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Background: As the demand for digital dentistry constantly increases, digital devices are gradually replacing conventional methods of recording occlusal contacts. The study aimed to assess the inter-rater reliability of occlusal contact point detection using 40 μm articulating paper, Medit i700, and OccluSense and to compare the distribution of occlusal contacts using the articulating paper and intraoral scanner. Material and Methods: The study included 25 participants aged 20 to 30 (13 women and 12 men). Photographs of contact points were taken and marked in maximum intercuspal position (MIP), in protrusive and laterotrusive movements, on working and non-working sides using 40 μm articulating paper and digital devices. The Cohen's Kappa coefficient assessed the inter-rater reliability. The Wilcoxon signed-rank test was used to compare dependent groups, articulating paper, and Medit i700. Results: The Cohen's Kappa index showed that almost perfect agreement was achieved with 40 μm articulating paper. Compared to Medit i700, the 40 μm articulating paper showed an increased mean number of contacts per tooth, except for the third molars. Conclusions: The 40 μm articulating paper has detected more overall contacts than the digital devices, particularly in the posterior areas. An ideal method for registering occlusal contacts has not been established yet. [ABSTRACT FROM AUTHOR]

Evidence-based medicine integrates results from randomized controlled trials (RCTs) and meta-analyses, combining the best external evidence with individual clinical expertise and patients' preferences. However, RCTs of surgery differ from those of medicine in that surgical performance is often assumed to be consistent. Yet, evaluating whether each surgery is performed to the same standard is quite challenging. As a primary issue, the novelty of this review is to emphasize—with a focus on orthopedic trauma—the advantage of having complete intra-operative image documentation, allowing the direct evaluation of the quality of the intra-operative technical performance. The absence of complete intra-operative image documentation leads to the inhomogeneity of case series, yielding inconsistent results due to the impossibility of a secondary analysis. Thus, comparisons and the reproduction of studies are difficult. Access to complete intra-operative image data in surgical RCTs allows not only secondary analysis but also comparisons with similar cases. Such complete data can be included in electronic papers. Offering these data to peers—in an accessible link—when presenting papers facilitates the selection process and improves publications for readers. Additionally, having access to the full set of image data for all presented cases serves as a rich resource for learning. It enables the reader to sift through the information and pinpoint the details that are most relevant to their individual needs, allowing them to potentially incorporate this knowledge into daily practice. A broad use of the concept of complete intra-operative image documentation is pivotal for bridging the gap between clinical research findings and real-world applications. Enhancing the quality of surgical RCTs would facilitate the equalization of evidence acquisition in both internal medicine and surgery. Joint effort by surgeons, scientific societies, publishers, and healthcare authorities is needed to support the ideas, implement economic requirements, and overcome the mental obstacles to its realization. [ABSTRACT FROM AUTHOR]

KBG syndrome (KBGS; OMIM #148050) is a rare disease characterized by short stature, facial dysmorphism, macrodontia of the upper central incisors, skeletal anomalies, and neurodevelopmental disorder/intellectual disability. It is caused by a heterozygous variant or 16q24.3 microdeletions of the ANKRD11 gene (OMIM #611192), which plays a primary role in neuronal development. KBGS traits are variable, and mild expressions of the phenotype may complicate diagnosis. The present work aims at improving the characterization of KBGS in order to facilitate its recognition. A psychopathological evaluation of 17 subjects affected by KBGS found that 10 patients exhibited peculiar behavior related to "paper handling". These children and adolescents performed repetitive activities with paper, reminiscent of the hoarding and ordering behaviors characteristic of obsessive compulsive disorder. Their activities were time consuming and carried out in solitary, and forced interruption could generate intense emotional reactions. Paper handling may thus be understood as a potential distinct KBGS symptom akin to an obsessive compulsive symptom. Further research is needed to verify this claim. [ABSTRACT FROM AUTHOR]

Benign conditions of the lower urinary tract, including benign prostatic hyperplasia, overactive bladder syndrome, and stress urinary incontinence, are frequent in the general population. Despite their benign nature, they have major adverse effects on the quality of life of the afflicted patients and their partners. Despite major progress in the diagnosis and treatment of these conditions, improved understanding and management of these patients remain substantial medical needs. This editorial discusses some recent high-quality articles published in the Journal of Clinical Medicine on the understanding of the epidemiology, pathophysiology, diagnostic, and treatment of benign diseases of the lower urinary tract tissues such as the bladder and prostate. [ABSTRACT FROM AUTHOR]

Biliary atresia, a fibro-obliterative disease of the newborn, is usually initially treated by Kasai portoenterostomy, although there are many variations in technique and different options for post-operative adjuvant medical therapy. A questionnaire on such topics (e.g., open vs. laparoscopic; the need for liver mobilisation; use of post-operative steroids; use of post-operative anti-viral therapy, etc.) was circulated to delegates (n = 43) of an international webinar (Biliary Atresia and Related Diseases—BARD) held in June 2021. Respondents were mostly European, but included some from North America, and represented 18 different countries overall. The results of this survey are presented here, together with a commentary and review from an expert panel convened for the meeting on current trends in practice. [ABSTRACT FROM AUTHOR]

Intra-operative 3D X-rays have been confirmed to decrease revision rates and improve optimal screw placement in complex fractures of the distal radius. Compared with traditional surgical publications, another advantage of whole intraoperative clinical imaging can be presented in electronic databases, e.g., the ICUC working group, through a link without size limitation. The detail of complete intra-operative image dataset includes essential technical details which can be analyzed secondarily for costs and complications, considering the technical performance bias. Furthermore, the new format complies with reading/learning preferences of young surgeons and allows secondary work-up by artificial intelligence. Intra-operative 3D X-ray is a new approach for better surgical outcomes, economic benefit, and educational purposes. [ABSTRACT FROM AUTHOR]

(1) Background: we compare a new SBAR based electronic handover tool versus a paper-based checklist for handover in a pediatric intensive care unit (PICU). (2) Methods: this is a randomized, observational study of 40 electronic vs. 40 paper checklist handovers after pediatric cardiac surgery, with a 48 items checklist for comparison of reporting frequencies and notification of disturbances and noise. PICU staff satisfaction was evaluated by a 12-item questionnaire. (3) Results: in 14 out of 40 cases, there were problems with data processing (incomplete or no data processing). Some item groups (e.g., hemodynamics) were consistently reported at higher frequencies than other groups. Items not specifically asked for did not get reported. Some items, automatically processed in the SBAR handover page, did not get reported. Many handovers suffered a noisy and distracting atmosphere. There was no difference in staff satisfaction between the two handover approaches. Nurses were highly unsatisfied with the general approach by which the handover was performed. (4) Conclusions: human error appears to be a main factor for unreliable data processing. Software is still too complicated, and multitasking is a stressful and error prone event. Handover is a complex task with many factors required for a successful completion. [ABSTRACT FROM AUTHOR]

Background: Coeliac disease (CD) is an immune-mediated disorder, with dietary exclusion of gluten the only current treatment. A good knowledge of CD and gluten-free diet (GFD) is essential for those with CD to support effective self-management. Knowledge assessment with a validated tool helps evaluate understanding and knowledge gaps to better tailor educational resources. This study's aim was to perform a systematic review to identify validated CD knowledge assessment tools. Methods: PRISMA guidelines were followed, and searches were carried out in five literature databases. Papers were reviewed for tool development and testing process and assessed against pre-defined criteria for feasibility, validity, and reliability. Results: Twenty-five papers were included in the final analysis. Studies were from 16 countries, with a range of target populations, study designs, and development processes. Eleven reported pilot testing, and five assessed readability. Content validity was assessed in ten papers and formal content validity testing in one. Many tools contained items affecting generalisability outside the region developed. Conclusions: For a CD knowledge assessment tool to be suitable for use, it needs to be well designed, tested, and generalisable. No papers identified satisfied all requirements, thus highlighting a need to develop an appropriate tool. [ABSTRACT FROM AUTHOR]

