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Background:Conducting and/or disseminating research in partnership with potential research users is a popular approach to conducting useful and relevant research. Despite calls for guidance to support these research partnerships, evidence-based tools and resources remain limited. Aims and objectives:This study aimed to explore principles and related strategies for conducting and/or disseminating spinal cord injury (SCI) research in partnership with the SCI community, in order to gain insight into ways to support SCI research partnerships. This qualitative study included ten semi-structured interviews with SCI research partnership champions. The interviews focused on participants’ experiences with SCI research projects that are conducted or disseminated in partnership, and related principles and strategies to work in research partnerships. Participants mainly talked about principles related to: (1) the relationship between researchers and research users (for example, respect each other, avoid tokenism); (2) co-production of knowledge (for example, research user engagement early and throughout); and (3) meaningful engagement (for example, allowing flexibility). Examples of related strategies included attending collaborative conferences, research user engagement in refinement of research questions, training in research methods, and hiring people with SCI as part of the research team. Key conclusions:This qualitative study presents research partnership principles (norms) and related strategies (observable actions). This study can provide guidance for other researchers and research users who want to engage in (SCI) research partnerships. The findings of this study could be used to inform the development of evidence-based tools and resources to support future research partnerships.

The spinal cord injury (SCI) research community has experienced great advances in discovery research, technology development, and promising clinical interventions in the past decade. To build upon these advances and maximize the benefit to persons with SCI, the National Institutes of Health (NIH) hosted a conference February 12-13, 2019 titled "SCI 2020: Launching a Decade of Disruption in Spinal Cord Injury Research." The purpose of the conference was to bring together a broad range of stakeholders, including researchers, clinicians and healthcare professionals, persons with SCI, industry partners, regulators, and funding agency representatives to break down existing communication silos. Invited speakers were asked to summarize the state of the science, assess areas of technological and community readiness, and build collaborations that could change the trajectory of research and clinical options for people with SCI. In this report, we summarize the state of the science in each of five key domains and identify the gaps in the scientific literature that need to be addressed to move the field forward.

There are few pharmacological therapeutics available for spinal cord injury despite years of preclinical and clinical research. This brief editorial discusses some of the shortcomings of translational research efforts. In addition, we comment on our previous experiences with data curation and highlight evolving efforts by the spinal cord injury research community to improve prospects for future therapeutic development, especially pertaining to preclinical data sharing through the Open Data Commons for Spinal Cord Injury (ODC-SCI).

Each year, the Journal of Spinal Cord Medicine, official journal of the Academy of Spinal Cord Injury Professionals, offers The Ernest Bors, MD Award for Scientific Development.1 The award memorial...

The supraspinal connectome consists of dozens of neuronal populations that project axons from the brain to the spinal cord to influence a wide range of motor, autonomic, and sensory functions. The complexity and wide distribution of supraspinal neurons present significant technical challenges, leading most spinal cord injury research to focus on a handful of major pathways such as the corticospinal, rubrospinal, and raphespinal. Much less is known about many additional populations that carry information to modulate or compensate for these main pathways, or which carry pre-autonomic and other information of high value to individuals with spinal injury. A confluence of technical developments, however, now enables a whole-connectome study of spinal cord injury. Improved viral labeling, tissue clearing, and automated registration to 3D atlases can quantify supraspinal neurons throughout the murine brain, offering a practical means to track responses to injury and treatment on an unprecedented scale. Here we discuss the need for expanded connectome-wide analyses in spinal injury research, illustrate the potential by discussing a new web-based resource for brain-wide study of supraspinal neurons, and highlight future prospects for connectome analyses.

Objective: In order to encourage the inclusion of bladder and bowel outcome measures in preclinical spinal cord injury (SCI) research, this paper identifies and categorizes 1) fundamental, 2) recommended, 3) supplemental and 4) exploratory sets of outcome measures for pre-clinical assessment of bladder and bowel function with broad applicability to animal models of SCI. Methods: Drawing upon the collective research experience of autonomic physiologists and informed in consultation with clinical experts, a critical assessment of currently available bladder and bowel outcome measures (histological, biochemical, in vivo functional, ex vivo physiological and electrophysiological tests) was made to identify the strengths, deficiencies and ease of inclusion for future studies of experimental SCI. Results: Based upon pre-established criteria generated by the Neurogenic Bladder and Bowel Working Group that included history of use in experimental settings, citations in the literature by multiple independent groups, ease of general use, reproducibility and sensitivity to change, three fundamental measures each for bladder and bowel assessments were identified. Briefly defined, these assessments centered upon tissue morphology, voiding efficiency/volume and smooth muscle-mediated pressure studies. Additional assessment measures were categorized as recommended, supplemental or exploratory based upon the balance between technical requirements and potential mechanistic insights to be gained by the study. Conclusion: Several fundamental assessments share reasonable levels of technical and material investment, including some that could assess bladder and bowel function non-invasively and simultaneously. Such measures used more inclusively across SCI studies would advance progress in this high priority area. When complemented with a few additional investigator-selected study-relevant supplemental measures, they are highly recommended for research programs investigating the efficacy of therapeutic interventions in preclinical animal models of SCI that have a bladder and/or bowel focus.

