Search Results (100)

Background/Objectives: Anterior redisplacement, defined as a postoperative anterior shift of the distal fragment despite intraoperative reduction, is occasionally observed after cephalomedullary nailing for trochanteric femoral fractures. However, its incidence and associated risk factors remain unclear. This study aimed to determine the incidence of anterior redisplacement following intramedullary nail fixation in geriatric trochanteric fractures, and to identify independent risk factors. Methods: This study retrospectively reviewed data from 598 consecutive hips in 577 patients (aged ≥ 65 years) who underwent intramedullary nail fixation for trochanteric fractures at a single center (2012–2023). Sagittal reduction on the lateral radiographic view was classified as posterior, anatomical, or anterior according to the position of the distal fragment, and was recorded preoperatively and postoperatively. Anterior redisplacement, the primary outcome, was defined as a change in alignment from a posterior or anatomical position postoperatively to an anterior position on any subsequent follow-up radiograph. Independent risk factors were identified by logistic regression. Results: Among the 543 hips reduced posteriorly (n = 204) or anatomically (n = 339), anterior redisplacement occurred in 73 (13.4%). The incidence of anterior redisplacement was significantly higher following anatomical compared to posterior reduction (19.5% vs. 3.4%; p < 0.001), and also higher in fractures that were anteriorly aligned preoperatively (18.0%) compared to anatomical (8.5%; p < 0.01) and posterior (6.2%; p < 0.01) alignment. Multivariate analysis revealed two independent predictors: preoperative anterior alignment (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.24–2.81; p = 0.003) and postoperative anatomical (vs. posterior) reduction (OR 6.49, 95% CI 2.92–14.44; p < 0.001). Age, sex, Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association classification, Evans–Jensen classification, nail length, and canal-filling ratio were not associated with redisplacement. No lag‑screw cutout occurred during the follow-up. Conclusions: Anterior redisplacement occurred in one of seven geriatric trochanteric fractures despite apparently satisfactory fixation. An anatomical sagittal reduction—traditionally considered “ideal”—increases the risk more than sixfold, whereas a deliberate posterior-buttress is protective. Unlike patient-related risk factors, sagittal reduction is under the surgeon’s control. The study findings provide evidence that choosing a slight posterior bias can significantly improve stability. Full article

Background: Hip fractures represent a major clinical challenge, particularly in elderly and frail patients, where postoperative pain control must balance effective analgesia with motor preservation to facilitate early mobilization. Various regional anesthesia techniques are used in this setting, including the pericapsular nerve group (PENG) block, fascia iliaca compartment block (FICB), femoral nerve block (FNB), and quadratus lumborum block (QLB), yet optimal strategies remain debated. Objectives: To systematically review the efficacy, safety, and clinical applicability of major regional anesthesia techniques for pain management in hip fractures, including considerations of fracture type, surgical approach, and functional outcomes. Methods: A systematic literature search was conducted following PRISMA 2020 guidelines in PubMed, Scopus, Web of Science, and the virtual library of the Hospital Central de la Defensa “Gómez Ulla” up to March 2025. Inclusion criteria were RCTs, systematic reviews, and meta-analyses evaluating regional anesthesia for hip surgery in adults. Risk of bias in RCTs was assessed using RoB 2.0, and certainty of evidence was evaluated using the GRADE approach. Results: Twenty-nine studies were included, comprising RCTs, systematic reviews, and meta-analyses. PENG block demonstrated superior motor preservation and reduced opioid consumption compared to FICB and FNB, particularly in intracapsular fractures and anterior surgical approaches. FICB and combination strategies (PENG+LFCN or sciatic block) may provide broader analgesic coverage in extracapsular fractures or posterior approaches. The overall risk of bias across RCTs was predominantly low, and certainty of evidence ranged from moderate to high for key outcomes. No significant safety concerns were identified across techniques, although reporting of adverse events was inconsistent. Conclusions: PENG block appears to offer a favorable balance of analgesia and motor preservation in hip fracture surgery, particularly for intracapsular fractures. For extracapsular fractures or posterior approaches, combination strategies may enhance analgesic coverage. Selection of block technique should be tailored to fracture type, surgical approach, and patient-specific functional goals. Full article

