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At least 19 recordsLinked to original sources

PubMed2026

SARS-CoV-2-related immune dysregulation and biologically plausible pathways to lymphomagenesis: a PRISMA-ScR-based scoping review.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related immune dysregulation has generated interest in diagnostic pathology because infection-related inflammation, long coronavirus disease (COVID)-related immune disturbance, and post-vaccination lymphoid reactions may overlap with lymphoid-biological mechanisms and complicate the distinction between reactive lymphoid proliferations and lymphoid neoplasia. AIM: This scoping review aimed to map biologically plausible pathways through which SARS-CoV-2-associated immune perturbation may intersect with lymphomagenesis-related mechanisms, emphasizing diagnostic implications rather than causality. MATERIALS AND METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed∕MEDLINE, Scopus, and Web of Science were searched from January 2020 to March 2026, with selected pre-2020 sources retained for mechanistic or diagnostic relevance. Sources were charted across mechanistic, immunological, virological, clinicopathological, and diagnostic domains. RESULTS: After screening and eligibility assessment, 63 sources were retained for thematic synthesis. Evidence clustered around lymphoma-relevant but non-specific mechanisms, including inflammatory signaling, impaired immune surveillance, latent oncogenic viral reactivation, prolonged germinal-center activity with activation-induced cytidine deaminase (AID)-related genomic vulnerability, and lymphoid microenvironment remodeling. These mechanisms appear most relevant in predisposed hosts with chronic immune dysregulation, latent viral infection, defective deoxyribonucleic acid (DNA) repair, or occult abnormal lymphoid clones. Infection and vaccination are distinct contexts, because infection may produce broader immune disruption, whereas most post-vaccination nodal events are reactive and self-limited. CONCLUSIONS: Current evidence supports biological plausibility rather than a direct or generalizable causal relationship. The main diagnostic implication is careful clinicopathological correlation and distinction between reactive lymphoid proliferations and lymphoid neoplasia in post-COVID-19 and post-vaccination settings.

Humans↗

PubMed1992

[Preparation of tooth colored adhesive inlays. Prisma AP.H-inlay system].

Explore the source record for details and available documents.

Color↗

PubMed1992

Bond strengths of dentine bonding agents to dentine.

This study assessed comparatively the tensile bond strengths to dentine of four resin dentine bonding agents. Flat surfaces were produced in the occlusal dentine of human third molars, finished with 600-grit paper and prepared for bonding to Silux Plus composite with Gluma, Prisma Universal Bond 2, Scotchbond 2 and Tenure. After 24 hours in water and 250 thermal cycles, the specimens were loaded in tension to failure on an Instron machine. There were 20 specimens in each test group. An analysis of variance and Duncan's test showed that the bond strengths of Scotchbond 2 (22.8 +/- 7.2 MPa) and Prisma Universal Bond 2 (20.1 +/- 7.8 MPa) were similar but significantly higher than those of Tenure (14.3 +/- 5.3 MPa) or Gluma (12.3 +/- 6.4 MPa). A Weibull analysis confirmed the superiority of Scotchbond 2 and Prisma Universal Bond 2. Scotchbond 2 and Prisma Universal Bond 2 specimens failed either in an adhesive-cohesive mode, or cohesively through the composite or the dentine. It was concluded that Scotchbond 2 and Prisma Universal Bond 2 are effective and are the dentine bonding agents of choice.

Composite Resins↗

PubMedDate not supplied

Effect of interchanging two composite resin system with a dentine adhesive.

There is a tendency to interchange dentine adhesives and composite resins when using composite resins for restorations. This study used marginal contraction gaps to test the effect of changing composite resins with a dentine adhesive. Cylindrical butt-joint cavities were prepared entirely in dentine using extracted human teeth. Two groups of control cavities (30 cavities per group) were restored with Prisma-Bond/Prisma-Fil and Heliobond/Heliomolar respectively. Two groups of test cavities (30 cavities per group) were restored using the dentine adhesive. Prisma Universal Bond with Prisma-Fil on one group and Prisma Universal Bond and Heliomolar in the other. Following thermocycling the marginal contraction gaps were measured and assessed. The results showed a significant reduction in marginal contraction gaps when using either composite resin with Prisma Universal Bond. This indicates a compatibility of both resins with the adhesive in this instance.

