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Frontiers in Aging Neuroscience 2023Neuromodulation is a non-invasive technique that allows for the modulation of cortical excitability and can produce changes in neuronal plasticity. Its application has...
INTRODUCTION
Neuromodulation is a non-invasive technique that allows for the modulation of cortical excitability and can produce changes in neuronal plasticity. Its application has recently been associated with the improvement of the motor pattern in older adults individuals with sequelae from neurological conditions.
OBJECTIVE
To highlight the effects of non-invasive neuromodulation on the risk of falls and fear of falling in community-dwelling older adults.
METHODS
Systematic review conducted in accordance with the items of the Cochrane Handbook for Systematic Reviews of Interventions. Searches were carried out in electronic databases: CENTRAL, Clinical Trials, LILACS, PEDro, PubMed, Web of Science, between 13/06/2020 and 20/09/2023, including all indexed texts without language and publication date restrictions, randomized controlled clinical trials, which presented as their main outcome non-invasive neuromodulation for reducing the fear of falling and risk of falls in the older adults, regardless of gender.
RESULTS
An extensive search identified 9 eligible studies for qualitative synthesis from 8,168 potential articles. Rigorous filtering through automated tools, title/abstract screening, and full-text evaluation ensured a focused and relevant selection for further analysis. Most studies (80%) used transcranial direct current electrical stimulation as an intervention, over the motor cortex or cerebellum area, with anodal current and monopolar electrode placement. The intensity ranged from 1.2 mA to 2 mA, with a duration of 20 min (80%). The profile of the research participants was predominantly individuals over 65 years old (80%), with a high risk of falls (60%) and a minority reporting a fear of falling (40%). The outcomes were favorable for the use of neuromodulation for the risk of falls in the older adults, through improvements in static and dynamic balance.
CONCLUSION
The results may have limited applicability to direct outcomes related to the risk of falls, in addition to evidence regarding the difference or lack thereof in applicability between genders, fallers and non-fallers, as well as older adults individuals with low and high fear of falling.
SYSTEMATIC REVIEW REGISTRATION
The protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) to obtain the identification of ongoing research (ID: 222429).
PubMed: 38516635
DOI: 10.3389/fnagi.2023.1301790 -
The American Journal of Tropical... May 2024Snakebites still constitute a significant public health problem in developing countries and are considered a neglected tropical condition by the WHO. Snake accidents are... (Meta-Analysis)
Meta-Analysis
Snakebites still constitute a significant public health problem in developing countries and are considered a neglected tropical condition by the WHO. Snake accidents are associated with substantial morbidity and mortality and may produce secondary complications, such as severe infections. The objective of this systematic review was to determine the prevalence of snakebite infections and characterize the bacteria isolated from these infections. A systematic literature review in five databases was carried out to assess the prevalence of snakebite infection. A meta-analysis was performed using a random-effects model to calculate the pooled prevalence and 95% CIs. Cochran's Q test and the I2 statistic were used to assess between-study heterogeneity. The pooled prevalence of infection due to snakebite was 27.0% (95% CI: 22.0-32.0%), with high heterogeneity among studies (I2 = 99.7%). The prevalence was higher in Asia (32%) than in the Americas (21%). Snakebite infections required surgical interventions in 68% (95% CI: 37.0-98.0%). The leading group of pathogens identified corresponded to Gram-negative bacteria (63%), particularly Morganella morganii (32%), but also, Gram-positive cocci (40%), especially Enterococcus spp. (23%) and Staphylococcus aureus (15%). However, multiple other pathogens, including anaerobes, were found. A high prevalence of snakebite-associated infection has been described, primarily due to M. morganii, with the corresponding implications for empirical therapy. Rational use of antimicrobials is recommended, and this should guide initial empirical treatment. Moreover, isolation and identification of the possible bacteria present in snakebite wounds is recommended in all cases to confirm or rule out associated infection.
