Effects of Composite Attachments on Orthodontic Clear Aligners Therapy: A Systematic Review

This systematic review aims to highlight the differences between different clear aligner therapies that differ in the presence of attachments or in attachment configuration. Eight electronic databases were searched up to March 2020. Two authors independently proceeded to study selection, data extraction, and risk of bias assessment. The analysis of the results was carried out examining six groups of movements (mesio-distal tipping/bodily movement; anterior bucco-lingual tipping/root torque; posterior bucco-lingual tipping/expansion; intrusion; extrusion; rotation). Five clinical trials were selected and all of them showed a medium risk of bias. Literature showed that attachments mostly increase the effectiveness of orthodontic treatment with clear aligners, improving anterior root torque, rotation, and mesio-distal (M-D) movement; they are also important to increase posterior anchorage. However, some articles showed contradictory or not statistically significant results. Attachments also seem to improve intrusion, but the evidence about this movement, as well as extrusion, is lacking. No studies evaluated posterior bucco-lingual tipping/expansion. Further clinical trials are strongly suggested to clarify the influence of attachments and their number, size, shape, and position on each orthodontic movement.

Predictors of Higher Quality of Systematic Reviews Addressing Nutrition and Cancer Prevention

Systematic reviews/meta-analyses (SR/MAs) are considered a reliable source of information in healthcare. We aimed to explore the association of several characteristics of SR/MAs addressing nutrition in cancer prevention and their quality/risk of bias (using assessments from AMSTAR-2 and ROBIS tools). The analysis included 101 SR/MAs identified in a systematic survey. Associations of each specified characteristic (e.g., information about the protocol, publication year, reported use of GRADE, or other methods for assessing overall certainty of evidence) with the number of AMSTAR-2 not met (‘No’ responses) and the number of ROBIS items met (‘Probably Yes’ or “Yes’ responses) were examined. Poisson regression was used to identify predictors of the number of ‘No’ answers (indicating lower quality) for all AMSTAR-2 items and the number of ‘Yes’ or ‘Probably Yes’ answers (indicating higher quality/lower concern for bias) for all ROBIS items. Logistic regression was used to identify variables associated with at least one domain assessed as ‘low concern for bias’ in the ROBIS tool. In multivariable analysis, SR/MAs not reporting use of any quality/risk of bias assessment instrument for primary studies were associated with a higher number of ‘No’ answers for all AMSTAR-2 items (incidence rate ratio (IRR) 1.26, 95% confidence interval (CI) 1.09–1.45), and a lower number of ‘Yes’ or ‘Probably Yes’ answers for all ROBIS items (IRR 0.76, 95% CI 0.66–0.87). Providing information about the protocol and search for unpublished studies was associated with a lower number of ‘No’ answers (IRR 0.73, 95% CI 0.56–0.97 and IRR 0.75, 95% CI 0.59–0.95, respectively) and a higher number of ‘Yes’ or ‘Probably Yes’ answers (IRR 1.43, 95% CI 1.17–1.74 and IRR 1.28, 95% CI 1.07–1.52, respectively). Not using at least one quality/risk of bias assessment tool for primary studies within an SR/MA was associated with lower odds that a study would be assessed as ‘low concern for bias’ in at least one ROBIS domain (odds ratio 0.061, 95% CI 0.007–0.527). Adherence to methodological standards in the development of SR/MAs was associated with a higher overall quality of SR/MAs addressing nutrition for cancer prevention.

Effect of treatments on skin microbiota in patients with atopic dermatitis: a protocol for systematic review

IntroductionAtopic dermatitis (AD) is a chronic inflammatory skin disease and skin microbiota dysbiosis shows an important role in the pathogenesis of AD. Effects of treatment on skin microbiota for patients with AD have been evaluated in recent years; however, the results remained controversial across studies. This systematic review will summarise studies evaluating the effect of treatments on skin microbiota among patients with AD.Methods and analysisWe will search PubMed, EMBASE, Web of Science, ClinicalTrials.gov and Chinese Clinical Trial Registry in November 2021; other data sources will also be considered, including searching specific authors and screening references cited in the enrolled articles. Interventional studies, which enrolled patients with AD receiving treatments and reported treatment-related skin microbiota changes, will be included. Our primary outcomes include skin microbiota diversity and treatment-related differential microbes; the secondary outcomes include microbiota functions and microbial interactions. Risk of bias assessment will be performed using Cochrane risk-of-bias tool for randomised trials, risk of bias in non-randomised studies of interventions and methodological index for non-randomised studies. Two researchers will independently perform study selection, data extraction and risk of bias assessment, with disagreements resolved by group discussions. Subgroup analyses will be performed according to different types of treatment for AD.Ethics and disseminationEthics approval is not required for this systematic review. Findings will be disseminated via peer-reviewed publication or conference proceedings.PROSPERO registration numberCRD42021246566.