Advances in spinal cord injury-based research in the last 50 years have resulted in significant improvements to therapy options. However, the efficacy of such research could be further enhanced if threats to internal and external validity were addressed. To provide perspective, a sample topic was identified: the effects of acute and chronic exercise on clinical and sub-clinical markers of cardiovascular health. The intention was not a systematic review, nor a critique of exercise-based research, but rather a means to generate further discussion. Thirty-one articles were identified, and four common issues were found relating to: (1) sampling; (2) study design; (3) control group; and (4) clinical inference. These concerns were largely attributed to insufficient resources, and challenges associated with recruiting individuals with spinal cord injury. Overcoming these challenges will be difficult, but some opportunities include: (1) implementing multi-center trials; (2) sampling from subject groups appropriate to the research question; (3) including an appropriate control group; and (4) clearly defining clinical inference. These opportunities are not always feasible, and some easier to implement than others. However, addressing these concerns may assist in progressing spinal cord injury-based research, thereby helping to ensure steady advancement of therapy options for persons with spinal cord injury.

Cardiometabolic disease (CMD) is among the leading causes of morbidity and mortality in people with a spinal cord injury (SCI). Despite well-acknowledged sex and gender differences in CMD in the general population, they remain insufficiently studied in persons with SCI. To describe the landscape of sex and gender in SCI research, we searched the literature for systematic reviews on cardiometabolic health in this population. Out of 15 systematic reviews identified, only 9 provided meaningful information on sex. Although one-quarter to one-fifth of the SCI population is female, women comprised only one-eighth to a quarter of study participants. A number of clinical studies purposively excluded women, to make the study population more homogenous. For those studies which included both sexes, in general, no sex-specific analyses were performed due to small sample sizes. All these reasons have contributed to the underrepresentation of females in the current body of evidence. Therefore, future studies should adopt a more sex- and gender-sensitive research framework to address cardiometabolic risk in SCI. Novel and advanced epidemiological methods should also be used, considering small sample sizes. Finally, collaborative research (through consortia and multi-center studies) should be encouraged to include more females. More inclusive research will ensure that everyone will benefit from scientific advancements, regardless of sex and gender.

Background: Research partnership approaches are becoming popular within spinal cord injury (SCI) health research system, providing opportunities to explore experiences of and learn from SCI research partnership champions. This study aimed to explore and describe SCI researchers’ and research users’ (RU’) experiences with and reasons for conducting and/or disseminating (health) research in partnership in order to gain more insight into potentially ways to build capacity for and foster change to support research partnerships within a health research system. Methods: Underpinned by a pragmatic perspective, ten semi-structured timeline interviews were conducted with researchers and RU who have experiences with SCI research partnerships. Interviews focused on experiences in participants’ lives that have led them to become a person who conducts and/or disseminates research in partnership. Data were analysed using narrative thematic analysis. Results: We identified three threads from participants’ stories: (1) seeing and valuing different perspectives, (2) inspirational role models, and (3) relational and personal aspect of research partnerships. We identified sub-threads related to experiences that participants draw on how they came to be a person who engage in (health) research partnerships, and sub-threads related to participants’ reasons for engaging in research partnerships. While most sub-threads were identified from both researchers’ and RU’ perspectives (eg, partnership successes and failures), some were unique for researchers (morally the right thing to do) or RU (advocating). Conclusion: Using a narrative and pragmatic approach, this study provided a new understanding of SCI researchers’ and RU’ partnership experiences over time. We found that participants’ research partnership experiences and motivations align with components of leadership theories. The findings from this study may be used to inform strategies and policy programs to build capacity for conducting and disseminating (health) research in partnership, within and beyond SCI research.

