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Abstract Background Patients with knee osteoarthritis (KOA) often experience persistent pain and functional impairment after total knee arthroplasty (TKA), which presents challenges for pain management. Accurate preoperative assessment of pain characteristics is crucial for tailoring individualized treatment plans. The PainDETECT Questionnaire has been widely used to identify neuropathic components in chronic pain and has been validated for its reliability and validity across various cultural contexts. However, a culturally adapted version tailored to Chinese patients is currently lacking. This study aims to translate and culturally adapt PainDETECT for Chinese patients and evaluate its validity in TKA patients in China. Methods This study followed international guidelines to translate and adapt the PainDETECT Questionnaire (PDQ) into Chinese (PDQ-CV). A cohort of 241 knee osteoarthritis (KOA) patients completed the PDQ-CV, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol-5 Dimensions-5 Levels (EQ-5D-5 L), and Central Sensitization Inventory Chinese Version (CSI-CV). We assessed internal consistency using Cronbach’s alpha and test-retest reliability via intraclass correlation coefficient (ICC). Construct and structural validity were evaluated through Pearson correlations and factor analyses. Results The PDQ-CV demonstrated good acceptability among KOA patients, with no floor or ceiling effects observed. Internal consistency was high (Cronbach’s α = 0.896), and test-retest reliability was excellent (ICC = 0.994; 95% CI: 0.943–1.045). The PDQ-CV total score showed significant positive correlations with WOMAC (r = 0.589, P

Hematopoietic stem cells (HSCs) maintain homeostasis in the hematopoietic ecosystem, which is tightly regulated at multiple layers. Acute myeloid leukemia (AML) is a severe hematologic malignancy driven by genetic and epigenetic changes that lead to the transformation of leukemia stem cells (LSCs). Since somatic mutations in DNA methylation-related genes frequently occur in AML, DNA methylation is widely altered and functions as a starting engine for initiating AML. Additionally, RNA modifications, especially N6-methyladenosine (m6A), also play an important role in the generation and maintenance of the hematopoietic ecosystem, and AML development requires reprogramming of m6A modifications to facilitate cells with hallmarks of cancer. Given the complex pathogenesis and poor prognosis of AML, it is important to fully understand its pathogenesis. Here, we mainly focus on DNA methylation and RNA m6A modification in hematopoiesis and AML and summarize recent advances in this field.

BackgroundPatients with knee osteoarthritis (OA) who receive unilateral total knee arthroplasty (TKA) often report reduced pain and enhanced function in the untreated knee, yet the kinematic mechanisms are not fully understood. Our study aimed to clarify these effects through a gait analysis of the untreated knee following unilateral TKA.MethodsThis study enrolled 118 end-stage OA patients with varus deformity scheduled for TKA, categorized into the contralateral osteoarthritis group (Contra-OA), consisting of patients with end-stage OA in both knees requiring surgical treatment, and the contralateral TKA group (Contra-TKA), which included patients who had undergone TKA on one knee and had end-stage OA in the untreated knee awaiting surgery. Kinematic data of the knee joint during treadmill walking were collected using the Opti_Knee gait analysis system, and a comparative analysis was conducted.ResultsThe Contra-TKA group exhibited improvements in step length, anterior-posterior translation, range of motion, vertical translation, and internal-external rotation compared to the Contra-OA group (p-values ranging from 0.0013 to 0.0463). Notable differences in flexion-extension angles and abduction/adduction rotation were also observed (p = 0.0013 and 0.0166, respectively). At the initial contact (IC), obvious differences in internal-external rotation, anterior/posterior translation, and vertical translation were noted. At the opposite toe-off (OT), significant differences in internal-external rotation. At the tibia vertical (TV) moment, significant differences were observed in all three translation indicators of joint translation. At other pivotal gait cycle points, vertical and anterior/posterior translations in Contra-TKA group continued to exhibit more meaningful decrease. Collectively, these findings underscore the protective kinematic effects of TKA on the untreated contralateral knee, indicating an improved biomechanical adaptation following TKA surgery.ConclusionIn summary, the study’s findings indicate that unilateral TKA imparts kinetic effects on the untreated contralateral knee, as evidenced by significant improvements in key gait parameters. These enhancements, observed at both initial contacts and throughout the gait cycle, suggest a positive biomechanical support post-TKA, might contribute to better gait efficiency and reduced load on the contralateral untreated knee.

