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PubMed2026

GLP-1 Receptor Agonists and Musculoskeletal Outcomes: A Systematic Literature Review and Meta-Analysis.

INTRODUCTION: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for the treatment of type 2 diabetes and obesity, but their effects on musculoskeletal health remain completely misunderstood. OBJECTIVE: This systematic review/meta-analysis aims to synthesise clinical data on the effects of GLP-1 RAs on key relevant bone, muscle, and joint outcomes. METHODS: MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL) (both via Ovid® platform) and Embase were searched from inception to March 2025 to identify relevant randomised controlled trials (RCTs) or real-world evidence (RWE) studies to be included. This bibliographic search was completed manually. A random-effect model meta-analysis was performed for any outcome reported in at least 2 studies. Subgroup analyses were performed on the type of GLP-1 RAs, type of comparator used and study design. Sensitivity analyses (i.e., leave-out sensitivity analyses and analyses restricted to the most adjusted effect estimate) were performed to test the robustness of the data. The strength of evidence was assessed using GRADE. This work has been performed in adherence with PRISMA statement. (PROSPERO Record ID: CRD420251024082). RESULTS: From 1148 potentially relevant references, 60 articles (46 RCTs, 13 RWE studies and 1 pharmacovigilance study, comprising 1,250,717 individuals) met our inclusion criteria. Different GLP-1 RAs were represented across the panel of studies, i.e., semaglutide, liraglutide, exenatide, dulaglutide, tirzepatide (dual agonist gastric inhibitory polypeptide [GIP]/GLP-1) and others. No effect on bone outcomes (i.e., bone mineral density [all sites] and fractures [all sites]) were observed when the meta-analytical models included the most adjusted effect size. Regarding muscle outcomes, a significant decrease of lean body mass/fat-free mass was consistently observed with GLP-1 RAs in the global model (k = 28, standardised mean difference [SMD] 0.52, 95% confidence interval [CI] -0.8; -0.23, I2 88%, p-value for heterogeneity <0.0001), which remained robust in all sensitivity analyses. Subgroup analyses showed that the effect was mainly driven by liraglutide and semaglutide, with a decrease in lean body mass/fat-free mass observed when GLP-1 RAs were compared with placebo. No publication bias was found. Regarding joint outcome, models revealed no significant change in The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, physical function and stiffness. CONCLUSIONS: This meta-analysis is the first to investigate the effects of GLP-1 RAs on a large panel of musculoskeletal health outcomes. While no significant effects were observed on bone- or joint-related outcomes, GLP-1 RAs were associated with reductions in lean body mass/fat-free mass, although the certainty of evidence was low and these changes appeared largely related to weight loss. Whether these changes translate into clinically meaningful impairments in muscle function or physical performance remains uncertain. Further studies in this field, including those looking at muscle function, strength or performance and using multivariate models considering confounding are needed to better reinforce the models and final findings.

Journal Article↗

PubMed2026

Proprioception Training and Surrogate Outcomes: A Systematic Review of Definitions, Measures, and Effectiveness Claims.

