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Abstract: According to results of a recent literature search performed by the European Academy of Dermatology and Venereology (EADV) Task Forces (TF) on Quality of Life and Patient Oriented Outcomes (QoL and PO) and Acne, Rosacea and Hidradenitis Suppurativa (ARHS), most of the publications where health‐related (HR) QoL of acne patients was studied were clinical trials. Members of the EADV TF on QoL and PO decided to detect which acne treatment has the best influence on HRQoL of acne patients. A new literature search was organized to find publications on acne treatment where the HRQoL of patients was assessed as an outcome measure. From 186 papers with HRQoL assessment, 37 papers were included for further analysis. Our results revealed that oral isotretinoin had the best influence on HRQoL of acne patients. Several other treatment methods also showed good effects on the HRQoL of acne patients. Oral isotretinoin and norethindrone acetate/ethinyl estradiol, topical clindamycin phosphate/benzoyl peroxide and adapalene/benzoyl peroxide showed significantly better effect on HRQoL than placebo. There is limited number of the high‐quality studies on acne treatment where HRQoL was assessed. Dermatology‐specific and acne‐specific instruments showed much better sensitivity to successful therapeutic intervention than generic HRQoL instruments. The most frequently used HRQoL instrument was the Dermatology Life Quality Index questionnaire. [ABSTRACT FROM AUTHOR]

With the heightened popularity of childhood sporting activity, the number of paediatric anterior cruciate ligament (ACL) ruptures has increased. Management of these injuries presents a particular challenge due to the open femoral and tibial growth plates. Physeal damage has the potential to cause angular deformity or length discrepancy. This review was conducted to determine the best way to treat this injury. A primary search of Ovid MEDLINE (1 October 2017) used the terms: (ACL or anterior cruciate ligament) and (young or child or children or pediatric or immature or pre-pubescent). Titles/Abstracts of 369 articles were screened for relevance. A total of 217 were excluded, leaving 152 articles for full-paper retrieval. Of these, 9 articles remained with one further article identified during cross-referencing; 10 papers (1 level 2 and 9 level 3) were included for analysis. Comparative studies investigating surgical (140 knees) versus conservative (110 knees) treatment provide evidence in favour of the former, in reducing instability and meniscal tears and improving return to previous activity. Of the papers analysed (163 reconstructions), there was only one case of growth arrest (0.6%) and no cases of length discrepancy. In those studies investigating early (218 patients) versus delayed (140 patients) reconstruction, medial meniscal tears and chondral injuries occurred more frequently in the delayed group. To conclude, for children, there is level 2/3 evidence that early operative ACL reconstruction offers the best chance of a return to pre-injury sporting activity and minimises the risks of further structural damage. Iatrogenic growth disturbance remains a rare but worrying complication. [ABSTRACT FROM AUTHOR]

Background Within contemporary medical practice, Parkinson's disease ( PD) is treated using a biomedical, neurological approach, which although bringing numerous benefits can struggle to engage with how people with PD experience the disease. A bio-psycho-social approach has not yet been established in PD; however, bio-psycho-social approaches adopted within dementia care practice could bring significant benefit to PD care. Methods This paper summarises existing bio-psycho-social models of dementia care and explores how these models could also usefully be applied to care for PD. Specifically, this paper adapts the bio-psycho-social model for dementia developed by Spector and Orrell (), to suggest a bio-psycho-social model, which could be used to inform routine care in PD. Results Drawing on the biopsychosocial model of Dementia put forward by Spector and Orrell (), this paper explores the application of a bio-psycho-social model of PD. This model conceptualises PD as a trajectory, in which several interrelated fixed and tractable factors influence both PD's symptomology and the various biological and psychosocial challenges individuals will face as their disease progresses. Using an individual case study, this paper then illustrates how such a model can assist clinicians in identifying suitable interventions for people living with PD. Conclusion This model concludes by discussing how a bio-psycho-social model could be used as a tool in PD's routine care. The model also encourages the development of a theoretical and practical framework for the future development of the role of the PD specialist nurse within routine practice. Implications for practice A biopsychosocial approach to Parkinson's Disease provides an opportunity to move towards a holistic model of care practice which addresses a wider range of factors affecting people living with PD. The paper puts forward a framework through which PD care practice can move towards a biopsychosocial perspective. PD specialist nurses are particularly well placed to adopt such a model within routine clinical practice, and should therefore be encouraged within PD services. [ABSTRACT FROM AUTHOR]

Accessible Summary: Sometimes people find it hard to notice what is going on in their mind, body and feelings. Mindfulness can help us with this. Some studies show that mindfulness might help people with intellectual disabilities.We asked people to play a mindfulness computer game to see whether it helped them to notice their mind, bodies and feelings more easily. People who work with people with intellectual disabilities helped to play the game too.We asked people what they thought about the game.People seem to enjoy playing the game and said it helped them be more mindful.We think that learning mindfulness in a computer game might be helpful for people with intellectual disabilities. Background: This paper evaluates the user experience of a newly developed mindfulness and relaxation game designed to teach mindfulness skills to people with intellectual disabilities. Computer‐assisted mindfulness programs have gained considerable attention among researchers in both adult and child populations. However, less is known about the experiences of people with intellectual disabilities who engage in computerised mindfulness programs. The present study aimed to explore the experiences of adults with intellectual disabilities and clinicians in using a computerised mindfulness and relaxation game. Method: Twelve adults (with a mild or moderate intellectual disability) and sixteen clinicians were individually interviewed. Thematic analysis was used to analyse and generate themes within the data. Findings: Three main themes with a number of subthemes were generated for people with intellectual disabilities including the following: (1) The Process of Mindful Island; (2) Fostering Relationships Through the Computer; and (3) The Impact of the Game. Three themes from clinician interviews were also generated including the following: (1) A Good Concept but More to Do; (2) Uncertainties Around Players' Understanding of Mindfulness; and (3) The Computer as a Tool to Build Relationships. The findings indicated that participants found the game an enjoyable experience and saw a number of benefits to engaging in it including perceived improved confidence and perceived reduction of worries. Conclusions: Mindfulness can be adapted to computer‐assisted technology for use among people with intellectual disabilities and may foster a number of benefits. [ABSTRACT FROM AUTHOR]

