Influência de drogas anticonvulsivantes no tratamento ortodôntico / Influence of anticonvulsant drugs on orthodontic treatment

As drogas utilizadas para prevenção de convulsões podem impactar na movimentação dentária durante o tratamento ortodôntico. O objetivo deste estudo foi avaliar a influência de drogas anticonvulsivantes no tratamento ortodôntico. O desenho deste estudo é uma revisão narrativa da literatura onde uma busca eletrônica foi realizada sem restrição de idioma e data em três bases de dados (PubMed via MEDLINE, SCOPUS e BVS). Foram utilizados os seguintes termos para o PubMed e BVS: anticonvulsants drugs AND orthodontic movement e para o SCOPUS: anticonvulsants AND drugs AND orthodontic AND movement. Uma pesquisa complementar foi realizada nas referências bibliográficas dos estudos incluídos. Os artigos indicaram que o uso de medicação anticonvulsivante favorece o desenvolvimento de hiperplasias gengivais, xerostomia e alterações no metabolismo ósseo que modulam a taxa de movimentação ortodôntica. Dentro das limitações desta revisão, concluiu-se que não há contraindicações para tratamento ortodôntico em pacientes utilizando anticonvulsivantes, no entanto os ortodontistas devem estar cientes dos potenciais efeitos adversos advindos do uso desses medicamentos para que possam adotar medidas para mitigar esses riscos.

Drugs used to prevent seizures can have an impact on tooth movement during orthodontic treatment. This study aimed to evaluate the influence of anticonvulsant medications on orthodontic treatment. The design of this study is a narrative literature review in which an electronic search was carried out without language or date restriction in three databases (PubMed/MEDLINE, SCOPUS, and BVS). The following terms were used for PubMed and BVS: anticonvulsants drugs AND orthodontic movement and SCOPUS: anticonvulsants AND drugs AND orthodontic AND movement. A complementary search was carried out on the bibliographical references of the included studies. The articles indicated that using anticonvulsant medication favors the development of gingival hyperplasia, xerostomia, and alterations in bone metabolism that modulate the rate of orthodontic movement. Within the limitations of this review, it was concluded that there is no contraindication for orthodontic treatment in patients using anticonvulsants. However, orthodontists should be aware of the potential adverse effects arising from the use of these drugs so that they can adopt measures to minimize these risks.

Use of computed tomography for shoulder arthroplasty: A systematic review.

Introduction: The prevalence of total shoulder arthroplasties is on the rise annually. Improvements in implant quality, construct stability, and surgical techniques have notably enhanced post-operative results, prompting an expansion of indications for shoulder arthroplasty. Despite its high success rate, opportunities for enhancement remain, especially in preoperative planning and intraoperative execution. Advanced imaging technologies offer significant potential in optimizing implant placement, thus improving the longevity of the procedure. To our knowledge, a comprehensive review examining the impact of advanced imaging on shoulder arthroplasty has yet to be conducted. This systematic review aims to investigate the benefits of advanced imaging technologies in this context, focusing on their application in preoperative planning, osteoarthritis assessment, intraoperative adjustments, patient-specific instrumentation, and navigational aids. Methods: This review utilized a comprehensive search of PubMed to identify relevant studies published from 2000 to 2024, focusing on the application of various imaging techniques in shoulder arthroplasty. The search was conducted by two authors and centered on plain radiography, CT scans, and MRI. The selection criteria included availability of full-text articles, English language, direct comparison of imaging techniques, and a focus on patient outcomes, including discussions on broader applications such as intraoperative navigation and patient-specific instrumentation development. Results: Enhanced imaging techniques, particularly CT scans and MRIs, have been shown to significantly improve outcomes in shoulder arthroplasty. While plain radiographs remain standard, CT scans provide superior bony detail, crucial for evaluating glenoid wear and determining augmentation needs. Preoperative CT imaging has been demonstrated to enhance implant placement accuracy. Moreover, intraoperative technologies based on CT imaging, such as patient-specific instrumentation and navigation systems, contribute to better surgical results. Conclusion: The benefits of CT imaging in shoulder arthroplasty significantly outweigh the associated costs. Current literature strongly supports the adoption of CT imaging in these procedures, particularly when used alongside modern operative technologies.

