executive functioning tend to have poorer performance at work or school. These cognitive functions are crucial for setting and achieving goals, as well as adapting to one's surroundings, so deficiencies in these areas can impact occupational or educational performance. The findings suggest that regular monitoring of cognitive function should be integrated into the standard care for haemophilia patients, particularly those facing occupational or vocational challenges. Further research is necessary to develop a cost-effective and clinically feasible method for monitoring cognitive function in these individuals. The study investigates how cognitive impairment affects functional limitations in haemophilia patients. The researchers discover that impairments in attention, motor processing speed, and cognitive flexibility are linked to a decline in functional status. The study proposes that regular screening for cognitive deficits and cognitive rehabilitation may be necessary for this population. However, the study has limitations, such as potential selection bias and the absence of a control group. Further research is needed to validate the findings and assess the long-term consequences of functional limitations in haemophilia patients. [Extracted from the article]

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation. [ABSTRACT FROM AUTHOR]

Background: Survivorship of medial unicompartmental knee arthroplasty (UKA) is technique-dependent. Correct femoral-tibial component positioning associates with improved survivorship. Image-free robotic-assisted unicompartmental knee arthroplasty enables preoperative and intraoperative planning of alignment and assessment of positioning prior to execution. This study aimed to compare the radiological outcomes between robotic-assisted UKA (R-UKA) and conventional UKA (C-UKA). Methods: This retrospective case control study involved 140 UKA (82 C-UKA and 58 R-UKA) performed at an academic institution between March 2016 to November 2020, with a mean follow-up of 3 years. Postoperative radiographs were evaluated for mechanical axis and femoral-tibial component position. Component position was measured by two methods: (1) femoral-tibial component contact point with reference to four medial-to-lateral quadrants of the tibial tray and (2) femoral-tibial component contact point deviation from the center of the tibial tray as a percentage of the tibial tray width. Baseline demographics and complications were recorded. Results: There was a higher mean component deviation in C-UKA compared with R-UKA using method 2 (17.2% vs. 12.8%; P = 0.007), but no difference in proportion of zonal outliers using method 1 (4 outliers in C-UKA, 5.1% vs. 1 outlier in R-UKA, 1.8%; P = 0.403). R-UKA showed no difference in mean mechanical alignment (C-UKA 5° vs. R-UKA 5°; P = 0.250). 2-year survivorship was 99% for C-UKA and 97% for R-UKA. Mean operative time was 18 min longer for R-UKA (P < 0.001). Conclusion: Image-free robotic-assisted UKA had improved component medio-lateral alignment compared with conventional technique. [ABSTRACT FROM AUTHOR]

The carbohydrate ganglioside GD2/GD3 cancer vaccine adjuvanted by β-glucan stimulates anti-GD2 IgG1 antibodies that strongly correlate with improved progression-free survival (PFS) and overall survival (OS) among patients with high-risk neuroblastoma. Thirty-two patients who relapsed on the vaccine (first enrollment) were re-treated on the same vaccine protocol (re-enrollment). Titers during the first enrollment peaked by week 32 at 751 ± 270 ng/mL, which plateaued despite vaccine boosts at 1.2–4.5 month intervals. After a median wash-out interval of 16.1 months from the last vaccine dose during the first enrollment to the first vaccine dose during re-enrollment, the anti-GD2 IgG1 antibody rose to a peak of 4066 ± 813 ng/mL by week 3 following re-enrollment (p < 0.0001 by the Wilcoxon matched-pairs signed-rank test). Yet, these peaks dropped sharply and continually despite repeated boosts at 1.2–4.5 month intervals, before leveling off by week 20 to the first enrollment peak levels. Despite higher antibody titers, patients experienced no pain or neuropathic side effects, which were typically associated with immunotherapy using monoclonal anti-GD2 antibodies. By the Kaplan–Meier method, PFS was estimated to be 51%, and OS was 81%. The association between IgG1 titer during re-enrollment and β-glucan receptor dectin-1 SNP rs3901533 was significant (p = 0.01). A longer prime–boost interval could significantly improve antibody responses in patients treated with ganglioside conjugate cancer vaccines. [ABSTRACT FROM AUTHOR]