BACKGROUND: "Proprioception training" is widely advocated in rehabilitation and sports practice, yet the term encompasses heterogeneous constructs, interventions, and outcomes. Many trials infer proprioceptive benefits from surrogate outcomes (balance, strength, or pain) rather than direct psychophysical indices. OBJECTIVE: We aimed to examine how proprioception is defined and measured, and how improvement is claimed, in randomized controlled trials. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, PubMed, Scopus, and Web of Science were searched to October 2025. Eligible randomized controlled trials explicitly described interventions as "proprioceptive" or "sensorimotor training" and reported at least one proprioceptive outcome, either direct (e.g., joint position reproduction, threshold to detection of passive motion, active movement extent discrimination) or indirect (e.g., sway, balance). Methodological quality was appraised with the Physiotherapy Evidence Database (PEDro) scale and risk of bias using the Cochrane Risk of Bias 2 (RoB 2) tool. RESULTS: Fifty-one randomized controlled trials (n = 2319) were included. Comparative synthesis showed that improvements inferred from surrogate outcomes were more frequent and often larger than improvements observed in direct psychophysical measures. Directly targeted practice, angle specific, attentionally demanding, and aligned with the measured proprioceptive submodality and task construct, produced the most consistent benefits in position-reproduction accuracy/error, movement-detection sensitivity, or discrimination performance, depending on the outcome assessed. In contrast, multimodal regimens (balance, strengthening, taping, manual therapy) commonly improved balance, pain, strength, or function without comparably consistent evidence of enhanced direct psychophysical proprioceptive function. CONCLUSIONS: Specific psychophysical components of proprioceptive function appear modifiable, but only when training explicitly targets the sensory construct measured. The field remains conceptually diffuse, with frequent conflation of sensorimotor performance and proprioception. Progress depends on defining proprioceptive submodalities a priori, privileging validated psychophysical outcomes over surrogate outcomes, and aligning intervention content with measurement to substantiate true perceptual learning rather than generic motor adaptation.

Journal Article↗

PubMed2026

Optimising Exercise Prescription: A Meta-Analysis Examining the Dose Response of Exercise Duration on Cardiorespiratory Fitness Following HIIT and MICT.

BACKGROUND: High-intensity interval training (HIIT) is often promoted as a time-efficient alternative to moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness, yet the duration of HIIT sessions varies considerably across studies. OBJECTIVE: We aimed to characterise the dose-response relationship between exercise session duration and the improvement in cardiorespiratory fitness for HIIT and MICT. METHODS: A dose-response meta-analysis of randomised controlled trials comparing exercise duration in HIIT and MICT, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (CRD42022335590). Effect sizes were calculated using a random-effects meta-analysis. The primary outcome was maximal oxygen uptake (VO2max). Secondary outcomes included blood pressure, lipid profiles, glucose metabolism markers and body composition measures. A one-stage random-effects dose-response meta-analysis was performed to examine the relationship between exercise duration and adaptations. We searched PubMed and Google Scholar; eligibility criteria for selecting studies were randomised controlled trials in humans, published in English and exercise interventions lasting at least 4 weeks. RESULTS: We identified 69 randomised controlled trials (2387 participants). High-intensity interval training elicited greater improvements in VO2max than MICT (d = 0.38, 95% confidence interval 0.27-0.49, p < 0.001). High-intensity interval training demonstrated a non-linear dose-response relationship between exercise session duration and VO2max, with 80% of maximal effect (changes in VO2max = 3.45 mL/kg/min) achieved with only ~11 min/session (95% confidence interval 9.5-40.2). Moderate-intensity interval training showed a linear dose-response relationship between exercise session duration and VO2max, requiring ~52 min/session to achieve 80% of the maximal observed effect (95% confidence interval 30.4-55.8). The dose-response relationship was consistent across populations. High-intensity interval training and MICT had comparable effects in improving cardiometabolic risk factors. CONCLUSIONS: High-intensity interval training demonstrated a non-linear dose response, with 80% of maximal effect on VO2max in ~11 min/session, whilst MICT required four to five times longer to reach similar responses. The different types of training had comparable effects on cardiometabolic risk factors.

Journal Article↗

PubMed2026

Self-Report Health Screening Tools in Female Athletes: A Systematic Review of Domain Coverage, Validation, and Use Across Participation Levels.

