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This systematic review aimed to determine the effects of the interproximal enamel reduction (IPR) techniques used in orthodontics. Six databases were searched: PubMed, Scopus, Web of Science, Dentistry & Oral Sciences Source, ScienceDirect and Clinical Trials. Grey literature was sourced from Google Scholar. The risk of bias was assessed by Risk of Bias 2, Newcastle-Ottawa Scale and Robins-I depending on the design of the evaluated study. Additionally, the quality of the included studies was determined using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. This systematic review included randomized clinical trials, non-randomized clinical trials and observational studies with a control group that reported the effects of IPR for orthodontic purposes on the teeth and periodontium. Case reports, and in vitro and in vivo studies were excluded. Eight clinical studies match the eligibility criteria. As a result, no demineralization of the enamel, no increase in caries incidence, no periodontal changes or dental sensitivity was found after IPR. Also, considering the duration of orthodontic treatment, IPR resulted in a quicker technique than dental extractions. At the risk-of-bias assessment, all observational studies showed low risk, the non-randomized clinical trial had a critical bias, and all randomized clinical trials exhibited some concerns. The overall quality of the studies was found to be between low and very low. After the analysis of the data from included studies, it was concluded that the IPR procedures could be useful to treat dental crowding in orthodontic clinical practice without negative effects. However, more randomized controlled clinical trials with a longer follow-up time and high-quality studies are required to generate robust statements.
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Cárie Dentária , Esmalte Dentário , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
To determine whether the application of photobiomodulation (PBM), as an adjunctive treatment for patients with orthodontic fixed appliances, decreased the total treatment time compared to conventional orthodontics. Studies were collected from four electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Eligibility criteria were full-text articles in English or Spanish with the design of randomized (RCT), non-randomized clinical trials (non-RCT), and retrospective cohort, without any restriction regarding the publication time, in which the effect of PBM using low-level laser irradiation (LLLI) and light-emitting diode (LED) for the acceleration of the orthodontic movement had been evaluated. Data collection and analysis: Two authors independently extracted data for the characteristics and outcomes of the studies selected for inclusion. The risk of bias (RoB 2 and Robins-I) and the quality assessments (GRADE) were performed. For the quantitative synthesis, the standardized mean difference was calculated for each individual study selected and then the data were combined using a random-effects meta-analysis. The total number of included studies was n = 22 (only RCT and non-RCT were found) with a total of 515 participants. The included studies exhibited high risk of bias and some concerns, though none of them presented a low risk of bias. The quality of the studies was very low. The meta-analysis showed that the means (mm) and 95% confidence intervals (95% CI) of acceleration of tooth movement at 1, 2, and 3 months were 0.50 (- 0.28, 1.28), 1.40 (0.27, 2.53), and 0.46 (- 0.33, 1.24), respectively. The analysis showed that there is no evidence to support the use of LLLI to accelerate the orthodontic movement. LED for the acceleration of orthodontic movement does not have sufficient evidence to generate conclusions about it.
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Ortodontia , Técnicas de Movimentação Dentária , Aceleração , Humanos , Aparelhos Ortodônticos , Estudos RetrospectivosRESUMO
BACKGROUND: A good level of knowledge in dentists is crucial for an early diagnosis of oral cancer (OC). In Latin America there are a few studies of OC knowledge among dentist, those has been performed in Brazil, Colombia, and Chile, and their results showed low level of OC knowledge. On the other hand, there is no publication in which the level of knowledge of dentists in Mexico has been addressed. Therefore, this study aimed to assess knowledge of OC and to determine the association of the level of knowledge with sociodemographic characteristics among dentists in Mexico. METHODS: A cross-sectional online survey was designed to obtain information via questionnaire. The questionnaire was developed in the Spanish language, and the content validity was determined. The study was conducted among Mexican dentists with a 23-item questionnaire that was designed to be anonymous. The sample size was calculated using the finite population formula. Based on the responses, the level of knowledge of OC was categorized as very low, low, regular, good, or excellent. Additionally, the association between sociodemographic characteristics and the level of knowledge about OC was evaluated. RESULTS: This research was conducted on a sample of 387 dentists. Most of the respondents were general dentists and worked in urban zones. The majority of dentists lacked a specialty (76.7%). Additionally, most of the respondents were students (44.2%). The level of knowledge of the participants was between regular and good (77.8%). On the other hand, concerning self-evaluation, most of the participants considered their knowledge of OC to be regular (50.6%). In addition, there was no association between sociodemographic characteristics and knowledge about OC. CONCLUSIONS: This research identified some weaknesses in most Mexican dentists' knowledge of OC.
