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Purpose: This review investigated the effectiveness of adjuvant therapy combined with constraint-induced movement therapy (CIMT) in improving the paretic upper limb functionality in adults with stroke sequelae during the subacute to chronic rehabilitation phase. Materials and methods: In this systematic review and meta-analysis of randomized controlled trials (RCT), electronic databases, including PubMed, Web of Science, CINAHL, and MEDLINE, were searched. We included RCTs that investigated the outcomes of adjuvant therapy (i.e. other therapies) added to CIMT compared with CIMT alone. Key trial findings were qualitatively synthesized and analyzed. This meta-analysis examined variables, such as mean scores and standard deviations, using the following outcome measures: Fugl-Meyer Assessment (FMA) upper limb items, Action Research Arm Test (ARAT), Amount of Use (AOU) of Motor Activity Log (MAL), and Quality of Movement (QOM) of MAL. Results: Eighteen eligible RCTs were included in the analysis. Adding CIMT to adjunctive therapy significantly improved FMA compared with CIMT alone (mean difference [MD] 4.02, 95% confidence interval [CI] 2.60–5.44; I2 = 85%; 15 studies; 330 participants). Similarly, the ARAT and MAL-AOU scores improved significantly. Conclusions: CIMT combined with several adjunctive therapies effectively improved upper limb function. IMPLICATIONS FOR REHABILITATION: In recent years, clinical trials combining other therapies with Constraint-induced movement therapy (CIMT) have become increasingly common. This study shows that combining CIMT with adjuvant therapy improves upper limb function. Different protocols of the CIMT in each study could be factor that impacted the results of Motor Activity Log. In clinical practice, the findings of this study into their treatment protocols to improve patient outcomes and ensure the effective application of evidence-based rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Boron carbide (B4C)–stainless steel (SS) eutectic reaction behavior is one of the most important issues in the core disruptive accidents (CDAs) of sodium-cooled fast reactors (SFRs). In this study, the immersion experiments using B4C pellets with molten SS were conducted to evaluate the CDA sequences such as contact event of solid B4C with degraded core materials including SS at very high temperature. The immersion experiment aims at understanding the kinetic behavior of solid B4C–liquid SS reaction based on the reduced thickness of B4C pellet after the experiment in the temperature ranges from 1763 to 1943 K, which is higher than the temperature of solid B4C–solid SS reaction. Based on the kinetic consideration of the reaction rate constants for solid B4C–liquid SS reaction, it was found that similar temperature dependency was identified between solid B4C–liquid SS and solid B4C–solid SS. Besides, the reaction rate constants of solid B4C–liquid SS were smaller than those of solid B4C–solid SS extrapolated in higher temperature region by two or more orders of magnitude due to two different evaluation method for B4C side/SS side. It was confirmed that this difference was reasonable through the consideration of previous reaction tests in solid–solid contact for B4C side/SS side. [ABSTRACT FROM AUTHOR]

Background: Distal humerus fracture in the elderly is a challenging fracture for orthopedic surgeons. Non-union is one of the serious complications of distal humerus fracture after surgery. This retrospective multicenter study aimed to estimate the incidence of distal humeral non-union after open reduction and internal fixation, determine factors related to non-union, and compare the postoperative results of cases with non-union to cases with the union. Methods: Among 423 patients diagnosed with distal humeral fracture and who were treated by surgical therapy in 2010–2020 from our database called TRON. Only 190 subjects met the inclusion criteria. We performed a logistic regression analysis with the presence of non-union as the response variable to examine risk factors. We compare the Mayo Elbow Performance Scores of cases with non-union to cases with the union. Results: Non-union occurred after surgery in 15 patients (7.9%). The logistic regression analysis showed that body mass index<20 kg/m2 and ≥25 kg/m2, and ≤3 screws in the articular segment were significant explanatory factors for non-union (odds ratio 10.4 and 47.8, respectively). The Mayo Elbow Performance Scores were significantly worse in patients with non-union. Discussion: Low and high body mass index and three or fewer screws in the articular segment might be risk factors for non-union of distal humerus fracture in the elderly. Non-union is associated with poor clinical outcomes. [ABSTRACT FROM AUTHOR]

Aim: To assess whether oral semaglutide provides better glycaemic control, compared with dipeptidyl peptidase‐4 inhibitor (DPP‐4i) continuation, in people with type 2 diabetes. Materials and Methods: In this multicentre, open‐label, prospective, randomized, parallel‐group comparison study, participants receiving DPP‐4is were either switched to oral semaglutide (3‐14 mg/day) or continued on DPP‐4is. The primary endpoint was the change in glycated haemoglobin (HbA1c) over 24 weeks. Secondary endpoints included changes in metabolic parameters and biomarkers, along with the occurrence of adverse events. Factors associated with HbA1c improvement were also explored. Results: In total, 174 eligible participants were enrolled; 17 dropped out of the study. Consequently, 82 participants in the DPP‐4i group and 75 participants in the semaglutide group completed the study and were included in the analysis. Improvement in HbA1c at week 24 was significantly greater when switching to semaglutide compared with DPP‐4i continuation [−0.65 (95% confidence interval: −0.79, −0.51) vs. +0.05 (95% confidence interval: −0.07, 0.16) (p <.001)]. Body weight, lipid profiles and liver enzymes were significantly improved in the semaglutide group than in the DPP‐4i continuation group. Multiple linear regression analysis revealed that baseline HbA1c and homeostasis model assessment 2‐R were independently associated with HbA1c improvement after switching to semaglutide. Seven participants in the semaglutide group discontinued medication because of gastrointestinal symptoms. Conclusions: Although the potential for gastrointestinal symptoms should be carefully considered, switching from DPP‐4is to oral semaglutide may be beneficial for glycaemic control and metabolic abnormalities in people with higher HbA1c and insulin resistance. [ABSTRACT FROM AUTHOR]