Mapping Review. The objective of this study was to map out and characterize the quantity and quality of all published spinal cord injury (SCI) randomized controlled trials (RCTs) with respect to number, sample size, and methodological quality between January 1970 and December 2016. Not applicable. A literature search of multiple research databases was conducted. Studies adhering to the following criteria were included: the research design was an RCT; written in English; participants were >18 years; and the sample was >50% SCI. Data were extracted pertaining to author(s), year of publication, country of origin, initial and final sample size, intervention, and control. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) tool. Data was assessed overall and by each year of publication. In total, 466 RCTs were published 1971–2016 on 29 primary topic areas, with Bladder (n = 78, 16.7%) most common, followed by Pain (n = 54, 11.6%), and Lower Limb (n = 45, 9.7%). Studies were published in 172 unique journals, with the most common being Spinal Cord (n = 68, 14.6%). The most common producer of studies was the United States (n = 191, 41.0%). RCT publications increased linearly until 2012 when the rate tripled, resulting in 40.8% published 2012–2016. A total of 247 (59.4%) RCTs had

The authors want to acknowledge the financial support from Premios Santa Casa Neurociencias ‐ Prize Melo e Castro for Spinal Cord Injury Research (MC-04/17); from Portuguese Foundation for Science and Technology [Doctoral fellowship (SFRH/BD/103075/2014) to EDG; Post‐ Doctoral fellowship (SFRH/BPD/97701/2013) to NAS; IF Development Grant to AJS]. This work is funded by national funds through FCT under the scope of grant reference TUBITAK/0007/2014 and 3599-PPCDT Project: PTDC/DTP-FTO/5109/2014. This article has been developed under the scope of the projects NORTE-01-0145- FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER). This work has been funded by FEDER funds, through the Competitiveness Factors Operational Programme (COMPETE), and by National funds, through the Foundation for Science and Technology (FCT), under the scope of the project POCI-01- 0145-FEDER-007038.

The authors acknowledge the financial support of Premios Santa Casa Neurociencias—Prize Melo e Castro for Spinal Cord Injury Research; Portuguese Foundation for Science and Technology: [Financiado no âmbito do Projecto 3599—Promover a Producao Cientifica e Desenvolvimento Tecnologico e a Constituicao de Redes Tematicas (3599-PPCDT), project: PTDC/DTP-FTO/5109/2014]; Doctoral fellowship (SFRH/BD/103075/2014) to E.D. Gomes; Doctoral fellowship (PDE/BDE/113596/2015) to R.C. Assuncao-Silva; Post-Doctoral fellowship (SFRH/BPD/97701/2013) to N.A. Silva; IF Development Grant to A.J. Salgado (IF/ 00111/2013); by national funds through grant TUBITAK/0007/2014. This article was developed under the scope of the project NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER). This work was funded by FEDER funds, through the Competitiveness Factors Operational Programme (COMPETE), and by National funds, through the Foundation for Science and Technology (FCT), under the scope of the project POCI-01-0145-FEDER-007038.

Approximately half of the clinical cases of spinal cord injury are caused by a rapid contusive impact to the soft tissue of the spinal cord. Reproducible models of contusion injury are produced in rodents using a variety of approaches following the exposure of the intact dura with a dorsal laminectomy. In the contusion model developed at The Ohio State University (OSU), an impact to the spinal cord is mediated by the rapid and calibrated displacement of a vertical shaft, using a sensitive electromagnetic shaker controlled by interactive software. Key elements of the technology are the initiation of the impact from a fixed and measurable starting force or “touch” feature, investigator control of the slope, duration and amplitude of peak displacement, rapid retraction of the impactor after a single impact to prevent bounce effects, and the direct and real time measurement of displacement and force of impact upon the spinal compartment. To date, there has not been a comprehensive description of the development of this device and the methods used to obtain reproducible injuries to the spinal cord with this device. In this chapter, we will briefly describe the history of the design and the procedures that are used to calibrate, perform, and evaluate controlled contusion injuries using the OSU electromagnetic spinal cord injury device (ESCID). Final comments emphasize the advantages and limitations of the device and provide suggestions for future uses in advancing spinal cord injury research.