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Neoplasias Bucais , Humanos , Atitude do Pessoal de Saúde , Estudos Transversais , Odontólogos , México , Neoplasias Bucais/diagnóstico , Inquéritos e QuestionáriosRESUMO
Orthodontic treatment could lead to undesirable effects such as external apical root resorption (EARR). Moreover, trauma to both the face and teeth can predispose to EARR. On the other hand, the practice of combat sports results in increased maxillofacial injuries. Consequently, our objective was to determine if there is a statistically significant difference in the EARR of the patients undergoing fixed orthodontic treatment who practice combat sports and controls. Our null hypothesis was that there is no difference in the EARR between patients undergoing orthodontic treatment who practice combat sports and the patients under the same treatment that do not practice combat sports. An observational, descriptive, and prospective case-control pilot study was designed. The exposed group consisted of patients that practice combat sports. Whereas the control group was conformed of patients that do not practice combat sports without a previous history of facial trauma and without face trauma during the orthodontic treatment. EARR of the maxillary and mandibular anterior teeth was measured using cone-beam computed tomography (CBCT). The CBCT scans were obtained from all patients prior to the beginning of the orthodontic treatment and 1 year later. At the end of the follow-up for the maxillary right central and lateral incisors of the exposed group, the EARR was significantly higher than the homologous teeth of the control group (p < 0.05). As a consequence, the patients treated orthodontically who practice combat sports could be more susceptible to EARR.
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Reabsorção da Raiz , Humanos , Reabsorção da Raiz/etiologia , Projetos Piloto , Incisivo , Maxila , Estudos de Casos e ControlesRESUMO
OBJECTIVE: To perform a literature review aimed to analyze if acupoint stimulation increases lactation quantity. METHOD: Studies were collected from five electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Eligibility criteria were full-text articles in English or Spanish with clinical trial design and observational studies, with no restriction on time of publication, in which the effect of acupoint stimulation on improving the quantity of lactation by conventional acupuncture, electroacupuncture, laser, fire needling, manual stimulation, tuina or catgut had been evaluated. Two authors independently extracted data for the characteristics and main outcomes of the studies selected for inclusion. The risk of bias (RoB 2 and Robins-I) and the quality assessments (GRADE) were performed. For the quantitative synthesis, the standardized mean difference was calculated for each individual study selected and then the data were combined using a random-effects meta-analysis. RESULTS: A total of 14 studies were included in the present review. Most of the included studies exhibited some concerns in the risk of bias assessment. The quality of the studies was moderate. The meta-analysis showed that manual acupoint stimulation improves the lactation quantity (SMD 95% CI = 1.63 [1.13-2.13]; p < 0.0001). CONCLUSION: The literature suggests that manual stimulation of acupuncture points improves the amount of milk produced during lactation.
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Pontos de Acupuntura , Terapia por Acupuntura , Humanos , Terapia por Acupuntura/métodos , Feminino , LactaçãoRESUMO
One potential application of neural networks (NNs) is the early-stage detection of oral cancer. This systematic review aimed to determine the level of evidence on the sensitivity and specificity of NNs for the detection of oral cancer, following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) and Cochrane guidelines. Literature sources included PubMed, ClinicalTrials, Scopus, Google Scholar, and Web of Science. In addition, the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the risk of bias and the quality of the studies. Only 9 studies fully met the eligibility criteria. In most studies, NNs showed accuracy greater than 85%, though 100% of the studies presented a high risk of bias, and 33% showed high applicability concerns. Nonetheless, the included studies demonstrated that NNs were useful in the detection of oral cancer. However, studies of higher quality, with an adequate methodology, a low risk of bias and no applicability concerns are required so that more robust conclusions could be reached.