Severe traumatic brain injury (sTBI) is a silent epidemic, causing approximately 300,000 intensive care unit (ICU) admissions annually, with a 30% mortality rate. Despite worldwide efforts to optimize the management of patients and improve outcomes, the level of evidence for the treatment of these patients remains low. The concomitant occurrence of thromboembolic events, particularly pulmonary embolism (PE), remains a challenge for intensivists due to the risks of anticoagulation to the injured brain. We performed a literature review on sTBI and concomitant PE to identify and report the most recent advances on this topic. We searched PubMed and Scopus for papers published in the last five years that included the terms "pulmonary embolism" and "traumatic brain injury" in their title or abstract. Exclusion criteria were papers referring to children, non-sTBI populations, and post-acute care. Our search revealed 75 papers, of which 38 are included in this review. The main topics covered include the prevalence of and risk factors for pulmonary embolism, the challenges of timely diagnosis in the ICU, the timing of pharmacological prophylaxis, and the treatment of diagnosed PE. [ABSTRACT FROM AUTHOR]

In the first paper [[10]], the epidemiologic, clinical, and immunological features of CVID-associated giardiasis are reviewed, evidencing that patients with giardiasis more commonly have reduced IgA levels and lower levels of switched memory B cells. 35566429 12 Pieniawska-'Smiech K., Kuraszewicz A., Sado J., 'Smiech K., Lewandowicz-Uszy'nska A. Assessment of COVID-19 Incidence and the Ability to Synthesise Anti-SARS-CoV-2 Antibodies of Paediatric Patients with Primary Immunodeficiency. The atypical presentation of IEI is also the main focus of the paper by Morawska et al., which explores the spectrum of atopic manifestations in patients with selective IgA deficiency (sIgAD). This work analyzes the most common autoimmune manifestations in patients with antibody deficiencies, combined immunodeficiencies, and immune dysregulation disorders, and also introduces some specific monogenic entities that are used as a paradigm of "druggable" IEI. [Extracted from the article]

Background: The prevalence of neurological disorders is increasing worldwide. In recent decades, the conventional rehabilitation for people with neurological disorders has been often reinforced with the use of technological devices (robots and virtual reality). The aim of this systematic review was to identify the evidence on the economic cost of rehabilitation with robotic and virtual reality devices for people with neurological disorders through a review of the scientific publications over the last 15 years. Methods: A systematic review was conducted on partial economic evaluations (cost description, cost analysis, description of costs and results) and complete (cost minimization, cost-effectiveness, cost utility and cost benefit) studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The main data sources used were PubMed, Scopus and Web of Science (WOS). Studies published in English over the last 15 years were considered for inclusion in this review, regardless of the type of neurological disorder. The critical appraisal instrument from the Joanna Briggs Institute for economic evaluation and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) were used to analyse the methodological quality of all the included papers. Results: A total of 15 studies were included in this review. Ten papers were focused on robotics and five on virtual reality. Most of the studies were focused on people who experienced a stroke. The robotic device most frequently used in the papers included was InMotion® (Bionik Co., Watertown, MA, USA), and for those focused on virtual reality, all papers included used semi-immersive virtual reality systems, with commercial video game consoles (Nintendo Wii® (Nintendo Co., Ltd., Kyoto, Japan) and Kinect® (Microsoft Inc., Redmond, WA, USA)) being used the most. The included studies mainly presented cost minimization outcomes and a general description of costs per intervention, and there were disparities in terms of population, setting, device, protocol and the economic cost outcomes evaluated. Overall, the methodological quality of the included studies was of a moderate level. Conclusions: There is controversy about using robotics in people with neurological disorders in a rehabilitation context in terms of cost minimization, cost-effectiveness, cost utility and cost benefits. Semi-immersive virtual reality devices could involve savings (mainly derived from the low prices of the systems analysed and transportation services if they are applied through telerehabilitation programmes) compared to in-clinic interventions. [ABSTRACT FROM AUTHOR]

This study aims to systematise subfoveal choroidal thickness (SFCT) measured using optical coherence tomography (OCT) in patients with different severities of thyroid eye disease (TED) compared with healthy subjects. The PubMed, Web of Science and Scopus databases were searched for the following terms: ((Graves' ophthalmopathy) OR (thyroid eye disease) OR (Graves' orbitopathy) OR (thyroid-associated orbitopathy)) AND (choroidal thickness) AND ((optical coherence tomography) OR (OCT)). The pool of papers was narrowed down to articles published until 31 January 2023 (26, 26 and 96 papers, respectively). Twenty-five (25) articles were taken into consideration, which were original papers and included the choroidal thickness measurements among TED patients in their results. Finally, eight papers were included in the comparative analysis of the SFCT parameter in TED patients and a group of healthy controls, and seven papers in the comparative analysis of the same parameter between active and inactive TED patients. The mean value of the difference between the TED group and the healthy group was 38.79 μm, with a confidence interval (CI) from 0.09 to 77.49 μm (p = 0.0495). The mean difference between the active TED group and inactive TED group was 38.02 μm, with a CI from 8.62 to 67.42 μm (p = 0.0113). All the results were statistically significant. [ABSTRACT FROM AUTHOR]

Minimally invasive interventions for myomata treatment have gained acceptance due to the possibility of preserving fertility with reduced trauma induced by laparotomy as way of entrance. There are insufficient data regarding outcomes of high intensity focused ultrasound (HIFU) in non-Asiatic women. Therefore, we revised the available evidence to present an expert opinion that could support physicians, patients and policy-makers for considering this approach in other populations. We revisited systematic reviews, randomized controlled trials and cohort studies from January 2018 to August 2021 using PubMed and Google scholar, regarding short and long term outcomes after ablation with focused ultrasound waves. In total, 33 studies, including 114,810 adult patients showed that outcomes of this approach depend on several parameters directly related with resistance to thermal ablation, especially fibroid size and vascularization. Two studies report satisfactory outcomes in Afro-American women. In accordance to the technique used, fibroid volume reduction showed to be higher in fibroids <300 cm3 after ultrasound guided HIFU than after MRI guided. Compared to myomectomy and uterine artery embolization, HIFU seems to have shorter hospital stay, higher pregnancy rates and similar adverse events rates, with skin burn being the most reported. Symptoms and quality of life improvement is similar to myomectomy but lower than embolization, however reintervention rate is higher after HIFU. Lacks evidence about long-term sarcoma risk after ablation. Available evidence shows that HIFU can be considered as a uterine sparing treatment for women of different ethnicities suffering of uterine myomatosis, especially for those wishing to preserve their fertility. [ABSTRACT FROM AUTHOR]

The last thirty years have seen significant advances in cognitive and behavioural psychotherapies and their application in health care/clinical practices. The papers included in this Special Issue describe the adaptations of ACT for HIV, Inflammatory Bowel Disease (IBD), and Eating Disorders (EDs); two engage technology in intervention delivery. The third ACT paper involved a Randomised Controlled Trial of a digital, gamified intervention for women and girls at high risk for developing an eating disorder. Acceptance and Commitment Therapy (ACT) is a contemporary cognitive and behavioural therapy that is grounded in functional contextualism and is process-based [[5]]. [Extracted from the article]

