Which is better? Early versus delayed rehabilitation after arthroscopic rotator cuff repair.

PURPOSE: This study aimed to compare the 5-year clinical and functional outcomes, including repaired tendon healing status, between early and delayed rehabilitation after arthroscopic rotator cuff repair METHODS: A total of 75 patients with rotator cuff tears (less than 5 cm) underwent arthroscopic repairs over a 60-month period. Participants were randomly assigned to early and delayed postoperative rehabilitation groups with distinct protocols. Clinical and functional outcome measures included Constant score, University of California at Los Angeles (UCLA) score, visual analogue scale for pain and isokinetic dynamometer test for muscle strength recovery. Clinical and functional scores were compared between baseline and 5 years postoperatively. Radiologic assessment via magnetic resonance imaging was performed at a minimum of 12 months postoperatively for evaluations of tendon integrity and recurrent tears. RESULTS: Baseline characteristics showed no statistically significant differences between groups. Both groups demonstrated equivalent improvement in range of motion and pain scores with no statistical differences. Clinical scores improved significantly in both groups by postoperative 12 months and plateaued. At the postoperative 5-year mark, the early group showed better improvement in the visual analogue scale and UCLA score, while the delayed group had superior Constant scores. Postoperative magnetic resonance imaging revealed six recurrent tears, two in the early group and four in the delayed group, with no statistical differences. Muscle strength recovery showed no differences between the two groups. CONCLUSION: Both the early and the delayed rehabilitation groups showed similar outcomes in postoperative range of motion, functional scores, muscle strength recovery and tendon healing in the short- and mid-term follow-ups. LEVEL OF EVIDENCE: Level III.

Developing and Applying an Urban Resilience Index for the Evaluation of Declining Areas: A Case Study of South Korea's Urban Regeneration Sites.

This study attempts to identify the direction of urban regeneration projects in declining areas by using the concept of urban resilience to cope with climate change and disaster. To this end, urban resilience was classified into a Green Resilient Infrastructure (GRI) and an Interactive Safety System (ISS), through a review of previous studies, and categorized into vulnerability, adaptability, and transformability. A total of 12 detailed indicators were derived and indexed using Euclidean distance. Using the indicators, three Korean urban regeneration targets, in Daegu, Mokpo, and Seosan, were selected to evaluate resilience before and after the urban regeneration plan. Consequently, the postplanning resilience index improved in all three target sites, compared to before the regeneration plan. Additionally, previously the regeneration plan showed lower index values in comparison to places not designated as urban regeneration areas. These results suggest that urban resilience needs to be considered in future urban regeneration projects, and that resilience indicators can be used as a means to set the direction of urban regeneration projects. To improve the overall resilience of a region, these indices can help local government establish a reference point for urban resilience in its region.

DoE-Based Design of a Simple but Efficient Preparation Method for a Non-Effervescent Gastro-Retentive Floating Tablet Containing Metformin HCl.

A sustained-release non-effervescent floating matrix tablet was prepared using a simple and efficient direct compression of spray-dried granules containing metformin hydrochloride and cetyl alcohol with hydroxypropyl methylcellulose K15M (HPMC K15M). The design of experiments was employed to explore the optimal composition of the tablet. The similarity factor was employed to evaluate the equivalence in dissolution profiles between the test tablets and Glucophage XR as a reference. Bootstrap analysis was used to eliminate the formulations for which the dissolution profile was potentially inequivalent to that of the reference. The optimized tablet consisting of 150 mg of cetyl alcohol and 17% HPMC K15M showed a dissolution profile comparable with that of the reference with a similarity factor of 52.41, exhibited a floating lag time of less than 3 s in buffer media, remained floating for 24 h, and reduced the tablet weight by about 20% compared to that of the reference. The current study sheds light on the potential use of non-effervescent gastro-retentive extended-release tablets for high-dose drugs using a simple and efficient direct compression method, and as a potential alternative treatment for Glucophage XR. This study also highlights the importance of a systematic approach to formulation optimization and the evaluation of the dissolution profile.

Optimization of in-line near-infrared measurement for practical real time monitoring of coating weight gain using design of experiments.

This study was conducted to develop an in-line near-infrared (NIR) spectroscopy approach that allows real time quantitative analysis of the coating weight gain on a moving tablet surface during a coating process where talc is used. A holder directly inserting a diffuse reflectance probe into a coating pan was designed, and the optimal measurement conditions were identified using the design of experiments (DoE). The surface of the probe was kept clean of coating droplets at a maximum distance between the probe and the holder of 272.5 mm, leading to the acquisition of accurate spectral data. Under this condition, partial least squares regression (PLSR) was developed using the spectra from 7197 to 6233 cm-1, which covers the specific peaks for the core tablet and the coating solution. Under the same conditions, least squares regression (LSR) was developed using the univariate predictive analysis of the single absorption spectrum of talc at 7181 cm-1. In a comparison of the accuracy of the two models, PLSR was found to be more accurate as a result of testing the significance of differences between these distributions in terms of the root mean square errors of prediction (RMSEP) using a randomization t-test. Additionally, it confirmed that the predicted weight gain using NIR spectroscopy was correlated with the coating thickness measured using micro-CT. In conclusion, this study developed an in-line NIR measurement approach for the real-time monitoring of the coating weight gain of tablets and optimized the conditions by evaluating the effect of various factors.

Coating process optimization through in-line monitoring for coating weight gain using Raman spectroscopy and design of experiments.

In this study the authors developed a real-time Process Analytical Technology (PAT) of a coating process by applying in-line Raman spectroscopy to evaluate the coating weight gain, which is a quantitative analysis of the film coating layer. The wide area illumination (WAI) Raman probe was connected to the pan coater for real-time monitoring of changes in the weight gain of coating layers. Under the proposed in-line Raman scheme, a non-contact, non-destructive analysis was performed using WAI Raman probes with a spot size of 6 mm. The in-line Raman probe maintained a focal length of 250 mm, and a compressed air line was designed to protect the lens surface from spray droplets. The Design of Experiment (DOE) was applied to identify factors affecting the Raman spectra background of laser irradiation. The factors selected for DOE were the strength of compressed air connected to the probe, and the shielding of light by the transparent door connecting the probe to the pan coater. To develop a quantitative model, partial least squares (PLS) models as multivariate calibration were developed based on the three regions showing the specificity of TiO2 individually or in combination. For the three single peaks (636 cm-1, 512 cm-1, 398 cm-1), least squares method (LSM) was applied to develop three univariate quantitative analysis models. One of best multivariate quantitative model having a factor of 1 gave the lowest RMSEP of 0.128, 0.129, and 0.125, respectively for prediction batches. When LSM was applied to the single peak at 636 cm-1, the univariate quantitative model with an R2 of 0.9863, slope of 0.5851, and y-intercept of 0.8066 had the lowest RMSEP of 0.138, 0.144, and 0.153, respectively for prediction batches. The in-line Raman spectroscopic method for the analysis of coating weight gain was verified by considering system suitability and parameters such as specificity, range, linearity, accuracy, and precision in accordance with ICH Q2 regarding method validation. The proposed in-line Raman spectroscopy can be utilized as a PAT for product quality assurance as it offers real-time monitoring of quantitative changes in coating weight gain and process end-points during the film coating process.