Aims: To assess the trends in calcific aortic valve disease (CAVD) epidemiology, with an emphasis on CAVD mortality, leading risk factors, and their associations with age, period, and birth cohort. Methods and results: Prevalence, disability-adjusted life years, and mortality were derived from the Global Burden of Disease Study 2019. The age–period–cohort model was employed to study the detailed trends of CAVD mortality and its leading risk factors. Globally, CAVD showed unsatisfactory results from 1990 to 2019, with the CAVD deaths of 127 000 in 2019. CAVD mortality was substantially reduced in high socio-demographic index (SDI) countries [−1.45%, 95% confidence interval (CI) (−1.61 to −1.30)], mildly increased in high-middle SDI countries [0.22%, 95% CI (0.06–0.37)], and unchanged in other SDI quintiles. There was a noticeable transition in CAVD deaths from younger to older populations globally. The CAVD mortality increased exponentially with age, and the male had higher mortality than the female before 80 years old. Favourable period [0.69, 95% CI (0.66–0.72)] and birth effects [0.30, 95% CI (0.22–0.43)] were mainly observed in high SDI countries, while unfavourable effects were mostly noticed in high-middle SDI countries. High systolic blood pressure was the leading risk factor of CAVD deaths globally, and it showed favourable trends in high SDI regions. Conclusion: Although CAVD mortality reduction was observed globally, unfavourable period, and cohort effects were found in many countries. Increase of mortality rate among the population ≥85 years was the common challenge across all SDI quintiles, stressing the necessity to further improve health care for CAVD patients worldwide.

A variety of prescribed accommodation periods have been used in published prosthesis intervention studies that have examined biomechanical outcomes. Few investigators included repeated measurements in their study design, leaving questions as to how measured outcomes change as amputees acclimate to a new prosthesis. This paper is the product of our investigation as to whether measured gait variables were affected by the duration of accommodation period, and to assess the relationship between measured outcomes and the subjective perception of the participants. A sample of transtibial amputees were recruited for this study. Gait data was collected by wearable sensor repeatedly, starting immediately after fitting the interventional foot and extending over a subsequent four days. Participants indicated their perceived accommodation quality on a visual analog scale (VAS). A total of twelve commonly used spatiotemporal gait parameters were analyzed. Friedman tests were used to determine overall differences across time points in both early (one hour) and late (day two through five) accommodation phases, for each gait variable. Statistically significant changes across the early phase were found for variables gait speed χ²(2)=8.000, p=0.018, cadence χ²(2)=7.185, p=0.028, and double support time on the sound side χ²(2)=8.615, p=0.013. Across days two through five, no gait variable significantly changed. VAS scores correlated strongly with step count (r=1.000, p<0.001) and cadence (r=0.857, p=0.014). Longer accommodation periods resulted in less deviations of gait variables for the clinical assessment in the process of prosthetic rehabilitation. Trying out prosthetic interventions for less than one hour has yielded unreliable outcomes.

BACKGROUND: Prosthetists conventionally evaluate alignment based on visual interpretation of patients’ gait, which is convenient, but largely subjective and depends on prosthetists’ experience. OBJECTIVE: In this paper, we explore the feasibility of

Background. Berg Balance Scale (BBS) can be considered the standard for assessment of functional balance but has a noted ceiling effect in active transtibial amputees (TTAs). Development of ceiling‐free measures based on quantitative measurement techniques that is suitable for patients in any experience levels, yet sensitive enough to capture improvements in any stage of prosthetic rehabilitation, is needed. Research Question. Does a scoring scheme based on Multiattribute Utility (MAU) theory assess balance abilities of multileveled TTAs comparable to BBS? Methods. A case‐control study including 28 participants (8 novice TTAs, 10 experienced TTAs, and 10 healthy controls) was conducted. Guided by MAU theory, a novel balance model was developed and initially validated by Spearman correlation between index‐generated scores and expert assigned scores, providing preliminary evidence of validity. Floor/ceiling effects were tested, and between‐group comparisons of static/dynamic balance were conducted by paired t‐test or Wilcoxon signed‐rank test depending on data distribution normality. Results. BBS score was correlated with computed balance index (r = 0.847, p < 0.001). The BBS score of novice/experienced TTAs was 39/54, and the computed balance index was 38/75. A ceiling effect of BBS (30%) was observed in the experienced TTA group, whereas no ceiling effects were found for the computed index in any combination of TTA groups. Group differences between novice and experienced TTAs were observed in center of pressure (COP) ellipse shift area, COP path length, COP average velocity, gait speed, and cadence (all p < 0.05). Significance. Evidence from first stage validation of the proposed MAU balance model indicated that the model performed well. This proposed method can monitor the progress of balance for varied experience‐leveled TTAs and provide clinicians with useful information for assessing the rehabilitation training.

Surgical intervention is the preferred approach to prevent further progression of deformity for patients with adolescent idiopathic scoliosis (AIS); among existing surgeries, posterior spinal fusion is predominant. The minimal clinically important difference (MCID) of the total score of the Scoliosis Research Society (SRS)-22r questionnaire is an increase of ≥ 0.4 in surgically treated patients. However, to the best of our knowledge, there is no research exploring the factors influencing SRS-22r total scores exceeding MCID at 2 years postoperatively. Patients who underwent posterior spinal fusion between February 2019 and November 2023 and had a minimum follow-up duration of > 2 years were included. The radiological data and SRS-22r scores were assessed preoperatively and postoperatively. Based on the SRS-22r total scores, the patients were divided into two groups: ‘I’ = Improvement group (∆ Score ≥ 0.4) and ‘NI’ = Non-improvement group (∆ Score < 0.4). Demographic characteristics, radiographic data, and SRS-22r scores were analyzed using chi-square tests and t-tests for comparison. Multivariate logistic regression analysis was used to determine influencing factors. A total of 66 patients with AIS underwent posterior spinal fusion surgery were included in the study. The major Cobb angle decreased from 52.9 ± 12.3° preoperatively to 12.3 ± 8.6° (p < 0.001) at 2 years postoperatively, while the SRS-22r total score improved from 3.9 ± 0.4 to 4.2 ± 0.5 (p < 0.001). Overall, 32 of 66 of patients (48.5%) achieved MCID. Preoperatively, the Improvement group trended toward a larger Cobb angle (p = 0.042). Postoperatively, patients who achieved a greater Cobb angle correction in degrees were more likely to attain the MCID (p = 0.003). Postoperative MCID attainment in patients with AIS is influenced by both the preoperative Cobb angle and the degree of its surgical correction.