Final Review Research Articles

Inaccuracies Exist in Trauma Registry Data Regarding Shooting Intent for Pediatric Firearm Injuries

BackgroundInstitutional trauma registries, which contribute data to the National Trauma Data Bank, are a fundamental resource for trauma research, though may have significant deficits in data accuracy. We hypothesize that inaccuracies in shooting intent exist at institutional registries of pediatric trauma centers. MethodsPediatric firearm injuries (ages 0–17 years) in a single county between 2018 and 2020 were identified from three Level I trauma centers. Demographics and Ecodes were extracted from each registry and shooting intent was compared to retrospective review of the hospital records, including bystander as a category. ResultsOf 410 pediatric firearm injuries included, the majority were male (84%), non-Hispanic Black (45%) or Hispanic White (40%), and 15–17 years old (69%). Compared to final reviewer designations, the trauma registry's assault category showed high sensitivity (88.5%), but low specificity (67%), and only 78% accuracy. The trauma registry's accidental category was less sensitive (88%) but more specific (88%), with an accuracy of 88%. The most specific and accurate intention category was intentional self-harm, which had 79% sensitivity, 99.5% specificity, and 99% accuracy. Bystander shootings were most commonly categorized as assault (75%), followed by accidental (18%). ConclusionSignificant inaccuracies in coding of pediatric firearm shooting intent exist in trauma registries. Additionally, there is no Ecode for bystander shootings, which overestimates other intent categories. Our study highlights the importance of improving the accuracy of firearm injury data collection to provide a better understanding of firearm injuries at a national level to inform targeted prevention efforts specific to shooting types. Level of evidenceIII.

A Short Appraisal of Magnetic Nanoparticles for Breast Cancer: In vitro and In vivo Research.

The increasing incidence of breast cancer and the associated morbidity due to higher metastasis created the urge to develop a nanocarrier that can be used as a potent therapeutic carrier with targeting efficacy. The use of superparamagnetic nanoparticles in breast cancer research and treatment has gained considerable attention in recent years. Magnetic nanoparticles (MNPs) can be used to construct nanocarriers since they possess superior properties such as superparamagnetism, easy surface functionalization to attach ligands, and non-immunogenic. MNPs are superior carriers that are used to target cancer cells without harming the normal cells in the body, which leads to therapeutic efficacy in the body. Along with their established anticancer potential and enhanced drug concentration at endosomal pH, the superparamagnetic property of MNPs was further exploited for their applications in reticuloendothelial uptake, drug delivery, medical imaging, and theranostics applications in breast cancer. Moreover, the clinical translational of MNPs, along with future prospects and key challenges in vivo, have been duly presented in the final review. The scientists preferred the ongoing research in MNPs due to their high biocompatibility and ease of targeting at molecular and cellular levels. The review highlighted the in vitro and in vivo research and patent supported data for potential use of MNPs for the treatment of breast cancer.

A meta-synthesis study on the effect of critical thinking on improving language skills

The current meta-synthesis study investigated the effective strategies for improving critical thinking ability among EFL/ESL learners, and the relationship between language learning skills and critical thinking ability. To achieve this aim, meta-synthesis was selected as the design of the study. Therefore, some databases were searched using the defined key terms, in order to select the related qualitative, quantitative, and mixed-method studies. As a result, 550 articles were found, 43 articles of which were included in the final review. Using thematic analysis, the obtained data from these 43 articles were analyzed in 6 steps and then coded for each research question. Although no single method was proposed in this study as the best to improve critical thinking, it was indicated that a number of them together can be effective when properly implemented. It was shown that all 4 language skills can be improved by enhancing the level of critical thinking ability among EFL/ESL learners.

