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European Journal of Orthodontics Nov 2023Orthognathic surgical procedures, whether in one or both jaws, can affect structures regarding the articulation and resonance of voice and speech. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Orthognathic surgical procedures, whether in one or both jaws, can affect structures regarding the articulation and resonance of voice and speech.
OBJECTIVE
Evaluating the impact of orthognathic surgery on voice and speech performance in individuals with skeletal dentofacial disharmony.
SEARCH METHODS
Word combinations and truncations were adapted for the following electronic databases: EMBASE, PubMed/Medline, Scopus, Web of Science, Cochrane Library, and Latin American and Caribbean Literature in Health Sciences (LILACS), and grey literature.
SELECTION CRITERIA
The research included studies on nonsyndromic adults with skeletal dentofacial disharmony undergoing orthognathic surgery. These studies assessed patients before and after surgery or compared them with individuals with good facial harmony using voice and speech parameters through validated protocols.
DATA COLLECTION AND ANALYSIS
Two independent reviewers performed all stages of the review. The Joanna Briggs Institute tool was used to assess risk of bias in the cohort studies, and ROBINS-I was used for nonrandomized clinical trials. The authors also performed a meta-analysis of random effects.
RESULTS
A total of 1163 articles were retrieved after the last search, of which 23 were read in full. Of these, four were excluded, totalling 19 articles for quantitative synthesis. When comparing the pre- and postoperative periods, both for fundamental frequency, formants, and jitter and shimmer perturbation measures, orthognathic surgery did not affect vowel production. According to the articles, the main articulatory errors associated with skeletal dentofacial disharmonies prior to surgery were distortions of fricative sounds, mainly/s/ and/z/.
CONCLUSIONS
Orthognathic surgery may have little or no impact on vocal characteristics during vowel production. However, due to the confounding factors involved, estimates are inconclusive. The most prevalent articulatory disorders in the preoperative period were distortion of the fricative phonemes/s/ and/z/. However, further studies must be carried out to ensure greater robustness to these findings.
REGISTRATION
PROSPERO (CRD42022291113).
Topics: Adult; Humans; Orthognathic Surgery; Speech; Orthognathic Surgical Procedures
PubMed: 37467104
DOI: 10.1093/ejo/cjad025 -
Neuroscience and Biobehavioral Reviews Dec 2021It has been documented that individuals who hear auditory verbal hallucinations (AVH) exhibit diminished capabilities in processing external speech. While functional...
It has been documented that individuals who hear auditory verbal hallucinations (AVH) exhibit diminished capabilities in processing external speech. While functional neuroimaging studies have attempted to characterise the cortical regions and networks facilitating these deficits in a bid to understand AVH, considerable methodological heterogeneity has prevented a consensus being reached. The current systematic review investigated the neurobiological underpinnings of external speech processing deficits in voice-hearers in 38 studies published between January 1990 to June 2020. AVH-specific deviations in the activity and lateralisation of the temporal auditory regions were apparent when processing speech sounds, words and sentences. During active or affective listening tasks, functional connectivity changes arose within the language, limbic and default mode networks. However, poor study quality and lack of replicable results plague the field. A detailed list of recommendations has been provided to improve the quality of future research on this topic.
Topics: Auditory Perception; Functional Neuroimaging; Hallucinations; Humans; Language; Magnetic Resonance Imaging; Speech
PubMed: 34517037
DOI: 10.1016/j.neubiorev.2021.09.006 -
The Laryngoscope Mar 2022To determine how above cuff vocalization (ACV) is implemented in clinical practice, to identify what evidence exists on the effectiveness and safety of ACV, and to...
OBJECTIVES/HYPOTHESIS
To determine how above cuff vocalization (ACV) is implemented in clinical practice, to identify what evidence exists on the effectiveness and safety of ACV, and to evaluate the acceptability of ACV.
STUDY DESIGN
Systematic review.
METHODS
A literature search was conducted in eight databases (MEDLINE, Embase, AMED, CINAHL, Cochrane Library, PsycINFO, Scopus, and Web of Science) in May 2019 and updated in June 2020. Two reviewers independently screened, selected, and extracted data. Study quality was appraised using the Joanna Briggs Institute Critical Appraisal Tools and a narrative synthesis was conducted. Systematic review registration number: CRD42019133942.
