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Iranian Journal of Public Health Jan 2021Conspicuity has been one of the key factors in motorcycle road crashes around the world. The inability and difficulty of other road users in detecting motorcycles either... (Review)
Review
BACKGROUND
Conspicuity has been one of the key factors in motorcycle road crashes around the world. The inability and difficulty of other road users in detecting motorcycles either at day or at night have contributed to conspicuity related motorcycle crashes. This literature review attempts to understand the motorcycle conspicuity issues in road traffic. The review also analyses relevant types of conspicuity intervention in terms of its effectiveness in enhancing motorcycle conspicuity that had been discussed in past studies.
METHODS
Using specific keywords and search terms, relevant articles were screened, identified and analyzed systematically using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
Twenty-seven final articles were reviewed and found that almost every part of motorcycle and motorcyclist's conspicuity intervention have been covered in past studies. In terms of conspicuity aids, the majority of past studies discussed conspicuity enhancement in the frontal area, particularly on motorcycle daytime running headlight (DRH) color and configurations. Few other studies have discussed in other areas, particularly on rear running and brake light and motorcycle color. There were also numerous studies looking at motorcyclists' appearances in terms of their attire and helmet color.
CONCLUSION
Motorcycle and motorcyclist's appearances are highly associated with the risk of motorcycle crashes. The most important part of enhancing motorcycle conspicuity is to ensure motorcycle appearance is always in contrast with the road traffic environment.
PubMed: 34178761
DOI: 10.18502/ijph.v50i1.5069 -
Journal of Neuroengineering and... Dec 2022Spasticity is defined as "a motor disorder characterised by a velocity dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks". It is a... (Review)
Review
BACKGROUND
Spasticity is defined as "a motor disorder characterised by a velocity dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks". It is a highly prevalent condition following stroke and other neurological conditions. Clinical assessment of spasticity relies predominantly on manual, non-instrumented, clinical scales. Technology based solutions have been developed in the last decades to offer more specific, sensitive and accurate alternatives but no consensus exists on these different approaches.
METHOD
A systematic review of literature of technology-based methods aiming at the assessment of spasticity was performed. The approaches taken in the studies were classified based on the method used as well as their outcome measures. The psychometric properties and usability of the methods and outcome measures reported were evaluated.
RESULTS
124 studies were included in the analysis. 78 different outcome measures were identified, among which seven were used in more than 10 different studies each. The different methods rely on a wide range of different equipment (from robotic systems to simple goniometers) affecting their cost and usability. Studies equivalently applied to the lower and upper limbs (48% and 52%, respectively). A majority of studies applied to a stroke population (N = 79). More than half the papers did not report thoroughly the psychometric properties of the measures. Analysis identified that only 54 studies used measures specific to spasticity. Repeatability and discriminant validity were found to be of good quality in respectively 25 and 42 studies but were most often not evaluated (N = 95 and N = 78). Clinical validity was commonly assessed only against clinical scales (N = 33). Sensitivity of the measure was assessed in only three studies.
CONCLUSION
The development of a large diversity of assessment approaches appears to be done at the expense of their careful evaluation. Still, among the well validated approaches, the ones based on manual stretching and measuring a muscle activity reaction and the ones leveraging controlled stretches while isolating the stretch-reflex torque component appear as the two promising practical alternatives to clinical scales. These methods should be further evaluated, including on their sensitivity, to fully inform on their potential.