Outcomes of arthroscopic coracoclavicular management for acromioclavicular joint injuries: A systematic review.

Introduction: Various surgical procedures for coracoclavicular (CC) ligament repair have been described for symptomatic acromioclavicular joint dislocations, with none emerging as a clear gold standard. There has been increased interest in arthroscopic approaches. This systematic review evaluates clinical outcomes after arthroscopic surgeries used to treat chronic and acute AC joint dislocations. Methods: We searched three databases (PubMed, EMBASE, and OVID [MEDLINE]) from database inception to December 20, 2022. Studies were included if they met the following criteria: studies evaluating humans, English language studies, level of evidence I to IV, and studies investigating clinical outcomes in patients following arthroscopic surgery for coracoclavicular ligament reconstruction. Studies on open reconstruction techniques only were excluded. Primary outcomes included function/pain scores, coracoclavicular distances, complications, and revision rates. Results: Fifty-two studies were included. In 33 studies, postoperative Constant-Murley scores ranged from 82.8 to 99 points. Postoperative VAS scores ranged from 0.3 to 4.1 in 16 studies. In 46 studies, revision rates ranged from 0 % to 44.4 %. We did not observe a difference in revision rates between chronic and acute cases (P = 0.268). Complications were more common in chronic than acute cases (25.5 % vs. 16.4 %; P < 0.001). Conclusions: Arthroscopic surgery for chronic and acute CC ligament injuries exceeds the MCID and PASS for several outcomes, with low failure rates. Arthroscopic CC reconstruction is a safe and effective alternative for chronic AC joint dislocations. Level of evidence: IV (Systematic Review of Level I-IV Studies).

Evaluating the Efficacy of Immune Checkpoint Inhibitors in Elderly Patients: A Systematic Review and Meta-analysis.

In this chapter, we outline the steps for designing and conducting a rigorous systematic review and meta-analysis, focusing on the efficacy of immune checkpoint inhibitors (ICIs) in elderly patients. ICIs have improved survival rates in advanced cancers, yet their effectiveness in older populations remains unclear. We detail the essential processes involved in both systematic reviews and meta-analyses. We can evaluate the efficacy of ICIs in elderly patients with advanced cancer, examining outcomes such as overall survival and progression-free survival.

Gerontological educational interventions for student nurses: a systematic review of qualitative findings.

OBJECTIVES: This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. METHODS: Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. CONCLUSIONS: Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.

Neutralizing antibodies in milk and blood of lactating women vaccinated for SARS-CoV-2: a systematic review / Anticorpos neutralizantes no leite e no sangue de lactantes vacinadas para SARS-CoV-2: uma revisão sistemática

ABSTRACT Objective: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. Data source: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. Data synthesis: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. Conclusions: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.

RESUMO Objetivo: Comparar a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite materno e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Fontes de dados: Foi efetuado registro no International Prospective Register of Systematic Reviews — PROSPERO (CRD42021287554) e foram seguidas as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Foram elegíveis estudos de coorte, caso-controle e transversais que avaliaram anticorpos contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e tiveram como grupo controle lactantes não vacinadas. Utilizaram-se os Descritores em Ciências da Saúde (DeCs), Medical Subject Heading (MeSH) e Emtree para as bases Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (Medline/PubMed) e Embase, respectivamente. Na Web of Science e Scopus foi feita adaptação da estratégia. Não foram estabelecid as restrições quanto ao período de publicação e idioma. Síntese dos dados: As buscas identificaram 233 registros. Foram excluídos 128 duplicados e 101 fora dos critérios de inclusão, e quatro estudos de coorte foram elegíveis. As lactantes vacinadas com Pfizer-BioNTech e Moderna apresentaram anticorpos contra SARS-CoV-2 no sangue e no leite materno. Conclusões: As mulheres lactantes vacinadas apresentaram níveis mais elevados de imunoglobulina G (IgG) e A (IgA) no soro e no leite materno em comparação com as mulheres não vacinadas.