Background and Purpose: Radiation therapy‐induced gastrointestinal distress is partly associated with the elimination of gut microbiota. The effectiveness of 5‐HT receptor antagonists to treat radiation therapy‐induced emesis implies a pathophysiological role of 5‐HT. Peripheral 5‐HT is derived from intestinal epithelium. We have investigated the role of gut microbiota in regulating intestinal 5‐HT availability. Experimental Approach: A radiation therapy murine model accompanied by faecal microbiota transplantation from donors fed different diets was investigated, and mouse ileal organoids were used for mechanistic studies. The clinical relevance was validated by a small‐scale human study. Key Results: Short‐term high‐fat diet (HFD) induced gut bacteria to produce butyrate. Irradiated mice receiving HFD‐induced microbiome had the lowest ileal levels of 5‐HT, compared with other recipients. Treatment with butyrate increased 5‐HT uptake in mouse ileal organoids, assayed by the real‐time tracking of a fluorescent substrate for monoamine transporters. Silencing the 5‐HT transporter (SERT) in the organoids abolished butyrate‐stimulated 5‐HT uptake. The competitive tests using different types of selective 5‐HT reuptake inhibitors suggested that butyrate acted as a positive allosteric modulator of SERT. In human gut microbiota, butyrate production was associated with the interconversion between acetate and butyrate. Faecal contents of both acetate and butyrate were negatively associated with serum 5‐HT, but only butyrate was positively correlated with body mass index in humans. Conclusion and Implications: Short‐term HFD may be beneficial for alleviating gastrointestinal reactions by increasing butyrate to suppress local 5‐HT levels and providing energy to cancer patients given radiation therapy. [ABSTRACT FROM AUTHOR]

Background: Anti-GD2 monoclonal antibodies (mAbs) have shown to improve the overall survival of patients with high-risk neuroblastoma (HR-NB). Serious adverse events (AEs), including pain, within hours of antibody infusion, have limited the development of these therapies. In this study, we provide evidence of Autonomic Nervous System (ANS) activation as the mechanism to explain the main side effects of anti-GD2 mAbs. Methods: Through confocal microscopy and computational super-resolution microscopy experiments we explored GD2 expression in postnatal nerves of infants. In patients we assessed the ANS using the Sympathetic Skin Response (SSR) test. To exploit tachyphylaxis, a novel infusion protocol (the Step-Up) was mathematically modelled and tested. Results: Through confocal microscopy, GD2 expression is clearly visible in the perineurium surrounding the nuclei of nerve cells. By computational superresolution microscopy experiments we showed the selective expression of GD2 on the cell membranes of human Schwann cells in peripheral nerves (PNs) significantly lower than on NB. In patients, changes in the SSR were observed 4 minutes into the anti-GD2 mAb naxitamab infusion. SSR latency quickly shortened followed by gradual decrease in the amplitude before disappearance. SSR response did not recover for 24 hours consistent with tachyphylaxis and absence of side effects in the clinic. The Step-Up protocol dissociated on-target off-tumor side effects while maintaining serum drug exposure. Conclusion: We provide first evidence of the ANS as the principal non-tumor target of anti-GD2 mAbs in humans. We describe the development and modeling of the Step-Up protocol exploiting the tachyphylaxis phenomenon we demonstrate in patients using the SSR test. [ABSTRACT FROM AUTHOR]

Background: The high co-prevalence of obesity and end-stage osteoarthritis requiring arthroplasty, with the former being a risk factor for complications during arthroplasty, has led to increasing interest in employing preoperative weight loss interventions such as bariatric surgery and diet modification. However, the current evidence is conflicting, and this study aimed to investigate the effect of weight loss intervention before arthroplasty in prospective randomized controlled trials. Methods: Four electronic databases (MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) were searched for prospective randomized controlled trials that compared weight loss interventions with usual care from inception to October 2023 by following the PRISMA guidelines. The Cochrane risk of bias tool and GRADE framework were used to assess the quality of the studies. Meta-analyses were performed when sufficient data were available from 2 or more studies. Results: Three randomized controlled trials involving 198 patients were identified. Two studies employed diet modification, and one study utilized bariatric surgery. All three studies reported significant reductions in body weight and body mass index (BMI), and intervention groups had fewer postoperative complications. There was no difference in the length of stay between the intervention group and the control group. Variable patient-reported outcome measures were used by different research groups. Conclusion: Weight loss intervention can achieve significant reductions in body weight and body mass index before arthroplasty, with fewer postoperative complications reported. Further studies with different populations could confirm the effect of these interventions among populations with different obesity characteristics. [ABSTRACT FROM AUTHOR]