BACKGROUND Monoclonal antibodies (mAbs) presently dominate the biotherapeutic market. However, biotherapeutics in general, and mAbs in particular, are expensive therapies and outside the realm of affordability for most of the world. In an attempt to lower their cost of manufacturing, a novel in‐house non‐protein A continuous platform has recently been reported for mAb purification. In this paper, we perform an in‐depth evaluation of the process economics to assess the impact of removing the protein A step on the cost of goods (COGs). RESULTS: The non‐protein A platform was found to result in significant savings in COGs at about 23% when comparing both platforms in batch mode. Conversion of the non‐protein A platform from batch to continuous mode led to a further increase in these savings with about 39% gains in COGs over the conventional protein A platform. CONCLUSIONS: The non‐protein A purification platform offers a viable alternative to the standard protein A platform and can be considered when setting up a new facility. The continuous non‐protein A platform can especially be considered given the flexibility of the setup and the utility at both small and large scales. © 2021 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

CD38 is a multifunctional receptor and enzyme present on the surface of B lymphocytes, which can induce B lymphocytes proliferation and apoptosis by crosslinking related cytokines to affect the function of B cells, thus affecting immune regulation in humans and promoting tumorigenesis. The level of CD38 expression in B cells has become an important factor in the clinical diagnosis, treatment, and prognosis of malignant tumors and other related diseases. Therefore, studying the relationship between CD38 expression on the surface of B cells and the occurrence of the disease is of great significance for elucidating its association with disease pathogenesis and the clinical targeted therapy. In this paper, we review the effects of CD38 on B‐cell activation, proliferation, and differentiation, and elaborate the functional role and mechanism of CD38 expression on B cells. We also summarize the relationship between the level of CD38 expression on the surface of B cells and the diagnosis, treatment, and prognosis of various diseases, as well as the potential use of targeted CD38 treatment for related diseases. This will provide an important theoretical basis for the scientific research and clinical diagnosis and treatment of B‐cell‐related diseases. [ABSTRACT FROM AUTHOR]

Aim To introduce dental hygienists ( DHs) in the UK to the principles of research through a practice-based product evaluation programme. Methods The programme consisted of an initial training and orientation day with presentations on evidence-based practice, research methods and the structure of research papers. The programme and its aims were explained in detail, and participants were briefed on the methods to be used. Participants then recruited seven to ten patients from their practices (offices), carried out a baseline assessment of: plaque, gingival health, calculus and staining at anterior teeth, and gave the patients a questionnaire asking about their teeth and then provided a 3-month supply of a test toothpaste. About 10 weeks later, a follow-up assessment of the same variables was performed and the questionnaire was repeated. A second training day followed during which the DHs provided feedback of their experiences and received training in literature searching and critical appraisal of literature including interpretation of results. Results Sixty-five DHs attended the first training day; 31 were able to recruit sufficient patients and attend the second training day. The DHs recruited 168 patients who received baseline and follow-up assessments. All the variables improved overall. Feedback from the DHs was very positive, and patients expressed delight with the care they had received. Conclusions Qualitative feedback for participating DHs suggests the programme met its aim and could be used in the future as a mechanism for helping DHs who want to increase their understanding of research methodology. [ABSTRACT FROM AUTHOR]

The standardization of outcome reporting is crucial for interpretation and comparison of studies related to laser treatment of skin disorders. In collaboration with the Cochrane Skin‐Core Outcome Set Initiative (CS‐COUSIN), a procedure has been proposed to find consensus on the most important generic outcome domains (what to measure) for implementation in the international Laser TrEAtment in Dermatology (LEAD) registry. As the first step in the development of a generic outcome set for the LEAD registry, we undertook a systematic review to identify outcomes, outcome measurement instruments, methods and definitions reported in recently published literature of laser treatments for skin disorders. A systematic search was conducted and generated a total of 707 papers. We assessed 150 studies including all types of studies involving laser treatments for the skin. Two researchers independently extracted the type, definition and frequency of all outcomes and used outcome measurement instruments. We identified 105 verbatim outcomes that were categorized into eight domains recommended by the COMET framework: appearance, long‐term effects, physician and patient‐reported physical signs, satisfaction, health‐related quality of life, psychological functioning and adverse events. Heterogeneity in outcome reporting (e.g. categories and outcome measurement instruments) was high, and definitions were insufficiently reported. There was a clear under representation of life impact domains, including satisfaction (23%) quality of life (3%) and psychological functioning (1%). Outcome reporting concerning laser treatments for the skin is heterogeneous. Standardized outcomes are needed for improving evidence synthesis. Results of this review will be used in the next step to reach consensus between stakeholders on the outcome domains to be implemented in the LEAD registry. [ABSTRACT FROM AUTHOR]

Comprehensive reviews of the clinical characteristics and pathogenesis of Aicardi-Goutières syndrome (AGS), particularly its contextualization within a putative type I interferonopathy framework, already exist. However, recent reports of attempts at treatment suggest that an assessment of the field from a therapeutic perspective is warranted at this time. Here, we briefly summarize the neurological phenotypes associated with mutations in the seven genes so far associated with AGS, rehearse current knowledge of the pathology as it relates to possible treatment approaches, critically appraise the potential utility of therapies, and discuss the challenges in assessing clinical efficacy. WHAT THIS PAPER ADDS: Progress in understanding AGS disease pathogenesis has led to the first attempts at targeted treatment. Further rational therapies are expected to become available in the short- to medium-term. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 13-day-old newborn who developed adrenal crisis due to delayed diagnosis. Topics covered include the impairment of cortisol synthesis by congenital adrenal hyperplasia (CAH) disorders, the indication of hyponatremia and hypekalemia in the infant's blood sample, and the infant's treatment with hydrocortisone and fludrocortisone. Also noted is the effectiveness of newborn screening programs for preventing adrenal crises in infants with CAH.

Background: The clinical diagnosis of manifest Huntington's disease (HD) relies on a high level of clinical confidence (99% confidence) of HD‐consistent motor signs. Longitudinal data have reliably identified cognitive and behavioral dysfunction predating clinical motor diagnosis by up to 15 years. Reliance on motor signs to establish a diagnosis of HD increases risk of early misdiagnosis or delayed diagnosis. Clinical neuropsychologists are uniquely positioned to advise on the clinical application of the Movement Disorder Society Task Force's recently proposed non‐motor diagnostic criteria for HD. Objectives: To provide (1) a recommended clinical approach toward non‐motor diagnostic criteria in persons with HD and facilitation of accurate diagnosis; (2) recommended practices for medical treatment providers to screen and longitudinally monitor non‐motor signs of HD. Methods: The Huntington Study Group re‐established the Neuropsychology Working Group, then recruited a multi‐disciplinary group of neuropsychologists, neurologists, and psychiatrists to conduct an unstructured literature review and discuss expert opinions on practice, to facilitate an informal consensus opinion to accomplish the objectives. Results: The opinion and an example protocol for medical treatment providers to screen, monitor, and triage non‐motor signs and symptoms of Huntington's disease is provided. Conclusions: Clinical diagnosis of non‐motor HD is empirically justified and clinically important. Screening and triage by non‐neuropsychologist clinicians can aid in detecting and monitoring non‐motor Huntington's disease manifestation. The Neuropsychology Working Group consensus advances good clinical practice, clinical research, and quality of life. A companion position paper presenting the details of our consensus opinion regarding evidence‐based guidelines for neuropsychological practice is forthcoming. [ABSTRACT FROM AUTHOR]

