Effect of Photodynamic Therapy on Halitosis: A Systematic Review of Randomized Controlled Trials

Background: This systematic review aimed to assess the effectiveness and safety of aPDT for the treatment of halitosis. Methods: Search strategies were conducted in October 2021 without language or data restrictions, on the following databases: MEDLINE, EMBASE, CENTRAL, LILACS and BBO, as well as a manual search. Randomized clinical trials (RCTs) with parallel design were considered for inclusion, assessing individuals (adolescents and adults) with a clinical diagnosis of halitosis treated with photodynamic therapy (aPDT). Primary outcomes assessed were halitosis measurements, adverse events and quality of life. The risk of bias for each included study was evaluated with the Cochrane Risk of Bias tool and the certainty of the body of the evidence was assessed with the GRADe approach. Results: Six RCTs (total of 225 participants) were included and due to clinical diversities it was not possible to group the outcome data in meta-analyses. Based on very low-certainty evidence (GRADE) the results showed that, when compared to tongue scraper, aPDT seems to promote a little to no difference in reducing halitosis and in the microbiological analysis. No adverse events were reported. Considering aPDT combined with tongue scraper, better outcome results were observed when compared to tongue scraper alone. Conclusions: Based on very low-certainty evidence, the findings of this review are uncertain about the effects of aPDT for halitosis control. Further RCTs with higher number of participants and long term assessments need to be conducted to support the use of this intervention. The protocol was registered in the PROSPERO database (number: CRD42020215319) on 19 November 2020—retrospectively registered.

Comparing natural hydrogels to self-assembling peptides in spinal cord injury treatment: a systematic review

Background: In many cases, central nervous system (CNS) injury is unchanging due to the absence of neuronal regeneration and repair capabilities. In recent years, regenerative medicine, and especially hydrogels, has reached a significant amount of attention for their promising results for the treatment of spinal cord injury (SCI) currently considered permanent. Hydrogels are categorized based on their foundation: synthetic, natural, and combination. The objective of this study was to compare the properties and efficacy of commonly used hydrogels, like collagen, and other natural peptides with synthetic self-assembling peptide hydrogels in the treatment of SCI. Methods: Articles were searched in PubMed, Scopus, Web of Science, and Embase. All studies from 1985 until January 2020 were included in the primary search. Eligible articles were included based on the following criteria: administering hydrogels (both natural and synthetic) for SCI treatment, solely focusing on spinal cord injury treatment, and published in a peer-reviewed journal. Data on axonal regeneration, revascularization, elasticity, drug delivery efficacy, and porosity were extracted. Results: A total of 24 articles were included for full-text review and data extraction. There was only one experimental study comparing collagen I (natural hydrogel) and polyethylene glycol (PEG) in an in vitro setting. The included study suggested the behavior of cells with PEG is more expectable in the injury site, which makes it a more reliable scaffold for neurites. Conclusions: There is limited research comparing and evaluating both types of natural and self-assembling peptides (SAPs) in the same animal or in vitro study, despite its importance. Although we assume that the remodeling of natural scaffolds may lead to a stable hydrogel, there was not a definitive conclusion that synthetic hydrogels are more beneficial than natural hydrogels in neuronal regeneration.

Review of novel therapeutics in cardiac arrest (ReNTICA): systematic review protocol

IntroductionCardiac arrest remains a common and devastating cause of death and disability worldwide. While targeted temperature management has become standard of care to improve functional neurologic outcome, few pharmacologic interventions have shown similar promise.Methods/analysisThis systematic review will focus on prospective human studies from 2015 to 2020 available in PubMed, Web of Science and EMBASE with a primary focus on impact on functional neurologic outcome. Prospective studies that include pharmacologic agents given during or after cardiac arrest will be included. Study selection will be in keeping with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. If sufficient data involving a given agent are available, a meta-analysis will be conducted and compared with current evidence for therapies recommended in international practice guidelines.Ethics and disseminationFormal ethical approval will not be required as primary data will not be collected. The results will be disseminated through peer-reviewed publication, conference presentation and lay press.PROSPERO registration numberInternational Prospective Register for Systematic Reviews (CRD42021230216).

