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STUDY DESIGN: Survey-based, prospective study. OBJECTIVE: Identify age-adjusted baseline NDI values in the American population. SUMMARY OF BACKGROUND DATA: The Neck Disability Index (NDI) is the most widely used tool for assessing self-rated disability in patients with neck pain. Establishing baseline NDI values can aid in understanding the clinical impact of cervical spine pathologies and treatment interventions. METHODS: An internet-based survey was distributed using the Connect (TM) platform powered by CloudResearch. Based on the latest US Census, this survey was designed to engage a demographically representative sample of the US adult population. We captured 699 individuals, aiming for 100 people per each 10-year age group between 18-89. Participants scored their disability using the NDI survey. Mean NDI scores stratified by age group and sex were calculated for each cohort. RESULTS: A total of 699 participants were included with 352 (50.4%) males and 347 (49.6%) females and an age distribution closely aligning with national demographics. The overall mean NDI for the combined age groups was 16.5 with a 95% confidence interval (CI) of 15.5-17.5. The 18-29 age group had the lowest mean NDI of 12.3 (95% CI [10.4, 14.2]). Mean NDI scores increased until the 60-69 age group with a mean of 20.1 (95% CI [17.3, 23.0]) with women having a mean NDI of 22.2 (95% CI [18.8, 25.7]) compared to men with 15.4 (95% CI [10.3, 20.4]). Mean NDI scores decreased in the 70-79 and 80-89 age groups. CONCLUSION: This is the first study to assess age-adjusted baseline values of NDI in the US population. Our findings demonstrate a disproportionate distribution of disability ratings across age groups. This data is important for healthcare professionals as it provides age- and sex-specific levels of disability. LEVEL OF EVIDENCE: Level III.
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STUDY DESIGN: A mixed-methods investigation with both retrospective and prospective components. OBJECTIVE: Determine the mean Oswestry Disability Index (ODI) scores for individuals who underwent surgical intervention compared to a non-surgical population and identify threshold values that distinguish between these groups. SUMMARY OF BACKGROUND DATA: The Oswestry Disability Index (ODI) quantifies disability in patients with low back pain and commonly serves as a significant determinant in lumbar spine pathology and surgical outcomes. An empirically established ODI threshold can aid in optimizing surgical decision-making processes. METHODS: This study retrospectively analyzed 557 patients who consulted with a spine surgeon and subsequently underwent lumbar spine surgery from 2019 to 2023. Additionally, ODI scores were surveyed from 797 individuals in the general American population using the CloudResearch Connect platform, with participants matched for age and sex according to US census data. Mean ODI scores stratified by age group and sex were calculated for each cohort. Receiver Operating Characteristic (ROC) analysis was utilized to ascertain ODI cutoff values for different demographics. RESULTS: The retrospective cohort demonstrated a higher disability level with an overall mean ODI of 34.7 (95% CI [33.1, 36.2]) for ages 18-89. In contrast, the general population surveyed had a mean ODI of 14.4 (95% CI [13.3, 15.4]). An ROC-derived ODI threshold of 16.5 within the comprehensive age group of 18-89 exhibited a sensitivity of 0.84 and a specificity of 0.68. CONCLUSION: The ODI values identified in this study offer benchmarks that can assist in the evaluation process for spine surgery. These findings highlight the importance of considering ODI scores as part of a comprehensive clinical evaluation, rather than as standalone indicators for surgical intervention. Further prospective validation of these findings and their integration into clinical practice is recommended for future research.
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Genetic editing of hematopoietic stem and progenitor cells can be employed to understand gene-function relationships underlying hematopoietic cell biology, leading to new therapeutic approaches to treat disease. The ability to collect, purify, and manipulate primary cells outside the body permits testing of many different gene editing approaches. RNA-guided nucleases, such as CRISPR, have revolutionized gene editing based simply on Watson-Crick base-pairing, employed to direct activity to specific genomic loci. Given the ease and affordability of synthetic, custom RNA guides, testing of precision edits or large random pools in high-throughput screening studies is now widely available. With the ever-growing number of CRISPR nucleases being discovered or engineered, researchers now have a plethora of options for directed genomic change, including single base edits, nicks or double-stranded DNA cuts with blunt or staggered ends, as well as the ability to target CRISPR to other cellular oligonucleotides such as RNA or mitochondrial DNA. Except for single base editing strategies, precise rewriting of larger segments of the genetic code requires delivery of an additional component, templated DNA oligonucleotide(s) encoding the desired changes flanked by homologous sequences that permit recombination at or near the site of CRISPR activity. Altogether, the ever-growing CRISPR gene editing toolkit is an invaluable resource. This chapter outlines available technologies and the strategies for applying CRISPR-based editing in hematopoietic stem and progenitor cells.