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Background/Objectives: The direct superior approach (DSA) is a tissue-sparing alternative to the traditional posterior approach (PA) in total hip arthroplasty (THA), potentially offering improved recovery and fewer complications. This study compares perioperative parameters, radiological and functional outcomes, and complications between the DSA and the PA in primary THA. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases searched included MEDLINE/PubMed, Cochrane Library, Embase, and Scopus. Studies comparing the DSA and the PA in primary THA were included based on predefined criteria. Data extraction and quality assessment were performed independently by two authors. Statistical analyses included calculating standardized mean differences (SMD), odds ratios (OR), and 95% confidence intervals (CI). Heterogeneity was assessed using the χ2 test, I2 statistics, and sensitivity analyses. Results: Out of 126 identified articles, 10 studies were included, which encompassed 28,063 patients (DSA: 1464; PA: 26,599). Significant advantages of the DSA over the PA were observed in blood loss (SMD −0.26, p < 0.01), transfusion rate (OR 0.59, p = 0.03), length of stay (SMD −0.59, p < 0.01), discharge to home rates (OR 2.32, p < 0.01), and incision length (SMD −2.75, p < 0.01). No significant differences were found in radiological outcomes or most functional scores, although the DSA showed higher Harris Hip Scores at 1 month (SMD 0.77, p < 0.01). Conclusions: The DSA offers significant perioperative advantages over the PA, including reduced blood loss, transfusion rates, LOS, incision length, and improved early functional recovery with higher discharge to home rates. Comparable complication rates and radiological outcomes support the DSA's safety and efficacy for quicker recovery in THA. [ABSTRACT FROM AUTHOR]

This study investigated future projections of extreme precipitation (PR) over the Korean Peninsula (KP) under global warming levels of 1.5 °C and 2.0 °C (GWL 1.5 °C and 2.0 °C). The bias-corrected large ensemble of the Regional Climate Model (RCM) in the Coordinated Regional Climate Downscaling Experiment–East Asia Phase 2 was used. Under GWL 1.5 °C, the RCM multi-model ensemble (MME) predicted the extreme PR intensity (RX1day) to increase by 10.14% more than the mean PR of 4.69%. A regional difference was observed in the projection, with a larger increase over the northern KP (NKP) and southern KP (SKP) than central KP. Accordingly, the distribution of extreme PR was expected to shift with the right, and extreme events occurring once every 20 years over the SKP and NKP were expected to change to a reoccurrence of 12.56 years and 10.04 years, respectively. The mechanism of extreme PR was examined for cases from June to September. The expected increase in extreme PR per warming over the SKP and NKP was 5.64% °C−1 and 8.37% °C−1, respectively, which was close to the Clausius-Clapeyron scale (7.7% °C−1). This implies that increased moisture capability from the warming will affect the change in extreme PR. Other possible factors were investigated and the RCM MME predicted vertical instability over East Asia to continue, and moisture flux and convergence around the KP to be intensified. Meanwhile, under GWL 2.0 °C, mean PR and extreme PR were projected to increase more than under GWL 1.5 °C. [ABSTRACT FROM AUTHOR]

Background: Comorbid chronic obstructive pulmonary disease (COPD) is increasingly common and may have an adverse impact on outcomes in patients undergoing total joint arthroplasty (TJA) of lower extremity. The purpose of this meta-analysis is to compare the postoperative complications between COPD and non-COPD patients undergoing primary TJA including total hip and knee arthroplasty. Methods: PubMed, EMBASE, and Cochrane Library were systematically searched for relevant studies published before December 2021. Postoperative outcomes were compared between patients with COPD versus those without COPD as controls. The outcomes were mortality, re-admission, pulmonary, cardiac, renal, thromboembolic complications, surgical site infection (SSI), periprosthetic joint infection (PJI), and sepsis. Results: A total of 1,002,779 patients from nine studies were finally included in this meta-analysis. Patients with COPD had an increased risk of mortality (OR [odds ratio] = 1.69, 95% confidence interval [CI] 1.42–2.02), re-admission (OR = 1.54, 95% CI 1.38–1.71), pulmonary complications (OR = 2.73, 95% CI 2.26–3.30), cardiac complications (OR = 1.40, 95% CI 1.15–1.69), thromboembolic complications (OR = 1.21, 95% CI 1.15–1.28), renal complications (OR = 1.50, 95% CI 1.14–1.26), SSI (OR = 1.23, 95% CI 1.18–1.30), PJI (OR = 1.26, 95% CI 1.15–1.38), and sepsis (OR = 1.36, 95% CI 1.22–1.52). Conclusion: Patients with comorbid COPD showed an increased risk of mortality and postoperative complications following TJA compared with patients without COPD. Therefore, orthopedic surgeons can use the study to adequately educate these potential complications when obtaining informed consent. Furthermore, preoperative evaluation and medical optimization are crucial to minimizing postoperative complications from arising in this difficult-to-treat population. Level of evidence: Level III. Registration: None. [ABSTRACT FROM AUTHOR]