Constructing a graphical model of the relationship between physical activity and cognitive function based on a systematic review of prospective evidence

Elucidating the factors that contribute to healthy ageing is an important research goal. Physical activity (PA) has been associated with benefits for cognitive function (CF). However, most of this evidence comes from longitudinal cohort studies which, in the absence of experimental design, have limited scope to make causal inferences regarding observed relationships. This review aimed to utilise recent methodological developments allowing researchers to formulate and answer stronger causal questions using observational data, by following a best-practice method for synthesising evidence to produce a graphical causal model known as a directed acyclic graph (DAG). Following a search of 3 databases (EMBASE, MEDLINE and PsycINFO), 21 observational studies on the PA-CF relationship were reviewed and their methodological quality, characteristics, and key findings were summarised. The outcomes of interest were the covariates and modelling practices employed in each study. The reported covariates were synthesised against a set of criteria to determine their role in the DAG as confounders or mediators of the PA-CF relationship. Every included study had some areas of methodological weakness. The resulting DAG included a wide range of biopsychosocial covariates spanning the entire life-course and indicated potential intermediate pathways between PA and CF via structural brain health. Strengths, limitations and implications of this review for modelling decisions are discussed, prior to the model being taken forward to inform an empirical analysis using data from the UK Biobank cohort, separate from this review.

Gifting a Healing Education Through Writing Life and Art: A Paris Studio Residency

We are two Canadian arts-based educational researchers who collaborated during a studio residency in Paris, France, during May 2015, for ten days. Our residency curriculum included study of feminist poet-thinker Hélène Cixous, taking walks in Paris locales, viewing women’s art, and engaging arts-based inquiry methods such as journaling, life writing and creative embodied practices, as a way to pay attention to and document our daily experiences. We practiced what we call companion pedagogy, with a feminist focus on mothering and gifting relations. We find that arts-based, restorative practices strengthen our wellbeing and resiliency as educators, and also support our desire for a more nurturing, mothering humanity to come forward for gifting a healing education. Healing education begs the question of how to address the resiliency of educators over time through what are increasingly challenging and depleting conditions of institutional cultures and economies. We thus offer creative practices such as studio residencies for collective care and gifting that can nurture a restorative pacing of life, while supporting the resiliency of educators to gift their energies towards creative curriculum visioning and enacting of social change.

Gut Microbiome and Its Associations With Acute and Chronic Gastrointestinal Toxicities in Cancer Patients With Pelvic Radiation Therapy: A Systematic Review

AimPelvic radiation therapy (RT) can impact the gut microbiome in patients with cancer and result in gastrointestinal (GI) toxicities. The purpose of this systematic review was to describe the effects of RT on the gut microbiome and the associations between the gut microbiome and GI toxicities in patients treated with pelvic RT.MethodsPubMed, Embase, and Web of Science databases were searched from their earliest records to August 2020. The articles screening process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Mixed Method Assessment Tool was used to assess the methodological quality for each included study. All study findings were synthesized and presented in narrative format. Thirteen studies were included. The gut microbiome of fecal samples was analyzed using 16S rRNA sequencing approaches.ResultsThere were disparities in alpha and beta diversities that existed across the studies. Divergent results were found among various phyla, including Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, Cyanobacteria, Fusobacteria, and Deinococcus-Thermus. Moreover, alteration in the gut microbiome diversity and abundance related to cancer treatment was associated with pelvic toxicities, specifically diarrhea. Following treatment, increases in the abundance of Bacteroides was associated with diarrhea and radiation enteritis.ConclusionsPelvic RT can disrupt the diversity and abundance of commensal gut microorganisms. A dysbiotic gut microbiome showed a promising association with radiation enteritis through alterations of the intestinal barrier function, innate immunity, and intestinal repair mechanisms; however, confounders, such as diet, were not thoroughly addressed.

Evacuation solutions for individuals with functional limitations in the built environment: a scoping review protocol

Background Whether due to aging, disability, injury, or other circumstances, an increasing number of Canadians experience functional limitations that reduce their ability to participate in activities of daily life. While the built environment has become increasingly accessible, existing Canadian evacuation guidelines lack comprehensive strategies for evacuating individuals with functional limitations from buildings during emergencies. To inform guideline revisions, a map of existing solutions for evacuating such individuals is required. Therefore, this scoping review aims to provide an account of solutions that have been reported to safely evacuate individuals with functional limitations from the built environment. Methods We will conduct a scoping review using the Arksey and O’Malley methodological framework. To identify potentially relevant studies, comprehensive searches (from January 2002 onwards) of the CINAHL, Ei Compendex, Inspec, Embase, MEDLINE, KCI, RSCI, SciELO CI, Web of Science Collection, and Scopus databases will be performed. Using a set of inclusion and exclusion criteria, two reviewers will independently (1) classify identified studies as relevant, irrelevant, or maybe relevant by evaluating their titles and abstracts and (2) classify the relevant and maybe relevant studies as included or excluded by evaluating their full-text. From each included study, data on publication information, study purpose, methodological details, evacuation information, and outcomes will be extracted using a set of data extraction items. We will present a numerical summary of the key characteristics of the included studies. For each evacuation activity, reported evacuation solutions will be summarized, and citations provided for functional limitations that are targeted by a given evacuation solution. To inform Canadian evacuation guideline revisions, we will tabulate evacuation activities common to different types of buildings and emergencies. Discussion To our knowledge, this will be the first scoping review to identify the state and use of solutions for evacuating individuals with functional limitations from the built environment. Identifying solutions that enable all individuals to safely evacuate from different types of buildings will allow us to inform recommendations for the revision of evacuation guidelines in Canada and other jurisdictions. The findings of this scoping review will be published in a peer-reviewed journal, presented at relevant conferences, and made publicly available on the internet. Systematic review registration Open Science Framework: osf.io/jefgy