Effects of Horticultural Therapy on Korean Elderly with Dementia: A Meta-analysis

Purpose: The aim of this meta-analysis was to identify the effects of horticultural therapy on Korean elderly with dementia.Methods: We searched the PubMed, EMBASE, Cochrane, CINAHL, and eight domestic databases, until February 2021. Data extraction and the risk of bias assessment were independently conducted by two authors. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis.Results: Of the 478 studies retrieved from the databases, 21 studies were included in the final analysis. A total of 93 outcome variables were analyzed in 21 literatures. The overall effect size of the horticultural treatment program was 0.91 (95% CI: 0.74~1.09, p<.001), which was statistically significant. Compared to the control group, horticultural therapy improved cognitive functions (SMD=0.71, 95% CI: 0.42~0.99, I2=79.9%), psychosocial functions (SMD=1.01, 95% CI: -0.70~1.31, I2=67.8%), and physical functions (SMD=1.05, 95% CI: 0.77~1.33, I2=72%) in Korean elderly with dementia.Conclusion: This meta-analysis found that horticultural therapy improved the cognitive, psychosocial, and physical functions of dementia patients compared to subjects in the control group.

Diagnostic Accuracy of Imaging Findings in Pleural Empyema: Systematic Review and Meta-Analysis

Computed tomography (CT) diagnosis of empyema is challenging because current literature features multiple overlapping pleural findings. We aimed to identify informative findings for structured reporting. The screening according to inclusion criteria (P: Pleural empyema, I: CT C: culture/gram-stain/pathology/pus, O: Diagnostic accuracy measures), data extraction, and risk of bias assessment of studies published between 01-1980 and 10-2021 on Pubmed, Embase, and Web of Science (WOS) were performed independently by two reviewers. CT findings with pooled diagnostic odds ratios (DOR) with 95% confidence intervals, not including 1, were considered as informative. Summary estimates of diagnostic accuracy for CT findings were calculated by using a bivariate random-effects model and heterogeneity sources were evaluated. Ten studies with a total of 252 patients with and 846 without empyema were included. From 119 overlapping descriptors, five informative CT findings were identified: Pleural enhancement, thickening, loculation, fat thickening, and fat stranding with an AUC of 0.80 (hierarchical summary receiver operating characteristic, HSROC). Potential sources of heterogeneity were different thresholds, empyema prevalence, and study year.

The contamination rate of Aflatoxin M1 in milk samples of Iran: A systematic review and meta-analysis protocol

Aflatoxin M1 (AFM1) as a 4-hydroxylated metabolite of carcinogenic mycotoxin Aflatoxin B1 (AFB1) is considered as an acute toxic compound found in milk and its derived products (1). Regarding the critical public health issue induced by AFM1 and as milk is essential in human food chain, its maximum limit has been set by regulatory agencies considering the economic status and development of the countries (4). The maximum permissible limit for AFM1 is 50 ng/kg (different countries including European Union (EU) members) to 100 ng/kg (different countries including USA) (5). In Iran, it has been regulated as 100 ng/kg (6). To the best of our knowledge, there is several similar systematic review and meta-analysis about the contamination of campylobacter in milk, globally and specifically in Iran (4, 5, 7-10). However, we will try to examine the mean and prevalence of AFM1 in different type of milk (cow, sheep, goat, raw, processed) in different region of Iran with long time interval (1974-2021). Moreover, more general and specific databases and grey literature with excellent eligibility criteria will be applied to have a more comprehensive review leading to an interesting finding by techniques such as risk of bias assessment (for assessing quality of included studies), publication bias assessment, finding the source of heterogeneity by sub-group analysis in addition to meta-analysis process.