Topics: Humans; Muscle Spasticity; Reflex, Stretch; Stroke Rehabilitation; Stroke; Technology
PubMed: 36494721
DOI: 10.1186/s12984-022-01115-2 -
Clinical Ophthalmology (Auckland, N.Z.) 2023Sclerochoroidal calcification (SCC) is a rare disease which is characterized by calcium deposition in the sclera. The choroid is secondarily involved. Typical... (Review)
Review
Sclerochoroidal calcification (SCC) is a rare disease which is characterized by calcium deposition in the sclera. The choroid is secondarily involved. Typical localization is in the midperipheral region, outside the vascular arcades. SCC is mostly located in the superotemporal quadrant. Often times, the patients are referred with the diagnosis of an amelanotic tumor. SCC may be dystrophic or metastatic. Metastatic SCC lesions are associated with conditions altering calcium and phosphate metabolism including primary and secondary hyperparathyroidism, vitamin D intoxication, renal failure, hyperphosphatemia, and destructive bony lesions. SCC lesions have a characteristic appearance and appear as distinct, ill-defined, yellow-white, elevated scleral/choroidal masses funduscopically. The purpose of this literature review is to review the current knowledge on SCC, highlight the imaging features, and discuss the differential diagnosis as well as management options.
PubMed: 37720010
DOI: 10.2147/OPTH.S399058 -
Journal of Medical Internet Research Dec 2023Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position... (Review)
Review
BACKGROUND
Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position ECAs as innovative tools for delivering interventions for promoting health-related behavior adoption. This includes motivational interviewing (MI), a therapeutic approach that combines brief interventions with motivational techniques to encourage the adoption of healthier behaviors.
OBJECTIVE
This study aims to identify the health issues addressed by ECAs delivering MI interventions, explore the key characteristics of these ECAs (eg, appearance, dialogue mechanism, emotional model), analyze the implementation of MI principles and techniques within ECAs, and examine the evaluation methods and primary outcomes of studies that use ECAs providing MI interventions.
METHODS
We conducted a scoping review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) methodology. Our systematic search covered the PubMed, Scopus, IEEE Xplore, ACM Digital, and PsycINFO databases for papers published between January 2008 and December 2022. We included papers describing ECAs developed for delivering MI interventions targeting health-related behaviors and excluded articles that did not describe ECAs with human appearances and without the necessary evaluation or MI explanation. In a multistage process, 3 independent reviewers performed screening and data extraction, and the collected data were synthesized using a narrative approach.
RESULTS
The initial search identified 404 articles, of which 3.5% (n=14) were included in the review. ECAs primarily focused on reducing alcohol use (n=5, 36%), took on female representations (n=9, 64%), and gave limited consideration to user ethnicity (n=9, 64%). Most of them used rules-driven dialogue mechanisms (n=13, 93%), include emotional behavior to convey empathy (n=8, 57%) but without an automatic recognition of user emotions (n=12, 86%). Regarding MI implementation, of 14 studies, 3 (21%) covered all MI principles, 4 (29%) included all processes, and none covered all techniques. Most studies (8/14, 57%) conducted acceptability, usability, and user experience assessments, whereas a smaller proportion (4/14, 29%) used randomized controlled trials to evaluate behavior changes. Overall, the studies reported positive results regarding acceptability, usability, and user experience and showed promising outcomes in changes in attitudes, beliefs, motivation, and behavior.
CONCLUSIONS
This study revealed significant advancements in the use of ECAs for delivering MI interventions aimed at promoting healthier behaviors over the past 15 years. However, this review emphasizes the need for a more in-depth exploration of ECA characteristics. In addition, there is a need for the enhanced integration of MI principles, processes, and techniques into ECAs. Although acceptability and usability have received considerable attention, there is a compelling argument for placing a stronger emphasis on assessing changes in attitudes, beliefs, motivation, and behavior. Consequently, inclusion of more randomized controlled trials is essential for comprehensive intervention evaluations.
Topics: Humans; Female; Motivational Interviewing; Health Behavior; Communication; Motivation; Emotions
PubMed: 38064707
DOI: 10.2196/52097 -
International Journal of Nursing Studies Oct 2023Pressure ulcers are a major health concern. They have a significant impact on the healthcare system and individuals, reducing quality of life across several domains. In... (Review)
Review
BACKGROUND
Pressure ulcers are a major health concern. They have a significant impact on the healthcare system and individuals, reducing quality of life across several domains. In community settings, self-management behaviours are central to their prevention. However, adherence with pressure ulcer prevention guidelines remains low, with little evidence guiding the relationship between patients and healthcare professionals to establish a concordant partnership.
