How does smartphone addiction affect the lives of adolescents socially and academically?: a systematic review study

Today, adolescents tend to accept smartphones more quickly than adults and spend more time with these devices since they are members of the first generation born and living in environments where smartphones and the internet are common. However, when they use smartphones excessively and become addicted to smartphones, this may cause them to suffer from various psychological, emotional, and physical health problems from an early age. Therefore, this study systematically examines the articles on smartphone addiction in adolescents. For this purpose, the related articles were screened using the Web of Science database and 188 studies by the search criteria were subjected to a systematic review. In this sense, methodological tendencies, variables and main findings of the studies included in the present study were examined. This study revealed that the quantitative research method was primarily used. The studies mainly investigated smartphone use, social relations, demographic characteristics, depression, personal characteristics, and sleep variables. Moreover, the studies were primarily conducted in China, and large sample groups were preferred. The factors that triggered the smartphone addiction of adolescents were family problems, and especially females were more addicted to smartphones than males. Moreover, smartphone addiction causes depressive symptoms, sleep problems, and decreased academic achievement in adolescents. Finally, various suggestions were presented based on the findings of this study.

A New Clinical Tool for Scoliosis Risk Analysis: Scoliosis Tele-Screening Test

STUDY DESIGN

Methodological, observational clinical study.

PURPOSE

This study aimed to develop a virtual screening test to detect scoliosis risk initially by parents without the need for medical visit during the coronavirus disease 2019 pandemic.

OVERVIEW OF LITERATURE

The scoliosis screening program has been implemented to early detect scoliosis. Unfortunately, access to health professionals was limited during the pandemic. However, during this time, interest in telemedicine has increased remarkably. Recently, mobile applications related to postural analysis were developed, but none permits evaluation by parents.

METHODS

Researchers developed the Scoliosis Tele-Screening Test (STS-Test), which included drawing-based images of body asymmetries, to assess the scoliosis-associated risk factors. The STS-Test was shared on social networks, allowing the parents to evaluate their children. After test completion, the risk score was generated automatically, and children with medium and high risks were then advised for medical consultation for further evaluation. The test accuracy and consistency between the clinician and parents were also analyzed.

RESULTS

Of the 865 tested children, 358 (41.4%) consulted clinicians to confirm their STS-Test results. Scoliosis was then confirmed in 91 children (25.4%). The parents were able to detect asymmetry in 50% of the lumbar/thoracolumbar curvatures and 82% of the thoracic curvatures. In addition, the forward bend test revealed favorable agreement between parents and clinicians (r =0.809, p<0.0005). Internal consistency of the esthetic deformities domain in the STS-Test was also excellent (α=0.901). This tool was 94.97% accurate, 83.51% sensitive, and 98.87% specific.

CONCLUSIONS

The STS-Test is a new parent-friendly, virtual, cost-effective, result-oriented, and reliable tool for scoliosis screening. It allows parents to actively participate in the early detection of scoliosis by screening their children for the risk of scoliosis periodically without the need to visit the health institution.

The use of immersive technologies in distance education: A systematic review

This study aims to conduct a systematic review that includes studies on the use of immersive technologies in distance education. For this purpose, 132 studies detected by searching Web of Science, Eric, Taylor & Francis and Education Full Text (EBSCO) databases were examined. The studies were analysed using the content analysis method. As a result of the analyses, it was observed that the first study investigating the subject was conducted in 2002, and the number of related studies increased over the years. In addition, these studies were primarily conducted quantitatively, were mainly journal articles, and originated mostly from China and the USA. Moreover, the sample groups of these studies consisted mostly of university students. Therefore, they mainly used academic performance and motivation variables. Furthermore, these studies were conducted primarily in the science and medical education disciplines. When the studies were evaluated in terms of publication journals, it was determined that they were published mostly in "Education Science" and "Computers & Education" journals. They were also included in the proceedings published within the scope of various conferences. When the application platforms in the studies were examined, it was determined that the UNITY and ARTUTOR platforms were mostly used. The findings of the studies revealed that the increase in academic performance and motivation was one of the most reported advantages of such technologies. On the other hand, the problems caused while using these technologies and the internet were the most reported difficulties in the studies. Finally, the review presented suggestions for future studies.

