InSpace Balloon for the Management of Massive Irreparable Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Mohammad Daher,Adam Pearl,Zalaquett Ziad,Bassem T. Elhassan,Joseph A. Abboud,Mohamad Y. Fares,Khaled J. Saleh 대한정형외과학회 2023 Clinics in Orthopedic Surgery Vol.15 No.5

Background: The best course of action for massive irreparable rotator cuff tears (MIRCTs) is not universally agreed upon. Numerous surgical techniques have been discussed. The implantation of a biodegradable spacer into the subacromial area has been documented since 2012 by several authors. The implantation method is touted as being simpler, repeatable, and less invasive than other solutions that are now available. The purpose of this systematic review and meta-analysis, being the first of its kind, was to evaluate the literature to see the efficacy of InSpace balloon (ISB) implantation in the management of MIRCTs. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and with 2 researchers assessing and analyzing each study separately, an extensive electronic search of the literature was conducted in the PubMed database from 1961 until July 27, 2022. Results: Fourteen studies were included in this systematic review and three in the meta-analysis. Eleven out of fourteen studies favored ISB use for MIRCTs, while only three were against its use. All spacers were arthroscopically implanted in the subacromial space. Three studies were included in the meta-analysis. The differences in the compared outcomes were statistically insignificant. Conclusions: A controversy about the use of ISB remains in patients with MIRCTs. Both good and bad outcomes were reported. However, the majority of patients had good clinical outcomes across several grading scales, radiographic evidence of improved impingement, and self-report that they would redo the procedure in hindsight. To draw more solid conclusions and have statistically significant results in the meta-analysis, more randomized controlled trials and comparative studies comparing this device to other treatments are needed.

A Review of the Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Lean Body Mass in Humans

Jack Alistair Sargeant,Joseph Henson,James Adam King,Thomas Yates,Kamlesh Khunti,Melanie Jane Davies 대한내분비학회 2019 Endocrinology and metabolism Vol.34 No.3

Weight loss is an important goal in the management of several chronic conditions, including type 2 diabetes mellitus, and pharmacological therapies that aid weight loss are appealing. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) are novel glucose-lowering therapies that have been shown to induce clinically significant reductions in body weight. However, this weight loss may not be attributed solely to fat mass (FM). Given the importance of skeletal muscle and lean body mass (LBM) on cardio-metabolic health and physical function, we reviewed the available literature reporting theeffects of GLP-1RAs and SGLT2is on body composition. Results demonstrate that, in most circumstances, the weight loss associatedwith both therapies predominantly comprises a reduction in FM, although significant heterogeneity exists between studies. In overhalf of the studies identified, the proportion of LBM reduction ranged between 20% and 50% of total weight lost, which is consistentwith diet-induced weight loss and bariatric surgery. No clear differences existed between GLP-1RAs and SGLT2is. Consequently,the loss of LBM and skeletal muscle associated with weight loss induced by GLP-1RAs and SGLT2is warrants attention. Strategiesto preserve skeletal muscle and improve physical function, for example through structured exercise, are of great importance.

Study design of Real World Evidence for Treatment of Hyperkalemia in the Emergency Department (REVEAL-ED): a multicenter, prospective, observational study

Zubaid Rafique,Mikhail Kosiborod,Carol L. Clark,Adam J. Singer,Stewart Turner,Joseph Miller,Douglas Char,W. Frank Peacock IV 대한응급의학회 2017 Clinical and Experimental Emergency Medicine Vol.4 No.3

Objective Hyperkalemia affects up to 10% of hospitalized patients and, if left untreated, can lead to serious cardiac arrhythmias or death. Although hyperkalemia is frequently encountered in the emergency department (ED), and is potentially life-threatening, standard of care for the treatment is poorly defined, with little supporting evidence. The main objectives of this observational study are to define the overall burden of hyperkalemia in the ED setting, describe its causes, the variability in treatment patterns and characterize the effectiveness and safety of ED standard of care therapies used in the United States. Methods This is an observational study evaluating the management of hyperkalemia in the ED. Two hundred and three patients who presented to the ED with a potassium value ≥5.5 mmol/L were enrolled in the study at 14 sites across the United States. Patients were treated per standard of care practices at the discretion of the patient’s physician. In patients who received a treatment for hyperkalemia, blood samples were drawn at pre-specified time points and serum potassium values were recorded. The change in potassium over 4 hours and the adverse events after standard of care treatment were analyzed. Results and Conclusion This article describes the background, rationale, study design, and methodology of the REVEAL-ED (Real World Evidence for Treatment of Hyperkalemia in the Emergency Department) trial, a multicenter, prospective, observational study evaluating contemporary management of patients admitted to the ED with hyperkalemia.

A Systematic Review of Randomized Controlled Trials Comparing Buccal Mucosal Graft Harvest Site Non-Closure versus Closure in Patients Undergoing Urethral Reconstruction

Hwang Eu Chang,de Fazio Adam,Hamilton Kallie,Bakker Caitlin,Pariser Joseph J.,Dahm Philipp 대한남성과학회 2022 The World Journal of Men's Health Vol.40 No.1