Accurate and reliable multi-scene positioning remains a critical challenge in autonomous driving systems, as conventional fixed-noise fusion strategies struggle to handle the dynamic error characteristics of heterogeneous sensors in complex operational environments. This paper proposes a novel noise-adaptive fusion framework integrating Global Navigation Satellite System (GNSS) and Inertial Navigation System (INS) measurements. Our key innovation lies in developing a dual noise estimation model that synergizes priori weighting with posterior variance compensation. Specifically, we establish an a priori weighting model for satellite pseudorange errors based on elevation angles and signal-to-noise ratios (SNRs), complemented by a Helmert variance component estimation for posterior refinement. For INS error modeling, we derive a bias instability noise accumulation model through Allan variance analysis. These adaptive noise estimates dynamically update both process and observation noise covariance matrices in our Error-State Kalman Filter (ESKF) implementation, enabling real-time calibration of GNSS and INS contributions. Comprehensive field experiments demonstrate two key advantages: (1) The proposed noise estimation model achieves 37.7% higher accuracy in quantifying GNSS single-point positioning uncertainties compared to conventional elevation-based weighting; (2) in unstructured environments with intermittent signal outages, the fusion system maintains an average absolute trajectory error (ATE) of less than 0.6 m, outperforming state-of-the-art fixed-weight fusion methods by 36.71% in positioning consistency. These results validate the framework’s capability to autonomously balance sensor reliability under dynamic environmental conditions, significantly enhancing positioning robustness for autonomous vehicles. Full article

In causal inference research, accurate estimation of individualized treatment effects (ITEs) is at the core of effective intervention. This paper proposes a dual-structure ITE-estimation model based on Bayesian Additive Regression Trees (BART), which constructs independent BART sub-models for the treatment and control groups, estimates ITEs using the potential outcome framework and enhances posterior stability and estimation reliability through Markov Chain Monte Carlo (MCMC) sampling. Based on psychological stress questionnaire data from graduate students, the study first integrates BART with the Shapley value method to identify employment pressure as a key driving factor and reveals substantial heterogeneity in ITEs across subgroups. Furthermore, the study constructs an ITE model using a dual-structured BART framework (BART-ITE), where employment pressure is defined as the treatment variable. Experimental results show that the model performs well in terms of credible interval width and ranking ability, demonstrating superior heterogeneity detection and individual-level sorting. External validation using both the Bootstrap method and matching-based pseudo-ITE estimation confirms the robustness of the proposed model. Compared with mainstream meta-learning methods such as S-Learner, X-Learner and Bayesian Causal Forest, the dual-structure BART-ITE model achieves a favorable balance between root mean square error and bias. In summary, it offers clear advantages in capturing ITE heterogeneity and enhancing estimation reliability and individualized decision-making. Full article

Objectives: This study aimed to evaluate the efficacy of various nutritional supplements in enhancing endurance performance and subjective thermal perception in athletes exposed to high-temperature environments through a systematic review and network meta-analysis. Methods: A comprehensive search was conducted in PubMed, Embase, Web of Science, Cochrane Library, and EBSCOhost from inception to January 2025. Studies were included if they evaluated the effects of nutritional supplements on either endurance performance or subjective thermal perception in athletes under heat stress. Two independent reviewers screened the literature, extracted data, and assessed the risk of bias. A network meta-analysis was performed using R software (version 4.3.1). The search was limited to English-language publications and employed both MeSH and free-text terms related to “athletes,” “nutritional supplements,” and “exercise performance,” using Boolean operators (AND/OR) to construct the strategy. Results: Twenty-five randomized controlled trials (RCTs) involving 552 participants were included, yielding 22 comparisons: 18 assessed endurance performance, and 11 assessed subjective perception. Standardized mean differences (SMDs) and posterior probabilities (P-scores based on Bayesian ranking) were calculated using random-effects and Bayesian models. Menthol (SMD = −1.83, 95% CI [−3.15, −0.51]; P-score = 71.04%) and taurine (SMD = 0.91, 95% CI [0.08, 1.73]; P-score = 12.75%) demonstrated significant positive effects on endurance. Menthol energy gel showed the greatest improvement in thermal comfort (SMD = 2.14, 95% CI [1.01, 3.26]; P-score = 99.54%). Conclusions: Menthol and taurine appear effective in enhancing endurance in hot environments, while menthol energy gel substantially improves perceived thermal comfort. Future research should apply stricter controls regarding environmental conditions, supplement dosage, and participant characteristics. While individual supplements may offer limited benefits, synergistic combinations may yield greater improvements in performance and comfort. Full article

Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread’s crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone–implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS’s cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, p = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (p = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density. Full article

This study aimed to evaluate prosthetic complications, implant survival rates, and marginal bone loss in implant-supported monolithic restorations compared to metal-ceramic restorations. The study was registered in PROSPERO (CRD420251022336) and conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. A systematic search was conducted in the electronic databases MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to December 2024. The inclusion criteria comprised studies evaluating only randomized clinical trials that evaluated implant-supported monolithic restorations directly compared to metal-ceramic restorations, considering any type of ceramic material and regardless of the fixation system (screw-retained or cemented), with a minimum follow-up of one year. A meta-analysis was performed using RevMan 5.4 software, and the risk of bias and certainty of evidence were assessed using the RoB 2.0 and GRADE tools, respectively. A total of six studies were included, all of which exclusively evaluated monolithic zirconia single crowns over follow-up periods ranging from 1 to 3 years. None of the included studies evaluated fixed partial dentures or restorative materials other than monolithic zirconia. In total, 267 patients (mean age range: 18–57 years) were analyzed, with a total of 174 implant-supported monolithic zirconia crowns and 165 metal-ceramic single crowns in the posterior region (premolars and molars). The meta-analysis revealed that implant-supported monolithic zirconia single crowns exhibited significantly fewer prosthetic complications compared to metal-ceramic single crowns (p < 0.0001; Risk Ratio [RR]: 0.26; Confidence Interval [CI]: 0.14–0.47). However, no statistically significant differences were observed between implant-supported monolithic zirconia and metal-ceramic single crowns regarding implant survival rates (p = 0.36; RR: 1.66; CI: 0.56–4.94) or marginal bone loss (p = 0.15; Mean Difference [MD]: −0.05; CI: −0.11–0.02). The risk of bias assessment indicated that four studies had a low risk of bias. However, the certainty of evidence was classified as low for prosthetic complications and implant survival rates and very low for marginal bone loss. Within the limitations of this review, it can be concluded that implant-supported monolithic zirconia single crowns can be considered a favorable treatment option as they show comparable implant survival and bone stability to metal-ceramic crowns, with a potential reduction in short-term prosthetic complications such as screw loosening and ceramic chipping. However, due to the limited number of studies included and low certainty of evidence, further long-term research is still needed to confirm their clinical performance over time. Full article

Background: Degenerative lumbar disease (DLD) affects older adults, causing lumbar degeneration and lower extremity dysfunction. The five-times sit-to-stand test (5xSTS) reveals kinematic changes associated with DLD. While marker-based motion capture systems detect these changes, their complexity limits clinical use. Markerless motion capture offers a portable alternative, yet its functional assessment applications in DLD remain underexplored. Thus, the aim of this study is to evaluate the reliability and validity of markerless motion capture for assessing functional tests in DLD patients. Methods: This study included 11 healthy individuals (mean age: 27.28 ± 6.92 years) and 10 with DLD (mean age: 70.00 ± 8.08 years). Participants performed the 5xSTS while being recorded by marker-based (VICON) and markerless (MediaPipe) systems using two synchronized cameras. Test–retest reliability was assessed over one week via the intraclass correlation coefficient (ICC). Concurrent validity and agreement between VICON and MediaPipe were evaluated via Pearson/Spearman correlation coefficients, systematic bias, and the root mean square error (RMSE). Movement time, joint excursions, and angular velocities were also analyzed and compared across two groups. Results: Both systems showed high test–retest reliability (ICC: 0.81–0.99) and strong correlations (r: 0.75–0.99). The highest RMSE was observed at the ankle in the anterior–posterior (A–P) direction in the DLD group (54.55 mm) and at the hip A–P axis in the control group (51.20 mm). The lowest RMSE was found at the knee medial–lateral (M–L) axis in the DLD group (7.88 mm) and at the ankle M–L axis in the control group (8.54 mm). Bias values ranged from 0.30 mm (hip vertical in control group) to +53.47 mm (ankle A–P in DLD group), with underestimation more common at the hip and overestimation at the ankle. The control group demonstrated a faster 5xSTS completion time (5.89 ± 0.69 s vs. 8.13 ± 1.96 s, p < 0.05), greater hip joint excursions during sit-to-stand (65.07 ± 25.94° vs. 38.13 ± 9.84°, p < 0.05) and stand-to-sit (62.56 ± 24.74° vs. 27.85 ± 11.45°, p < 0.05) tests, and higher angular velocities compared to the DLD group. Conclusion: MediaPipe markerless motion capture can quantify 3D kinematic changes in DLD patients during functional performance. It enables a clinical evaluation with minimal setup, offers potential for remote assessment, and accurately detects sagittal plane movement. The two-camera system provides 3D kinematic data comparable to multi-camera systems, suitable for home rehabilitation and assessment. Full article

