Current Systematic Review Research Articles

Inflammatory biomarkers in cardiac syndrome X: a systematic review and meta-analysis

IntroductionIn the current systematic review and meta-analysis, we aim to analyze the existing literature to evaluate the role of inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), tumor necrosis factor-a (TNF-a), and interleukin-6 (IL-6) among individuals with cardiac syndrome X (CSX) compared to healthy controls.MethodsWe used PubMed, Web of Science, Scopus, Science Direct, and Embase to systematically search relevant publications published before April 2, 2023. We performed the meta-analysis using Stata 11.2 software (Stata Corp, College Station, TX). So, we used standardized mean difference (SMD) with a 95% confidence interval (CI) to compare the biomarker level between patients and healthy controls. The I2 and Cochran’s Q tests were adopted to determine the heterogeneity of the included studies.ResultsOverall, 29 articles with 3480 participants (1855 with CSX and 1625 healthy controls) were included in the analysis. There was a significantly higher level of NLR (SMD = 0.85, 95%CI = 0.55–1.15, I2 = 89.0 %), CRP (SMD = 0.69, 95%CI = 0.38 to 1.02, p < 0.0001), IL-6 (SMD = 5.70, 95%CI = 1.91 to 9.50, p = 0.003), TNF-a (SMD = 3.78, 95%CI = 0.63 to 6.92, p = 0.019), and PLR (SMD = 1.38, 95%CI = 0.50 to 2.28, p = 0.02) in the CSX group in comparison with healthy controls.ConclusionThe results of this study showed that CSX leads to a significant increase in inflammatory biomarkers, including NLR, CRP, IL-6, TNF-a, and PLR.

Interventions for children who have experienced physical abuse: A systematic review narrative synthesis

AimPhysical abuse has been linked to poor mental and physical health in adulthood, more recently findings have suggested that these effects can be present in children as young as three. Though these effects are known, research exploring interventions specifically for children who have experienced physical abuse is scarce. The current systematic review uses a narrative synthesis approach to examine studies which reported on interventions for children who have experienced physical abuse. MethodA number of databases were searched, and studies were selected based on hierarchical criteria. This systematic review used a narrative synthesis approach to evaluate the interventions involved in the studies selected. Results: There were 17 studies included in this review, each of the studies reported improvements in at least one of the necessary outcome areas evaluated which included: behavioural, cognitive, and socio-emotional outcomes. ConclusionOverall efficacy of interventions was not able to be determined due to the heterogeneity of the studies, however theoretical underpinnings and successful components of interventions are discussed in this review. Limitations and recommendations for the future are also addressed.

Fecal Calprotectin as a Biomarker of Depression Severity: A Systematic Review

Introduction: Depression is a debilitating mental health condition. Although the underlying pathophysiology of depression is poorly understood, emerging evidence suggests that the gut-brain-immune axis may contribute to depressive symptoms. Recent literature has established that depression is associated with systemic low-grade inflammation. According to the leaky-gut hypothesis, this systemic inflammation is thought to be caused by increased permeability—a by-product of mucosal inflammation. Accordingly, some research has demonstrated that fecal calprotectin (FC)—a marker of mucosal inflammation—is positively associated with depressive symptoms. However, with some research showing no correlation between the two, the literature has a lack of consensus on the topic. The aim of the current systematic review was to clarify the association between FC and depression. Methods: A search was conducted in Ovid MEDLINE, Embase, and APA PsycInfo using MeSH terms related to fecal calprotectin and depression. All English studies with human participants were screened for eligibility by two individual raters, excluding case studies and review papers. Selected articles were subsequently used in the data extraction to look for relevant study characteristics and their findings regarding the correlation between fecal calprotectin and depression. Additionally, the JBI tool was used to assess risk of bias. Results: A total of 7 articles were included in the study, comprising 1184 patients. The review found that there is no consensus on whether calprotectin and depression are correlated; therefore, no evidence suggesting utility of calprotectin as a biomarker of depression was found. Discussion: Despite the conflicting findings of the study, there is still some evidence to suggest that calprotectin could be useful as a biomarker. Some of the included studies found that the time of sample collection in relation to the ranking of depression symptoms has an effect on the degree of correlation. Conclusion: This study found that fecal calprotectin is a weak biomarker of depression and is impractical in the general population due to the collection method. Alternatives include serum calprotectin and markers of neuroinflammation. Other studies looking at the role of salivary biomarkers in depression may prove to be promising.

