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Frontiers in Surgery 2023Endometrial scratching (ES) during hysteroscopy before embryotransfer (ET) remains doubtable on whether it benefits the reproductive outcomes. The optimal technique is... (Review)
Review
OBJECTIVE
Endometrial scratching (ES) during hysteroscopy before embryotransfer (ET) remains doubtable on whether it benefits the reproductive outcomes. The optimal technique is not clear and repeated implantation failure as a challenging field in fertilization (IVF) seems to be the springboard for clinicians to test its effectiveness.
METHODS
Medline, PMC, ScienceDirect, Scopus, CENTRAL, Google Scholar were searched from their inception up to April 2023 for studies to evaluate the effectiveness of adding endometrial scratching during hysteroscopy before ET.
RESULTS
The initial search yielded 959 references, while 12 eligible studies were included in the analyses, involving 2,213 patients. We found that hysteroscopy and concurrent ES before ET resulted in a statistically significant improvement in clinical pregnancy rate (CPR) [RR = 1.50, (95% CI 1.30-1.74), 0.0001] and live birth rate (LBR) [RR = 1.67, (95% CI 1.30-2.15), < 0.0001] with no statistically significant difference on miscarriage rate [RR = 0.80 (95% CI 0.52-1.22), = 0.30].
CONCLUSION
Our meta-analysis suggests that hysteroscopy with concurrent ES may be offered in IVF before ET as a potentially improving manipulation. Future randomized trials comparing different patient groups would also provide more precise data on that issue, to clarify specific criteria in the selection of patients.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42023414117).
PubMed: 37795147
DOI: 10.3389/fsurg.2023.1225111 -
Digital Health 2023Augmented reality (AR) is a relatively new technology that merges virtual and physical environments, augmenting one's perception of reality. AR creates a... (Review)
Review
OBJECTIVE
Augmented reality (AR) is a relatively new technology that merges virtual and physical environments, augmenting one's perception of reality. AR creates a computer-generated environment that evokes a unique perception of reality, where real and virtual objects are registered with one another, which operates interactively and in real time. Recently, the medical application of AR technology has dramatically increased with other assisted technologies, from training to clinical practice. The ability to manipulate the real environment extensively has given AR interventions an advantage over traditional approaches. In this study, we aim to conduct a systematic review of the use of AR to have a better understanding of how the use of AR may affect patients with mental health-related conditions when combined with gamification.
METHOD
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by searching Pubmed and Web of Science databases.
RESULTS AND CONCLUSION
We identified 48 relevant studies that fulfill the criteria. The studies were grouped into four categories: Neurodevelopmental disorders, anxiety and phobia, psychoeducation & well-being, and procedural & pain management. Our results revealed the effectiveness of AR in mental health-related conditions. However, the heterogeneity and small sample sizes demonstrate the need for further research with larger sample sizes and high-quality study designs.
PubMed: 37791140
DOI: 10.1177/20552076231203649 -
Frontiers in Human Neuroscience 2023Mood disorders are very common among adolescents and include mainly bipolar disorder (BD) and major depressive disorder (MDD), with overlapping depressive symptoms that...
BACKGROUND
Mood disorders are very common among adolescents and include mainly bipolar disorder (BD) and major depressive disorder (MDD), with overlapping depressive symptoms that pose a significant challenge to realizing a rapid and accurate differential diagnosis in clinical practice. Misdiagnosis of BD as MDD can lead to inappropriate treatment and detrimental outcomes, including a poorer ultimate clinical and functional prognosis and even an increased risk of suicide. Therefore, it is of great significance for clinical management to identify clinical symptoms or features and biological markers that can accurately distinguish BD from MDD. With the aid of bibliometric analysis, we explore, visualize, and conclude the important directions of differential diagnostic studies of BD and MDD in adolescents.
MATERIALS AND METHODS
A literature search was performed for studies on differential diagnostic studies of BD and MDD among adolescents in the Web of Science Core Collection database. All studies considered for this article were published between 2004 and 2023. Bibliometric analysis and visualization were performed using the VOSviewer and CiteSpace software.
