Search

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]

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]

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]

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]

International Business (IB) research on foreign-location choice has experienced a revival in recent years, yet a comprehensive review has been sorely lacking. The purpose of this review is to synthesize the findings of recently published articles on the topic of foreign-location choice and offer fruitful directions for future research. This review consists of three sections: first, the authors provide a historical overview of this research stream by tracing its origins and analyzing the general trend that has shaped research on foreign-location choice. Next, the authors conduct a review of 137 recent articles published in leading IB and business/management journals. These articles are categorized according to common topics, and the main findings of each category are synthesized in order to bring some cohesion to this fragmented field. Lastly, the authors identify issues that remain under-researched or require re-thinking some taken-for-granted assumptions. Through this effort, they are able to connect the past, present and future of research on foreign-location choice and to shed some new light on the IB literature. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to critically assess the theoretical underpinnings and extant progress of the research on regional multi-national enterprises (MNEs) and offer a blueprint for future research by re-conceptualizing how (regional) boundaries relate to the international diversification of MNEs. Design/methodology/approach – The paper integrates key insights from the theory of the regional MNE and economic geography to re-orient the treatment of regional borders within international business (IB) literature. Findings – The paper suggests that the (L) component within the ownership location and internalization (OLI) paradigm should be disaggregated into continuous “distance effects” and discrete “border effects”. Within this rubric, regional borders represent discrete border effects that generate discontinuities that are permeable, fluid and firm specific. Such reconceptualization opens up avenues for future research and more tightly integrates the research on regional MNEs with other research streams. Research limitations/implications – IB scholars need to make concerted effort to think of regions as one among several parameters in studying the strategy and structure of MNEs. A stronger focus on internal processes and mechanisms elucidating the main drivers of MNEs strategies is needed. Originality/value – The paper offers innovative ways in which future research can advance the study of how regions matter in the internationalization strategy of MNEs. [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]

Purpose – While many studies have investigated the impact of foreign direct investment (FDI) on a host country's economic development, little research has been done on the role of FDI as related to economic decline and recovery. This paper aims to fill this gap by investigating the economic effects of inward and outward FDI during turbulent times. Design/methodology/approach – This paper develops a theoretical argument postulating that FDI will have a stabilizing effect on a nation's economic growth during crisis and also at times of recovery. Hypotheses were advanced and tested with data collected from affected economies during the Asian financial crisis using a fixed-effect panel regression analysis. Findings – Results confirm that both inward and outward FDI stabilizes a country's economic growth during times of a financial crisis. Countries that had higher levels of FDI prior to the crisis experienced a milder recession and a more gradual recovery. This stabilizing effect, however, is found to be more robust for FDI-stock than for FDI-flow. Social implications – This paper reveals that FDI has a stabilizing rather than an accelerating effect on a country's economy growth during both periods of crisis and recovery. It contradicts the common belief that FDI would help speed up, not stabilize or dampen the uptake of economic activities during the recovery period. This finding will help policy makers educate the public and set realistic expectations about the economic impact of FDI. Originality/value – This paper makes original contributions by uncovering the complex and unexpected role of FDI as related to a nation's economic decline and recovery during a financial crisis. The findings have important implications for both international business scholars and public-policy decision makers. [ABSTRACT FROM AUTHOR]

