-
Environmental Health and Preventive... 2023Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the...
BACKGROUND
Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance.
METHODS
A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs.
RESULTS
47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields.
CONCLUSIONS
Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection.
Topics: Humans; COVID-19; Pandemics; Cross-Sectional Studies; Personal Protective Equipment; Health Personnel
PubMed: 36624079
DOI: 10.1265/ehpm.22-00131 -
Frontiers in Immunology 2022As the first barrier of host defense, innate immunity sets up the parclose to keep out external microbial or virus attacks. Depending on the type of pathogens, several...
As the first barrier of host defense, innate immunity sets up the parclose to keep out external microbial or virus attacks. Depending on the type of pathogens, several cytoplasm pattern recognition receptors exist to sense the attacks from either foreign or host origins, triggering the immune response to battle with the infections. Among them, cGAS-STING is the major pathway that mainly responds to microbial DNA, DNA virus infections, or self-DNA, which mainly comes from genome instability by-product or released DNA from the mitochondria. cGAS was initially found functional in the cytoplasm, although intriguing evidence indicates that cGAS exists in the nucleus where it is involved in the DNA damage repair process. Because the close connection between DNA damage response and immune response and cGAS recognizes DNA in length-dependent but DNA sequence-independent manners, it is urgent to clear the function balance of cGAS in the nucleus versus cytoplasm and how it is shielded from recognizing the host origin DNA. Here, we outline the current conception of immune response and the regulation mechanism of cGAS in the nucleus. Furthermore, we will shed light on the potential mechanisms that are restricted to be taken away from self-DNA recognition, especially how post-translational modification regulates cGAS functions.
Topics: Signal Transduction; Immunity, Innate; Nucleotidyltransferases; DNA; DNA Damage
PubMed: 36591232
DOI: 10.3389/fimmu.2022.1076784 -
Journal of Cancer Research and... Jan 2023A key challenge in radiation therapy is to maximize the radiation dose to cancer cells while minimizing damage to healthy tissues. In recent years, the introduction of...
A key challenge in radiation therapy is to maximize the radiation dose to cancer cells while minimizing damage to healthy tissues. In recent years, the introduction of remote after-loading technology such as high-dose-rate (HDR) brachytherapy becomes the safest and more precise way of radiation delivery compared to classical low-dose-rate (LDR) brachytherapy. However, the axially symmetric dose distribution of HDR with single channel cylindrical applicator, the physical "dead-space" with multichannel applicators, and shielding material heterogeneities are the main challenges of HDR brachytherapy. Thus, this review aimed to quantitatively evaluate the dose enhancement factor (DEF) produced by high atomic number nanoparticles (NPs) which increases the interaction probability of photons mainly through the photoelectric effect induced in the great number of atoms contained in each nanoparticle. The NPs loaded to the target volume create a local intensification effect on the target tissue that allows imparting the prescribed therapeutic dose using lower fluxes of irradiation and spare the surrounding healthy tissues. An electronic database such as PubMed/Medline, Embase, Scopus, and Google Scholar was searched to retrieve the required articles. Unpublished articles were also reached by hand from available sources. The dose is increased using the high atomic number of nanoparticle elements under the high dose iridium radionuclide whereas the cobalt-60 radionuclide source did not. However, much work is required to determine the dose distribution outside the target organ or tumor to spare the surrounding healthy tissues for the iridium source and make compressive work to have more data for the cobalt source.
Topics: Humans; Iridium; Radioisotopes; Iridium Radioisotopes; Brachytherapy; Neoplasms; Nanoparticles; Radiotherapy Dosage; Cobalt Radioisotopes
PubMed: 38384008
DOI: 10.4103/jcrt.jcrt_1353_22 -
The Cochrane Database of Systematic... Dec 2022Primary healthcare, particularly Indigenous-led services, are well placed to deliver services that reflect the needs of Indigenous children and their families. Important... (Review)
Review
BACKGROUND
Primary healthcare, particularly Indigenous-led services, are well placed to deliver services that reflect the needs of Indigenous children and their families. Important characteristics identified by families for primary health care include services that support families, accommodate sociocultural needs, recognise extended family child-rearing practices, and Indigenous ways of knowing and doing business. Indigenous family-centred care interventions have been developed and implemented within primary healthcare services to plan, implement, and support the care of children, immediate and extended family and the home environment. The delivery of family-centred interventions can be through environmental, communication, educational, counselling, and family support approaches.
OBJECTIVES
To evaluate the benefits and harms of family-centred interventions delivered by primary healthcare services in Canada, Australia, New Zealand, and the USA on a range of physical, psychosocial, and behavioural outcomes of Indigenous children (aged from conception to less than five years), parents, and families.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was 22 September 2021.