Efectos de la terapia manual en personas con fibromialgia: Revisión sistemática y metaanálisis / Effects of Manual Therapy in People with Fibromyalgia: Systematic Review and Meta-Analysis

Resumen Objetivo: El objetivo de esta revisión sistemática con metaanálisis es sintetizar la evidencia científica disponible sobre los efectos de la terapia manual aplicada de forma aislada en comparación a otras intervenciones en el dolor, la capacidad funcional, la impresión global de mejoría y severidad de síntomas autopercibida en personas con fibromialgia. Metodología: Se realizó una revisión sistemática y metaanálisis con búsqueda electrónica en MEDLINE, WoS, SCOPUS, PEDro, CENTRAL y LILACS. Resultados: Once estudios cumplieron con los criterios de selección y seis fueron incluidos en una síntesis cuantitativa. El dolor al terminar el tratamiento tuvo una diferencia de medias de -0.42 (IC al 95% -1.14, 0.30, p = 0.25), el estado funcional al terminar el tratamiento tuvo una diferencia de medias de -0.15 (IC al 95% -0.69, 0.40, p = 0.60), la impresión global de salud al terminar el tratamiento tuvo una diferencia de media de -1.13 (IC al 95% -1.68, -0.57 p = <0.00) y posterior a doce meses una diferencia de media de -0.48 (IC al 95% -0.78, -0.19 p = <0.00), la impresión global de severidad después de la intervención tuvo una diferencia de medias de -0.62 (IC al 95% -1.22, -0.03, p = 0.04) y posterior a doce meses una diferencia de medias de -0.43 (IC al 95% -1.18, 0.32, p = 0.26). Conclusiones: La terapia manual aislada es una intervención que podría mejorar significativamente la autopercepción del estado global de mejoría y severidad de síntomas a corto plazo en comparación a agentes físicos placebo. Sin embargo, no es mejor que otras intervenciones para disminuir el dolor y mejorar la capacidad funcional.

Abstract Objective: The aim of this systematic review with meta-analysis is to synthesize the available scientific evidence on the effects of manual therapy applied in isolation in comparison to other interventions on pain, functional capacity, global impression of improvement, and self-perceived severity of symptoms in people with fibromyalgia. Methodology: A systematic review with meta-analysis was conducted with electronic search of MEDLINE, WoS, SCOPUS, PEDro, CENTRAL, and LILACS. Results: Eleven studies met the selection criteria and six were included in a quantitative synthesis. Pain at the end of treatment had a mean difference of -0.42 (95% CI -1.14, 0.30, p = 0.25), functional status at the end of treatment had a mean difference of -0.15 (95% CI - 0.69, 0.40, p = 0.60), the global impression of health at the end of treatment had a mean difference of -1.13 (95% CI -1.68, -0.57 p = <0.00) and a mean difference of -0.48 after twelve months (95% CI -0.78, -0.19 p = <0.00), the global impression of severity after the intervention had a mean difference of -0.62 (95% CI -1.22, -0.03, p = 0.04 ) and a mean difference of -0.43 after twelve months (95% CI -1.18, 0.32, p = 0.26). Conclusions: Isolated manual therapy is an intervention that could significantly improve the self-perception of the global state of improvement and severity of symptoms in the short term compared to sham physical agents. However, it is not better than other interventions to reduce pain and improve functional capacity.

Efficacy and safety of vancomycin compared with those of alternative treatments for methicillin-resistant Staphylococcus aureus infections: An umbrella review.

OBJECTIVE: To summarize the evidence on the efficacy and safety of vancomycin compared with those of alternative treatments in adult patients with methicillin-resistant Staphylococcus aureus (MRSA) infection. METHODS: PubMed, Embase, and Web of Science were searched up to December 15, 2023, for systematic reviews and meta-analyses comparing vancomycin with alternative MRSA treatments. Primary outcomes included clinical cure and microbiological eradication rates. Organ-specific safety outcomes were assessed. Summary estimates were recalculated using a random-effects model. Evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. This study was registered in PROSPERO (CRD42022340359). RESULTS: This umbrella review included 19 studies and 71 meta-analyses (46 efficacy and 25 safety) comparing vancomycin with 10 alternative treatments across different MRSA infection types and populations. GRADE assessment showed that 29.58% of the meta-analyses were of high quality. Linezolid and daptomycin showed higher efficacy in MRSA-induced skin and soft tissue infections and pneumonia (moderate evidence quality) and bacteremia (very low evidence quality), respectively, compared with that of vancomycin. Cephalosporins had a higher risk of nausea, whereas linezolid had a higher risk of nausea, diarrhea, and thrombocytopenia than that of vancomycin. Vancomycin posed a higher risk of rash, pruritus, red man syndrome, and nephrotoxicity than that of alternatives. CONCLUSIONS: The quality of evidence supporting the higher efficacy of alternative treatment over vancomycin for MRSA infection was not high. Given varying safety profiles and advancements in therapeutic monitoring, careful consideration of patient-specific factors and pharmacokinetics is crucial when selecting treatment alternatives to vancomycin.