Systematic Review of Utilized Ports in Laparoscopic Cholecystectomy: Pushing the Boundaries.

Surgical procedures have undergone a paradigm shift in the last 3 decades, with minimally invasive surgery becoming standard of care for a number of surgeries, including the treatment of benign gallbladder diseases. By providing a thorough and impartial summary of the earlier published systematic reviews, the current systematic review is the first to present comparison results. This review illustrates the data of intraoperative and postoperative results of each laparoscopic cholecystectomy technique. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was meticulously followed to conduct the present systematic review. MEDLINE (via PubMed), Cochrane Database of Systematic Reviews, and Web of Science were searched for eligible publications, and a total of 14 systematic reviews were included. A newly developed extraction table was utilized to obtain the predefined parameters from eligible systematic reviews, including operative time, conversion rate, estimated blood loss, bile leak, length of hospital stay, postoperative pain, and cosmetic results. All statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) software, version 26.0. The analysis of dichotomous results was summarized using relative risks and 95% confidence intervals (95% CI), and continuous results were summarized using mean differences and 95% CIs. The proportions were compared using a single proportion z-test. The analysis of our primary and secondary outcomes revealed a statistically significant improvement in aesthetic results after single-incision laparoscopic cholecystectomy (SILC) in comparison to the multiport approach of laparoscopic cholecystectomy. This, however, is accompanied by extended operative timing and subsequently, prolonged exposure to anesthesia. Patients should be carefully selected for SILC to minimize technical difficulties and prevent complications both intraoperatively and shortly after the procedure. This trial is registered with CRD42023392037.

Performance of Artificial Intelligence Models Designed for Automated Estimation of Age Using Dento-Maxillofacial Radiographs-A Systematic Review.

Automatic age estimation has garnered significant interest among researchers because of its potential practical uses. The current systematic review was undertaken to critically appraise developments and performance of AI models designed for automated estimation using dento-maxillofacial radiographic images. In order to ensure consistency in their approach, the researchers followed the diagnostic test accuracy guidelines outlined in PRISMA-DTA for this systematic review. They conducted an electronic search across various databases such as PubMed, Scopus, Embase, Cochrane, Web of Science, Google Scholar, and the Saudi Digital Library to identify relevant articles published between the years 2000 and 2024. A total of 26 articles that satisfied the inclusion criteria were subjected to a risk of bias assessment using QUADAS-2, which revealed a flawless risk of bias in both arms for the patient-selection domain. Additionally, the certainty of evidence was evaluated using the GRADE approach. AI technology has primarily been utilized for automated age estimation through tooth development stages, tooth and bone parameters, bone age measurements, and pulp-tooth ratio. The AI models employed in the studies achieved a remarkably high precision of 99.05% and accuracy of 99.98% in the age estimation for models using tooth development stages and bone age measurements, respectively. The application of AI as an additional diagnostic tool within the realm of age estimation demonstrates significant promise.