Acrylates↗

PubMed1990

Adaptation of two different calcium hydroxide bases under a composite restoration.

A preliminary scanning electron microscope (SEM) study was carried out to investigate how the adaptation of two calcium hydroxide bases (one chemically cured, one light cured) was affected by the polymerization contraction of a supervening light-cured composite resin restoration. Occlusal cavities were prepared in 40 sound extracted human premolars, divided into two equal groups. In the first group a chemically cured calcium hydroxide (Dycal, De Trey Dentsply, Konstanz, FRG) was placed as a base. In the second group a new light-cured calcium hydroxide product (Prisma VLC Dycal, De Trey Dentsply) was used. The restorations were completed with an acid-etched, incrementally placed composite resin. The specimens were sectioned vertically and debrided. A replica was made of each half-tooth. The interfaces between composite resin/base and base/dentine were viewed and photographed in the SEM. The marginal adaptation at these two interfaces was classified into three categories according to the extent of the gaps that were observed. Prisma VLC Dycal base was found to be pulled away from the dentine floor of the cavity as a result of an apparent adhesion to the composite resin during polymerization contraction. Dycal was better adapted to the cavity floor than Prisma VLC Dycal. Disorganization of the resin-bonded Prisma VLC Dycal was minimal even after acid etching the enamel, sectioning and ultrasonic debridement. Dycal appeared to be more friable, and occasionally exhibited marked disorganization as a result of these procedures.

Acid Etching, Dental↗

PubMed1991

Shear bond strength to dentin by simulation of three-dimensional Class V cavity configuration.

The purpose of this study was to investigate the effect of composite polymerization contraction on early shear bond strength of conventional and new dentin adhesives to dentin. The dentin adhesives selected for this study, i.e., Bondlite, Gluma, Prisma Universalbond, Scotchbond LC, Scotchbond 2, and XR Bonding, were tested in combination with Silux and in combination with their respective composites. The composite was applied to the treated dentin surface in cylindrical brass moulds of 4 mm diameter and 3 mm length. The configuration of cylindrical butt-joint Class V cavities was simulated by the coating of the insides of the brass moulds with silane in order that a chemical bond to the composite could be established. The results showed that shear bond strength to dentin was higher for XR Bonding and Scotchbond 2 compared with conventional phosphate ester-based dentin adhesives and Gluma. When XR Bonding or Scotchbond 2 was used, the obstruction of polymerization contraction had no effect on the bond strength to dentin. In contrast, the dentin adhesion of Scotchbond LC/Silux, Prisma Universalbond/Prisma Microfine, Bondlite/Herculite, and Gluma/Lumifor was adversely affected by the reduction of the unbonded composite surfaces. However, this effect was not observed when Prisma Universalbond, Bondlite, and Gluma were tested in combination with Silux. It can therefore be concluded that the effect of polymerization contraction on the bond strength to dentin depends not only on the dentin adhesive but also on the type of composite used.

Adhesives↗

PubMed1990

Laser photopolymerization of dental materials with potential endodontic applications.

Photopolymerizing resins were exposed to three different wavelengths of light emanating from the argon laser. It was determined that the most efficient wavelengths for photopolymerization of camphorquinone-activated resins were at 477 and 488 nm. The 514.5-nm wavelength was relatively ineffective in activating polymerization. Four camphorquinone-activated resins were placed in the root canals of teeth and tested for polymerization depth using a 488-nm wavelength laser beam coupled to an optical fiber 200 microns in diameter. In regard to polymerization depth, these materials ranked as follows: Genesis greater than Prisma-Fil greater than Prisma Microfine greater than Prisma VLC Dycal. Alterations in the positions of the optical fiber and the surface of the resin in the canal made only minor differences in polymerization depth of the samples. The results indicate that an argon laser coupled to an optical fiber could become a useful modality in endodontic therapy.

Argon↗

PubMed1992

Quantitative analysis of six composite polishing techniques on a hybrid composite material.