Due to the high dimensional integration over latent variables, computing marginal likelihood and posterior distributions for the parameters of a general hierarchical model is a difficult task. The Markov Chain Monte Carlo (MCMC) algorithms are commonly used to approximate the posterior distributions. These algorithms, though effective, are computationally intensive and can be slow for large, complex models. As an alternative to the MCMC approach, the Laplace approximation (LA) has been successfully used to obtain fast and accurate approximations to the posterior mean and other derived quantities related to the posterior distribution. In the last couple of decades, LA has also been used to approximate the marginal likelihood function and the posterior distribution. In this paper, we show that the bias in the Laplace approximation to the marginal likelihood has substantial practical consequences. Full article

Background/Objectives: The mental foramen (MF) constitutes a passage for mental nerves and vessels, and it is a crucial anatomical landmark in the body of the mandible. The accessory mental foramen (AMF) is a small, addable foramen proximate to the MF, and it is mainly located posteriorly. The AMF is a rare anatomical variation in human mandibles that must be taken into consideration throughout dental and surgical operations. We aimed to assess the incidence and perform morphological and morphometric analyses of AMFs in the human dry mandibles of the Greek population, in addition to a relevant systematic review and meta-analysis of global data. Methods: We studied 114 human adult dry mandibles of unknown gender and age available from the Laboratory of Anatomy, Medical School, Democritus University of Thrace, Greece. We used the search term “accessory mental foramen” in the PubMed, Scopus, and Google Scholar databases to detect all publications of the last 50 years reporting the prevalence and morphology of AMFs in dry mandibles; the search ended on 13 January 2025. Quality assessments were performed using the relevant Joanna Briggs Institute tool. Data were synthesized with the random-effects REML model after Freeman–Tukey double arcsine transformationusing STATA 18. No external funding was received. The PROSPERO CRD is 42025638135. Results: According to our data, the MF was present in all observed mandibles, and it was bilateral. Nine AMFs (five right/four left; five round/four oval; six posterior/three anterior to the MF) were found in seven mandibles (five single and two double), and all were unilateral. AMFs presented a mean diameter of 0.96 ± 0.43 mm and mean distances of 4.12 ± 2.15 mm from the MF, 12.68 ± 4.10 mm from the alveolar ridge, and 11.92 ± 1.57 mm from the lower border of the mandible. Furthermore, 27 publications were included in the meta-analysis; the combined AMF prevalence was 6.1% (95% CI: 4.8–7.6%; I² 60%), the combined mean vertical axis was 1.18 ± 0.61 mm, and the combined mean distance from the MF was 3.64 ± 2.29 mm. Bilateral AMFs were detected in 2.1% of AMF cases. An oval shape was described in 37.3% of AMFs. No publication bias was detected. Conclusions: AMFs are not considered rare, and they are occasionally bilateral or even multiple in number. Moreover, they demonstrate considerable variation regarding their size, shape, anddistance from the MF, alveolar ridge, and lower border of the mandible. Dental surgeons must be aware of AMFs’ anatomical variations during surgical and anesthetic planning in order to effectively prevent or mitigate the risk of postoperative complications, such as pain, anesthesia, injury, and other adverse outcomes. Full article