Objective: This paper describes a pilot study, in a small sample of older adults, designed to ascertain the feasibility, acceptability and potential effectiveness of group Cognitive Behavioural Therapy For Insomnia (CBT‐I). Methods: Eleven older adults participated in a 3‐week group CBT‐I intervention with pre‐ and post‐intervention outcome measures of sleep and fatigue. Acceptability was measured via post‐intervention focus groups. Feasibility was measured via recruitment, retention and completion data. Subjective sleep outcomes were measured pre‐ and post‐intervention using the Pittsburgh Sleep Quality Index. Fatigue was measured using the Fatigue Severity Index. Objective sleep outcome measures were obtained via pre‐ and post‐intervention wrist actigraphy. Results: Feasibility and acceptability were confirmed in the pilot study. Retention and completion levels were high, with participants largely positive in the focus group feedback. Preliminary sleep outcome data supported the potential effectiveness of the intervention in significantly improving several measures of sleep and fatigue including a three‐point reduction in the Global PSQI scores, an increase in total sleep time of almost an hour per night and these results were mirrored by a significant reduction of nine points in the overall measure of fatigue severity. Conclusions: A group CBT‐I intervention is a low‐cost, low‐risk intervention which improves subjective and objective measures of sleep in older adults. These positive sleep outcomes are translated into significantly decreased levels of fatigue. Future research should focus on a larger sample size with a randomised controlled trial design. [ABSTRACT FROM AUTHOR]

Most rare diseases have no approved treatments available, and doctors often prescribe existing drugs for "off‐label" use in the sense that a drug is prescribed for a medical condition that is different from the original condition approved by regulatory authorities. To develop approved treatments for rare diseases quickly without starting from scratch, governments have introduced different subsidy programs to entice pharmaceutical companies to exert extra efforts to "convert" certain drugs from off‐label to "on‐label" use. However, the impact of this subsidized conversion strategy on patient welfare remains unclear because both efficacy and price can change once a drug is converted from off‐label to on‐label use. This paper represents an initial attempt to investigate the effectiveness of different types of government subsidies (e.g., offer subsidies to manufacturers, patients, or both) for improving patient welfare through the drug conversion strategy. We present a three‐stage Stackelberg game‐theoretic model that captures the interactions among the government, manufacturer, and patients, and determine whether it is optimal to subsidize the manufacturer, patients, or both. We identify requisite (market and subsidy) conditions for a manufacturer to convert a drug from off‐label to on‐label use. We also determine the optimal extra development effort to convert an off‐label drug, and the optimal unit selling price for the on‐label drug after conversion. Contrary to the generally held public opinions, our analysis reveals that subsidizing pharmaceutical manufacturers is more effective than subsidizing patients. This result implies that subsidies offered to manufacturers would incentivize higher conversion efforts, and subsequently increase the expected patient welfare. Furthermore, we show that this result continues to hold even when the patients are risk‐averse or on‐label market size is uncertain. Our numerical analysis on the drugs Aralen, Humira, Revlimid, and Zostex reveals that government subsidies are necessary for enticing conversion from off‐label to on‐label use. [ABSTRACT FROM AUTHOR]

Transplantation is a high‐risk, high‐cost treatment for end‐stage diseases and is the most strictly regulated area of healthcare in the United States. Thus, achieving success for patients and the program requires skillful and collaborative leadership. Various factors, such as outcomes, volume, and financial health, may measure the success of a transplant program. Strong collaboration between clinical and administrative leaders is key to achieving and maintaining success in those three categories. Clinical leaders of adult programs, such as medical and surgical directors, bear the primary responsibility for a program's volume, outcomes, and patient safety, while administrative directors are focused on business intelligence and regulatory compliance. This paper aims to provide readers with insights into the critical role of collaborative leadership in running a successful program, with a focus on clinical, business, and regulatory perspectives. [ABSTRACT FROM AUTHOR]

Introduction: Hereditary factor X deficiency is a rare bleeding disorder, with limited treatment options. This paper describes the approach to pre‐clinical development and characterization of a high‐purity plasma‐derived factor X concentrate, to achieve orphan drug marketing authorization for the treatment of hereditary factor X deficiency. Methods: A chromatographic process was developed, to purify factor X from human plasma for fractionation. The product was characterized using in vitro, in vivo and ex vivo tests for potency, purity, thrombogenicity, immunogenicity, toxicity and stability. Results: The production process complied with good pharmaceutical manufacturing practice. It achieved 6000‐fold purification and 100‐fold concentration of the factor X protein compared to human plasma. The factor X protein was 94%–96% pure. Other residual plasma proteins were well below levels in plasma, minimizing potential interference in hemostasis after therapeutic administration. Effective virus‐reduction during manufacture, and the absence of thrombogenicity, toxicity and immunogenic potential were confirmed, addressing the main safety concerns historically associated with plasma‐derived therapeutics. The freeze‐dried product remained stable between +2°C and +30°C for at least three years. After reconstitution with water for injections, the factor X activity was maintained for at least 48 h at +18°C to +22°C. Conclusion: Targeted pre‐clinical development of the first highly‐purified concentrate to treat hereditary factor X deficiency is described. Following international guidelines for nonclinical safety testing, particular strategies were adopted for unmodified products derived from human blood plasma. This approach may also be relevant to the development of other ultra‐orphan medicinal products. [ABSTRACT FROM AUTHOR]

This paper presents findings from a qualitative study that explored children's and families' experiences of alternative care in Thailand. The study used arts‐based methods to engage 160 children living in a range of care settings. This included government and NGO‐run residential care settings (RCS), children's villages, Buddhist temples, migrant learning centres and foster care homes. Interviews were also conducted with 20 parents/guardians who had placed their children in care. Findings show that despite the alternative care system presenting significant challenges, the participants revealed how they strived to preserve their family connections, and how they are 'doing family' in adversity. [ABSTRACT FROM AUTHOR]

Pneumatosis intestinalis (PI) is a rare complication after thoracic organ transplantation. There are several theories for explaining the pathophysiology of this disease. In this paper, we highlight three cases of PI in a single pediatric center, one after lung transplantation and two after heart transplantation. Although the presentations differed, all cases improved with non‐surgical therapies. There are not many articles in the pediatric literature about post‐transplantation PI, and there are still many questions regarding the incidence, etiology, and treatment for this disease. [ABSTRACT FROM AUTHOR]