Clinical and radiographic changes following transcrestal sinus augmentation: A scoping review of the last 25 years.

INTRODUCTION: Maxillary sinus floor elevation is a surgical procedure intended to increase the volume of the bone vertically to accommodate dental implant placement. This intervention is frequently required for implant installation in the posterior maxilla, where the bone may be insufficient for securing implants of necessary length and stability. Sinus floor elevation can be completed either through a direct approach with a "window" through the lateral wall of the alveolar ridge or an indirect "transcrestal/transalveolar" sinus floor elevation (TSFE), which accesses the sinus floor through the crest of the edentulous ridge. Our study aims to provide a comprehensive scoping review of research conducted over the past 25 years on TSFE, specifically. METHODS: A literature search aimed at identifying pertinent literature for the purpose of this PRISMA-ScR-compliant scoping review was conducted. Only randomized controlled trials, non-randomized controlled trials, prospective cohort studies, and case series that met the eligibility criteria were selected. Relevant data from these studies were extracted. Primary outcome measures included radiographic bone levels and implant failure >5 years. Secondary outcome measures included implant stability at time of placement and complications. Interventions reported in the selected studies were grouped based on treatment modality, which were then compared with the control therapy (traditional osteotome technique) after a minimum of 12 months healing period. RESULTS: Our search yielded 633 records, and after deduplication, 574 of these were screened. Application of the eligibility criteria led to the inclusion of 37 articles in the final selection. Case selection for included studies enrolling subjects: Four different transcrestal sinus elevation treatment modalities were identified: (a) osteotome, (b) piezoelectric surgery, (c) osseodensification, and (d) hydraulic techniques. Due to the heterogeneity of the studies, no superior approach for TSFE could be identified. Overall, all techniques demonstrated high implant survival rates. CONCLUSION: Comprehensive understanding of the patient's medical history, available armamentarium, and post-operative complications/management strategies are all essential to the completion of a successful TSFE approach for implant placement in the posterior maxilla, regardless of the treatment modality used.

[Utilizing ChatGPT in Systematic Reviews and Meta-Analyses].

The current uses, potential risks, and practical recommendations for using chat generative pre-trained transformers (ChatGPT) in systematic reviews (SRs) and meta-analyses (MAs) are reviewed in this article. The findings of prior research suggest that, for tasks such as literature screening and information extraction, ChatGPT can match or exceed the performance of human experts. However, for complex tasks such as risk of bias assessment, its performance remains significantly limited, underscoring the critical role of human expertise. The use of ChatGPT as an adjunct tool in SRs and MAs requires careful planning and the implementation of strict quality control and validation mechanisms to mitigate potential errors such as those arising from artificial intelligence (AI) 'hallucinations'. This paper also provides specific recommendations for optimizing human-AI collaboration in SRs and MAs. Assessing the specific context of each task and implementing the most appropriate strategies are critical when using ChatGPT in support of research goals. Furthermore, transparency regarding the use of ChatGPT in research reports is essential to maintaining research integrity. Close attention to ethical norms, including issues of privacy, bias, and fairness, is also imperative. Finally, from a human-centered perspective, this paper emphasizes the importance of researchers cultivating continuous self-iteration, prompt engineering skills, critical thinking, cross-disciplinary collaboration, and ethical awareness skills with the goals of: continuously optimizing human-AI collaboration models within reasonable and compliant norms, enhancing the complex-task performance of AI tools such as ChatGPT, and, ultimately, achieving greater efficiency through technological innovative while upholding scientific rigor.

How are Extended Reality Technologies Being Used for Behavioral Prevention and Health Promotion With Children and Adolescents? A Scoping Review.