OBJECTIVE
To synthesise evidence on factors contributing to community-based pressure ulcer prevention using the Theoretical Domains Framework and the Capability, Opportunity, Motivation, Behaviour (COM-B) model of behaviour.
DESIGN
Mixed methods systematic review and narrative synthesis.
METHOD
Systematic searches were conducted in the CINAHL, Cochrane, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases on 14th December 2022. Studies were eligible if they contained data on the factors associated with adherence and concordance with pressure ulcer prevention guidelines in the community for patients, caregivers, and healthcare professionals. Methodological quality was assessed using the Hawker tool. Findings were synthesised using the Theoretical Domains Framework. The resulting themes were mapped onto the Capability, Opportunity, Motivation, Behaviour (COM-B) model.
RESULTS
Thirty studies were included in the review, including quantitative, qualitative, and mixed methods research. The synthesis identified 12 of the 14 Theoretical Domains Framework domains, with knowledge, social influences, beliefs about consequences, and beliefs about capabilities the most prevalent. Although knowledge appears to be an important contributor to adherence with prevention guidelines, knowledge alone does not appear sufficient to achieve concordance. A concordant relationship was facilitated by healthcare professionals' knowledge, motivation to work alongside patients and their priorities, and interpersonal skills to build rapport and trust, whilst barriers included lack of healthcare professional skills to navigate sensitive issues, paternalistic views of patient compliance and organisational processes that impact building rapport.
CONCLUSIONS
Several psychosocial factors may affect the ability to achieve concordance between individuals, caregivers and healthcare professionals with pressure ulcer prevention guidelines in the community. However, data regarding the efficacy of behaviour change interventions targeting these constructs is limited, with further research required to guide intervention development in this area.
Topics: Humans; Pressure Ulcer; Quality of Life; Motivation; Health Personnel; Patient Compliance; Qualitative Research
PubMed: 37542960
DOI: 10.1016/j.ijnurstu.2023.104561 -
Sleep Medicine Reviews Apr 2018An increased incidence of narcolepsy was seen in many countries after the pandemic H1N1 influenza vaccination campaign in 2009-2010. The H1N1 vaccine - narcolepsy... (Meta-Analysis)
Meta-Analysis Review
An increased incidence of narcolepsy was seen in many countries after the pandemic H1N1 influenza vaccination campaign in 2009-2010. The H1N1 vaccine - narcolepsy connection is based on observational studies that are prone to various biases, e.g., confounding by H1N1 infection, and ascertainment, recall and selection biases. A direct pathogenic link has, however, remained elusive. We conducted a systematic review and meta-analysis to analyze the magnitude of H1N1 vaccination related risk and to examine if there was any association with H1N1 infection itself. We searched all articles from PubMed, Web of Science and Scopus, and other relevant sources reporting the incidence and risk of post-vaccine narcolepsy. In our paper, we show that the risk appears to be limited to only one vaccine (Pandemrix). During the first year after vaccination, the relative risk of narcolepsy was increased 5 to 14-fold in children and adolescents and 2 to 7-fold in adults. The vaccine attributable risk in children and adolescents was around 1 per 18,400 vaccine doses. Studies from Finland and Sweden also appear to demonstrate an extended risk of narcolepsy into the second year following vaccination, but such conclusions should be interpreted with a word of caution due to possible biases. Benefits of immunization outweigh the risk of vaccination-associated narcolepsy, which remains a rare disease.
Topics: Humans; Incidence; Influenza A Virus, H1N1 Subtype; Influenza Vaccines; Influenza, Human; Narcolepsy; Risk; Vaccination
PubMed: 28847694
DOI: 10.1016/j.smrv.2017.06.006 -
Archives of Oral Biology Nov 2017To systematically assess and contrast reported differences in microstructure, mineral density, mechanical and chemical properties between... (Review)
Review
OBJECTIVES
To systematically assess and contrast reported differences in microstructure, mineral density, mechanical and chemical properties between molar-incisor-hypomineralization-affected (MIH) enamel and unaffected enamel.
