• Clinical Endoscopy
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• v.56 no.1
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• pp.38-49
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• 2023

Background/Aims: Patients with Barrett's esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett's esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872-0.939; I²=0%). Pooled stricture rate was 2.0% (95% CI, 0.005-0.042; I²=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007-0.055; I²=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

• Clinics in Shoulder and Elbow
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• v.27 no.2
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• pp.196-202
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• 2024

Background: As the population is aging and indications are expanding, shoulder arthroplasty is becoming more frequent, especially bilateral staged replacement. However, surgeons are hesitant to use bilateral reverse prostheses due to potential limitations on activities of daily living. Methods: This meta-analysis was conducted to compare bilateral anatomic to bilateral reverse shoulder implants. PubMed, Cochrane, and Google Scholar (pages 1-20) were searched until April 2023. The clinical outcomes consisted of postoperative functional scores (American Shoulder and Elbow Surgeons [ASES], Single Assessment Numeric Evaluation [SANE], Physical Component Score [PCS], Mental Component Score, and Simple Shoulder Test), pain, and range of motion (external rotation and forward elevation). Three studies were included in this meta-analysis. Results: Bilateral anatomic implants had better postoperative functional outcomes and range of motion, but no significant difference was seen in postoperative pain when compared to the reverse prosthesis. Better ASES score, SANE score, and PCS as well as better external rotation and forward elevation were seen in the bilateral anatomic shoulder replacement group, but no significant difference in pain levels was seen between the two groups Conclusions: The results may be explained by the lower baseline seen in the reverse prosthesis group, which may be due to an older population and different indications. Nevertheless, more randomized controlled studies are needed to confirm these findings. Level of evidence: III.

• Imaging Science in Dentistry
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• v.54 no.3
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• pp.232-239
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• 2024

Purpose: The use of artificial intelligence (AI) and deep learning algorithms in dentistry, especially for processing radiographic images, has markedly increased. However, detailed information remains limited regarding the accuracy of these algorithms in detecting mandibular fractures. Materials and Methods: This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Specific keywords were generated regarding the accuracy of AI algorithms in detecting mandibular fractures on radiographic images. Then, the PubMed/Medline, Scopus, Embase, and Web of Science databases were searched. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was employed to evaluate potential bias in the selected studies. A pooled analysis of the relevant parameters was conducted using STATA version 17 (StataCorp, College Station, TX, USA), utilizing the metandi command. Results: Of the 49 studies reviewed, 5 met the inclusion criteria. All of the selected studies utilized convolutional neural network algorithms, albeit with varying backbone structures, and all evaluated panoramic radiography images. The pooled analysis yielded a sensitivity of 0.971 (95% confidence interval [CI]: 0.881-0.949), a specificity of 0.813 (95% CI: 0.797-0.824), and a diagnostic odds ratio of 7.109 (95% CI: 5.27-8.913). Conclusion: This review suggests that deep learning algorithms show potential for detecting mandibular fractures on panoramic radiography images. However, their effectiveness is currently limited by the small size and narrow scope of available datasets. Further research with larger and more diverse datasets is crucial to verify the accuracy of these tools in in practical dental settings.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.3
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• pp.291-301
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• 2024

This systematic review and meta-analysis aimed to evaluate the impact of prospective payment systems (PPSs) on cholecystectomy. A comprehensive literature review was conducted, examining studies published until December 2023. The review process focused on identifying research across major databases that reported critical outcomes such as length of stay (LOS), mortality, complications, admissions, readmissions, and costs following PPS for cholecystectomy. The studies were specifically selected for their relevance to the impact of PPS or the transition from fee-for-service (FFS) to PPS. The study analyzed six papers, with three eligible for meta-analysis, to assess the impact of the shift from FFS to PPS in laparoscopic and open cholecystectomy procedures. Our findings indicated no significant changes in LOS and mortality rates following the transition from FFS to PPS. Complication rates varied and were influenced by the diagnosis-related group categorization and surgeon cost profiles under episode-based payment. There was a slight increase in admissions and readmissions, and mixed effects on hospital costs and financial margins, suggesting varied responses to PPS for cholecystectomy procedures. The impact of PPS on cholecystectomy is nuanced and varies across different aspects of healthcare delivery. Our findings indicate a need for adaptable, patient-centered PPS models that balance economic efficiency with high-quality patient care. The study emphasizes the importance of considering specific surgical procedures and patient demographics in healthcare payment reforms.

• Hip & pelvis
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• v.36 no.3
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• pp.168-178
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• 2024

The purpose of this meta-analysis is to compare the postoperative outcomes and complications of labral repair with those of labral reconstruction. An electronic search strategy was conducted from 1986 until August 2023 using the following databases: PubMed, Cochrane, and Google Scholar (pages 1-20). The primary objectives included the postoperative clinical outcomes determined by the number of patients who reached minimal clinical important difference (MCID) on the visual analog scale (VAS), modified Harris hip score (mHHS), Hip Outcome Score-Sports Subscale (HOS-SS), Hip Outcome Score-Activities of Daily Life (HOS-ADL), and International Hip Outcome Tool-12 (iHOT-12). In addition, analysis of the rate of revision arthroscopy, the rate of conversion to total hip arthroplasty (THA), the postoperative VAS, mHHS, HOS-SS, HOS-ADL, iHOT-12, nonarthritic hip score (NAHS), patient satisfaction, lower extremity function scale (LEFS), and the SF-12 (12-item shortform) was also performed. Any differences arising between the investigators were resolved by discussion. Seventeen studies were relevant to the inclusion criteria and were included in this meta-analysis. A higher rate of patients who reached MCID in the mHHS (P=0.02) as well as a higher rate of revision arthroscopy was observed for labral repair (P=0.03). The remaining studied outcomes were comparable. Despite the greater predictability of success in the reconstruction group, conduct of additional studies will be required for evaluation of the benefits of such findings. In addition, labral reconstruction is more technically demanding than a labral repair.