(1) Background: Interactive VR (virtual reality) environments (i.e., using three-dimensional graphics presented with a head-mounted display) have recently become a popular professional tool for the treatment of patients with eating disorders (EDs). However, there are no published review reports that have analyzed the original papers between 2015 and 2021, which additionally focused only on HMD (head-mounted display) 3DVR (three-dimensional virtual reality) exposure and included only three therapeutic categories for ED patients. (2) Methods: The EbscoHost and Scopus databases were searched to identify relevant papers on VR research employing VR in the assessment and treatment of eating disorders. (3) Results: In addition to the known therapeutic divisions for ED, there are new forms of therapy based on 360 cameras, eye-tracking, and remote therapy. (4) Conclusions: The potential of VR in combination with different therapies may offer an alternative for future research. More rigorous testing, especially in terms of larger sample sizes, the inclusion of control groups or multisessions, and follow-up measures, is still needed. The current state of research highlights the importance of the nature and content of VR interventions for ED patients. Future research should look to incorporate more home-based and remote forms of VR tools. [ABSTRACT FROM AUTHOR]

Patients suffering from Unilateral Spatial Neglect (USN) fail to pay attention to, respond to, and report sensory events occurring in the contralesional side of space. The traditional neuropsychological assessment of USN is based on paper-and-pencil tests, whose data recording and scoring may be subjected to human error. The utilization of technological devices can be expected to improve the assessment of USN. Therefore, we built Neurit.Space, a modified digital version of three paper-and-pencil tests, widely used to detect signs of USN, namely: Bells Cancellation, Line Bisection and Five Elements Drawing Test. Administration and data processing is fully automatic. Twelve right brain-damaged patients (six with and six without USN) and 12 age- and education-balanced healthy participants were enrolled in the study. All participants were administered both the computerized and the paper-and-pencil versions of the tests. The results of this preliminary study showed good sensitivity, specificity, and usability of Neurit.Space, suggesting that these digital tests are a promising tool for the evaluation of USN, both in clinical and in research settings. [ABSTRACT FROM AUTHOR]

Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid disorders characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth and a significantly higher risk of developing premature atherosclerotic cardiovascular disease. The majority of the current pediatric guidelines for clinical management of children and adolescents with FH does not consider the impact of genetic variations as well as characteristics of vascular phenotype as assessed by recently developed non-invasive imaging techniques. We propose a combined integrated approach of cardiovascular (CV) risk assessment and clinical management of children with FH incorporating current risk assessment profile (LDL-C levels, traditional CV risk factors and familial history) with genetic and non-invasive vascular phenotyping. Based on the existing data on vascular phenotype status, this panel recommends that all children with FH and cIMT ≥0.5 mm should receive lipid lowering therapy irrespective of the presence of CV risk factors, family history and/or LDL-C levels Those children with FH and cIMT ≥0.4 mm should be carefully monitored to initiate lipid lowering management in the most suitable time. Likewise, all genetically confirmed children with FH and LDL-C levels ≥4.1 mmol/L (160 mg/dL), should be treated with lifestyle changes and LLT irrespective of the cIMT, presence of additional RF or family history of CHD. [ABSTRACT FROM AUTHOR]

Visual acuity is one of the most important parameters for evaluating the vision of patients with keratoconus. This study reviewed 295 articles related to keratoconus published between 2017 and 2022 in which visual acuity was one of the parameters measured. The methodology of visual acuity testing in studies on keratoconus was thoroughly analyzed. The analysis showed that the most commonly indicated chart for testing visual acuity papers on keratoconus is the Snellen chart. It was shown that in 150 out of 295 articles, the authors do not describe the methodology for testing visual acuity. What is more, it was also shown that in 68 of the 295 articles which were analyzed, a procedure for converting visual acuity tested with a Snellen chart into a logMAR scale was used. In this review, we discuss the validity and reliability of such conversions. In particular, we show that insufficient description of visual acuity testing methodology and lack of information on the conversion of visual acuity results into the logMAR scale may contribute to the misinterpretation of visual acuity test results. [ABSTRACT FROM AUTHOR]

The use of the direct oral anticoagulants dabigatran, rivaroxaban, apixaban and edoxaban (DOACs) offers some major advantages over warfarin and other vitamin K antagonists (VKAs). One advantage is the possibility to use a fixed dose in normal-weight patients, overweight patients and patients with obesity. However, the "one size fits all" strategy raised a concern regarding the possibility to undertreat patients with a high body mass index. No randomized controlled trials (RCTs) have ever compared VKAs and DOACs in this population. We analyzed data from the literature on DOAC pharmacokinetics and pharmacodynamics, results from the four pivotal phase III trials on non-valvular atrial fibrillation, retrospective observational studies and metanalyses. While we are aware of the limitation imposed by the absence of specific RCTs, we propose the position of the Italian Association of Hospital Cardiologists (ANMCO) on the use of DOACs in patients with obesity based on the existing evidence. [ABSTRACT FROM AUTHOR]

Multidisciplinary management of worsening heart failure (HF) in the elderly improves survival. To ensure patients have access to adequate care, the current HF and French health authority guidelines advise establishing a clearly defined HF patient pathway. This pathway involves coordinating multiple disciplines to manage decompensating HF. Yet, recent registry data indicate that insufficient numbers of patients receive specialised cardiology care, which increases the risk of rehospitalisation and mortality. The patient pathway in France involves three key stages: presentation with decompensated HF, stabilisation within a hospital setting and transitional care back out into the community. In each of these three phases, HF diagnosis, severity and precipitating factors need to be promptly identified and managed. This is particularly pertinent in older, frail patients who may present with atypical symptoms or coexisting comorbidities and for whom geriatric evaluation may be needed or specific geriatric syndrome management implemented. In the transition phase, multi-professional post-discharge management must be coordinated with community health care professionals. When the patient is discharged, HF medication must be optimised, and patients educated about self-care and monitoring symptoms. This review provides practical guidance to clinicians managing worsening HF in the elderly. [ABSTRACT FROM AUTHOR]

This paper delves into the historical evolution of spinal surgery, focusing on the pivotal role of the Harrington rod in treating spinal deformities. Introduced in 1955, the Harrington rod marked a significant breakthrough in neurosurgery, especially for scoliosis treatment, by offering a novel approach to spinal stabilization. Through a retrospective analysis, this study examines the development and impact of the Harrington rod, highlighting Dr. Paul Harrington's contributions to spinal surgery. His innovative technique revolutionized the management of spinal deformities, laying the groundwork for future advancements in spinal instrumentation. Despite initial skepticism, Harrington's methods gained acceptance, significantly influencing neurosurgical practices and patient outcomes. This study also explores subsequent advancements that built on Harrington's work, including the transition to long-segment spine constructs and the introduction of segmental pedicle screws, which allowed for more precise deformity correction. Reflecting on Harrington's legacy, this paper acknowledges the continuous evolution of spinal surgery, driven by the interplay between clinical challenges and technological innovations. Harrington's pioneering spirit exemplifies the ongoing pursuit of better surgical outcomes, underscoring the importance of innovation in the field of neurosurgery. [ABSTRACT FROM AUTHOR]

Background: Liquid biopsy is a method that could potentially improve the management of thyroid cancer (TC) by enabling the detection of circulating tumor DNA and RNA (ctDNA, ctRNA). The BRAFV600E mutation appears to be the most representative example of a biomarker in liquid biopsy, as it is the most specific mutation for TC and a target for molecular therapeutics. The aim of this review is to summarize the available data on the detection of the BRAFV600E mutation in liquid biopsy in patients with TC. Methods: A comprehensive analysis of the available literature on the detection of the BRAFV600E mutation in liquid biopsy in TC was performed. Thirty-three papers meeting the inclusion criteria were selected after full-text evaluation. Results: Eleven papers discussed correlations between BRAF mutation and clinicopathological characteristics. Nine studies tested the utility of BRAFV600E detection in the assessment of residual or recurrent disease. Seven studies investigated BRAF-mutated circulating tumor nucleic acids (ctNA) as a marker of response to targeted therapy. In seven studies the method did not detect the BRAFV600E mutation. Conclusions: This review shows the potential of BRAFV600E-mutated ctNA detection in monitoring disease progression, particularly in advanced TC. The diagnostic value of BRAFV600E-mutated ctNA detection appears to be limited to advanced TC. The choice of the molecular method (quantitative PCR [qPCR], droplet digital polymerase chain reaction [ddPCR], and next-generation sequencing [NGS]) should be made based on the turnaround time, sensitivity of the test, and the clinical indications. Despite the promising outcomes of some studies, there is a need to verify these results on larger cohorts and to unify the molecular methods. [ABSTRACT FROM AUTHOR]