BACKGROUND: Female athlete health encompasses multiple interconnected domains; however, the self-report screening tools used to assess these domains have not been comprehensively synthesised. OBJECTIVE: To systematically identify self-report health screening tools used to assess female athlete health, map domain coverage, determine validation reporting, and describe application across participation levels. METHODS: This systematic review was pre-registered with PROSPERO ( CRD420251056910 ) and conducted in accordance with PRISMA guidelines. Four databases (PubMed, MEDLINE, SPORTDiscus and Web of Science) were searched from inception to January 2026 using female health and screening-related terms. Methodological quality was appraised using Joanna Briggs Institute and National Institutes of Health tools, and findings were synthesised descriptively. Eligible, peer-reviewed studies reported the use, development or validation of self-report health screening tools assessing one or more domains relevant to female health applied in female athlete populations, spanning recreational through elite participation levels. All sports and activities were included. The search was restricted to English language with no date limits. RESULTS: In total, 360 studies (1990-2026) representing 134,506 female participants spanning recreational to elite sport and 273 screening tools were included. Mental health (n = 77, 34.1%), disordered eating (n = 33, 14.6%) and body image (n = 30, 13.3%) predominated. Domains related to female health, including menstrual health, pelvic floor health, pregnancy/postpartum and breast health were comparatively underrepresented. Most studies reported tools were used for risk identification (n = 323, 80.3%). Validation reporting was inconsistent, with half (n = 180, 50%) reporting use of at least one validated tool. Tool use was concentrated in professional and elite sport, with limited inclusion of recreational, masters and disability athlete cohorts. Health literacy constructs were explicitly assessed in 12.5% of studies (n = 45). CONCLUSIONS: Health screening in female athlete populations remains fragmented and uneven in domain coverage, with inconsistent validation reporting. Development of integrated, multi-domain and contextually inclusive screening frameworks is warranted.

Journal Article↗

PubMed2026

Effectiveness of different anaesthetic techniques, agents and adjunctive interventions in handling pain during dental treatment of MIH-affected teeth: a systematic review.

BACKGROUND: Molar incisor hypomineralisation (MIH) is frequently associated with hypersensitivity, dental anxiety and reduced efficacy of local anaesthesia, complicating pain control during dental treatment in children. AIM: To evaluate, based exclusively on randomised controlled trials (RCTs), the effectiveness of different local anaesthetic techniques, agents and adjunctive interventions in reducing pain during dental treatment of MIH-affected teeth in children. METHODS: A systematic review was conducted following PRISMA 2020 guidelines and registered in PROSPERO (CRD420251150485). MEDLINE, Cochrane Central, ScienceDirect, SCOPUS, EBSCO, and LILACS were searched up to September 2025. Eligible studies were RCTs involving children and adolescents (6 - 18 years-of-age) with MIH, assessing pain outcomes during dental procedures. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated using the GRADE approach. RESULTS: Eight RCTs were included. Low-certainty evidence suggested that intraosseous anaesthesia and 4% articaine may reduce intra-operative pain compared with conventional techniques or 2% lidocaine. Adjunctive cryotherapy and pre-emptive ibuprofen showed potential benefits, but evidence was of very low certainty and limited to single trials. Findings for photobiomodulation were inconsistent across studies. Most trials were judged to be at high risk of bias, primarily due to lack of blinding and reliance on subjective pain outcomes. CONCLUSION: Current evidence supporting specific pain management strategies for MIH-affected teeth is limited and of low certainty. Whilst 4% articaine and intraosseous anaesthesia appear promising, well-designed, adequately powered RCTs with standardised pain outcomes are required to inform robust clinical recommendations.

Local anaesthesia↗

PubMed2026

Evaluation of oral health-related quality of life following pulp therapy or extraction in paediatric patients: a systematic review.