Objectives: SlowMo therapy is a pioneering blended digital therapy for paranoia, augmenting face‐to‐face therapy with an interactive 'webapp' and a mobile app. A recent large‐scale trial demonstrated small–moderate effects on paranoia alongside improvements in self‐esteem, worry, well‐being and quality of life. This paper provides a comprehensive account of therapy personalisation within this targeted approach. Design: Case examples illustrate therapy delivery and descriptive data are presented on personalised thought content. Method: Thought content was extracted from the webapp (n = 140 participants) and coded using newly devised categories: Worries: (1) Persecutory, (2) Negative social evaluation, (3) Negative self‐concept, (4) Loss/life stresses, (5) Sensory‐perceptual experiences and (6) Health anxieties. Safer thoughts: (1) Safer alternative (specific alternatives to worries), (2) Second‐wave (generalised) coping, (3) Positive self‐concept, (4) Positive activities and (5) Third‐wave (mindfulness‐based) coping. Data on therapy fidelity are also presented. Results: Worries: 'Persecutory' (92.9% of people) and 'Negative social evaluation' (74.3%) were most common. 'General worries/ life stresses' (31.4%) and 'Negative self‐concept' (22.1%) were present in a significant minority; 'Health anxieties' (10%) and 'Sensory‐perceptual' (10%) were less common. Safer thoughts: 'Second‐wave (general) coping' (85%), 'Safer alternatives' (76.4%), 'Positive self‐concept' (65.7%) and 'Positive activities' (64.3%) were common with 'Third‐wave' (mindfulness) coping observed for 30%. Fidelity: Only three therapy withdrawals were therapy related. Session adherence was excellent (mean = 15.2/16; SD = 0.9). Behavioural work was conducted with 71% of people (119/168). Conclusion: SlowMo therapy delivers a targeted yet personalised approach. Potential mechanisms of action extend beyond reasoning. Implications for cognitive models of paranoia and causal interventionist approaches are discussed. [ABSTRACT FROM AUTHOR]

The stimuli‐responsiveness of injectable hydrogel has been drastically developed for the controlled release of drugs and has achieved encouraging curative effects in a variety of diseases including wounds, cardiovascular diseases, and tumors. The gelation, swelling, and degradation of such hydrogels respond to endogenous biochemical factors (such as pH, reactive oxygen species, glutathione, enzymes, glucose) and/or to exogenous physical stimulations (like light, magnetism, electricity, and ultrasound), thereby accurately releasing loaded drugs in response to specifically pathological status and as desired for treatment plan, and thus improving therapeutic efficacy effectively. This paper gives a detailed introduction of recent progresses in responsive injectable hydrogels and focuses on the design strategy of various stimuli‐sensitivities and their resultant alteration of gel dissociation and drug liberation behavior. Their application in disease treatment is also discussed. [ABSTRACT FROM AUTHOR]

COVID-19, ataxia, myoclonus, SARS CoV-2 References 1 Godani M, Beronio A, Lanza G. Post-COVID-19 myoclonus-ataxia syndrome responsive to intravenous immunoglobulins. Keywords: COVID-19; SARS CoV-2; ataxia; myoclonus EN COVID-19 SARS CoV-2 ataxia myoclonus 724 725 2 04/18/23 20230401 NES 230401 We have read with interest the case report on post-COVID-19 myoclonus-ataxia syndrome responsive to intravenous immunoglobulins (IVIG).[1] In recent months, post COVID-19 motor complications have been described in several papers. [Extracted from the article]

There are two main modes of replacement therapy for haemophilia patients: either to stop bleeding (on-demand) or regular infusions of clotting factor to prevent bleeds (prophylaxis). Fifty yr of clinical experience have provided evidence of the superiority of prophylaxis by showing a reduction in bleeds and development of arthropathy. Prophylaxis has been described extensively in terms of efficacy and health-economic aspects; however, on-demand treatment has received less attention. The aim of this study was to critically review the published literature on PubMed and discuss potential gaps of knowledge in on-demand treatment in persons with severe haemophilia without inhibitors by focusing on two key aspects: how on-demand treatment is provided and what outcome measures have been reported. We identified 134 papers of which 112 were excluded. Of the remaining 22 papers, 16 were comparative studies between prophylaxis and on-demand treatment and six were descriptions of on-demand treatment. The results showed limited reporting on data related to the key aspects of treatment on-demand. Early studies looked at degrees of joint bleeds and different treatment regimens in finding the optimal dose. However, from the late 1980s, there was almost no research into on-demand therapy except efficacy and safety studies of new rFVIII products and studies to prove superiority of prophylaxis over treatment on-demand. The success of on-demand therapy may depend on several factors, for example time to initial dose after a bleed and duration of treatment. Data on these key factors are limited and highlight the necessity of research to optimise replacement therapy. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005. Materials and Methods An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed. Results The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years. Conclusions Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years. [ABSTRACT FROM AUTHOR]

Contemporary psychoanalysis views the countertransference as equally important to the therapeutic endeavour as its counterpart, the transference. This paper focuses on a particular kind of countertransference phenomena: those which are bodily in form and perceivable to the patient. It begins with a brief rehearsal of some of the fundamental psychoanalytic principles related to bodily symptoms, and then reviews the developments and changes that have occurred in the understanding of the concept of countertransference. The focus then shifts to theoretical developments around somatic countertransference in particular, and the division seen in the literature between authors who locate the source of the phenomenon of somatic countertransference in the patient's unconscious, and those who locate it in the therapist. The paper will argue that exploring the uniqueness and specificity of the therapeutic dyad will reveal important information about the dynamics at work in the therapy. A clinical example illustrates the specificity of the form that a somatic countertransference takes in a particular therapy. It then proposes that in order to make sense of the rich information that this unique response provides, the therapist must mentalize and make meaning of her particular somatic experience by way of a therapeutic analysis of reverie. [ABSTRACT FROM AUTHOR]

Aim Aim was to systematically review behavioural aspects in the prevention and control of dental caries and periodontal diseases at individual and population level. Material & Methods With regard to caries, MEDLINE/PubMed was searched on three subheadings focusing on early childhood, proximal and root caries. For periodontal diseases, a meta-review on systematic reviews was performed; thus, the search strategy included specific interventions to change behaviour in order to perform a meta-review on systematic reviews. After extraction of data and conclusions, the potential risk of bias was estimated and the emerging evidence was graded. Results Regarding early childhood, proximal and root caries, 28, 6 and 0 papers, respectively, could be included, which predominantly reported on cohort studies. Regarding periodontal diseases, five systematic reviews were included. High evidence of mostly high magnitude was retrieved for behavioural interventions in early childhood caries ( ECC), weak evidence for a small effect in proximal caries and an unclear effect of specific informational/motivational programmes on prevention of periodontal diseases and no evidence of root caries. Conclusion Early childhood caries can be successfully prevented by population-based preventive programmes via aiming at the change in behaviour. The effect of individual specific motivational/informational interventions has not yet been clearly demonstrated neither for the prevention of caries nor for periodontal diseases. [ABSTRACT FROM AUTHOR]