RESULTS
In total, 148 publications were retrieved. The number of publications on differential diagnostic studies of BD and MDD among adolescents has been generally increasing since 2012, with the United States being an emerging hub with a growing influence in the field. Boris Birmaher is the top author in terms of the number of publications, and the is the most published journal in the field. Co-occurrence analysis of keywords showed that clinical characteristics, genetic factors, and neuroimaging are current research hotspots. Ultimately, we comprehensively sorted out the current state of research in this area and proposed possible research directions in future.
CONCLUSION
This is the first-ever study of bibliometric and visual analyses of differential diagnostic studies of BD and MDD in adolescents to reveal the current research status and important directions in the field. Our research and analysis results might provide some practical sources for academic scholars and clinical practice.
PubMed: 37780961
DOI: 10.3389/fnhum.2023.1192544 -
Pain Physician Sep 2023Various percutaneous intradiscal procedures have been implemented to manage lumbosacral discogenic pain. But most of these procedures simply end up manipulating the...
Clinical Effectiveness of Posterior Annular Targeted Ablative Decompression as an Alleviative Intervention for Lumbosacral Discogenic Pain: Systematic Review and Meta-analysis.
BACKGROUND
Various percutaneous intradiscal procedures have been implemented to manage lumbosacral discogenic pain. But most of these procedures simply end up manipulating the central nucleus pulposus or the inner annulus, instead of accessing the posterior outer annulus where the actual, major pain generators exist. Thus, more localized percutaneous techniques, specifically derived to address the pathologic tissues creeped between the torn, posterior annulus and hyperplastic sinuvertebral nerve, have been devised. However, the clinical effectiveness of these "more" accurate procedures is still skeptical.
OBJECTIVES
This study has investigated whether the posterior annular targeted decompression was a useful method to treat lumbosacral discogenic pain in terms of pain control or functional improvement.
STUDY DESIGN
A systematic review and meta-analysis.
SETTING
Primary clinic and tertiary referral center.
PATIENTS
Published past references that have dealt with the issue of clinical effectiveness after the posterior annular targeted decompression as a treatment of discogenic pain in terms of pain control and functional improvement.
METHODS
A literature search was performed using MEDLINE, EMBASE, Cochrane Review, and KoreaMed databases from the studies published until December 2022. After reviewing titles, abstracts, and full texts of 65 studies during the initial database search, 12 studies were included in a qualitative synthesis, and 9 trials from 8 studies were in quantitative meta-analysis. Data, including pain and functional scores, were extracted and were analyzed using a random effects model to obtain statistical significance of mean difference. Quality assessment and evidence level were established in accordance with the Grading of Recommendations Assessment, Development and Evaluation methodology.
RESULTS
Finally, 12 single-arm studies without the control group were included. All studies showed significant pain reduction and functional improvement from a 1-month to 1-year follow-up period. A meta-analysis showed significant reduction in pain scores at 1 month, 3 months, 6 months, and 1 year and functional scores at 1 month, 6 months, and 1 year. The level of evidence was very low because of the nonrandomized study design and inconsistency and imprecision across studies.
LIMITATIONS
Only single-arm studies comparing clinical results before and after treatment without the control group were analyzed. The statistical and clinical heterogeneity, due to different aspect of techniques across the studies and a relatively small number of patients, reduced the evidence level.
CONCLUSIONS
Comprehensive reviews of selected articles revealed posterior annular targeted decompression could be recommended as treatment option in the patients with discogenic pain who have failed in attaining clinical improvement after the conservative managements under weak evidential strength support.
KEY WORDS
Discogenic pain, minimal invasive technique, percutaneous targeted disc decompression, systematic review, meta-analysis.
PubMed: 37774180
DOI: No ID Found -
Journal of Orthopaedic Surgery and... Sep 2023Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Rehabilitation post-knee arthroplasty is integral to regaining knee function and ensuring patients' overall well-being. The debate over the relative effectiveness and safety of outpatient versus home-based rehabilitation persists.