Purpose: To assess the effects of buccal mucosal graft site non-closure versus closure on postoperative oral morbidity for male undergoing augmentation urethroplasty for urethral stricture. Materials and Methods: We included randomized controlled trials. Inclusion criteria were male over the age of 18 with urethral stricture disease requiring reconstruction with buccal mucosal graft harvest. Primary outcomes of the review were postoperative oral pain, need for secondary oral procedures and cosmetic defects. Results: We included 5 studies with 346 randomized patients with urethral strictures, of whom 260 completed the trials. In terms of primary outcomes, non-closure graft site may reduce oral pain on postoperative day #1 (standard mean difference [SMD] 0.24 lower; 95% confidence interval [CI] 0.61 lower to 0.12 higher; low certainty evidence [CoE]) but we are uncertain how this impacts pain on postoperative days 3 to 6 (SMD 0.35; 95% CI 0.12 to 0.81 higher; very low CoE). We are also very uncertain as to how it affects the need for secondary oral procedures (risk ratio [RR] 0.22; 95% CI 0.01 to 4.28; very low CoE). Non-closure may increase the risk of cosmetic defects (RR 2.40; 95% CI 0.93 to 6.22; low CoE). Conclusions: This review describes the trade-off for buccal mucosal graft site non-closure versus closure for various patientimportant outcomes; decision-making will likely hinge on the relative value individual patients and surgeons place on them. The supporting evidence was rated as low and very low, thereby signaling substantial underlying uncertainty and the need for better trials.

Initial Ignition Time and Calorific Value Enhancement of Briquette with Added Pine Resin

Gustan PARI,Lisna EFIYANTI,Saptadi DARMAWAN,Nur Adi SAPUTRA,Djeni HENDRA,Joseph ADAM,Alfred INKRIWANG,Rachman EFFENDI 한국목재공학회 2023 목재공학 Vol.51 No.3

The increasing demand for clean energy requires considerable effort to find alternative energy sources, such as briquettes. This research aims to develop a charcoal briquette with added pine resin (API) that has excellent combustion speed and distinctive aroma. Briquettes are composed of charcoal, pine resin (concentration: 0%–30%), and starch (up to 7%). They are produced in several stages, including coconut shell pyrolysis in conventional combustion, to obtain charcoal for the briquette precursor. Briquette compaction is conducted by mixing and densifying the charcoal, pine resin, and starch using a hydraulic press for 3 min. The hydraulic press has a total surface area and diameter of 57.7 cm2 and 3.5 cm, respectively. The briquettes are dried at different temperatures, reaching 70℃ for 24 h. The study results show that the briquettes have a thickness and diameter of up to 2 and 3.5 cm, respectively; moisture of 2.18%–2.62%; ash of 11.61%–13.98%; volatile matter of 27.15%– 51.74%; and fixed carbon content of 40.24%–59.46%. The compressive strength of the briquettes is 186–540 kg/cm2. Their calorific value is 5,338–6,120 kcal/kg, combusting at a high speed of 0.15–0.40 s. The methoxy naphthalene, phenol, benzopyrrole, and lauryl alcohol; ocimene, valencene, and cembrene are found in the API. The API briquette has several chemical compounds, such as musk ambrette, ocimene, sabinene, limonene, 1-(p-cumenyl) adamantane, butane, and propanal, which improve aroma, drug application, and fuel production. Accordingly, API briquettes have considerable potential as an alternative energy source and a health improvement product.

Cerebral critical closing pressure in hydrocephalus patients undertaking infusion tests.

Varsos, Georgios V,Czosnyka, Marek,Smielewski, Peter,Garnett, Matthew R,Liu, Xiuyun,Kim, Dong-Joo,Donnelly, Joseph,Adams, Hadie,Pickard, John D,Czosnyka, Zofia Butterworths [etc.] 2015 Neurological research Vol.37 No.8

<P>Links between cerebrospinal fluid (CSF) compensation and cerebral blood flow (CBF) have been studied in many clinical scenarios. In hydrocephalus, disturbed CSF circulation seems to be a primary problem, having been linked to CBF disturbances, particularly in white matter close to surface of dilated ventricles. We studied possible correlations between cerebral haemodynamic indices using transcranial Doppler (TCD) ultrasonography and CSF compensatory dynamics assessed during infusion tests.</P>

High-resolution tunnelling spectroscopy of a graphene quartet

Song, Young Jae,Otte, Alexander F.,Kuk, Young,Hu, Yike,Torrance, David B.,First, Phillip N.,de Heer, Walt A.,Min, Hongki,Adam, Shaffique,Stiles, Mark D.,MacDonald, Allan H.,Stroscio, Joseph A. Nature Publishing Group, a division of Macmillan P 2010 Nature Vol.467 No.7312

Electrons in a single sheet of graphene behave quite differently from those in traditional two-dimensional electron systems. Like massless relativistic particles, they have linear dispersion and chiral eigenstates. Furthermore, two sets of electrons centred at different points in reciprocal space (??valleys??) have this dispersion, giving rise to valley degeneracy. The symmetry between valleys, together with spin symmetry, leads to a fourfold quartet degeneracy of the Landau levels, observed as peaks in the density of states produced by an applied magnetic field. Recent electron transport measurements have observed the lifting of the fourfold degeneracy in very large applied magnetic fields, separating the quartet into integer and, more recently, fractional levels. The exact nature of the broken-symmetry states that form within the Landau levels and lift these degeneracies is unclear at present and is a topic of intense theoretical debate. Here we study the detailed features of the four quantum states that make up a degenerate graphene Landau level. We use high-resolution scanning tunnelling spectroscopy at temperatures as low as 10??mK in an applied magnetic field to study the top layer of multilayer epitaxial graphene. When the Fermi level lies inside the fourfold Landau manifold, significant electron correlation effects result in an enhanced valley splitting for even filling factors, and an enhanced electron spin splitting for odd filling factors. Most unexpectedly, we observe states with Landau level filling factors of 7/2, 9/2 and 11/2, suggestive of new many-body states in graphene.