Abstract Background This study was conducted to develop a simplified Chinese version of the central sensitization inventory (CSI-CV) and to evaluate its reliability and validity. Methods The CSI-CV was developed through a process involving the translation and back translation of the original CSI. Subsequently, experts reviewed and revised the content of the items to ensure their appropriateness. A total of 325 patients with knee osteoarthritis (KOA), who were scheduled to undergo total knee arthroplasty (TKA), completed the CSI-CV at a prominent orthopedic center in Xi'an, China. Afterward, a random selection of 100 participants was chosen for retesting after one week. The reliability and validity of the inventory were evaluated through exploratory factor analysis, correlation coefficient calculation and other methods. Results The CSI-CV consists of 25 items in five dimensions (emotional distress, headache and jaw symptoms, physical symptoms, urological symptoms, and fatigue and sleep problems). The cumulative variance contribution rate was 75.3%, the Cronbach's α coefficient was 0.83, the Guttman split-half reliability coefficient was 0.88 and the intraclass correlation coefficient was 0.965. The CSI-CV scores correlated moderately with the total scores of the brief pain inventory (r = 0.506), Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.466) and EuroQoL Group's five-dimension questionnaire (r = 0.576). Conclusions The findings demonstrate that the CSI was successfully trans-culturally adapted into a simplified Chinese version (CSI-CV) that was reliable and valid for Chinese-speaking patients who awaiting TKA for KOA.

Abstract Background Knee osteoarthritis (KOA) primarily presents with symptoms of pain and compromised functionality. Pain is a subjective manifestation that necessitates the employment of reliable evaluation tools for practical assessment, thereby enabling the formulation of appropriate interventional strategies. The Brief Pain Inventory (BPI) is a widely utilized questionnaire for evaluating the status of chronic pain. The purpose of the present study is to translate the short form of BPI into Chinese version (BPI-CV) and conduct cross-cultural adaptation to evaluate the psychometric characteristics of BPI-CV in KOA patients. Methods BPI-CV was translated and cross-culturally adapted according to internationally recognized guidelines. A cohort comprising 150 patients diagnosed with KOA successfully completed the demographic questionnaire, BPI-CV, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the EuroQoL Group's five-dimension questionnaire (EQ-5D). Internal consistency and test–retest analysis were used to evaluate the reliability. The internal consistency of the scale items was evaluated by calculating the Cronbach's α value (> 0.7). We chose to employ two scales commonly used in the evaluation of KOA patients: the disease-specific WOMAC scale and the universal EQ-5D scale. Construct validity was determined through Pearson correlation analysis, comparing BPI scores with those obtained from the WOMAC and EQ-5D scales. Exploratory factor analysis was used to structural validity. Results The BPI-CV was well accepted with no ceiling or floor effect. Cronbach's α for assessing internal consistency was 0.894. Test–retest reliability was excellent with an ICC of 0.852 (95%CI 0.785–0.905). The BPI-CV showed moderate to strong correlations with the pain dimension (r = 0.496–0.860) and the functional interference dimension (r = 0.517–0.712) of the WOMAC and the EQ-5D (r = 0.527–0.743). Three factors resulted using exploratory factor analysis: pain severity, activity interference, and emotional interference, accounting for 79.0% of the total variance. Standard error of measurement was 0.539. Conclusion BPI-CV has good feasibility, reliability, and validity. It can be recommended for KOA patients in mainland China.

Abstract Background The use of poly-ether-ether-ketone (PEEK) prosthesis during total knee arthroplasty (TKA) is a relatively new concept. Several studies have suggested that the thickness of cement penetration during TKA may affect the stability of the implants. The present study aimed to compare the cement penetration and clinical performance between PEEK and traditional cobalt chromium molybdenum (CoCrMo) prosthesis during TKA. Methods This study was a randomized controlled trial with level I of evidence. A total of 48 patients were randomly assigned to either the PEEK group (n = 24) or the CoCrMo group (n = 24). Mean bone cement penetration under the tibial baseplate was assessed radiographically in four zones in the anteroposterior view and two zones in the lateral view, in accordance with the Knee Society Scoring System. Furthermore, parameters such as the Knee Society Score (KSS), visual analogue scale (VAS) scores, complications and survivorship at 1 year postoperatively were also compared. Results According to the results of this study, the mean bone cement penetration exhibited no significant difference between PEEK and CoCrMo groups (2.49 ± 0.61 mm vs. 2.53 ± 0.68 mm, p = 0.85). Additionally, there were no remarkable differences in the KSS clinical score, functional score, and VAS score between the two groups. Moreover, complications and survivorship were also statistically compared between the groups and presented no significant differences. Conclusions Based on the current findings, it can be concluded that PEEK implant present similar bone cement penetration, short-term clinical outcomes, and survivorship with traditional CoCrMo implant in TKA without added complications. Trial registration Chinese Clinical Trial Registry (ChiCTR2100047563).