In prevention and health promotion with children and adolescents, extended reality (XR) technologies (including virtual reality, augmented reality, augmented virtuality, and mixed reality) are of interest, as they were shown to enhance learning in educational contexts. However, unlike in clinical research, there is no clear overview of its use for these purposes. Therefore, this scoping review provides an overview of XR in behavioral prevention and health promotion in childhood and adolescence. For this purpose, 10 databases were systematically searched for relevant entries, combined with outreach to professional societies and associations, and experts in the field. As a result, 27 reports were included that describe XR applications (mostly virtual reality) in different areas of prevention (e.g., substance use, violence, emotion regulation, road/fire/water safety). XR is often co-created through participatory action and seems to achieve good acceptance and feasibility, yet most studies so far are pilot studies with small and selective samples with mixed results. Although participatory research principles were often implemented, many dimensions of health equity and public health impact were also not considered. In conclusion, XR may be promising for behavioral prevention, but more rigorous efficacy studies using larger, representative samples and longitudinal observations are urgently needed to advance the field.

Short- versus standard-course antibiotic therapy for urinary tract infection in children: a systematic review and meta-analysis.

BACKGROUND: Urinary tract infections are prevalent among children and are responsible for a significant healthcare burden. Antibiotic therapy is the cornerstone of treatment, but the optimal treatment duration remains elusive. OBJECTIVES: This systematic review and meta-analysis aimed to explore the optimal duration of antibiotic therapy for urinary tract infection (UTI) in pediatric patients. DATA SOURCES: A comprehensive search was performed, including MEDLINE, Embase, and Cochrane Library databases. STUDY ELIGIBILITY CRITERIA: We included only randomized controlled trials (RCTs) comparing short-course (2 to 5 days) and standard-course (≥ 7 days) antibiotic treatment in patients < 18 years of age. STUDY APPRAISAL AND SYNTHESIS METHODS: We performed this systematic review and meta-analysis following Cochrane Collaboration recommendations using a random-effects model. Effect estimate was calculated using the risk ratio (RR) with 95% confidence interval (95% CI) for dichotomous and mean difference (MD) with 95% CI for continuous endpoints. Significance was regarded at p-value < 0.05. Statistical analysis was performed using Review Manager 5.4.1. RESULTS: Data from 12 RCTs, encompassing 1442 children, were included. Follow-up ranged from 1 to 12 months. The mean age was 5.9 years, with approximately 87% female patients. E. coli was the most common pathogen isolated from urine cultures. There was a significant difference in cure rates (RR 0.97; 95% CI 0.95-0.99; p = 0.01) between the groups when only studies that included febrile UTI were analyzed together, favoring 7 days or more of treatment, but with high heterogeneity. Otherwise, there was no significant difference in cure rates (RR 0.99; 95% CI 0.91-1.08; p = 0.80) in children with afebrile UTI or recurrence of UTI at any time in children with afebrile (RR 0.98; 95% CI 0.84-1.15; p = 0.80) or febrile UTI (RR 0.52; 95% CI 0.10-2.83; p = 0.45). Also, there was no significant difference in failure rates in children with urinary tract abnormalities and afebrile UTI (RR 0.79; 95% CI 0.47-1.32; p = 0.36), between the short- and the standard-course treatment groups. LIMITATIONS: This analysis was limited by the moderate heterogeneity and the small subgroup of children with urinary tract abnormalities, which could have underpowered our results. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: The primary outcome of this analysis suggests that a short course of antibiotic therapy is feasible in children with afebrile UTI, but more studies are warranted to safely establish an optimal treatment duration for children with febrile UTI. SYSTEMATIC REVIEW REGISTRATION NUMBER: The study protocol was registered in the PROSPERO platform under the number CRD42023489094.

Climate Anxiety: Current Evidence and Future Directions.