Background context. Proximal junctional kyphosis (PJK) following surgical treatment of lumbar degenerative kyphosis (LDK) is one of the critical complications leading to the failure of instrumentation and additional extensive surgery. However, most previous studies have focused on idiopathic scoliosis resulting from variable surgical techniques. LDK usually differ from other scoliotic deformities in terms of patient characteristics and disease mechanisms. Purpose. Identification of the prevalence of PJK after the surgical treatment of LDK and searching for the predictable value for the progression of PJK. Study design. Retrospective comparative study. Patient sample (must be included in clinical studies). Forty-seven consecutive patients who underwent surgical correction of a sagittal imbalance due to LDK, from January 2005 to December 2008 in a single spine clinic, were evaluated with a minimum 2 years follow-up (mean 3.8 years). Methods. Patients were divided into 2 groups: with or without the occurrence of PJK, and three categorized factors according to patient characteristics, surgical variables, and the radiographic spinopelvic parameters were evaluated. Results. PJK had occurred in 29 of 47 patients (61.7%). Among variable factors, old age, upper-instrumented vertebra below L2, lumbar lordosis to PI ratio, and the sum of lumbar lordosis, and the sacral slope related to PI were found to be statistically significant. Conclusions. The overall incidence of PJK following surgical treatment of LDK patients was higher than expected. Spinal biomechanics may be changed after long instrumented fusion surgery. Thorough consideration of these factors is needed in the treatment strategy of LDK patients. A long-term follow-up study should be conducted. [ABSTRACT FROM AUTHOR]

Abstract: In this study, golf-putting movements were examined under three goal distances (short, 1.7m; middle, 3.25m; long, 6m), two different putter weights (500g, 750g), and two levels of expertise (5 experts, 5 novices). The study’s aim was to identify differences in kinematics and accuracy between expert and novice golfers. The results demonstrated that experts achieved higher accuracy with lower impact velocity than novices. In addition, while novices showed symmetrical movements, experts exhibited asymmetrical movements, which were achieved by modulating their movement time and amplitude differently from novices. These results demonstrated differences in relative timing, relative amplitude and velocity, but no difference in time-to-contact between novices and experts. The results reaffirmed the role of prior learning and supported the hypothesis of that motor learning is a hierarchical process organized at both macroscopic and microscopic levels. [ABSTRACT FROM AUTHOR]

Ectopic fat and abdominal adiposity phenotypes have never been studied holistically in individuals after acute pancreatitis (AP). The aim of the study was to investigate phenotypical differences in ectopic fat and abdominal fat between individuals after AP (with and without diabetes) and to determine the role of pancreatitis-related factors. Eighty-four individuals were studied cross-sectionally after a median of 21.5 mo since last episode of AP and were categorized into “diabetes” and “no diabetes” groups. Twenty-eight healthy volunteers were also recruited. With the use of magnetic resonance imaging, intrapancreatic fat percentage, liver fat percentage, visceral fat volume (VFV), subcutaneous fat volume, and visceral-to-subcutaneous (V/S) fat volume ratio were quantified. Analysis of variance was used to investigate the differences in these phenotypes between the groups. All analyses were adjusted for age and sex. Linear regression analysis was used to investigate the association between pancreatitis-related factors and the studied phenotypes. Intrapancreatic fat percentage was significantly higher in the diabetes group (10.2 ± 1.2%) compared with the no diabetes (9.2 ± 1.7%) and healthy volunteers (7.9 ± 1.9%) groups (P < 0.001). VFV was significantly higher in the diabetes (2,715.3 ±1,077.6 cm3) compared with no diabetes (1,983.2 ± 1,092.4 cm3) and healthy volunteer (1,126.2 ± 740.4 cm3) groups (P < 0.001). V/S fat volume ratio was significantly higher in the diabetes (0.97 ± 0.27) compared with no diabetes (0.68 ± 0.42) and healthy volunteer (0.52 ± 0.34) groups (P = 0.001). Biliary AP was associated with significantly higher intrapancreatic fat percentage (β = 0.67; 95% CI, 0.01, 1.33; P = 0.047). C-reactive protein levels during hospitalization for AP were associated with significantly higher VFV (β = 3.32; 95% CI, 1.68, 4.96; P < 0.001). In conclusion, individuals with diabetes after AP have higher intrapancreatic fat percentage, VFV, and V/S fat volume ratio. Levels of C-reactive protein during AP are significantly associated with VFV, whereas biliary AP is significantly associated with intrapancreatic fat percentage. NEW & NOTEWORTHY Individuals with diabetes after acute pancreatitis have significantly higher intrapancreatic fat percentage and visceral fat volume compared with individuals without diabetes after acute pancreatitis and healthy controls. C-reactive protein levels during hospitalization for acute pancreatitis and biliary etiology of acute pancreatitis are associated with significantly larger visceral fat and pancreatic fat depots, respectively. [ABSTRACT FROM AUTHOR]

