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Clinical Oral Implants Research Sep 2023The significance on the association between the peri-implant bucco-lingual dimension (BLD) at the stage of implant placement and the occurrence of biological and... (Review)
Review
BACKGROUND
The significance on the association between the peri-implant bucco-lingual dimension (BLD) at the stage of implant placement and the occurrence of biological and esthetic complications is yet unknown.
MATERIAL AND METHODS
Systematic screening of electronic sources was carried out to identify clinical and preclinical studies reporting on the baseline BLD and/or buccal bone thickness (BBT) values. A secondary objective was to assess the effect of simultaneous grafting at sites with deficient or no buccal bone wall (BBW) at baseline. The primary outcome variables were BBT, BLD, and buccal vertical bone loss (VBL) at re-evaluation. Moreover, radiographic, clinical, and patient-reported outcome measures (PROMs) were evaluated.
RESULTS
Overall, 12 clinical and four preclinical studies met the inclusion criteria. Inconsistencies were found in defining the critical BBT across the clinical and preclinical data evaluated. The clinical evidence demonstrated that during healing, dimensional changes occur in the alveolar bone and in the BBW that may compromise the integrity of the peri-implant bone, leading to VBL and mucosal recession (MR), particularly in scenarios exhibiting a thin BBW. The preclinical evidence validated the fact that implants placed in the presence of a thin BBW, are more prone to exhibit major dimensional changes and VBL. Moreover, the clinical data supported that, in scenarios where dehiscence-type defects occur and are left for spontaneous healing, greater VBL and MR together with the occurrence of biologic complications are expected. Furthermore, the augmentation of dehiscence-type defects is associated with hard and soft tissue stability. PROMs were not reported.
CONCLUSIONS
Dimensional changes occur as result of implant placement in healed ridges that may lead to instability of the peri-implant hard and soft tissues. Sites presenting a thin BBW are more prone to exhibit major changes that may compromise the integrity of the buccal bone and may lead to biologic and esthetic complications.
Topics: Humans; Dental Implants; Bone Diseases, Metabolic; Wound Healing; Zygoma; Biological Products
PubMed: 37750522
DOI: 10.1111/clr.14177 -
Journal of Intensive Medicine Mar 2023Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, prone positioning has been widely applied for non-intubated, spontaneously breathing patients....
Efficacy and safety of awake prone positioning in the treatment of non-intubated spontaneously breathing patients with COVID-19-related acute respiratory failure: A systematic review and meta-analysis.
BACKGROUND
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, prone positioning has been widely applied for non-intubated, spontaneously breathing patients. However, the efficacy and safety of prone positioning in non-intubated patients with COVID-19-related acute hypoxemic respiratory failure remain unclear. We aimed to systematically analyze the outcomes associated with awake prone positioning (APP).
METHODS
We conducted a systematic literature search of PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science from January 1, 2020, to June 3, 2022. This study included adult patients with acute respiratory failure caused by COVID-19. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study quality was assessed using the Cochrane risk-of-bias tool. The primary outcome was the reported cumulative intubation risk across randomized controlled trials (RCTs), and the effect estimates were calculated as risk ratios (RRs; 95% confidence interval [CI]).
RESULTS
A total of 495 studies were identified, of which 10 fulfilled the selection criteria, and 2294 patients were included. In comparison to supine positioning, APP significantly reduced the need for intubation in the overall population (RR=0.84, 95% CI: 0.74-0.95). The two groups showed no significant differences in the incidence of adverse events (RR=1.16, 95% CI: 0.48-2.76). The meta-analysis revealed no difference in mortality between the groups (RR=0.93, 95% CI: 0.77-1.11).
CONCLUSIONS
APP was safe and reduced the need for intubation in patients with respiratory failure associated with COVID-19. However, it did not significantly reduce mortality in comparison to usual care without prone positioning.
PubMed: 37362868
DOI: 10.1016/j.jointm.2023.02.001 -
Journal of Advanced Nursing Apr 2019To synthesize evidence about the effect of individual circadian preference (chronotype) and gender in the development of sleep and mood problems in nursing professionals. (Meta-Analysis)
Meta-Analysis
AIM
To synthesize evidence about the effect of individual circadian preference (chronotype) and gender in the development of sleep and mood problems in nursing professionals.
BACKGROUND
Shift workers are more prone to having unhealthy habits and unfavourable clinical conditions than nonshift workers. These associations are mediated by chronotype and gender differences have also been detected.
DESIGN
A quantitative systematic review.