Background: Arthroscopic rotator cuff repair (RCR) is a common orthopaedic procedure, but it has a high rate of retears that can negatively affect the functional outcomes. Bone marrow stimulation (BMS) has been suggested as an additional treatment to improve the outcomes of RCR., Purpose: To compare the effectiveness of the BMS procedure during RCR with conventional RCR., Study Design: Systematic review; Level of evidence, 2., Methods: A systematic literature search was conducted in MEDLINE/PubMed, Embase, Cochrane Library, and Scopus, on March 1, 2023, for studies comparing postoperative retear rates and functional outcomes between patients who underwent primary arthroscopic RCR with and without the BMS procedure. Only level 1 and 2 randomized controlled trials with a minimum 12-month follow-up were included. The primary outcomes were retear rates and functional outcomes as measured by the Constant; American Shoulder and Elbow Surgeons (ASES); and University of California, Los Angeles (UCLA) scores and by postoperative range of motion. Subgroup analyses were performed based on repair technique (single-row repair vs double-row or suture-bridge repair). The standardized mean difference (SMD) and odds ratio (OR) were utilized to synthesize continuous and dichotomous outcomes, respectively. Homogeneity was evaluated using the chi-square test and I 2 statistic., Results: The literature search yielded 661 articles, of which 6 studies (522 patients; 261 with BMS, 261 without BMS) met the eligibility criteria. The combined analysis showed no significant decrease in retear rates with the utilization of the BMS procedure during RCR (OR, 0.60; 95% CI, 0.35 to 1.03; P = .07; I 2 = 24%). There was no significant intergroup difference in functional outcomes (Constant score: SMD, 0.13; 95% CI, -0.04 to 0.31; P = .13; I 2 = 0%; ASES score: SMD, 0.04; 95% CI, -0.20 to 0.28; P = .73; I 2 = 0%; UCLA score: SMD, -0.13; 95% CI, -0.50 to 0.23; P = .47; I 2 = 0%). Subgroup analyses revealed no significant differences in postoperative retear risk or total Constant score according to the repair technique., Conclusion: Based on the available evidence, this systematic review did not find a significant benefit of the BMS procedure at the footprint during arthroscopic RCR compared with conventional RCR in terms of retear rates and functional outcomes at short-term follow-up., Competing Interests: The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2024.)

[Purpose] The purpose of this study was to compare the strength and endurance of the orbicularis oris muscle in healthy Korean (young vs. elderly adults). [Participants and Methods] A total of 60 participants (30 young adults and 30 elderly adults) were recruited. The Iowa Oral Performance Instrument was used to measure orbicularis oris muscle maximal strength and endurance. [Results] Elderly adults showed significantly lower orbicularis oris muscle strength and endurance than younger adults. [Conclusion] This study confirmed a significant age-related decrease in orbicularis oris muscle strength and endurance. The data collected will be useful as a basis for future on speech and swallowing therapy.

[Purpose] This study investigated the characteristics of oropharyngeal swallowing function in patients with presbyphagia. [Participants and Methods] Data for 25 patients with presbyphagia were retrospectively analyzed. The oropharyngeal swallowing function was evaluated using VDS based on videofluoroscopic swallowing study. [Results] Lip closure, mastication, laryngeal elevation, and aspiration showed a relative decrease in function. [Conclusion] This study showed a reduction in oropharyngeal swallowing in patients with presbyphagia. Our results may help in the diagnosis and treatment of presbyphagia.

The objective of this study is to present a rare case of an invaginated inferior vena cava (IVC) aneurysm in the lumbar intradiscal space. A 73-year-old woman with lower back pain and bilateral lower extremity swelling presented to the clinic. She had undergone spinal surgery performed thrice at the same site (L4-L5) in another hospital and a separate posterolateral fusion surgery procedure 3 years previously. On plain radiography, pseudarthrosis was observed at L4-L5 segment. Contrast computed tomography (CT) imaging revealed a dilatation of the IVC in the intradiscal space of L4-L5. On the anterior side, anterior discectomy was performed. Following insertion of the allograft bone chip and cage, the invaginated IVC aneurysm was repositioned. Implant removal and screw fixation were performed posteriorly. Post-surgery, the patient's lower back pain improved, and the start of anticoagulation treatment after vascular evaluation was planned. Although there have been numerous case reports of patients with intradiscal cysts or gas requiring surgical treatment, there have not yet been any reports of those with invaginated IVC in an intradiscal space. It is important to provide the appropriate treatment based on a thorough prior understanding of the patient's anatomy., Competing Interests: Conflicts of Interest Disclosure None.

Objective: To compare radiographic analysis on the sagittal lumbar curve when standing, sitting on a chair, and sitting on the floor., Methods: Thirty asymptomatic volunteers without a history of spinal pathology were recruited. The study population comprised 11 women and 19 men with a mean age of 29.8 years. An independent observer assessed whole lumbar lordosis (WL) and segmental lordosis (SL) between L1 and S1 using the Cobb's angle on lateral radiographs of the lumbar spine obtained from normal individuals when standing, sitting on a chair, and sitting on the floor. WL and SL at each segment were compared for each position., Results: WL when sitting on the floor was reduced by 72.9% than the average of that in the standing position. Of the total decrease in WL, 78% occurred between L4 to S1. There were significant decreases in SL at all lumbar spinal levels, except L1-2, when sitting on the floor as compared to when standing and sitting on a chair. Changes in WL between the positions when sitting on a chair and when sitting on the floor were mostly contributed by the loss of SL at the L4-5 and L5-S1 levels., Conclusion: When sitting on the floor, WL is relatively low; this is mostly because of decreasing lordosis at the L4-5 and L5-S1 levels. In the case of lower lumbar fusion, hyperflexion is expected at the adjacent segment when sitting on the floor. To avoid this, sitting with a lordotic lumbar curve is important. Surgeons should remember to create sufficient lordosis when performing lower lumbar fusion surgery in patients with an oriental life style.