BACKGROUND: Treatment decision between pulp therapy and extraction for compromised teeth in paediatric patients remains a topic of debate. While both approaches address the associated pain, their long-term impact on children's well-being remains unclear. This systematic review aimed to analyse and compare the impact of pulp therapy and extraction on OHRQoL in paediatric patients. METHODS: This review was conducted in accordance with PRISMA guidelines. A comprehensive search was performed in multiple electronic databases. Methodological quality and risk of bias were evaluated using the RoB 2 tool for randomised controlled trials, ROBINS-I tool for non-randomised trials, and the Newcastle-Ottawa Scale for observational studies. RESULTS: Seven studies comprising a total of 1367 participants met the inclusion criteria. The results indicated that pulp therapy was associated with superior OHRQoL outcomes compared to extraction. Children who underwent pulp therapy reported lower anxiety, better emotional well-being, and higher parental satisfaction. Given the heterogeneity among the studies, a narrative synthesis was performed. CONCLUSION: Pulp therapy may offer better OHRQoL outcomes than extractions in paediatric patients by preserving function, reducing anxiety, and minimising long-term complications. However, these findings should be interpreted cautiously since the available evidence was limited and of low to very low certainty. Further well-designed randomised controlled trials are required.

Children↗

PubMed2026

Air Pollution and Heat Impacts on Respiratory Morbidity and Mortality Outcomes in Africa: A Systematic Review Towards a Meta-analysis.

PURPOSE OF THE REVIEW: This review synthesised evidence on associations between air pollution and respiratory morbidity in Africa. Following PRISMA guidelines, we systematically searched PubMed, ScienceDirect and Elicit for case-control studies published between 2015 and 2025. RECENT FINDINGS: Thirteen studies from ten African countries reported pollutant levels far exceeding WHO guidelines. Indoor PM₂.₅ in biomass-using homes ranged from 96 to 177 µg/m³, and ambient PM₂.₅ reached 259 µg/m³. Nitrogen oxides were consistently associated with reduced lung function in children, while household air pollution increased risks of under-five mortality and low birthweight. Associations with acute respiratory infections varied across settings. Vulnerability was greatest among young children, those with airway hyperresponsiveness, and households with poor ventilation. Only three studies included temperature, and none examined heat-respiratory interactions. Across African case-control studies, particulate matter and household air pollution remain consistently linked to adverse respiratory outcomes, highlighting urgent needs for cleaner fuels, improved ventilation, and stronger evidence on combined pollution and heat exposures.

Humans↗

PubMed1985

Interface seal of incremental placement of visible light-cured composite resins.

An investigation was conducted to determine the quality of seal at the interface when a visible light-cured composite resin was placed and cured in increments. Five samples of each of the following composite materials were tested: Aurafill, Command, Command Ultrafine, Durafill, Prisma-Fil, and Silux. Samples of each material were placed in a thermocycling dye bath that contained a 0.5% aqueous solution of basic fuchsin dye for 25 hours. The samples were removed from the dye bath, rinsed, dried, and prepared for examination with a x25 microscope by two examiners. Neither examiner reported dye penetration at the interface of the materials tested. These findings effectively highlight the practicality of the incremental placement of light-cured composite resins.

Chemical Phenomena↗

PubMed1989

Evaluation of potassium oxalate as a cavity liner.

All dental restoratives exhibit some microleakage. Recent studies disclosed that oxalate salts were superior to Copalite varnish in reducing dentinal permeability, but inferior in reducing microleakage. This study compared the effectiveness of a potassium oxalate solution (DDS) with three other cavity liners (Copalite, Cavi-Line, Prisma Universal Bond) and a no-liner control in reducing microleakage under amalgam restorations. Under the conditions of this study, DDS solution was significantly effective in reducing microleakage under amalgam restorations.

Composite Resins↗

PubMed1993

Comparative study of the sealing ability of light-cured versus chemically cured materials placed into furcation perforations.

Two light-cured materials, Vitrebond and Prisma VLC Dycal, were compared with two chemically cured materials, Ketac Fil and Dycal, for ability to seal furcation perforations. Access openings and furcation perforations were prepared in 60 teeth and randomly divided into four equal groups. Furcation perforations were repaired with each of the tested materials, and the access openings were filled with composite resin. After teeth were immersed in 2% erythrocin B dye solution for 10 days, they were sectioned longitudinally and dye penetration was measured. The light-cured materials allowed statistically significant less dye leakage than did the chemically cured materials.