SELECTION CRITERIA
We included randomised controlled trials (RCTs), cluster RCTs, quasi-RCTs, controlled before-after studies, and interrupted time series of family-centred care interventions that included Indigenous children aged less than five years from Canada, Australia, New Zealand, and the USA. Interventions were included if they met the assessment criteria for family-centred interventions and were delivered in primary health care. Comparison interventions could include usual maternal and child health care or one form of family-centred intervention versus another.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methods. Our primary outcomes were 1. overall health and well-being, 2. psychological health and emotional behaviour of children, 3. physical health and developmental health outcomes of children, 4. family health-enhancing lifestyle or behaviour outcomes, 5. psychological health of parent/carer. 6. adverse events or harms. Our secondary outcomes were 7. parenting knowledge and awareness, 8. family evaluation of care, 9. service access and utilisation, 10. family-centredness of consultation processes, and 11. economic costs and outcomes associated with the interventions. We used GRADE to assess the certainty of the evidence for our primary outcomes.
MAIN RESULTS
We included nine RCTs and two cluster-RCTs that investigated the effect of family-centred care interventions delivered by primary healthcare services for Indigenous early child well-being. There were 1270 mother-child dyads and 1924 children aged less than five years recruited. Seven studies were from the USA, two from New Zealand, one from Canada, and one delivered in both Australia and New Zealand. The focus of interventions varied and included three studies focused on early childhood caries; three on childhood obesity; two on child behavioural problems; and one each on negative parenting patterns, child acute respiratory illness, and sudden unexpected death in infancy. Family-centred education was the most common type of intervention delivered. Three studies compared family-centred care to usual care and seven studies provided some 'minimal' intervention to families such as education in the form of pamphlets or newsletters. One study provided a minimal intervention during the child's first 24 months and then the family-centred care intervention for one year. No studies had low or unclear risk of bias across all domains. All studies had a high risk of bias for the blinding of participants and personnel domain. Family-centred care may improve overall health and well-being of Indigenous children and their families, but the evidence was very uncertain. The pooled effect estimate from 11 studies suggests that family-centred care improved the overall health and well-being of Indigenous children and their families compared no family-centred care (standardised mean difference (SMD) 0.14, 95% confidence interval (CI) 0.03 to 0.24; 2386 participants). We are very uncertain whether family-centred care compared to no family-centred care improves the psychological health and emotional behaviour of children as measured by the Infant Toddler Social Emotional Assessment (ITSEA) (Competence domain) (mean difference (MD) 0.04, 95% CI -0.03 to 0.11; 2 studies, 384 participants). We assessed the evidence as being very uncertain about the effect of family-centred care on physical health and developmental health outcomes of children. Pooled data from eight trials on physical health and developmental outcomes found there was little to no difference between the intervention and the control groups (SMD 0.13, 95% CI -0.00 to 0.26; 1961 participants). The evidence is also very unclear whether family-centred care improved family-enhancing lifestyle and behaviours outcomes. Nine studies measured family health-enhancing lifestyle and behaviours and pooled analysis found there was little to no difference between groups (SMD 0.16, 95% CI -0.06 to 0.39; 1969 participants; very low-certainty evidence). There was very low-certainty evidence of little to no difference for the psychological health of parents and carers when they participated in family-centred care compared to any control group (SMD 0.10, 95% CI -0.03 to 0.22; 5 studies, 975 parents/carers). Two studies stated that there were no adverse events as a result of the intervention. No additional data were provided. No studies reported from the health service providers perspective or on outcomes for family's evaluation of care or family-centredness of consultation processes.
AUTHORS' CONCLUSIONS
There is some evidence to suggest that family-centred care delivered by primary healthcare services improves the overall health and well-being of Indigenous children, parents, and families. However, due to lack of data, there was not enough evidence to determine whether specific outcomes such as child health and development improved as a result of family-centred interventions. Seven of the 11 studies delivered family-centred education interventions. Seven studies were from the USA and centred on two particular trials, the 'Healthy Children, Strong Families' and 'Family Spirit' trials. As the evidence is very low certainty for all outcomes, further high-quality trials are needed to provide robust evidence for the use of family-centred care interventions for Indigenous children aged less than five years.
Topics: Child; Child, Preschool; Humans; Child Rearing; Parenting; Parents; Health Services; Primary Health Care
PubMed: 36511823
DOI: 10.1002/14651858.CD012463.pub2 -
Journal of Periodontal & Implant Science Apr 2023The aim of this systematic review was to evaluate the effectiveness of the socket shield technique (SST), an innovative surgical method introduced in 2010, for reducing... (Review)
Review
PURPOSE
The aim of this systematic review was to evaluate the effectiveness of the socket shield technique (SST), an innovative surgical method introduced in 2010, for reducing buccal bone plate resorption.