Antibiotic treatment for patients with exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis

BackgroundAlthough respiratory tract infection is a significant factor that triggers exacerbation of chronic obstructive pulmonary disease (COPD), the benefit of antibiotics for patients with COPD exacerbation remains controversial. It is necessary to evaluate the efficacy and safety of antibiotics versus placebo in such patients. MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials of antibiotics versus placebo for the treatment of COPD exacerbation, and compared the frequencies of treatment failure, mortality, and adverse events between patients treated with antibiotics and those treated with placebo. ResultsA total of six studies were included in this meta-analysis. The frequency of treatment failure was significantly lower in the antibiotic-treated patients compared to the placebo-treated patients (odds ratios [OR] 0.50, 95% confidence intervals [CI] 0.35–0.71, p = 0.0001). There was no significant difference between the two groups in mortality (OR 0.44, 95% CI 0.05–3.76, p = 0.45) or frequency of adverse events (OR 1.05, 95% CI 0.75–1.48, p = 0.78). ConclusionIn the current systematic review and meta-analysis, we found that antibiotics were superior to placebo in patients with exacerbated COPD, as shown by the lower treatment failure rate.

Neuronal Correlates of Empathy: A Systematic Review of Event-Related Potentials Studies in Perceptual Tasks.

Empathy is a crucial component to infer and understand others' emotions. However, a synthesis of studies regarding empathy and its neuronal correlates in perceptual tasks using event-related potentials (ERPs) has yet to occur. The current systematic review aimed to provide that overview. Upon bibliographic research, 30 studies featuring empathy assessments and at least one perceptual task measuring ERP components in healthy participants were included. Four main focus categories were identified, as follows: Affective Pictures, Facial Stimuli, Mental States, and Social Language. The Late Positive Potential was the most analyzed in Affective Pictures and was reported to be positively correlated with cognitive and affective empathy, along with other late components. In contrast, for Facial Stimuli, early components presented significant correlations with empathy scales. Particularly, the N170 presented negative correlations with cognitive and affective empathy. Finally, augmented N400 was suggested to be associated with higher empathy scores in the Mental States and Social Language categories. These findings highlight the relevance of early perceptual stages of empathic processing and how different EEG/ERP methodologies provide relevant information.

The use of virtual technologies with music in rehabilitation: a scoping systematic review

IntroductionThe use of virtual environments in rehabilitation has been growing. The current systematic review aimed to evaluate how and where virtual technologies are combined with music in rehabilitation.MethodsA literature search was conducted in seven databases (ACM Digital Library, CINAHL Complete, Cochrane Library, Computer Science database, Medline, Nursing &amp;amp; Allied Health database, and Scopus). It included articles published from 2006 to February 2023. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for study selection. Twelve studies with 160 participants were included in the review. In addition, a descriptive approach was used to gather data from the studies for the areas of interest.ResultsVirtual Reality (VR) and Augmented Reality were most familiar and used in rehabilitation, but Mixed Reality, and Extended Reality were less studied. It became evident that equipment, diverse applications, assessment metrics, training environments, and methodologies were highly varied. Most of the studies were pilots, the overall quality of included studies was rated moderate, and the risk of bias was high in the included studies. The studies on motor rehabilitation after stroke showed a clinical improvement in hand functions, specifically fractionation. Furthermore, studies that included motivation, adherence, and mental health, slightly supported the idea that VR technologies with music have the potential to promote motivation and exercise adherence, increase positive emotions, and decrease anxiety. In addition, user experience and feasibility studies presented technologies combined with music to be safe and acceptable in rehabilitation.DiscussionIn light of these findings, it can be inferred that virtual technologies with music offer promising avenues for future rehabilitation research. However, some confusion was obtained related to the included studies’ definitions of technologies and management terms. Furthermore, it is important to note the limited number of studies and participants, the heterogeneity among participants, and the overall quality of the studies that restrict the generalizability of these results to a larger population. Therefore, future researchers should define concepts and terms, delve deeper into this area to uncover the potential benefits, and clarify the specific mechanisms through which virtual technologies with music can positively impact rehabilitation outcomes.

Chemokines as Prognostic Factor in Colorectal Cancer Patients: A Systematic Review and Meta-Analysis.