Analysis of Variance↗

PubMed1989

Physical properties of calcium hydroxide and glass-ionomer base and lining materials.

Compressive, diametral tensile and flexural strengths, moduli of elasticity, pH, and acid solubility values were compared for six calcium hydroxide cements, seven glass-ionomer cements, and one calcium aluminate cement. Results indicated that the glass-ionomer materials were generally stronger than the calcium hydroxide liners. Prisma VLC Dycal showed the lowest value for modulus of elasticity and the least acid solubility. The glass-ionomer materials were initially acidic, reaching a final pH between 5.4 and 7.3, whereas the calcium hydroxide and calcium aluminate cements were strongly alkaline at all time intervals.

Calcium Hydroxide↗

PubMed1989

Photocalorimetry of light-cured dental composites.

The reactivity of six light-curable dental composite materials has been examined by a novel technique, photocalorimetry, which permits in situ analysis of photoreactions in opaque cross-linking systems. According to photocalorimetry, the rates of reaction of dental composites decrease in the following order: Uvio Fil, Scintilux 2, Visio Dispers, Visio Fil, Silux, and Prisma Fil. By comparing the heats of reaction of the composites and of the resins, one may assume that at least two types of reactive resins are used in these dental composites: one with a heat of reaction of about 35 cal/g, and others with considerably less reactivity, ranging from 14 cal/g to 25 cal/g. Photocalorimetry allows for a rapid assessment of the rate of polymerization (photospeed) of light-curing dental composites and is ideally suited for the study of kinetics and for optimization of formulations.

Calorimetry↗

PubMed1989

31P-NMR study of P-based dental adhesives and electron probe microanalysis of simulated interfaces with dentin.

The structure and function of P in P-based dental adhesives have not been defined properly. The purpose of this study was to evaluate these parameters in some currently available materials. Five dental adhesives were selected: Bondlite, Clearfil New Bond, J&J Dental Adhesive, Prisma Universal Bond, and Scotchbond. High-resolution 31P-NMR spectroscopy was used to identify the phases of the incorporated P and the kinetics of monomer-bonded P in an aqueous environment. Areas of 5 mm diameter located on polished sound dentin were subjected to the corresponding adhesive treatments and covered with translucent molds of the same diameter, which were filled up to 1 mm length with a visible-light-cured hybrid composite. Following 60 sec of light exposure from lateral directions, the specimens were embedded in fast-setting resin, cross-sectioned, and analyzed in an electron probe microanalyzer. The elemental profiles of Ca, P, and Cl were determined from area and line scans. Great differences in the 31P resonance shifts were obtained from the tested adhesives, indicating the presence of monomer-bonded and free P. A rapid hydrolysis of the resin-bonded P in the presence of water was identified. The x-ray images revealed dentin demineralization, with distinct differences in the P distribution pattern and the P/Cl ratio.

Dental Bonding↗

PubMed1990

Evaluation of the bond mediated by eight DBA's to enamel and dentin.

It is well-established that the bonding strength between resin and acid-etched enamel is considered clinically adequate. The tensile bonding strength mediated by a group of dentinal bonding agents (DBA's) to both dentin and acid-etched enamel was measured after one hour and the results compared. For all the DBA's tested, the bonding strength to enamel was higher than that to dentin. These differences were significant for all DBA's except for Gluma/Clearfil F-II. Analysis of variance revealed significant differences between material-specific means to either enamel or dentin. For enamel, the significant differences were due to the relatively low bonding strength value measured with the Prisma Bond. The bonding strength of all DBA's tested to acid-etched enamel would secure clinically high retention rate and adequate marginal quality. For dentin, these differences were due mainly to the high mean values for strength of bonds when the Gluma/Clearfil F-II combination was used. The low values and the large variations of the bonds to dentin measured with the commercial systems would affect the two major functions of DBA's, namely, retention of the restoration and prevention of marginal gaps. The Gluma/Clearfil combination should be recommended for clinical trials.

