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Journal of the American Academy of... Mar 2024
Topics: Humans; Isotretinoin; Dermatologic Agents; Acne Vulgaris; Dietary Supplements; Administration, Oral
PubMed: 37871802
DOI: 10.1016/j.jaad.2023.10.037 -
Evidence-based Dentistry Dec 2023The present systematic review was executed to evaluate the stress shielding effect of PEEK and its composite dental implants as compared to other implant (titanium and...
PURPOSE
The present systematic review was executed to evaluate the stress shielding effect of PEEK and its composite dental implants as compared to other implant (titanium and zirconia) materials in peri-implant bone.
MATERIALS AND METHOD
The comprehensive online literature search was conducted on PubMed, Google Scholar, and Web of Science from January 2011 to January 2023. A total of 43 in vitro studies were identified related to the raised question. In all, 34 studies were excluded as they included in vitro studies focusing on stress distribution in prosthesis framework, abutments, crown, and on biological properties such as cell adhesion, etc. Only eight studies after full-text screening were included in the present systematic review.
RESULTS
The data extracted from included studies showed that PEEK and its composite materials, have a less stress shielding effect due to their low modulus of elasticity resulting in higher stress concentration and strain in the peri-implant bone as compared to titanium and zirconia implant materials.
CONCLUSION
The PEEK and its composites can be used as an alternative material in the esthetic region and in those who have an allergy to metal implants. However, due to the low elastic modulus of PEEK, a homogenous stress distribution is not observed along the entire length of the implant. Further studies are required to improve the composition of PEEK material so that a homogenous reduction of stress shielding effect along the whole length of a dental implant can be achieved.
Topics: Humans; Dental Implants; Titanium; Esthetics, Dental; Polyethylene Glycols; Ketones; Dental Materials
PubMed: 37749243
DOI: 10.1038/s41432-023-00935-y -
Journal of Orthopaedic Research :... Jun 2024Revision total hip arthroplasty (rTHA) involving acetabular defects is a complex procedure associated with lower rates of success than primary THA. Computational...
Revision total hip arthroplasty (rTHA) involving acetabular defects is a complex procedure associated with lower rates of success than primary THA. Computational modeling has played a key role in surgical planning and prediction of postoperative outcomes following primary THA, but modeling applications in rTHA for acetabular defects remain poorly understood. This study aimed to systematically review the use of computational modeling in acetabular defect classification, implant selection and placement, implant design, and postoperative joint functional performance evaluation following rTHA involving acetabular defects. The databases of Web of Science, Scopus, Medline, Embase, Global Health and Central were searched. Fifty-three relevant articles met the inclusion criteria, and their quality were evaluated using a modified Downs and Black evaluation criteria framework. Manual image segmentation from computed tomography scans, which is time consuming, remains the primary method used to generate 3D models of hip bone; however, statistical shape models, once developed, can be used to estimate pre-defect anatomy rapidly. Finite element modeling, which has been used to estimate bone stresses and strains, and implant micromotion postoperatively, has played a key role in custom and off-the-shelf implant design, mitigation of stress shielding, and prediction of bone remodeling and implant stability. However, model validation is challenging and requires rigorous evaluation and comparison with respect to mid- to long-term clinical outcomes. Development of fast, accurate methods to model acetabular defects, including statistical shape models and artificial neural networks, may ultimately improve uptake of and expand applications in modeling and simulation of rTHA for the research setting and clinic.
PubMed: 38850264
DOI: 10.1002/jor.25902 -
Biochimie Apr 2024Mesenchymal Stem Cells (MSCs) are of interest in the clinic because of their immunomodulation capabilities, capacity to act upstream of inflammation, and ability to...
Mesenchymal Stem Cells (MSCs) are of interest in the clinic because of their immunomodulation capabilities, capacity to act upstream of inflammation, and ability to sense metabolic environments. In standard physiologic conditions, they play a role in maintaining the homeostasis of tissues and organs; however, there is evidence that they can contribute to some autoimmune diseases. Gaining a deeper understanding of the factors that transition MSCs from their physiological function to a pathological role in their native environment, and elucidating mechanisms that reduce their therapeutic relevance in regenerative medicine, is essential. We conducted a Systematic Review and Meta-Analysis of human MSCs in preclinical studies of autoimmune disease, evaluating 60 studies that included 845 patient samples and 571 control samples. MSCs from any tissue source were included, and the study was limited to four autoimmune diseases: multiple sclerosis, rheumatoid arthritis, systemic sclerosis, and lupus. We developed a novel Risk of Bias tool to determine study quality for in vitro studies. Using the International Society for Cell & Gene Therapy's criteria to define an MSC, most studies reported no difference in morphology, adhesion, cell surface markers, or differentiation into bone, fat, or cartilage when comparing control and autoimmune MSCs. However, there were reported differences in proliferation. Additionally, 308 biomolecules were differentially expressed, and the abilities to migrate, invade, and form capillaries were decreased. The findings from this study could help to explain the pathogenic mechanisms of autoimmune disease and potentially lead to improved MSC-based therapeutic applications.