Topics: Snake Bites; Humans; Prevalence; Animals; Anti-Bacterial Agents; Asia
PubMed: 38507793
DOI: 10.4269/ajtmh.23-0278 -
Cureus Feb 2024This systematic review evaluates the efficacy of surgical interventions in improving the quality of life for patients with chronic pancreatitis (CP). A thorough... (Review)
Review
This systematic review evaluates the efficacy of surgical interventions in improving the quality of life for patients with chronic pancreatitis (CP). A thorough literature search, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identified 11 studies that focused on patient-reported outcomes after surgical treatments, including pancreatic resections, drainage procedures, and duodenum-preserving head resections. The findings indicate that organ-preserving procedures, notably the Frey and Beger operations, significantly enhance pain control and overall quality of life while reducing analgesic dependency. This review provides crucial insights into the long-term efficacy and comparative benefits of different surgical approaches, highlighting the need for personalized surgical strategies in CP management. It emphasizes the necessity for standardized outcome measures and further comparative research to refine CP treatment protocols.
PubMed: 38476813
DOI: 10.7759/cureus.53989 -
Indian Journal of Anaesthesia Mar 2024Healthcare workers (HCWs), which include surgeons, anaesthesiologists, nurses, technicians, and other non-medical staff working in the operation theatre (OT), change to...
BACKGROUND AND AIMS
Healthcare workers (HCWs), which include surgeons, anaesthesiologists, nurses, technicians, and other non-medical staff working in the operation theatre (OT), change to surgical scrubs for providing designated services. This study was intended to investigate the association of moving in and out of OT to other hospital areas without changing scrubs and its impact on bacterial infection.
METHODS
After PROSPERO registration, we performed a systematic review to compare the occurrence of surgical site infections (SSIs) with or without the movement of HCWs outside OT. We searched PubMed, Scopus, and Cochrane Library using relevant keywords. RoB-2 and ROBINS-E tools were used to assess the risk of bias in randomised controlled trials (RCTs) and observational studies, respectively.
RESULTS
We identified six articles that fulfilled the inclusion criteria: three RCTs and three observational studies. A risk of bias assessment revealed an overall low bias in the RCTs and an overall high bias in the observational studies. The analysis revealed a comparable incidence of bacterial infection in terms of colony-forming units when scrubs when HCWs moved in and out of OT with the same scrubs. A meta-analysis was not performed due to heterogeneity in participants and the OT set-up, as well as fewer studies and sample size.
CONCLUSION
The evidence is insufficient to suggest that wearing scrubs outside the OT could increase the incidence of SSI in surgical patients or transmit the organisms to patients, causing infection. The present review neither supports nor is against wearing surgical scrubs outside OT premises.
PubMed: 38476545
DOI: 10.4103/ija.ija_949_23 -
Diagnostics (Basel, Switzerland) Mar 2024A common application for intraoral scanners is the digitization of the morphology of teeth and palatal rugae. Palatal scans are most commonly required to fabricate... (Review)
Review
A common application for intraoral scanners is the digitization of the morphology of teeth and palatal rugae. Palatal scans are most commonly required to fabricate complete dentures and immediate transitional dentures and serve as a reference point for assessing orthodontic results. However, they are also frequently included by accident, even though the main purpose of intraoral scanning is to reconstruct dentition using computer-aided manufacturing (CAM). The literature shows that the identification of disaster victims has frequently involved palatal rugae impressions. As the skull provides sound insulation, the rugae are resistant to heat, chemicals, and stress. Antemortem data might be difficult to find during a forensic inquiry, particularly in disaster victim identification cases. In contrast with DNA and fingerprints, there is a greater likelihood of having a dental record that contains palatal scans. With specialized software, the scans can be exported as open stereolithography (STL) files. Considering that a full case consumes up to about 100 MB of hard drive space, long-term storage should not be an issue compared to a plaster model. Additionally, dentists widely use online databases to exchange data for smile design, implant registration, and orthodontic purposes. This will produce a digital database that grows quickly and is readily usable for forensic investigations. The uniqueness of forensic features is frequently challenged; however, palatal morphology's unique trait could make it possible as it is characteristic of individuals as well as the most distinguishing factor. This review will highlight how rugae, palatal morphology, mirroring, superimposition, and geometrics can serve in forensic identification.