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Neoplasias Bucais , Redes Neurais de Computação , Humanos , Sensibilidade e Especificidade , Neoplasias Bucais/diagnósticoRESUMO
PURPOSE: Fixed restorations and dental enamel have different structures that produce different wear on opposing teeth, resulting in clinical problems. Therefore, it is necessary to determine the type of restoration that causes less wear on naturally opposing teeth to make recommendations. The objective of this study was to systematically analyze the evidence from observational studies and clinical trials on enamel wear in different ceramic restorations. STUDY SELECTION: The designs of the included studies were randomized clinical trials (RTCs), non-randomized clinical trials (non-RTCs), and observational studies (OS). The studies must answer the research question, be available in full text, be written in English or Spanish, and have had at least six months of follow-up. Protocol number: CRD42023397759. RESULTS: After screening 499 records, 20 RTCs were subjected to data extraction, 10 were excluded, 10 were included in the systematic review, and only 5 were included in the network meta-analysis. The risk of bias assessment reported moderate to high risk of bias, quality, and certainty of evidence was evaluated and rated as moderate. Network meta-analysis showed higher enamel wear was observed in natural dental enamel against metal-ceramic antagonists. CONCLUSIONS: Enamel wear occurs in all teeth, even when the antagonist is a natural tooth. The wear is larger on surfaces with the ceramic crown antagonists studied (metal-ceramic, glazed zirconia, and polished zirconia). It is necessary to conduct additional clinical trials with larger follow-up periods and sample sizes.
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CD36 is a type 2 cell surface scavenger receptor expressed in various tissues. In macrophages, CD36 recognizes oxidized low-density lipoprotein (ox-LDL), which promotes the formation of foam cells, the first step toward an atherosclerotic arterial lesion. CD36 possesses a variety of posttranslational modifications, among them N-glycosylation and O-GlcNAc modification. Some of the roles of these modifications on CD36 are known, such as N-linked glycosylation, which provides proper folding and trafficking to the plasma membrane in the human embryonic kidney. This study aimed to determine whether variations in the availability of UDP-GlcNAc could impact Rab-5-mediated endocytic trafficking and, therefore, the cellular localization of CD36. These preliminary results suggest that the availability of the substrate UDP-GlcNAc, modulated in response to treatment with Thiamet G (TMG), OSMI-1 (O-GlcNAcylation enzymes modulators) or Azaserine (HBP modulator), influences the localization of CD36 in J774 macrophages, and the endocytic trafficking as evidenced by the regulatory protein Rab-5, between the plasma membrane and the cytoplasm.
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Antígenos CD36 , Macrófagos , Antígenos CD36/metabolismo , Macrófagos/metabolismo , Animais , Camundongos , Linhagem Celular , Glicosilação , Membrana Celular/metabolismo , Humanos , Lipoproteínas LDL/metabolismo , Hexosaminas/metabolismo , Hexosaminas/biossíntese , Proteínas rab5 de Ligação ao GTP/metabolismo , Transporte Proteico , Vias Biossintéticas , Processamento de Proteína Pós-TraducionalRESUMO
BACKGROUND: Intravenous immunoglobulin (IVIG) can suppress the inflammatory response in adults, but its role in pregnant women and newborns is poorly studied. While the adult immune system is considered mature, it is immature in neonates and suppressed in pregnancy. Since the immune response differs in these 3 groups, the use of IVIG could differentially modulate the immune response. OBJECTIVES: We aimed to explore the effect of IVIG on myeloid blood cells from non-pregnant women, pregnant women and newborns. MATERIAL AND METHODS: Whole blood from healthy donors was incubated with lipopolysaccharide (LPS) and/or IVIG. After 0 h, 24 h and 48 h of culture, Fc-gamma receptor (CD16, CD32 and CD64) expression, monocyte and neutrophil bacterial phagocytosis, and cytokine and chemokine concentrations were determined in the supernatant. RESULTS: The baseline expression of monocyte CD16 was higher in newborns than in adult women, but the expression of CD32 and CD64 was similar between groups. Furthermore, LPS and IVIG stimulation, together or separately, did not change Fc-gamma receptor expression in monocytes or neutrophils and did not modify their phagocytosis capacity. On the other hand, IVIG did not downregulate the proinflammatory cytokine response induced by LPS in any group. Interestingly, IVIG induced a strong interleukin 8 (IL-8) response in neonates but not in non-pregnant or pregnant women. CONCLUSIONS: Our results show that IVIG did not induce changes in Fc-gamma receptor expression, phagocytic ability, or the cytokine response to LPS in blood cells from neonates, non-pregnant or pregnant women. However, IVIG induced a strong IL-8 response in neonates that could improve immunity.