Abstract Background Total knee arthroplasty (TKA) is a surgical procedure primarily used to treat patients with end-stage knee osteoarthritis (KOA). Postoperative physical exercise is a critical part of the overall treatment of KOA and can bring significant benefits to the patients' recovery. Wearable devices can monitor patients' exercise data and upload it to the physician's workstation. This allows the rehabilitation physician to make timely adjustments based on the patients' movement feedback, and the surgeon can be informed of the patients' functional status. Overall, this study aims to evaluate the effectiveness of using wearable monitoring devices for rehabilitation exercise after TKA, with a focus on cost, time savings, and patient outcomes. Method/design This is a single-center, single-blinded, parallel randomized controlled trial conducted at Xi'an Honghui Hospital, a regional orthopedic medical center. Eligible patients will be recruited to participate in the study, and baseline data collection and clinical assessments will be conducted at the time of admission. Using the principle of random allocation, recruited patients will be divided into either the experimental or control group. Both groups will undergo a standard, widely promoted rehabilitation program. The patients in the experimental group will wear equipment to detect and track mobility in the lower limbs. All patients will return to the outpatient clinic for follow-up assessments at 2 weeks, 12 weeks, and 24 weeks after discharge, where outcome indicators will be measured. The primary outcome will be the cost and time after discharge, while secondary outcomes will include the 6-min walk test (6MWT), range of motion (ROM), visual analog scale (VAS), American Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Discussion We should encourage the adoption of novel, easy-to-use, supervised devices if they prove to be beneficial for patients in terms of cost, time, and effectiveness after TKA. This type of device is particularly important for people in remote rural areas, those with limited financial resources, and those who are reluctant to return to hospitals for follow-up care. Trial registration Chinese Clinical Trial Registry ChiCTR2300068418. Registered on 17 February 2023.

Background: In recent decades, there have been notable advancements in the field of analgesia and total knee arthroplasty (TKA). This study aims to employ bibliometric analysis to elucidate the prevailing research focal points and trends within analgesia and TKA from 1990 to 2022. Material and methods: Relevant publications were retrieved from the Web of Science Core Collection. CiteSpace, VOSviewer, and Scimago Graphica were used for visualization and bibliometric analysis of countries, institutions, authors, journals, references, and keywords. Results: A total of 2776 publications on analgesia and TKA were identified, with the United States having the highest number of publications. The University of Copenhagen was the most productive institution, and Kehlet, Henrik was the most prolific author. The Journal of Arthroplasty had the most publications and citations. The most common keywords were “TKA,” “pain management,” “postoperative pain,” “Total hip arthroplasty (THA),” and “postoperative management.” Keyword burst detection demonstrated that adductor canal block (ACB) was a recent research hotspot. Conclusion: Our study revealed a sharp increase in global publications on analgesia and TKA, and this trend is expected to continue. Further research is necessary to determine the optimal regimen for multimodal analgesia, the ideal location and volume of ACB, and their clinical significance.

PurposeFrailty is a difficult-to-measure condition that is susceptible to adverse outcomes. The Japan Frailty Scale (JFS) is a tool for assessing frailty status in older adults. This study aimed to translate and culturally adapt the JFS into a Chinese version (JFS-C).Materials and methodsThe study included 160 older adults as participants. Internal consistency was assessed using Cronbach’s alpha, and test–retest reliability was conducted using the intraclass correlation coefficient (ICC). Convergent validity was evaluated by assessing the correlation between JFS-C and the Barthel Index, the Frail scale, and the 36-item Short-Form Health Survey (SF-36). Criterion validity was assessed by comparing JFS-C scores with the Frail scale.ResultsJFS-C demonstrated adequate internal consistency (Cronbach’s alphas = 0.711) and excellent test–retest reliability over a 7 to 10-day interval (ICC = 0.949). Correlation analysis showed a strong positive correlation between JFS-C and the Frail scale (r = 0.786, p

Controlling overlay in lithography is crucial for improving the yield of integrated circuit manufacturing. The process disturbances can cause undesirable morphology changes of overlay targets (such as asymmetric grating), which can significantly impact the accuracy of overlay metrology. It is essential to decouple the overlay target asymmetry from the wafer deformation, ensuring that the overlay metrology is free from the influence of process-induced asymmetry (e.g., grating asymmetry and grating imbalance). Herein, we use an asymmetric grating as a model and show that using high-diffraction-order light can mitigate the impact of asymmetric grating through the rigorous coupled-wave analysis (RCWA) method. In addition, we demonstrate the diffraction efficiency as a function of the diffraction order, wavelength, and pitch, which has guiding significance for improving the measurement accuracy of diffraction-based overlay (DBO) metrology.