PubMed: 38473003
DOI: 10.3390/diagnostics14050531 -
Aging Clinical and Experimental Research Mar 2024Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention.
METHODS
We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework.
RESULTS
Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group. In the NMA, the results of incidence of falls were as follows: 24-form > Yang style > Sun style > control > TCEP. The rank probability of BBS was as follows: 24-form > TCEP > Yang style > control.
CONCLUSION
Among the four types of Tai Chi studied, the 24-form simplified Tai Chi has shown better efficacy than other types.
Topics: Aged; Humans; Exercise Therapy; Network Meta-Analysis; Randomized Controlled Trials as Topic; Tai Ji; Accidental Falls
PubMed: 38472538
DOI: 10.1007/s40520-023-02674-7 -
Journal of Education and Health... 2023Nowadays, accidents and disasters are one of the most important issues facing humans. Training is an important feature in disasters and distance learning is a suitable... (Review)
Review
Nowadays, accidents and disasters are one of the most important issues facing humans. Training is an important feature in disasters and distance learning is a suitable method for education in every place and at every time. The aim of this study is to determine distance learning methods in disaster preparedness. This study was conducted to this question: what types of distance learning methods can use in disaster preparedness?". In this study, all published English language papers, with no time limit, were extracted by the end of December 2021 through search in PubMed, Scopus, Google scholar, ISI WOS (Web of Science), and Embase. The primary search used "distance learning", "disaster" and their MeSH terms. Quality appraisal carried out with CASP. Information in the articles including study time, study population, e-learning methods, and type of disasters or emergencies were extracted. Based on the search, 46 studies were carried out between 2002 and 2021. The most studied target group in the studies was health professionals and the content of the courses was attributed to disaster preparedness as well as biological disasters. Regarding e-learning methods, the most used method was 'simulation'. At the time of disasters, including pandemics, disruption in education may be long-term and may require overlapping response and recovery periods. And virtual education during a disaster may be rejected or endorsed by individuals or groups based on cultural, ideological, or prejudicial issues. Distance education can be used for effective disaster education in different phases of the disaster cycle, depending on the available facilities and infrastructure.
PubMed: 38464629
DOI: 10.4103/jehp.jehp_1721_22 -
Annals of Medicine and Surgery (2012) Mar 2024This study aims to investigate the factors affecting the severity of trauma caused by traffic accidents based on martrix Haddon; a systematic review and meta-analysis. (Review)
Review
OBJECTIVE
This study aims to investigate the factors affecting the severity of trauma caused by traffic accidents based on martrix Haddon; a systematic review and meta-analysis.
METHODS
In this study searched five international databases in this study, including Medline/PubMed, ProQuest, Scopus, Web of Knowledge, and Google Scholar, for published articles by the end of 2022. Data were entered into the statistical program and analyses were performed using STATA 17.0 software. Odds ratio (OR) values were computed for severity accidents.
RESULTS
Results of study showed that among the risk factors related to the host, not using helmet increased the risk of injury severity by 3.44 times compared to people who have used helmets (OR = 3.44, 95% CI: 2.27-5.00, =0.001, I=0.00%). Also, crossing over a centre divider has a protective role for the risk of injury severity compared to undertaking (OR =0.39, 95% CI: 0.20-0.75, =0.01, I=25.79%). in terms of the type of accident, accident of car-car reduces the risk of injury severity by 23% compared to accident of car-pedestrian (OR =0.77, 95% CI: 0.61-0.96, =0.02, I=0.00%).
CONCLUSIONS
It is necessary to pay attention to the intersection of human, vehicle and environmental risks and their contribution and how they interact. Based on the Haddon matrix approach, special strategies can be designed to prevent road damage. Safety standards for vehicles should also be addressed through stricter legal requirements and inspections.
