• Title/Summary/Keyword: electronic evidence

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Extracorporeal Life Support in Treatment of Poisoning Patient: Systematic Review (체외 생명유지술을 이용한 중독 환자의 치료: 체계적 고찰)

  • Lee, Yong Hee;Ko, Dong Ryul;Kong, Taeyoung;Joo, Young Seon;You, Je Sung;Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.1
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    • pp.1-8
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    • 2016
  • Purpose: Extracorporeal life support (ECLS) is a term used to describe a number of modalities including extracorporeal membrane oxygenation (ECMO) to support cardiac and/or pulmonary systems. The purpose of this study is to review the available evidence regarding the effect of ECLS in patients with acute poisoning. Methods: Electronic literature searches with PubMed, Embase, Cochrane library, and KoreaMed were conducted for identification of relevant studies addressing ECLS in treatment of acute poisoning. The literature search was conducted by two investigators in March, 2016 with publication language restricted to English and Korean. The toxic substance, technique of ECLS, and final outcome of each case were analyzed. Results: The final analysis included 64 articles including 55 case reports. There were no articles classified according to a high level of evidence such as randomized trial and prospective cohort study. ECLS treatment was used in the management of patients poisoned with 36 unique substances. Venovenous ECMO was performed in 4 cases. Among the reported cases, 10 patients died despite treatment with ECLS. Conclusion: Evidence supporting ECLS for patients with acute poisoning is inadequate. However, many case reports suggest that early consideration of ECLS in poisoned patients with refractory cardiac arrest or hemodynamic compromise refractory to standard therapies may be beneficial.

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Chuna Manual Therapy for Functional Dyspepsia : A Systematic Review and Meta-analysis (기능성 소화불량증에 대한 추나요법의 효과 : 체계적 문헌고찰과 메타분석)

  • Heo, In;Shin, Byung-Cheul;Hwang, Eui-Hyoung;Hwang, Man-Suk;Kim, Byung-Jun;Kim, So-Yeon;Heo, Kwang-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.1
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    • pp.1-14
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    • 2015
  • Objectives : To evaluate the evidence supporting the effectiveness of Chuna manual therapy for functional dyspepsia. Methods : We conducted search across the 3 electronic databases (Pubmed, CAJ and Oasis) to find all of randomized controlled clinical trials(RCTs) that used Chuna manual therapy as a treatment for functional dyspepsia. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : Thirteen RCTs met our inclusion criteria. The meta-analysis showed positive results for the use of Chuna manual therapy combined with medication treatments in terms of the efficacy rate when compared to medication treatments alone. Positive results were also obtained, in terms of the efficacy rate, when comparing Chuna manual therapy combined with medication plus specific electromagnetic therapy to medication treatments alone. Conclusions : Our systematic review found encouraging but limited evidence of Chuna manual therapy for functional dyspepsia. However, to obtain stronger evidence without the drawbacks of trial design and the quality of studies, we recommend sham-controlled RCTs or comparative effectiveness research to test the effectiveness of Chuna manual therapy.

Chuna Manual Therapy for Adult Constipation : A Systematic Review (성인 변비에 대한 추나요법의 효과 : 체계적 문헌 고찰)

  • Kim, Byung-Jun;Hwang, Eui-Hyoung;Heo, In;Lim, Kyeong-Tae;Cho, Ju-Chan;Shin, Byung-Cheul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.2
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    • pp.23-33
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    • 2016
  • Objectives : This study aimed to determine the evidence of effectiveness and safety of Chuna manual therapy for adult constipation patients. Methods : We searched 10 electronic databases(Ovid-MEDLINE, Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, KISS, NDSL, KMBASE, KISTI) and related 2 journals up to October 2016. We included randomized controlled trials(RCTs) of testing Chuna manual therapy for adults constipation patients. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : Nine RCTs were eligible in our inclusion criteria. The meta-analysis of 6 studies showed positive results for the use of Chuna manual therapy for constipation. Conclusions : There is favorable evidence of Chuna manual therapy for treating adult constipation with meta-analysis. However, our systematic review has limited evidence to support Chuna manual therapy for constipation because of low quality of original articles and further well-designed RCTs should be encouraged.