Organization of Medical Support for the Military Service Call-Up of Citizens during New Coronavirus Infection COVID-19 Pandemic

The aim of the study was to evaluate the organization of screening of conscripts for COVID-19 infection in one of the subjects of the Russian Federation — Orenburg region. Materials and methods of the study. The study of organization of examination of conscripts for COVID-19 infection included study of the experience of the Center of Military Medical Examination of the Military Commissariat of Orenburg Region in carrying out military conscription under conditions of the COVID-19 pandemic; methodological recommendations approved by the Head of the Main Military Medical Department of the Defense Ministry of Russia as well as the analysis of the activities carried out at different stages of medical sorting. Results of the study and their analysis. The results of the study of the organization of COVID-19 screening of conscripts in Orenburg Region showed that sufficient and effective barrier medical screening was organized at all stages. Conscripts in good health condition were sent to the Armed Forces for military service under conscription. No claims were received from military units about poor quality selection of conscripts. In 2020, during the COVID-19 pandemic, recruitment commissions of Orenburg Region coped successfully with the task of drafting citizens for military service.

Evaluation of bone marrow-derived cell-based therapies in the hindlimb ischaemia model: a protocol for a systematic review and meta-analysis

ObjectiveBone marrow(BM)-derived cell-based therapies for critical limb ischamia showed less clinical benefit than expected. While this might be due to patient-specific factors, it remains possible that important details were lost in the bench-to-clinic translation. The hindlimb ischaemia model is the golden standard to evaluate cell-based therapies aimed at promoting neovascularisation. To inform future trial design and identify potential knowledge gaps, we propose a systematic review and meta-analysis of preclinical evidence to assess the efficacy of BM-derived cell administration in restoring relative perfusion in the hind limb model and identify determinants of therapeutic efficacy.Search strategyPubMed and EMBASE were searched for prospective studies in which the hindlimb ischaemia model was used to assess BM-derived therapies.Screening and annotationStudies with an outcome measure related to relative perfusion of the hindlimb will be included. Study characteristics which include model-related factors as well as details on BM therapy will be extracted.Data management and reportingFor the primary analysis, a random effects model will be constructed using the mean difference calculated from the maximum relative perfusion for each study arm in each study. A separate model will be constructed using the relative perfusion at the latest time point in each study. We will also assess the risk of bias using the SYRCLE tool for internal validity. Subgroup analysis will be performed on animal characteristics, administration route, dose and cell characteristics such as the cell donor.PROSPERO registration numberThis protocol has been registered at PROSPERO (CRD2021226592).

Prevalence, classification, risk factors and outcome impact of delirium in patients with COVID-19: a meta-analysis protocol for systematic review

IntroductionPrevious studies have shown mixed results that delirium may result in a high risk of adverse clinical outcomes in patients with COVID-19. The aim of this meta-analysis is to summarise the evidence of prevalence, classification, risk factors and outcomes impact of delirium in adult patients with COVID-19.MethodsA systematic search will be performed in PubMed, EMBase, ISI Knowledge via Web of Science and preprint databases (MedRxiv and BioRxiv) (from inception until June 2021) to identify all cohort studies concerning delirium in adult patients with COVID-19. The primary outcome will be the prevalence of delirium with different classifications (hyperactive, hypoactive or mixed type). The secondary outcomes will include the association of risk factors and the association with all-cause mortality during hospitalisation. Univariable or multivariable meta-regression and subgroup analyses will be conducted for the study design and patient characteristics. Sensitivity analyses were used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of primary and secondary outcomes.Ethics and disseminationEthical approval is not an essential element for the systematic review protocol in accordance with the Institutional Review Board /Independent Ethics Committee of Beijing Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication.PROSPERO registration numberCRD42020224871.