Clinical Outcomes of Metal-Ceramic versus Metal-Acrylic Resin Implant-Supported Fixed Complete Dental Prostheses: A Systematic Review and Meta-analysis.

PURPOSE: To compare the clinical outcomes of metal-ceramic vs metal-acrylic resin implant-supported fixed complete denture prostheses (IFCDPs). MATERIALS AND METHODS: An electronic literature database search was conducted in the CINAHL, EMBASE, PubMed, and Web of Science databases. Additionally, a manual search of the literature was performed. Studies conducted in edentulous human subjects comparing clinical outcomes of metal-acrylic resin IFCDPs to those of metal-ceramic IFCDPs were included if quantitative outcomes for the following variables were reported: implant failure, prosthetic failure, incidence of peri-implantitis, incidence of peri-implant mucositis, incidence of peri-implant mucosal recession, prosthetic complications, and any patient-centered outcomes. Data from included studies were pooled to estimate effect size. RESULTS: Five studies met the inclusion criteria. A quantitative analysis was possible for risk of implant failure, prosthesis failure, and incidence of peri-implantitis. Meta-analysis showed no statistically significant differences in the risk of implant or prosthesis failure between the two groups. However, meta-analysis showed a significantly greater risk of developing peri-implantitis at the implant level in the metal-acrylic group when compared to the metal-ceramic group (risk difference = 0.069; 95% CI = 0.028 to 0.06; P = .001; fixed-effects model). Furthermore, descriptive analysis of the literature indicated a higher incidence of other biologic complications such as peri-implant mucositis and peri-implant mucosal recession, as well as prosthetic complications such as abrasion and veneer fracture, in metal-acrylic resin IFCDPs compared to metal-ceramic IFCDPs. CONCLUSION: The available evidence suggests that a higher incidence of biologic and prosthetic complications, including a higher risk of peri-implantitis, are present with metal-acrylic resin IFCDPs compared to metal-ceramic IFCDPs.

Inpatient Care Team Views on Child Life Services: A Scoping Review.

CONTEXT: The utilization of Child Life Services is influenced by interprofessional collaboration and perceptions of other members of the medical team. OBJECTIVES: To summarize studies which address pediatric health care team perspectives on Child Life Services and their utilization in the hospital setting. DATA SOURCES: A comprehensive literature search was conducted with controlled vocabularies and key terms in MEDLINE, Embase, CINAHL, PsycInfo, and Web of Science. STUDY SELECTION: Primary studies published before November 2021 were screened using a predetermined set of inclusion and exclusion criteria. DATA CHARTING: Data charting was performed by 2 independent reviewers. Data extracted include baseline study characteristics, common themes, main outcomes, strengths, and limitations. Because this is not a systematic review, data from included studies was not quantitatively analyzed, but carefully summarized in the manner of a standard scoping review. RESULTS: Nine studies met criteria for inclusion. Common qualitative themes on certified child life specialists include: (1) their broad responsibilities, (2) their positive impact on patients and families, (3) challenges with interprofessional collaboration and integration, and (4) the value of educating others on their roles and responsibilities. CONCLUSIONS: Medical subject headings, controlled vocabulary, or other standardized subject headings that index literature on Child Life Services is limited. However, the existing body of literature supports the positive impact certified child life specialists have on patients and families, despite challenges with complete integration into the interdisciplinary care team. Additional research is required to fully understand and overcome these challenges in continued efforts to further drive patient and family-centered care.

Negative-Pressure Wound Therapy versus Standard Surgical Dressings after Malignant Tumor Resection: A Systematic Review and Meta-Analysis.

BACKGROUND: Negative-pressure wound therapy offers many advantages over standard surgical dressings in the treatment of open wounds, including accelerated wound healing, cost savings, and reduced complication rates. Although contraindicated by device manufacturers in malignancy-resected wounds because of hypothesized risk of tumor recurrence, negative-pressure wound therapy is still applied postoperatively because of limited clinical support. The authors performed a systematic review with meta-analysis to compare negative-pressure wound therapy outcomes with those of standard surgical dressings on open wounds, with their null hypothesis stating there would be no outcome differences. METHODS: A systematic review of the literature on negative-pressure wound therapy and standard surgical dressings on malignancy-resected wounds was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Embase, CINAHL, and Cochrane Central databases. Meta-analysis compared group outcomes, including malignancy recurrence, wound complication, and surgical site infection rates, with a random effects model. RESULTS: A total of 1634 studies were identified and 27 met eligibility criteria, including four randomized controlled trials, four prospective cohort studies, and 19 retrospective reviews. Eighty-one percent of articles ( n = 22) recommended negative-pressure wound therapy in malignancy-resected wounds. Meta-analysis determined that the treatment yielded significantly lower overall surgical site infection ( p = 0.004) and wound complication ( p = 0.01) rates than standard surgical dressings; however, there were no statistically significant differences found for other outcomes between the two groups. CONCLUSIONS: This review demonstrates favorable outcomes of negative-pressure wound therapy over standard surgical dressings for malignancy-resected wounds without an increased risk of malignancy recurrence. However, because limited randomized controlled trials (detailing only incisional wounds for limited malignancies and anatomic regions) are available, additional high-power randomized controlled trials are recommended.