Acid Etching, Dental↗

PubMed1992

Shear bond strengths of ten dentin adhesive systems.

This in vitro study tested the shear bond strengths of nine third-generation dentin bonding systems. All of these systems had higher bond strengths than the control, a second-generation agent. Amalgambond and All-Bond had the strongest bonds to dentin, 23.3 +/- 5.7 and 19.3 +/- 5.6 MPa, respectively. Clearfil Photo Bond and Prisma Universal Bond 3 had intermediate bond strengths (approximately 13 MPa). Gluma, PowerBond, Scotchbond 2, Tenure, and XR-Bond all had mean shear bond strengths of less than 8 MPa.

Analysis of Variance↗

PubMed1993

Measuring polymerization shrinkage of photo-activated restorative materials by a water-filled dilatometer.

A water-filled dilatometer specifically designed for determining the polymerization shrinkage of photo-activated composite restorative materials was used to measure the polymerization shrinkage of three visible light-activated composites. Polymerization shrinkage values ranged from 1.82% for P-50 to 2.15% and 2.19% for Herculite XRV and Prisma APH, respectively. Shrinkage data obtained in this investigation were compared with the published data, and the factors which affect shrinkage measurements were reviewed. It was concluded that maintaining a constant temperature environment (+ or - 0.02 degrees C) for the dilatometer during the shrinkage test was the most critical factor for successful application of the dilatometer.

Bisphenol A-Glycidyl Methacrylate↗

PubMed1989

Effect of temperature and ageing on the mechanical properties of dental polymeric composite materials.

Evaluation of the mechanical properties of some dental composite materials, Compact, Finesse and Prisma-Fil based on bisphenol glycidyl methacrylate resin was undertaken by applying compression, tension and hardness tests. The effects of temperature and ageing times on these properties were studied. There was a marked increase in the mechanical properties (compressive strength, diametral tensile strength, compressive elastic modulus and hardness) for all the investigated composites with increase of both temperature and time. This was explained in terms of the influence of temperature on the polymerization rate of the materials. The improvement in the mechanical properties of the samples, kept at 37 degrees C, was attributed to further and continued polymerization of the polymer content of their resin system. Such mechanical improvement was verified by the regression equation of linearity versus both temperature and time.

Chemical Phenomena↗

PubMed1995

SEM characterization of the resin-dentine interface produced in vivo.

OBJECTIVES: A freeze-fracture technique with critical-point drying has been shown to preserve the structure of collagen in demineralized primed dentine in vitro (Titley K et al. Am J Dent 1994; 7: 22-26). This study utilized the technique to examine the attachment to dentine produced in vivo All-Bond 2 (AB2), Scotchbond Multi-Purpose (SBMP) and Prisma Universal Bond 3 (PUB3). METHODS: Eighteen medium-depth restorations were placed in buccal and/or lingual surfaces of premolar teeth (n = 7) scheduled for extraction for orthodontic purposes. After extraction, the restored teeth were split transversely by freeze-fracture, critical-point dried and examined under SEM. RESULTS: AB2 and SBMP produced significant gap-free attachment to dentine showing similar microscopic structural features. Resin interdiffusion with collagen fibrils of the intertubular matrix was clearly seen. Microspaces, observed at the periphery of the widened tubules and among the interdiffused collagen fibrils, suggested incomplete resin penetration. Fractures occurring parallel with the interface frequently showed detachment in the deepest layers of the hybrid zone. Adhesive gaps were seen at the resin-dentine interface, indicating some clinical technique failure. The PUB3 attachment was generally incomplete, with separation between the primed dentinal surface and the composite restoration. Where present, the bonded interface showed no evidence of true hybridization. CONCLUSION: Dentine conditioning, as a separate step, prior to priming, appears to be an important factor in successful resin-dentine attachment. Critical-point drying revealed variations in the degree of resin interdiffusion with intertubular collagen, suggesting potential sites for bond failure.

Acid Etching, Dental↗