Validity, inter-rater reliability, and feasibility of the Chelsea Physical Assessment Tool for assessing physical function in post-acute COVID-19 patients: A cross-sectional study

BACKGROUND

Various tools have been created to measure physical function during intensive care unit (ICU) stay and after ICU discharge, but those have not been validated in coronavirus 2019 (COVID-19) patients. There is a need for a reliable, valid and feasible tool to define the rehabilitation needs of post-ICU COVID-19 patients entering the acute wards and then rehabilitation clinics.

OBJECTIVE

This study aims to investigate the validity, inter-rater reliability and feasibility of Chelsea Physical Assessment Tool (CPAx) in assessing the functional status of COVID-19 patients after discharge from the ICU.

METHODS

Demographic and clinical characteristics of the patients were recorded. Patients were evaluated using the modified Medical Research Council (MRC) dyspnea scale, Functional Oral Intake Scale, Glasgow Coma Scale, CPAx, Barthel Index, Katz Index and MRC sum score, measurements of grip strength obtained by dynamometer, the 5 time sit-to-stand test and 30 seconds and sit-to-stand test. CPAx and the other functional assessment tools were administered to 16 patients within 48 hours following ICU discharge. For inter-rater reliability, another physiatrist independently re-assessed the patients. MRC sum score, Barthel and Katz indexes were used to assess construct validity of CPAx. The discriminative validity of CPAx was determined by its ability to differentiate between patients with and without ICU acquired muscle weakness based on MRC sum score. The intra-class correlation coefficients (ICC) were calculated to determine inter-rater reliability for total scores of the functional assessment tools. Cohen's Kappa (κ) coefficient and weighed Kappa (κw) were calculated to determine inter-rater reliability of individual CPAx items. Ceiling and flooring effects were calculated by percentage frequency of lowest or highest possible score achieved. The number and percentages of the patients who were able to complete each tool were calculated to assess feasibility.

RESULTS

The CPAx score was strongly correlated with MRC sum score (rho: 0.83), Barthel Index (rho: 0.87) and Katz Index (rho: 0.89) (p< 0.001) showing construct validity. Area under the ROC curve demonstrated that cut off score for CPAx was ⩽ 12 to discriminate patients with MRC sum score < 48, with a sensitivity and a specificity of 100% and 63%, respectively (AUC = 0.859, p< 0.001). ICC was high for CPAx, MRC sum score, Barthel and Katz indexes, Glasgow Coma Scale, and hand grip strength measurement, with the highest value observed for CPAx (ICC, 0.96; 95% confidence interval (CI), 0.71-0.98). κ and κw analysis showed good to excellent inter-rater reliability for individual CPAx items. No floor or ceiling effect was observed at CPAx while floor effect was observed at Barthel Index scores (25%) and Katz Index scores (37.5%). All patients could be evaluated using CPAx while less were physically able to complete the 5 time sit-to-stand, 30 seconds sit-to-stand tests (n= 4) and MRC sum score (n= 14).

CONCLUSION

CPAx is a valid, reliable, and feasible tool to assess the physical functional state in COVID-19 patients following discharge from the ICU.

Musculoskeletal complaints and associated factors in school children aged between 6 and 13 years in Istanbul during the COVID-19 pandemic: A cross-sectional study

BACKGROUND: Following the first COVID-19 cases in Turkey, face-to-face education was ceased after March 16, 2020 until the end of the educational year (i.e. June 19, 2020) and education was substituted remotely due to confinement. OBJECTIVE: This study aims to investigate the frequency of musculoskeletal complaints in school-age children and associated risk factors including reduced physical activity, increased screen time and poor ergonomics conditions in school-age children during the pandemic. METHODS: This cross-sectional study included parents or guardians of 960 students aged between 6–13 years old with a non-randomized sampling. A survey was administered consisting of 66 items related with sociodemographic characteristics of the children and family, online education hours, technological device(s) used, screen time, type of physical activity, presence of musculoskeletal problems and poor ergonomics conditions such as incorrect sitting posture. RESULTS: Logistic regression results demonstrated that age, excess weight gain, total daily screen time, smartphone use, incorrect sitting posture were associated with musculoskeletal complaints. CONCLUSION: The long-term closure of schools due to the pandemic may have led to an increase in musculoskeletal complaints in 6–13 years old children, based on the factors identified in this study, which were excess weight gain, increased screen time and incorrect sitting posture. These findings might help education and health authorities to develop strategies to improve musculoskeletal health of children especially in emergencies such as the pandemic.