Chemokines orchestrate many aspects of tumorigenic processes such as angiogenesis, apoptosis and metastatic spread, and related receptors are expressed on tumor cells as well as on inflammatory cells (e.g., tumor-infiltrating T cells, TILs) in the tumor microenvironment. Expressional changes of chemokines and their receptors in solid cancers are common and well known, especially in affecting colorectal cancer patient outcomes. Therefore, the aim of this current systematic review and meta-analysis was to classify chemokines as a prognostic biomarker in colorectal cancer patients. A systematic literature search was conducted in PubMed, CENTRAL and Web of Science. Information on the chemokine expression of 25 chemokines in colorectal cancer tissue and survival data of the patients were investigated. The hazard ratio of overall survival and disease-free survival with chemokine expression was examined. The risk of bias was analyzed using Quality in Prognosis Studies. Random effects meta-analysis was performed to determine the impact on overall respectively disease survival. For this purpose, the pooled hazard ratios (HR) and their 95% confidence intervals (CI) were used for calculation. Twenty-five chemokines were included, and the search revealed 5556 publications. A total of thirty-one publications were included in this systematic review and meta-analysis. Overexpression of chemokine receptor CXCR4 was associated with both a significantly reduced overall survival (HR = 2.70, 95%-CI: 1.57 to 4.66, p = 0.0003) as well as disease-free survival (HR = 2.68, 95%-CI: 1.41 to 5.08, p = 0.0026). All other chemokines showed either heterogeneous results or few studies were available. The overall risk of bias for CXCR4 was rated low. At the current level of evidence, this study demonstrates that CXCR4 overexpression in patients with colorectal cancer is associated with a significantly diminished overall as well as disease-free survival. Summed up, this systematic review and meta-analysis reveals CXCR4 as a promising prognostic biomarker. Nevertheless, more evidence is needed to evaluate CXCR4 and its antagonists serving as new therapeutic targets.

Adverse events in endoscopic ultrasound-guided choledochoduodenostomy with lumen-apposing metal stents: A systematic review and meta-analysis.

Several meta-analyses have analyzed the technical and clinical success of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) by using lumen-apposing metal stents (LAMS) in malignant biliary obstruction, but those concerning adverse events (AEs) are scarce. The current systematic review and meta-analysis was conducted to evaluate the AEs after EUS-CDS with LAMS. A comprehensive literature search of PubMed, Embase, Scopus, Web of Science, and the Cochrane Library was conducted for studies reporting the outcomes of EUS-CDS with LAMS. The main endpoints were the incidence of overall and specific AEs. Moreover, the stent dysfunction, and reintervention rates were evaluated independently. A total of 21 studies (n=1438) were included in the final meta-analysis. The pooled rate of technical and clinical success was 93.5% (95% confidence interval [CI]: 91.3-95.1) and 88.0% (95% CI: 83.9-91.1), respectively. After EUS-CDS with LAMS, the pooled incidence of overall AEs was 20.1% (95% CI: 16.0-24.9). The estimated rate of early AEs was 10.6% (95% CI: 7.9-14.2), and late AEs was 11.2% (95% CI: 8.2-15.2). Infection/cholangitis was the commonest AE, with a pooled incidence of 6.1% (95% CI: 3.7-10.1). The estimated incidence of stent dysfunction and reintervention was 10.5% (95% CI: 7.5-14.4), and 12.1% (95% CI: 9.3-15.7), respectively. Despite with a high technical and clinical success rate, EUS-CDS with LAMS may be associated with overall AEs and stent dysfunction in one-fifth and one-tenth of cases, respectively. Further efforts are required to optimize its safety and long-term stent patency.

Gestational Diabetes Mellitus and Its Correlation in the Development of Pancreatic Cancer: A 10-Year Systematic Review.