In vivo imaging of the spinal cord has allowed the observation of single axons over relatively long periods in the living mouse. After spinal cord injury, this methodology has helped to differentiate several pathological stages and tissue processes which impact axon morphology. In addition, the combination of in vivo imaging techniques with particular molecular intervention has shown that specific pathological axon changes can respond to distinct treatments. Combining in vivo imaging with molecular interventions is, hence, a powerful approach to extend our knowledge of the pathological processes leading to axonal loss. It also allows testing possible treatment options to, for example, increase axonal outgrowth. This review will provide a detailed description and critical examination of several studies that have combined the two methodologies in spinal cord injury research and pinpoints the specificities of the approach.

Human neural stem cells (hNSCs) and human induced pluripotent stem cells (hiPSCs) have been the primary focuses in basic science and translational research as well as in investigative clinical applications. Therefore, the capability to perform reliable derivation, effective expansion, and long-term maintenance of uncommitted hNSCs and hiPSCs and their targeted phenotypic differentiations through applying chemically and biologically defined medium in vitro is essential for expanding and enriching the fundamental and technological capacities of stem cell biology and regenerative medicine. In this chapter, we systematically summarized a set of protocols and unique procedures that have been developed in the laboratories of Prof. Teng and his collaborators. These regimens have been, over the years, reproducibly and productively used to derive, propagate, maintain, and differentiate hNSCs, including those derived from hiPSCs. We emphasize the multimodal methodologies that were pioneered and established in our laboratories for characterizing functional multipotency of stem cells and its value in basic science as well as translational biomedical studies.

Focus Group.To develop a unified, regional spinal cord injury (SCI) research strategy for Australia and New Zealand.Australia.A 1-day structured stakeholder dialogue was convened in 2013 in Melbourne, Australia, by the National Trauma Research Institute in collaboration with the SCI Network of Australia and New Zealand. Twenty-three experts participated, representing local and international research, clinical, consumer, advocacy, government policy and funding perspectives. Preparatory work synthesised evidence and articulated draft principles and options as a starting point for discussion.A regional SCI research strategy was proposed, whose objectives can be summarised under four themes. (1) Collaborative networks and strategic partnerships to increase efficiency, reduce duplication, build capacity and optimise research funding. (2) Research priority setting and coordination to manage competing studies. (3) Mechanisms for greater consumer engagement in research. (4) Resources and infrastructure to further develop SCI data registries, evaluate research translation and assess alignment of research strategy with stakeholder interests. These are consistent with contemporary international SCI research strategy development activities.This first step in a regional SCI research strategy has articulated objectives for further development by the wider SCI research community. The initiative has also reinforced the importance of coordinated, collective action in optimising outcomes following SCI.

This is a rapid evidence review.The objective of this study was to gain an overview of the volume, nature and findings of studies regarding priorities for spinal cord injury (SCI) research.A worldwide literature search was conducted.Six medical literature databases and Google Scholar were searched for reviews in which the primary aim was to identify SCI research priorities.Two systematic reviews were identified-one of quantitative and one of qualitative studies. The quality of the reviews was variable. Collectively, the reviews identified 31 primary studies; 24 quantitative studies totalling 5262 participants and 7 qualitative studies totalling 120 participants. Despite the difference in research paradigms, there was convergence in review findings in the areas of body impairments and relationships. The vast majority of literature within the reviews focused on the SCI patient perspective.The reviews inform specific research topics and highlight other important research considerations, most notably those pertaining to SCI patients' perspectives on quality of life, which may be of use in determining meaningful research outcome measures. The views of other SCI research stakeholders such as researchers, clinicians, policymakers, funders and carers would help shape a bigger picture of SCI research priorities, ultimately optimising research outputs and translation into clinical practice and health policy change. Review findings informed subsequent activities in developing a regional SCI research strategy, as described in two companion papers.This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand SCI Network.

Financial support from Premios Santa Casa Neurociencias - Prize Melo e Castro for Spinal Cord Injury Research; Portuguese Foundation for Science and Technology [Doctoral fellowship (SFRH/BD/103075/2014) to E. D. Gomes; IF Development Grant to A. J. Salgado; Post-Doctoral fellowship (SFRH/BPD/97701/2013) to N. A. Silva]; This article has been developed under the scope of the projects NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER); This work has been funded by FEDER funds, through the Competitiveness Factors Operational Programme (COMPETE), and by National funds, through the Foundation for Science and Technology (FCT), under the scope of the project POCI-01-0145-FEDER-007038.

The combination of spinal epidural stimulation and physical therapy is restoring walking function to people with spinal cord injury. With intensive rehabilitation, some participants are able to walk in their communities during stimulation and even regain control over previously paralyzed movement in the absence of stimulation.