The adverse impacts of extreme heat on human health when a concurrent daytime and nighttime heatwave (CDNHW) occurs are greater than when daytime or nighttime heatwaves occur individually, because of the reduced recovery time from heat exposure. This study projects increases in CDNHW over the whole of East Asia under two Representative Concentration Pathway scenarios (RCP2.6 and RCP8.5) and two Shared Socioeconomic Pathway scenarios (SSP1‐2.6 and SSP5‐8.5). The daily maximum and minimum temperatures, which are used to define a CDNHW, are calculated of 3‐hourly temperatures of 25 km horizontal resolution produced by 12 general circulation model and regional climate model chains participating in the Coordinated Regional Climate Downscaling Experiment East Asia phase 2 project. In Historical simulation (1981–2005), occurrence period and occurrence rate of CDNHW from April to September area‐averaged in East Asia are 10.9 days and 0.9%, respectively. In projections for the future (2071–2100), occurrence period and occurrence rate of CDNHW will be 3 weeks and 3.7% (RCP2.6), 2 months and 20.5% (RCP8.5), 2 months and 15.6% (SSP1‐2.6), and 3 months and 45.7% (SSP5‐8.5). In addition, it is expected that the CDNHW intensity will increase, and the spatial extent of CDNHW will be extended. Although a CDNHW lasting less than 3 days is the most common, the proportion of CDNHWs lasting more than 10 days, compared to the total CDNHW frequency, will increase to 1.2% (RCP2.6), 7.2% (RCP8.5), 6.1% (SSP1‐2.6), and 17.3% (SSP5‐8.5) from 0.2% (Historical). Both occurrence rate and intensity of CDNHW will increase to a relatively large extent in Indochina, East and West China, and India. If the current greenhouse gas emissions continue, East Asia will experience unprecedented heat stress because the frequency and intensity of CDNHWs, which rarely occur during present‐day, will increase significantly over all regions by the end of the 21st century. [ABSTRACT FROM AUTHOR]

The adverse impacts of extreme heat on human health when a concurrent daytime and nighttime heatwave (CDNHW) occurs are greater than when daytime or nighttime heatwaves occur individually, because of the reduced recovery time from heat exposure. This study projects increases in CDNHW over the whole of East Asia under two Representative Concentration Pathway scenarios (RCP2.6 and RCP8.5) and two Shared Socioeconomic Pathway scenarios (SSP1‐2.6 and SSP5‐8.5). The daily maximum and minimum temperatures, which are used to define a CDNHW, are calculated of 3‐hourly temperatures of 25 km horizontal resolution produced by 12 general circulation model and regional climate model chains participating in the Coordinated Regional Climate Downscaling Experiment East Asia phase 2 project. In Historical simulation (1981–2005), occurrence period and occurrence rate of CDNHW from April to September area‐averaged in East Asia are 10.9 days and 0.9%, respectively. In projections for the future (2071–2100), occurrence period and occurrence rate of CDNHW will be 3 weeks and 3.7% (RCP2.6), 2 months and 20.5% (RCP8.5), 2 months and 15.6% (SSP1‐2.6), and 3 months and 45.7% (SSP5‐8.5). In addition, it is expected that the CDNHW intensity will increase, and the spatial extent of CDNHW will be extended. Although a CDNHW lasting less than 3 days is the most common, the proportion of CDNHWs lasting more than 10 days, compared to the total CDNHW frequency, will increase to 1.2% (RCP2.6), 7.2% (RCP8.5), 6.1% (SSP1‐2.6), and 17.3% (SSP5‐8.5) from 0.2% (Historical). Both occurrence rate and intensity of CDNHW will increase to a relatively large extent in Indochina, East and West China, and India. If the current greenhouse gas emissions continue, East Asia will experience unprecedented heat stress because the frequency and intensity of CDNHWs, which rarely occur during present‐day, will increase significantly over all regions by the end of the 21st century. [ABSTRACT FROM AUTHOR]