P240: Sarcopenia of the lower limb on Magnetic Resonance Imaging in patients with Diabetes Mellitus – a systematic review

Abstract Introduction Sarcopenia is defined by low measures of muscle quantity and quality and physical performance. Accelerated sarcopenic changes in diabetic patients leads to biomechanical changes in the foot and limb loss. Aim To systematically review the literature on Magnetic Resonance Imaging (MRI) and sarcopenia in the lower limb in patients with diabetes. Methods A literature review was conducted in accordance with PRISMA guidelines. Embase and Medline databases were searched with Ovid interface, as well as Pubmed and Cochrane. The grey literature was also reviewed on ClinicalTrials.gov, WHO international clinical trials registry platform, Cochrane library and the NIHR journals library and ProQuest. The MeSH terms “sarcopenia” AND “diabetes mellitus” AND “magnetic resonance imaging” were employed in the primary search string. The articles were reviewed by two independent reviewers. Results 874 studies were screened. 20 articles were included in the final review. Methods of measurement included cross sectional area measurements, stereological muscle measurements, muscle volume estimation, adipose infiltration, signal intensity cut-off, Goutallier grading, semiquantitative 5-point scale. Reduction in cross-sectional area and volumes and greater intramuscular fat infiltration was noted in patients with diabetes Sarcopenia ++ in Diabetic polyneuropathy (DPN) compared to non-diabetic and diabetic but non-DPN counterparts. MRI findings correlate with neuropathy disability scores and physical tests. Single study using a semi-automated process to measure sarcopenia. Conclusion MRI has its merit in providing accurate and detailed information on skeletal muscle volume and assessment of fat infiltration in muscle. This is relevant to reducing complications associated with changes in the biomechanics of the foot.

Quantifying BIM investment value: a systematic review

Purpose Perceived benefits of building information modelling (BIM) have been discussed for some time, but cost–benefit benchmarking has been inconsistent. The purpose of this paper is to investigate BIM feasibility and evaluate investment worth to elucidate and develop the current understanding of BIM merit. The aim of the study is to propose a research agenda towards a more holistic perspective of BIM use incorporating quantifying investment return. Design/methodology/approach An in-depth examination of research patterns has been conducted to identify challenges in the assessment of the investment value and return on investment (ROI) for BIM in the construction industry. A total of 75 research articles were considered for the final literature review. An evaluation of the literature is conducted using a combination of bibliometric analysis and systematic reviews. Findings This study, which analysed 75 articles, unveils key findings in quantifying BIM benefits, primarily through ROI calculation. Two major research gaps are identified: the absence of a standardized BIM ROI method and insufficient exploration of intangible benefits. Research focus varies across phases, emphasizing design and construction integration and exploring post-construction phases. The study categorizes quantifiable factors, including productivity, changes and rework reduction, requests for information reduction, schedule efficiency, safety, environmental sustainability and operations and facility management. These findings offer vital insights for researchers and practitioners, enhancing understanding of ’BIM’s financial benefits and signalling areas for further exploration in construction. Originality/value The ’study’s outcomes offer the latest insights for researchers and practitioners to create effective approaches for quantifying ’BIM’s financial benefits. Additionally, the proposed research agenda aims to improve the current limited understanding of BIM feasibility and investment worth evaluation. Results of the study could assist practitioners in overcoming limitations associated with BIM investment and economic evaluations in the construction industry.

"Follow the Science" in COVID-19 Policy: A Scoping Review.

"Follow the science" was commonly repeated during debates on COVID-19-related policy. The phrase "follow the science" raises questions that are central to our theories of knowledge and the application of scientific knowledge to maximize the wellbeing of our society. The purpose of this study was to (1) perform a scoping review of literature discussing "follow the science" and COVID-19, and (2) consider "follow the science" in the context of pediatric health. A comprehensive search of 14 databases was performed on May 23, 2023. Articles were included if they used terms such as "follow the science", "follow the scientists", "listen to science" or "listen to scientists", and discussed COVID-19. There were 24 articles included in the final review. Existing literature on "follow the science" (1) differentiates between scientific knowledge and policy decisions; (2) emphasizes the importance of social sciences in policy making; (3) calls for more transparency in the knowledge synthesis and policy generating process; and (4) finds that scientific advisors see their role as advising on science rather than policy decision making. There was no definitional, epistemological, or philosophical intellectual defense of "follow the science" in the peer reviewed literature. Policy requires (1) reliable data and (2) agreement on what to do considering those empirical facts by appealing to values, ethics, morality, and law. A review of school shutdowns is used as an example of the inadequacy of "follow the science" as a guiding principle for public policy.