PURPOSE OF REVIEW: Challenging cognitive, somatic, and behavioral responses to climate change are often conceptualized as climate anxiety (CA). Due to the increased recognition of the impacts of climate change on mental health, a growing body of scientific literature is developing. The purpose of this manuscript is to review the current evidence base for CA and propose future research needs for this emerging construct. RECENT FINDINGS: Early evidence supports underlying psychological mechanisms in the development and maintenance of CA, which are similar to other anxiety-related conditions. However, the study of CA poses unique challenges to researchers. The psychological impacts that occur in the context of climate change may be adaptive depending on the imminent threat of natural disasters, forced migration, or other climate-related challenges. Due to the potentially adaptive nature of CA and limited current evidence, a coordinated research program of climate-related distress is necessary. A review of the extant literature identified current gaps in understanding the epidemiology and individual differences that promote CA. Current evidence supports the prominent role of neuroticism, intolerance of uncertainty, and rumination. The development of evidence-based models of climate-related distress may provide a more valid and comprehensive depiction of the impacts of climate change on mental health. Transdiagnostic treatment methods are likely the most appropriate intervention for climate-related distress. As models, measures, and treatments of climate-related distress are developed, it is crucial to incorporate studies of populations most at risk for climate change-related mental health effects.

Effects of dyadic interventions on psychological outcomes among cancer patients with non-active treatment: a systematic review and meta-analysis.

OBJECTIVE: Cancer and its treatment can generate substantial psychological distress (depression and anxiety). The objective of this systematic review and meta-analysis is to explore the effectiveness of dyadic interventions on psychological outcomes in cancer patients with non-active treatment and to test subgroup analyses to explore the source of heterogeneity affecting effect sizes. DESIGN: Systematic searching across eight databases identified studies related to dyadic interventions for psychological outcomes of cancer patients published between 2007 and 2022. Rigorous inclusion and exclusion criteria were utilized. Random-effects models were used to compute effect sizes with Hedge's g, forest plot, and Q and I2 statistics to measure heterogeneity. Moderator analyses were examined. RESULTS: Eleven primary studies were identified (938 patients with cancer, 56.14 ± 7.29 years old). Overall, dyadic interventions significantly improved depression (g = .36, 95% confidence interval .026 to .68, I2 = 76%) and anxiety (g = .29, 95% confidence interval 0.14 to .45, I2 = 0%) compared to controls. With subgroup analyses, fidelity of dyadic interventions, number of weeks across intervention, and number of days after intervention measured were moderators affecting effect sizes. CONCLUSION: Dyadic interventions appear to be effective among adults with cancer with non-active treatment. Additional research is needed to explore the efficacy of dyadic interventions among more diverse samples and to examine routes for integrating dyadic interventions into practice. IMPLICATIONS FOR CANCER SURVIVORS: Adult with cancer might participate in the dyadic intervention for improving psychological outcomes.

A Scoping Review of the Barriers and Facilitators to Clinician Engagement in Hospital-Based Palliative Care in Australian Hospitals.

Background: Current research has shown that inpatient palliative care (PC) services are under-utilized, poorly integrated, and frequently introduced too late during inpatient hospital stays. The aim of this study was to identify a comprehensive list of multi-disciplinary facilitators and barriers to inpatient PC in Australian hospitals through a scoping literature review. Methods: This review identified articles published since 2000 from 3 electronic databases (CINAHL Plus, MEDLINE and Embase), which included discussion of collaboration among non-palliative care clinicians and palliative care professionals in Australian hospitals. We used an inductive approach to identifying key domains of barriers and facilitators. Results: Thirty-four articles met inclusion criteria following full text review. Barriers and facilitators were categorized in 7 domains: (1) Patient concerns, (2) Family concerns, (3) Clinician knowledge, education, and experience in palliative care, (4) Recognition and acceptance of prognosis when a patient was dying or needing end of life treatment, (5) Reconciliation of individual and professional values around PC, (6) Clinician access to resources for PC in the hospital, and (7) Communication between the PC team and ward clinicians. Each domain included potentially substantial barriers to PC delivery and practice. However, given the small sample sizes and specialized settings of many included studies, it was difficult to draw conclusions on the relative significance of different barriers across hospitals. Conclusion: This review identified a number of barriers and facilitators across studies. Subsequent research needs to more comprehensively compare factors impacting PC use in order to improve implementation of PC across hospital settings.

Impact of COVID-19 on Depression, Anxiety and Stress of Dental Students: A Systematic Review.