OBJECTIVE: The aims of this study were to provide a selection of biomedical domains based on the comprehensive International Classification of Functioning, Disability, and Health (ICF) core sets for spinal cord injury (SCI) and to present an overview of the corresponding measurement instruments. DESIGN: Based on the Biomedical Domain Set, the SCI literature, the International Spinal Cord Society international data sets, and the Spinal Cord Injury Rehabilitation Evidence project publications were used to derive category specifications for use in SCI research. Expert opinion was used to derive a priority selection. The same sources were used to determine candidate measurement instruments for the specification of body functions and body structures using an example, and guiding principles were applied to select the most appropriate biomedical measurement instrument(s) for use in an SCI research project. RESULTS: Literature searches were performed for 41 second-level ICF body functions categories and for four second-level ICF body structures categories. For some of these categories, only a few candidate measurement instruments were found with limited variation in the type of measurement instruments. CONCLUSIONS: An ICF-based measurement set for biomedical aspects of functioning with SCI was established. For some categories of the ICF core sets for SCI, there is a need to develop measurement instruments. Language: en

Dating back to ancient times, mankind has been absorbed with 'doing the right thing', that is, behaving in ways approved by the society and the culture during the era in which they lived. This has been and still is especially true for the medical and related health-care professions. Laws and professional codes have evolved over the years that provide guidelines as to how physicians should treat patients, beginning with the one authored by Hippocrates. Only more recently, however, have laws and codes been created to cover health-care research and the advances in health-care practice that have been brought to light by that research. Although these discoveries have clearly impacted the quality of life and duration of life for people with spinal cord injury and other maladies, they have also raised questions that go beyond the science. Questions such as when, why, how and for how long should such treatments be applied often relate more to what a society and its culture will condone and the answers can differ and have differed among societies depending on the prevailing ethics and morals. Modern codes and laws have been created so that the trust people have traditionally placed in their healers will not be violated or misused as happened during wars past, especially in Nazi Germany. This paper will trace the evolution of the rules that medical researchers, practitioners and payers for treatment must now follow and explain why guiding all their efforts that honesty must prevail.

Measurement of participation needs a rating of both objective performance and subjective appraisals of the person involved. However, only few measures rate subjective participation. Based on the strong resemblance of the concepts of subjective participation and of domain-specific life satisfaction, it is hypothesized that life satisfaction measures may also be useful to rate subjective participation. A literature review revealed several measures already used in spinal cord injury research. The contents and psychometric properties of these measures were described. The Life Satisfaction Questionnaire (LiSat-9) showed the best combination of efficiency, coverage, and psychometric evidence.

Spinal cord injury (SCI) is an irreversible condition causing damage to myelinated fiber tracts that carry sensation and motor signals to and from the brain. SCI is also associated with gray matter damage and often life-threatening secondary complications. This mini-review aims to provide the nonspecialist reader with a comprehensive description of recent advances made in 2008 using murine models of SCI. A variety of approaches, including advanced genetics and molecular techniques, have allowed a number of key findings in the field of secondary degeneration, repair, regeneration (including insights from peripheral nerve lesion models), metabolic dysfunctions, and pharmacological neuromodulation.

STUDY DESIGN: Discussion document. OBJECTIVES/METHODS: To review the Research Strategy of the International Spinal Research Trust (ISRT), which identifies key areas of basic and clinical research that are likely to be beneficial in developing potential treatments for spinal cord injury for funding. This strategy is intended to both guide the programme of research towards areas of priority and stimulate discussion of the different avenues of research. This latest document has been developed to take into account the scientific progress in the 6 years since publication of the previous Research Strategy. RESULTS/DISCUSSION: The latest scientific developments in research designed to repair the spinal cord and restore function following injury and how they might impact on spinal cord injury research are highlighted.

Spinal cord injury is currently incurable and treatment is limited to minimising secondary complications and maximising residual function by rehabilitation. Improved understanding of the pathophysiology of spinal cord injury and the factors that prevent nerve and tissue repair has fuelled a move towards more ambitious experimental treatments aimed at promoting neuroprotection, axonal regeneration, and neuroplasticity. By necessity, these new options are more invasive. However, in view of recent advances in spinal cord injury research and demand from patients, clinicians, and the scientific community to push promising experimental treatments to the clinic, momentum and optimism exist for the translation of candidate experimental treatments to clinical spinal cord injury. The ability to rescue, reactivate, and rewire spinal systems to restore function after spinal cord injury might soon be within reach.