PubMed: 38657832
DOI: 10.1016/j.biochi.2024.04.009 -
Health and Social Care Delivery Research Nov 2023Family carers are central in supporting patients nearing end of life. As a consequence, they often suffer detrimental impacts on their own mental health. Understanding...
What factors are associated with informal carers' psychological morbidity during end-of-life home care? A systematic review and thematic synthesis of observational quantitative studies.
BACKGROUND
Family carers are central in supporting patients nearing end of life. As a consequence, they often suffer detrimental impacts on their own mental health. Understanding what factors may affect carers' mental health is important in developing strategies to maintain their psychological well-being during caregiving.
AIM
To conduct a systematic review and thematic evidence synthesis of factors related to carers' mental health during end-of-life caregiving.
METHOD
Searches of MEDLINE, CINAHL, PsychINFO, Social Sciences Citation Index, EMBASE, Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effects 1 January 2009-24 November 2019. We included observational quantitative studies focusing on adult informal/family carers for adult patients at end of life cared for at home considering any factor related to carer mental health (anxiety, depression, distress and quality of life) pre-bereavement. Newcastle-Ottawa Quality Assessment Scale was used. Thematic analysis with box score presentation, and meta-analysis were done where data permitted.
RESULTS
Findings from 63 included studies underpinned seven emergent themes. (31 studies): worse patient psychological symptoms and quality of life were generally associated with worse carer mental health. Patient depression was associated with higher depression in carers (standardised mean difference = 0.59, 95% confidence interval 0.32 to 0.87, = 77%). Patients' other symptoms and functional impairment may relate to carer mental health, but findings were unclear. (14 studies): impact on carers' lives, task difficulty and general burden had clear associations with worse carer mental health. (8 studies): family dynamics and the quality of the carer-patient relationship may be important for carer mental health and are worthy of further investigation. (6 studies): insufficient resources may relate to carers' mental health and warrant further study. (13 studies): self-efficacy and preparedness were related to better mental health. However, findings regarding coping strategies were mixed. (18 studies): informal support given by family and friends may relate to better carer mental health, but evidence on formal support is limited. Having unmet needs was related to worse mental health, while satisfaction with care was related to better mental health. (16 studies): older age was generally associated with better carer mental health and being female was associated with worse mental health.
LIMITATIONS
Studies were mainly cross-sectional (56) rather than longitudinal (7) which raises questions about the likely causal direction of relationships. One-third of studies had samples < 100, so many had limited statistical power to identify existing relationships.
CONCLUSIONS AND FUTURE WORK
Future work must adopt a comprehensive approach to improving carers' mental health because factors relating to carer mental health cover a broad spectrum. The literature on this topic is diverse and difficult to summarise, and the field would benefit from a clearer direction of enquiry guided by explanatory models. Future research should (1) further investigate quality of relationships and finances; (2) better define factors under investigation; (3) establish, through quantitative causal analyses, why factors might relate to mental health; and (4) utilise longitudinal designs more to aid understanding of likely causal direction of associations.
STUDY REGISTRATION
This study is registered as PROSPERO registration 2019 CRD42019130279 at https://www.crd.york.ac.uk/prospero/.
FUNDING
This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme HSDR 18/01/01 and is published in full in . See the NIHR Funding and Awards website for further award information.
PubMed: 37991230
DOI: 10.3310/HTJY8442 -
BMC Medical Education Mar 2024The complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and...
Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis.
BACKGROUND
The complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and limited knowledge. Brief interventions that can be utilised in day-to-day practice are necessary to improve ways of managing PPS. This review aimed to establish (i) what training primary and secondary healthcare practitioners have undertaken to develop their clinical skills when working with PPS, (ii) what training techniques or theoretical models have been used within these interventions, and (iii) how effective was the training.
METHOD
A systematic literature search was undertaken on eight databases to identify professional development interventions for healthcare practitioners working with PPS, were of any study design, and at a minimum were single measure studies (i.e., training outcome alone). Studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and narratively synthesised.
RESULTS
Despite high methodological heterogeneity across the six included studies, they all aimed to improve healthcare practitioners' communication skills through educational (theory, awareness, attitudes, assessment, treatment, and management of PPS) and experiential (role play) learning.