METHODS
A thorough literature review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across four databases. Two researchers independently identified eligible studies centering on knee arthroplasty patients undergoing either outpatient or home-based rehabilitation. Study quality was assessed using the Cochrane Collaboration's risk of bias tool, while continuous outcomes were subject to meta-analyses using Stata 17 software.
RESULTS
Our analysis identified no significant differences in primary outcomes, including Range of Motion, Western Ontario and McMaster Universities Arthritis Index, Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score, and the Knee Society Score, between home-based and outpatient rehabilitation across different follow-up points. Adverse reactions, readmission rates, the need for manipulation under anesthesia, reoperation rate, and post-surgery complications were also similar between both groups. Home-based rehabilitation demonstrated cost-effectiveness, resulting in substantial annual savings. Furthermore, quality of life and patient satisfaction were found to be comparable in both rehabilitation methods.
CONCLUSIONS
Home-based rehabilitation post-knee arthroplasty appears as an effective, safe, and cost-efficient alternative to outpatient rehabilitation. Despite these findings, further multicenter, long-term randomized controlled trials are required to validate these findings and provide robust evidence to inform early rehabilitation choices post-knee arthroplasty.
Topics: Humans; Outpatients; Arthroplasty, Replacement, Knee; Quality of Life; Knee Joint; Anesthesia; Multicenter Studies as Topic
PubMed: 37726800
DOI: 10.1186/s13018-023-04160-2 -
The Journal of Chiropractic Education Oct 2023To update the state of the art regarding the acquisition of spinal high-velocity low-amplitude psychomotor skills competency among chiropractors and chiropractic...
OBJECTIVE
To update the state of the art regarding the acquisition of spinal high-velocity low-amplitude psychomotor skills competency among chiropractors and chiropractic students.
METHODS
Available electronic articles from 5 databases, published between June 2015 and August 2020, were obtained. Eligible studies underwent methodological quality assessments using the Joanna Briggs Institute Critical Appraisal Checklists and Cochrane Collaboration's Risk of Bias Tools.
RESULTS
Fourteen critically appraised studies were identified, including 10 cohort studies and 4 randomized controlled trials. There was no literature excluded due to high risk of bias. The type of augmented devices included a mannequin on a force platform, a computer-connected device, a human analogue mannequin, and a 3-dimensional electrogoniometer with an instrumented spatial linkage.
CONCLUSION
The use of augmented feedback devices such as human analogue mannequins with force-sensing table technology and computer-connected devices is potentially beneficial in the chiropractic curricula and may facilitate student learning and improvement of spinal manipulation. More studies are required to determine whether psychomotor skill aids translate directly into raised competency levels in novice clinicians.
PubMed: 37721391
DOI: 10.7899/JCE-22-10 -
Chiropractic & Manual Therapies Sep 2023Spinal manipulation (SM) is a recommended and effective treatment for musculoskeletal disorders. Biomechanical (kinetic) parameters (e.g. preload/peak force, rate of... (Review)
Review
BACKGROUND
Spinal manipulation (SM) is a recommended and effective treatment for musculoskeletal disorders. Biomechanical (kinetic) parameters (e.g. preload/peak force, rate of force application and thrust duration) can be measured during SM, quantifying the intervention. Understanding these force-time characteristics is the first step towards identifying possible active ingredient/s responsible for the clinical effectiveness of SM. Few studies have quantified SM force-time characteristics and with considerable heterogeneity evident, interpretation of findings is difficult. The aim of this study was to synthesise the literature describing force-time characteristics of manual SM.
METHODS
This scoping literature review is reported following the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) statement. Databases were searched from inception to October 2022: MEDLINE (Ovid), Embase, CINAHL, ICL, PEDro and Cochrane Library. The following search terms and their derivatives were adapted for each platform: spine, spinal, manipulation, mobilization or mobilisation, musculoskeletal, chiropractic, osteopathy, physiotherapy, naprapathy, force, motor skill, biomechanics, dosage, dose-response, education, performance, psychomotor, back, neck, spine, thoracic, lumbar, pelvic, cervical and sacral. Data were extracted and reported descriptively for the following domains: general study characteristics, number of and characteristics of individuals who delivered/received SM, region treated, equipment used and force-time characteristics of SM.