RESULTS
The searches identified 1327 records. The 13 eligible studies included four case studies, three case series, four observational studies without a control group, one quasi-experimental study, and one randomized controlled trial. Study quality was low, with most studies having high risk of bias. There was a high level of heterogeneity in study design and outcome measures used. Detailed information on ACV application and dose-delivered was lacking in 12 studies. Positive effects were reported for communication (n = 7), swallowing (n = 4), cough response (n = 2), and quality-of-life (n = 2), but with inconsistent use of objective outcome measures. There is limited quantitative or qualitative evidence for acceptability. Adverse events and complications were reported in nine studies, and four highlighted the importance of involving an experienced speech and language therapist.
CONCLUSIONS
There is limited evidence for the acceptability, effectiveness, safety, or optimal implementation of ACV. The evidence is insufficient to provide recommendations regarding optimal intervention delivery. Future research should ensure detailed recording of ACV delivery and utilize a core outcome set. Laryngoscope, 132:600-611, 2022.
Topics: Humans; Intubation, Intratracheal; Speech; Tracheostomy; Treatment Outcome
PubMed: 33932229
DOI: 10.1002/lary.29591 -
Head & Neck Jan 2020The development of automatic tools based on acoustic analysis allows to overcome the limitations of perceptual assessment for patients with head and neck cancer. The aim... (Review)
Review
BACKGROUND
The development of automatic tools based on acoustic analysis allows to overcome the limitations of perceptual assessment for patients with head and neck cancer. The aim of this study is to provide a systematic review of literature describing the effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis.
METHODS
Two databases (PubMed and Embase) were surveyed. The selection process, according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, led to a final set of 22 articles.
RESULTS
Nasalance is studied mainly in oropharyngeal patients. The vowels are mostly studied using formant analysis and vowel space area, the consonants by means of spectral moments with specific parameters according to their phonetic characteristic. Machine learning methods allow classifying "intelligible" or "unintelligible" speech for T3 or T4 tumors.
CONCLUSIONS
The development of comprehensive models combining different acoustic measures would allow a better consideration of the functional impact of the speech disorder.
Topics: Acoustics; Humans; Oropharyngeal Neoplasms; Speech Acoustics; Speech Intelligibility; Speech Production Measurement
PubMed: 31571334
DOI: 10.1002/hed.25949 -
Journal of the Indian Society of... 2021Pain, fear, and anxiety have long been associated with pediatric dentistry. A child's cooperation with a dental.procedure.usually requires various behavioral management... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pain, fear, and anxiety have long been associated with pediatric dentistry. A child's cooperation with a dental.procedure.usually requires various behavioral management strategies conveyed by the entire dental team. The use of sedatives in dental clinics for providing analgesia and anxiolysis allows the patient to respond appropriately to verbal commands and light tactile stimulation., thus making dental treatment more patient friendly and effective.
AIM
The aim of this study was to compare the safety and efficacy of dexmedetomidine versus midazolam for the management of pediatric patients in the dental clinic.
MATERIALS AND METHODS
This systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six articles were selected for this systematic review. Of them, only in four articles, homogeneous data were available which were subjected to meta-analysis.
RESULTS
When compared with midazolam, premedication with dexmedetomidine resulted in much lower incidence of emergence delirium (odds ratio = 0.07, 95% confidence interval: 0.01-0.54, P = 0.01). No significant difference was observed with respect to satisfactory behavior of the child, successful parental separation, and satisfactory mask acceptance following sedation.
CONCLUSION
Both dexmedetomidine and midazolam are equally effective for the management of pediatric patients in the dental clinic. In addition, dexmedetomidine premedication is associated with lower incidence of emergence delirium and has a better margin of safety.