Objective: Neuropathic pain poses a persistent challenge in clinical management. Neuromodulation has emerged as a last‐resort therapy. Conventional spinal cord stimulation (Con SCS) often causes abnormal sensations and provides short analgesia, whereas high‐frequency spinal cord stimulation (HF SCS) is a newer therapy that effectively alleviates pain without paresthesia. However, the modes of action of 10kHz HF SCS (HF10 SCS) in pain relief remain unclear. To bridge this knowledge gap, we employed preclinical models that mimic certain features of clinical SCS to explore the underlying mechanisms of HF10 SCS. Addressing these issues would provide the scientific basis for improving and evaluating the effectiveness, reliability, and practicality of different frequency SCS in clinical settings. Methods: We established a preclinical SCS model to examine its effects in a neuropathic pain rat model. We conducted bulk and single‐cell RNA sequencing in the spinal dorsal horn (SDH) to examine cellular and molecular changes under different treatments. We employed genetic manipulations through intrathecal injection of a lentiviral system to explore the SCS‐mediated signaling axis in pain. Various behavioral tests were performed to evaluate pain conditions under different treatments. Results: We found that HF10 SCS significantly reduces immune responses in the SDH by inactivating the Kaiso‐P2X7R pathological axis in microglia, promoting long‐lasting pain relief. Targeting Kaiso‐P2X7R in microglia dramatically improved efficacy of Con SCS treatment, leading to reduced neuroinflammation and long‐lasting pain relief. Interpretation: HF10 SCS could improve the immunopathologic state in the SDH, extending its benefits beyond symptom relief. Targeting the Kaiso‐P2X7R axis may enhance Con SCS therapy and offer a new strategy for pain management. ANN NEUROL 2024;95:966–983 [ABSTRACT FROM AUTHOR]

Background: Perceived social support (PSS) plays a considerable role in mental health. The Multidimensional Scale of Perceived Social Support (MSPSS) is one of the most widely used scales, leading to much research evidence. The present study investigated its measurement model, equivalence across gender (male and female) and age groups (older patients= above 60 and non-older patients= below 60), and concurrent validity. Methods: A cross-sectional survey was conducted between March and October 2020, on patients hospitalized due to COVID-19 in Tehran, Iran. The scales were administered to 328 COVID-19 patients (54.6% male, aged 21 to 92) from two general hospitals; participants completed MSPSS (including friends, family, and significant others subscales), Pittsburgh Sleep Quality Index (PSQI, include sleep latency, subjective sleep quality, habitual sleep efficiency, sleep duration, use of sleep medication, daytime dysfunction, and sleep disturbances subscales), and the Perceived Stress Scale-10 (PSS-10, to assess patients' appraisal of stressful conditions). Results: The MSPSS three-factor structure was confirmed among COVID-19 patients by Confirmatory Factor Analysis (CFA). The results support the MSPSS internal consistency and configural, metric, and scalar invariance across gender and age groups. Nevertheless, small but significant differences were found across ages based on the latent factor mean of the MSPSS from friends, with a lower mean level in older patients. The coefficients of Cronbach's alpha (ranging from.92 to.96), the ordinal theta (ranging from.95 to.98), and Omega (ranging from.93 to.97) suggested high internal consistency of MSPSS. The concurrent validity of MSPSS was evidenced by its significant negative correlation with PSS-10 (Γb = -.13, p <.01) and also subjective sleep quality (Γb = -.22, p <.01), sleep disturbances (Γb = -.26, p <.001), and daytime dysfunction (Γb = -.26, p <.001). Conclusions: The MSPSS was valid and reliable for measuring individuals' perception of social support between males and females and older and non-older COVID-19 patients. [ABSTRACT FROM AUTHOR]

Collaborative problem-solving competence (CPSC) is a core skill in the twenty-first century. As an innovative literacy, CPSC was assessed for the first time in the Program for International Student Assessment (PISA) 2015. Our study aims to identify the effects of student's perceptions toward interpersonal relationships on CPSC in PISA 2015. Multiple linear regression was used to examine these effects across Hong Kong, Macao, Taiwan, and the four affluent communities in China. After controlling student's gender and socio-economic status, the results indicated that: (a) Student's external perceptions such as teacher unfairness and disciplinary climate, and student's internal perceptions such as valuing relationships and valuing teamwork significantly predicted CPSC; (b) Disciplinary climate was the strongest predictor among all the external perceptions analyzed; (c) Regarding the internal perceptions, valuing relationships positively predicted CPSC, while valuing teamwork negatively predicted CPSC. These findings enlighten educational practitioners to help students develop their CPSC from the perspective of interpersonal relationships. [ABSTRACT FROM AUTHOR]