This systematic review presents the oral manifestations of paediatric Crohn's disease. Our review of 28 papers published from 2000 to 2015 showed that the prevalence of oral manifestations was 10-80%. Specific symptoms included mucosal tags, swelling of the lips, cheeks and gingiva, and cobblestoning mucosa. Nonspecific symptoms included aphthous-like ulcers, angular cheilitis, lip fissuring and gingivitis.Conclusion: The oral manifestations of Crohn's disease might precede intestinal inflammation or coincide with it. Crohn's disease should be considered in children with multiple oral manifestations and paediatric dentists, and gastroenterologists should be involved in their coordinated evaluation and follow-up. [ABSTRACT FROM AUTHOR]

publisher‐imprint‐name Springer volume‐issue‐count 1 issue‐article‐count 46 issue‐toc‐levels 0 issue‐pricelist‐year 2016 issue‐copyright‐holder The Author(s) issue‐copyright‐year 2016 article‐contains‐esm No article‐numbering‐style Unnumbered article‐registration‐date‐year 2016 article‐registration‐date‐month 9 article‐registration‐date‐day 17 article‐toc‐levels 0 toc‐levels 0 volume‐type Regular journal‐product ArchiveJournal numbering‐style Unnumbered article‐grants‐type OpenChoice metadata‐grant OpenAccess abstract‐grant OpenAccess bodypdf‐grant OpenAccess bodyhtml‐grant OpenAccess bibliography‐grant OpenAccess esm‐grant OpenAccess online‐first false pdf‐file‐reference BodyRef/PDF/40169_2016_Article_121.pdf target‐type OnlinePDF issue‐type Regular article‐type OriginalPaper journal‐subject‐primary Medicine & Public Health journal‐subject‐secondary Medicine/Public Health, general journal‐subject‐collection Medicine --> Background: We conducted a clinical study that tested the effect of suppressive treatment with the botanical product Gene‐Eden‐VIR/Novirin on genital herpes. Our previous paper showed that the treatment decreased the number of genital herpes outbreaks without any side effects. It also showed that the clinical effects of Gene‐Eden‐VIR/Novirin are mostly better than those reported in the studies that tested acyclovir, valacyclovir, and famciclovir. The current paper reports the effect of suppressive treatment with Gene‐Eden‐VIR/Novirin on the duration of outbreaks, in severe and mild genital herpes cases. Methods: The framework was a retrospective chart review. The population included 137 participants. The treatment was 1–4 capsules per day. The duration of treatment was 2–48 months. The study included three controls: baseline, no‐treatment, and dose–response. Results: The treatment decreased the duration of outbreaks in 87 % of participants and decreased the mean duration of outbreaks from 8.77 days and 6.7 days in the control groups to 2.87 days in the treatment group (P < 0.001, both groups). All participants reported no adverse experiences. Conclusions: This paper shows that suppressive treatment with Gene‐Eden‐VIR/Novirin decreased the duration of genital herpes outbreaks, in both severe and mild cases, without any side effects. Based on the results reported in this and our previous paper, we recommend suppressive treatment with Gene‐Eden‐VIR/Novirin as a natural alternative to both suppressive and episodic treatments with current drugs, in both severe and mild genital herpes cases. Trial registration ClinicalTrials.gov NCT02715752 Registered 17 March 2016 Retrospectively Registered [ABSTRACT FROM AUTHOR]

Objective: To systematically review literature reporting interventions for weight change following paediatric acquired brain injury (ABI).Method: A systematic search of the literature was conducted using advanced search techniques. The retrieval identified 1562 papers, of which 30 were relevant. The total number of paediatric participants was 759.Results: There is a paucity of higher quality evidence to support the use of weight change interventions following paediatric ABI. Substantial variation in screening, outcome measures, intervention, and reporting were demonstrated. Some support was found for the use of hypothalamic-sparing surgery as a method to prevent obesity following craniopharyngioma resection.Interpretation: There is a need for further study in this area to inform clinical and research practice; recommendations are given. [ABSTRACT FROM AUTHOR]

A new method to improve the interface of A‐Si and SiNx in A‐Si TFT process, the influence of H content in PECVD system equipment and the A‐Si remain to image sticking are studied in the paper. The suitable NH3 plasma pretreatment power and time or A‐Si remain can decease the leakage current and to overcome the image sticking in four‐mask process [ABSTRACT FROM AUTHOR]

The article discusses studies that led to the conceptual shift regarding periodontitis as an inflammatory disease caused by bacteria. Topics addressed include a 1976 paper on the disease's pathogenesis, the search for periodontitis' immune-inflammatory nature in the 1970s and 1980s, and studies on how tetracyclines inhibit the breakdown of connective tissue by non-antimicrobial mechanisms. Also mentioned are the use of anti-inflammatory therapy and causes of chronic inflammation.

Undergraduate research is an important component of a B.Tech. Biotechnology program. In the present study, a customizable approach designed with open‐source bioinformatics tools and databases was introduced to predict siRNAs for ZIKV therapeutics. With minimal prior exposure to bioinformatics, this workflow can be executed with detailed steps as demonstrated in this paper. All software, databases, and servers used in this research are open‐source, allowing this project‐based learning methodology to be implemented remotely as well. The workflow designed in the present study is flexible and customizable according to the mentor and student's requirements. [ABSTRACT FROM AUTHOR]

Background: Young adults with long‐term conditions can struggle to accept their diagnosis and can become overwhelmed with managing their condition. Suboptimal transfer from paediatric to adult services with a resultant disengagement with the service can result in less involvement in care and decision‐making. Shared decision‐making can improve involvement in health decisions and increase satisfaction with treatment/therapy and care. Objectives: An integrative literature review was conducted to explore and understand young adults' experiences of decision‐making in health care. Design: An integrative literature review. Data Sources: CINAHL, EMCARE, PsycINFO, HMIC, EMBASE, Web of Science, PubMed, MEDLINE, EBSCOHOST and COCHRANE databases were searched for relevant literature published between January 1999 and January 2020. Findings: Thirteen primary research papers met the inclusion criteria. Four main themes were identified: (1) Information delivery and communication; (2) participation in decision‐making; (3) social factors influencing decision‐making and (4) emotional impact of decision‐making. Conclusions: Young adults with long‐term conditions have specific decision‐making needs which can impact their emotional health. Research with a specific focus on young adults' experiences of decision‐making in health care is needed. [ABSTRACT FROM AUTHOR]