RESULTS
Of 7,607 records identified, 66 (0.9%) fulfilled the eligibility criteria and were included in the analysis. Of these, SM was delivered to the cervical spine in 12 (18.2%), the thoracic spine in 40 (60.6%) and the lumbopelvic spine in 19 (28.8%) studies. In 6 (9.1%) studies, the spinal region was not specified. For SM applied to all spinal regions, force-time characteristics were: preload force (range: 0-671N); peak force (17-1213N); rate of force application (202-8700N/s); time to peak thrust force (12-938ms); and thrust duration (36-2876ms).
CONCLUSIONS
Considerable variability in the reported kinetic force-time characteristics of SM exists. Some of this variability is likely due to differences in SM delivery (e.g. different clinicians) and the measurement equipment used to quantify force-time characteristics. However, improved reporting in certain key areas could facilitate more sophisticated syntheses of force-time characteristics data in the future. Such syntheses could provide the foundation upon which dose-response estimates regarding the clinical effectiveness of SM are made.
Topics: Humans; Biomechanical Phenomena; Bone Diseases; Cervical Vertebrae; Chiropractic; Manipulation, Spinal
PubMed: 37705030
DOI: 10.1186/s12998-023-00512-1 -
American Journal of Obstetrics and... Feb 2024This study aimed to assess the effects on oncologic outcomes of intrauterine manipulator use during laparoscopic hysterectomy for endometrial cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aimed to assess the effects on oncologic outcomes of intrauterine manipulator use during laparoscopic hysterectomy for endometrial cancer.
DATA SOURCES
A systematic literature search was performed by an expert librarian in multiple electronic databases from inception to January 31, 2023.
STUDY ELIGIBILITY CRITERIA
We included all studies in the English language that compared oncologic outcomes (recurrence-free, cause-specific, or overall survival) between endometrial cancer patients who underwent total laparoscopic or robotic hysterectomy for endometrial cancer with vs without the use of an intrauterine manipulator. Studies comparing only peritoneal cytology status or lymphovascular space invasion were summarized for completeness. No selection criteria were applied to the study design.
METHODS
Four reviewers independently reviewed studies for inclusion, assessed their risk of bias, and extracted data. Pooled hazard ratios with 95% confidence intervals were estimated for oncologic outcomes using the random effect model. Heterogeneity was quantified using the I tests. Publication bias was assessed by funnel plot and Egger test.
RESULTS
Out of 350 identified references, we included 2 randomized controlled trials and 12 observational studies for a total of 14 studies and 5,019 patients. The use of an intrauterine manipulator during hysterectomy for endometrial cancer was associated with a pooled hazard ratio for recurrence of 1.52 (95% confidence interval, 0.99-2.33; P=.05; I=31%; chi square P value=.22). Pooled hazard ratio for recurrence was 1.48 (95% confidence interval, 0.25-8.76; P=.62; I=67%; chi square P value=.08) when only randomized controlled trials were considered. Pooled hazard ratio for overall survival was 1.07 (95% confidence interval, 0.65-1.76; P=0.79; I=44%; chi square P value=.17). The rate of positive peritoneal cytology or lymphovascular space invasion did not differ using an intrauterine manipulator.
CONCLUSION
Intrauterine manipulator use during hysterectomy for endometrial cancer was neither significantly associated with recurrence-free and overall survival nor with positive peritoneal cytology or lymphovascular space invasion, but further prospective studies are needed.
Topics: Female; Humans; Endometrial Neoplasms; Hysterectomy; Laparoscopy; Peritoneum; Recurrence
PubMed: 37704174
DOI: 10.1016/j.ajog.2023.09.004 -
Medicine Sep 2023This study aimed to evaluate the efficacy and safety of single-use flexible ureteroscope and reusable flexible ureteroscope for upper urinary calculi. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to evaluate the efficacy and safety of single-use flexible ureteroscope and reusable flexible ureteroscope for upper urinary calculi.