The university students' self-regulated effort, flexibility and satisfaction in distance education

Distance education offers flexible learning opportunities in terms of time, place and learning speed to teachers and students through internet technologies. However, the learning opportunities provided in distance education environments require students to act more autonomously and take more responsibility for regulating their learning processes to achieve their learning goals. For this reason, it is crucial to reveal the relationships between flexibility, self-regulated effort and satisfaction factors to provide efficient and effective learning environments in distance education. Accordingly, within the scope of this study, it is aimed to investigate university students' perceptions of flexibility, self-regulated effort and satisfaction with the distance education process, and their views on distance education. Survey research was used as the research method in the study. The study sample consisted of 1760 university students studying at 28 different universities. Data were analysed using t-test, ANOVA, and regression methods. As a result of the study, male students were more satisfied with distance education than female students, and education faculty students had the highest level of satisfaction. In addition, self-regulated effort and flexibility variables were significant factors affecting students' satisfaction towards distance education. Furthermore, the advantages and problems of distance education and suggestions for future distance learning environments were presented in the light of students views. Finally, the study's implications and various recommendations for practitioners and researchers were discussed in detail.

Is tele-rehabilitation superior to home exercise program in COVID-19 survivors following discharge from intensive care unit? - A study protocol of a randomized controlled trial

Background and Purpose

Evaluating the patients with COVID‐19 following discharge from intensive care unit for pulmonary rehabilitation is crucial. It could be difficult to participate rehabilitation program due to transportation problems and cautions for contagiousness. Tele‐rehabilitation could serve as a favorable alternative. The primary aim of this study is to investigate whether supervised telerehabilitation is superior to home exercise program regarding walking distance and secondarily muscle strength, muscle endurance, quality of life, physical activity level and perceived respiratory disability.

Methods

This is a randomized assessor blinded control trial with two groups; tele‐rehabilitation and home exercise. One hundred twenty‐two COVID‐19 survivors following discharge from intensive care unit will be allocated into two groups. The tele‐rehabilitation group will receive breathing, aerobic, posture, stretching, strengthening exercises at their home under remote supervision via Internet for 3 days/week for 10 weeks. Home exercise group will receive the same program at their home on their own and they will be called weekly. The patients will be evaluated at the beginning, at the end of the program, 6^th and 12^th months following the rehabilitation. The primary outcome is the change in 6‐minute walking distance; the secondary outcomes are changes in quality of life, physical function, health status, dyspnea and muscle strength.

Impact Statement

This detailed description of the rehabilitation protocol will guide to plan the rehabilitation program and help how to design an efficacy study comparing different models of rehabilitation in COVID‐19 survivors following discharge from intensive care unit with evidence‐based contribution to the literature.

Physical rehabilitation in Intensive Care Unit in acute respiratory distress syndrome patients with COVID-19

BACKGROUND

The risk of muscle weakness is high in the survivors of acute respiratory distress syndrome with COVID-19 following discharge from intensive care unit.

AIM

To evaluate the effects of early rehabilitation program in intensive care unit in patients with acute respiratory distress syndrome secondary to COVID-19.

DESIGN

The design of the study is observational.

SETTING

The setting of the study is inpatient.

POPULATION

Thirty-five patients with acute respiratory distress syndrome secondary to COVID-19 were enrolled.

METHODS

This study was performed in an intensive care unit of a university hospital. Early rehabilitation program consisting of passive or active range of motion exercises and neuromuscular electrical stimulation in addition to standard intensive care (N.=18) compared to standard intensive care (N.=17). Primary outcome was hand grip strength following discharge.