Pancreatic cancer (PC) is a fatal malignancy with an aggressive course derived from the cells of pancreatic tissue. Gestational diabetes mellitus (GDM) is a state of spontaneous hyperglycemia occurring during gestation and has been suggested as a risk factor PC. Women with a history of GDM revealed a risk rate of 7.1% for the development of PC. The current systematic review aims to investigate the correlation between GDM and the degree to the prevalence of PC. For this systematic review, the PICO model was prepared to construct and outline the exact questions of the study, a PRISMA flow diagram was prepared and quality assessment was conducted using the Newcastle Ottawa Scale (NOS) for Cohort Studies, the NIH Quality Assessment Tool-Criteria for Case Reports and the Cochrane quality assessment tool for Systematic Reviews and Meta-analysis studies. A total of eight articles were retrieved from the main databases, and a table was created to summarize the information found. Even though the data found were limited, the quality assessment performed revealed that the articles were of high validity. It can be concluded that GDM has an association with the development of PC and can be considered as a risk factor.

Psychological interventions to promote self-forgiveness: a systematic review

BackgroundBeing able to forgive one’s own wrongdoings improves the health and well-being of a person. People find it difficult to forgive themselves due to different reasons. It is essential to enhance the ability to accept one’s deeds and thereby enhance self-forgiveness. The current systematic review’s objective is to comprehend the application and efficiency of numerous interventions that improve self-forgiveness.MethodsThe search was done on electronic databases such as PubMed, ERIC, Web of Science, PsycNet, Science Direct, and Google Scholar. The initial search yielded 399 articles. After the duplicate removal, 19 articles met the eligibility criteria. Two studies were identified through related references. Thus, 21 articles were finalized for review. The study adhered to the PRISMA recommendations for systematic reviews.ResultsThe 21 finalized articles varied in method, participants, research design, duration, measurement tools used, and observed outcomes. Thirteen of the 21 finalized articles followed interventions specifically designed to promote self-forgiveness. Interventions are seen to be applied at both individual and group levels.ConclusionThe review categorizes the interventions into self-directed and group. The self-directed interventions, notably those based on Enright’s process model, demonstrate its efficiency in nurturing self-forgiveness. Self-forgiveness interventions are also found to be effective in promoting other positive psychological and clinical variables. Further implications and future research avenues are outlined.

Comparisons of different focuses of attention on children’s learning and performance: a systematic review

ABSTRACT A growing body of investigation has suggested the benefits of an external focus of attention on the performance and learning of motor skills in adults and the elderly. This systematic review investigates the effects of focus of attention on the performance and learning of motor skills in children with typical and atypical development. The literature search was conducted in the electronic databases PubMed, Science Direct, Web of Science, and Scielo, with data inception in December 2023. Of the 43 studies in the review, 30 involved the performance and learning of motor skills in children with typical development and 13 in children with atypical development. The current systematic review demonstrates that the direction of instructions/feedback can influence the performance and learning of children's motor skills, regardless of the children's developmental condition or task.

Utility and Prognostic Value of Intraoperative Blink Reflex in Trigeminal or Facial Nerve Monitoring in Skull Base Surgeries: A Systematic Review

Blink reflex (BR) is an oligosynaptic reflex that involves the ophthalmic branch of the trigeminal nerve (TN), ipsilateral main sensory and trigeminospinal nuclei, bilateral facial nuclei, and the facial nerves (FNs). Theoretically, as BR tests the function of both TN and FNs simultaneously, it is an ideal tool for monitoring the status of TN and FNs during skull base surgeries. Nevertheless, it has been used only recently in surgeries as the use of anesthesia limits its use. For this systematic review, 2 authors input the search terms [(Blink Reflex) AND (Intraoperative Neuromonitoring OR Neuro Intraoperative Monitoring OR Intraoperative OR NIOM OR IONM) AND (skull base surgery OR Facial Nerve OR Trigeminal Nerve OR Microvascular Decompression OR Hemifacial Spasm)] in MEDLINE through its PubMed interface and other search engines. Articles that fulfilled the inclusion and exclusion criteria were obtained and scrutinized. Seven observational articles with a total of 437 participants were included. All 5 studies that described the use of BR in FN surgery noted that intraoperative BR is beneficial, safe, sensitive, specific, and predictive of outcomes, while 2 articles describing patients with trigeminal neuralgia recommended use of BR in microvascular decompression of TN. Intraoperative BR is a sensitive, specific, and safe monitoring technique that has good predictability of facial paresis and paresthesia among patients undergoing MVD for trigeminal neuralgia and primary hemifacial spasm and patients undergoing cerebellopontine angle tumor resection.