Literature review/semi-structured interviews.To develop a spinal cord injury (SCI) research strategy for Australia and New Zealand.Australia.The National Trauma Research Institute Forum approach of structured evidence review and stakeholder consultation was employed. This involved gathering from published literature and stakeholder consultation the information necessary to properly consider the challenge, and synthesising this into a briefing document.A research strategy 'roadmap' was developed to define the major steps and key planning questions to consider; next, evidence from published SCI research strategy initiatives was synthesised with information from four one-on-one semi-structured interviews with key SCI research stakeholders to create a research strategy framework, articulating six key themes and associated activities for consideration. These resources, combined with a review of SCI prioritisation literature, were used to generate a list of draft principles for discussion in a structured stakeholder dialogue meeting.The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper. These resources could also be of value in other research strategy or planning exercises.This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network.

The validity of measures utilized in research is of vital importance. The ASIA motor score (AMS) and the FIM™ are scales commonly used in spinal cord injury research. They each have two-dimensional structures, but the structure of the dimensions is very different. A model is developed and tested that clearly demonstrates the discrete AMS subscale structure and the separate but highly related dimensions of the FIM.

In this review, we have documented some current research trends in rodent models of spinal cord injury. We have also catalogued the treatments used in studies published between October 2002 and November 2003, with special attention given to studies in which treatments were delayed for at least 4 days after injury.Most spinal cord injury studies are performed with one of three general injury models: transection, compression, or contusion. Although most treatments are begun immediately after injury, a growing number of studies have used delayed interventions. Mice and the genetic tools they offer are gaining in popularity. Some researchers are setting their sights beyond locomotion, to issues more pressing for people with spinal cord injury (especially bladder function and pain).Delayed treatment protocols may extend the window of opportunity for treatment of spinal cord injury, whereas continued progress in the prevention of secondary cell death will reduce the severity of new cases. The use of mice will hopefully accelerate progress towards useful regeneration in humans. Researchers must improve cross-study comparability to allow balanced decisions about potentially useful treatments.

On reviewing the literature on spinal cord injury (SCI) and sexuality in males, there was found to be a plethora of research in physical domains. Sadly, the psychological aspect of sexuality for men who experience SCI has been largely neglected. For this reason a phenomenological study was conducted to understand the experience of sexuality in its totality for the male who experiences SCI. Four males with SCI were included in the study. Central themes that emerged from the transcribed interviews included the establishment of an existential baseline, diminished independence and perceptions of masculinity post-injury. Participants also divulged needs pertaining to their (potential) relationships. Lastly, religion and certain coping mechanisms were found to either facilitate or hinder sexuality post-trauma depending on their rigidity and effectiveness respectively.

Interview with Don C Reed We caught up with Don Reed to discuss some of the highlights and frustrations of his work as a patient advocate and why scientists in the field must learn to speak up for their research. Don C Reed has supported regenerative research ever since his son Roman became paralyzed in a college football accident in 1994. He sponsored California’s Roman Reed Spinal Cord Injury Research Act, source of America’s first state-funded embryonic stem cell research, and has been an integral part of numerous local, state and national efforts. A frequently published author, he received the National Press Award in 1996. A board member of the Proposition 71 campaign committee, Reed is a strong supporter of California’s US$6 billion stem cell program. He currently serves as Vice President for Public Policy of the Americans for Cures Foundation.

Background: Sexual function is one of the most important aspects of life affected by chronic disorders. Objectives: This study aims to investigate sexual function in women diagnosed with rheumatoid arthritis. Patients and Methods: This case-control study was conducted on 50 women with rheumatoid arthritis as the case group and 50 healthy women as the control group in Hafez Hospital, Shiraz, Iran. Data were collected by demographic and the Female Sexual Function Index questionnaires from June to August, 2013. Statistical analysis that included the chi square test, independent sample t-test, and linear regression were carried out using SPSS software (version 16). Results: Two groups were matched according to age, educational level, occupation, menarche age, husband’s age, marital age, gravidity and menstrual cycle status (P > 0.05). Total score from the Female Sexual Function Index in the case group (15.9 ± 11.16) was significantly lower than control group (27.29 ± 5.67). Also, in all subscales, the score for sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain) in the case group was lower than the control group (P < 0.001). From patients’ perspective, fatigue, limitation of joint movement, vaginal dryness, and reduction of sexual desire affected their sexual function. Also, linear regression indicated a negative association between duration of disease and sexual dysfunction. Conclusions: Our findings show that rheumatoid arthritis adversely effects women’s sexual function. Thus, clinicians should pay attention to these patients regardless of symptom severity or treatment response.

