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An evaluation of scapula position is important to predict spine curvature and shoulder function in patients with adolescent idiopathic scoliosis (AIS). Therefore, a reliable scapula position is required to assess posture in patients with AIS. This study investigated the reliabilities of scapula position tests and differences in scapula position and shoulder function between individuals with and without AIS. The study compared 18 patients with AIS and 18 healthy controls to identify differences in scapula position and shoulder function. The acromion-table distance, lateral displacement of the scapula, acromion depression, winged scapula, upward rotation of the scapula, and anterior tilt of the scapula were measured. Scapula position test reliabilities were assessed using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum clinically important difference (MCID). Shoulder function was measured using the Shoulder Pain and Disability Index. The reliabilities of scapula position tests (ICC 0.85–0.93, SEM 0.1–1.2, and MCID 0.2–2.5) were good. There were significant differences in scapula position and shoulder function between patients with AIS and healthy controls (p< 0.05). Scapula position tests were highly reliable in patients with AIS; they can be used to evaluate scapula position during clinical assessment of posture in patients with AIS. [ABSTRACT FROM AUTHOR]

Simple Summary: Spinal metastases can cause instability, making it difficult for clinicians to decide on the best treatment. While guidelines exist for stable and unstable spinal metastases, those with intermediate instability (a SINS of 7–12) pose a clinical challenge. This study examines risk factors that might require surgical intervention following initial radiotherapy in these patients. We analyzed data from 469 patients with spinal metastases treated between 2019 and 2021. Our findings show that patients with primary tumors in the lung, liver, or kidney, higher Bilsky grades of spinal cord compression, lytic bone lesions, and higher radiation doses are more likely to need surgery. These results suggest that the careful evaluation of these factors can help us to develop better treatment strategies for patients with intermediate spinal instability. Background: One important determinant in choosing a treatment modality is spinal instability. Clear management guidelines are suggested for stable and unstable spinal metastatic lesions, but lesions in the intermediate instability category (SINS [spinal instability neoplastic score] score of 7–12) remain a clinical dilemma. This study aims to analyze the risk factors necessitating surgical intervention after radiotherapy (RT) in patients with those lesions. Methods: A multicenter cohort of 469 patients with spinal metastases of intermediate instability who received radiotherapy (RT) as the initial treatment between 2019 and 2021 were retrospectively enrolled. All patients were neurologically intact at the time of RT. According to the performance of surgical intervention after RT, various clinical and radiographic risk factors for surgical intervention were compared between surgery and non-surgery groups using uni- and multivariate analyses. A recursive partitioning analysis (RPA) was performed using significant determinants identified in multivariate analysis. Results: The mean age at the time of RT was 59.9 years and there were 198 females. The lung was the most common primary site. During the mean follow-up duration of 18.2 months, surgical treatment was required in 79 (17.9%) of patients. The most common surgical method was decompressive laminectomy with stabilization (62.0%), followed by vertebrectomy with stabilization (22.8%) and stabilization only (15.2%). The mean SINS for the total cohort was 9.0. Multivariate regression analyses revealed that the primary tumor site of the lung, liver, and kidney, higher Bilsky grades of ESCC, lytic bone lesions, and higher EQD210 were significant risk factors for surgical intervention after RT. Among them, Bilsky grade, primary tumor type of the lung, liver, and kidney, and EQD210 were the most important determinants for expecting the probability of surgical intervention on RPA. Conclusions: Surgical intervention was performed in 17.9% of patients with intermediate instability after RT as the initial treatment. The primary tumor site of the lung, liver, and kidney, higher Bilsky grade of ESCC, and EQD210 were the most important determinants for expecting the probability of surgical intervention. Therefore, the optimal treatment strategy needs to be devised by carefully evaluating the risk of surgical intervention. [ABSTRACT FROM AUTHOR]

Aims Evidence of an association between atrial fibrillation (AF) and sudden cardiac arrest (SCA) in young adults is limited. In this study, we aim to evaluate this association in a general population aged between 20 and 39 years. Methods and results Young adults who underwent health check-ups between 2009 and 2012 were screened from a nationwide healthcare database in South Korea. A history of AF diagnosis before the health check-ups was identified based on the relevant International Classification of Diseases, 10th edition codes reported in the database. Associations between an established diagnosis of AF and the risk of SCA during follow-up were examined. A total of 6 345 162 young people were analysed with a mean follow-up duration of 9.4 years. The mean age was 30.9 ± 5.0 years, and 5875 (0.09%) individuals were diagnosed with AF. During follow-up, SCA occurred in 5352 (0.08%) individuals, and the crude incidence was 0.56 and 0.09 events per 1000 person-years for participants with and without AF, respectively. Individuals with AF had a 3.0-fold higher risk in a multivariate model adjusted for age, sex, lifestyle, anthropometric data, and medical comorbidities (adjusted hazard ratio 2.96, 95% confidence interval 1.99–4.41, P < 0.001). Both incident and prevalent AFs were associated with an increased risk of SCA, with no significant differences between the two groups. Conclusion Atrial fibrillation was associated with a significantly higher risk of SCA developing in healthy young adults. Whether the rate or rhythm control influences the risk of SCA in young patients with AF remains to be examined. [ABSTRACT FROM AUTHOR]