The risk of post-operatory hypothyroidism and hypocalcaemia, along with recurrent laryngeal nerve injury, is lower following a less-than-total thyroidectomy; however, a previously unsuspected carcinoma or a disease progression might be detected after initial surgery, hence indicating re-intervention as mandatory (so-called "redo" surgery) with completion. This decision takes into consideration a multidisciplinary approach, but the surgical technique and the actual approach is entirely based on the skills and availability of the surgical team according to the standard protocols regarding a personalised decision. We aimed to introduce a review of the most recently published data, with respect to redo thyroid surgery. For the basis of the discussion, a novel vignette on point was introduced. This was a narrative review. We searched English-language papers according to the key search terms in different combinations such as "redo" and "thyroid", alternatively "thyroidectomy" and "thyroid surgery", across the PubMed database. Inclusion criteria were original articles. The timeframe of publication was between 1 January 2020 and 20 July 2024. Exclusion criteria were non-English papers, reviews, non-human studies, case reports or case series, exclusive data on parathyroid surgery, and cell line experiments. We identified ten studies across the five-year most recent window of PubMed searches that showed a heterogeneous spectrum of complications and applications of different surgeries with respect to redo interventions during thyroid removal (e.g., recurrent laryngeal nerve monitoring during surgery, other types of incision than cervicotomy, the use of parathyroid fluorescence, bleeding risk, etc.). Most studies addressing novel surgical perspectives focused on robotic-assisted re-intervention, and an expansion of this kind of studies is expected. Further studies and multifactorial models of assessment and risk prediction are necessary to decide, assess, and recommend redo interventions and the most adequate surgical techniques. [ABSTRACT FROM AUTHOR]

This document is a letter written in response to a paper published in the Journal of Clinical Medicine. The authors of the letter express their interest in the paper and congratulate the authors for their informative review on the use of new tools to evaluate the efficacy of mechanical in-exsufflation (MI-E) in neuromuscular disorders. However, they raise concerns about the lack of reference to contemporary literature on two key upper airway assessment methods: cervical auscultation and ultrasound. They argue that a balanced critique of current literature is necessary to ensure that readers are well-informed and that the limitations of emerging assessment tools are recognized. The authors also provide insights into the limitations of cervical auscultation and ultrasound in assessing the upper airway, and they propose recommendations for future practice and collaboration between professionals in order to improve outcomes for patients. [Extracted from the article]

The prevalence of nonalcoholic fatty liver disease (NAFLD) is likely to be approaching 38% of the world's population. It is predicted to become worse and is the main cause of morbidity and mortality due to hepatic pathologies. It is particularly worrying that NAFLD is increasingly diagnosed in children and is closely related, among other conditions, to insulin resistance and metabolic syndrome. Against this background is the concern that the awareness of patients with NAFLD is low; in one study, almost 96% of adult patients with NAFLD in the USA were not aware of their disease. Thus, studies on the therapeutic tools used to treat NAFLD are extremely important. One promising treatment is a well-formulated ketogenic diet (KD). The aim of this paper is to present a review of the available publications and the current state of knowledge of the effect of the KD on NAFLD. This paper includes characteristics of the key factors (from the point of view of NAFLD regression), on which ketogenic diet exerts its effects, i.e., reduction in insulin resistance and body weight, elimination of fructose and monosaccharides, limitation of the total carbohydrate intake, anti-inflammatory ketosis state, or modulation of gut microbiome and metabolome. In the context of the evidence for the effectiveness of the KD in the regression of NAFLD, this paper also suggests the important role of taking responsibility for one's own health through increasing self-monitoring and self-education. [ABSTRACT FROM AUTHOR]

Meta-analysis is a statistical tool used to combine and synthesise the results of multiple independent studies on a particular topic. To this end, researchers isolate important moderators and mediators to investigate their influence on outcomes. This paper introduces a novel approach to meta-analysis, known as multidimensional meta-analysis (mi-MA), to study memory performance in those with obsessive–compulsive disorder (OCD). Unlike traditional meta-analyses, mi-MA allows researchers to extract multiple data points (e.g., using different measures) from single studies and groups of participants, facilitating the exploration of relationships between various moderators while avoiding multicollinearity issues. Therefore, in the first instance, we outline the use of the mi-MA approach to quantify the impact of complex models of memory performance in individuals with OCD. This approach provides novel insights into the complex relationship between various factors affecting memory in people with OCD. By showcasing the effectiveness of mi-MA in analysing intricate data and modelling complex phenomena, the paper establishes it as a valuable tool for researchers exploring multifaceted phenomena, both within OCD research and beyond. [ABSTRACT FROM AUTHOR]

Objectives: The selection of an appropriate formula for intraocular lens power calculation is crucial in phacoemulsification, particularly in pediatric patients. The most commonly used formulas are described and their accuracy evaluated in this study. Methods: This review includes papers evaluating the accuracy of intraocular lens power calculation formulas for children's eyes published from 2019–2024. The articles were identified by a literature search of medical and other databases (Pubmed/MEDLINE, Crossref, Google Scholar) using the combination of the following key words: "IOL power calculation formula", "pediatric cataract", "congenital cataract", "pediatric intraocular lens implantation", "lens power estimation", "IOL power selection", "phacoemulsification", "Hoffer Q", "Holladay 1", "SRK/T", "Barrett Universal II", "Hill-RBF", and "Kane". A total of 14 of the most recent peer-reviewed papers in English with the maximum sample sizes and the greatest number of compared formulas were considered. Results: The outcomes of mean absolute error and percentage of predictions within ±0.5 D and ±1.0 D were used to assess the accuracy of the formulas. In terms of MAE, Hoffer Q yielded the best result most often, just ahead of SRK/T and Barrett Universal II, which, together with Holladay 1, most often yielded the second-best outcomes. Considering patients with PE within ±1.0 D, Barrett Universal II most often gave the best results and Holladay 1 most often gave the second-best. Conclusions: Barrett Universal II seems to be the most accurate formula for intraocular lens calculation for children's eyes. Very good postoperative outcomes can also be achieved using the Holladay 1 formula. However, there is still no agreement in terms of formula choice. [ABSTRACT FROM AUTHOR]

Surface electromyography (sEMG) is a technique for measuring and analyzing the electrical signals of muscle activity using electrodes placed on the skin's surface. The aim of this paper was to outline the history of the development and use of surface electromyography in dentistry, to show where research and technical solutions relating to surface electromyography currently lie, and to make recommendations for further research. sEMG is a diagnostic technique that has found significant application in dentistry. The historical section discusses the evolution of sEMG methods and equipment, highlighting how technological advances have influenced the accuracy and applicability of this method in dentistry. The need for standardization of musculoskeletal testing methodology is highlighted and the needed increased technical capabilities of sEMG equipment and the ability to specify parameters (e.g., sampling rates, bandwidth). A higher sampling rate (the recommended may be 2000 Hz or higher in masticatory muscles) allows more accurate recording of changes in the signal, which is essential for accurate analysis of muscle function. Bandwidth is one of the key parameters in sEMG research. Bandwidth determines the range of frequencies effectively recorded by the sEMG system (the recommended frequency limits are usually between 20 Hz and 500 Hz in masticatory muscles). In addition, the increased technical capabilities of sEMG equipment and the ability to specify electromyographic parameters demonstrate the need for a detailed description of selected parameters in the methodological section. This is necessary to maintain the reproducibility of sEMG testing. More high-quality clinical trials are needed in the future. [ABSTRACT FROM AUTHOR]