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Dental caries is a serious multifactorial oral disease that causes demineralization of the tooth's hard tissues and affects more than half of the world's population. The objective of this exploratory systematic review was to determine the prevalence of dental caries in Mexican children and adolescents, as well as related factors such as sex, nutritional status, type of dentition, education, living conditions, socioeconomic level, and the type of demographic area. The eligibility criteria to be considered were observational studies whose sample included Mexicans 0-15 years of age in which the prevalence or an index of dental caries had been evaluated. Eligible studies were identified through the search carried out in 6 databases and manual search, without publication time restriction. Fifty-four studies were found that met the eligibility criteria. In these included studies it was observed that, in the last decades, the prevalence of caries in Mexican children and adolescents exhibits a tendency to decrease this disease. In the 1980s, caries prevalences of up to 92.8% were reported; between 1990-1999, the highest reported prevalence was 97%; from 2000-2009, the highest reported prevalence was 95%; from 2010 to 2019 the highest prevalence was 94.6%; and from 2020 and 2021, prevalences of up to 88.5% were reported. Although there has been a decrease in the prevalence of caries in Mexican children, this disease continues to be linked to biological, behavioral and socioeconomic determinants.
La caries dental es una enfermedad bucodental multifactorial grave que provoca la desmineralización de los tejidos duros del diente y afecta a más de la mitad de la población mundial. El objetivo de esta revisión sistemática exploratoria fue determinar la prevalencia de caries dental en niños y adolescentes mexicanos, así como los factores relacionados como el sexo, el estado nutricional, el tipo de dentición, la educación, las condiciones de vida, el nivel socioeconómico y el tipo de área demográfica. Los criterios de elegibilidad fueron estudios observacionales cuya muestra incluyera mexicanos de 0 a 15 años en los que se hubiera evaluado la prevalencia o un índice de caries dental. Los estudios elegibles fueron identificados mediante la búsqueda realizada en 6 bases de datos y de manera manual, sin restricción de tiempo de publicación. Se encontraron 54 estudios que cumplieron con los criterios de elegibilidad. En estos estudios incluidos se observó que en las últimas décadas la prevalencia de caries en niños y adolescentes mexicanos exhibe una tendencia a la baja. En la década de 1980, se reportaron prevalencias de caries de hasta 92.8%; entre 1990-1999, la mayor prevalencia reportada fue de 97%; de 2000-2009, la prevalencia más alta reportada fue de 95%; de 2010 a 2019 la mayor prevalencia fue de 94.6%; y de 2020 y 2021, se reportaron prevalencias de hasta 88.5%. Aunque ha habido un decremento en la prevalencia de caries en niños mexicanos, esta enfermedad continúa vinculada a determinantes biológicas, conductuales y socioeconómicas.
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Cárie Dentária , Adolescente , Criança , Humanos , Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Escolaridade , México/epidemiologia , Prevalência , Fatores SocioeconômicosRESUMO
Temporomandibular joint disorders (TMD) generate pain and difficulties for mouth opening affecting the patients' quality of life. Ozone is an emerging therapy that has been proposed as a potential treatment, due to that, the evidence about its efficacy should be reviewed. Therefore, this work aimed to conduct a comprehensive systematic review to address the efficacy of ozone therapy for the treatment of pain and limited mouth opening in patients with TMD. The design of the included studies was clinical trials and observational studies, whereas, a series of cases, in vivo, and in vitro studies were excluded. The search was performed in PubMed, ClinicalTrials, Web of Science, and Scopus. Gray literature was searched at Google Scholar. Relevant data of all included studies were recorded. The risk of bias (using RoB 2) and the quality (using Grading of Recommendations Assessment, Development, and Evaluation) assessments were carried out. Meta-analyses using random-effects models of pain and maximal mouth opening data were performed. This review included 8 studies with 404 participants suffering limited function and pain related to TMD. At the overall bias of the studies, 25% exhibited some concerns and 75% had high risk; and the quality of the studies was low. The analysis of the included studies suggests that ozone therapy can diminish pain and improve the maximal mouth opening in TMD patients. However, there is no conclusive evidence of ozone therapy as a superior treatment for TMD compared with occlusal splint and pharmacotherapy.
