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Clinical Oral Implants Research Sep 2023The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or... (Meta-Analysis)
Meta-Analysis Review
Systematic review evaluating the influence of the prosthetic material and prosthetic design on the clinical outcomes of implant-supported multi-unit fixed dental prosthesis in the posterior area.
OBJECTIVE
The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iS C) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes.
METHODS
Electronic and manual searches were performed to identify randomized-, prospective-, and retrospective clinical trials with follow-up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iS Cs. Survival and complication rates were analyzed using robust Poisson's regression models.
RESULTS
Thirty-two studies reporting on 42 study arms were included in the present systematic review. The meta-analysis of the included studies indicated estimated 3-year survival rates of 98.3% (95%CI: 95.6-99.3%) for porcelain-fused-to-metal (PFM) iFDPs, 97.5% (95%CI: 95.5-98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8-99.6%) for monolithic or micro-veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8-99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly (p < .01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6-99.3%] vs. 99.1% [95%CI: 97.6-99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iS Cs.
CONCLUSIONS
Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iS Cs showed similarly high short-term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs.
Topics: Prospective Studies; Retrospective Studies; Dental Prosthesis Design; Dental Restoration Failure; Dental Porcelain; Ceramics; Zirconium; Crowns; Dental Prosthesis, Implant-Supported
PubMed: 37750526
DOI: 10.1111/clr.14103 -
Journal of Esthetic and Restorative... Dec 2023The aim of this systematic review was to evaluate the influence of the characteristics of intraoral scan bodies (ISBs) on the accuracy of intraoral scanning. (Review)
Review
OBJECTIVE
The aim of this systematic review was to evaluate the influence of the characteristics of intraoral scan bodies (ISBs) on the accuracy of intraoral scanning.
MATERIALS AND METHODS
An electronic search was conducted through PubMed (MEDLINE), Scopus and Cochrane Library, up to March 2023. The literature search intended to retrieve all relevant clinical and in vitro studies about the effect that the various properties of ISBs may have on the accuracy (trueness and precision) of intraoral scanning. Only publications in English language were selected with animal studies, case reports, case series, technique presentation articles and expert opinions being excluded.
RESULTS
A total of 28 studies met the inclusion criteria and were included in this systematic review. They were published between 2019 and 2023 and were all in vitro studies. Among the parameters described, the scan body material, position, geometry, height, diameter, and fixation torque were evaluated. The most common materials used for ISBs were polyetheretherketone (PEEK) and titanium alloys. The diameter and position of ISBs seemed to affect the trueness of implant impressions. Subgingival implant position and decreased ISB height affected negatively the trueness of scanning. Geometrical characteristics of ISBs also affect the implant impression accuracy, especially the bevel location and the types of designing modifications.
CONCLUSIONS
The characteristics of the currently used ISBs vary widely and the available scientific evidence is not yet conclusive about the optimal design of ISB. The implant impression accuracy achieved by any of the studied parameters is encouraging. Clinical studies are however necessary for more concrete conclusions.
CLINICAL SIGNIFICANCE
ISBs play a vital role in the digital workflow and influence significantly the accuracy and fit of implant restorations. More clinical trials are needed in order to conclude to the optimal characteristics of ISBs which would further enhance the success of the restorations.
Topics: Dental Implants; Dental Impression Technique; Computer-Aided Design; Research Design; Imaging, Three-Dimensional
PubMed: 37381677
DOI: 10.1111/jerd.13074 -
Journal of Pediatric Nursing 2023To determine the pooled incidence and prevalence rate of medical device-related pressure injuries(MDRPIs) using the Braden QD scale, medical devices that frequently... (Meta-Analysis)
Meta-Analysis
PROBLEM
To determine the pooled incidence and prevalence rate of medical device-related pressure injuries(MDRPIs) using the Braden QD scale, medical devices that frequently cause MDRPIs, and anatomical locations that are vulnerable to them.
ELIGIBILITY CRITERIA
Using the Braden QD scale, being published in English between 01/01/2018-and 01/03/2023.
METHODS
This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations and registered in the International Prospective Register of Systematic Reviews database (No: CRD42021276501).
SAMPLE
A total of 7 studies with 25,742 pediatric patients were included.
RESULTS
The pooled prevalence and cumulative incidence of hospital-acquired pressure injuries(HAPIs) were 7.8% (95% CI: 5.2-11.4%) and 3.9% (95% CI: 0.5-24.6%) respectively, and the incidence rate was 8.2/1000 person-days (95% CI: 2.4-14.2/1000 person-days). The pooled prevalence and cumulative incidence of MDRPIs were 7% (95% CI: 5.5-8.8%) and 5% (95% CI: 3.2-7.8%) respectively, and the incidence rate was 6.7/1000 person-days (95% CI, 0.11-13.4/1000 person-days). The most affected anatomical locations were the face (29.1%), ankle/foot (20.1%), and head (15.7%). Medical devices that frequently caused MDRPIs were external monitoring devices (24.5%), respiratory devices (22.8%), and supportive/securing devices (14.9%).
