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Dental Traumatology : Official... Oct 2020It is crucial to store an avulsed tooth appropriately to preserve the viability of the periodontal ligament cells prior to replantation. The aim of this systematic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/AIM
It is crucial to store an avulsed tooth appropriately to preserve the viability of the periodontal ligament cells prior to replantation. The aim of this systematic review was to identify the best available evidence for the effectiveness of any technique available to laypeople for storing an avulsed tooth compared with storage in milk or saliva.
METHODS
The following databases were searched (September 2019): Cochrane Library, MEDLINE, and Embase. Two reviewers independently considered trial eligibility, then extracted and analyzed data, and assessed the risk of bias. The certainty of the body of evidence was appraised according to the GRADE methodology.
RESULTS
Out of 4118 references, 33 studies were included and reported 23 comparisons of which 10 were synthesized in a meta-analysis. The limited evidence available favors storing an avulsed tooth in Hank's balanced salt solution (pooled SMD 2.47, 95% CI [1.59;3.34], P < .00001), propolis solution (pooled SMD 1.73, 95% CI [1.12;2.33], P < .00001), oral rehydration salts (pooled SMD 4.16, 95% CI [2.10;6.23], P < .0001), rice water, and cling film compared with storage in milk. The cell viability rate was significantly lower in teeth stored in saline solutions (pooled SMD -4.35, 95% CI [-7.55;-1.14], P = .008), tap water, buttermilk, castor oil, GC Tooth Mousse, and turmeric extract than those stored in milk. There is insufficient evidence to recommend for or against temporary storage of an avulsed tooth in saliva compared with alternative solutions. The certainty of evidence was considered low to very low due to limitations in study design, indirect study populations and outcome measures, and imprecision.
CONCLUSION
Although milk was shown to extend the periodontal ligament cell viability before replantation compared with saline or tap water, the following media have also demonstrated efficacy at preserving the cell viability: Hank's balanced salt solution, propolis, oral rehydration salts, rice water, and cling film.
Topics: Animals; Cell Survival; Isotonic Solutions; Milk; Organ Preservation Solutions; Periodontal Ligament; Tooth Avulsion; Tooth Replantation
PubMed: 32344468
DOI: 10.1111/edt.12564 -
Journal of Clinical Orthopaedics and... Dec 2021The unique attributes of distributed ledger blockchain systems including robust security, immutability, transparency, and decentralisation, make them highly suitable... (Review)
Review
INTRODUCTION
The unique attributes of distributed ledger blockchain systems including robust security, immutability, transparency, and decentralisation, make them highly suitable solutions for many healthcare-related problems. This review examines the potential applications for blockchain technology in the field of orthopaedics, by taking a systematic approach to the evolving blockchain literature and mapping potential use cases against the current needs of orthopaedic practice.
METHOD
A literature search was performed using Pubmed, EMBASE, OVID and the Cochrane library with the primary aim of identifying detailed accounts of blockchain solutions and use cases in healthcare. These articles were then reviewed and mapped against current orthopaedic practice to illustrate applications specific to that specialty.
RESULTS
One hundred and forty-one papers were identified which described case studies, simulations, or detailed proposals of blockchain solutions in healthcare. Most studies described blockchain solutions at the simulated or prototype testing phase, with only 10 case studies describing blockchains in "real-world" use. The most frequently cited use cases for blockchain technology involved the storage, security and sharing of electronic medical records. Other blockchain solutions focused on the "Internet of Things", research, COVID 19, supply chains and radiology. There were no solutions focusing specifically on orthopaedics. Many of the described blockchain solutions had considerable scope for application in orthopaedic practice however, providing the potential for greater inter-institutional collaboration, cross border data exchange, enhanced patient participation, and more robust and transparent research practices.
CONCLUSION
Blockchain solutions for healthcare are increasing in number and scope and have multiple applications relevant to orthopaedic practice. The orthopaedic community needs to be aware of this innovative and growing field of computer science so that surgeons can leverage the power of blockchain safely for the future of orthopaedics.