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Ozônio , Transtornos da Articulação Temporomandibular , Humanos , Ozônio/uso terapêutico , Qualidade de Vida , Resultado do Tratamento , Dor , Transtornos da Articulação Temporomandibular/tratamento farmacológicoRESUMO
BACKGROUND: Elastomeric chains promote controlled movements and are widely used in orthodontics. OBJECTIVES: The aim of the study was to evaluate the force decay and elongation of orthodontic chains exposed to low-pH saliva (pH = 4) and different beverages common in the diet. MATERIAL AND METHODS: Force decay and elongation were determined in vitro at 6 time intervals over 21 days for 2 commercial elastomeric chains - Ormco (group A) and Borgatta (group B). The samples were immersed in artificial saliva (AS) at pH 4, Coca-Cola®, coffee, or beer for 15 min every day, or in AS (the control group). For the remaining time, the chains were placed into AS at 37°C. In addition, microscopic qualitative changes were recorded by means of scanning electron microscopy (SEM). RESULTS: The group B chains showed higher force decay and elongation at the end of the follow-up as compared to the group A chains. Exposure to beer had a greater impact on the force decay and elongation of the chains as compared to other liquids, but it was not statistically significant. The group A chains showed a more irregular surface than the group B chains, in particular, those exposed to coffee. CONCLUSIONS: Elastomeric chains suffer force decay and elongation as a function of time, mainly in the first 24 h. At the end of the follow-up, the group A chains exhibited less force decay in comparison with the group B chains. The qualitative observations showed that the chains in group A had a more irregular surface than the chains in group B.
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Café , Elastômeros , Humanos , Aparelhos Ortodônticos , Elasticidade , Saliva Artificial , DietaRESUMO
The difficulty in predicting fatal outcomes in patients with coronavirus disease 2019 (COVID-19) impacts the general morbidity and mortality due to severe acute respiratory syndrome-coronavirus 2 infection, as it wears out the hospital services that care for these patients. Unfortunately, in several of the candidates for prognostic biomarkers proposed, the predictive power is compromised when patients have pre-existing comorbidities. A cohort of 147 patients hospitalized for severe COVID-19 was included in a descriptive, observational, single-center, and prospective study. Patients were recruited during the first COVID-19 pandemic wave (April-November 2020). Data were collected from the clinical history whereas immunophenotyping by multiparameter flow cytometry analysis allowed us to assess the expression of surface markers on peripheral leucocyte. Patients were grouped according to the outcome in survivors or non-survivors. The prognostic value of leucocyte, cytokines or HLA-DR, CD39, and CD73 was calculated. Hypertension and chronic renal failure but not obesity and diabetes were conditions more frequent among the deceased patient group. Mixed hypercytokinemia, including inflammatory (IL-6) and anti-inflammatory (IL-10) cytokines, was more evident in deceased patients. In the deceased patient group, lymphopenia with a higher neutrophil-lymphocyte ratio (NLR) value was present. HLA-DR expression and the percentage of CD39+ cells were higher than non-COVID-19 patients but remained similar despite the outcome. Receiver operating characteristic analysis and cutoff value of NLR (69.6%, 9.4), percentage NLR (pNLR; 71.1%, 13.6), and IL-6 (79.7%, 135.2 pg/mL). The expression of HLA-DR, CD39, and CD73, as many serum cytokines (other than IL-6) and chemokines levels do not show prognostic potential, were compared to NLR and pNLR values.