Several international large-scale assessments were conducted at the turn of the new century, and during the past two decades the Programme for International Student Assessment (PISA) completed seven cycles of assessment to facilitate practitioners' policy debates and governance. This study reviews PISA-related articles published in English and Chinese. Three literature databases were searched, with a focus on SSCI, CSSCI, and TSSCI journal publications. The frequency of publication was analyzed according to the author's country affiliation, type of journal, and research categories/themes. Findings indicate that research on student-, school- and system-level indicators with a focus on students' learning processes and outcomes as well as critiques of technical matters on PISA were frequent topics in the literature during the past two decades. Issues of equality and equity examined in the publications have implications for enhancing practitioners' capabilities in terms of policy making and governance. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective cohort Study. Objectives: To identify predictive factors for coronal imbalance after selective fusion in adolescent idiopathic scoliosis (AIS) with Lenke type 1 curves. Methods: AIS patients with Lenke type 1 curve with A, B and C lumbar modifiers underwent selective thoracic fusion. The curve fulcrum flexibility and fulcrum bending correction index (FBCI) was studied. Coronal imbalance was defined as more than 2 cm of truncal shift or more than 2 cm list at two-year follow-up. Results: A total of 301 patients were included in the study. Coronal imbalance at two-year follow-up was found in 38 patients (13%). At the preoperative stage, we found a significant difference in main curve flexibility with 66±15% in the balanced group and 60±15% in the imbalanced group (P =.032). At the immediate postoperative stage, mean curve correction was 71±13% vs 70±13% and mean FBCI was 112±29% vs 122±29% in the balance and unbalanced group, respectively (P =.031). Postoperative FBCI of more than 125% (third quartile) resulted in an odds ratio of 2.1 (95%CI:1.1-4.3) for coronal imbalance at two years (P=.031). No significant changes in fusion mass or LIV tilt was observed. Conclusions: A decreased preoperative flexibility and a higher FBCI was significantly associated with coronal imbalance. A high FBCI is an indication of a curve correction that exceeds the inherent flexibility of the spine, and our results add to a growing body of evidence that "overcorrection" of the main curve can lead to postoperative imbalance. [ABSTRACT FROM AUTHOR]

Dementia is a long‐term and progressive syndrome that not only influences the person with dementia (PWD) but also the caregiver. However, informal caregivers are not always empathic and understand the symptoms of dementia, leading to destructive caregiving relationships and poor quality of caregiving. VR‐based simulation interventions can provide a more realistic and memorable learning experience for caregivers to walk in PWDs' shoes. This review aimed to provide practitioners and researchers with insights on developing and/or adopting an effective VR‐based simulation intervention for enhancing the empathy of informal caregivers of PWD. A mixed‐methods systematic review was conducted. Quantitative, qualitative, and mixed‐methods studies were searched from MEDLINE, PsycINFO, CINAHL, Scopus, Embase, and Cochrane Library updating. Standard JBI critical appraisal instruments were used for the quality appraisal. A convergent segregated approach was used to synthesize and integrate the data. A total of seven studies were included. Inconsistent quantitative results were reported on the effects of VR‐based simulation on empathy enhancement. Significant effects were reported on knowledge of dementia and emotion‐focused coping strategies. Two themes were generated from the qualitative studies, including "Informal caregivers gained better insight into problems encountered by older people with dementia" and "Thinking from the perspective of older people with dementia, leading to changes in attitudes and behaviours towards dementia". The qualitative synthesized evidence showed that informal caregivers gained better insight into problems encountered by PWD, but the quantitative synthesized results are inconsistent. Yet, informal caregivers experienced a change in attitude by thinking from the perspective of PWD. [ABSTRACT FROM AUTHOR]

Family business groups (FBGs) typically control several member firms and can hire a single auditor or multiple auditors to audit their member firms. This article examines what type of auditor appointment strategy constrains intragroup value transfers within FBGs. Analyzing related-party transactions (RPTs) within FBGs in Hong Kong, this study provides evidence that FBGs with multiple auditors undertake more intragroup value transfers than FBGs with a single auditor. However, the adverse effect of multiple-auditor appointments is mitigated by a stronger board and higher financial reporting comparability among member firms. Using an alternative measure of intragroup value transfers, we also find that the market perceives multiple-auditor appointments as impairing audit effectiveness. Overall, our findings offer the new insight that controlling families can exploit the appointment of multiple auditors as a "divide and conquer" strategy which undermines the monitoring role of auditors against intragroup value transfers, but stronger corporate governance of member firms can mitigate the adverse effect. [ABSTRACT FROM AUTHOR]

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada. [ABSTRACT FROM AUTHOR]

Introduction: This study explores the motivators to use learning management systems (LMS) adopted and used in eLearning by Hong Kong universities among Mainland Chinese postgraduate students amid COVID-19 pandemic. Methods: An adapted and extended UTUAT2 model was first proposed and tested using the structural equation modeling approach. Through self-report online questionnaire, data were collected in 2022 from 352 Mainland Chinese postgraduate students of nine universities in Hong Kong. The reliability and validity of the data were tested using the confirmatory factor analysis, followed by path analysis to test the hypotheses in the proposed model. Results: The study revealed nine motivators which explained 50% of the variance in LMS use intention. Trust (0.204), instructor characteristics (0.202), performance expectancy (0.181), and facilitating conditions (0.181) were identified as strong motivators of behavioral intention. Other factors such as effort expectancy (0.148), learning value (0.118) and social influence (0.115) also had significant positive effects on LMS use intention. Habit (0.014) and hedonic motivation (-0.016) had no significant direct effect on it. Discussion: These findings provide inspirations for educational stakeholders to promote the acceptance of LMS platforms among distance and online learners who adopt the cyberspace as the only means of learning. They also offer insights about instructor recruitment and evaluation methods. [ABSTRACT FROM AUTHOR]