Lycium barbarum have received an increasing popularity due to its powerful biological activity and medicinal use. However, the effect of Lycium barbarum on skin remains largely uncharacterized. The general purpose of this paper was to characterize the phenolic compounds in Lycium barbarum extract (LBE) using LC‐HRMS/QTOF method and to investigate whether topical administration of LBE can repair skin barrier dysfunction in mice. Our data demonstrated that LBE could not only decrease ROS level and matrix metalloproteinase expression, but also strengthen intrinsic antioxidant defense system including SOD, GSH‐Px and CAT, thereby resulting in increased skin collagen content and an improvement of UV‐induced skin erythema, thickness and wrinkles. Improved skin barrier functions were highly correlated with increased expression of filaggrin, involucrin and loricrin as well as antioxidant proteins such as Nrf2 and HO‐1 in UV‐irradiated mice, suggesting that LBE may be promising natural products at a lower cost for the topical application in the treatment of skin diseases with defective barrier function. [ABSTRACT FROM AUTHOR]

Background: National UK guidance makes recommendations for speech and language therapy staffing levels in critical care and rehabilitation settings. Traumatic spinal cord injury patients often require admission primarily to critical care services within a major trauma centre prior to transfer to a specialist spinal injury unit but may not receive similar levels of care. Dysphagia and communication difficulties are recognised features of cervical spinal cord injury; however, little is known about access to speech and language therapy services to provide rehabilitation and improve outcomes. Aims: The aim of this study was to compare the workforce and clinical practices of speech and language therapy services in eight spinal injury units and four major trauma centres in England through an online survey. Methods & Procedures: An online survey was created with 26 multiple‐choice questions across seven sub‐sections, with options for free‐text comments. These were sent to a named speech and language therapy contact at each of the specified units. Responses were uploaded into Excel for analyses, which included descriptive statistics and analysis of themes. Outcomes & Results: Responses were received from 92% (11/12) speech and language therapy services invited, which included seven out of eight spinal injury units and all four major trauma centres. No units met national staffing recommendations. Staff in spinal injury units provided an average of 27 h per week input to the unit compared to 80 h in a major trauma centre. Despite caseload variations, speech and language range of therapy involvement and prioritisation process were equivalent. Access to instrumental assessment varied, with less use of Fibreoptic Endoscopic Evaluation of Swallowing in spinal injury units despite its clinical value to the spinal cord injury caseload. Conclusions & Implications: Speech and language therapy services delivering post‐acute and long‐term rehabilitation to spinal cord injury patients are limited by their resources and capacity, which restricts the level of therapy delivered to patients. This may have an impact on clinical outcomes for communication and swallowing impairments. Further evidence is needed of the interventions delivered by speech and language therapists and outcomes will be beneficial alongside benchmarking similar services. What this paper adds: What is already known on this subject: In England, people who sustain a spinal cord injury are admitted to a major trauma centre prior to transfer to a specialist spinal injury unit. Dysphagia and communication impairments are recognised as a complication of cervical spinal cord injury and benefit from speech and language therapy intervention. National recommendations exist for staffing levels, expertise and competencies for speech and language therapists working in critical care and rehabilitation units. What this study adds: This study identified variations in the levels of speech and language therapy staffing, seniority, service delivery and access to instrumental assessments for dysphagia between major trauma centres and spinal injury units. None of the services complied with national staffing recommendations. Clinical implications of this study: Speech and language therapy services in spinal injury units are often available part‐time or have limited access to diagnostic tools which limits the range and intensity of rehabilitation input available. This has clinical implications for outcomes for swallowing and communication as well as long‐term consequences for integrating back into community. [ABSTRACT FROM AUTHOR]

The randomized controlled trial (RCT) is the gold standard for evaluating the causal effects of medications. Limitations of RCTs have led to increasing interest in using real‐world evidence (RWE) to augment RCT evidence and inform decision making on medications. Although RWE can be either randomized or nonrandomized, nonrandomized RWE can capitalize on the recent proliferation of large healthcare databases and can often answer questions that cannot be answered in randomized studies due to resource constraints. However, the results of nonrandomized studies are much more likely to be impacted by confounding bias, and the existence of unmeasured confounders can never be completely ruled out. Furthermore, nonrandomized studies require more complex design considerations which can sometimes result in design‐related biases. We discuss questions that can help investigators or evidence consumers evaluate the potential impact of confounding or other biases on their findings: Does the design emulate a hypothetical randomized trial design? Is the comparator or control condition appropriate? Does the primary analysis adjust for measured confounders? Do sensitivity analyses quantify the potential impact of residual confounding? Are methods open to inspection and (if possible) replication? Designing a high‐quality nonrandomized study of medications remains challenging and requires broad expertise across a range of disciplines, including relevant clinical areas, epidemiology, and biostatistics. The questions posed in this paper provide a guiding framework for assessing the credibility of nonrandomized RWE and could be applied across many clinical questions. [ABSTRACT FROM AUTHOR]

This paper describes the work of Armando Bianco Ferrari whose central tenet is the very direct relationship between the body ( Concrete Original Object) and the mind to which it gives rise, but which is also mind's first and essentially only real object. Ferrari's approach offers an important avenue of approach to the treatment of psychosis, psychosomatic illness and anorexia, for instance, as is recorded in a by now growing Anglophone literature. The direct relationship between body and mind is in contrast to the object relations model in which this relationship is mediated through the breast. The paper starts with a short biological sketch of Ferrari's life before describing his theoretical position. This is largely concerned with the relationship between the mind and its body, the so-called 'vertical axis', and that with the external world which he calls, the 'horizontal axis'. The relationship between body and mind is achieved through the means of a 'contact net' (as opposed to Bion's contact barrier) and the evolution of 'language registers' out of patterns of bodily experience. Ferrari's formulation also involves modifications of the ways he conceives the ego and the oedipal situation (' Oedipal constellation'), especially in the light of what he takes to be an innate femininity and masculinity in either sex, as well as the way in which he frames ideas about health and illness. The fact that the emphasis is directed towards the subject's direct apperception of the sensational and emotional life of his body rather than one mediated exclusively via the object involves a parallel shift away from the transference as always necessarily central to interpretation, without of course dispensing with it or suggesting that it is not ubiquitous. This is one of the various clinical implications of Ferrari's model which is discussed before offering an illustrative clinical vignette, and finally relating Ferrari's thought to some other current theoretical and clinical formulations. [ABSTRACT FROM AUTHOR]

