Facet tropism and orientation are thought to be associated with lumbar disc herniation (LDH), but the relationship is not well established. Moreover, the effect of facet joint on LDH has not been outlined in young patients. The objective of this study was to investigate the associations of facet joint tropism and orientation with LDH in young patients (18-35 years) by computed tomography (CT). Fifty-three patients with LDH and 129 with neither LDH nor low back pain (18-35 years) were included in this study. The facet joint angles were measured for each facet joint by CT as per the method described by Noren et al. We defined facet tropism as a bilateral angle difference > 5°. Young cases with neither LDH nor low back pain were used as the control group. The results showed that LDH was significantly associated with more coronal facet joint orientation at L1-2 (p = 0.009), L2-3 (p = 0.004), and L3-4 (p = 0.004). No association was established between facet tropism and LDH. This study revealed that facet joint orientation was associated with LDH in young patients (18-35 years); they were more of coronal facing at upper levels. Also, the facet tropism was not associated with LDH.

Purpose Because of the complexity of technological innovation and the dynamics of the technological environment, it is impossible for a single firm to have all knowledge needed for technological innovation, making it essential for firms to conduct cross-border knowledge search and integration. However, it is very difficult for firms to acquire and assimilate cross-border knowledge. The purpose of this paper is to explore how an open innovation platform (OIP) helps firms to effectively search and integrate cross-border knowledge, and to understand the key roles that OIP plays during the cross-border knowledge search and integration processes. Design/methodology/approach This paper takes the case analysis method, which provides a comprehensively understanding on the complex process of cross-border knowledge search and integration as well as the internal mechanism. Drawing on the research paradigm of Eisenhardt (1989), Bakker and Akkerman (2014), this paper analyzes and verifies the mechanism of OIP cross-border knowledge search and integration based on extensive interviews. Findings First, this paper analyzes the process of cross-border knowledge search and integration through Haier open partnership ecosystem (HOPE), which is theoretically divided into three stages, including motivation formation, cross-border knowledge search and integration. These three stages have been further decomposed into the following seven steps: demands discovery, problems definition, problems decomposition, resource search, resource evaluation, technology redevelopment and test. In addition, this study investigates the manifestation of interrelationships among these stages and steps, depicting the pathways through which HOPE facilitates the firm’s cross-border knowledge search and integration. The conclusions indicate that OIP timely discovers the consumer demands during the motivation formation stage, effectively decomposes problems and find related technology resources during the search stage and improves the efficacy of integration stage. Research limitations/implications This study reveals the mechanism of OIP cross-border knowledge search and integration and draws some valuable conclusions, which contribute to the literature on cross-border knowledge search, enrich the research on problem-solving and also propose a new perspective to study the roles of OIP on innovation. However, there are still some limitations. First, this study is built on a single platform (HOPE), further studies may focus on more platforms to ensure the conclusions of this paper. Second, this study conducts data analysis using a simple encoding analysis, so it is possible that some critical information is emitted while collating and analyzing data. Meanwhile, for the research methods, qualitative and quantitative methods can be combined to analyze related issues, then the correlation and corresponding mechanism can be incorporated into the same framework to further verify the conclusions and generalize the results. Practical implications This paper theoretically analyzes how and why HOPE helps firms search and integrate cross-border knowledge. It provides not only a reference for OIP but also a proven and effective way for companies’ acquiring and integrating cross-border knowledge. Then it will further improve firms’ innovative abilities, especially disruptive innovation abilities. Social implications Technological innovation, especially disruptive innovation is not only a driving force of firms’ sustainable development but also a vital driver of national development. This paper clarified that OIP can help firms conduct successful disruptive innovation through cross-border knowledge search and integration, which will further increase national innovative competence and improve social welfare. Originality/value This paper extends the literature on the process of cross-border knowledge search and integration, as well as the roles of OIP. From a managerial standpoint, the conclusions have practical implications for firms to successfully acquire and integrate cross-border knowledge.

The current study evaluated the efficacy and safety of a denosumab biosimilar, QL1206 (60 mg), compared to placebo in postmenopausal Chinese women with osteoporosis and high fracture risk. At 31 study centers in China, a total of 455 postmenopausal women with osteoporosis and high fracture risk were randomly assigned to receive QL1206 (60 mg subcutaneously every 6 months) or placebo. From baseline to the 12-month follow-up, the participants who received QL1206 showed significantly increased bone mineral density (BMD) values (mean difference and 95% CI) in the lumbar spine: 4.780% (3.880%, 5.681%), total hip :3.930% (3.136%, 4.725%), femoral neck 2.733% (1.877%, 3.589%) and trochanter: 4.058% (2.791%, 5.325%) compared with the participants who received the placebo. In addition, QL1206 injection significantly decreased the serum levels of C-terminal crosslinked telopeptides of type 1 collagen (CTX): −77.352% (−87.080%, −66.844%), and N-terminal procollagen of type l collagen (P1NP): −50.867% (−57.184%, −45.217%) compared with the placebo over the period from baseline to 12 months. No new or unexpected adverse events were observed. We concluded that compared with placebo, QL1206 effectively increased the BMD of the lumbar spine, total hip, femoral neck and trochanter in postmenopausal Chinese women with osteoporosis and rapidly decreased bone turnover markers. This study demonstrated that QL1206 has beneficial effects on postmenopausal Chinese women with osteoporosis and high fracture risk.