METHODS
The review was conducted following the PRISMA guidelines. Clinical studies conducted in humans and investigating the SST were searched on PubMed (MEDLINE), Embase, Web of Knowledge, and Google Scholar in November and December 2021. The implant survival rate, percentage of complications, and clinical parameters (marginal bone loss [MBL], pink esthetic score [PES], and buccal bone plate resorption [BBPR]) were analyzed using the collected data.
RESULTS
The initial search resulted in 132 articles. After article screening, the full texts of 19 studies were read and 17 articles were finally included in the review. In total, 656 implants were installed with the SST. Nine of the 656 implants experienced failure, resulting in an implant survival rate of 98.6%. The percentage of complications was about 3.81%. The analysis of clinical parameters (MBL, PES, and BBPR), showed favorable results for the SST. The mean MBL in implants placed with the SST was 0.39±0.28 mm versus 1.00±0.55 mm in those placed without the SST. PES had a better outcome in the SST group, with an average of 12.08±1.18 versus 10.77±0.74. BBPR had more favorable results in implants placed with the SST (0.32±0.10 mm) than in implants placed with the standard technique (1.05±0.18 mm).
CONCLUSIONS
The SST could be considered beneficial for preserving the buccal bone plate. However, since only 7 of the included studies were long-term randomized controlled trials comparing the SST with the standard implant placement technique, the conclusions drawn from this systematic review should be interpreted with caution.
TRIAL REGISTRATION
PROSPERO Identifier: CRD42020180637.
PubMed: 36468475
DOI: 10.5051/jpis.2201780089 -
Frontiers in Neurology 2022As a common endovascular treatment for intracranial aneurysms, the pipeline embolization device (PED) is considered a standard treatment option, especially for large,...
INTRODUCTION
As a common endovascular treatment for intracranial aneurysms, the pipeline embolization device (PED) is considered a standard treatment option, especially for large, giant, wide-necked, or dissecting aneurysms. A layer of phosphorylcholine biocompatible polymer added to the surface of the PED can substantially improve this technology. This PED with shield technology (pipeline shield) is relatively novel; its early technical success and safety have been reported. We conducted a systematic literature review with the aim of evaluating the efficacy and safety of the pipeline shield.
METHODS
We searched the PubMed, Embase, and Cochrane databases, following the preferred reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
RESULTS
We selected five prospective and two retrospective studies for review. A total of 572 aneurysms were included; of these, 506 (88.5%) were unruptured. The antiplatelet regimens were heterogeneous. The rate of perioperative and postoperative complications was 11.1% [95% confidence interval (CI): 6.5-18.9%]. The adequate occlusion rate at 6 months was 73.9% (95% CI: 69.1-78.7%). The adequate occlusion rate of more than 12 months was 80.9% (95% CI: 75.1-86.1%). The mortality rate was 0.7% (95% CI: 0.2-1.5%). Subgroup analyses showed that aneurysm rupture status had no effect on aneurysm occlusion rate, patient morbidity, or mortality.
CONCLUSION
This review demonstrates the safety and efficacy of the pipeline shield for treating intracranial aneurysms. However, direct comparisons of the pipeline shield with other flow diverters are needed to better understand the relative safety and effectiveness of different devices.
PubMed: 36452166
DOI: 10.3389/fneur.2022.971664 -
Mechanisms of Ageing and Development Jan 2023Advanced glycation end products (AGEs) and AGEs receptor (RAGE) may play a role in sarcopenia. This systematic review evaluated the associations between AGEs measured in...
BACKGROUND
Advanced glycation end products (AGEs) and AGEs receptor (RAGE) may play a role in sarcopenia. This systematic review evaluated the associations between AGEs measured in tissues (skin) by autofluorescence (SAF) and/or circulation (blood, urine) and muscle health outcomes (strength, mass, function) and sarcopenia in observational studies.
METHODS
MEDLINE, Embase, Scopus and Web of Science were searched for studies reporting associations between AGEs and muscle-related outcomes in community-dwelling adults aged ≥ 30 years (until March 2022).
RESULTS
Fourteen cross-sectional and one prospective study were included in the narrative summary. SAF was negatively associated with muscle strength, mass, and physical functioning in adults aged ≥ 30 years (four studies), and muscle mass (three studies), strength, and sarcopenia (one study) in adults aged ≥ 65 years. Circulating AGEs were negatively associated with muscle strength and physical functioning (four studies) and predicted the risk of walking disability (one prospective study), and sarcopenia (one study) in older adults. The role of RAGE in muscle health was inconclusive.
CONCLUSIONS
SAF and circulating AGEs were negatively associated with muscle-related outcomes in adults aged ≥ 30 years in cross-sectional studies. This finding should be confirmed in well-designed prospective studies investigating sarcopenia, as AGEs represent a potentially modifiable target for intervention.