PubMed: 38463059
DOI: 10.1097/MS9.0000000000001792 -
Accident; Analysis and Prevention May 2024Road traffic deaths are increasing globally, and preventable driving behaviours are a significant cause of these deaths. In-vehicle telematics has been seen as...
BACKGROUND
Road traffic deaths are increasing globally, and preventable driving behaviours are a significant cause of these deaths. In-vehicle telematics has been seen as technology that can improve driving behaviour. The technology has been adopted by many insurance companies to track the behaviours of their consumers. This systematic review presents a summary of the ways that in-vehicle telematics has been modelled and analysed.
METHODOLOGY
Electronic searches were conducted on Scopus and Web of Science. Studies were only included if they had a sample size of 10 or more participants, collected their data over at least multiple days, and were published during or after 2010. 45 relevant papers were included in the review. 27 of these articles received a rating of "good" in the quality assessment.
RESULTS
We found a divide in the literature regarding the use of in-vehicle telematics. Some articles were interested in the utility of in-vehicle telematics for insurance purposes, while others were interested in determining the influence that in-vehicle telematics has on driving behaviour. Machine learning analyses were the most common forms of analysis seen throughout the review, being especially common in articles with insurance-based outcomes. Acceleration, braking, and speed were the most common variables identified in the review.
CONCLUSION
We recommend that future studies provide the demographical information of their sample so that the influence of in-vehicle telematics on the driving behaviours of different groups can be understood. It is also recommended that future studies use multi-level models to account for the hierarchical structure of the telematics data. This hierarchical structure refers to the individual trips for each driver.
Topics: Humans; Accidents, Traffic; Automobile Driving; Insurance; Technology; Telemetry
PubMed: 38458008
DOI: 10.1016/j.aap.2024.107519 -
Frontiers in Public Health 2024While Advanced Driver Assistance Systems (ADAS) have become a prominent topic in road safety research, there has been relatively little discussion about their...
INTRODUCTION
While Advanced Driver Assistance Systems (ADAS) have become a prominent topic in road safety research, there has been relatively little discussion about their effectiveness in preventing car collisions involving specific vulnerable road users, such as cyclists. Therefore, the primary objective of this systematic literature review is to analyze the available evidence regarding the effectiveness of in-vehicle ADAS in preventing vehicle collisions with cyclists.
METHODS
To achieve this goal, this systematic review analyzed a selection of original research papers that examined the effectiveness of ADAS systems in preventing car-cyclist collisions. The review followed the PRISMA protocol, which led to the extraction of 21 eligible studies from an initial pool of 289 sources indexed in the primary scientific literature databases. Additionally, word community-based content analyses were used to examine the research topics and their links within the current scientific literature on the matter.
RESULTS
Although the current number of studies available is still scarce (most sources focus on car-motorcyclist or car-pedestrian crashes), the overall quality of the available studies has been reasonably good, as determined by the selected evaluation methods. In terms of studies' outcomes, the literature supports the value of in-vehicle ADAS for preventing car-cyclist crashes. However, threatful side effects such as unrealistic expectations of these systems and users' overconfidence or desensitization are also highlighted, as well as the need to increase driver training and road user awareness.
CONCLUSION
The results of this study suggest that Advanced Driver Assistance Systems have significant potential to contribute to the prevention of driving crashes involving cyclists. However, the literature emphasizes the importance of concurrently enhancing user-related skills in both ADAS use and road-user interaction through educational and training initiatives. Future research should also address emerging issues, such as ADAS-related behavioral ergonomics, and conduct long-term effectiveness assessments of ADAS in preventing car-cycling crashes and their subsequent injuries.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, unique identifier CRD42024505492, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=505492.
Topics: Accidents, Traffic; Automobiles; Bicycling; Databases, Factual; Educational Status
PubMed: 38439758
DOI: 10.3389/fpubh.2024.1335209