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Effectiveness of Arch Support Taping is Subjects With Excessive Foot Pronation: A Meta-analysis

  • Park, So-yeon
    • Physical Therapy Korea
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    • v.26 no.4
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    • pp.70-76
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    • 2019
  • Background: An excessive pronated foot is defined as a flattening or complete loss of the medial longitudinal arch. Excessive foot pronation is considered to have high risk factors of overuse injuries in the lower limb. Various treatments have been investigated in attempts to control excessive pronation. Objects: This meta-analysis identifies the effects of an anti-pronation taping technique using different materials. Methods: The electronic databases used include MEDLINE, the Physiotherapy Evidence Database (PEDro), Science Direct, the Korean Studies Information Service System (KISS), the Research Information Sharing Service (RISS), the Korea National Library, and the Korean Medical Database (studies published up to July 31, 2019). The database search used the following keywords: "foot drop" OR "foot arch" OR "foot pronation" OR "flat foot (pes planus)" AND "taping" OR "support." Eight eligible studies were analyzed to determine the effectiveness of anti-pronation taping in study and control groups. Results: The overall random effect size (Hedges'g) of the anti-pronation taping technique was 0.147 (95% confidence interval [CI]: -.214 to .509). When the effect (Hedges' g) was compared by the type of tape material, rigid tape (RT; Lowdye taping) was .213 (95% CI: -.278 to .704) and kinesiotape (KT; arch support taping) was -.014 (95% CI: -.270 to .242). Based on this meta-analysis, it was not possible to identify the extent to which anti-pronation taping was effective in preventing navicular drop, improving balance, or changing foot pressure. Only three of the eight eligible studies applied KT on excessive pronated feet, and the outcome measure areas were different to those of the RT studies. The KT studies used EMG data, overall foot posture index (FPI) scores, and rear foot FPI scores. In contrast, the RT studies measured navicular heights, various foot angles, and foot pressure. Conclusion: This review could not find any conclusive evidence about the effectiveness of any taping method for patients with pronated feet. Future studies are needed to develop the anti-pronation taping technique based on the clinical scientific evidence.

Acupuncture for Symptomatic Rotator Cuff Disease: A Systematic Review and Meta-Analysis

  • Choi, Seoyoung;Lee, Jisun;Lee, Seunghoon;Yang, Gi Young;Kim, Kun Hyung
    • Journal of Acupuncture Research
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    • v.38 no.1
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    • pp.20-31
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    • 2021
  • The objective was to evaluate the effectiveness and safety of acupuncture for patients with rotator cuff diseases. There were 12 electronic databases and 3 trial registries searched up to November 30th, 2019. All randomized trials were eligible, regardless of language, date of publication, or settings. The primary outcomes were pain, shoulder function, and proportion of improved participants assessed within 12 weeks of randomization of the trial. The Cochrane risk of bias for the studies was assessed. Effects sizes were presented as a risk ratio, mean difference, or standardized mean difference with a 95% confidence intervals. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to rate certainty of evidence. Of the 3,686 records screened, 28 randomized trials (2,216 participants) were included in this review. The types of acupuncture included manual acupuncture, dry needling, electroacupuncture, acupotomy, warm needle acupuncture, and fire needle acupuncture. All of the studies had an unclear or high risk of bias related to more than 1 domain. Significant benefits of acupuncture in terms of pain and shoulder function were observed in all comparisons, however, the proportion of improved participants was not described in 2 comparisons. There was substantial heterogeneity among meta-analyzed trials. No serious harm was observed. For primary outcomes, the overall certainty of evidence was very low. There was very low certainty of evidence for the benefits of acupuncture for patients with rotator cuff diseases. The safety of acupuncture remains unclear due to the incompleteness of reporting. Future well-designed randomized trials with transparent reporting are required.