CONCLUSIONS
According to the current systematic review and meta-analyses, the incidence and prevalence of HAPIs and MDRPIs are moderate to high.
IMPLICATIONS
The findings suggested that healthcare providers should pay more attention to reducing HAPIs and MDRPIs and future studies should be conducted to understand their characteristics and risk factors.
Topics: Child; Humans; Pressure Ulcer; Incidence; Prevalence; Risk Factors; Databases, Factual
PubMed: 37344345
DOI: 10.1016/j.pedn.2023.06.019 -
Sensors (Basel, Switzerland) Aug 2023Smart wearable devices enable personalized at-home healthcare by unobtrusively collecting patient health data and facilitating the development of intelligent platforms... (Review)
Review
Smart wearable devices enable personalized at-home healthcare by unobtrusively collecting patient health data and facilitating the development of intelligent platforms to support patient care and management. The accurate analysis of data obtained from wearable devices is crucial for interpreting and contextualizing health data and facilitating the reliable diagnosis and management of critical and chronic diseases. The combination of edge computing and artificial intelligence has provided real-time, time-critical, and privacy-preserving data analysis solutions. However, based on the envisioned service, evaluating the additive value of edge intelligence to the overall architecture is essential before implementation. This article aims to comprehensively analyze the current state of the art on smart health infrastructures implementing wearable and AI technologies at the far edge to support patients with chronic heart failure (CHF). In particular, we highlight the contribution of edge intelligence in supporting the integration of wearable devices into IoT-aware technology infrastructures that provide services for patient diagnosis and management. We also offer an in-depth analysis of open challenges and provide potential solutions to facilitate the integration of wearable devices with edge AI solutions to provide innovative technological infrastructures and interactive services for patients and doctors.
Topics: Humans; Artificial Intelligence; Awareness; Chronic Disease; Heart Failure; Wearable Electronic Devices
PubMed: 37571678
DOI: 10.3390/s23156896 -
British Journal of Sports Medicine Dec 2023To investigate the effects of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the effects of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis.
DESIGN
Systematic review of randomised controlled trials (RCTs).
DATA SOURCES
AMED, MEDLINE, PEDro, Cochrane, SPORTDiscus, CINAHL, EMBASE and PsycINFO without language or date restrictions up to 3 February 2023.
ELIGIBILITY CRITERIA
RCTs that evaluated the efficacy of any pharmacological and non-pharmacological therapies compared with control (placebo, sham, waiting list or no intervention) on pain intensity and disability in people with plantar fasciitis. Two reviewers independently screened eligible trials, extracted data, assessed the methodological quality of included trials and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. Mean differences (MDs) with 95% CIs were reported.
RESULTS
Seventeen different therapies investigated in 28 trials were included in the quantitative analysis. For non-pharmacological therapies, moderate certainty evidence showed short-term effects of customised orthoses on pain intensity when compared with control (MD of -12.0 points (95% CI -17.1 to -7.0) on a 0-100 scale). Low certainty evidence showed short-term effects of taping on pain intensity (-21.3 (95% CI -38.6 to -4.0)). Long-term effects and effects on disability are still uncertain. For pharmacological therapies, low to very low quality evidence from few trials with small samples was inconclusive and supports that high-quality trials are needed.
CONCLUSIONS
Moderate-quality and low-quality evidence demonstrates customised orthoses and taping, respectively, reduce pain intensity in the short term in patients with plantar fasciitis.
PROSPERO REGISTRATION NUMBER
CRD42021224416.
Topics: Humans; Fasciitis, Plantar; Pain Measurement; Orthotic Devices; Quality of Life
PubMed: 37620126
DOI: 10.1136/bjsports-2022-106403 -
Journal of Clinical Nursing Sep 2023This study systematically compared the efficacy of various dressings that may prevent facial medical device-related pressure injury (MRDPI) in medical staff during the... (Meta-Analysis)
Meta-Analysis Review
Evaluation of dressings preventing facial medical device-related pressure injury in medical staff during the COVID-19 pandemic: A systematic review and network meta-analysis.
AIM
This study systematically compared the efficacy of various dressings that may prevent facial medical device-related pressure injury (MRDPI) in medical staff during the COVID-19 pandemic.
BACKGROUND
During the COVID-19 pandemic, medical staff who are required to wear masks, goggles and other personal protective equipment (PPE) are susceptible to facial MRDPI, which exacerbates working conditions. Dressings can effectively prevent or alleviate MRDPI, but it is unclear which dressings are most effective.