Background: Over the last two decades, a number of imaging studies have evaluated the characteristics and clinical implications of mitral annular disjunction (MAD) among patients with mitral valve prolapse (MVP). The present systematic review has been primarily designed to summarize the main findings of these studies and to examine the overall impact of MAD in MVP patients. Methods: All imaging studies assessing the prevalence, pathophysiological role and determinants of MAD in MVP individuals, selected from the PubMed and EMBASE databases, were included. There was no limitation in terms of time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: The full texts of 23 studies on 7718 MVP individuals were analyzed. The overall pooled prevalence of MAD in MVP individuals was 40% (range 5.4–90%). When considering the different imaging modalities for assessing MAD, the average MAD prevalence was 20% for cardiac computed tomography studies, 31.3% for transthoracic echocardiography (TTE) studies, 44.7% for transesophageal echocardiography studies and 47% for cardiac magnetic resonance studies. MAD presence was more commonly associated with female sex, young age, narrow antero-posterior thoracic diameter, symptoms of palpitations and syncope, T-wave inversion in inferolateral leads and frequent and/or complex ventricular arrhythmias (VAs) on electrocardiogram, myxomatous leaflets, bileaflet prolapse, larger mitral valve annulus and non-severe mitral regurgitation on TTE. A total of 12 studies (52.2%) provided follow-up data. Over a median follow-up time of 3.9 yrs (range 1–10.3 yrs), MVP individuals with MAD showed increased risk of clinical arrhythmic events, no difference in survival rate and good surgical outcomes. Conclusions: MAD was present in more than one-third of MVP patients, with a wide range of variability depending on the specific imaging method used for assessing MAD presence and on a nonunivocal MAD definition, with a possible overestimation due to Pseudo-MAD rather than True-MAD measurement. A multimodality imaging approach comprehensive of noninvasive chest shape assessment might improve MAD detection among MVP individuals. It appears that careful serial monitoring for VAs should be mandatory for MAD patients. Full article

Background/Objectives: Cruciate ligament injuries, particularly those involving the anterior cruciate ligament and posterior cruciate ligament, are common among active individuals and often require surgical reconstruction followed by intensive rehabilitation to restore knee stability, movement, and strength. Virtual reality exposure therapy has emerged as a potentially beneficial adjunct to traditional rehabilitation, offering immersive, interactive environments that may aid in pain relief, balance, proprioception, and functional recovery. This meta-analysis aimed to evaluate the efficacy of VRET compared to conventional rehabilitation for postoperative cruciate ligament reconstruction, focusing on outcomes in pain, balance, proprioception, and the knee flexion range of motion. Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines and registered in PROSPERO (CRD42024604706). A comprehensive search across databases including MEDLINE (PubMed), SPORTDiscus, ScienceDirect, Web of Science (WOS), Cochrane Library, Scopus, and EBSCOhost included studies from inception until the date of search, using terms such as “cruciate ligament”, “virtual reality”, “rehabilitation”, “pain”, and “balance”, combined with Booleans “AND” and “OR”. Methodological quality, risk of bias, and recommendation strength were assessed using PEDro Scale, Cochrane Risk of Bias Tool (RoB 2.0), and GRADE, respectively. Results: Eleven studies (n = 387) met the inclusion criteria, involving patients who had undergone ACL or PCL reconstruction. Virtual reality exposure therapy showed significant benefits in reducing pain intensity [SMD = −2.33, 95% CI: −4.24 to −0.42, Z = 2.40, p = 0.02], improving proprioception, and enhancing the knee flexion range of motion. However, the results for static balance [SMD = −0.37, 95% CI: −1.62 to 0.88, Z = 0.58, p = 0.56] and dynamic balance [SMD = −0.37, 95% CI: −1.83 to 1.09, Z = 0.50, p = 0.62] were mixed and not statistically significant. Conclusions: Virtual reality exposure therapy is an effective adjunct therapy to postoperative rehabilitation for cruciate ligament reconstruction, particularly in reducing pain and enhancing proprioception. However, the small sample sizes and variability across studies underscore the need for further research with larger cohorts to validate these benefits in diverse patient populations. Full article