In the dental profession, the belief that bruxism and dental (mal-)occlusion ('the bite') are causally related is widespread. The aim of this review was to critically assess the available literature on this topic. A PubMed search of the English-language literature, using the query 'Bruxism [Majr] AND (Dental Occlusion [Majr] OR Malocclusion [Majr])', yielded 93 articles, of which 46 papers were finally included in the present review*. Part of the included publications dealt with the possible associations between bruxism and aspects of occlusion, from which it was concluded that neither for occlusal interferences nor for factors related to the anatomy of the oro-facial skeleton, there is any evidence available that they are involved in the aetiology of bruxism. Instead, there is a growing awareness of other factors (viz. psychosocial and behavioural ones) being important in the aetiology of bruxism. Another part of the included papers assessed the possible mediating role of occlusion between bruxism and its purported consequences (e.g. tooth wear, loss of periodontal tissues, and temporomandibular pain and dysfunction). Even though most dentists agree that bruxism may have several adverse effects on the masticatory system, for none of these purported adverse effects, evidence for a mediating role of occlusion and articulation has been found to date. Hence, based on this review, it should be concluded that to date, there is no evidence whatsoever for a causal relationship between bruxism and the bite. [ABSTRACT FROM AUTHOR]

This article serves as an introduction to this third version of research reviews of couple and family therapy (CFT) that have appeared in this journal beginning in 1995. It also presents a methodological and substantive overview of research in couple and family therapy from about 2001/2002 to 2010/2011 (the period covered in this issue), while also making connections with previous research. The article introduces quantitative research reviews of family-based intervention research that appear in this issue on 10 substantive areas including conduct disorder/delinquency, drug abuse, childhood and adolescent disorders (not including the aforementioned), family psycho-education for major mental illness, alcoholism, couple distress, relationship education, affective disorders, interpersonal violence, and chronic illness. The paper also introduces the first qualitative research paper in this series, as well as a paper that highlights current methodologies in meta-analysis. The first part of this article rates the 10 content areas on 12 dimensions of methodological strength for quantitative research and makes generalizations about the state of quantitative methodology in CFT. The latter part of the papers summarizes and makes comments on the substantive findings in the 12 papers in this issue, as well as on the field as a whole. [ABSTRACT FROM AUTHOR]

This article serves as an introduction to the special issue on Identification, Classification, and Treatment of Reading and Language Disabilities in Spanish‐speaking English Learners. The article explains the driving forces behind the need for the special issue, the global nature of linguistic diversity, and provides an overview of the five papers that comprise the special issue. [ABSTRACT FROM AUTHOR]

With the rising popularity of field experiments in economics, re‐randomization schemes have emerged as tools to induce balance in observable variables across treatment groups. However, re‐randomization is not fully understood and the methodologies to estimate its effects on the distribution of parameters are still under‐developed. This paper helps to close that gap by suggesting an asymptotically normal re‐randomization scheme and bootstrapping procedure to carry inference under a wide range of estimators and re‐randomization schemes. [ABSTRACT FROM AUTHOR]

This study focuses on the intrahospital routing of phlebotomists at the University of Iowa Hospitals and Clinics (UIHC). Phlebotomists are responsible for drawing specimens from patients based on doctors' orders. The results of the analysis of these specimens play an important role in determining patient treatment. However, the demand for phlebotomists is likely to outpace supply over the next few years. Therefore, it is important to improve the efficiency of phlebotomists. In this paper, we formulate the phlebotomist intrahospital routing problem as a team orienteering problem with stochastic rewards and service times. The rewards and service times are particularly interesting as they are the result of a queueing process. We present an a priori solution approach and derive a method for efficiently sampling the value of a solution, a value that cannot be determined analytically. Finally, we demonstrate that our proposed approach outperforms the current practice at UIHC. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma is a benign vascular proliferation of the skin and mucous membranes, whose pathogenesis is not fully understood. Despite its benign nature, it can have a significant negative impact on patients' quality of life, and therefore appropriate therapy is needed. Over the years, a lot of therapeutic modalities have been used in order to successfully treat this condition. This paper is an updated systematic overview of all the reported successful treatments described in the literature and was conducted according to the PRISMA guidelines for systematic reviews. Articles derived from the databases PubMed, EMBASE, and SCOPUS, published between 1981 and 2018, were analyzed for this study. In the literature, there are several studies, case series, and case reports that demonstrate encouraging results with the use of various methods, such as surgical intervention or laser treatment, but also with more conservative approaches, including the application of topical and systemic agents. The selection of the appropriate treatment should be made individually, depending on severity of the disease and patient characteristics. Both research efforts as well as clinical reporting are necessary in order to provide more insight on the management of these vascular tumors. This paper aims to provide a summarized update on the reported therapies and to raise awareness for the need to conduct larger systematic studies in order to adequately evaluate and compare the effectiveness of the presented therapeutic strategies. [ABSTRACT FROM AUTHOR]

The article focuses on a research which aims to evaluate the efficacy of bendamustine, dexamethasone and thalidomide in relapsed or refractory multiple myeloma patients following lenalidomide and bortezomib therapy or who were ineligible to receive such drugs as measured by the rate of response in terms of overall response rate. It also aims to assess the tolerability and toxicity and evaluate the time to treatment failure, overall survival, and disease-free survival.

The article offers an overview of research paper that discussed the women-focused topics including the epidemiology of alcohol use among women, health and behavioral consequences of drinking, prenatal alcohol use and interventions, and enhanced alcohol treatment services. It also mentions the objectives of research to examine the harmful physiological and behavioral effects of alcohol in women.

