***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Correctable weaknesses in the design , conduct , and analysis of biomedical and public health research studies can produce misleading results and waste valuable re sources . Small effects can be difficult to distinguish from bias introduced by study design and analyses . An absence of detailed written protocol s and poor documentation of research is common . Information obtained might not be useful or important , and statistical precision or power is often too low or used in a misleading way . Insufficient consideration might be given to both previous and continuing studies . Arbitrary choice of analyses and an overemphasis on r and om extremes might affect the reported findings . Several problems relate to the research workforce , including failure to involve experienced statisticians and method ologists , failure to train clinical research ers and laboratory scientists in research methods and design , and the involvement of stakeholders with conflicts of interest . Inadequate emphasis is placed on recording of research decisions and on reproducibility of research . Finally , reward systems incentivise quantity more than quality , and novelty more than reliability . We propose potential solutions for these problems , including improvements in protocol s and documentation , consideration of evidence from studies in progress , st and ardisation of research efforts , optimisation and training of an experienced and non-conflicted scientific workforce , and reconsideration of scientific reward systems Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials AIM : This was to evaluate the retention rate of fissure sealants applied to MIH molars with occlusal enamel opacities , using two different application methods after 4 years . METHODS : 54 children exhibiting molars with MIH aged 6–7 years , participated in the study . Selection criteria : presence of at least 2 fully erupted caries-free maxillary or m and ibular first permanent molars in the opposite sides of the mouth , both with occlusal enamel opacities without breakdown . Following parental consent , sealants were applied using a half-mouth experimental design . Group A : On a r and omly assigned first molar on one side of the mouth sealants ( Fissurit ® ) were placed using a single bottle adhesive system ( One-step ® ) prior to sealant application . Group B : Sealants were applied on the contra-lateral molar using the conventional etch and seal technique . Children were seen biannually when a preventive program was applied , without replacing any lost sealant . RESULTS : After 4 years , 47 sets of molars ( 94 teeth ) were available for blind evaluation . Teeth in Group A presented a better retention rate ; 70.2 % were fully sealed , 29.7 % partly sealed and none unsealed ( lost sealant ) . Group B revealed 25.5 % fully sealed , 44.6 % partly sealed and 29.7 % unsealed teeth . STATISTICS : Differences between groups A and B were statistically significant ( p<0.001 ) . Also both groups revealed a decreasing retention rate over the 4-year period ( p<0.001 ) . There was no difference in dental caries increment rate and enamel breakdowns at the end of the study ( p>0.01 ) . CONCLUSIONS : In hypomineralised molars with occlusal opacities  sealants appear to have greater retention when applied using 5th generation adhesive systems prior to sealant AIM The objective of this investigation was to evaluate the clinical performance of  composite restorations in enamel hypomineralised posterior teeth . METHODS 52 composite restorations were placed in 52 permanent molars of 46 children , aged 8 - 10 years . All the teeth were clinical ly diagnosed as hypomineralised and restorations were placed on two or more surfaces of the teeth , including cusps . All treated teeth had at least 2 sound surfaces , thus excluding defective teeth with total disruption of the crown . The material s used were a hybrid composite and a fourth generation one-bottle adhesive material and manufacturer 's instructions were carefully followed . The restorations were initially evaluated 7 days after the treatment and subsequent evaluation was performed at 12 , 24 , 36 , 48 months . Clinical evaluation of the restorations was made according to the criteria of Ryge [ 1980 ] . RESULTS In 6 cases , postoperative complaint was relieved after occlusal re-adjustment at the second appointment , 7 days later . At the end of the 48 months study period , 49 restorations were available for evaluation , all with full retention . Radiographically there was no periapical pathology . Problems were found in colour match in 10 , surface appearance in 3 and anatomic form in 4 restorations . Hypersensitivity was recorded in 17 teeth after one week and in 3 teeth one year later . All teeth were sensitivity free after two years and until the end of the study period . CONCLUSIONS Composite resin restorations using contemporary material s , in certain cases of hypomineralised permanent molars , can be an acceptable restorative procedure with satisfactory long-term results Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE The objective of this study was to investigate the effect of fluoride varnish on remineralization of anterior teeth affected by Molar-Incisor Hypomineralization ( MIH ) by means of Quantitative Light-Induced Fluorescence- QLF . STUDY DESIGN Fifty-one healthy 9 - 12- year-old children were selected according to different clinical ly diagnosed levels of MIH , proposed by the European Academy of Pediatric Dentistry ( 2003 ) ( considering the most severe lesion per patient , n= 51 lesions ) , and r and omly divided into two groups : ( 1 ) four applications of 5 % NaF varnish , with one-week interval , and ( 2 ) usual home care- control . At each visit , the mean change in fluorescence and area of lesion were measured by QLF . The data