Patient-reported outcome measures (PROMs) have become increasingly important in orthodontic treatment as they reflect patients' perceptions of treatment outcomes. Understanding patient satisfaction with orthodontic treatment is crucial for improving healthcare delivery and patient-centered care. This systematic review aimed to critically appraise the evidence regarding patient satisfaction after orthodontic treatment, exploring the effects of different treatment types, patient demographics, and other factors on satisfaction levels. Eight electronic bibliographic databases were searched without publication time or language restrictions, including PubMed®, Scopus®, the Cochrane Central Register of Controlled Trials, Web of Science™, Embase®, Google™ Scholar, Trip, and OpenGrey. A manual search was conducted on the references in the included papers. Eligibility criteria were established based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework. Studies were included if they reported patient satisfaction levels following orthodontic treatment using standardized questionnaires. Two reviewers independently collected and analyzed the data. The risk of bias was assessed using Cochrane's risk of bias tool (RoB2) for randomized clinical trials, and the methodologic quality for cohort and cross-sectional studies was assessed using the modified version of the Newcastle-Ottawa scale. Fourteen studies employed various questionnaires and timings to gauge post-orthodontic treatment satisfaction. Patient satisfaction levels were generally high, with most studies reporting satisfaction rates above 91%. Fixed orthodontic appliances were associated with higher satisfaction levels compared to removable appliances. While age and gender did not significantly influence satisfaction, the quality of care and doctor-patient relationships were crucial factors in patient satisfaction. This systematic review proves that patient satisfaction with orthodontic treatment is generally high, with fixed appliances and positive doctor-patient relationships contributing to higher satisfaction levels. However, the quality of the evidence was moderate to low, highlighting the need for further high-quality clinical studies in this area.
This paper presents the investigation of path loss variation for subject-specific on-body radio propagation channels, considering the effect of metallic spectacles and loop like metallic accessories. Adding metallic items may affect the operability of Body Centric Wireless Communications (BCWC). Measurements were carried out in an RF-shielded room lined with microwave absorbing sheets for strategically placed bodyworn antennas covering the upper front torso and the lower limbs. The path loss of the on-body radio channel was characterized explicitly taking into account the body size of the subjects. For metallic loop-like accessories, the results indicate that for underweight subjects, there was a slightly higher influence, up to 2%, compared to normal and overweight subjects. Our findings indicate that a noticeable effect exists on on-body channels for dynamic movements where the metallic watch acts as a local scatterer that affects the non-line-of-sight (NLOS) signal path between transmitter and receiver for underweight subjects in comparison to normal and overweight subjects. The path loss decreases when the receiving terminal was positioned very close to the metallic item. If a loop-like metallic accessory is not appropriately considered when designing the radio channel on a subject, the reliability of the body-centric wireless system may degrade.
This research proposes the various versions of modified cuckoo search (MCS) metaheuristic algorithm deploying the strength Pareto evolutionary algorithm (SPEA) multiobjective (MO) optimization technique in rectangular array geometry synthesis. Precisely, the MCS algorithm is proposed by incorporating the Roulette wheel selection operator to choose the initial host nests (individuals) that give better results, adaptive inertia weight to control the positions exploration of the potential best host nests (solutions), and dynamic discovery rate to manage the fraction probability of finding the best host nests in 3-dimensional search space. In addition, the MCS algorithm is hybridized with the particle swarm optimization (PSO) and hill climbing (HC) stochastic techniques along with the standard strength Pareto evolutionary algorithm (SPEA) forming the MCSPSOSPEA and MCSHCSPEA, respectively. All the proposed MCS-based algorithms are examined to perform MO optimization on Zitzler-Deb-Thiele's (ZDT's) test functions. Pareto optimum trade-offs are done to generate a set of three non-dominated solutions, which are locations, excitation amplitudes, and excitation phases of array elements, respectively. Overall, simulations demonstrates that the proposed MCSPSOSPEA outperforms other compatible competitors, in gaining a high antenna directivity, small half-power beamwidth (HPBW), low average side lobe level (SLL) suppression, and/or significant predefined nulls mitigation, simultaneously.