RECENT FINDINGS: Recent advances in hydrogel-based engineering of vascularized organ bud enable vascular regeneration in self-assembled cellular niche containing parenchymal and stromal cells. The emerging technology of whole-organ decellularization provides scaffold materials that serve as extracellular niche guiding vascular regeneration to recapitulate native organ's vascular anatomy. Increasing morphological and molecular evidences suggest endothelial heterogeneity across different organs and across different vascular compartments within an organ. Deriving organ-specific endothelium from pluripotent stem cells has been shown to be possible by combining endothelial induction with parenchymal differentiation.
SUMMARY: Engineering organ-specific vasculature requires the combination of organ-specific endothelium with its unique cellular and extracellular niches. Future investigations are required to further delineate the mechanisms for induction and maintenance of organ-specific vascular phenotypes, and how to incorporate these mechanisms to engineering organ-specific vasculature.
METHODS: Published literature was systematically searched according to PRISMA guidelines using specific key terms. Initial search identified 785 studies; however only seven met the inclusion criteria and were assessed for final review. Studies were methodologically appraised using the McMaster Critical Review Form-Quantitative Studies.
RESULTS: The review found no randomised control trial study design pertaining to the reviewed area. However, it can be seen that occupational therapy interventions for writing skills in 4-6 year old children managed to increase the targeted skills. The results were similar across samples with or without disabilities. An effective integration of occupational therapy interventions into educational curriculum was found to save both time and cost.
CONCLUSION: The long-term benefit from these interventions and the effects of these interventions on a broader spectrum of fine motor abilities need to be explored further with stronger research designs. However, the lack of studies adopting high level study designs, i.e., RCT designs means, results need to be approached with caution by occupational therapists when implementing handwriting skills intervention in practice.
AIM OF THE STUDY: To assess the effectiveness of miswak in maintaining periodontal health among adults.
MATERIALS AND METHODS: We searched for randomised controlled trials (RCTs) investigating the effect of miswak published in PubMed, EBSCOHOST (Dentistry & Oral Sciences), SCOPUS, and Cochrane Database for Systematic Review (CDSR) from inception to May 08, 2022. The primary outcomes of interest were changes in the periodontal health measured with plaque and gingivitis scores as well as subgingival bacteria load. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach while the estimates of effect were pooled using a random-effects model.
RESULTS: Ten eligible articles were identified, of which 9 could be analysed quantitatively. The remaining report was included as part of the qualitative analysis. The meta-analysis showed that miswak was comparable with the toothbrush in reducing the mean plaque score (p= 0.08, SMD: 0.39, and 95% CI: -0.05 to 0.83) and mean gingivitis score (p= 0.37, SMD: 0.13, and 95% CI: -0.16 to 0.43). Even higher certainty of evidence for the effect of miswak on mean plaque reduction on labial surface of anterior teeth. However, the adjunctive effect of miswak was significantly more superior for reducing plaque (p= 0.01, SMD: 0.68, and 95% CI: 0.14 to 1.22) and gingivitis score (p= 0.04, SMD: 0.66, and 95% CI: 0.03 to 1.29).
CONCLUSIONS: Miswak effectively reduced plaque and gingivitis scores to a level comparable to toothbrush when used exclusively. Adjunctive miswak use was particularly effective in improving periodontal health. However, the included studies inadequately reported on the method of toothbrushing using miswak and the frequency of miswak use. Therefore, further clinical studies are recommended to explore on the advantages and proper method of miswak practice for optima outcome and safety.
METHODS: Based on predefined eligibility criteria, the search was conducted following PRISMA-P 2015 guidelines on MEDLINE, EBSCO Host, Scopus, PubMed, and Web of Science databases in 2022 by 2 reviewers. Articles then underwent Cochrane GRADE approach and JBI critical appraisal for certainty of evidence and bias evaluation.
RESULTS: Thirty articles were included following eligibility screening. Both in vitro experiments (20%) and in vivo (80%) devices ranging from electronic axiography, electromyography, optoelectronic and ultrasonic, oral or extra-oral tracking, photogrammetry, sirognathography, digital pressure sensors, electrognathography, and computerised medical-image tracing were documented. 53.53% of the studies were rated below "moderate" certainty of evidence. Critical appraisal showed 80% case-control investigations failed to address confounding variables while 90% of the included non-randomised experimental studies failed to establish control reference.
CONCLUSION: Mandibular and condylar growth, kinematic dysfunction of the neuromuscular system, shortened dental arches, previous orthodontic treatment, variations in habitual head posture, temporomandibular joint disorders, fricative phonetics, and to a limited extent parafunctional habits and unbalanced occlusal contact were identified confounding variables that shaped jaw movement trajectories but were not highly dependent on age, gender, or diet. Realistic variations in device accuracy were found between 50 and 330 µm across the digital systems with very low interrater reliability for motion tracing from photographs. Forensic and in vitro simulation devices could not accurately recreate variations in jaw motion and muscle contractions.
MATERIALS AND METHODS: A comprehensive search was performed for studies comparing the natural fixatives- and formaldehyde-fixed tissues using databases from inception to January 2022: PubMed, Ovid Medline and Google Scholar. Two independent reviewers did data extraction. The data were pooled for the type of natural fixatives, their concentrations and fixative qualities compared to formaldehyde.
RESULTS: Fifteen studies were included in this systematic review. Nine studies used one natural fixative with different dilutions, while six used several natural fixatives to compare their fixative properties with formaldehyde. The most used natural fixative was honey (n = 12) followed by jaggery (n = 8), sugar (n = 3) and others (n = 1). Honey showed the most promising results in fixation and staining, which are compatible with formalin. Jaggery and sugar also showed the possibility of replacing formaldehyde in tissue fixation and staining in smaller tissue samples.
CONCLUSION: Natural fixatives showed promising results in tissue fixation. However, optimising the concentrations and conditions of natural fixatives is difficult because of the different chemical constituents and production steps. More comprehensive studies are necessary for application.
MATERIALS AND METHODS: This study is a novel retrospective study in a tertiary centre in Malaysia. Case notes of COVID- 19 patients who underwent tracheostomy in Hospital Ampang were collected using the electronic Hospital Information System. Data were analysed using the SPSS system.
RESULTS: From a total of 30 patients, 15 patients survived. All patients underwent either open or percutaneous tracheostomy. The median age is 53 (range: 28-69) with a significant p-value of 0.02. Amongst comorbidities, it was noted that diabetes mellitus was significant with a p-value of 0.014. The median time from the onset of COVID-19 to tracheostomy is 30 days. The median duration of intensive care unit (ICU) stay is 30.5 days, with the median duration of hospital length of stay of 44 days (p = 0.009 and <0.001, respectively). No complications that contributed to patient death were found. Survivors had a median of 29.5 days from tracheostomy to oxygen liberation.
CONCLUSION: Tracheostomy in COVID-19 patients that requires prolonged ventilation is unavoidable. It is a safe procedure and mortality is not related to the procedure. Mortality is primarily associated with COVID-19.