It remains a challenge to produce soft robots that can mimic the responsive adaptability of living organisms. Rather than fabricating soft robots from bulk hydrogels,hydrogels are integrated into the interfacial assembly of aqueous two‐phase systems to generate ultra‐soft and elastic all‐aqueous aquabots that exhibit responsive adaptability, that can shrink on demand and have electrically conductive functions. The adaptive functions of the aquabots provide a new platform to develop minimally invasive surgical devices, targeted drug delivery systems, and flexible electronic sensors and actuators. [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms commonly co‐occur with cognitive decline in older adults. However, prospective interrelationships between different cognitive function domains and depressive symptoms are not well understood. This study evaluated prospective interrelationships between depressive symptoms and cognitive functioning components among individuals aged 50 years or older from a perspective of network analysis. Method: Longitudinal data from the English Longitudinal Study of Aging were analyzed. Depressive symptoms were measured with the eight‐item Center for Epidemiologic Studies Short–Depression Scale. Cognitive functions assessed included memory, orientation, and executive function. Contemporaneous network analyses were conducted using mixed graphical model, while a temporal network model was assessed using cross‐lagged panel network model. To identify important predictors and outcomes, centrality indices, including expected influence, out‐expected influence, and in‐expected influence, were calculated. Results: A total of 6,433 older adults were included in the network analysis. Baseline "Not enjoy life" (CESD‐6) was negatively associated with executive function at the follow‐up assessment. Moreover, improvements in "Everything was an effort" (CESD‐2) and "Loneliness" (CESD‐5) were related to less future decline of executive function and memory ability. Furthermore, analyses suggested targeting "Lack of happiness" (CESD‐4) could be useful in reducing the co‐occurrence of depression and cognitive decline among older adults. Conclusions: This network analysis study highlighted dynamic interrelationships between depressive symptoms and cognitive decline in older adults. Findings suggest that interventions targeting specific depressive symptoms may have the potential to alleviate declines in executive function and memory for this population. [ABSTRACT FROM AUTHOR]

Emerging evidence implicates common genetic variation - aggregated into polygenic scores (PGS) - in the onset and phenotypic presentation of rare diseases. Here, we comprehensively map individual polygenic liability for 1102 open-source PGS in a cohort of 3059 probands enrolled in the Genomic Answers for Kids (GA4K) rare disease study, revealing widespread associations between rare disease phenotypes and PGSs for common complex diseases and traits, blood protein levels, and brain and other organ morphological measurements. Using this resource, we demonstrate increased polygenic liability in probands with an inherited candidate disease variant (VUS) compared to unaffected carrier parents. Further, we show an enrichment for large-effect rare variants in putative core PGS genes for associated complex traits. Overall, our study supports and expands on previous findings of complex trait associations in rare diseases, implicates polygenic liability as a potential mechanism underlying variable penetrance of candidate causal variants, and provides a framework for identifying novel candidate rare disease genes. Polygenic scores aggregate the effects of common genetic variants and have been shown to underly certain rare diseases. Here, the authors conduct a large-scale association analysis of rare disease phenotypes and open-source polygenic scores and apply this information to rare variant interpretation and disease gene discovery [ABSTRACT FROM AUTHOR]

Oceanic anoxic events (OAEs) are historical intervals of global-scale ocean deoxygenation associated with hyperthermal climate states and biological crises1,2. Massive volcanic carbon dioxide (CO2) emissions frequently associated with these events are thought to be a common driver of ocean deoxygenation through several climate-warming-related mechanisms1,3,4. The Early Cretaceous OAE1a is one of the most intense ocean deoxygenation events, persisting for more than 1 Myr (refs. 5,6). However, existing records of marine chemistry and climate across OAE1a are insufficient to fully resolve the timing and dynamics of the underlying processes, thus obscuring cause-and-effect relationships between climate forcing and ocean oxygenation states. Here we show that rapid ocean deoxygenation during OAE1a is linked to volcanic CO2 emissions and the crossing of an associated climate threshold, after which the sluggish pace of the silicate-weathering feedback and climate recovery delayed reoxygenation for >1 Myr. At the end of OAE1a, recrossing this threshold allowed for ocean reoxygenation. Following OAE1a, however, the Earth system remained sufficiently warm such that orbitally forced climate dynamics led to continued cyclic ocean deoxygenation on approximately 100-kyr timescales for another 1 Myr. Our results thus imply a tight coupling between volcanism, weathering and ocean oxygen content that is characterized by a climate threshold.Rapid ocean deoxygenation during the Early Cretaceous OAE1a is shown to provide evidence for a strong link between volcanic CO2 emissions, weathering and ocean oxygen content that is characterized by a climate threshold. [ABSTRACT FROM AUTHOR]