PubMed: 34671546
DOI: 10.1016/j.jcot.2021.101615 -
HIV Medicine Sep 2022Healthcare workers in developing countries are at particularly increased risk of infections from blood-borne pathogens because of the high prevalence of such pathogens... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Healthcare workers in developing countries are at particularly increased risk of infections from blood-borne pathogens because of the high prevalence of such pathogens in their communities as well as the lack of basic personal protective equipment, such as gloves, gowns and goggles. For those exposed healthcare workers, the immediate administration of antiretroviral drugs following exposure to potentially infected blood or other bodily fluids is essential in order to minimize the risk of acquiring HIV infection. This review is aimed at estimating the pooled prevalence of knowledge and uptake of post-exposure prophylaxis among healthcare providers in Africa.
METHODS
We accessed PubMed, Science Direct, Google Scholar, SCOPUS, African Journals Online (AJOL), Journal Storage (JSTOR) and EMBASE. The search for unpublished studies included Google and institutional repositories were also used. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of studies was assessed using the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out with a random-effects method using STATA v.14 software.
RESULTS
Out of 654 692 studies retrieved, 37 studies from four African regions involving 6482 healthcare providers were included in this meta-analysis. The overall estimated pooled uptake and knowledge of HIV/AIDS post-exposure prophylaxis among healthcare providers in Africa using a random-effects model were 40.09% (95% CI: 30.14-50.04) and 57.67% (95% CI: 44.32-71.01) respectively, whereas the highest uptake and knowledge were 45.48% (95% CI: 24.79-66.17) and 61.37% (95% CI: 46.39-76.36) in the southern and eastern regions, respectively.
CONCLUSIONS
The results of this meta-analysis indicated that the knowledge and uptake of post-exposure prophylaxis, one of the best approaches to tackling HIV/AIDS transmission, are significantly low. Therefore, healthcare organizations should work on strategies to increase knowledge and uptake of post-exposure prophylaxis among healthcare providers.
REGISTRATION
Prospero (ID: CRD42021244003).
Topics: Acquired Immunodeficiency Syndrome; Africa; Anti-Retroviral Agents; HIV Infections; Health Personnel; Humans; Post-Exposure Prophylaxis; Prevalence
PubMed: 35355388
DOI: 10.1111/hiv.13271 -
Obesity Reviews : An Official Journal... Jan 2023This study aimed to investigate the prevalence of anemia and related nutrient deficiencies after sleeve gastrectomy (SG). Four online databases were searched for... (Meta-Analysis)
Meta-Analysis Review
This study aimed to investigate the prevalence of anemia and related nutrient deficiencies after sleeve gastrectomy (SG). Four online databases were searched for relevant articles. Thirty-one studies with 7639 patients were included in the meta-analysis. The pooled anemia prevalence was 7%, 6%, 9%, 10%, 12%, 25%, 20%, and 18% at baseline, 3 months, 6 months, 12 months, 24 months, 36 months, 48 months, and 60 months, respectively. Although the prevalence of vitamin B12 and folate deficiencies remained low postoperatively, the prevalence of ferritin deficiency steadily increased from 6% at baseline to 27% at 60 months. The prevalence of serum iron deficiency decreased from 13% at baseline to 6% at 24 months and increased to 20% at 60 months. Anemia and ferritin deficiency were strongly correlated (Pearson correlation coefficient = 0.774, p = 0.041). Subgroup analysis suggested that age ≤40 years, preoperative anemia, and insufficient iron supplementations were high-risk factors for postoperative anemia. SG is associated with an increased risk of anemia and decreased iron storage over long-term observation. Routine iron supplementations may reduce anemia after SG; however, the dosages recommended by current guidelines may be insufficient. More strict monitoring schedules and supplementation strategies should be established for the timely detection and management of postoperative anemia.
Topics: Humans; Adult; Obesity, Morbid; Prevalence; Gastrectomy; Anemia; Ferritins; Iron; Nutrients
PubMed: 36323610
DOI: 10.1111/obr.13516 -
International Journal of Medical... Sep 2022We summarized a decade of new research focusing on semantic data integration (SDI) since 2009, and we aim to: (1) summarize the state-of-art approaches on integrating... (Review)
Review
OBJECTIVE
We summarized a decade of new research focusing on semantic data integration (SDI) since 2009, and we aim to: (1) summarize the state-of-art approaches on integrating health data and information; and (2) identify the main gaps and challenges of integrating health data and information from multiple levels and domains.