DESIGN
A systematic review and network meta-analysis, in accordance with PRISMA.
METHODS
A comprehensive literature search was conducted in four English and four Chinese databases to identify relevant studies published up to 8 September 2022. The selected studies were randomised controlled trials, with populations comprising medical staff who wore PPE during the COVID-19 pandemic and included an observation and control group.
RESULTS
The network meta-analysis of the 12 selected articles showed that foam dressing, hydrocolloid dressing and petrolatum gauze were better than conventional protection for preventing MRDPI. The surface under the cumulative ranking curve indicated that foam dressing was the best preventative.
CONCLUSION
Foam dressing is more effective than other dressings in preventing facial MRDPI in medical staff. When PPE must be worn for many hours, such as during the COVID-19 pandemic, medical staff can use foam dressings to prevent MRDPI.
RELEVANCE TO CLINICAL PRACTICE
The results support the use of dressings, especially foam dressings, to prevent MRDPI in healthcare workers. The appropriate dressings are recommended to prevent MRDPI associated with wearing PPE.
Topics: Humans; COVID-19; Pressure Ulcer; Network Meta-Analysis; Pandemics; Bandages; Medical Staff
PubMed: 37082837
DOI: 10.1111/jocn.16721 -
Journal of Sport and Health Science Sep 2024The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time... (Review)
Review
PURPOSE
The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time measured with devices in the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) and published in 2000 or later.
METHODS
A systematic search was carried out in PubMed and Web of Science in June 2023 using predefined search terms.
RESULTS
Fourteen unique research projects or surveillance studies were identified. Additionally, 2 surveillance studies published by national agencies were included, resulting in a total of 16 studies for inclusion. National surveillance systems exist in Finland and Norway, with regular survey waves in school-aged children/adolescents and adults. In Denmark, recent nationally representative data have been collected in school children only. So far, Sweden has no regular national surveillance system using device-based data collection. No studies were found from Iceland. The first study was conducted in 2001 and the most recent in 2022, with most data collected from 2016 to date. Five studies included children/adolescents 6-18 years, no study included preschoolers. In total 11 studies included adults, of which 8 also covered older adults. No study focused specifically on older adults. The analytical sample size ranged from 205 to 27,890. Detailed methodology is presented, such as information on sampling strategy, device type and placement, wear protocols, and physical activity classification schemes. Levels of physical activity and sedentary time in children/adolescents, adults, and older adults across the Nordic countries are presented.
CONCLUSION
A growing implementation of device-based population surveillance of physical activity and sedentary behavior in the Nordic countries has been identified. The variety of devices, placement, and data procedures both within and between the Nordic countries highlights the challenges when it comes to comparing study outcomes as well as the need for more standardized data collection.
Topics: Humans; Sedentary Behavior; Exercise; Scandinavian and Nordic Countries; Adolescent; Child; Adult; Fitness Trackers
PubMed: 38580050
DOI: 10.1016/j.jshs.2024.04.003 -
Ophthalmic & Physiological Optics : the... Mar 2024To review the rebound effect after cessation of different myopia control treatments. (Review)
Review
PURPOSE
To review the rebound effect after cessation of different myopia control treatments.
METHODS
A systematic review that included full-length randomised controlled studies (RCTs), as well as post-hoc analyses of RCTs reporting new findings on myopia control treatments rebound effect in two databases, PubMed and Web of Science, was performed according to the PRISMA statement. The search period was between 15 June 2023 and 30 June 2023. The Cochrane risk of bias tool was used to analyse the quality of the selected studies.
RESULTS
A total of 11 studies were included in this systematic review. Unifying the rebound effects of all myopia control treatments, the mean rebound effect for axial length (AL) and spherical equivalent refraction (SER) were 0.10 ± 0.07 mm [-0.02 to 0.22] and -0.27 ± 0.2 D [-0.71 to -0.03] after 10.2 ± 7.4 months of washout, respectively. In addition, spectacles with highly aspherical lenslets or defocus incorporated multiple segments technology, soft multifocal contact lenses and orthokeratology showed lower rebound effects compared with atropine and low-level light therapy, with a mean rebound effect for AL and SER of 0.04 ± 0.04 mm [0 to 0.08] and -0.13 ± 0.07 D [-0.05 to -0.2], respectively.
CONCLUSIONS
It appears that the different treatments for myopia control produce a rebound effect after their cessation. Specifically, optical treatments seem to produce less rebound effect than pharmacological or light therapies. However, more studies are required to confirm these results.