Determining the best technique for finishing and polishing composite resins is important to ensure longevity of the restoration and prevention of recurrent decay and periodontal disease. This study quantitatively compared the surface roughness of a small particle hybrid composite material finished and polished using six different techniques. Five composite samples were randomly assigned to one of six polishing techniques. Uniform composite surfaces were prepared by finishing samples with a 600-grit carborundum disk prior to polishing. The unpolished surfaces were analyzed with the Taylor-Hobson Talysurf 10 surface texture measuring instrument. The surfaces were then polished and analyzed again. There were no statistical differences among treatment groups prior to polishing. There was a statistical difference between treatment groups after polishing. The smoothest surfaces were obtained using Centrix System rubber points alone, Centrix System rubber points plus Caulk's Prisma Gloss fine and super-fine pastes, and Caulk's Enhance disks plus Caulk's Prisma Gloss fine and super-fine pastes. There was no statistical difference between these methods and 3M Sof-flex disks alone. The roughest surface was produced by the Enhance disks only without using the Prisma Gloss pastes. There was no statistical difference between this method, however, and the use of Sof-flex disks plus Kerr's Lustre Paste. Lustre Paste, included with Herculite kits, did not improve a surface polished with Sof-flex disks.

Analysis of Variance↗

PubMed2026

Ibuprofen versus acetaminophen for acute mild-to-moderate pain management in pediatric populations: a systematic review and meta-analysis of their efficacy.

UNLABELLED: Ibuprofen and acetaminophen are the most widely used analgesics in pediatric practice for the management of acute mild-to-moderate pain. Despite their widespread use, the comparative analgesic efficacy of these two agents in children remains a subject of ongoing debate, with existing evidence largely derived from heterogeneous clinical settings and small individual trials. Therefore, this study aimed to systematically review and meta-analyze randomized controlled trials comparing the analgesic efficacy of ibuprofen versus acetaminophen in pediatric populations with acute mild-to-moderate pain. A systematic literature search was conducted up to May 2026 in PubMed, Scopus, and Web of Science. The review was conducted and reported in accordance with the PRISMA-Children and Adolescents (PRISMA-C) 2026 reporting guideline. Eligible studies were randomized controlled trials comparing ibuprofen with acetaminophen in children and adolescents (defined as individuals aged 0 to < 18 years) with acute pain, reporting at least one extractable efficacy outcome. Continuous outcomes were synthesized as standardized mean differences (Hedges' g) using random-effects models; dichotomous outcomes were pooled as risk ratios (RRs) with 95% confidence intervals. Risk of bias was assessed using the Cochrane RoB 2 tool and certainty of evidence was evaluated using the GRADE framework. Eight randomized controlled trials enrolling 1325 participants were included. Three pediatric trials contributed to the primary continuous pain outcome meta-analysis (n = 196 analyzable participants), yielding a pooled SMD of - 0.28 (95% CI - 0.57 to 0.00; p = 0.052; I2 = 0%), indicating a small effect favoring ibuprofen that did not reach conventional statistical significance. Given the small number of contributing studies (k = 3), the I2 statistic should be interpreted with caution as it has limited power to detect heterogeneity in this context. For the dichotomous pain freedom outcome (2 trials, n = 114), no significant difference was observed (pooled RR 1.03, 95% CI 0.53-1.99; p = 0.93; I2 = 0%). A prespecified sensitivity analysis including an adult soft-tissue injury trial attenuated the pooled effect toward the null (SMD - 0.15, 95% CI - 0.38 to 0.09; p = 0.23; I2 = 36.6%). Narrative synthesis of additional studies generally demonstrated comparable analgesic efficacy between the two agents across postoperative and outpatient pediatric settings. The overall certainty of evidence was rated as low for both primary outcomes, primarily due to imprecision and indirectness. CONCLUSION: Current evidence from randomized controlled trials does not demonstrate a superiority of ibuprofen over acetaminophen for acute mild-to-moderate pain management in children. Both agents appear to provide clinically meaningful analgesia across heterogeneous pediatric pain settings. The clinical choice between agents should be guided by individual patient factors, including contraindications to NSAIDs, the inflammatory nature of the pain etiology, and patient-specific characteristics. The low certainty of evidence underscores the need for adequately powered, methodologically rigorous trials to definitively establish the comparative efficacy of these two analgesics in the pediatric population. WHAT IS KNOWN: • Ibuprofen and acetaminophen are the two most widely used non-opioid analgesics for acute mild-to-moderate pain in children, and both are recommended as first-line agents by major international guidelines. • Prior meta-analyses in mixed pediatric-adult populations have suggested a modest analgesic advantage of ibuprofen over acetaminophen, but pediatric-specific evidence has remained limited and methodologically heterogeneous. WHAT IS NEW: • This systematic review and meta-analysis, restricted to randomized controlled trials in pediatric populations, found that ibuprofen showed a small effect favoring pain reduction compared with acetaminophen (SMD - 0.28, p = 0.052), although this did not reach conventional statistical significance. • The analgesic advantage of ibuprofen may be more pronounced in pain etiologies with a significant inflammatory component (e.g., fractures). At the same time, both agents appear broadly equivalent in most other acute pediatric pain settings, supporting individualized analgesic selection based on clinical context and patient-specific factors.