MATERIALS AND METHODS
We used PubMed as our focus is applications of SDI in biomedical domains and followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) to search and report for relevant studies published between January 1, 2009 and December 31, 2021. We used Covidence-a systematic review management system-to carry out this scoping review.
RESULTS
The initial search from PubMed resulted in 5,326 articles using the two sets of keywords. We then removed 44 duplicates and 5,282 articles were retained for abstract screening. After abstract screening, we included 246 articles for full-text screening, among which 87 articles were deemed eligible for full-text extraction. We summarized the 87 articles from four aspects: (1) methods for the global schema; (2) data integration strategies (i.e., federated system vs. data warehousing); (3) the sources of the data; and (4) downstream applications.
CONCLUSION
SDI approach can effectively resolve the semantic heterogeneities across different data sources. We identified two key gaps and challenges in existing SDI studies that (1) many of the existing SDI studies used data from only single-level data sources (e.g., integrating individual-level patient records from different hospital systems), and (2) documentation of the data integration processes is sparse, threatening the reproducibility of SDI studies.
Topics: Humans; Information Storage and Retrieval; Mass Screening; Reproducibility of Results; Semantics
PubMed: 35863206
DOI: 10.1016/j.ijmedinf.2022.104834 -
Healthcare Analytics (New York, N.Y.) Nov 2023The unexpected and rapid spread of the COVID-19 pandemic has amplified the acceptance of remote healthcare systems such as telemedicine. Telemedicine effectively... (Review)
Review
The unexpected and rapid spread of the COVID-19 pandemic has amplified the acceptance of remote healthcare systems such as telemedicine. Telemedicine effectively provides remote communication, better treatment recommendation, and personalized treatment on demand. It has emerged as the possible future of medicine. From a privacy perspective, secure storage, preservation, and controlled access to health data with consent are the main challenges to the effective deployment of telemedicine. It is paramount to fully overcome these challenges to integrate the telemedicine system into healthcare. In this regard, emerging technologies such as blockchain and federated learning have enormous potential to strengthen the telemedicine system. These technologies help enhance the overall healthcare standard when applied in an integrated way. The primary aim of this study is to perform a systematic literature review of previous research on privacy-preserving methods deployed with blockchain and federated learning for telemedicine. This study provides an in-depth qualitative analysis of relevant studies based on the architecture, privacy mechanisms, and machine learning methods used for data storage, access, and analytics. The survey allows the integration of blockchain and federated learning technologies with suitable privacy techniques to design a secure, trustworthy, and accurate telemedicine model with a privacy guarantee.
PubMed: 37223223
DOI: 10.1016/j.health.2023.100192 -
Journal of Assisted Reproduction and... Apr 2022Few studies explored whether prolonged cryo-storage after vitrification affects embryo competence and perinatal outcomes. This systematic review and meta-analysis aims... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Few studies explored whether prolonged cryo-storage after vitrification affects embryo competence and perinatal outcomes. This systematic review and meta-analysis aims at highlighting any putative impact of cryo-storage duration on cryo-survival, miscarriage, live birth and major malformations.
METHODS
A systematic review was performed using MEDLINE (PubMed), ISI Web of Knowledge, Scopus and Embase databases up to June 2021. Data were combined to obtain a pooled OR, and meta-analysis was conducted using a random effects model. Out of 1,389 screened abstracts, 22 papers were assessed for eligibility, and 5 studies were included (N = 18,047 embryos). Prolonged cryo-storage was defined as > 12 months (N = 3389 embryos). Subgroup analysis was performed for untested vitrified cleavage stage embryos (N = 1739 embryos) and for untested and euploid vitrified blastocysts (N = 13,596 and 2712 embryos, respectively).
RESULTS
Survival rate, miscarriage, live birth and major malformation rates were all similar in the two groups.