Topics: Child; Dexmedetomidine; Humans; Hypnotics and Sedatives; Midazolam; Premedication
PubMed: 34810337
DOI: 10.4103/jisppd.jisppd_517_20 -
Heliyon Jun 2024Autism spectrum disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by persistent social communication and interaction deficit.... (Review)
Review
Autism spectrum disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by persistent social communication and interaction deficit. Transcranial magnetic stimulation (TMS) is a promising and emerging tool for the intervention of ASD by reducing both core and associate symptoms. Several reviews have been published regarding TMS-based ASD treatment, however, a systematic review on study characteristics, specific stimulating parameters, localization techniques, stimulated targets, behavioral outcomes, and neuroimage biomarker changes is lagged behind since 2018. Here, we performed a systematic search on literatures published after 2018 in PubMed, Web of Science, and Science Direct. After screening, the final systematic review included 17 articles, composing seven randomized controlled trial studies and ten open-label studies. Two studies are double-blind, while the other studies have a moderate to high risk of bias attributing to inadequate subject- and evaluator-blinding to treatment allocation. Five studies utilize theta-burst stimulation mode, and the others apply repetitive TMS with low frequency (five studies), high frequency (six studies), and combined low and high frequency stimulation (one study). Most researchers prioritize the bilateral dorsolateral prefrontal lobe as stimulation target, while parietal lobule, inferior parietal lobule, and posterior superior temporal sulci have also emerged as new targets of attention. One third of the studies use neuronavigation based on anatomical magnetic resonance imaging to locate the stimulation target. After TMS intervention, discernible enhancements across a spectrum of scales are evident in stereotyped behavior, repetitive behavior, and verbal social domains. A comprehensive review of literature spanning the last five years demonstrates the potential of TMS treatment for ASD in ameliorating the clinical core symptoms.
PubMed: 38933955
DOI: 10.1016/j.heliyon.2024.e32251 -
Journal of Clinical and Experimental... Apr 2024Semantic verbal fluency (SVF) is a widely used measure of frontal executive function and access to semantic memory. SVF scoring metrics include the number of unique... (Review)
Review
INTRODUCTION
Semantic verbal fluency (SVF) is a widely used measure of frontal executive function and access to semantic memory. SVF scoring metrics include the number of unique words generated, perseverations, intrusions, semantic cluster size and switching between clusters, and scores vary depending on the language the test is administered in. In this paper, we review the existing normative data for Turkish, the main metrics used for scoring SVF data in Turkish, and the most frequently used categories.
METHOD
We conducted a systematic review of peer-reviewed papers using Medline, EMBASE, PsycInfo, Web of Science, and two Turkish databases, TR-Dizin and Yok-Tez. Included papers contained data on the SVF performance of healthy adult native speakers of Turkish, and reported the categories used. Versions of the SVF that required participants to alternate categories were excluded. We extracted and tabulated demographics, descriptions of groups, metrics used, categories used, and sources of normative data. Studies were assessed for level of detail in reporting findings.
RESULTS
1400 studies were retrieved. After deduplication, abstract, full text screening, and merging of theses with their published versions, 121 studies were included. 114 studies used the semantic category "animal", followed by first names ( = 14, 12%). All studies reported word count. More complex measures were rare (perseverations: = 12, 10%, clustering and switching: = 5, 4%). Four of seven normative studies reported only word count, two also measured perseverations, and one reported category violations and perseverations. Two normative studies were published in English.
CONCLUSIONS
There is a lack of normative Turkish SVF data with more complex metrics, such as clustering and switching, and a lack of normative data published in English. Given the size of the Turkish diaspora, normative SVF data should include monolingual and bilingual speakers. Limitations include a restriction to key English and Turkish databases.
Topics: Humans; Semantics; Turkey; Neuropsychological Tests; Verbal Behavior; Reference Values; Adult; Female; Male; Executive Function
PubMed: 38904178
DOI: 10.1080/13803395.2024.2331827 -
Journal of Fluency Disorders Dec 2023Treatment of school-age children (6-12 years of age) who stutter is a public health priority. Their clinical needs include a psychosocial focus and stuttering reduction.... (Review)
Review
BACKGROUND
Treatment of school-age children (6-12 years of age) who stutter is a public health priority. Their clinical needs include a psychosocial focus and stuttering reduction. For the latter clinical need, there is a critical window of opportunity for these children warranting research attention.