Prevalence of post-caesarean section surgical site infections in Rwanda: A systematic review and meta-analysis.

Caesarean section (C-section) is the most performed major surgery worldwide. About 15% of births are delivered through C-section in Rwanda. The post-caesarean surgical section is one of the most frequent complications that follow a C-section. The purpose of this systematic review and meta-analysis is to estimate the pooled prevalence of surgical site infections following caesarean section deliveries in Rwanda. A comprehensive search was conducted across PubMed/MEDLINE, Google Scholar, DOAJ, AJOL and the Cochrane Library to identify primary studies on post-caesarean surgical site infections in Rwanda. Studies meeting predetermined criteria were included, and their quality was assessed using the JBI Critical Appraisal Tools. Heterogeneity was evaluated using I2 statistics, while publication bias was examined via funnel plots and statistical tests. Pooled prevalence was calculated using Jamovi 2.3.28 software, with subgroup analysis conducted to identify sources of heterogeneity. Statistical significance was set at p < 0.05. From 139 articles initially searched from the databases, only 17 studies with 8, 082 individuals were finally included in the systematic review and meta-analysis. Using the random-effects model, the pooled estimate of post C-section SSIs prevalence in Rwanda was 6.85% (95% CI 5.2, 8.5). Subgroup analysis based on publication year, sample size, hospital and study design showed no much difference in SSI prevalence. The current systematic review and meta-analysis indicates that post-caesarean surgical site infections are significant in Rwanda. A collaborative effort is required to lower post-C-section SSIs and provide the best surgical care in the country.

Dual-factor Models of Mental Health: A Systematic Review of Empirical Evidence.

Objective: Dual-factor models of mental health propose that mental health includes two interrelated yet distinct dimensions - psychopathology and well-being. However, there is no systematization of the evidence following these models. This review aims to address the following research question: what evidence exists using dual-factor models? Method: The current systematic review was conducted using PRISMA guidelines on the following databases: Web-of-science, Scopus, Academic Search Complete, APA PsycArticles, APA PsycInfo, Psychology and Behavioral Sciences Collection, ERIC, and MEDLINE. The screening process resulted in 85 manuscripts that tested the assumptions of dual-factor models. Results: Evidence revealed psychometric substantiation on the two-dimensionality of the dual-factor model, and 85% of the manuscripts provided evidence related to classifying participants into different mental health groups. Most studies showed that the Complete Mental Health or Positive Mental Health group is the most prevalent status group, and longitudinal evidence suggests that most participants (around 50%-64%) remain in the same group across time. Regarding the factors associated with mental health status groups, studies reviewed in this manuscript focus mainly on school-related outcomes, followed by supportive relationships, sociodemographic characteristics, psychological assets, individual attributes, physical health, and stressful events. Conclusions: This review highlights the importance of considering the two dimensions of mental health when conceptualizing, operationalizing, and measuring mental health. Fostering mental health must go beyond reducing symptoms, and practitioners would be able to include well-being-related interventions in their regular practice to improve individuals' mental health outcomes.