Five regional climate models (RCMs)—CCLM, RegCM, HadGEM3‐RA, SNURCM and WRF—participating in the Coordinated Regional Climate Downscaling Experiment‐East Asia (CORDEX‐EA) Phase 2 project are evaluated for their ability to simulate spatiotemporal variability in Asian summer precipitation. For this purpose, two dynamical downscaling sets, experiments forced by ERA‐Interim reanalysis data (reproduction experiment) and historical data from three Coupled Model Intercomparison Project 5 (CMIP5) general circulation models (GCMs) (historical experiment) are analysed. The horizontal resolution of the downscaled results is 25 km, and the analysis period is from 1981 to 2005 (25 years). The RCMs show reasonable performance in simulating the spatial and temporal characteristics of summer precipitation in CORDEX‐EA Phase 2 domain. To assess spatiotemporal patterns in Asian precipitation, cyclostationary empirical orthogonal function (CSEOF) analysis is used. In the first mode representing seasonal variations, the model ensemble results of both the reproduction experiment (Rep_ENS) and the historical experiment (His_ENS) simulate the peak times, location of precipitation and progression of the monsoons in Asia reasonably. Their features are greatly influenced by the moisture flux, indicating that the relation between precipitation and 850 hPa moisture flux is depicted well by RCM ensembles. In the second mode, which represents intraseasonal variations, the Rep_ENS depicts the western North Pacific summer monsoon break (WNPSM break) phenomenon similar to the observation. Although the His_ENS simulates the WNPSM break later than the observation, it does present the intraseasonal variation in the East Asian summer monsoon region. Based on these results, the five RCM ensemble results show the ability to capture spatiotemporal characteristics of summer precipitation in CORDEX‐EA Phase 2 domain, as well as added value from dynamical downscaling. [ABSTRACT FROM AUTHOR]

Wind power, which is the fastest–growing renewable energy source, is directly influenced by weather or climate conditions. This study examined the recent changes and future projections under different carbon emission levels in the wind power potential (Wpot) over East Asia using the ERA5 datasets and high–resolution multiple regional climate models (RCMs). Because wind conditions are constantly changing, we employed the wind velocity range–based approach for estimating the Wpot using the shortest time interval data available, which is the three–hourly wind velocity. Seasonal Wpot climatology of area–averaged Wpot over East Asia was the highest in spring. The average Wpot showed the highest values in northern China and southern Mongolia throughout all seasons, while recent changes in the Wpot over East Asia were characterized by overall increases in spring, autumn, and winter, but a decrease in summer. However, there were large regional variabilities. Northern China and southern Mongolia are expected to remain significant regions with high Wpot in the future. This is due to the large contribution of the frequency of optimal wind conditions, ranging from 12 m s−1 to 25 m s−1, to the Wpot in these regions, both currently and in the future. The average future Wpot in East Asia is expected to show no significant changes in both the low and the highest carbon emission scenarios compared to the present. However, it is projected that regional disparities in the Wpot will increase in a scenario with enhanced emission by the end of the 21st century. [Display omitted] • Seasonal Wpot climatology of area–averaged Wpot over East Asia was the highest in the spring, and the rest of the seasons were similar. • Northern China and southern Mongolia are expected to remain significant regions with high Wpot in the future due to the relatively significant contribution of 12 m s−1 to 25 m s−1 wind velocity range, which is good for wind power generation, to the future Wpot in these regions. • The average future Wpot in East Asia is expected to show no significant changes compared to the present, but it is projected that regional disparities in the Wpot will increase in a scenario with enhanced emission by the end of the 21st century. [ABSTRACT FROM AUTHOR]

Heavily industrialized East Asia, with its high greenhouse gas emissions, must inevitably increase renewable energy production to achieve the goals of the Paris Agreement. Photovoltaics (PV), a widely utilized renewable energy source, is directly affected by the weather and climate. This study conducted the first analysis of current and future PV potential (PVpot) changes over East Asia using the ERA5 reanalysis and multiple high-resolution regional climate model simulations. The recent PVpot over East Asia did not exhibit any notable changes, but the future PVpot of the multi-model ensemble is predicted to decrease by −4.3% (winter) to −1.5% (summer) on average with excellent inter-model agreements. Results demonstrated that the widespread increase in near-surface air temperature causes the overall PVpot decrease (around −2.0%) over East Asia across all seasons. Interestingly, surface down-welling shortwave radiation increases in summer, offsetting temperature-induced PVpot decreases (by about 0.7%) while it declines in winter and spring, intensifying the warming-driven PVpot decrease (by approximately −1.4% to −2.3%). Further, the changes in the number of rainy days are associated with the changing patterns of surface down-welling shortwave radiation, indicating the importance of reliable projections of precipitation. Wind speed exerts a negligible effect on the future PVpot change. [Display omitted] [ABSTRACT FROM AUTHOR]