Which anchorage device is the best during retraction of anterior teeth? An overview of systematic reviews

  • Yassir, Yassir A.;Nabbat, Sarah A.;McIntyre, Grant T.;Bearn, David R.
    • The korean journal of orthodontics
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    • v.52 no.3
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    • pp.220-235
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    • 2022
  • Objective: To evaluate the available evidence regarding the clinical effectiveness of different types of anchorage devices. Methods: A comprehensive literature search of different electronic databases was conducted for systematic reviews investigating different anchorage methods published up to April 15, 2021. Any ongoing systematic reviews were searched using PROSPERO, and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed independently by two authors. Information was categorized and narratively synthesized for the key findings from moderate- and high-quality reviews. Results: Fourteen systematic reviews were included (11 were of moderate/high quality). Skeletal anchorage with miniscrews was associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage was more effective in retracting anterior teeth and intruding incisors and molars, resulting in minor vertical skeletal changes and improvements in the soft tissue profile. However, insufficient evidence was obtained for the preference of any anchorage method in terms of the duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when: directly loaded, used in the mandible rather than the maxilla, used buccally rather than palatally, using dual rather than single miniscrews, used for en-masse retraction, and in adults. Conclusions: The level of evidence regarding anchorage effectiveness is moderate. Nevertheless, compared to conventional anchorage, skeletal anchorage can be used with more anchorage preservation. Further high-quality randomized clinical trials are required to confirm these findings.

Extracorporeal Shock Wave Therapy with Meridian and Acupoint Theory for Adhesive Capsulitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials (경혈경락 이론에 근거한 체외충격파 치료가 유착성 관절낭염에 미치는 영향: 무작위 대조 임상연구에 대한 체계적 문헌고찰과 메타분석)

  • Han, Donghun;Park, In-hwa;Heo, In
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.55-63
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    • 2022
  • Objectives This review was conducted to evaluate effectiveness and safety of extracorporeal shock wave therapy (ESWT) with meridian and acupoint theory for adhesive capsulitis. Methods By December 2021, 11 electronic databases were reviewed with the key words 'extracorporeal shock wave' and '(acupuncture OR acupoint OR meridian)'. This key words was set up to increase the sensitivity of the search. After the search, adhesive capsulitis study was selected based on the title and abstract and then included after full-texts were read. Results Five randomized controlled trials were eligible in our inclusion criteria. The meta-analysis of 3 studies showed positive results for the using ESWT with meridian and acupoint theory for adhesive capsulitis compared with the control group on efficancy rate and range of shoulder flexion. Conclusions Some studies showed ESWT with meridian and acupoint theory were statistically effective to adhesive capsulitis. But the evidence is limited due to the defective design of the included randomized controlled trials (RCTs). So use of ESWT with meridian and acupoint theory for adhesive capsulitis has limited evidence. More well-designed RCTs are required to provide clearer evidence for this claim.

Computer Security Incident Inspection and Response based on Digital Forensics in Windows10 environment (윈도우10 환경의 디지털 포렌식 기반 침해사고 진단 및 대응)

  • HyunWoo Kim;Taeshik Shon
    • Journal of Platform Technology
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    • v.11 no.4
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    • pp.35-49
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    • 2023
  • Recently, real-time cyber threats are constantly occurring for various reasons. Most companies have the characteristic of digitizing important internal information and storing it centrally, so it can be said that the impact is very high when an Computer Security Incident occurs. All electronic device information collected and analyzed in the process of responding to an Computer Security Incident has the characteristic of being subject to change at any time. Submission of related evidence is required in future investigations and courts. At this time, the basic principles of digital forensics, such as the principle of integrity and the principle of chain of custody, must be followed to ensure legitimacy and accuracy of the evidence. In this paper, we propose a digital forensic-based Computer Security Incident Inspection and Response procedure in the Windows 10 environment to secure the legitimacy and accuracy of digital evidence collected and analyzed when an intrusion occurs, prevent intrusion in advance, and quickly recognize it.