were analyzed by repeated measures ANOVA and Tukey 's test . RESULTS All patients showed enamel alterations in first permanent molars and incisors , frequently with two molars affected by MIH ( 41.1 % ) . There was no statically significant difference in the mean of fluorescence and area of lesion between groups over the studied time . CONCLUSION We observed no favorable effect on the remineralization of MIH lesions in anterior teeth after four applications of fluoride varnish The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . Introduction The restorative management of molars with molar incisor hypomineralization ( MIH ) represents a challenge in the clinical practice with high failure rate . Objective The aim of this study is to evaluate the clinical survival of  direct composite resin restorations in first permanent molars ( FPMs ) that are affected by MIH , comparing two adhesive systems . Material and methods We selected 41 FPMs with MIH from children aged 6–8 years . FPM fully erupted and with restorative treatment needed were the inclusion criteria . We excluded FPMs with destroyed crowns . The FPMs were r and omly assigned to two groups : self-etching adhesive ( SEA ) and total-etch adhesive ( TEA ) . Clinical evaluation was performed by a blinded examiner during 18 months according to the modified US Public Health Service ( USPHS ) criteria . The actuarial method was used to evaluate survival of the restorations , and Chi-square and Fisher ’s exact tests were used to compare differences between the groups ( α = 5 % ) . Results The cumulative survival rates were 100 % at 1 month , 89 % at 6 months , 73 % at 12 months , and 68 % at 18 months in SEA , and 95 % at 1 month , 72 % at 6 months , 59 % at 12 months , and 54 % at 18 months in TEA ; there was no significant difference between groups . Conclusions There was no difference in clinical survival of restorations in FPMs affected by MIH using TEA or SEA adhesives in the end of 18 months . Clinical relevance It was suggested that SEAs as well as TEAs can be applied to restore molars affected by MIH , when it is performed a conservative cavity preparation . Once , cavosurface margins ( cavity design ) in hypomineralized enamel have less bonding capability Background R and omized controlled trials ( RCTs ) are considered the gold st and ard for assessing the efficacy of new treatments compared to st and ard treatments . However , the reasoning behind treatment selection in RCTs is often unclear . Here , we focus on a cohort of RCTs in multiple myeloma ( MM ) to underst and the patterns of competing treatment selection s. Methods We used social network analysis ( SNA ) to study relationships between treatment regimens in MM RCTs and to examine the topology of RCT treatment networks . All trials considering induction or autologous stem cell transplant among patients with MM were eligible for our analysis . Medline and abstract s from the annual proceedings of the American Society of Hematology and American Society for Clinical Oncology , as well as all references from relevant publications were search ed . We extracted data on treatment regimens , year of publication , funding type , and number of patients enrolled . The SNA metrics used are related to node and network level central ity and to node positioning characterization . Results 135 RCTs enrolling a total of 36,869 patients were included . The density of the RCT network was low indicating little cohesion among treatments . Network Betweenness was also low signifying that the network does not facilitate exchange of information . The maximum geodesic distance was equal to 4 , indicating that all connected treatments could reach each other in four “ steps ” within the same pathway of development . The distance between many important treatment regimens was greater than 1 , indicating that no RCTs have compared these regimens . Conclusion Our findings show that research programs in myeloma , which is a relatively small field , are surprisingly de central ized with a lack of connectivity among various research pathways . As a result there is much crucial research left unexplored . Using SNA to visually and analytically examine treatment networks prior to design ing a clinical trial can lead to better design ed studies Objectives This prospect i ve longitudinal study aim ed to evaluate if the occurrence of post-eruptive breakdown of demarcated opacities in hypomineralized teeth is influenced by the color or location of the opacity . Material s and methods Patients diagnosed with molar-incisor hypomineralization ( MIH ) between 2012 and 2014 were eligible . Two calibrated examiners performed the initial and follow-up evaluations according to European Academy of Paediatric Dentistry ( EAPD ) criteria . Sixty-five patients were included . Fifty-eight ( 89.2 % ) , with a mean age of 8.8 years ( SD : 1.4 ) , were reassessed after 1 year . Two hundred and nine of 1155 tooth surfaces were considered for the study : 86 with white opacity ( OP-W ) , 91 with yellow opacity ( OP-Y ) , and 32 with enamel breakdown ( EB ) . Results From the OP-W , OP-Y , and EB , 14 , 27.5 , and 46.9 % worsened to breakdown exposing dentin , atypical restoration , or extraction ( DB + RA or EXT ) , respectively . Yellow opacities tended to be more prone to breakdown than white opacities . The occurrence of EB , DB + AR , or EXT was not influenced by the location ( p = 0.25 ) . Conclusions The color of the opacity seems to play an important role on the occurrence of fracture and should be considered as a potential predictor . Clinical relevance Dentists should be aware that demarcated opacities related to 
    Output:
    
Two highly clustered comparator networks emerged ; many interventions were not robustly linked to these networks .
MIH intervention studies recorded both clinical ly centred and patient-centred outcomes .