Sacral fractures in elderly patients with associated lumbosacral lesions can be overlooked easily because of vague symptoms and delayed neurological insufficiency. A 70-year-old female and a 73-year-old female presented with delayed neurological insufficiency caused by transverse sacral fracture after minor trauma. Both patients had suffered from lower extremity symptoms with dysuresia and dyschezia for more than a month. Coexisting lumbosacral pathological lesions may confuse the correct diagnosis for sacral fractures. Decompressive sacral laminectomy was performed, and the patients showed relatively favorable outcomes.

Object: The purpose of this study was to demonstrate the clinical characteristics of postoperative retroperitoneal hematoma (RPH) following transforaminal percutaneous endoscopic lumbar discectomy (PELD) and to discuss how to prevent the complication of unintended hemorrhage., Methods: The medical records of 412 consecutive patients treated with transforaminal PELD between January 2005 and May 2007 were reviewed. A total of 4 patients (0.97%) experienced symptomatic postoperative RPH. The clinical outcomes were evaluated using the visual analog scale and the Oswestry Disability Index., Results: The common symptom in all patients with a hematoma was inguinal pain. The mean hematoma volume was 527.9 ml (range 53.3-1274.1 ml). Two patients with massive diffuse-type RPHs compressing the intraabdominal structures required open hematoma evacuation performed by general surgeons, and the other 2 patients with small, localized RPHs of < 100 ml were treated conservatively. The mean follow-up period was 21.3 months (range 13-29 months). The mean visual analog scale score for radicular leg pain improved from 7.6 to 1.8 and that for back pain improved from 4.3 to 2. The mean Oswestry Disability Index improved from 58.8 to 9.1%. The preoperative symptoms improved after the second treatment without significant neurological sequelae in all patients., Conclusions: Although transforaminal PELD is a minimally invasive and safe procedure, the possibility of RPH should be kept in mind. Adequate technical and anatomical considerations are important to avoid this unusual hemorrhagic complication, especially in the patient with underlying medical problems or previous operative scarring. A high index of suspicion and early detection is also important to avoid the progression of the hematoma.

A 52-year-old female presented with extraforaminal lumbar synovial cyst at the L4-5 level causing sudden foot drop on the right. Computed tomography, magnetic resonance (MR) imaging, and coronal MR myelography source images identified the cystic mass in the extraforaminal zone. The patient underwent microdecompression via a lateral transmuscular route, and the extraforaminal cyst compressing L4 ganglion was successfully removed. The histological diagnosis was synovial cyst. This unique case of surgically proven extraforaminal lumbar synovial cyst causing sudden foot drop indicates that extraforaminal synovial cyst should be included in the differential diagnosis of patients presenting with sudden foot drop.

Aim: To evaluate the attitude of primary care physicians in the diagnosis and treatment of Helicobacter pylori (H. pylori) infection., Methods: Primary care physicians in the Seoul metropolitan area answered self-administered questionnaire from January to March 2003., Results: One hundred and eight doctors responded to the questionnaire. The most frequent reasons for testing H. pylori infection were gastric and duodenal ulcers (93.5% and 88.9%, respectively). For patients with H. pylori positive dyspepsia, 28.7% of doctors always tried to eradicate the worm and 34.4% treated selectively. A large proportion (28.7%) of primary care physicians treated H. pylori on a patient's request basis. Only 9.3% of primary care physicians always conducted follow-up testing after treating H. pylori infection. When H. pylori was not cleared by the first treatment, 40.7% of doctors reused the same regimen, 16.7% changed to another triple regimen and 25% to a quadruple regimen., Conclusion: It has been well documented that the issuance of guidelines alone has little impact on practice. Communication between primary care physicians and gastroenterologists in the form of continuous medical education is required.