Dental Composite Restorations Repair: A Systematic Review and Meta-analysis

Background: Controversy exists in the literature regarding the most optimal repair procedure for improving the adhesion between the repair resin and the existing resin composite materials. Hence the aim of the present study was to do a systematic review and to analyze the adhesion potential of resin-based composites to similar and dissimilar composites and aimed to determine the possible dominant factors affecting the bond strength results. Materials & Methods: Randomized clinical trials (RCTs) and prospective cohort design were searched through electronic databases including MEDLINE, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials for randomized clinical trials (RCTs) until July 2020 that compared different methods of composite restoration repair and a minimum mean follow-up time of 1 year. There were no restrictions on a particular treatment indication or outcome measures. Two authors independently conducted screening, risk of bias assessment, and data extraction of eligible trials in duplicate. We applied the Cochrane risk of bias assessment tool to consider the risk of bias. Results: We identified 10 articles; two of them were RCTs, and eight prospective cohort studies. There were 530 participants, with 990 teeth, dealing with resin-based composite (RBC) restorations. The intervention of defective restorations ranged from minimal intervention to total restoration replacement. The evaluation criteria were also varied with different evaluation protocols. The low number and heterogeneity of RCTs did not allow for meta-analyses. Conclusions: Although different repair protocols are mentioned in the literature according to the included studies, an appropriate and definitive conclusion can't be drawn. However, it seems repairs versus replacements should be considered as the first line of treatment when all factors lead to repair rather than replacement. Further randomized controlled trials with high methodological quality need to be conducted in order to establish evidence-based recommendations, particularly for RBC repair.

INTERLEUKIN AS BIOMARKER OF RECURRENT APHTHOUS STOMATITIS (RAS): A SYSTEMATIC LITERATURE REVIEW

This review aimed to describe the interleukins and interleukin gene polymorphisms related to and recommended as a RAS biomarker. Articles were searched through PubMed, ScienceDirect, and Cochrane Library databases, using the keywords of “Interleukin” AND “Recurrent Aphthous Stomatitis”. The Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) was used, and the writing of this review refers to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. A total of 8 articles met the criteria and showed a low risk of bias assessment. The level of IL-2, IL-6, IL-8, and IL-18 in the acute clinical phase of RAS were higher than in the recovery phase, but IL-10 levels showed decreased. IL-2, IL-6, IL-10 gene polymorphisms were found to be more frequent in RAS patients compared to controls, while IL-12 gene polymorphisms were found to be less associated with RAS pathogenesis. Interleukins at the proteomic level that recommended as a pro-inflammatory biomarker are IL-2, IL-6, IL-8, IL-12, and IL-18, while an anti-inflammatory is IL-10. Only IL-2 can be recommended as a biomarker at the genomic level, as other interleukins still require more investigation.

Seroprevalence and incidence of hepatitis A in Southeast Asia: A systematic review

Background A previous review on hepatitis A virus (HAV) seroprevalence in 2005 categorized Southeast Asia as a low HAV endemicity region. In 2010, the World Health Organization modified this from low to low/medium endemicity, pointing out that these estimates were based on limited evidence. Since then, there has been no attempt to review HAV epidemiology from this region. We conducted a systematic review of literature to collect information on HAV incidence and seroprevalence in select countries in the Southeast Asian region, specifically, The Association of Southeast Asian Nations over the last 20 years. Methodology This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. From the relevant articles, we extracted data and conducted a risk of bias assessment of individual studies. Results The search yielded 22 and 13 publications on HAV seroprevalence and incidence, respectively. Overall, our findings point to a very low HAV endemicity profile in Thailand and Singapore and evidence of a shift towards low HAV endemicity in Indonesia, Lao People’s Democratic Republic, Malaysia, the Philippines, and Vietnam. Only Singapore, Thailand, Malaysia, and the Philippines have existing HAV disease surveillance and reported incidence rates below 1 per 100,000. Several outbreaks with varying magnitude documented in the region provide insights into the evolving epidemiology of HAV in the region. Risk of bias assessment of studies revealed that the individual studies were of low to medium risk. Conclusions/Significance The available HAV endemicity profiles in Southeast Asian countries, aside from Thailand, are limited and outdated, but suggest an endemicity shift in the region that is not fully documented yet. These findings highlight the need to update information on HAV epidemiology through strengthening of disease surveillance mechanisms to confirm the shift in HAV endemicity in the region.