Background: To date, various forms of physiotherapy are used in the treatment of cubital tunnel syndrome (CuTS). The effectiveness of physiotherapy for CuTS is inconclusive. The aim of this systematic review was to evaluate the effects of physiotherapy in the conservative treatment of CuTS. Methods: The six databases were searched from December 2020 to March 2022. The inclusion criteria were randomised controlled trials, case series, and case reports that evaluate the effects of physiotherapy in the treatment of adult participants with diagnosis CuTS. A total of 11 studies met the eligibility criteria, capturing a total of 187 participants. Results: In three types of papers, pain, muscle strength, and limitation of upper limb function were the most frequently assessed characteristics. Physiotherapy was most often based on manual therapy, neurodynamic techniques, and electrical modalities. One clinical trial rated the risk of bias "high" and the other two "some concerns". In case-series designs, five studies rated the risk of bias as "serious" and three as "moderate". Most of the studies showed a significant improvement in the clinical condition, also in the follow-up study. Only one clinical trial showed no therapeutic effect. Conclusion: There is no possibility of recommending the best method of physiotherapy in clinical practice for people with CuTS based on the results of this systematic review. More high-quality studies are required. [ABSTRACT FROM AUTHOR]

Introduction: Translational science has gained prominence in medicine, but there is still much work to be done before scientific results are used optimally and incorporated into everyday health practice. As the main focus is still on generating new scientific data with financial resources primarily available for that purpose, other activities that are necessary in the transition from research to community benefit are considered less needy. The European Statistical Office of the European Commission has recently reported that 1.7 million people under 75 years of age died in Europe in 2016, with around 1.2 million of those deaths being avoidable through effective primary prevention and public health intervention. Therefore, Academia Europaea, one of the five Pan-European networks that form SAPEA (Science Advice for Policy by European Academies), a key element of the European Commission's Scientific Advice Mechanism (SAM), has launched a project to develop a model to facilitate and accelerate the utilisation of scientific knowledge for public and community benefit. Methods: During the process, leaders in the field, including prominent basic and clinical researchers, editors-in-chief of high-impact journals publishing translational research articles, translational medicine (TM) centre leaders, media representatives, academics and university leaders, developed the TM cycle, a new model that we believe could significantly advance the development of TM. Results: This model focuses equally on the acquisition of new scientific results healthcare, understandable and digestible summation of results, and their communication to all participants. We have also renewed the definition in TM, identified challenges and recommended solutions. Conclusion: The authors, including senior officers of Academia Europaea, produced this document to serve as a basis for revising thinking on TM with the end result of enabling more efficient and cost-effective healthcare. [ABSTRACT FROM AUTHOR]

Vascular graft infection (VGI) is a rare but severe complication of vascular surgery that is associated with a bad prognosis and high mortality rate. An accurate and prompt identification of the infection and its extent is crucial for the correct management of the patient. However, standardized diagnostic algorithms and a univocal consensus on the best strategy to reach a diagnosis still do not exist. This review aims to summarize different radiological and Nuclear Medicine (NM) modalities commonly adopted for the imaging of VGI. Moreover, we attempt to provide evidence-based answers to several practical questions raised by clinicians and surgeons when they approach imaging in order to plan the most appropriate radiological or NM examination for their patients. [ABSTRACT FROM AUTHOR]

This paper provides an overview on the use of virtual surgical planning (VSP) and point-of-care 3D printing (POC 3DP) in oral and cranio-maxillofacial (CMF) surgery based on a literature review. The authors searched PubMed, Web of Science, and Embase to find papers published between January 2015 and February 2022 in English, which describe human applications of POC 3DP in CMF surgery, resulting in 63 articles being included. The main review findings were as follows: most used clinical applications were anatomical models and cutting guides; production took place in-house or as "in-house—outsourced" workflows; the surgeon alone was involved in POC 3DP in 36 papers; the use of free versus paid planning software was balanced (50.72% vs. 49.27%); average planning time was 4.44 h; overall operating time decreased and outcomes were favorable, though evidence-based studies were limited; and finally, the heterogenous cost reports made a comprehensive financial analysis difficult. Overall, the development of in-house 3D printed devices supports CMF surgery, and encouraging results indicate that the technology has matured considerably. [ABSTRACT FROM AUTHOR]

Background: Potentially inappropriate polypharmacy (PIP) is among the major factors leading to adverse drug reactions, increased healthcare costs, reduced medication adherence, and worsened patient conditions. This study aims to identify existing interventions implemented to monitor and manage polypharmacy in the Italian setting. Methods: A systematic literature review (PROSPERO: CRD42023457049) was carried out according to the PRISMA statement guidelines. PubMed, Embase, ProQuest, and Web of Science were queried without temporal constraints, encompassing all published papers until October 2023. Inclusion criteria followed the PICO model: patients with polypharmacy; interventions to monitor/manage polypharmacy regimen versus no/any intervention; outcomes in terms of intervention effectiveness and cost variation. Results: After duplicate deletion, 153 potentially relevant publications were extracted. Following abstract and full-text screenings, nine articles met the inclusion criteria. Overall, 78% (n = 7) were observational studies, 11% (n = 1) were experimental studies, and 11% (n = 1) were two-phase studies. A total of 44% (n = 4) of the studies involved patients aged ≥ 65 years, while 56% (n = 5) were disease-specific. Monitoring was the most prevalent choice of intervention (67%; n = 6). Outcomes were mainly related to levels of polypharmacy (29%; n = 6) and comorbidities (29%; n = 6), effectiveness rates (14%; n = 3), and avoidable costs (9%; n = 2). Conclusions: This review outlines that Italy is still lacking in interventions to monitor/manage PIP, addressing an unmet need in developing patient-tailored strategies for reducing health-system burden. [ABSTRACT FROM AUTHOR]

Background: Transcranial electrical stimulation (tES) generates an electric field (or current density) in the brain through surface electrodes attached to the scalp. Clinical significance has been demonstrated, although with moderate and heterogeneous results partly due to a lack of control of the delivered electric currents. In the last decade, computational electric field analysis has allowed the estimation and optimization of the electric field using accurate anatomical head models. This review examines recent tES computational studies, providing a comprehensive background on the technical aspects of adopting computational electric field analysis as a standardized procedure in medical applications. Methods: Specific search strategies were designed to retrieve papers from the Web of Science database. The papers were initially screened based on the soundness of the title and abstract and then on their full contents, resulting in a total of 57 studies. Results: Recent trends were identified in individual- and population-level analysis of the electric field, including head models from non-neurotypical individuals. Advanced optimization techniques that allow a high degree of control with the required focality and direction of the electric field were also summarized. There is also growing evidence of a correlation between the computationally estimated electric field and the observed responses in real experiments. Conclusions: Computational pipelines and optimization algorithms have reached a degree of maturity that provides a rationale to improve tES experimental design and a posteriori analysis of the responses for supporting clinical studies. [ABSTRACT FROM AUTHOR]