This study examined the accuracy of place name translation during remote simultaneous interpreting (RSI) when interpreters were required to use a different variant of their native language. Participants, professional English/ Mandarin from mainland China, were divided into two groups: the Taiwan group, using the Taiwanese Mandarin variant, and the control group, using the mainland variant. The source speech consisted of three lists of place names, some of which had the same Chinese translation in both the mainland China Mandarin variant and the Taiwanese Mandarin variant, while others did not. The two groups of participants performed RSI from English into Chinese. The analysis focused on the third item in each list, chosen due to the differences in Chinese translations between the two Mandarin variants. Results showed no significant difference in the number of incorrect translations for the first test item between the two groups. However, significant variations were observed for the second and third test items, potentially linked to progressive mental fatigue and increased cognitive demand faced by the Taiwan group participants. This suggests that using a non-habitual language variant can impact the accuracy of RSI. [ABSTRACT FROM AUTHOR]

Background Early risk assessment is needed to stratify Staphylococcus aureus infective endocarditis (SA-IE) risk among patients with S. aureus bacteremia (SAB) to guide clinical management. The objective of the current study was to develop a novel risk score that is independent of subjective clinical judgment and can be used early, at the time of blood culture positivity. Methods We conducted a retrospective big data analysis from territory-wide electronic data and included hospitalized patients with SAB between 2009 and 2019. We applied a random forest risk scoring model to select variables from an array of parameters, according to the statistical importance in predicting SA-IE outcome. The data were divided into derivation and validation cohorts. The areas under the curve of the receiver operating characteristic (AUCROCs) were determined. Results We identified 15 741 SAB patients, among them 658 (4.18%) had SA-IE. The AUCROC was 0.74 (95%CI 0.70–0.76), with a negative predictive value of 0.980 (95%CI 0.977–0.983). The four most discriminatory features were age, history of infective endocarditis, valvular heart disease, and community onset. Conclusions We developed a novel risk score with performance comparable with existing scores, which can be used at the time of SAB and prior to subjective clinical judgment. [ABSTRACT FROM AUTHOR]

γδ T-cells are a rare population of T-cells with both adaptive and innate-like properties. Despite their low prevalence, they have been found to be implicated various human diseases. γδ T-cell infiltration has been associated with improved clinical outcomes in solid cancers, prompting renewed interest in understanding their biology. To date, their biology remains elusive due to their low prevalence. The introduction of high-resolution single-cell sequencing has allowed various groups to characterize key effector subsets in various contexts, as well as begin to elucidate key regulatory mechanisms directing the differentiation and activity of these cells. In this review, we will review some of insights obtained from singlecell studies of γδ T-cells across various malignancies and highlight some important questions that remain unaddressed. [ABSTRACT FROM AUTHOR]

This study relates to positively surface-charged liposomes ((+)-LPS) coated with cationic polyelectrolytes via covalent bonds and the preparation method and applications thereof. This nanosized (+)-LPS was synthesized via a single-step microfluidic process, in which the formation of LPS and the coating of N-[(2-hydroxy-3-trimethylammonium)-propylchitosan (HTCC) on the surface via covalent bonds were completed in situ. Flow cytometric endocytosis analysis of (+)-LPS on JAWS II dendritic cells demonstrated that HTCC coated via covalent bonds showed higher uptake efficiency than those coated via hydrogen bonds and increased uptake by 100-fold compared to LPS without HTCC coating. HTCC-coated LPS, via covalent binding, also reduced the cytotoxicity after incubation with JAWS II cells. In vivo experiments showed that BALB/c mice vaccinated with anthrax vaccine adsorbed (AVA) mixed with HTCC-covalently coated (+)-LPS could induce IgG anti-PA antibodies in a shorter time and at a higher level than mice vaccinated with AVA plus (+)-LPS coated with HTCC via hydrogen bonds and AVA only and that the humoral immune response was more dominant. Moreover, the preparation process allows rapid and high-quality production of (+)-LPS with low cost and simple operation. Thus, the present disclosure is competitive with practicability, providing an advantage in commercialization. [ABSTRACT FROM AUTHOR]