Abstract Background The cement-screw technique is a convenient method to repair tibial plateau defects in primary and revision total knee arthroplasty (TKA). However, the optimal angle of screw insertions is unknown. This study aimed to perform a finite element analysis (FEA) to determine the optimal screw angle for the repair of tibial plateau defects in TKA. Methods Seven FEA models were set and two common different defects (defect 1: area 12%, depth > 12 mm) were simulated. One screw was used in defect 1, and one or two screws were used in defect 2. Screws were parallel to the proximal cortical bone (oblique screw) or perpendicular to the upper surface (vertical screw) of the tibia. Contact stresses on cancellous bone in different areas were determined. Maximum principal stress on the cancellous bone around each screw was also compared. Results The FEA models showed that stresses on the surface of cancellous bone in tibial defect (0.13–0.39 MPa) and stress focus spot (0.45 MPa) around the screw were lower when one vertical screw was used in defect 1. The stresses on the surface of cancellous bone in tibial defect (0.09–0.44 MPa), stresses in the medial tibial plateau (0.14–0.21 MPa), and stress focus spot around the screws were lowest (0.42 MPa and 1.37 MPa) when two vertical screws were used in defect 2, followed by of one vertical and one oblique (0.16–0.48 MPa; 0.15–0.21 MPa; 1.63 MPa and 1.11 MPa). No other statistically significant differences were found. Conclusions Either for one or two screws, those perpendicular to the upper surface achieve better stability than those parallel to the proximal cortical bone of the tibia. If two vertical screws cannot be performed, one vertical and one oblique is also acceptable.

Visual inspection of long-term electroencephalography (EEG) is a tedious task for physicians in neurology. Based on bidirectional gated recurrent unit (Bi-GRU) neural network, an automatic seizure detection method is proposed in this paper to facilitate the diagnosis and treatment of epilepsy. Firstly, wavelet transforms are applied to EEG recordings for filtering pre-processing. Then the relative energies of signals in several particular frequency bands are calculated and inputted into Bi-GRU network. Afterwards, the outputs of Bi-GRU network are further processed by moving average filtering, threshold comparison and seizure merging to generate the discriminant results that the tested EEG belong to seizure or not. Evaluated on CHB-MIT scalp EEG database, the proposed seizure detection method obtained an average sensitivity of 93.89% and an average specificity of 98.49%. 124 out of 128 seizures were correctly detected and the achieved average false detection rate was 0.31 per hour on 867.14 h testing data. The results show the superiority of Bi-GRU network in seizure detection and the proposed detection method has a promising potential in the monitoring of long-term EEG.

Abstract Background Tourniquet application is expected to improve surgery exposure and cementation process in total knee arthroplasty (TKA) but its effectiveness remains controversial and needs to be further explored. The aim of this meta-analysis was to assess the effect of tourniquet in primary TKA. The hypothesis is that the tourniquet application affects the cement penetration in TKA. Methods A search was conducted in PubMed, Embase, and the Cochrane Library for the potentially eligible articles. Two independent researchers reviewed the articles retrieved against the pre-designed inclusion and exclusion criteria. In primary TKA, cement penetration was assessed, and the data between the tourniquet-assisted and non-tourniquet-assisted TKAs were compared. Statistical significance was set at P 0.05). There were no significant differences in the total surgical time, blood loss, blood transfusion, the Knee Society Score, and the visual analogue scale (VAS) between the two kinds of procedures (P > 0.05). Conclusions Tourniquet application may not affect cement penetration in primary TKA and may not help reduce blood loss, ease knee pain or improve the knee function. A surgeon may choose to use a tourniquet or not according to his or her own preference. Level of Evidence Level Ib, meta-analysis.

N6-methyladenosine (m6A) is a commonly modification of mammalian mRNAs and plays key roles in various cellular processes. Emerging evidence reveals the importance of RNA m6A modification in maintaining stem cell function in normal hematopoiesis and leukemogenesis. In this review, we first briefly summarize the latest advances in RNA m6A biology, and further highlight the roles of m6A writers, readers and erasers in normal hematopoiesis and acute myeloid leukemia. Moreover, we also discuss the mechanisms of these m6A modifiers in preserving the function of hematopoietic stem cells (HSCs) and leukemia stem cells (LSCs), as well as potential strategies for targeting m6A modification related pathways. Overall, we provide a comprehensive summary and our insights into the field of RNA m6A in normal hematopoiesis and leukemia pathogenesis.