Humans↗

PubMed1991

Immediate and delayed direct pulp capping with the use of a new visible light-cured calcium hydroxide preparation.

The pulpal response to mechanical exposure and capping either immediately or after 24 hours was investigated in 64 teeth of four cynomolgus monkeys with the use of Dycal, VLC Dycal, or Prisma-Bond. All overlying amalgam restorations were surface-sealed with zinc oxide-eugenol cement. After 2 months the teeth were removed and prepared for histologic examination; dentine bridges were present in almost all teeth filled with Dycal or VLC Dycal, and pulpal inflammation was observed in only one tooth that showed evidence of infection. Dentine bridges were usually incomplete when Prisma-Bond was used, although pulpal inflammation was only observed in 2 of 22 teeth. The success rate of pulp capping delayed for 24 hours was as high as that for immediate capping.

Animals↗

PubMed1991

Comparison of wet and dry finishing of resin composites with aluminum oxide discs.

Samples of four composites (Herculite, Visio-Dispers, Silux, and Prisma-Fil) were finished with aluminum-oxide discs either wet or dry so that the effects of these two finishing procedures could be compared. The samples were evaluated for surface smoothness, color stability, and surface hardness. Surface smoothness was determined immediately after a sample was finished with a profilometer. Knoop hardness values were determined for each sample immediately after being finished and once a week for five weeks. Color stability was evaluated with a tristimulus colorimeter by the color of each sample being finished and once a week for five weeks. When surface smoothness was compared between the wet- and dry-finished samples, there was no significant difference between Prisma-Fil, Silux, or Herculite; however, the wet-finished Visio-Dispers was significantly rougher than the dry-finished. When surface hardness was compared, there was no significant difference in hardness values between the wet and dry samples when compared over time. When changes in color were evaluated, only Visio-Dispers had no significant change in color for both the wet- and dry-finished samples over the five-week evaluation period. Dry finishing of only one composite (Silux) produced a significant change in color. Dry finishing of composites was superior or equal to wet finishing in all tests except for the color change in Silux.

Aluminum Oxide↗

PubMed2026

Treatment of Established Groin Lymphatic Complications After Arterial Surgery: A Systematic Review.