Background: Many people with aphasia have word‐finding difficulties, with some showing particular difficulties with verbs. Picture‐naming therapy is often used to improve naming, but gains are usually limited to therapy items and do not transfer to conversation. Therapy where words are produced in sentences and in real‐life activities may be more effective. Aims: The current pilot study investigated whether an activity‐oriented therapy approach would be accepted and viable if implemented in a community setting, and whether communicating whilst cooking was more beneficial than using paper‐based activities. If successful, it would be expected that verb production would improve in structured and unstructured tasks in both naming and narrative tasks. Methods & Procedures: The study employed a case‐series repeated‐measures design, with testing of treated and control items. Seven adults with anomia participated, although only five completed the full programme. Participants were divided into two groups and each group completed both treatments, but in different orders. Each treatment was employed for six 2‐h sessions over a 3‐week period. Outcomes & Results: Naming of both treated and untreated verbs showed a statistically significant improvement following both treatments and this continued into the maintenance phase. There was a numerical but not statistically significant gain in the variety of verbs used in spoken narratives. Participants predominantly chose positive terms to describe their experience of the programme, but did not prefer one therapy over the other. Conclusions & Implications: Preliminary findings suggest that an activity‐oriented therapy approach, whether it involves carrying out tasks or paper‐based activities, can result in clinically meaningful improvements for people with chronic aphasia. Further research using a randomized control trial is required to determine whether cooking therapy alone is effective. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that cognitive behavioural therapy (CBT) can be effective for people with intellectual disabilities. The aim of this review was to report the nature and frequency of adaptations reported in studies of CBT for people with intellectual disabilities. Method: This review updated and extended a previous review by (Whitehouse et al. 2006, J Appl Res Intellect Disabil, 19, 55), which used a framework of adaptations developed by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Adaptations included simplification, language, activities, developmental level, use of directive style, flexible methods, involve caregivers, transference/countertransference and disability/rehabilitation approaches. A search identified peer‐reviewed papers that reported individual CBT informed psychological interventions for people with an Intellectual Disability. Results: The search identified 23 studies which met the inclusion criteria for review. Studies reported the majority of the categories of adaptation described by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Conclusions: The results suggest that the framework of adaptations needs further development to increase sensitivity in identifying and categorizing adaptations of CBT. Increased, systematic reporting of adaptations to studies of CBT with people with intellectual disabilities is recommended. [ABSTRACT FROM AUTHOR]

Objectives: To review the effectiveness of antiseptic oral sprays on oral health. Methods and materials: Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included. Results: Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta‐analyses. A meta‐analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: −1.03 to −0.45) and 0.22 (95% CI: −0.38 to −0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta‐analysis demonstrated an increase of 0.18 (95% CI: −0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta‐analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta‐analysis, eight studies reported significant improvements in PI and GI scores. Conclusions: Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high‐quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health. [ABSTRACT FROM AUTHOR]

Background: Cerebral gas embolism is a complication of several medical procedures and occurs when gas enters the cerebral circulation. Knowledge about etiology and outcome in affected patients is limited, and prospective trials on management and treatment are hardly feasible. Case reports are therefore an important source of information.Methods: A systematic literature search was conducted in June 2016 and May 2018, supplemented by a manual search. Titles and abstracts were systematically assessed for eligibility, followed by full-text screening for included papers. Screening and data extraction were performed independently by two researchers. Cases of cerebral gas embolism due to any iatrogenic cause were included. Criteria for exclusion were: animal studies, non-cerebral localization, extravascular gas only, and non-iatrogenic causes. 264 cases reported in 189 papers were included.Results: A broad range of procedures leading to iatrogenic cerebral gas embolism (ICGE) were identified and a comprehensive list is presented in this article. Procedures were mostly reported as conducted correctly, but procedure related error, patient activity, or defective equipment were also reported as causes. Neurological, neuropsychological, and cardiopulmonary symptoms were common. The diagnosis was frequently based on or confirmed by radiology, usually CT. Hyperbaric oxygen therapy was applied in a large number of cases.Conclusion: The reported causes, symptoms and signs, and outcomes of ICGE vary significantly, and awareness of the condition in the medical community is essential. A standardized method of reporting could facilitate higher quality research in the field. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Devroey et al. (2011) Online monitoring of flu in Belgium. Influenza and Other Respiratory Viruses 5(5), 351-356. Background The diagnosis and treatment of patients with the A(H1N1) pandemic flu caused some serious burden for general practitioners (GPs) in the summer and autumn of 2009. Objective The aim of this study was to track the incidence of influenza and influenza-like illness (ILI) in Belgium and to describe the characteristics of the affected patients. Methods In July 2009, the Belgian online influenza surveillance system (BOISS) was set up to monitor the spread of influenza and ILI. Registrations were made by 93 GPs from all 10 Belgian provinces who participated at least 1 week during the first 12 months of the registration. Only patients who met the WHO criteria for flu were recorded. Results In total, 1254 patients (53% men) with influenza or ILI were included. Mainly younger persons were affected: 43% was under the age of 20 years. A risk factor for influenza-related complications was determined in 19% of cases, mainly patients with chronic respiratory problems. A treatment with oseltamivir or zanamivir was prescribed in 13%, and 3% of the patients was admitted to a hospital. The time of the peak incidence (44th week) and the magnitude (623 cases per week per 100 000 inhabitants) corresponded with the figures of the existing paper-based registration network. The small sample size and possible reporting biases may have influenced the findings of the study. Conclusions The BOISS provides a good alternative to conduct surveillance activities for influenza and ILI in Belgium. It provides complementary information regarding ILI compared to the existing data capturing. [ABSTRACT FROM AUTHOR]

Background: Promotion of a healthy lifestyle for people with intellectual disabilities is important; however, the effectiveness of lifestyle change interventions is unclear. Aims: This research will examine the effectiveness of lifestyle change interventions for people with intellectual disabilities. Methods and Procedures: Randomized controlled trials (RCTs) of lifestyle change interventions for people with intellectual disabilities were included in a systematic review and meta‐analysis. Data on study and intervention characteristics were extracted, as well as data on outcome measures and results. Internal validity of the selected papers was assessed using the Cochrane Collaboration's risk bias tool. Outcomes and Results: Eight RCTs were included. Multiple outcome measures were used, whereby outcome measures targeting environmental factors and participation were lacking and personal outcome measures were mostly used by a single study. Risks of bias were found for all studies. Meta‐analysis showed some effectiveness for lifestyle change interventions, and a statistically significant decrease was found for waist circumference. Conclusion and Implications: Some effectiveness was found for lifestyle change interventions for people with intellectual disabilities. However, the effects were only statistically significant for waist circumference, so current lifestyle change interventions may not be optimally tailored to meet the needs of people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

This paper describes the evidence base for Dyadic Developmental Psychotherapy as an evidence-based, empirically validated, and effective family-therapy treatment for children with reactive attachment disorder and complex trauma. It is in response to a note by Mercer, Pennington, Pignotti, & Rosa. to our previous paper describing the evidence-base of Dyadic Developmental Psychotherapy. The paper summarizes the extensive empirical literature that describes the effectiveness of such dimensions of Dyadic Develop-mental Psychotherapy as affect arousal and regulation, gradual expo-sure to trauma, parent education and consultation, explaining how the past may be continuing to affect present behaviour, forming and maintaining a therapeutic relationship through therapist acceptance, affirmation, empathy and various other dimensions. The paper presents several generally accepted criteria for determining evidence-based practice and evidence-based treatment and demonstrates how Dyadic Developmental Psychotherapy meets those criteria. These criteria include those developed by Saunders et al., the UK National Health Services system, and the US Preventative Services Task Force system for ranking the quality of evidence. Finally, the paper responds to specific points raised by Mercer et al. indicating those with which we agree and those with which we disagree. [ABSTRACT FROM AUTHOR]