Academic medicine's glass ceiling: Author's gender in top three medical research journals impacts probability of future publication success.

INTRODUCTION: In December 2017, Lancet called for gender inequality investigations. Holding other factors constant, trends over time for significant author (i.e., first, second, last or any of these authors) publications were examined for the three highest-impact medical research journals (i.e., New England Journal of Medicine [NEJM], Journal of the American Medical Association [JAMA], and Lancet). MATERIALS AND METHODS: Using randomly sampled 2002-2019 MEDLINE original publications (n = 1,080; 20/year/journal), significant author-based and publication-based characteristics were extracted. Gender assignment used internet-based biographies, pronouns, first names, and photographs. Adjusting for author-specific characteristics and multiple publications per author, generalized estimating equations tested for first, second, and last significant author gender disparities. RESULTS: Compared to 37.23% of 2002 - 2019 U.S. medical school full-time faculty that were women, women's first author publication rates (26.82% overall, 15.83% NEJM, 29.38% Lancet, and 35.39% JAMA; all p < 0.0001) were lower. No improvements over time occurred in women first authorship rates. Women first authors had lower Web of Science citation counts and co-authors/collaborating author counts, less frequently held M.D. or multiple doctoral-level degrees, less commonly published clinical trials or cardiovascular-related projects, but more commonly were North American-based and studied North American-based patients (all p < 0.05). Women second and last authors were similarly underrepresented. Compared to men, women first authors had lower multiple publication rates in these top journals (p < 0.001). Same gender first/last authors resulted in higher multiple publication rates within these top three journals (p < 0.001). DISCUSSION: Since 2002, this authorship "gender disparity chasm" has been tolerated across all these top medical research journals. Despite Lancet's 2017 call to arms, furthermore, the author-based gender disparities have not changed for these top medical research journals - even in recent times. Co-author gender alignment may reduce future gender inequities, but this promising strategy requires further investigation.

Leveraging Survey Results in Support of a Library Renovation: A Case Study.

The Health Sciences Library (HSL) at Stony Brook University along with the School of Medicine were motivated to make improvements in seating and hours based on survey results from an LCME self-study. Preparation for the site visit from the Liaison Committee for Medical Education helped to garner resources and support for this initiative. To meet the evolving needs of the HSL patrons, librarians completed an overdue collection assessment project which allowed for 142 new seats, including newly designed spaces and furnishings. Ongoing assessment of the redesigned space will be conducted to evaluate success and areas for continued improvement.

A partnership between academic and public librarians: "What the Health" workshop series.

BACKGROUND: Public librarians are in a unique position to assist the general public with health information inquiries. However, public librarians might not have the training, detailed knowledge, and confidence to provide high-quality health information. CASE PRESENTATION: The authors created and delivered three workshops to public librarians in Suffolk County, New York, highlighting several National Library of Medicine resources. Each workshop focused on a different topic: general consumer health resources, genetics health resources, and environmental/toxicology resources. At the end of each workshop, participants were asked to complete the Training Session Evaluation form provided by the National Network of Libraries of Medicine (NNLM). All participants reported that they learned a new skill or about a new tool, that their ability to locate online health information improved, and that they planned to use the knowledge they gained in the future. Online tutorials covering the major resources from each workshop were created and made accessible to the public on several organizations' websites. Virtual reference services were initiated for public librarians who need further assistance with these resources and will continue to be provided on an ongoing basis. Financial support for the equipment and software utilized in each of these tasks was awarded by NNLM. CONCLUSIONS: Based on attendance and participant feedback, this model of health information outreach appears to have been successful in furthering the educational needs of public librarians and may be useful to others in creating a similar program in their communities.

Three professions come together for an interdisciplinary approach to 3D printing: occupational therapy, biomedical engineering, and medical librarianship.

BACKGROUND: Although many libraries have offered 3D printing as a service or available technology, there is a lack of information on course-integrated programs for 3D printing in which the library played a primary role. Therefore, librarians at the Touro College School of Health Sciences began exploring 3D printing for inclusion in the occupational and physical therapy curriculum. CASE PRESENTATION: The goal of this project was to educate occupational and physical therapy students and faculty about the potential applications of 3D printing in health care and provide hands-on experience, while increasing collaboration between librarians and faculty. Students' tasks included designing and creating a 3D-printed assistive device as part of their course. CONCLUSION: Students were able to successfully print assistive devices, demonstrating the feasibility of 3D printing in a health sciences curriculum. Librarians involved with this project reached approximately 78 students and 200 other librarians and faculty members. 3D printing at Touro College continues to evolve and expand; the trial 3D printing course is being reviewed for formal adoption into the occupational therapy curriculum, and additional funding for 3D printing technologies is currently being allocated by Touro administration.