BACKGROUND: To systematically review the effectiveness and safety of interventions for established groin lymphatic complications after arterial vascular surgery. METHODS: PubMed, Embase, and Cochrane CENTRAL were searched from inception to May 28, 2025. This review was registered in PROSPERO (CRD420251061708) and conducted according to PRISMA, PRISMA-S, and Synthesis Without Meta-analysis (SWiM) guidance. Eligible studies included adults with established groin lymphorrhea/lymphocutaneous fistula or seroma/lymphocele after arterial exposure in the common femoral or iliofemoral region. Prophylactic studies were excluded. Two reviewers independently screened studies and assessed full texts. Prespecified outcomes were resolution, time to resolution, length of stay, surgical site infection, wound complications, reintervention, and recurrence. Owing to substantial heterogeneity, meta-analysis was not performed. RESULTS: Eighteen retrospective single-center studies were included; no randomized trials were identified. Reported strategy-family totals were operative control (n = 240, including 55 dye-assisted cases), intranodal lymphangiography with glue embolization (n = 39), intracavitary or chemical instillation (n = 52), negative-pressure wound therapy (n = 20), radiotherapy (n = 206), and drainage or aspiration alone (n = 7). One additional cohort compared nonsurgical with surgical management. Definitions, follow-up windows, and statistical reporting were inconsistent, and arm-level denominators were frequently incomplete. Risk of bias was serious to critical across the evidence base, mainly because of retrospective design, confounding by indication, treatment-selection bias, inconsistent outcome definitions, and incomplete reporting. Using GRADE principles, certainty of evidence was very low across strategies and phenotypes. Across study arms, conduit-directed approaches for external leak and cavity-directed approaches for encapsulated collections often achieved control, but valid comparative inference was not possible. CONCLUSION: Evidence is limited to small retrospective series with heterogeneous definitions, serious to critical risk of bias, and very low certainty. Reliable comparisons between interventions cannot currently be made. Standardized phenotype-specific definitions and outcome reporting are needed to support prospective studies and future trials.

Humans↗

PubMed1991

Leakage of a light-activated base: effect of dentin bonding agents.

This study investigated the sealing properties of Cavalite light-activated base material in conjunction with various dentin bonding agents. Thirty extracted molars were selected and cleaned. Slot preparations with standard dimensions were made. The prepared cavities were filled with Cavalite material after application of the dentin bonding agents Gluma, Prisma Universal Bond, Scotchbond 2, and Tenure. Samples were thermocycled for 180 cycles between 3 degrees C and 60 degrees C, then immersed in 0.05% crystal violet solution for 2 hours. The samples were embedded in clear casting resin, sectioned, and examined with a light microscope. Results indicated that Cavalite material used alone, without a dentin bonding agent, allowed the greatest degree of dye penetration. Cavalite material with Tenure bonding agent had the lowest degree of leakage. Cavalite material used with Scotchbond 2, Gluma, or Prisma Universal Bond bonding agents allowed an intermediate degree of dye penetration. According to an analysis of variance, however, there was no statistical difference in the effects of Tenure, Scotchbond 2, and Gluma bonding agents.

Acrylic Resins↗

PubMedDate not supplied

Shear bond strength of Dicor using resin adhesive systems and light activated cement.

A laboratory study was conducted to determine the shear bond strength to dentin of etched and silane-treated Dicor castable ceramic glass using a resin cement and newer generation adhesive systems. Scanning electron microscopy (SEM) examinations were also completed to evaluate the failure sites. The mean shear bond strength of the control (resin cement only, no adhesive system) was 2.1 +/- 1.2 MPa. The shear bond strength values determined for the adhesive systems and resin cement are as follows: Prisma Universal Bond 2, 18.7 +/- 2.9; XR Primer/XR Bond, 16.9 +/- 6.4; Scotchbond 2, 15.8 +/- 6.2; Tenure Solution, 15.4 +/- 4.5; and Gluma, 14.8 +/- 5.5 MPa. SEM examinations of the debonded specimens attached with Prisma Universal Bond 2 and Tenure Solution showed a complex failure pattern with cohesive failure in the glass ceramic material and adhesive failure between the resin cement and the etched and silane-treated glass surface. The debonding pattern of specimens attached with XR Primer/XR Bond, Scotchbond 2 and Gluma were primarily adhesive between the dentin and resin materials. The results of this study support the use of an adhesive system in conjunction with a resin cement for placement of Dicor castable ceramic restorations.

Ceramics↗

PubMed1992

Effect on dentinal adhesives on marginal adaptation and cavity sealing with resin restorations in vitro.