DATA SOURCES
Electronic searches were performed in MEDLINE, Scopus, ScienceDirect, and Web of Science from 1 July 2012 - 1 July 2017.
REVIEW METHODS
A systematic review was conducted using the Cochrane Collaboration guidelines and two quality assessment tools: the National Heart, Lung and Blood Institute and GRADE. Inclusion criteria were quantitative studies where the sample consists entirely of nurses, analysing circadian rhythms or individual chronotype or gender and sleep/mood disturbances in nursing activity. The review was reported using the PRISMA statement.
RESULTS
A total of 23 studies were included in the review (five cohort studies and 18 cross-sectional studies). Data on gender-specific attention were scarce (two studies) and showed a higher incidence of sleep problems. Female nurses with eveningness-oriented personality seem to be more prone to having sleep disorders, insomnia, fatigue, and anxiety than male and morningness ones.
CONCLUSIONS
Evidence seems to show that female nurses with an evening-oriented preference suffer more problems of insomnia, sleepiness, fatigue, and anxiety. The impact of our results may affect nurses, patient safety and the quality of clinical practice.
Topics: Chronobiology Disorders; Circadian Rhythm; Cohort Studies; Female; Humans; Male; Mood Disorders; Nursing; Observational Studies as Topic; Occupational Diseases; Sex Characteristics; Sleep Wake Disorders; Work Schedule Tolerance
PubMed: 30307057
DOI: 10.1111/jan.13876 -
The Journal of Prosthetic Dentistry Feb 2023The advent of machine learning in the complex subject of occlusal rehabilitation warrants a thorough investigation into the techniques applied for successful clinical... (Review)
Review
STATEMENT OF PROBLEM
The advent of machine learning in the complex subject of occlusal rehabilitation warrants a thorough investigation into the techniques applied for successful clinical translation of computer automation. A systematic evaluation on the topic with subsequent discussion of the clinical variables involved is lacking.
PURPOSE
The purpose of this study was to systematically critique the digital methods and techniques used to deploy automated diagnostic tools in the clinical evaluation of altered functional and parafunctional occlusion.
MATERIAL AND METHODS
Articles were screened by 2 reviewers in mid-2022 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible articles were critically appraised by using the Joanna Briggs Institute's Diagnostic Test Accuracy (JBI-DTA) protocol and Minimum Information for Clinical Artificial Intelligence Modeling (MI-CLAIM) checklist.
RESULTS
Sixteen articles were extracted. Variations in mandibular anatomic landmarks obtained via radiographs and photographs produced notable errors in prediction accuracy. While half of the studies adhered to robust methods of computer science, the lack of blinding to a reference standard and convenient exclusion of data in favor of accurate machine learning suggested that conventional diagnostic test methods were ineffective in regulating machine learning research in clinical occlusion. As preestablished baselines or criterion standards were lacking for model evaluation, a heavy reliance was placed on the validation provided by clinicians, often dental specialists, which was prone to subjective biases and largely governed by professional experience.
CONCLUSIONS
Based on the findings and because of the numerous clinical variables and inconsistencies, the current literature on dental machine learning presented nondefinitive but promising results in diagnosing functional and parafunctional occlusal parameters.
PubMed: 36801145
DOI: 10.1016/j.prosdent.2023.01.013 -
IEEE Transactions on Neural Systems and... 2023Post-stroke therapy restores lost skills. Traditionally, patients are supported by skilled therapists who monitor their progress and evaluate the program's...
Post-stroke therapy restores lost skills. Traditionally, patients are supported by skilled therapists who monitor their progress and evaluate the program's effectiveness. Due to a shortage of qualified therapists, rehabilitation facilities are both expensive and inadequate. Furthermore, evaluations may be subjective and prone to errors. These limitations motivate the researchers to devise automated systems with minimal human intervention, therapist-like assessment, and broader outreach. This article reviews seminal works from 2013 onwards, qualitatively and quantitatively adapting the PRISMA approach to examine the potential of robot-assisted, virtual reality-based rehabilitation and automated assessments through data-driven learning. Extensive experimentation on KIMORE and UI-PRMD datasets reveal high agreement between automated methods and therapists. Our investigation shows that deep learning with spatio-temporal skeleton data and dynamic attention outperforms others, with an RMSE as low as 0.55. Fully automated rehabilitation is still in development, but, being an active research topic, it could hasten objective assessment and improve outreach.