CONCLUSIONS
The review findings demonstrate that developing healthcare practitioners' communicative behaviours led to increased confidence and self-efficacy when working with PPS, which facilitated improved consultations and improvements on some patient outcomes. Barriers to the uptake of training programmes and implementation into daily clinical practice are discussed, including the need for PPS to be formally implemented into undergraduate teaching and post-qualification continuous professional development.
TRIAL REGISTRATION
This review was registered at PROSPERO [CRD42022315631] prior to the review starting.
Topics: Humans; Health Personnel; Clinical Competence; Delivery of Health Care; Students; Attitude
PubMed: 38519955
DOI: 10.1186/s12909-024-05306-4 -
BMC Public Health Jul 2023The COVID-19 pandemic has exacerbated the psychological burden on young people around the world and may have disproportionately large impacts for young people with...
BACKGROUND
The COVID-19 pandemic has exacerbated the psychological burden on young people around the world and may have disproportionately large impacts for young people with disabilities. This review aims to systematically review the quantitative evidence on the impact of the COVID-19 pandemic on the mental health of young people with disabilities and evaluate the quality of included studies.
METHODS
A systematic search was conducted using 5 electronic databases. The quality of the studies was assessed using the SIGN risk of bias assessment tool. A narrative synthesis was performed to synthesize the results of included studies.
RESULTS
The initial search yielded 1935 studies, of which two met the eligibility criteria, one longitudinal study and one cross-sectional study, both assessed to be of low quality. In the cross-sectional study, young people with intellectual and developmental disabilities self-reported an increase in mental health symptoms. The longitudinal study found no evidence of a change in mental health symptoms from pre-pandemic to during the pandemic among young people with autism spectrum disorder, although these individuals reported negative impacts of the COVID-19 pandemic on their emotional or mental health.
CONCLUSIONS
The findings of this review provide some weak evidence of a negative impact of the COVID-19 pandemic on the mental health of young people with disabilities. Importantly, the findings highlight the lack of research in this area. More research is needed to investigate the impact of the pandemic on the mental health of young disabled people, in order for governments to develop emergency preparedness plans to safeguard the well-being of this population.
Topics: Humans; Adolescent; Mental Health; COVID-19; Pandemics; Autism Spectrum Disorder; Cross-Sectional Studies; Longitudinal Studies; Disabled Persons
PubMed: 37468866
DOI: 10.1186/s12889-023-16260-z -
Healthcare (Basel, Switzerland) Jun 2024Evaluation of post-nephrectomy social health in living kidney donors is essential. This systematic review examines their emotional need for social relatedness... (Review)
Review
INTRODUCTION
Evaluation of post-nephrectomy social health in living kidney donors is essential. This systematic review examines their emotional need for social relatedness post-donation.
METHODS
Following the PRISMA guidelines, we systematically searched Scopus, CINAHL, and PsycINFO.
RESULTS
Among the screened records, 32 quantitative and 16 qualitative papers met the inclusion criteria. Quantitative research predominantly utilized questionnaires featuring generic items on social functioning. However, a minority delved into emotional and social dimensions, aligning with qualitative studies emphasizing the importance of social connection and perceived social support post-donation. Specifically, post-donation changes in connecting with others encompass a sense of belongingness, heightened autonomy, shifts in concern for the recipient's health, and continued care by shielding the recipient from personal health issues. Social acknowledgment and social support from both close and extended networks are reported as relevant for recovery after nephrectomy.
DISCUSSION
These findings underscore the necessity for targeted measures of emotional needs and social functioning to effectively assess post-donation adjustment. They also inform the identification of key health themes for kidney donor Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) questions.
PubMed: 38921330
DOI: 10.3390/healthcare12121216 -
Journal of Patient Experience 2024This study aimed to synthesize all qualitative evidence on the experiences of hematopoietic stem cell transplant (HSCT) patients attending long-term monitoring clinics...
This study aimed to synthesize all qualitative evidence on the experiences of hematopoietic stem cell transplant (HSCT) patients attending long-term monitoring clinics from their perspective. A systematic search of the literature was undertaken across 8 databases. The Critical Appraisal Skills Program was used to evaluate each study's quality. Confidence in the Evidence from Reviews of Qualitative Research was employed to assess confidence in each finding. Three themes from 4 qualitative studies were identified relating to patients' experiences, "[It's] important to maintain a good relationship with the nurses and doctors," "There's always the thing about the logistics," and "Once you have cancer, you're always thinking do I have it again?". The findings suggest that HSCT patients' experiences of long-term follow-up care clinics are influenced by the patient-provider relationship and the logistical set-up of monitoring practices, and weakly connected with fear of cancer recurrence. Future research is needed to understand the impact of each finding of this review, specifically in relation to patients' country of residence to gain a greater understanding of their monitoring support needs.
PubMed: 38343689
DOI: 10.1177/23743735241229378