Arab, Middle Eastern, and North African Health Disparities Research: A Scoping Review.

Research in health disparities and how they affect underserved populations continues to grow and expand. However, the experiences of Arab/Middle Eastern and North African (MENA) Americans often go unnoticed, and yet, preliminary data suggests there are significant disparities between this population and other groups. The purpose of this scoping review is to examine and synthesize the extent of available literature on health disparities and outcomes for this group. A scoping review was conducted to investigate the current state of research on health disparities and outcomes among Arab/MENA individuals within the USA. The PRISMA protocol for scoping reviews was utilized. Through the use of PubMed and PsychInfo databases, the search identified 43 articles that were eligible for inclusion in the final review. Five themes emerged: prevalence and health outcomes, factors impacting health, comparison studies, barriers, and health literacy and beliefs. Extant data was equivocal, suggesting the need for further research. Research on Arab/MENA health disparities and outcomes is in the detection phase, indicating that more research is needed to elucidate the state of Arab/MENA health in the USA. These findings can help healthcare professionals and researchers understand the emerging literature on health disparities within the Arab/MENA community and inform further research and clinical practice within this population.

A scoping review of international allied health professions escape room practices and scholarship

Purpose The purpose of this scoping review is to assess the literature on allied health professions escape rooms (AHPERs), investigating their common purposes and practices, and the trends in scholarship. Methods This scoping review followed PRISMA-ScR guidelines to assess the size and scope of evidence in the literature, categorize common purposes and practices, and explore trends in AHPER scholarship. Two reviewers developed a review protocol, collected literature using a search strategy aligned with inclusion criteria, and charted review results. Results The literature search yielded 6,170 articles. After the final review, 34 unique records met inclusion criteria. Studies were conducted in the United States, Spain, Australia, France, Brazil, and Canada. Most escape rooms reported participants, team size, puzzle type, and outcomes, but few used causal research designs, primarily using pre-post with no control designs. AHPERs represent an increasingly popular pedagogical approach. AHPERs tend to be simply structured, patient themed, and convey either disciplinary or interprofessional lessons. Generally, AHPERs were self-reported as effective and satisfying, but scholarship supporting AHPERs was insufficient in design for causal claims. Conclusion Developers and scholars may benefit from considering frameworks and guidelines for consistent creation and increased trustworthiness in the AHPER practice and knowledge base. Where AHPER scholars can increase attention to learning outcomes, and plan scholarly works in advance of the escape room, the AHPER body of knowledge will increase.

Relationship between Antibiotic Consumption and Resistance: A Systematic Review.

Unreserved use of antibiotics exerted selective pressure on susceptible bacteria, resulting in the survival of resistant strains. Despite this, the relationship between antibiotic resistance (ABR) and antibiotic consumption (ABC) is rarely studied. This systematic review aims to review the relationship between ABC and ABR from 2016 to 2022. Articles published over 7 years (2016-2022) were searched from December 23 to 31, 2022. The search strategy was developed by using keywords for ABC and ABR. From 3367 articles, 58 eligible articles were included in the final review. The pooled ABC was 948017.9 DPDs and 4108.6 DIDs where over 70% of antibiotics were from the Watch and Reserve category based on the WHO AWaRe classification. The average pooled prevalence of ABR was 38.4%. Enterococcus faecium (59.4%), A. baumannii (52.6%), and P. aeruginosa (48.6%) were the most common antibiotic-resistant bacteria. Cephalosporins (76.8%), penicillin (58.3%), and aminoglycosides (52%) were commonly involved antibiotics in ABR. The positive correlation between ABR and consumption accounted for 311 (81%). The correlation between ABR P. aeruginosa and ABC accounted for 87 (22.7%), followed by 78 (20.3%) and 77 (20.1%) for ABR E. coli and K. pneumoniae with ABCs, respectively. Consumption of carbapenems and fluoroquinolones was most commonly correlated with resistance rates of P. aeruginosa, K. pneumoniae, E. coli, and A. baumannii. There is a positive correlation between ABC and the rate of ABR. The review also revealed a cross-resistance between the consumption of different antibiotics and ABR. Optimizing antibiotic therapy and reducing unnecessary ABC will prevent the emergence and spread of ABR. Thus, advocating the implementation of stewardship programs plays a pivotal role in containing ABR.