The impact of community-based tourism (CBT) on residents' quality of life (QOL) has been realized in many aspects, concerning attitude, physical, environmental, and relationships in society. However, several positive and negative factors influence QOL, and few studies have explored these factors. Focusing on measuring the significant CBT factors that have not been previously explored and examined, this study explored factors that influence QOL in CBT using factor analysis. The results show that CBT factors measuring residents' QOL, such as economic, public administration, technology, external actors, and social inequalities in several community-based attributes, can measure the effect on residents' QOL. This study emphasizes that CBT factors are suitably performed and managed can dynamically reduce and alleviate the impacts on residents' QOL. [ABSTRACT FROM AUTHOR]

Background: Teriparatide is an anabolic agent for osteoporosis and is believed to improve the bone healing process. Previous studies showed that teriparatide could enhance not only fracture healing but also spine fusion. It has been reported that use of teriparatide could promote the spine fusion process and decrease mechanical complications. However, there was no consensus regarding optimal treatment duration. The purpose of this study was to compare surgical outcomes between short-duration and long-duration teriparatide treatment after lumbar fusion surgery in elderly patients. Materials and Methods: All consecutive patients older than 60 years who underwent 1-level lumbar fusion surgery for degenerative diseases between January 2015 and December 2019 were retrospectively reviewed. Based on the duration of teriparatide treatment (daily subcutaneous injection of 20 µg teriparatide), patients were subdivided into two groups: a short-duration (SD) group (<6 months) and a long-duration (LD) group (≥6 months). Mechanical complications, such as screw loosening, cage subsidence, and adjacent vertebral fractures, were investigated. Postoperative 1-year union rate was also evaluated on computed tomography. Clinical outcomes were recorded using visual analog scale (VAS) and Oswestry Disability Index (ODI). Between-group differences for these radiographic and clinical outcomes were analyzed. Results: Ninety-one patients were reviewed in this study, including sixty patients in the SD group and thirty-one patients in the LD group. Their mean age was 72.3 ± 6.2 years, and 79 patients were female. Mean T-score was −3.3 ± 0.8. Cage subsidence (6.7% vs. 3.2%), screw loosening (28.3% vs. 35.5%), and adjacent vertebral fracture (6.7% vs. 9.7%) were not significantly different between the SD and LD groups. Union rate at 1-year postoperative was 65.0% in the SD group and 87.1% in the LD group (p = 0.028). Both groups showed improvement in VAS and ODI after surgery. However, the differences of VAS from preoperative to 6 months and 1 year postoperative were significantly higher in the LD group. Conclusions: Longer teriparatide treatment after lumbar fusion surgery resulted in a higher union rate at 1-year postoperative than the shorter treatment. Also, it could be more beneficial for clinical outcomes. [ABSTRACT FROM AUTHOR]

Polymorphism in transition metal dichalcogenides (TMDs) allows unique physical properties to be controlled, such as artificial heavy fermion phenomena, the quantum spin Hall effect, and optimized device operations with 2D materials. Besides lattice structural and metal‐semiconductor polymorphs, intriguing charge density wave (CDW) states with different electronic and magnetic phases are demonstrated in TMDs. Typically, the "normal" state is stabilized at high temperature above the CDW energy scale, and therefore, is not relevant to many low‐temperature quantum phenomena, such as magnetic ordering and the heavy fermion Kondo state. Here, a local and robust phase manipulation of the normal (1T) and CDW (1T') states of VTe2 is reported by laser irradiation, and polymorphic Kondo effects are demonstrated with the two phases at low temperatures. The theoretical calculations show that Kondo screening of vanadium 3d electron moments is markedly enhanced in 1T'‐VTe2, which is responsible for the observed transport properties distinct from its 1T counterpart. Controlling the spin‐lattice coupling and Kondo physics via laser‐driven CDW phase patterning allows the design of correlated electronic and magnetic properties in TMDs. [ABSTRACT FROM AUTHOR]