Topics: Humans; Myopia; Atropine; Contact Lenses, Hydrophilic; Refraction, Ocular; Eyeglasses
PubMed: 38193312
DOI: 10.1111/opo.13277 -
JMIR MHealth and UHealth Nov 2023The rapid growth of digital health apps has necessitated new regulatory approaches to ensure compliance with safety and effectiveness standards. Nonadherence and...
BACKGROUND
The rapid growth of digital health apps has necessitated new regulatory approaches to ensure compliance with safety and effectiveness standards. Nonadherence and heterogeneous user engagement with digital health apps can lead to trial estimates that overestimate or underestimate an app's effectiveness. However, there are no current standards for how researchers should measure adherence or address the risk of bias imposed by nonadherence through efficacy analyses.
OBJECTIVE
This systematic review aims to address 2 critical questions regarding clinical trials of software as a medical device (SaMD) apps: How well do researchers report adherence and engagement metrics for studies of effectiveness and efficacy? and What efficacy analyses do researchers use to account for nonadherence and how appropriate are their methods?
METHODS
We searched the Food and Drug Administration's registration database for registrations of repeated-use, patient-facing SaMD therapeutics. For each such registration, we searched ClinicalTrials.gov, company websites, and MEDLINE for the corresponding clinical trial and study articles through March 2022. Adherence and engagement data were summarized for each of the 24 identified articles, corresponding to 10 SaMD therapeutics. Each article was analyzed with a framework developed using the Cochrane risk-of-bias questions to estimate the potential effects of imperfect adherence on SaMD effectiveness. This review, funded by the Richard King Mellon Foundation, is registered on the Open Science Framework.
RESULTS
We found that although most articles (23/24, 96%) reported collecting information about SaMD therapeutic engagement, of the 20 articles for apps with prescribed use, only 9 (45%) reported adherence information across all aspects of prescribed use: 15 (75%) reported metrics for the initiation of therapeutic use, 16 (80%) reported metrics reporting adherence between the initiation and discontinuation of the therapeutic (implementation), and 4 (20%) reported the discontinuation of the therapeutic (persistence). The articles varied in the reported metrics. For trials that reported adherence or engagement, there were 4 definitions of initiation, 8 definitions of implementation, and 4 definitions of persistence. All articles studying a therapeutic with a prescribed use reported effectiveness estimates that might have been affected by nonadherence; only a few (2/20, 10%) used methods appropriate to evaluate efficacy.
CONCLUSIONS
This review identifies 5 areas for improving future SaMD trials and studies: use consistent metrics for reporting adherence, use reliable adherence metrics, preregister analyses for observational studies, use less biased efficacy analysis methods, and fully report statistical methods and assumptions.
Topics: Mobile Applications; United States; Software; Equipment and Supplies; Clinical Trials as Topic
PubMed: 37966871
DOI: 10.2196/46237 -
International Wound Journal Sep 2023The aim of this review study is to investigate the nurses' knowledge and related factors towards the prevention of medical device-related pressure ulcers (MDRPUs). An... (Review)
Review
The aim of this review study is to investigate the nurses' knowledge and related factors towards the prevention of medical device-related pressure ulcers (MDRPUs). An extensive search was conducted in international electronic databases such as PubMed, Web of Science, and Scopus, and Persian databases, such as Iranmedex and the Scientific Information Database from December 1, 2022. During this search, keywords extracted from Medical Subject Headings, such as "Prevention knowledge," "Nurse," "Pressure ulcer," "Equipment and Supplies," and "Intensive Care Units" were used. The quality of the present studies in this review was evaluated based on the appraisal tool for cross-sectional studies (AXIS tool). A total of 1847 nurses participated in this review from five studies, and the majority of them (82.94%) were female. The mean age of the participants was 31.40 (SD = 5.97). The mean score of MDRPUs prevention knowledge in nurses based on PU2014 scale and researcher-made questionnaires were 16.50 (SD = 3.74) out of 31 and 65.49 (SD = 6.33) out of 100, respectively. The knowledge of nurses is influenced by factors such as age, sex, level of education, work experience, technical titles, type of hospital, level of hospital, and type of ward. Various factors had a significant positive relationship with nurses' MDRPUs prevention knowledge, which includes level of education, work experience, previous training on MDRPU, having a wound care certificate, an online search about MDRPU, and attitude and practise towards MDRPU prevention. At the same time, nurses' knowledge about the prevention of MDRPUs had a significant negative relationship with the time interval since last participating in MDRPU training or workshop. Overall, the level of MDRPUs prevention knowledge among nurses was insufficient to moderate. Therefore, it is suggested to provide facilities for nurses to receive the necessary training.
Topics: Humans; Male; Female; Pressure Ulcer; Cross-Sectional Studies; Clinical Competence; Attitude of Health Personnel; Hospitals; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice; Nurses
PubMed: 36792930
DOI: 10.1111/iwj.14122