In a companion article in this issue and a previous article in this journal, two experimental enamel dentin adhesive systems were evaluated and compared with four commercially available resin bonding agents by SEM investigation of the tooth adhesive interfaces and by determination of bond strengths to enamel and dentin under various conditions. In continuation of these screening investigations, the present article describes the results of cavity tests for assessment of marginal adaptation by measurement of gap dimensions, and of cavity sealing by rating of microleakage, when standardized dentin cavities were treated with the adhesive restorative systems. Both tests resulted in the same ranking of the six materials. Gluma, Clearfil Photo Bond, and two experimental compounds showed very narrow gaps and moderate microleakage. In contrast, Prisma Universal Bond 2 (the material has been replaced in the market by Prisma Universal Bond 3) and Scotchbond 2 showed significantly wider marginal gaps and more pronounced microleakage. Final discrimination between the efficacy of adhesive restorative materials by any of the currently used in vitro tests is disputable and prediction of long-term clinical performance by laboratory test data remains questionable.

Adhesives↗

PubMed2026

Remotely Supervised, Home-Based Transcranial Direct Current Stimulation for Major Depressive Disorder: Systematic Review and Meta-Analysis.

BACKGROUND: Major depressive disorder affects over 280 million people worldwide, and access to effective treatment remains limited. Transcranial direct current stimulation (tDCS) is a noninvasive option, and portable devices now allow for home-based delivery under varying degrees of remote supervision. OBJECTIVE: This study aimed to systematically review and meta-analyze the efficacy, safety, feasibility, and acceptability of home-based and remotely supervised tDCS for depressive disorders. METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 and PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension) guidelines, we searched MEDLINE, Embase, Web of Science, the Cochrane databases, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform up to July 2025, with backward and forward citation searching. Two reviewers independently screened records, extracted data, and assessed risk of bias (version 2 of the Cochrane risk-of-bias tool for randomized trials, Newcastle-Ottawa Scale for observational studies, and Critical Appraisal Skills Programme for qualitative studies) and certainty of evidence (Grading of Recommendations Assessment, Development, and Evaluation; GRADE). RESULTS: This review included 12 distinct studies (16 reports), of which 6 (50%) were randomized sham-controlled trials forming the meta-analytic pool. Active home-based tDCS produced a small, statistically significant improvement over sham (pooled Hedges g=0.36, 95% CI 0.06-0.66; P=.03; I2=34.3%). The effect was not robust to removal of the single largest positive trial (omitting the one study from 2025: g=0.39, 95% CI -0.12 to 0.91), and trial-level results were mixed: the 2 largest trials (one unsupervised [n=210] and one self-administered [n=141]) were negative on their primary depression outcomes, whereas the largest real-time supervised trial (n=174) was positive (between-group 95% CI 0.51-4.01; P=.01). This estimate was concordant in direction with an independent peer-reviewed meta-analysis of overlapping trials, which reported a pooled Montgomery-Åsberg Depression Rating Scale reduction (weighted mean difference -2.74, 95% CI -4.19 to -1.29) and Hamilton Depression Rating Scale reduction (weighted mean difference -2.24, 95% CI -4.16 to -1.49), attenuating to nonsignificance (P>.05) in major depressive disorder without comorbid cognitive impairment. The pooled effect fell at or near the minimal clinically important difference. GRADE certainty was moderate. Adverse events were predominantly mild: one pilot study was terminated early for skin lesions, and one nonfatal suicide attempt occurred in an unsupervised trial. CONCLUSIONS: Home-based and remotely supervised tDCS produces a small, statistically significant but clinically modest antidepressant effect that is sensitive to the inclusion of the largest positive trial, with the 2 largest trials being negative. The available controlled evidence does not establish supervision intensity as a determinant of efficacy. Current data are insufficient to recommend routine clinical adoption; adequately powered trials with standardized supervision and longer follow-up are needed.