Interstitial pregnancy is an unusual and potentially life-threatening form of ectopic pregnancy, accounting for approximately 1–6% of all ectopic pregnancies, with a maternal mortality rate of 2–2.5%. Implantation happens in the proximal portion of the fallopian tube as it passes through the myometrium. The resolution of interstitial pregnancy after medical treatment should be assessed by a decline in serum β-hCG, which occurs in about 85–90% of cases. Nonetheless, its effectiveness and consequences have been presented through case reports and case series. However, few cases of interstitial pregnancies treated totally medically with the use of methotrexate and mifepristone have been presented in the literature. Complications of this medical treatments have also never been reviewed before. In the present manuscript, we present a case of interstitial pregnancy treated with methotrexate and mifepristone. The patient after treatment developed a uterine arteriovenous malformation, treated with uterine artery embolization. Furthermore, we performed a systematic review of the literature using Scopus, PubMed and Google Scholar. A total of 186 papers were found, and 7 papers which included 10 cases were assessed for eligibility. The systemic medical treatment with the use of methotrexate and mifepristone was effective in 7 of the 10 cases. Two cases of hemoperitoneum following combined methotrexate and mifepristone treatment were reported. The applicability of this medical conservative treatment should be tailored to the patient, taking into account their obstetric history, gestational age at diagnosis and desire for future pregnancies. Complete resolution after this treatment was achieved in most of the cases reported without major complications. The appearance of uterine arteriovenous malformation can be managed conservatively, and we propose uterine artery embolization as an effective treatment of this rare complication. [ABSTRACT FROM AUTHOR]

Background: Liver transplantation is a lifesaving procedure for patients with end-stage liver disease (ESLD). However, many patients never receive a transplant due to insufficient donor supply. Historically, organs have been preserved using static cold storage (SCS). However, recently, ex vivo normothermic machine perfusion (NMP) has emerged as an alternative technique. This paper aims to investigate the clinical progress of NMP in humans. Methods: Papers evaluating the clinical outcomes of NMP for liver transplantation in humans were included. Lab-based studies, case reports, and papers utilizing animal models were excluded. Literature searches of MEDLINE and SCOPUS were conducted. The revised Cochrane risk-of-bias tool for randomised trials (RoB 2) and the risk of bias in nonrandomised studies for interventions (ROBINS-I) tools were used. Due to the heterogeneity of the included papers, a meta-analysis was unable to be completed. Results: In total, 606 records were identified, with 25 meeting the inclusion criteria; 16 papers evaluated early allograft dysfunction (EAD) with some evidence for lower rates using NMP compared to SCS; 19 papers evaluated patient or graft survival, with no evidence to suggest superior outcomes with either NMP or SCS; 10 papers evaluated utilization of marginal and donor after circulatory death (DCD) grafts, with good evidence to suggest NMP is superior to SCS. Conclusions: There is good evidence to suggest that NMP is safe and that it likely affords clinical advantages to SCS. The weight of evidence supporting NMP is growing, and this review found the strongest evidence in support of NMP to be its capacity to increase the utilization rates of marginal and DCD allografts. [ABSTRACT FROM AUTHOR]

Background: Dizziness and vertigo are among the most prevalent complaints in the elderly and have a major negative influence on (i) the perception of the quality of life; and (ii) the risk of falling. Due to population aging, particularly in wealthy nations, vertigo represents a growing issue and a serious public health concern. In order to approach the patient correctly and to offer the best treatment options, it is mandatory to identify vertigo's underlying causes. The aim of this paper was to identify the different etiologies of vertigo and possibly their frequency in the elderly population, by reviewing the scientific literature of the last decade (2012–2022). Methods: A systematic review was performed according to PRISMA guidelines, searching the Medline database from January 2012 through to December 2022. The search identified 1025 candidate papers, but after the application of specific selection criteria, only five were considered for further analysis. Results: A total of 2148 elderly patients (60–90 y old) presenting with vertigo were reported in the selected papers. A total of 3404 conditions were identified as the cause of vertiginous symptoms, (some patients presented multiple etiologies). All major diagnoses were categorized into different subgroups: the most common origin of vertigo was represented by audio-vestibular disorders (28.4%), followed by cardiovascular (20.4%) and neurological diseases (15.1%). Furthermore, 9.1% of patients were diagnosed with psychiatric conditions, whilst ophthalmologic and musculoskeletal disorders accounted for 7.5% and 6.3% of the cases respectively. Medication adverse effects and metabolic-related diseases were also considered among the causes. For 3.4% of cases the etiology remains unclear. Conclusions: Audio-vestibular disorders represent the most frequent cause of vertigo in the elderly. The etiologies affecting the vertigo patient must be defined in order to identify potential life-threatening conditions, such as cardiovascular and neurological disorders, which according to the data of this review constitute the second and third common causes of vertigo. A multidisciplinary strategy, involving different specialists (such as ENTs, Neurologists, Cardiologists, Geriatricians) is recommended for the correct assessment of these disorders. [ABSTRACT FROM AUTHOR]

The authors performed a systematic review, in accordance with the PRISMA guidelines, across multiple databases, including all original studies published until November 2022, focusing on External auditory canal cholesteatoma (EACC) after radiation therapy (RT) for nasopharyngeal cancer (NC). Inclusion criteria were original articles reporting on secondary EACC after RT for NC. Articles were critically appraised to assess level of evidence using the Oxford Center for Evidence-Based Medicine criteria. Overall, 138 papers were identified and after duplicate removal (34 papers) and excluding papers not in English, 93 papers were assessed for eligibility; finally, only five papers were included and summarized with the three cases coming from our institution. These mainly involved the anterior and the inferior part of the EAC. The mean time of diagnosis after RT was the largest series of 6.5 years (with a range from 0.5 to 15.4 years). Patients undergoing RT for NC have 18 times a higher risk of developing EACC compared to the normal population. EACC is probably one of the most underreported side effects, because patients may present variable clinical findings, which could lead to misdiagnosis. Early diagnosis of RT related EACC is advised to enable conservative treatment. [ABSTRACT FROM AUTHOR]

Background: Post-thrombotic syndrome (PTS) is a common and debilitating sequela of lower limb deep vein thrombosis (DVT). There is significant heterogeneity in reported PTS incidence due to lack of standardised diagnostic criteria. This review aimed to develop diagnostic criteria for PTS and subsequently refine the reported incidence and severity. Methods: PRISMA principles were followed; however, the review was not registered. The Cochrane CENTRAL database, MEDLINE, Embase, the NHS NICE Healthcare Databases Advanced Search interface, and trial registers including isrctn.com and clinicaltrials.gov were searched for studies addressing areas of interest (PTS definition, epidemiology, assessment). An experienced Clinical Librarian undertook the systematic searches, and two independent reviewers agreed on the relevance of the papers. Conflicts were resolved through panel review. Evidence quality was assessed using a modified Coleman scoring system and weighted according to their relevance to the aforementioned areas of interest. Results: A total of 339 abstracts were retrieved. A total of 33 full-text papers were included in this review. Following qualitative analysis, four criteria were proposed to define PTS: (1) a proven thrombotic event on radiological assessment; (2) a minimum 24-month follow-up period after an index DVT; (3) assessment with a validated score; and (4) evidence of progression of venous insufficiency from baseline. Four papers conformed to our PTS definition criteria, and the incidence of mild to moderate PTS ranged from 7 to 36%. On reviewing the studies which utilised the recommended Villalta scale, PTS incidence narrowed further to 23–36%. Incidence and severity reached a plateau at 24 months. Conclusions: Four diagnostic criteria were developed from qualitative synthesis. When these criteria were applied to the literature, the range of reported PTS incidence narrowed. These four criteria may standardise PTS diagnosis in future studies, facilitating the pooling of data for meta-analysis and synthesis of higher levels of evidence. [ABSTRACT FROM AUTHOR]