Topics: Humans; Stroke Rehabilitation; Stroke; Virtual Reality; Artificial Intelligence
PubMed: 36327176
DOI: 10.1109/TNSRE.2022.3219085 -
Indian Journal of Dermatology 2023Atopic dermatitis is a chronic inflammatory skin condition common in early childhood. Acute exacerbation is frequently associated with colonization.
BACKGROUND
Atopic dermatitis is a chronic inflammatory skin condition common in early childhood. Acute exacerbation is frequently associated with colonization.
AIMS AND OBJECTIVES
This study aims to explore the relationship between skin and nasal colonization with pediatric atopic dermatitis.
METHODS
A systematic review and meta-analysis were conducted by comparing atopic dermatitis patients aged ≤18 years and nondiseased controls. A random-effects model was used to obtain the pooled prevalence and odds ratio of colonization at eczematous skin, nonlesional skin, and nasal cavity. Subgroup analyses for colonization with methicillin-resistant were also evaluated.
RESULTS
A total of 2,670 cases and 1,224 controls from 26 studies were included in the meta-analysis. colonization at eczematous skin and nasal cavity is significantly higher in atopic dermatitis compared to control with odds ratios of 10.55 (95% confidence interval [CI]; 4.85-22.92, < .001) and 2.38 (nasal cavity; 95% CI; 1.46-3.90, < .001), respectively. The pooled prevalence of skin and nasal colonization were 55.0% (eczematous skin; 95% CI; 38.3-71.7), 23.3% (nonlesional skin; 95% CI; 12.6-33.9), and 56.3% (95% CI; 43.2-69.4), respectively. Methicillin-resistant strain was obtained from the nares and eczematous skin with rates of 11.6% (95% CI; 6.5-16.7) and 8.5% (95% CI; 4.3-12.8), respectively.
CONCLUSION
Children with atopic dermatitis are more prone to skin and nasal colonization by compared to nondiseased individuals.
PubMed: 38371569
DOI: 10.4103/ijd.ijd_453_22 -
BMC Infectious Diseases Jun 2023Awake prone positioning has been widely used in non-intubated patients with acute hypoxic respiratory failure (AHRF) due to COVID-19, but the evidence is mostly from... (Meta-Analysis)
Meta-Analysis
Awake prone positioning for non-intubated patients with COVID-19-related acute hypoxic respiratory failure: a systematic review based on eight high-quality randomized controlled trials.
BACKGROUND
Awake prone positioning has been widely used in non-intubated patients with acute hypoxic respiratory failure (AHRF) due to COVID-19, but the evidence is mostly from observational studies and low-quality randomized controlled trials (RCTs), with conflicting results from published studies. A systematic review of published high-quality RCTs to resolve the controversy over the efficacy and safety of awake prone positioning in non-intubated patients with AHRF due to COVID-19.
METHODS
Candidate studies were identified through searches of PubMed, Web of Science, Cochrane, Embase, Scopus databases from December 1, 2019 to November 1, 2022. Literature screening, data extraction and risk of bias assessment were independently conducted by two researchers.
RESULTS
Eight RCTs involving 2657 patients were included. Meta-analysis of fixed effects models showed that awake prone positioning did not increase mortality(OR = 0.88, 95%CI [0.72, 1.08]), length of stay in ICU (WMD = 1.14, 95%CI [-0.45, 2.72]), total length of stay (WMD = 0.11, 95%CI [-1.02, 1.23]), or incidence of adverse events (OR = 1.02, 95%CI [0.79, 1.31]) compared with usual care, but significantly reduced the intubation rate (OR = 0.72, 95%CI [0.60, 0.86]). Similar results were found in a subgroup analysis of patients who received only high flow nasal cannula (Mortality: OR = 0.86, 95%CI [0.70, 1.05]; Intubation rate: OR = 0.69, 95%CI [0.58, 0.83]). All eight RCTs had high quality of evidence, which ensured the reliability of the meta-analysis results.
CONCLUSIONS
Awake prone positioning is safe and feasible in non-intubated patients with AHRF caused by COVID-19, and can significantly reduce the intubation rate. More studies are needed to explore standardized implementation strategies for the awake prone positioning.
TRIAL REGISTRATION
CRD42023394113.