Background: The prognosis of people with multiple sclerosis (MS) has improved substantially in recent decades due to advances in diagnosis and treatment. Due to the unpredictable course and heterogenous treatment response in MS, there is a clear need for biomarkers that reflect disease activity in the clinical follow-up of these patients. We conducted a systematic review with Bayesian network meta-analysis with the aim of analyzing the effects of physical exercise on neurofilaments (NfL) and glial fibrillary acidic protein (GFAP) levels in patients with MS. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, starting with a PICO (patient/population, intervention, comparison, and outcome) question: what are the clinical effects of physical exercise (with independence of the type) on NfL and/or GFAP levels in patients with MS compared with other interventions or no intervention whatsoever? A systematically comprehensive literature search was conducted from January to March 2024 to identify original studies that answered the PICO question, using the main data sources. The quality of the studies included was assessed using the Quality Index of Downs & Black. For studies included in the systematic review that followed a randomized controlled trial (RCT) design, the methodological quality of each paper was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Risk of bias was also explored by two independent reviewers. Finally, all articles were classified according to the levels of evidence and grades of recommendation for diagnosis studies established by the Oxford Center for Evidence-Based Medicine. For continuous outcome measures with enough comparisons and a methodological quality greater than or equal to good according to the PEDro scale, a Bayesian network meta-analysis (NMA) was applied. The statistical analyses were performed in R (version 4.1.3, R Core Team 2023) using the “BUGSnet” and “gemtc” packages. Bayesian NMA can be used to obtain a posterior probability distribution of all the relative treatment effects, which allows us to quantify the uncertainty of parameter estimates and to rank all the treatments in the network. Results: Eight studies were included in this systematic review and six articles in the NMA, and they were appraised for quality. The characteristics of the included studies, types of training and described protocols, methodological quality, risk of bias, and clinical effects on the studied biomarkers were outlined. Qualitative synthesis, effects of different exercise modalities in NfL with the Bayesian NMA, selection of the final model and model assessment, and ranking of interventions are also shown. Conclusions: Our findings indicated that moderate-intensity exercise is more likely to reduce NfL concentration compared to high-intensity exercise, and, in turn, high-intensity exercise is more likely to reduce NfL concentration than low-intensity exercise. However, the effects of high-intensity exercise on GFAP levels were inconclusive. Full article

Background and Objective: The aim of this systematic review was to assess clinical trials on the efficiency of sinus lift techniques with and without bone grafting in the atrophic posterior maxilla. Materials and Methods: This article was written under the PRISMA and the Cochrane Handbook for Systematic Reviews of Interventions guidelines. PubMed, Scopus, and Web of Science databases were electronically searched until December 2023. The risk of bias was assessed according to Cochrane Risk of Bias tool guidelines. Statistical analysis was performed for implant survival rate (ISR), marginal bone loss (MBL), and endo-sinus bone gain (ESBG). Results: At the end of the electronic search, 5 clinical trials were considered eligible. Statistical analysis was achieved for osteotome sinus floor elevation. The ISR at 3 years had a risk ratio (RR) of 0.98 [0.90, 1.07] (CI 95%), p = 0.7, and at 5 years, RR 1.02 [0.93, 1.11] (CI 95%), p = 0.68. The MBL, at 3 years, indicated a weighted mean difference (WMD) of 0.01 [−0.15, 0.16] (CI 95%), p = 0.93, and at 5 years, WMD of −0.08 [−0.53, 0.37] (CI 95%), p = 0.73. ESBG at 3 years had a WMD of −0.44 [−1.05, 0.17] (CI 95%), p = 0.16, and at 5 years, WMD of −0.61 [−1.63, 0.41] (CI 95%), p = 0.24. Conclusions: The available evidence underlines that the osteotome sinus floor elevation technique without bone graft may be used. Full article

Background: This systematic review and meta-analysis aimed to investigate the effects of presurgical orthopedics (PSO) on maxillary arch dimensions in infants with cleft lip and palate during the first year of life. Methods: The review was conducted following PRISMA guidelines. A comprehensive electronic search was performed in MEDLINE, Embase, Cochrane, Scopus, and Google Scholar databases, supplemented by manual searching. Two reviewers independently conducted study selection, data extraction, quality assessment, and risk of bias evaluation. Results: Five studies were included in the meta-analysis. Quantitative analysis was performed based on the primary outcomes. The estimate was calculated using a random-effects model and z distribution (95% confidence interval (CI)). The results showed similar alveolar cleft widths (mean difference, −3.06; 95% CI, −8.03 to 2.70, p = 0.30, I2 = 99%) with clinical differences in favor of PSO, and comparable posterior cleft widths (mean difference, −0.88; 95% CI, −2.06 to 0.30, p = 0.14, I2 = 89%) with and without PSO in CLP babies. Conclusions: This meta-analysis found no statistically significant effects of presurgical orthopedic treatment on maxillary arch dimensions in infants with cleft lip and palate during the first year of life. Further high-quality randomized controlled trials are needed to definitively establish the efficacy of PSO. Full article