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Pre-pregnancy Diet to Maternal and Child Health Outcome: A Scoping Review of Current Evidence

  • Fadila Wirawan;Desak Gede Arie Yudhantari;Aghnaa Gayatri
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.2
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    • pp.111-127
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    • 2023
  • Objectives: Pre-pregnancy diet has an important role in preparing for healthy generation. However, evidence on this issue has been scarce. A scoping review synthesising current evidence will support the demand to map 'what has been researched' on pre-pregnancy diet and maternal and child health. Methods: Systematic search was performed using PICOS (Population, Intervention, Comparison, Outcomes, and Study design) framework in electronic databases. Articles were screened for eligibility, summarized, and the quality was assessed using the National Institute of Health assessment tool. The review structure complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guide. Results: Forty-two articles were included after full-text screening. Twenty-five studies were in high-income countries (HICs), six in each upper-middle income, five in lower-middle income countries (LMICs), and one in low-income countries (LIC). Based on the regions: North America (n=16), Europe (n=5), South America (n=4), Australia (n=4), Asia (n=5), Middle East (n=2), and sub-Saharan Africa (n=1). The two-most observed diet-related exposures were dietary pattern (n=17) and dietary quality (n=12). The most assessed outcome was gestational diabetes mellitus (n=28) and fetal and newborn anthropometry (n=7). The average quality score±standard deviation was 70±18%. Conclusions: Research related to pre-pregnancy diet is still concentrated in HICs. The context of diet may vary; therefore, future research is encouraged in LMICs and LICs context, and Mediterranean, South-East Asia, Pacific, and African regions. Some maternal and child nutrition-related morbidity, such as anemia and micronutrient deficiencies, have not been discussed. Research on these aspects will benefit to fill in the gaps related to pre-pregnancy diet and maternal and child health.

Variation of Practice in Prophylactic Protocol to Reduce Prosthetic Joint Infection in Primary Hip and Knee Arthroplasty: A National Survey in the United Kingdom

  • James Morris;Lee Hoggett;Sophie Rogers;John Ranson;Andrew Sloan
    • Hip & pelvis
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    • v.35 no.4
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    • pp.228-232
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    • 2023
  • Purpose: Prosthetic joint infection (PJI) has an enormous physiological and psychological burden on patients. Surgeons rightly wish to minimise this risk. It has been shown that a standardised, evidence-based approach to perioperative care leads to better patient outcomes. A review of current practice was conducted using a cross-sectional survey among surgeons at multiple centers nationwide. Materials and Methods: An 11-question electronic survey was circulated to hip and knee arthroplasty consultants nationally via the BOA (British Orthopaedic Association) e-newsletter. Results: The respondents included 56 consultants working across 19 different trusts. Thirty-four (60.7%) screen patients for asymptomatic bacteriuria (ASB) preoperatively, with 19 (55.9%) would treating with antibiotics. Fifty-six (100%) screen for methicillin-resistant Staphylococcus aureus and treat if positive. Only 15 (26.8%) screen for methicillin-sensitive S. aureus (MSSA) or empirically eradicate. Zero (0%) routinely catheterize patients perioperatively. Forty-one (73.2%) would give intramuscular or intravenous gentamicin for a perioperative catheterisation. All surgeons use laminar flow theatres. Twenty-six (46.4%) use only an impervious gown, 6 (10.7%) exhaust pipes, and 24 (42.3%) surgical helmet system. Five different antimicrobial prophylaxis regimens are used 9 (16.1%) cefuroxime, 2 (3.6%) flucloxacillin, 19 (33.9%) flucloxacillin and gentamicin, 10 (17.9%) teicoplanin, 16 (28.6%) teicoplanin and gentamicin. Twenty-two (39.3%) routinely give further doses. Conclusion: ASB screening, treatment and intramuscular gentamicin for perioperative catheterisation is routinely practiced despite no supporting evidence base. MSSA screening and treatment is underutilised. Multiple antibiotic regimens exist despite little variation in organisms in PJI. Practice varies between surgeons and centers, we should all be practicing evidence-based medicine.