For the comprehensive estimation of regional climate change over East Asia (EA) at the 2 and 3 °C global warming levels (GWLs), the Köppen‐Trewartha climate‐type change is assessed with ensemble regional climate change projections in line with Coordinated Regional Climate Downscaling Experiment (CORDEX)‐EA phase 2. Under the 2 °C (3 °C) GWL, 17.6% (25.2%) of the EA region is expected to undergo major climate‐type changes. Tropical and subtropical climate types will expand northward, accompanied by increasing hydroclimatic intensity. Limiting GWL to 2 °C shows benefits by preventing subtropical‐type expansion around far EA. Desertification over inland regions of EA exhibits scenario dependency. Boreal and tundra climate types over high‐latitude regions will tend to decrease rapidly, especially over the Tibetan Plateau. The results are expected to be a baseline assessment of climate change over EA under the 2 and 3 °C GWLs above the preindustrial level. Plain Language Summary: This paper investigates the Köppen‐Trewartha climate‐type changes over East Asia (EA) at the 2 and 3 °C global warming levels (GWLs) with the ensemble regional climate simulations. Under the 2 °C (3 °C) GWL, 17.6% (25.2%) of the EA region is expected to undergo major climate‐type changes. The result shows increased tropical, subtropical, and desert climate types accompanied by intensification of hydroclimatic stress. In addition, boreal and tundra climate types over high‐latitude regions will tend to decrease rapidly, especially over the Tibetan Plateau under the 2 and 3 °C GWLs. Key Points: Baseline assessment of climate change over East Asia under the 2 and 3 °C global warming is here presentedOf the East Asia region, 17.6% (25.2%) is expected to experience major climate‐type changes under the 2 and 3 °C global warmingThe changes are accompanied by intensified hydroclimatic stress and have statistically significant trends until the end of the 21st century [ABSTRACT FROM AUTHOR]

Abstract: Background context: Lumbar degenerative kyphosis (LDK) is characterized by sagittal imbalance resulting from a loss of lumbar lordosis (LL). The pelvic incidence (PI) regulates the sagittal alignment of the spine and pelvis. Purpose: The purpose of this study is to evaluate the spinopelvic parameters in patients with LDK and to compare them with those of a normal population. Study design/setting: A cross-sectional study. Patient sample: The selected patients showed characteristic clinical features of LDK. As control group, asymptomatic volunteers without spinal pathology were recruited. Outcome measures: Full-length radiographs of the spine in the anteroposterior and lateral planes were taken, extending from the base of the skull to the proximal femur. Pelvic incidence, sacral slope (SS), pelvic tilt (PT), main thoracic kyphosis (TK), thoracolumbar junction (TLJ), LL, and sagittal vertical axis (SVA) were evaluated. Methods: In terms of PI, the patient and control groups were divided into three groups: low (PI≤45°), middle (45°60°). All the spinopelvic parameters were compared between each group and between the patient and control groups in each group. The correlations between each of the parameters were analyzed. Results: We evaluated 172 patients with symptomatic LDK and 39 healthy volunteers. The number of LDK patients with low, middle, and high PI groups were 44 (25.6%), 72 (44.8%), and 51 (29.6%), respectively. In the control group, the number of low, average, and high PI patients were 18 (46.2%), 15 (38.5%), and 6 (15.4%), respectively. In the control group, PI determined all spinopelvic parameters except SVA. In the LDK group, PI also determined spinopelvic parameters except for TK and SVA. Lumbar degenerative kyphosis with low PI was associated with pronounced kyphosis in LL and TLJ; LDK with a high PI was associated with relatively preserved lordosis in LL with a flat or lordotic TLJ. In terms of pelvic parameters, low PI showed flattened SS and low PT, whereas high PI showed steep SS and high PT. Conclusions: The results of this study suggest the importance of the key anatomical parameter, PI, in the determination of sagittal contour in symptomatic LDK patients and normal population. Spinopelvic parameters and pelvic compensatory mechanisms in LDK patients differ according to PI. Identifying the spinopelvic parameters is useful when correcting deformities. [Copyright &y& Elsevier]