• KIPS Transactions on Software and Data Engineering
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• v.7 no.1
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• pp.33-42
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• 2018

The purpose of this study is to suggest the shortcomings and the direction of the web accessibility evaluation studies by analyzing the research trends on web accessibility evaluation in Korea. For this aim, a total of 59 theses presented in the registered academic journal and the candidate of registration academic journals from January 2000 to March 2017 were selected. The selected dissertations have been analyzed based on the evaluators, the evaluation targets, the evaluation methods, and the evaluation results with regard to web accessibility. As a result of the analysis, the highest rate in the evaluator aspect was 'independent evaluation (66 percent)' and the highest percentage in the evaluation target aspect was 'web site (83 percent)'. When it came to the evaluation methods, automatic evaluation and the mixture of automatic evaluation and manual evaluation had a similar percentage. Lastly, only two papers showed that web accessibility did not have any problems. This study is meaningful in the sense that it suggested a desirable direction for the web accessibility studies in Korea and web accessibility evaluation studies in the situation when the meta studies which analyzed research trends are insufficient.

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.277-282
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• 2020

Purpose: The main purposes of this study are to identify the degree of effect size and variables related to it, on the effect of physical therapy on shoulder adhesive capsulitis. Methods: This study were collected 8 studies published between 2010.01.01. and 2020.08.01. The Analysis result confirmed 16 effect size data, the random effect model was chosen because of the heterogeneity of the data. Results: First, full case showed the largest mean effect size 3.28 (p<0.001). Second, Size of the effect according to hands on+off intervention the 5.17 (p>0.344). Third, Number of participants showed 15 or more effect size 4.19 (p<0.002). intervention period showed 8 weeks effect size 5.12 (p>0.425). Number of intervention showed 14 or less effect size 3.99 (p>0.061). Publication type showed thesis effect size 4.34 (p<0.003). Finally, 'Trim and Fill' result confirmed that the calibration effect size is 1.71 (p<0.001). Conclusion: We were able to confirm that physical therapy had great effect on shoulders adhesive capsulitis, and that the effect differed according to the methods of intervention, the methods of evaluation.

• The Journal of Korean Physical Therapy
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• v.32 no.4
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• pp.222-227
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• 2020

Purpose: The primary purposes of this study were to identify the degree of the effect size and the variables related to it on the effects of physical therapy on myofascial pain syndrome. Methods: This study collected 15 studies published between 2008.01.01 and 2019.12.31. The Analysis results confirmed 57 effect size data. The random-effect model was chosen because of the heterogeneity of the data. Results: First, the full case showed the largest mean effect size of 2.03 (p<0.001). Second, the size of the effect, according to the handson intervention, was 2.74 (p<0.003). Third, the VAS showed an effect size of 2.30 (p<0.001). Fourth, the intervention period showed a 1- to 15-day effect size of 2.94 (p<0.001). The number of interventions showed a 6 to 10 effect size of 2.84 (p<0.006). The number of participants showed a 10 or less effect size of 2.66 (p<0.001). Finally, the 'Trim and Fill' result confirmed that the calibration effect size was 0.93 (p<0.001). Conclusion: Physical therapy had a great effect on myofascial pain syndrome in the neck and shoulders, and that the effect differed according to the methods of the intervention and the methods of evaluation.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.23.1-23.18
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• 2022

Objectives: The aim of this investigation was to evaluate the effectiveness of collagen cross-linking agents (CCLAs) used in combination with the adhesive technique in restorative procedures. Materials and Methods: In this systematic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. An electronic search was performed using PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and DOSS, up to October 2020. The gray literature was also researched. Only randomized clinical trials were selected. Results: The selection process yielded 3 studies from the 838 retrieved. The addition of CCLAs in the retention of restorations increased the number of events. The postoperative sensitivity scores and marginal adaptation scores showed no significant difference between the CCLA and control groups, and the marginal pigmentation scores showed a significant increase in the CCLA group. There were no caries events in any group throughout the evaluation period. Conclusions: This systematic review showed that there is no clinical efficacy to justify the use of CCLAs in the protocols performed.

• The Journal of Korean Medicine
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• v.43 no.2
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• pp.92-109
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• 2022

Objectives: The objective of this study was to appraise the effect of electroacupuncture (EA) for the treatment of acute gout. Methods: Since no suitable study could be found in the domestic database, we performed a literature search up to the end of December 2020 using four international electronic databases. Randomized controlled trials (RCTs) evaluating the effectiveness of EA in the treatment of acute gout were included. The risk of bias was evaluated from the Cochrane risk of bias tool. Results: Eight appropriate RCTs were included and analyzed. Three evaluation tools were mainly used: Total Effective Rate (TER), Uric acid (UA), and Pain score (VAS). In the case of TER, in all eight cases, electroacupuncture alone and combined treatment showed a statistically significant level of improvement compared to Western medicine treatment. In the case of VAS score, electroacupuncture alone and combined treatment showed a more significant effect than Western medicine treatment. In the case of UA level, electroacupuncture combined treatment showed a more significant effect than western medicine treatment. Although not all three evaluation tools were used in all studies, the majority of studies showed that electroacupuncture was effective for acute gout patients. Conclusions: The results of this study suggest that EA treatment may be effective for acute gout. It should be noted, however, that the studies included in this study were geographically biased, small in number, and mostly at high risk of bias. More well-designed studies are needed in the future.