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COVID-19 , Humanos , COVID-19/complicações , Estudos Prospectivos , Interleucina-6 , Pandemias , Prognóstico , Biomarcadores , Neutrófilos , Antígenos HLA-DR , Estudos RetrospectivosRESUMO
External apical root resorption (EARR) is a serious complication that should be avoided during orthodontic treatment; this pathology depends on multiple factors. Data from clinical studies should be assessed to determine the influence these factors have on the development of EARR. This systematic review aims to compare EARR produced by different factors (orthodontic systems, dental trauma, and dental vitality). The protocol was registered on the PROSPERO database. The search was performed on 5 databases. Accepted study designs included randomized controlled trials, nonrandomized clinical trials, and observational studies. Full-text articles from clinical studies of EARR associated with orthodontic treatment in English, Spanish, or Portuguese with no publication date restrictions were selected. Data from the studies, such as age, population, study groups, and outcome measures, were recorded. Multiple meta-analyses were performed with data from the included studies. Evidence suggests that EARR induced by orthodontic treatment is similar, regardless of the technique used. Evidence of the effect of previous dental trauma on EARR during orthodontic treatment is limited. There is less EARR associated with orthodontic treatment in endodontically treated teeth than in vital teeth. These conclusions should be considered with caution due to the low certainty of the evidence.
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Reabsorção da Raiz , Dente não Vital , Humanos , Aparelhos Ortodônticos Fixos/efeitos adversos , Reabsorção da Raiz/etiologia , Dente não Vital/complicaçõesRESUMO
Recently, biomimetic bioactive biomaterials have been introduced to the market for dental pulp capping. This systematic review and meta-analysis aimed to determine any variation between the effect of using TheraCal LC and other bioactive biomaterials for pulp capping is different, as measured by dentin increment and clinical success. The risk of bias was assessed using the Risk of Bias 2 and Newcastle−Ottawa tools for randomized clinical trials and observational studies. A search for relevant articles was performed on five databases. Additionally, the quality of the included studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A summary of individual studies and a meta-analysis were performed. The odds ratio of data from clinical success was combined using a random-effects meta-analysis. The meta-analysis results showed homogeneity between the studies (I2 = 0%). They revealed that the clinical success showed no differences between the patients who received TheraCal LC, light-cured calcium silicate-based biomimetic biomaterial, for dental pulp capping or the comparator biomaterials (p > 0.5). However, the certainty of the evidence was low to moderate due to the risk of bias in the included studies.
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This systematic review aimed to compare the efficacy of nonpharmacological therapies for painful temporomandibular joint disorders. The protocol was registered on International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020171364). The search was performed on the electronic databases PubMed, Google Scholar, Clinical Trials, and Web of Science. The eligibility criteria were randomized controlled trials in patients diagnosed with painful temporomandibular joint disorders comparing the pain relief between conventional treatment and nonpharmacological therapies such as acupuncture, physiotherapy, low-level laser, and massage. Fourteen articles were included in this review. At the overall bias of the studies included, 71.42% exhibited some concerns and 28.57% had high risk. The efficacy of nonpharmacological interventions was found to be moderate in the short term and variable in the long term for pain reduction in patients with temporomandibular joint disorders. The evidence pointed out that acupuncture, laser therapy, and physiotherapy are potentially useful interventions for pain relief in patients with temporomandibular joint disorders. However, there is a lack of consistency and short-term follow-up in the studies to determine the lasting of such effect.
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BACKGROUND: The assessment of motor function is vital in post-stroke rehabilitation protocols, and it is imperative to obtain an objective and quantitative measurement of motor function. There are some innovative machine learning algorithms that can be applied in order to automate the assessment of upper extremity motor function. OBJECTIVES: To perform a systematic review and meta-analysis of the efficacy of machine learning algorithms for assessing upper limb motor function in post-stroke patients and compare these algorithms to clinical assessment. MATERIAL AND METHODS: The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. The review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The search was performed using 6 electronic databases. The meta-analysis was performed with the data from the correlation coefficients using a random model. RESULTS: The initial search yielded 1626 records, but only 8 studies fully met the eligibility criteria. The studies reported strong and very strong correlations between the algorithms tested and clinical assessment. The meta-analysis revealed a lack of homogeneity (I2 = 85.29%, Q = 48.15), which is attributable to the heterogeneity of the included studies. CONCLUSION: Automated systems using machine learning algorithms could support therapists in assessing upper extremity motor function in post-stroke patients. However, to draw more robust conclusions, methodological designs that minimize the risk of bias and increase the quality of the methodology of future studies are required.