Cardiovascular Risk Assessment Scores: A Narrative Review

Cardiovascular disease (CVD) is considered to be one of the major groups of diseases which is preventable. The prevalence of such conditions is increasing due to the various lifestyle habits. In the majority of the cases, the disease remains asymptomatic. These CVDs can be prevented by early lifestyle modifications and treatment. CVDs are considered to be one of the major causes of death worldwide. Various risk assessment tools are used to identify patients with high risks, such as high blood pressure, cholesterol levels, age, obesity, and atherosclerosis. These tools are used for calculating the risk of beginning a CVD from various risk factors of the patient obtained from history, physical and general examination along with investigations. The risk assessment tools play an important role in preoperative period for better decision-making and planning for the treatment. The objective is to locate, evaluate, and synthesize current systematic reviews that discuss the role of risk assessment tools in primary CVD prevention. This review article comprises the various risk assessment tools or scores that can be used to calculate the cardiovascular risk in an individual and also the scores relevant in India. They are the Framingham risk score, systemic coronary risk evaluation, Reynolds risk score, JBS3 risk calculator, and many more.

The Emerging Importance of Sleep Regularity on Cardiovascular Health and Cognitive Impairment in Older Adults: A Review of the Literature.

The regularity of sleep/wake patterns across multiple days is emerging as an important determinant of health. However, the association between sleep regularity and health outcomes in the aging population is not well understood. The current systematic review identified 22 publications that examined the relationship between sleep regularity and selected health outcomes: cardiovascular risk, cognitive impairment, and mortality. All studies were published after 2010, reflecting a growing research interest in daily sleep regularity. Low sleep regularity was consistently associated with higher cardiovascular risk and elevated risk of all-cause mortality. Results on cognitive impairment are mixed, with inconsistency likely attributed to small sample sizes and differences in sleep regularity assessment. Overall, regularity in sleep carries important information about health and should be included in future studies that collect daily sleep measures. Gaps in literature and methodological shortcomings are discussed.

Efficacy of clear aligner therapy over conventional fixed appliances in controlling orthodontic movement: A systematic review.

The purpose of the current systematic review was to answer the clinical research question "Is Clear Aligner Therapy (CAT) effective in controlling the orthodontic movement?" by bringing together the most up-to-date information about the available evidence for CAT. On January 1, 2023, a search was conducted in PubMed, ERIC, Embase, and CINHAL for any research papers published in the previous 10 years that provided an overview of the PICO questions. Both the titles and abstracts of the selected studies were evaluated independently by two different authors, and if there was any disagreement between the two review authors, a third reviewer was brought in to settle it. Among included studies, three were retrospective non-randomized and two studies were prospective randomized clinical trials. Various authors reported better outcome for fixed orthodontic appliances than for clear aligner treatment (CAT) in relation to mandibular incisor proclination. The mean objective grading system score was better for braces (17) than for CAT (12) with no clinically significant difference, while staging had a significant impact on treatment efficacy. The results of this study suggest that clear aligners may be an effective alternative to traditional braces, but more research is needed to confirm these findings and determine the optimal size of future prospective studies evaluating this treatment.

Effect of Sensory Adapted Dental Environment (SADE) on physiological and behavioral parameters related to stress and anxiety in children with Autism Spectrum Disorder (ASD) undergoing dental treatment: A systematic review and meta-analysis.

Children with autism exhibit a higher general and dental anxiety, due to altered sensory sensibilities. This current systematic review aims to evaluate the effectiveness of Sensory adapted dental environment (SADE) over regular dental environment (RDE) on behavioral, physiological stress and overt anxiety in children with autism spectrum disorders (ASDs). Prospero registered (CRD42024508336). PubMed, Cochrane, Scopus databases are searched from years January 1, 1980-January 1, 2024 using pre-defined search strategy. A total of 269 titles, were obtained from the included databases after application of filters, exclusion of duplicates and reviews and irrelevant articles led to the final inclusion of 12 articles for full text screening from which, three studies sustained the targeted PICO search. Skin conductance level (parameter indicating physiological stress) is lower in SADE environment in children with ASD, other behavior stress related parameters there is no significant difference between SADE and RDE environments.