Topics: Humans; Aged; Sarcopenia; Prospective Studies; Cross-Sectional Studies; Glycation End Products, Advanced; Muscle, Skeletal
PubMed: 36368549
DOI: 10.1016/j.mad.2022.111744 -
European Journal of Psychotraumatology 2022Military members report higher instances of trauma exposure and subsequent posttraumatic stress disorder (PTSD) relative to civilians. Encounters with children in war... (Review)
Review
Military members report higher instances of trauma exposure and subsequent posttraumatic stress disorder (PTSD) relative to civilians. Encounters with children in war and conflict settings may have particularly unsettling consequences. However, the nature of these consequences has yet to be systematically examined. This systematic review sought to identify and document deployment-related encounters with children and associated outcomes reported by military personnel, as well as identify any current training programs, policies, or procedures in place regarding encountering children during deployment. A total of 17 studies with 86 independent samples were included. Analyses were based primarily on qualitative data. Based on the review, 77 military personnel samples documented their experiences encountering children during deployment. Most commonly, child encounters included armed children, porters/human shields, suicide bombers, and ambiguous interactions. Outcomes from encountering children during deployment were diverse, occurring both during the encounter, and described by many as persisting years following the exposure. Consequences of encounters as described by military personnel included: hesitation to complete mission objectives, mental health concerns, moral struggles, social isolation, and sleep disturbances. Of the 86 included reports, only nine provided information regarding training at any stage (pre-, during, or post-deployment) in relation to encountering children. Much of the available information underscored the lack of training, with six reports highlighting the lack of pre-deployment training and five reports describing the lack of policies, including rules of engagement, as they relate to encountering children during deployment. Only two reports described post-deployment procedures made available to military personnel following exposure to children while on deployment. Results from this review will be used to identify available research, develop and support training initiatives, and increase awareness regarding implications of encountering children during deployment. We further provide recommendations regarding research needs, policy implementation, and current training gaps.
Topics: Child; Humans; Military Personnel; Military Deployment; Stress Disorders, Post-Traumatic; Family; Mental Health
PubMed: 36325257
DOI: 10.1080/20008066.2022.2132598 -
International Journal of Environmental... Oct 2022A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and... (Meta-Analysis)
Meta-Analysis Review
A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and behavioral findings support the notion that EF skills impact eating regulation. However, a major gap in the current literature is a synthesis of the association between various EF skills and disinhibited eating patterns across child development. To address this gap, a systematic review and meta-analysis was conducted to examine the effect of EF skills on disinhibited eating behaviors among youth ages 3-18 years old. PubMed and PsychINFO databases were utilized and data from 15 studies with a total sample of 4909 youth were included. A random effects meta-analysis revealed a small negative effect of overall EF skills on disinhibited eating behavior, = -0.14, < 0.01. Analysis of individual EF skills found working memory had an overall medium negative effect on disinhibited eating behavior, = -0.25, < 0.05. Taken together, findings from this meta-analysis support an inverse relationship between EF abilities and disinhibited eating patterns in children and adolescents, such that poorer EF abilities are associated with higher levels of disinhibited eating. Given the effect on eating behavior, future research is needed to assess whether EF difficulties may be a barrier to effective weight management in youth. Specifically, research is needed to examine whether EF skills may be a key target to consider for effective obesity prevention and treatment in children and adolescents.
Topics: Child; Humans; Adolescent; Child, Preschool; Executive Function; Pediatric Obesity; Feeding Behavior; Memory, Short-Term; Problem Behavior
PubMed: 36293963
DOI: 10.3390/ijerph192013384 -
Temperature (Austin, Tex.) 2022In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this first paper of the... (Review)
Review
In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this first paper of the series, we conducted a systematic review (registration: INPLASY202090088) to identify all TSIs and provide reliable information regarding their use (funded by EU Horizon 2020; HEAT-SHIELD). Eight databases (PubMed, Agricultural and Environmental Science Collection, Web of Science, Scopus, Embase, Russian Science Citation Index, MEDLINE, and Google Scholar) were searched from database inception to 15 April 2020. No restrictions on language or study design were applied. Of the 879 publications identified, 232 records were considered for further analysis. This search identified 340 instruments and indicators developed between 200 BC and 2019 AD. Of these, 153 are nomograms, instruments, and/or require detailed non-meteorological information, while 187 can be mathematically calculated utilizing only meteorological data. Of these meteorology-based TSIs, 127 were developed for people who are physically active, and 61 of those are eligible for use in occupational settings. Information regarding the equation, operating range, interpretation categories, required input data, as well as a free software to calculate all 187 meteorology-based TSIs is provided. The information presented in this systematic review should be adopted by those interested in performing on-site monitoring and/or big data analytics for climate services to ensure appropriate use of the meteorology-based TSIs. Studies two and three in this series of companion papers present guidance on the application and validation of these TSIs, to guide end users of these indicators for more effective use.
PubMed: 36211945
DOI: 10.1080/23328940.2022.2037376