CONCLUSION
These data further support the safety of long-term cryo-storage of human embryos beyond 12 months. This is reassuring for good prognosis patients with surplus embryos, couples seeking a second child from supernumerary embryos and women postponing the transfer for clinical or personal reasons.
Topics: Abortion, Spontaneous; Blastocyst; Cryopreservation; Female; Humans; Live Birth; Pregnancy; Pregnancy Rate; Retrospective Studies; Vitrification
PubMed: 35119549
DOI: 10.1007/s10815-022-02405-3 -
BMC Public Health Jun 2021Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates.
METHODS
Household surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions.
RESULTS
From the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage.
CONCLUSIONS
Factors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient's pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.
Topics: Drug Storage; Family Characteristics; Female; Humans; Income; Insurance Coverage; Middle East
PubMed: 34118923
DOI: 10.1186/s12889-021-11100-4 -
Reviews on Environmental Health Aug 2023Today, many health problems related to work have overshadowed workers and their families. In the meantime, chemicals are among the risk factors that have created many... (Review)
Review
Today, many health problems related to work have overshadowed workers and their families. In the meantime, chemicals are among the risk factors that have created many problems due to para-occupational exposure. In para-occupational exposures, family members are exposed to work pollutants transferred to the home environment. This study was conducted to investigate para-occupational exposure to chemicals. To conduct this systematic review, databases such as "Web of Science", "Google Scholar", "Scopus", and "SID" were used. Relevant articles in these databases were extracted by searching keywords such as "take-home exposure", "para-occupational exposure", and "chemicals" from 2000 to 2022. To extract the required data, all parts of the articles were reviewed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020). Among the 44 identified articles, 23 were selected as final articles, of which 10 were related to agriculture workers and their families, and 13 were related to other occupations. These studies mainly investigated para-occupational exposure to pesticides (14 studies) and metals (four studies). Also, contaminated work clothes, the washing place of contaminated clothes, and storage of working clothes, equipment, and chemicals were proposed as the main routes of contamination transmission. As a result of these para-occupational exposures, problems like neuro-behavioral disorders in children, end-stage renal disease, black gingival borders, and autism spectrum disorder were created or aggravated. Limiting the transmission routes and taking measures such as training and providing facilities like devoting places for washing and storing clothes in the workplaces can decrease this type of exposure.
PubMed: 37525484
DOI: 10.1515/reveh-2023-0019 -
Journal of Environmental Management Dec 2023The livestock industry accounts for a considerable proportion of agricultural greenhouse gas emissions, and in response, the Australian red meat industry has committed... (Meta-Analysis)
Meta-Analysis Review
The livestock industry accounts for a considerable proportion of agricultural greenhouse gas emissions, and in response, the Australian red meat industry has committed to an aspirational target of net-zero emissions by 2030. Increasing soil carbon storage in grazing lands has been identified as one method to help achieve this, while also potentially improving production and provision of other ecosystem services. This review examined the effects of grazing management on soil carbon and factors that drive soil carbon sequestration in Australia. A systematic literature search and meta-analysis was used to compare effects of stocking intensity (stocking rate or utilisation) and stocking method (i.e, continuous, rotational or seasonal grazing systems) on soil organic carbon, pasture herbage mass, plant growth and ground cover. Impacts on below ground biomass, soil nitrogen and soil structure are also discussed. Overall, no significant impact of stocking intensity or method on soil carbon sequestration in Australia was found, although lower stocking intensity and incorporating periods of rest into grazing systems (rotational grazing) had positive effects on herbage mass and ground cover compared with higher stocking intensity or continuous grazing. Minimal impact of grazing management on pasture growth rate and below-ground biomass has been reported in Australia. However, these factors improved with grazing intensity or rotational grazing in some circumstances. While there is a lack of evidence in Australia that grazing management directly increases soil carbon, this meta-analysis indicated that grazing management practices have potential to benefit the drivers of soil carbon sequestration by increasing above and below-ground plant production, maintaining a higher residual biomass, and promoting productive perennial pasture species. Specific recommendations for future research and management are provided in the paper.
Topics: Australia; Biomass; Carbon; Ecosystem; Soil
PubMed: 37852027
DOI: 10.1016/j.jenvman.2023.119146