METHODS
Studies on extracted human teeth, clinically diagnosed with MIH, reporting on the microstructure, mechanical properties or the chemical composition and comparing them to unaffected enamel were reviewed. Electronic databases (PubMed, Embase and Google Scholar) were screened; hand searches and cross-referencing were also performed.
RESULTS
Twenty-two studies were included. Fifteen studies on a total of 201 teeth investigated the structural properties, including ten (141 teeth) on microstructure and seven (60 teeth) on mineral density; six (29 teeth) investigated the mechanical properties and eleven (87 teeth) investigated the chemical properties of MIH-affected enamel and compared them to unaffected enamel. Studies unambiguously found a reduction in mineral quantity and quality (reduced Ca and P content), reduction of hardness and modulus of elasticity (also in the clinically sound-appearing enamel bordering the MIH-lesion), an increase in porosity, carbon/carbonate concentrations and protein content compared to unaffected enamel.
FINDINGS
were ambiguous with regard to the extent of the lesion through the enamel to the enamel-dentin junction, the Ca/P ratio and the association between clinical appearance and defect severity.
CONCLUSIONS
There is an understanding of the changes related to MIH-affected enamel. The association of these changes with the clinical appearance and resulting implications for clinical management are unclear.
CLINICAL SIGNIFICANCE
MIH-affected enamel is greatly different from unaffected enamel. This has implications for management strategies. The possibility of correlating the clinical appearance of MIH-affected enamel with the severity of enamel changes and deducing clinical concepts (risk stratification etc.) is limited.
Topics: Dental Enamel; Dental Enamel Hypoplasia; Elasticity; Hardness; Humans; Incisor; Molar; Surface Properties
PubMed: 28843745
DOI: 10.1016/j.archoralbio.2017.08.008 -
Movement Disorders : Official Journal... Nov 2018We conducted a systematic review and meta-analysis aimed at establishing robust prevalence estimates and identifying clinical correlates of fatigue in PD. From 2,459... (Meta-Analysis)
Meta-Analysis Review
We conducted a systematic review and meta-analysis aimed at establishing robust prevalence estimates and identifying clinical correlates of fatigue in PD. From 2,459 titles and abstracts, we selected 44 relevant studies (n = 7427 patients). Overall, the meta-analysis showed a prevalence of fatigue of 50% in PD. This prevalence estimate, however, was significantly moderated by study heterogeneity in measurement scales and cut-off thresholds. In contrast, demographic features, disease severity, cognitive impairment, and depression did not moderate prevalence estimates. Moreover, fatigue prevalence did not differ between de novo and treated PD patients. Compared to nonfatigued patients, fatigued patients had sligthly higher age (1.44 years), disease duration (0.93 years), l-dopa equivalent daily dose (50.89 units), UPDRS-III (4.99 points), and H & Y (0.33 points), as well as risk of comorbid depression (risk ratio = 1.89) and had a little lower MMSE score (-0.66 points). Fatigue was moderately associated with apathy (Hedges' g = 0.55), anxiety (Hedges' g = 0.67), daytime somnolence (Hedges' g = 0.43), sleep disturbances (Hedges' g = 0.66), and poorer quality of life (Hedges' g = 1.23). Our analyses suggest that fatigue is a frequent, independent nonmotor symptom in PD appearing early and persisting throughout the disease course, and that establishing uniform diagnostic criteria for PD-related fatigue is critical. In addition, several nonmotor symptoms appear to be associated with fatigue and negatively impact quality of life. Pharmacological and nonpharmacological interventions targeting fatigue and associated symptoms may improve quality of life in patients with PD. © 2018 International Parkinson and Movement Disorder Society.