In cases of spinal cord injury (SCI), functional electrical stimulation (FES) is based on the concept that a paralyzed muscle can be stimulated by small amounts of electric current in a coordinated fashion to produce functional movement. This article reviews the experience of the Philadelphia Shriners Hospital with the use of FES for restoring upper extremity function in children with cervical SCI at the C5/C6 level. In addition, restoration of the ability to stand and some limited upright mobility are available with an FES system for patients with complete or incomplete SCI. The ability of FES to restore bladder and bowel function is also described. The Philadelphia Shriners Hospital specifically has expertise in children described in this review article as well as experience in preclinical studies an applying FES technology in growing animals and in growing children.

Spinal cord injury (SCI) can have a range of debilitating effects and permanently alter the capabilities and quality of life of survivors. The first specialized centers of care for SCI were established in 1944 and since then an increasing amount of research has been carried out in this area. Despite this, the present treatment and care levels for SCI are not comparable to those in other areas of medicine. In the clinic, the aim of SCI treatment is primarily to limit secondary damage by reducing compression in trauma spots and stabilizing the spinal column. Currently, no effective strategy for functional recovery is offered. In this review, we focus on research progress on the molecular mechanisms underlying SCI, and assess the treatment outcomes of SCI in animal models, i.e., neurotrophins and stem cells are discussed as pre-clinical therapies in animal models. We also assess the resources available and national research projects carried out on SCI in China in recent years, as well as making recommendations for the future allocation of funds in this area.

Division of Neurosurgery, Center for Neurophysiology and Restorative Neurology, University of California at San Diego School of Medicine, USA Spinal Cord Injury Research and Restorative Neurology, Crawford Research Institute, Shepherd Center, Departments of Neurology and Physiology, Emory University School of nta, G edicine, Atlanta Veterans Administration Medical Center, 2020 Peachtree Rd NW, Atla

Although the emphasis in clinical spinal cord injury (SCI) research has been directed towards the evaluation of clinical assessments (standards in neurological examination) and the appreciation of outcome measures (that is, extent and pattern of clinical recovery from SCI), the underlying neurological mechanisms for recovery from SCI are not well documented in humans. However, to improve the translational research, a meaningful preclinical–clinical dialogue is required, with an appreciation for both fundamental neural mechanisms and what makes human SCI unique. This holds true both for potential interventions in rehabilitation and novel drug or cell-based treatment approaches in acute SCI. The gap in translational research that needs to be approached from both ends not only includes the appreciation of principal neural mechanisms (repair, sprouting, plasticity) and their assumed impact onto outcomes (even though humans and non primate animals may rely on slightly different supraspinal control for some movements), but also includes an understanding of the spatial (location and size of lesion) and temporal (timelines of damage and recovery) factors in spinal cord damage that can vary considerably between the different species being studied. The preclinical–clinical dialogue should be encouraged as a venue to improve the appreciation of discoveries in basic research, and to power valid discoveries towards a meaningful translation into advanced treatments downstream. Similarly, the upstream identification of appropriate clinical targets that take into account clinical constraints depends on reliable and advanced clinical information being provided to preclinical investigators.

The understanding and measurement of participation and environmental context in spinal cord injury (SCI) is critically important. However, there is limited understanding of the environment-participation relationship in SCI research. There is little consensus on what is and on how to measure participation and its environmental determinants in the SCI. The objective of this article is to develop a set of International Classification of Functioning, Disability and Health (ICF)-based SCI Participation and Environment Domain Set and measurement instruments that intend to measure those domains. ICF categories from the ICF components of activities and participation and environmental factors based on the comprehensive ICF Core Set for SCI and the ICF Core Set for vocational rehabilitation were merged. Measurement instruments were selected based on published systematic reviews of measurement instruments in SCI. There were 128 ICF categories or domains in total (38 for environmental factors and 90 for activities and participation). There were six measurement instruments on environmental factors and six for participation based on existing systematic reviews. This article presents a domain set that is relevant to conducting research on the social and environmental perspectives, in an effort to understand and measure functioning in SCI (i.e., "SCI participation domain set" and "SCI environment domain set," respectively). The sample of SCI Participation and Environment Measurement Instruments gathered indicate the comprehensiveness and depth of the different domains. Guiding principles on the utilization of these measurement instruments depending on the purpose and design of a research study are highly recommended to investigators.