Background: Many papers exploring the role of resectioning metastases in colorectal cancer (CRC) have focused mainly on liver and lung sites, showing improved survival compared with non-resectional therapies. However, data about exceptional metastatic sites such as splenic metastases (SMs) are scarce. This paper aims to assess the role and effectiveness of splenectomy in the case of isolated metachronous SM of CRC origin. Methods: The patients' data were extracted after a comprehensive literature search through public databases for articles reporting patients with splenectomies for isolated metachronous SM of CRC origin. Potential predictors of survival were explored, along with demographic, diagnostic, pathology, and treatment data for each patient. Results: A total of 83 patients with splenectomies for isolated metachronous SM of CRC origin were identified. The primary CRC was at an advanced stage (Duke's C—70.3%) and on the left colon (45.5%) for most patients, while the median interval between CRC resection and SM was 24 months. The median overall survival after splenectomy was 84 months, and patients younger than 62 years presented statistically significantly worse overall survival rates than those ≥62 years old (p = 0.011). There was no significant impact on the long-term outcomes for factors including primary tumor location or adjuvant chemotherapy (p values ≥ 0.070, ns). Laparoscopic splenectomy was increasingly used in the last 20 years from 2002 (33.3% vs. 0%, p < 0.001). Conclusions: Splenectomy is the optimal treatment for patients with isolated metachronous SM of CRC, with the laparoscopic approach being increasingly used and having the potential to become a standard of care. Encouraging long-term survival rates were reported in the context of a multidisciplinary approach. Younger ages are associated with worse survival. Perioperative chemotherapy in the context of a patient diagnosed with SM of CRC origin appears to be a reasonable option, although the present study failed to show any significant impact on long-term survival. [ABSTRACT FROM AUTHOR]

This narrative review discusses the importance of rehabilitation in rheumatic and musculoskeletal diseases (RMDs), ultimately aiming to reduce their impact on individuals and society. It specifically emphasizes the need for rehabilitation in inflammatory arthritis (IA), particularly in cases where medical management is insufficient. It acknowledges that the complexity of rehabilitation demands a flexible approach. Thereby, it touches on the various models of rehabilitation, which may include multidisciplinary team care, extended practice models, shared care, remote care, and work rehabilitation. It discusses the challenges in research, practice, and policy implementation. In research, the need for innovative research designs is highlighted, whereas regarding clinical practice the importance of early detection of disability and patient engagement is underlined, as well as the role of telehealth and AI in reshaping the rehabilitation landscape. Financial barriers and work force shortages are identified as challenges that hinder the effective delivery of rehabilitative care. On the policy level, this paper suggests that the allocation of healthcare resources often prioritizes acute conditions over chronic diseases, leading to disparities in care. This paper concludes by emphasizing the critical role of evidence-based rehabilitation in improving the quality of life for people with RMDs, in particular for those with IA, and promoting their healthy aging. It also calls for tailored rehabilitation models and the early identification of persons with rehabilitation needs as future challenges in this field. [ABSTRACT FROM AUTHOR]

Background: Dermatofibrosarcoma protuberans (DFSP) is a superficial soft tissue sarcoma, and surgical excision is the first-line treatment. The aim of this systematic review is to provide an update about the current indications and clinical results regarding the use of postoperative radiotherapy in DSFP, considering both adjuvant and salvage setting. Methods: We conducted a systematic literature review using the main scientific database, including Cochrane library, Scopus, and PubMed, for any relevant article about the topic, and we considered all available papers without any time restriction. Results: Twenty-two papers, published between 1989 and 2023, were retrieved and considered eligible for inclusion in this review. Regarding the fractionation schedules, most authors reported using standard fractionation (2 Gy/die) with a wide total dose ranging from 50 to 70 Gy. The local control after postoperative radiotherapy was excellent (75–100%), with a median follow-up time of 69 months. Conclusions: After the primary surgical management of DFSP, postoperative radiotherapy may either be considered as adjuvant treatment (presence of risk factors, i.e., close margins, recurrent tumours, aggressive histological subtypes) or as salvage treatment (positive margins) and should be assessed within the frame of multidisciplinary evaluation. [ABSTRACT FROM AUTHOR]

Background: The umbilicus is a fibrous remnant located in the centre of the abdomen. Various entities may be encountered in this special anatomical location; however, little is known about their dermoscopic presentation. The aim of this study was to provide a comprehensive summary of existing evidence on dermoscopic features of umbilical lesions. Methods: Studies assessing dermoscopic images of umbilical lesions were included in this study. No age, ethnicity or skin phototype restrictions were applied. Papers assessing lesions outside of the umbilical area, lacking dermoscopic images and/or dermoscopic description and not related to the topic were excluded. Embase, Medline and Cochrane Library were searched from inception to the end of May 2023. The Joanna Briggs Institute critical appraisal tools were used to evaluate the risk of bias of the selected studies. The quality and the level of evidence of included studies were assessed according to the Oxford 2011 Levels of Evidence. Thirty-four studies reporting a total of 39 lesions met the inclusion criteria and were included in qualitative analysis. Results: A qualitative synthesis of the following entities was performed: melanoma, nevi, basal cell carcinoma, fibroepithelioma of Pinkus, Sister Mary Joseph nodule, mycosis fungoides, dermatofibroma, endometriosis, epidermal cyst, granuloma, intravascular papillary endothelial hyperplasia, lichen planus, omphalolith, seborrheic keratosis, and syringoma. Conclusions: Dermoscopy is a non-invasive technique that may be useful in the differential diagnosis of umbilical lesions. The main limitations of this study were lack of a high level of evidence in the studies and the lack of uniformity in applied dermoscopic terminology between included studies. [ABSTRACT FROM AUTHOR]

This document is a summary of a special issue of the Journal of Clinical Medicine titled "Spinal Cord Injuries: Advances in Rehabilitation." The special issue focuses on the challenges faced by individuals with spinal cord injuries (SCI) and the need for improved rehabilitation treatments and strategies. It highlights the importance of multidisciplinary collaboration in SCI rehabilitation and presents thirteen high-quality papers covering topics such as innovative rehabilitation approaches, improvements in screening and follow-up strategies, and research into novel treatments. The papers offer exciting advances in SCI rehabilitation and provide preliminary evidence for potential solutions to gaps in understanding and management of SCI. The ultimate goal is to enhance the quality of life for people living with SCI worldwide. [Extracted from the article]

Background: Before starting PA, pregnant women should select the appropriate type of training and adjust its components to the development of pregnancy and her capabilities. This review aimed to analyze current recommendations for pregnant women on methods for determining and assessing PA intensity levels and characterize the extent and nature of the information provided to pregnant women in official documents published by public health and sports medicine institutions. Methods: The review was conducted as per the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched scientific databases (PubMed, ScienceDirect, Web of Science, Academic Search Complete, and SPORTDiscus with Full Text via EBSCO) and the Internet to identify papers regarding recommendations for the PA intensity level for pregnant women. We analyzed 22 eligible guidelines, published over the last 10 years in English, from nine countries and three international organizations. Results: The PA of pregnant women should be at a moderate level. As for higher levels, the analyzed recommendations are contradictory. Methods for assessing PA intensity levels are often not included. The most frequently recommended methods for determining and assessing the PA intensity level for pregnant women are the rating of perceived exertion, the Talk Test, and heart rate measurements. Few guidelines offer specific advice for highly active women (e.g., elite athletes) or trimester-specific considerations. Conclusions: The number of published recommendations regarding PA during pregnancy has increased over the last decade. The amount of information on PA intensity levels is still insufficient. There is a need to update them, based on high-quality scientific work. [ABSTRACT FROM AUTHOR]