Fragility fractures of the pelvis: First 48 cases of surgical treatment at a level 1 trauma center in France

IntroductionLonger life expectancy is accompanied by a higher incidence of fragility fractures of the pelvis (FFP), which has repercussions on mortality and nursing home admissions. Given the paucity of data at French healthcare facilities, we carried out a retrospective study to (1) evaluate how surgical treatment of FFP with posterior displacement (type III and IV according to Rommens and Hofmann) affects a patient's pain, functional status and ability to stay at home and (2) evaluate the postoperative complications and mortality rate. HypothesisSurgery for posteriorly displaced FFP will relieve pain and preserve the patient's independence. MethodsAll the patients over 65 years of age who were operated on for a posterior FFP between January 2015 and August 2020 were included in this prospective, single-center study. The demographics, fracture type, details of the surgical treatment, complications and mortality were analyzed. Pain (visual analog scale, VAS), functional status (Activity of Daily Living [ADL] and Instrumental Activity of Daily Living [IADL]), mobility (Parker score) and rates of nursing home admissions were compared before the fracture, after surgery and at a mean follow-up of 28 months (minimum follow-up of 1 year). ResultsForty-eight patients with a mean age of 75 years were included. Twenty-four of these patients (50%) had at least two comorbidities. The FFPs were either type IV (31/48; 65%) or type III (17/48; 35%). The mean VAS for pain was significantly lower on the first day postoperative (3.5 versus 4.8; p=0.02). This significant reduction continued upon discharge from the hospital (1.95; p=0.003) and persisted at the mean follow-up of 28 months (2.2; p=0.64). The complication rate was 15% (7/48) and the mortality rate at the final review was 15% (7/48). Among the surviving patients, 81% (29/36) returned to living at home. The ADL (5.1 versus 5.8; p=0.09), IADL (5.9 versus 6.9; p=0.15) and Parker score (6.8 versus 8.2; p=0.08) at the final review were not significantly different from the values before the fracture. ConclusionThis is the first French study of patients operated on for an FPP. Fixation of posteriorly displaced fractures allows surviving patients to retain their mobility. Pain relief is achieved quickly and maintained during the follow-up period. Thus, our initial hypothesis is affirmed. The complication rate is not insignificant; given the complexity of this surgery, percutaneous treatment is preferable. Level of evidenceIV; retrospective study.

ATLAS ITk strip detector for the Phase-II Upgrade

The inner detector of the present ATLAS experiment has been designed and developed to function in the environment of the present Large Hadron Collider (LHC). At the ATLAS Phase-II Upgrade, the particle densities and radiation levels will exceed current levels by a factor of ten. The instantaneous luminosity is expected to reach unprecedented values, resulting in up to 200 proton-proton interactions in a typical bunch crossing. The new detectors must be faster and they need to be more highly segmented. The sensors used also need to be far more resistant to radiation, and they require much greater power delivery to the front-end systems. At the same time, they cannot introduce excess material which could undermine tracking performance. For those reasons, the inner tracker of the ATLAS detector was redesigned and will be rebuilt completely. The ATLAS Upgrade Inner Tracker (ITk) consists of several layers of silicon particle detectors. The innermost layers will be composed of silicon pixel sensors, and the outer layers will consist of silicon microstrip sensors. This contribution focuses on the strip region of the ITk. The central part of the strip tracker (barrel) will be composed of rectangular short (∼2.5 cm) and long (∼5 cm) strip sensors. The forward regions of the strip tracker (end-caps) consist of six disks per side, with trapezoidal shaped sensors of various lengths and strip pitches. After the completion of final design reviews in key areas, such as Sensors, Modules, Front-End electronics, and ASICs, a large scale prototyping program has been completed in all areas successfully. We present an overview of the Strip System and highlight the final design choices of sensors, module designs and ASICs. We will summarise results achieved during prototyping and the current status of pre-production and production on various detector components, with an emphasis on QA and QC procedures.

Diagnostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio to predict recurrent pregnancy loss and abortion; a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in women with a history of abortion (missed and threatened) and recurrent pregnancy loss (RPL) in comparison with healthy pregnancies. Electronic databases including MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library were searched for NLR and PLR in women who experienced early pregnancy loss up to January 1, 2023 with a combination of proper keywords. Meta-analysis was done for comparison with three or more studies and summary estimates were measured. A total of 390 citations were retrieved initially, and after screening, 16 articles were deemed eligible for the final review. Among these, 14 studies underwent meta-analysis. The meta-analysis revealed that the standard mean of the NLR was significantly higher in abortion cases compared to the control group. However, there was no significant difference in the PLR between the pregnancy loss group and the control group. NLR was significantly higher among RPL patients compared to the control group, according to these data, NLR may be capable of being used in the diagnosis of RPL as an easy, cheap, and accessible modality. Further studies, which take these variables into account, will need to be undertaken to determine the diagnostic value of NLR and PLR in early pregnancy loss.

Anti-racist interventions to reduce ethnic disparities in healthcare in the UK: an umbrella review and findings from healthcare, education and criminal justice

ObjectivesTo assess the evidence for anti-racist interventions which aim to reduce ethnic disparities in healthcare, with a focus on implementation in the UK healthcare system.DesignUmbrella review.Data sourcesEmbase, Medline, Social Policy...

Cervical Disc Arthroplasty: Rationale, Designs, and Results of Randomized Controlled Trials.

This review outlines clinical data and characteristics of current Food and Drug Administration (FDA)-approved implants in cervical disc replacement/cervical disc arthroplasty (CDR/CDA) to provide a centralized resource for spine surgeons. Randomized controlled trials (RCTs) on CDR/CDA were identified using a search of the PubMed, Web of Science, and Google Scholar databases. The initial search identified 69 studies. Duplicates were removed, and the following inclusion criteria were applied when determining eligibility of RCTs for the current review: (1) discussing CDR/CDA prosthesis and (2) published within between 2010 and 2020. Studies without clinical data or that were not RCTs were excluded. All articles were reviewed independently by 2 authors, with the involvement of an arbitrator to facilitate consensus on any discrepancies. A total of 34 studies were included in the final review. Findings were synthesized into a comprehensive table describing key features and clinical results for each FDA-approved CDR/CDA implant and are overall suggestive of expanding indications and increasing utilization. RCTs have provided substantial evidence to support CDR/CDA for treating single- and 2-level cervical degenerative disc disease in place of conventional anterior cervical discectomy and fusion. This review provides a resource that consolidates relevant clinical data for current FDA-approved implants to help spine surgeons make an informed decision during preoperative planning.

A preoperative package of care for osteoarthritis, consisting of weight loss, orthotics, rehabilitation, and topical and oral analgesia (OPPORTUNITY): a two-centre, open-label, randomised controlled feasibility trial

Osteoarthritis of the knee is a major cause of disability worldwide. Non-operative treatments can reduce the morbidity but adherence is poor. We hypothesised that adherence could be optimised if behavioural change was established in the preoperative period. Therefore, we aimed to assess feasibility, acceptability, and recruitment and retention rates of a preoperative package of non-operative care in patients awaiting knee replacement surgery. We did an open-label, randomised controlled, feasibility trial in two secondary care centres in the UK. Eligible participants were aged 15-85 years, on the waiting list for a knee arthroplasty for osteoarthritis, and met at least one of the thresholds for one of the four components of the preoperative package of non-operative care intervention (ie, weight loss, exercise therapy, use of insoles, and analgesia adjustment). Participants were randomly assigned (2:1) to either the intervention group or the standard of care (ie, control) group. All four aspects of the intervention were delivered weekly over 12 weeks. Participants in the intervention group were reviewed regularly to assess adherence. The primary outcome was acceptability and feasibility of delivering the intervention, as measured by recruitment rate, retention rate at follow-up review after planned surgery, health-related quality of life, joint-specific scores, and adherence (weight change and qualitative interviews). This study is registered with ISRCTN, ISRCTN96684272. Between Sept 3 2018, and Aug 30, 2019, we screened 233 patients, of whom 163 (73%) were excluded and 60 (27%) were randomly assigned to either the intervention group (n=40) or the control group (n=20). 34 (57%) of 60 participants were women, 26 (43%) were men, and the mean age was 66·8 years (SD 8·6). Uptake of the specific intervention components varied: 31 (78%) of 40 had exercise therapy, 28 (70%) weight loss, 22 (55%) analgesia adjustment, and insoles (18 [45%]). Overall median adherence was 94% (IQR 79·5-100). At the final review, the intervention group lost a mean of 11·2 kg (SD 5·6) compared with 1·3 kg (3·8) in the control group (estimated difference -9·8 kg [95% CI -13·4 to -6·3]). A clinically significant improvement in health-related quality o life (mean change 0·078 [SD 0·195]) were reported, and joint-specific scores showed greater improvement in the intervention group than in the control group. No adverse events attributable to the intervention occurred. Participants adhered well to the non-operative interventions and their health-related quality of life improved. Participant and health professional feedback were extremely positive. These findings support progression to a full-scale effectiveness trial. Versus Arthritis.