AIM: To determine the impact of the COVID-19 pandemic on depression, anxiety and stress of dental students by way of a systematic review. MATERIALS AND METHODS: This review was conducted following the Cochrane Handbook for Systematic Reviews. An electronic search was conducted for the period January 2020 to February 2023. Quality assessment was evaluated in accordance with the Newcastle-Ottawa Scale. Frequency distribution was calculated for stress, anxiety and depression associated with students' gender, year of study and living circumstances. RESULTS: Twenty-three studies were eligible for inclusion in the final review. Variables contributing to stress, anxiety and depression of dental students include gender, year of study and living circumstances. Being female is the most significant factor impacting on mental health. CONCLUSIONS: Results emphasise the need for dental institutions to develop targeted intervention programmes for more vulnerable students. Failure to act in a future pandemic event could result in ongoing psychological issues that persist following graduation, resulting in unfit dentists who may potentially affect the quality of the dental workforce.

Artificial Intelligence in Temporal Bone Imaging: A Systematic Review.

OBJECTIVE: The human temporal bone comprises more than 30 identifiable anatomical components. With the demand for precise image interpretation in this complex region, the utilization of artificial intelligence (AI) applications is steadily increasing. This systematic review aims to highlight the current role of AI in temporal bone imaging. DATA SOURCES: A Systematic Review of English Publications searching MEDLINE (PubMed), COCHRANE Library, and EMBASE. REVIEW METHODS: The search algorithm employed consisted of key items such as 'artificial intelligence,' 'machine learning,' 'deep learning,' 'neural network,' 'temporal bone,' and 'vestibular schwannoma.' Additionally, manual retrieval was conducted to capture any studies potentially missed in our initial search. All abstracts and full texts were screened based on our inclusion and exclusion criteria. RESULTS: A total of 72 studies were included. 95.8% were retrospective and 88.9% were based on internal databases. Approximately two-thirds involved an AI-to-human comparison. Computed tomography (CT) was the imaging modality in 54.2% of the studies, with vestibular schwannoma (VS) being the most frequent study item (37.5%). Fifty-eight out of 72 articles employed neural networks, with 72.2% using various types of convolutional neural network models. Quality assessment of the included publications yielded a mean score of 13.6 ± 2.5 on a 20-point scale based on the CONSORT-AI extension. CONCLUSION: Current research data highlight AI's potential in enhancing diagnostic accuracy with faster results and decreased performance errors compared to those of clinicians, thus improving patient care. However, the shortcomings of the existing research, often marked by heterogeneity and variable quality, underscore the need for more standardized methodological approaches to ensure the consistency and reliability of future data. LEVEL OF EVIDENCE: NA Laryngoscope, 2024.

The Use of Telehealth for People With Disabilities: A Systematic Literature Review and Narrative Synthesis.

AIMS: To identify the use of telehealth for people with disabilities in community or primary care settings and to explore effective telehealth interventions for this group. DESIGN: Systematic literature review and narrative synthesis. DATA SOURCES: The literature search was conducted in January 2024 using five electronic databases including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO. METHODS: The review followed the Tawfik's guideline and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines for reporting. Out of 7363 retrieved articles, 1871 duplicates were removed, 5389 were excluded after title and abstract review, and 4 were excluded due to unavailable full text. One additional article was obtained through citation and hand searching. Thirteen studies were quality assessed using the Mixed Methods Appraisal Tool. Quantitative data were narratively synthesised. RESULTS: Thirteen quantitative studies were selected including three quasi-experimental studies and ten randomised controlled trials. The types of telehealth included telemonitoring, computerised intervention, virtual reality, telephone care, mHealth tools, decision support tools, digital storytelling and technology-assisted language interventions. The most common type of disability was intellectual disability, and the most common telehealth provider was the digital device itself. Most studies used surveys as the data collection method and the interventions were mostly conducted individually. Computer-based telehealth interventions demonstrated significant improvement in attention, health knowledge and psychological well-being. Telephone, virtual reality and tablet interventions also had positive impacts on body weight, motor coordination and pragmatic language skills. Telemonitoring was also beneficial. CONCLUSIONS: This systematic review examined the current state and effectiveness of telehealth interventions for people with disabilities. However, few intervention studies were found, and some studies were of poor quality. Continued interest and efforts from the government and researchers are needed targeting people with disabilities. IMPACT: Results provide valuable insights for healthcare providers, policymakers and researchers. They raise awareness about the potential of telehealth to address healthcare disparities and improve access to care for people with disabilities. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution: Systematic review.