Programming cell signaling during T-cell activation represents a simple strategy for improving the potency of therapeutic T-cell products. Stim-R technology (Lyell Immunopharma) is a customizable, degradable synthetic cell biomimetic that emulates physiologic, cell-like presentation of signal molecules to control T-cell activation. A breadth of Stim-R formulations with different anti-CD3/anti-CD28 (αCD3/αCD28) antibody densities and stoichiometries were screened for their effects on multiple metrics of T-cell function. We identified an optimized formulation that produced receptor tyrosine kinase-like orphan receptor 1 (ROR1)-targeted chimeric antigen receptor (CAR) T cells with enhanced persistence and polyfunctionality in vitro, as assessed in repeat-stimulation assays, compared with a benchmark product generated using a conventional T-cell–activating reagent. In transcriptomic analyses, CAR T cells activated with Stim-R technology showed downregulation of exhaustion-associated gene sets and retained a unique subset of stem-like cells with effector-associated gene signatures following repeated exposure to tumor cells. Compared with the benchmark product, CAR T cells activated using the optimized Stim-R technology formulation exhibited higher peak expansion, prolonged persistence, and improved tumor control in a solid tumor xenograft model. Enhancing T-cell products with Stim-R technology during T-cell activation may help improve therapeutic efficacy against solid tumors. [ABSTRACT FROM AUTHOR]

This paper outlines an alternative approach to teaching quantum computing at the high school level, tailored for students with limited prior knowledge in advanced mathematics and physics. This approach diverges from traditional methods by building upon foundational concepts in classical computing before gradually introducing quantum mechanics, thereby simplifying the entry into this complex field. The course was initially implemented in a program for gifted high school students under the Hong Kong Education Bureau and received encouraging feedback, indicating its potential effectiveness for a broader student audience. A key element of this approach is the practical application through portable NMR quantum computers, which provides students with hands-on experience. The paper describes the structure of the course, including the organization of the lectures, the integration of the hardware of the portable nuclear magnetic resonance (NMR) quantum computers, the Gemini/Triangulum series, and detailed lecture notes in Additional file 1. The initial success in the specialized program and ongoing discussions to expand the course to regular high schools in Hong Kong and Shenzhen suggest the viability of this approach for wider educational application. By focusing on accessibility and student engagement, this approach presents a valuable perspective on introducing quantum computing concepts at the high school level, aiming to enhance student understanding and interest in the field. [ABSTRACT FROM AUTHOR]

Background: The purpose of this paper is to report on the process for developing an online RE-AIM evaluation toolkit in partnership with organizations that provide physical activity programming for persons with disabilities. Methods: A community-university partnership was established and guided by an integrated knowledge translation approach. The four-step development process included: (1) identify, review, and select knowledge (literature review and two rounds of Delphi consensus-building), (2) adapt knowledge to local context (rating feasibility of outcomes and integration into online platform), (3) assess barriers and facilitators (think-aloud interviews), and (4) select, tailor, implement (collaborative dissemination plan). Results: Step 1: Fifteen RE-AIM papers relevant to community programming were identified during the literature review. Two rounds of Delphi refined indicators for the toolkit related to reach, effectiveness, adoption, implementation, and maintenance. Step 2: At least one measure was linked with each indicator. Ten research and community partners participated in assessing the feasibility of measures, resulting in a total of 85 measures. Step 3: Interviews resulted in several recommendations for the online platform and toolkit. Step 4: Project partners developed a dissemination plan, including an information package, webinars, and publications. Discussion: This project demonstrates that community and university partners can collaborate to develop a useful, evidence-informed evaluation resource for both audiences. We identified several strategies for partnership when creating a toolkit, including using a set of expectations, engaging research users from the outset, using consensus methods, recruiting users through networks, and mentorship of trainees. The toolkit can be found at et.cdpp.ca. Next steps include disseminating (e.g., through webinars, conferences) and evaluating the toolkit to improve its use for diverse contexts (e.g., universal PA programming). Plain English summary: Organizations that provide sport and exercise programming for people with disabilities need to evaluate their programs to understand what works, secure funding, and make improvements. However, these programs can be difficult to evaluate due to lack of evidence-informed tools, low capacity, and few resources (e.g., money, time). For this project, we aimed to close the evaluation gap by creating an online, evidence-informed toolkit that helps organizations evaluate physical activity programs for individuals with disabilities. The toolkit development process was guided by a community-university partnership and used a systematic four-step approach. Step one included reviewing the literature and building consensus among partners and potential users about indicators related to the success of community-based programs. Step two involved linking indicators with at least one measure for assessment. Step three involved interviews with partners who provided several recommendations for the online toolkit. Step four included the co-creation of a collaborative plan to distribute the toolkit for academic and non-academic audiences. Our comprehensive toolkit includes indicators for the reach, effectiveness, adoption, implementation, and maintenance of physical activity programs for individuals with disabilities. This paper provides a template for making toolkits in partnership with research users, offers strategies for community-university partnerships, and resulted in the co-creation of an evidence-informed evaluation resource to physical activity organizations. Users can find the toolkit at et.cdpp.ca. [ABSTRACT FROM AUTHOR]