This special issue of Experimental Neurology compiles a series of papers that either explicitly replicate published studies or retest phenomena reported in previous publications. The explicit replications were carried out as part of the "Facilities of Research Excellence-Spinal Cord Injury" (FORE-SCI) program launched by the National Institute of Neurological Disorders and Stroke (NINDS) in 2003. Here, we review the FORE-SCI replication experiments published prior to those in this special issue. We then discuss emerging issues regarding replication and reproducibility in spinal cord injury research, especially in terms of potential translation to clinical trials.

Traumatic spinal cord injuries represent a significant source of morbidity in humans. Despite decades of research using experimental models of spinal cord injury to identify candidate therapeutics, there has been only limited progress toward translating beneficial findings to human spinal cord injury. Thoracolumbar intervertebral disk herniation is a naturally occurring disease that affects dogs and results in compressive/contusive spinal cord injury. Here we discuss aspects of this disease that are analogous to human spinal cord injury, including injury mechanisms, pathology, and metrics for determining outcomes. We address both the strengths and weaknesses of conducting pre-clinical research in these dogs, and include a review of studies that have utilized these animals to assess efficacy of candidate therapeutics. Finally, we consider a two-species approach to pre-clinical data acquisition, beginning with a reproducible model of spinal cord injury in the rodent as a tool for discovery with validation in pet dogs with intervertebral disk herniation.

Pain, which remains largely unsolved, is one of the most crucial problems for spinal cord injury patients. Due to sensory problems, as well as motor dysfunctions, spinal cord injury research has proven to be complex and difficult. Furthermore, many types of pain are associated with spinal cord injury, such as neuropathic, visceral, and musculoskeletal pain. Many animal models of spinal cord injury exist to emulate clinical situations, which could help to determine common mechanisms of pathology. However, results can be easily misunderstood and falsely interpreted. Therefore, it is important to fully understand the symptoms of human spinal cord injury, as well as the various spinal cord injury models and the possible pathologies. The present paper summarizes results from animal models of spinal cord injury, as well as the most effective use of these models.

Regenerative strategies that facilitate the regrowth and reconnection of neurons are some of the most promising methods in spinal cord injury research. An essential part of these strategies is an increased understanding of the mechanisms by which growing neurites seek out and synapse with viable targets. In this paper, we use computational and theoretical tools to examine the targeting efficiency of growing neurites subject to limited resources, such as maximum total neural tree length. We find that in order to efficiently reach a particular target, growing neurites must achieve balance between pruning and branching: rapidly growing neurites that do not prune will exhaust their resources, and frequently pruning neurites will fail to explore space effectively. We also find that the optimal branching/pruning balance must shift as the target distance changes: different strategies are called for to reach nearby vs. distant targets. This suggests the existence of a currently unidentified higher-level regulatory factor to control arborization dynamics. We propose that these findings may be useful in future therapies seeking to improve targeting rates through manipulation of arborization behaviors.

This study is part of the development of an International Classification of Functioning, Disability and Health (ICF) Core Set for spinal cord injury (SCI). Its specific objectives were to identify outcome parameters reported in published studies on individuals with SCI in the early post-acute and chronic situation, and to identify and quantify the concepts of the reported parameters using the ICF as a reference.Electronic searches of Medline, EMBASE, PsycINFO and CINAHL from 2001 to 2005 were carried out. All outcome parameters and their underlying concepts were retrieved from the included studies. These concepts were linked to categories of the ICF using standardized rules.From the 6681 abstracts retrieved, 2205 were randomly selected (33.0%) and 281 studies met the inclusion criteria (12.7%). A total number of 5217 concepts were retrieved from standardized and non-standardized measures, of which 4049 (77.6%) could be linked to 175 different ICF categories: 56 out of 114 Body Functions, 19 out of 56 Body Structures, 62 out of 118 Activities and Participation and 38 out of 74 Environmental Factors categories. Second-level categories reported in20% of all studies were pain, remunerative employment, health services, systems and policies, school education and higher education.The ICF provides a valuable reference to identify and quantify the concepts of measures focusing on SCI in the early post-acute and chronic situation. The findings show a great diversity in the consequences of SCI and underscore the importance of social participation and environment for people with SCI.