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Transtornos Motores , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Extremidade Superior , Reabilitação do Acidente Vascular Cerebral/métodos , ParesiaRESUMO
BACKGROUND: Serious games have been used as supportive therapy for traditional rehabilitation. However, most are designed without a systematic process to guide their development from the phases of requirement identification, planning, design, construction, and evaluation, which reflect the lack of adaptation of rehabilitation requirements and thus the patient's needs. OBJECTIVE: The aim of this study was to propose a conceptual framework with standardized elements for the development of information systems by using a flexible and an adaptable process centered on the patient's needs and focused on the creation of serious games for physical rehabilitation. METHODS: The conceptual framework is based on 3 fundamental concepts: (1) user-centered design, which is an iterative design process focused on users and their needs at each phase of the process, (2) generic structural activities of software engineering, which guides the independent development process regardless of the complexity or size of the problem, and (3) gamification elements, which allow the transformation of obstacles into positive and fun reinforcements, thereby encouraging patients in their rehabilitation process. RESULTS: We propose a conceptual framework to guide the development of serious games through a systematic process by using an iterative and incremental process applying the phases of context identification, user requirements, planning, design, construction of the interaction devices and video game, and evaluation. CONCLUSIONS: This proposed framework will provide developers of serious games a systematic process with standardized elements for the development of flexible and adaptable software with a high level of patient commitment, which will effectively contribute to their rehabilitation process.
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The cardiovascular system is a complex and well-organized system in which glycosylation plays a vital role. The heart and vascular wall cells are constituted by an array of specific receptors; most of them are N- glycosylated and mucin-type O-glycosylated. There are also intracellular signaling pathways regulated by different post-translational modifications, including O-GlcNAcylation, which promote adequate responses to extracellular stimuli and signaling transduction. Herein, we provide an overview of N-glycosylation and O-glycosylation, including O-GlcNAcylation, and their role at different levels such as reception of signal, signal transduction, and exogenous molecules or agonists, which stimulate the heart and vascular wall cells with effects in different conditions, like the physiological status, ischemia/reperfusion, exercise, or during low-grade inflammation in diabetes and aging. Furthermore, mutations of glycosyltransferases and receptors are associated with development of cardiovascular diseases. The knowledge on glycosylation and its effects could be considered biochemical markers and might be useful as a therapeutic tool to control cardiovascular diseases.
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Vital signs not only reflect essential functions of the human body but also symptoms of a more serious problem within the anatomy; they are well used for physical monitoring, caloric expenditure, and performance before a possible symptom of a massive failure-a great variety of possibilities that together form a first line of basic diagnosis and follow-up on the health and general condition of a person. This review includes a brief theory about fiber optic sensors' operation and summarizes many research works carried out with them in which their operation and effectiveness are promoted to register some vital sign(s) as a possibility for their use in the medical, health care, and life support fields. The review presents methods and techniques to improve sensitivity in monitoring vital signs, such as the use of doping agents or coatings for optical fiber (OF) that provide stability and resistance to the external factors from which they must be protected in in vivo situations. It has been observed that most of these sensors work with single-mode optical fibers (SMF) in a spectral range of 1550 nm, while only some work in the visible spectrum (Vis); the vast majority, operate through fiber Bragg gratings (FBG), long-period fiber gratings (LPFG), and interferometers. These sensors have brought great advances to the measurement of vital signs, especially with regard to respiratory rate; however, many express the possibility of monitoring other vital signs through mathematical calculations, algorithms, or auxiliary devices. Their advantages due to miniaturization, immunity to electromagnetic interference, and the absence of a power source makes them truly desirable for everyday use at all times.