Objective: Accumulating evidence indicates that oxidative stress and the disruption of antioxidant defenses play an important role in the neurobiology of bipolar disorder (BD). Studies have found that increased oxidative stress may be associated with cell apoptosis and neuronal damage in BD patients. Hence, this study explored the research field related to BD and oxidative stress from a bibliometrics perspective. Methods: Literature search and relevant data retrieval based on the Web of Sciences Core Collection (WoSCC). R software (version 4.2.2), VOSviewer software (version 1.6.18), and CiteSpace (version 6.1.6) were used in this bibliometric analysis. Results: A total of 2081 publications related to BD and oxidative stress were published between 1986 and 2024. Bipolar Disorders was the journal that had the most publications in this area (72; 3.46%; IF = 5.9), while the United States (1285; 61.7%) and the University of Toronto (377; 18.1%) were the most productive country and institution, respectively. Apart from "oxidative stress" and "bipolar disorder," the most frequently used keywords were "schizophrenia," "prefrontal cortex," and "nitric oxide." Conclusions: The growing number of publications related to BD and oxidative stress in recent years highlights the importance of this research field. Hot topics in research related to BD and oxidative stress included animal experiments and molecular mechanisms, psychiatric‐related inflammation and biomarkers, neurodegenerative diseases, and metabolism. Furthermore, the biological mechanisms of BD, particularly biomarkers and inflammation, may be the emerging research priority area in the future. [ABSTRACT FROM AUTHOR]

Objective: Although the relative survival rate of childhood cancer has increased substantially in recent years, the pursuit of successful outcomes is often accompanied by negative impacts on pediatric and adolescent cancer survivors and their parents' physical and psychological well‐being. However, little is known about their experiences during the period of cancer survivorship. This study aimed to gain an understanding of the experience of cancer survivorship among pediatric and adolescent cancer survivors and their parents. Methods: This study utilized a descriptive qualitative study employing the photovoice design. From September 2022 to March 2023, 17 pediatric and adolescent cancer survivors (9–18 years), who had completed active treatment at least 6 months before recruitment, participated in this study. A total of 217 photographs submitted by survivors and their parents and the interview data, were thematically analyzed to identify themes and subthemes. Results: The analysis revealed five prominent themes: indelible marks, struggling with late effects, striving to return to normalcy, the strength of support, and living in the moment and hope for the future. Conclusion: The findings shed light on the experiences of pediatric and adolescent cancer survivors and their parents throughout the cancer journey, elucidating the influence on both negative and positive aspects. Additionally, the study highlighted that photovoice facilitated self‐reflection, the discovery of values, and the recognition of strengths and can be a therapeutic strategy for pediatric and adolescent cancer survivors and their parents in further research. [ABSTRACT FROM AUTHOR]

Study Design: Multicenter, international prospective study. Objective: This study investigated the clinical outcome up to 2 years after multi-level spinal deformity surgery in the elderly by reporting the minimal clinically important difference (MCID) of EuroQol 5-dimensions (EQ-5D), EQ-VAS, and residential status. Methods: As an ancillary study of 219 patients ≥60 years with spinal deformity undergoing primary instrumented fusion surgery of ≥5 levels, this study focuses on EQ-5D (3-L) as the primary outcome and EQ-VAS and residential status as secondary outcomes. Data on EQ-5D were compared between pre-operatively and postoperatively at 10 weeks, 12 months, and 24 months. An anchor-based approach was used to calculate the MCID. Results: The EQ-5D index and EQ-VAS, respectively, improved significantly at each time point compared to pre-operatively (from.53 (SD.21) and 55.6 (SD 23.0) pre-operatively to.64 (SD.18) and 65.8 (SD 18.7) at 10 weeks,.74 (SD.18) and 72.7 (SD 18.1) at 12 months, and.73 (SD.20) and 70.4 (SD 20.4) at 24 months). 217 (99.1%) patients lived at home pre-operatively, while 186 (88.6%), 184 (98.4%), and 172 (100%) did so at 10 weeks, 12 months, and 24 months, respectively. Our calculated MCID for the EQ-5D index at 1 year was.22 (95% CI.15-.29). Conclusions: The EQ-5D index significantly increased at each time point over 24 months after ≥5 level spinal deformity surgery in elderly patients. The MCID of the EQ-5D-3 L was.22. Patients living at home pre-operatively can expect to be able to live at home 2 years postoperatively. [ABSTRACT FROM AUTHOR]