Topics: Age Factors; Fatigue; Humans; Mood Disorders; Parkinson Disease; Quality of Health Care; Quality of Life
PubMed: 30264539
DOI: 10.1002/mds.27461 -
Cancer Treatment Reviews Apr 2015Langerhans cell sarcoma (LCS) is a rare malignant tumour of Langerhans cells with a poor outcome. Given its rarity, there is a lack of evidence regarding the most... (Review)
Review
Langerhans cell sarcoma (LCS) is a rare malignant tumour of Langerhans cells with a poor outcome. Given its rarity, there is a lack of evidence regarding the most appropriate treatment for this condition. Therefore the aim of this work was to review, compile, analyse and present clinical details and to determine the optimal treatment regimen. A search of PubMed, CINAHL, EMBASE, Cochrane, CENTRAL, clinicaltrials.gov and Google Scholar was supplemented by hand searching. Data extracted included demographics, treatment, type of LCS and clinical outcome. Of 510 citations identified by a systematic literature search, 46 case series including 66 subjects with LCS met criteria for analysis. The most common treatment modality was chemotherapy, used alone or in combination in 47 cases (71%) followed by surgery in 31 cases (47%). Overall mean (S.E.) disease specific survival and disease free survival were 27.2 (3.9) and 18.3 (3.8) months respectively. There was a significant difference in both disease specific and disease free survival between the local, loco-regional and disseminated disease cohorts (DSS p=0.014; DFS p<0.001). More localised disease confers a survival advantage. Multi-modality therapy appears to be most effective, with the addition of radiotherapy to chemotherapy appearing beneficial. Complete surgical excision with clear margins being most effective for local disease control. Any adjuvant therapy should not be delayed. Bone marrow transplant appears to be the most reliable treatment in terms of outcome especially in disseminated disease however has well known patient selection and toxicity/tolerance issues. The role of cell surface markers for prognostication remains unclear.
Topics: Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Disease-Free Survival; Humans; Langerhans Cell Sarcoma
PubMed: 25805533
DOI: 10.1016/j.ctrv.2015.02.011 -
Annals of Nuclear Medicine May 2023Brown tumors (BT) are abnormal bone-repair processes and a consequence of hyperparathyroidism. The diagnosis of these lytic lesions in nuclear medicine, while a... (Review)
Review
Brown tumors (BT) are abnormal bone-repair processes and a consequence of hyperparathyroidism. The diagnosis of these lytic lesions in nuclear medicine, while a challenge, is not so rare, because functional imaging is used both in the management of cancer and hyperparathyroidism. The main objective of this review is to summarize the knowledge and the evidence concerning BT and the different imaging modalities in nuclear medicine. A systematic review was performed in Embase, PubMed and Google Scholar from 2005 to 2022. We included articles describing BT in the following imaging modalities: [F]-fluorodeoxyglucose PET/CT, [F]-fluorocholine or [C]-fluorocholine PET/CT, [Tc]-Sestamibi scintigraphy, bone scan, [F]-sodium fluoride PET/CT, [Ga]-FAPI PET/CT; [Ga]-DOTATATE PET/CT; [C]-methionine PET/CT. For each modality, appearance, avidity for radiotracer, available quantitative parameters and imaging evolution after parathyroidectomy were collected and analyzed. Fifty-two articles were included for a total of 392 BT lesions. If the diagnosis of BT is evoked on a known lesion, performing a [F]-fluorocholine PET/CT imaging seems the most appropriate. In [F]-fluorodeoxyglucose, [F]-fluorocholine, [F]-sodium fluoride PET/CT and bone scan, BT can mimic metastatic disease. BT uptakes appear reversible after parathyroidectomy, with a more or less rapid decrease depending on the imaging modality used.
Topics: Humans; Positron Emission Tomography Computed Tomography; Hyperparathyroidism, Primary; Nuclear Medicine; Gallium Radioisotopes; Sodium Fluoride; Radionuclide Imaging; Technetium Tc 99m Sestamibi; Fluorodeoxyglucose F18
PubMed: 36933117
DOI: 10.1007/s12149-023-01832-1