Background: The only complete and validated tool for evaluating professional orchestra musicians is the English-language Musculoskeletal Pain Intensity and Interference Questionnaire for professional orchestra Musicians (MPIIQM) questionnaire, which, in recent years, has been translated, adapted, and validated in other languages. The aim of the study was to validate the online version of the Polish version of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM-P). Materials and Methods: The group included 182 professional musicians. The respondents were asked to complete the MPIIQM-P, BPI, and QuickDash questionnaires twice within an interval of 4 days. The questionnaires were created in the web form creator—Google Form. Results: The EFA analysis showed a two-factor structure of the questionnaire consisting of factor 1—pain intensity and factor 2—pain interference. The internal agreement of the factors identified in the EFA analysis was measured by the α Cronbach index reaching from 0.813 to 0.913. The intraclass correlation coefficient of both factors ranged from 0.276 to 0.583. The analysis of convergent and divergent validity between the subscales of the questionnaire value ranged from 0.414 to 0.925. Conclusions: The online version of the MPIIQM-P questionnaire is a valid and reliable tool for the assessment of musculoskeletal pain and interference. The online MPIIQM-P questionnaire maintains the psychometric properties previously defined for the paper version. [ABSTRACT FROM AUTHOR]

Background: Incisor retraction is often a crucial phase in ongoing orthodontic treatment, with significant implications for alveolar remodeling mechanisms. There are two prevailing theories which seek to explain this. According to the first, teeth move with the bone, while according to the second, teeth move within the bone. This systematic review seeks to assess morphometric changes in the maxillary alveolar process resulting from incisor retraction following premolar extraction and to evaluate the potential for bone remodeling associated with orthodontic movement. Methods: The study was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following electronic databases were searched: PubMed, Google Scholar, Web of Science EMBASE and the Cochrane Central Register of Controlled Trials. The databases were searched using the following keywords: "Bone remodeling and retraction of incisors", "Alveolar bone and incisor retraction", "Bone thickness and incisor retraction", and "Bone changes and orthodontic treatment". Search filters were utilized to identify relevant papers and articles written in English and published during the last 10 years. Based on the information provided in their abstracts, papers and articles were selected according to the following criteria: randomized clinical trials (RCTs), controlled clinical prospective trials (CCTs), and retrospective studies. Articles unrelated to the study's scope or failing to meet inclusion criteria were excluded. These generally comprised individual case reports, case series reports, literature reviews, experimental studies, studies with limited data (including conference abstracts and journal writings), studies involving an unrepresentative group of patients (less than 10 patients), studies concerning patients with syndromes, and animal experiments. The remaining articles which were deemed relevant underwent comprehensive reference review and such journals as the American Journal of Orthodontics, Dentofacial Orthopedics, International Orthodontics, Journal of Clinical Orthodontics, and Angle Orthodontist were manually searched. Results: Seven articles meeting the inclusion criteria articles were selected for final evaluation, with a total of 284 participants, including 233 women and 51 men. During the analysis of the results included in the publications, a lack of homogeneity was observed, rendering a reliable statistical analysis and heterogeneity assessment unobtainable. Noteworthy disparities in methodologies and measurements posed a risk of drawing inappropriate conclusions. Consequently, emphasis was placed on qualitative analysis, emphasizing the need for standardization in future studies of a similar nature, to enable valid and comparable analyses. Conclusions: The research findings incorporated in this review demonstrate that significant bone loss occurs because of incisor retraction, which diminishes distance between the bone surface and the root surface on the palatal aspect. The magnitude of this change may vary, contingent upon both the extent of incisor displacement and alterations in their inclination, thereby affecting the positioning of the root tips. This change is significantly higher in adults than in growing adolescents. The rationale behind this assertion lies in the widely recognized phenomenon of declining cellular activity with advancing age. The decrease in the speed and intensity of cellular changes may explain the diminished capacity for remodeling as patient age increases. There is ongoing discourse regarding alterations in the volume of bone on the labial aspect of the alveolar process. Further research is necessary to measure whether bone remodeling during orthodontic movement is contingent upon other factors, such as the speed and biomechanics of retraction, the level of applied orthodontic force, and the patient age. [ABSTRACT FROM AUTHOR]

Gingivitis and periodontitis are common oral pathological conditions. Several optional adjunctive local therapies are used clinically. While antibiotics and chlorhexidine are the most common agents of choice, their long-term use is associated with several adverse effects. Some of these include staining of teeth and restorations, cellular cytotoxicity and hypersensitivity. Topical oxygen therapy has been recently introduced and could be clinically capable of inhibiting plaque bacterial biofilm growth. Available as a mouthwash, toothpaste and oral gel, this formulation comprises cellulose, glycerol and sodium peroxoborate, and releases topical oxygen in a controlled manner. Moreover, it releases topical oxygen, in a controlled manner, and lactoferrin, which are capable of antibacterial action and stimulation of bone cells, respectively. The aim of this paper is to report a case of gingivitis and another case of periodontitis, both of which were successfully treated clinically with adjunctive local oxygen therapy (blue®m). Additionally, this paper aims to review the relevant literature in terms of adjunct topical or local therapies used in the treatment of gingivitis and periodontitis, in order to understand how local therapies are helpful and to know if local oxygen therapy is a suitable clinical alternative. [ABSTRACT FROM AUTHOR]

Background: Stroke stands as a significant global health concern, constituting a leading cause of disability worldwide. Rehabilitation interventions are crucial in aiding the recovery of stroke patients, contributing to an overall enhancement in their quality of life. This scoping review seeks to identify current trends in gait rehabilitation for stroke survivors. Methods: The review followed the methodological framework suggested by Arksey and O'Malley. Electronic databases, such as CINAHL Complete, MEDLINE Complete, and Nursing & Allied Health Collection, were systematically searched in November 2023. Inclusion criteria comprised papers published in either English or Portuguese from 2013 to 2023. Results: From the initial search, a total of 837 papers were identified; twenty-one papers were incorporated into this review. Thirteen distinct categories of gait rehabilitation interventions were identified, encompassing diverse approaches. These categories comprise conventional rehabilitation exercises, traditional gait training with integrated technology, and gait training supported by modern technologies. Conclusions: Although traditional rehabilitation exercises have historically proven effective in aiding stroke survivors, a recent trend has emerged, emphasizing the development and integration of innovative therapeutic approaches that harness modern technologies. [ABSTRACT FROM AUTHOR]

(1) Background: Osteogenesis imperfecta (OI) is a rare skeletal dysplasia characterized as a heterogeneous disorder group with well-defined phenotypic and genetic features that share uncommon bone fragility. The current treatment options, medical and orthopedic, are limited and not efficient enough to improve the low bone density, bone fragility, growth, and mobility of the affected individuals, creating the need for alternative therapeutic agents. (2) Methods: We searched the medical database to find papers regarding treatments for OI other than conventional ones. We included 45 publications. (3) Results: In reviewing the literature, eight new potential therapies for OI were identified, proving promising results in cells and animal models or in human practice, but further research is still needed. Bone marrow transplantation is a promising therapy in mice, adults, and children, decreasing the fracture rate with a beneficial effect on structural bone proprieties. Anti-RANKL antibodies generated controversial results related to the therapy schedule, from no change in the fracture rate to improvement in the bone mineral density resorption markers and bone formation, but with adverse effects related to hypercalcemia. Sclerostin inhibitors in murine models demonstrated an increase in the bone formation rate and trabecular cortical bone mass, and a few human studies showed an increase in biomarkers and BMD and the downregulation of resorption markers. Recombinant human parathormone and TGF-β generated good results in human studies by increasing BMD, depending on the type of OI. Gene therapy, 4-phenylbutiric acid, and inhibition of eIF2α phosphatase enzymes have only been studied in cell cultures and animal models, with promising results. (4) Conclusions: This paper focuses on eight potential therapies for OI, but there is not yet enough data for a new, generally accepted treatment. Most of them showed promising results, but further research is needed, especially in the pediatric field. [ABSTRACT FROM AUTHOR]