Humans↗

PubMed2026

Effectiveness of Wearable Digital Therapeutics in Improving Sleep Outcomes Among Individuals With Insomnia: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Wearable devices are increasingly used for sleep monitoring and as adjunctive treatment. Existing meta-analyses mostly pool composite digital therapies and rarely isolate stand-alone wearables or distinguish between objective and subjective end points. Whether stand-alone wearable interventions improve sleep outcomes in adults with insomnia, and which factors moderate treatment heterogeneity, remains unclear. OBJECTIVE: This study aims to evaluate the effectiveness of wearable digital interventions on sleep outcomes in adults with insomnia versus control strategies and explore moderators of effectiveness, including device-wearing position, intervention duration, and control type, using meta-regression. METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‑Analyses) 2020 statement and the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta‑Analyses Literature Search Extension) guideline. Five electronic databases and clinical trial registries were searched from inception to May 18, 2026. Eligible studies were randomized controlled trials (RCTs) evaluating wearable digital interventions in adults with insomnia compared with sham, waitlist, usual care, or active control conditions and had an intervention duration of at least 1 week. Study screening, data extraction, and risk-of-bias assessment were carried out independently by 2 reviewers. Pooled estimates were calculated using a restricted maximum likelihood random-effects model with the Hartung-Knapp-Sidik-Jonkman correction. Heterogeneity was assessed using the I² statistic, and 95% prediction intervals (PIs) were calculated for the primary analyses. The certainty of evidence was rated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. RESULTS: Sixteen RCTs (N=910) were included. Wearable digital interventions were associated with a significant reduction in objective sleep-onset latency (SOL; mean difference [MD] -4.52, 95% CI -8.38 to -0.67, PI -9.52 to 0.47 min) and a significant improvement in subjective sleep efficiency (SE; MD 2.00%, 95% CI 1.90%-2.11%, PI 1.85%-2.15%). Subjective total sleep time (TST) also showed a significant increase (MD 19.11, 95% CI 2.98-35.24, PI -16.20 to 54.43 minutes). Meta-regression showed that control type, intervention duration, and device location did not explain the heterogeneity of the insomnia severity index (ISI) (R²=0). Sensitivity analysis confirmed the robustness of pooled ISI estimates, and an Egger test indicated no small-study effects (P=.07). Certainty of evidence ranged from moderate to high. CONCLUSIONS: Wearable digital interventions provide selective benefits for objective SOL, subjective SE, and subjective TST in adults with insomnia, with no improvement in overall ISI. Despite statistically significant effects on several sleep parameters, wide PIs, substantial heterogeneity, and limited study numbers indicate preliminary, nonconclusive findings. Wearables should be viewed as affordable adjunctive tools requiring further validation, not substitutes for first-line cognitive behavioral therapy for insomnia. Large-scale, long-term RCTs with standardized protocols and patient-level external validation are required to consolidate the evidence base.

Humans↗

PubMed2026

Gut Dysbiosis in Selected Gynecological Diseases Associated with Female Infertility: A Scoping Review.

Background/Objectives: Female infertility represents a significant public health issue. Available evidence supports the hypothesis that the gut microbiota may play an essential role in women's reproductive health and may serve as a diagnostic or prognostic biomarker in specific gynecological disorders. A substantial part of current research concerns disturbed communication between the hypothalamic-pituitary-ovarian axis and the gut microbiota, providing the basis for analyzing this phenomenon as the gut-ovary axis or the gut-vagina-ovary axis. The primary aim of this scoping review was to map the available evidence on the relationship between gut microbiota composition and female infertility, with particular emphasis on polycystic ovary syndrome (PCOS, currently polyendocrine metabolic ovarian syndrome, PMOS) endometriosis, and uterine fibroids. Methods: The review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, and Google Scholar were searched using terms related to gut microbiota, female infertility, PCOS, endometriosis, and uterine leiomyomas. Peer-reviewed publications in English published between 2015 and 2025 were considered. The included studies were descriptively synthesized to identify recurring microbiota patterns and research gaps. Results: The reviewed evidence indicates that gut dysbiosis may be associated with selected gynecological disorders affecting fertility, including PCOS, endometriosis, and uterine fibroids. The gut microbiome may have potential value as a biomarker supporting diagnosis, treatment selection, and prognosis. Conclusions: The gut microbiome represents a promising but still insufficiently validated area in the management of gynecological diseases associated with female infertility. Further high-quality clinical studies are needed to verify the effectiveness of microbiome-based therapies and to develop evidence-based guidelines for managing infertility associated with gut dysbiosis.

dysbiosis↗