METHODS
We conducted a meta-analysis that had a comprehensive search in PubMed, Embase, Cochrane Library, Web of Science, and WanFang databases from 2000/01/01 to 2023/06/01 for available randomized controlled trials. "Ureteroscopes," "Flexible Ureteroscope," "Single-use," and "Upper Urinary Calculi" were used as the major keywords for the search. Review Manager 5.0 and STATA 12.0 were used for calculation and statistical analysis.
RESULTS
A total of 9 randomized controlled trials comprising 1293 participants were included in our meta-analysis. Single use-FURS had better results in stone-free rate (relative risk: 1.08, 95% confidence interval: [1.02, 1.15], P = .02) and postoperative infection (relative risk: 0.41, 95% confidence interval: [0.23, 0.72], P = .002). Operative time, hemoglobin decline, postoperative serum creatinine, postoperative hospital stay, and overall complication after surgery showed no significant differences between the 2 procedures (P > .05).
CONCLUSION
Single-use flexible ureteroscope provides a valuable alternative to reusable flexible ureteroscope in upper urinary calculi with its better visual field performance and manipulation, opening a new technological revolution for kidney stone treatment.
Topics: Humans; Ureteroscopes; Urinary Tract; Urinary Calculi; Kidney Calculi; Databases, Factual; Randomized Controlled Trials as Topic
PubMed: 37682159
DOI: 10.1097/MD.0000000000034829 -
Clinical Neurophysiology : Official... Oct 2023Cortico-cortical paired associative stimulation (ccPAS) is a form of dual-site transcranial magnetic stimulation (TMS) entailing a series of single-TMS pulses paired at...
OBJECTIVE
Cortico-cortical paired associative stimulation (ccPAS) is a form of dual-site transcranial magnetic stimulation (TMS) entailing a series of single-TMS pulses paired at specific interstimulus intervals (ISI) delivered to distant cortical areas. The goal of this article is to systematically review its efficacy in inducing plasticity in humans focusing on stimulation parameters and hypotheses of underlying neurophysiology.
METHODS
A systematic review of the literature from 2009-2023 was undertaken to identify all articles utilizing ccPAS to study brain plasticity and connectivity. Six electronic databases were searched and included.
RESULTS
32 studies were identified. The studies targeted connections within the same hemisphere or between hemispheres. 28 ccPAS studies were in healthy participants, 1 study in schizophrenia, and 1 in Alzheimer's disease (AD) patients. 2 additional studies used cortico-cortical repetitive paired associative stimulation (cc-rPAS) in generalized anxiety disorder (GAD) patients. Outcome measures include electromyography (EMG), behavioral measures, electroencephalography (EEG), and functional magnetic resonance imaging (fMRI). ccPAS seems to be able to modulate brain connectivity depending on the ISI.
CONCLUSIONS
ccPAS can be used to modulate corticospinal excitability, brain activity, and behavior. Although the stimulation parameters used across studies reviewed in this paper are varied, ccPAS is a promising approach for basic research and potential clinical applications.
SIGNIFICANCE
Recent advances in neuroscience have caused a shift of interest from the study of single areas to a more complex approach focusing on networks of areas that orchestrate brain activity. Consequently, the TMS community is also witnessing a change, with a growing interest in targeting multiple brain areas rather than a single locus, as evidenced by an increasing number of papers using ccPAS. In light of this new enthusiasm for brain connectivity, this review summarizes existing literature and stimulation parameters that have proven effective in changing electrophysiological, behavioral, or neuroimaging-derived measures.
Topics: Humans; Motor Cortex; Evoked Potentials, Motor; Transcranial Magnetic Stimulation; Brain; Neuronal Plasticity
PubMed: 37634335
DOI: 10.1016/j.clinph.2023.06.016