PURPOSE
The purpose of the review is to guide future clinical research by establishing (a) what interventions are associated with stuttering reduction for school-age children (b) the reported immediate and longer-term effects of those interventions, and (c) the level of evidence for these interventions in terms of study design.
METHODS
Fourteen databases and three conference proceedings were searched for interventions used to reduce stuttering in school-age children. Primary outcomes were mean stuttering reductions pre-treatment, immediately post-treatment, and any follow-up assessments.
RESULTS
Of the 4305 studies identified from the databases, 67 studies met inclusion criteria. Five different treatment approaches were reported in the literature that might reduce stuttering for a school-age child, but with varying effect sizes. These include (a) operant methods, (b) speech restructuring, (c) combined operant methods and speech restructuring, (d) machine-driven treatments, and (e) treatments with a cognitive behaviour therapy component.
CONCLUSIONS
Operant methods warrant investigation in future clinical trial research, as do variants of speech restructuring. Hybrid approaches showed encouraging results, including speech restructuring variants combined with operant methods or with cognitive behaviour therapy. However, evidence is preliminary only at Phase I and II trials. Several treatments with reported clinical promise have been overlooked for decades and require further investigation.
Topics: Humans; Child; Stuttering; Treatment Outcome; Speech Therapy; Speech; Cognitive Behavioral Therapy
PubMed: 37776613
DOI: 10.1016/j.jfludis.2023.106015 -
Critical Care (London, England) Feb 2024To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units. (Meta-Analysis)
Meta-Analysis
Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures.
BACKGROUND
To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units.
METHODS
PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools.
RESULTS
Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low.
CONCLUSIONS
Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated.
SYSTEMATIC REVIEW REGISTRATION
The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).
Topics: Adult; Humans; Male; Health Personnel; Workplace Violence; Aggression; Intensive Care Units; Delivery of Health Care
PubMed: 38409034
DOI: 10.1186/s13054-024-04844-z -
JAMA Jan 2024Children with speech and language difficulties are at risk for learning and behavioral problems.
IMPORTANCE
Children with speech and language difficulties are at risk for learning and behavioral problems.
OBJECTIVE
To review the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force.
DATA SOURCES
PubMed/MEDLINE, Cochrane Library, PsycInfo, ERIC, Linguistic and Language Behavior Abstracts (ProQuest), and trial registries through January 17, 2023; surveillance through November 24, 2023.
STUDY SELECTION
English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions.
DATA EXTRACTION AND SYNTHESIS
Dual review of abstracts, full-text articles, study quality, and data extraction; results were narratively summarized.
MAIN OUTCOMES AND MEASURES
Screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms.
RESULTS
Thirty-eight studies in 41 articles were included (N = 9006). No study evaluated the direct benefits of screening vs no screening. Twenty-one studies (n = 7489) assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (eg, expressive language). Three studies assessing parent-reported tools for expressive language skills found consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). The accuracy of other screening tools varied widely. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders, although none enrolled children identified by routine screening in primary care. Two RCTs evaluating relatively intensive parental group training interventions (11 sessions) found benefit for different measures of expressive language skills, and 1 evaluating a less intensive intervention (6 sessions) found no difference between groups for any outcome. Two RCTs (n = 76) evaluating the Lidcombe Program of Early Stuttering Intervention delivered by speech-language pathologists featuring parent training found a 2.3% to 3.0% lower proportion of syllables stuttered at 9 months compared with the control group when delivered in clinic and via telehealth, respectively. Evidence on other interventions was limited. No RCTs reported on the harms of interventions.
CONCLUSIONS AND RELEVANCE
No studies directly assessed the benefits and harms of screening. Some parent-reported screening tools for expressive language skills had reasonable accuracy for detecting expressive language delay. Group parent training programs for speech delay that provided at least 11 parental training sessions improved expressive language skills, and a stuttering intervention delivered by speech-language pathologists reduced stuttering frequency.
Topics: Child; Humans; Language Development Disorders; Preventive Health Services; Speech; Speech Disorders; Stuttering; Practice Guidelines as Topic; Infant; Child, Preschool; Mass Screening
PubMed: 38261038
DOI: 10.1001/jama.2023.24647