Antipsychotic agents in anxiety disorders: An umbrella review.

Although not approved for the treatment of anxiety disorders (except trifluoperazine) there is ongoing off-label, unapproved use of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) for anxiety disorders. There have been systematic reviews and meta-analyses on the use of antipsychotics in anxiety disorders, most of which focused on SGAs. The specific aims of this umbrella review are to: (1) Evaluate the evidence of efficacy of FGAs and SGAs in anxiety disorders as an adjunctive treatment to traditional antidepressant treatments and other nonantipsychotic medications; (2) Compare monotherapy with antipsychotics to first-line treatments for anxiety disorders in terms of effectiveness, risks, and side effects. The review protocol is registered on PROSPERO (CRD42021237436). An initial search was undertaken to identify systematic reviews and meta-analyses from inception until 2020, with an updated search completed August 2021 and January 2023. The searches were conducted in PubMed, MEDLINE (Ovid), EMBASE (Ovid), APA PsycInfo (Ovid), CINAHL Complete (EBSCOhost), and the Cochrane Library through hand searches of references of included articles. Review quality was measured using the AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews) scale. The original and updated searches yielded 1796 and 3744 articles respectively, of which 45 were eligible. After final review, 25 systematic reviews and meta-analyses were included in the analysis. Most of the systematic reviews and meta-analyses were deemed low-quality through AMSTAR-2 with only one review being deemed high-quality. In evaluating the monotherapies with antipsychotics compared with first-line treatments for anxiety disorder there was insufficient evidence due to flawed study designs (such as problems with randomization) and small sample sizes within studies. There was limited evidence suggesting efficacy of antipsychotic agents in anxiety disorders other than quetiapine in generalized anxiety disorder (GAD). This umbrella review indicates a lack of high-quality studies of antipsychotics in anxiety disorders outside of the use of quetiapine in GAD. Although potentially effective for anxiety disorders, FGAs and SGAs may have risks and side effects that outweigh their efficacy, although there were limited data. Further long-term and larger-scale studies of antipsychotics in anxiety disorders are needed.

Health professionals' education related to people with intellectual and developmental disabilities: A scoping review.

People with intellectual and developmental disabilities are among the most underserved in an inequitable healthcare system. Using Arksey and O'Malley's methodology and a social determinants of health framework, we conducted a scoping review of literature on the state of practice in education of healthcare professionals in the health and healthcare needs of this population. Searches found 4948 articles, with 182 included in the final review. Themes identified included gaps of not being informed by workforce needs, continued use of the medical model of care, not addressing intersectionality with racial/ethnic and other discriminations, and lack of involvement of the population in developing/evaluating programs and promising trends of development of competency-based interprofessional programs with experiential learning. We provide recommendations for best practices in a concerted effort to educate a healthcare workforce equipped with the knowledge and skills to address the health needs of this population.

Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research

BackgroundMinimum clinically important difference (MCID) is the smallest change in an outcome measure that is considered clinically meaningful. Using validated MCID thresholds for outcomes powers trials adequately to detect meaningful treatment effects, aids in their interpretation and guides development of new outcome measures. ObjectivesTo provide a comprehensive summary of MCID thresholds of various symptom severity scales reported in movement disorder. MethodsWe conducted systematic review of the literature and included studies of one or more movement disorders, and reporting MCID scales. Results2763 reports were screened. Final review included 32 studies. Risk of bias (RoB) assessment showed most studies were of good quality. Most commonly evaluated scale was Unified Parkinson's Disease Rating Scale (UPDRS) (11 out of 32). Four studies assessing MDS-UPDRS had assessed its different sub-parts, reporting a change of 2.64,3.05,3.25 and 0.9 points to detect clinically meaningful improvement and 2.45,2.51,4.63 and 0.8 points to detect clinically meaningful worsening, for the Part I, II, III and IV, respectively. For Parts II + III, I + II + III and I + II + III + IV, MCID thresholds reported for clinically meaningful improvement were 5.73, 4.9, 6.7 and 7.1 points respectively; while those for clinically meaningful worsening were 4.7, 4.2, 5.2 and 6.3 points, respectively. MCID thresholds reported for other scales included Abnormal Involuntary Movement Scale (AIMS), Toronto Western Spasmodic Torticollis Rating Scale (TWSRS), and Burke-Fahn-Marsden Dystonia Scale (BFMD). ConclusionThis review summarizes all the MCID thresholds currently reported in Movement disorders research and provides a comprehensive resource for future trials, highlighting the need for standardized and validated MCID scales in movement disorder research.

What factors influence pain scores following Corticosteroid injection in patients with Greater Trochanteric Pain Syndrome? A systematic review

BackgroundCortico-Steroid Injections (CSI) are commonly used to treat patients with Greater Trochanteric Pain Syndrome (GTPS) but it is unclear which patients will experience improvements in pain.ObjectivesTo identify factors that influence improvements in pain for patients with GTPS treated with CSI.DesignSystematic review.MethodsA search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline and PEDro databases. Studies were eligible for inclusion if they investigated factors that influenced changes in pain experienced by patients with GTPS who received a CSI. Studies needed to include relevant summary statistics and tests of clinical significance. Risk Of Bias in Non-randomised Trials Of Interventions (ROBINS-I) and Risk Of Bias 2 (ROB2) tools were used to assess bias.ResultsThe search identified 466 studies, 8 were included in the final review with a total of 643 participants. There was no association between demographic variables such as age, sex, symptom duration or obesity and pain outcomes post-CSI. Having a co-existing musculoskeletal (MSK) condition such as knee osteoarthritis or sacroiliac/lumbar spine pain was associated with less pain reduction post-CSI. Injections into the Trochanteric Bursa were associated with longer lasting pain reduction than Gluteus Medius Bursa or extra-bursal injections. Image guidance of CSI maintained lower pain scores at six months but did not increase the duration of the therapeutic effect past six months. The presence of specific ultrasound scan features was not associated with differences in pain scores.ConclusionsPatients with co-existing MSK conditions may not respond to CSI as well as those without. Injections into the Greater Trochanteric Bursa may have longer lasting benefit. Further research is needed on the use of USS imaging findings and image guidance.

Student and clinical supervisor perceptions of community-based dental educational experiences: A scoping review.

This scoping review was conducted to map the breadth of experiences in community-based dental education (CBDE), as reported by students and clinical supervisors. This scoping review was conducted following the structured framework proposed by Arksey and O'Malley and adhering to PRISMA-SCR guidelines for scoping reviews. Applying specified eligibility criteria, a systematic search of four electronic databases (PubMed, Scopus, Embase, and Web of Science) was followed by data extraction and data synthesis of full-text articles. Research was conducted between June 2022 and September 2022. Sixteen articles were identified for the final full-text review. Utilizing a narrative thematic review, the following five domains emerged: preparation for autonomous practice, understanding of primary care dentistry, understanding of health disparities and patient needs, clinical confidence, clinical diversity, and skill development, and perspectives on quality of teaching and assessment. Community/outreach dental education effectively supplements traditional dental school-based education from the perspectives of students and community-based clinical supervisors.