Topics: Humans; COVID-19; Wakefulness; Prone Position; Randomized Controlled Trials as Topic; Hypoxia; Respiratory Distress Syndrome; Respiratory Insufficiency
PubMed: 37337193
DOI: 10.1186/s12879-023-08393-8 -
Journal of Medical Ultrasound 2022Children born with clefts encounter various postnatal issues which have a negative impact and long-term psychological effects on both the parents and themselves. This... (Review)
Review
Children born with clefts encounter various postnatal issues which have a negative impact and long-term psychological effects on both the parents and themselves. This systematic review aims to find the accuracy of two-dimensional (2D)/3D scans for screening cleft lip and palate which would help the parents to be mentally and psychologically prepared to plan for future surgeries. To identify relevant literature, an electronic search was performed using PubMed, Trip database, Cochrane, and Google Scholar database. The search yielded 927 articles, of which 10 fulfilled the eligibility criteria and were included in this systematic review. These studies showed that the combination of 2D and 3D ultrasound scans has increased the specificity and sensitivity in detecting orofacial clefts, as they aid in improved visualization of the fetal face. However, in future, the visualization of the palate can be improved by inventing other modified views as cleft palate diagnosis is more prone to error.
PubMed: 36484047
DOI: 10.4103/jmu.jmu_20_22 -
Asian Journal of Surgery Sep 2021To explore the effectiveness of transgluteal approach during extracorporeal shockwave lithotripsy (ESWL) for patients with distal ureteral stones compared to the prone... (Meta-Analysis)
Meta-Analysis Review
To explore the effectiveness of transgluteal approach during extracorporeal shockwave lithotripsy (ESWL) for patients with distal ureteral stones compared to the prone approach. A systematic literature search was carried out by two reviewers independently on the basis of three electronic databases up to Aug. 2020. Three randomized controlled trials (RCT) and one cohort studies (CS), with a total of 516 patients, comparing transgluteal approach with prone approach during ESWL for distal ureteral stones were included. The methodological quality of RCT was evaluated by Cochrane collaboration's tools, and the quality of CS and CCS was evaluated by modified Newcatle-Ottawa scale. The weighted mean difference (WMD) and odds ratio (OR) was respectively used to describe results of continuous and dichotomous variables. Pooled data showed that transgluteal approach could significantly improve the rate of stone free after the first treatment [OR = 3.18, 95% confidence interval (CI) 2.19-4.63, p < 0.00001] and the rate of overall stone free (OR = 4.03, 95% CI 2.43-6.69, p < 0.00001). In addition, compared with the prone approach, the transgluteal one could also significantly reduce the rate of ureteroscopy (OR = 0.21, 95% CI 0.12-0.36, p < 0.00001). What's more, complications were rarely reported, which demonstrated a similar safety for two approaches. Our study suggested that, during ESWL for patients with distal ureteral stones, transgluteal approach was a safe and more effective choice than the prone position.
Topics: Humans; Lithotripsy; Odds Ratio; Patient Positioning; Treatment Outcome; Ureteral Calculi; Ureteroscopy
PubMed: 33771425
DOI: 10.1016/j.asjsur.2021.02.021 -
Scientific Reports Jul 2021Prone position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of... (Meta-Analysis)
Meta-Analysis
Prone position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of PP on respiratory parameters and outcomes. PubMed, EMBASE, ProQuest, SCOPUS, Web of Sciences, Cochrane library, and Google Scholar were searched up to 1st January 2021. Twenty-eight studies were included. The Cochran's Q-test and I statistic were assessed heterogeneity, the random-effects model was estimated the pooled mean difference (PMD), and a meta-regression method has utilized the factors affecting heterogeneity between studies. PMD with 95% confidence interval (CI) of PaO/FIO Ratio in before-after design, quasi-experimental design and in overall was 55.74, 56.38, and 56.20 mmHg. These values for Spo (Sao) were 3.38, 17.03, and 7.58. PP in COVID-19 patients lead to significantly decrease of the Paco (PMD: - 8.69; 95% CI - 14.69 to - 2.69 mmHg) but significantly increase the PaO (PMD: 37.74; 95% CI 7.16-68.33 mmHg). PP has no significant effect on the respiratory rate. Based on meta-regression, the study design has a significant effect on the heterogeneity of Spo (Sao) (Coefficient: 12.80; p < 0.001). No significant associations were observed for other respiratory parameters with sample size and study design. The pooled estimate for death rate and intubation rates were 19.03 (8.19-32.61) and 30.68 (21.39-40.75). The prone positioning was associated with improved oxygenation parameters and reduced mortality and intubation rate in COVID-19 related respiratory failure.
Topics: COVID-19; Humans; Intubation, Intratracheal; Models, Theoretical; Prone Position; Respiratory Insufficiency
PubMed: 34257366
DOI: 10.1038/s41598-021-93739-y