RESULTS

Rehab group had higher prevalence of chronic pulmonary diseases and neurologic diseases. There was no difference in hand grip or manual muscle strength following discharge between rehab and non-rehab groups. No adverse event was noted.

CONCLUSIONS

The results did not support the beneficial effects of early rehabilitation in intensive care unit on improving muscle strength. More patients with pulmonary and neurologic diseases in rehab group might impede the impact of rehabilitation on outcomes. On the other hand, these comorbidities underline the role and need of rehabilitation. It is safe both for the patients and the health care workers when necessary precautions are taken.

CLINICAL REHABILITATION IMPACT

This study guide how to rehabilitate patients with acute respiratory distress syndrome with COVID-19 during intensive care unit in a safe way.

Peripheral axonal excitability in hemiplegia related to subacute stroke

Background/aim

This study aims to investigate peripheral nerve excitability in patients with subacute stroke.

Materials and methods

The study was performed in 29 stroke patients within the subacute period and 29 healthy controls using QTRAC software and TRONDNF protocol. The threshold electrotonus, recovery cycle, stimulus-response, strength-duration, and current-threshold relationships were recorded.

Results

The membrane was more hyperpolarized, and excitability was decreased in the hemiplegic side. The impairment of inward rectifying channel function, degree of hyperpolarization, and decrease of excitability were directly related to the Brunnstrom stages, which were more pronounced in lower stages.

Conclusion

The lower motor neurons were affected at the level of axonal channels as a result of upper motor neuron lesions. It can be due to dying back neuropathy, homeostasis, and neurovascular regulation changes in the axonal environment, activity-dependent plastic changes, loss of drive coming from the central nervous system, or a combination of these factors.

Functional Architecture of Motion Direction in the Mouse Superior Colliculus

Motion vision is important in guiding animal behavior. Both the retina and the visual cortex process object motion in largely unbiased fashion: all directions are represented at all locations in the visual field. We investigate motion processing in the superior colliculus of the awake mouse by optically recording neural responses across both hemispheres. Within the retinotopic map, one finds large regions of ∼500 μm size where neurons prefer the same direction of motion. This preference is maintained in depth to ∼350 μm. The scale of these patches, ∼30 degrees of visual angle, is much coarser than the animal's visual resolution (∼2 degrees). A global map of motion direction shows approximate symmetry between the left and right hemispheres and a net bias for upward-nasal motion in the upper visual field.

The sifting of visual information in the superior colliculus

Much of the early visual system is devoted to sifting the visual scene for the few bits of behaviorally relevant information. In the visual cortex of mammals, a hierarchical system of brain areas leads eventually to the selective encoding of important features, like faces and objects. Here, we report that a similar process occurs in the other major visual pathway, the superior colliculus. We investigate the visual response properties of collicular neurons in the awake mouse with large-scale electrophysiology. Compared to the superficial collicular layers, neuronal responses in the deeper layers become more selective for behaviorally relevant stimuli; more invariant to location of stimuli in the visual field; and more suppressed by repeated occurrence of a stimulus in the same location. The memory of familiar stimuli persists in complete absence of the visual cortex. Models of these neural computations lead to specific predictions for neural circuitry in the superior colliculus.

Optical dopamine monitoring with dLight1 reveals mesolimbic phenotypes in a mouse model of neurofibromatosis type 1

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder whose neurodevelopmental symptoms include impaired executive function, attention, and spatial learning and could be due to perturbed mesolimbic dopaminergic circuitry. However, these circuits have never been directly assayed in vivo. We employed the genetically encoded optical dopamine sensor dLight1 to monitor dopaminergic neurotransmission in the ventral striatum of NF1 mice during motivated behavior. Additionally, we developed novel systemic AAV vectors to facilitate morphological reconstruction of dopaminergic populations in cleared tissue. We found that NF1 mice exhibit reduced spontaneous dopaminergic neurotransmission that was associated with excitation/inhibition imbalance in the ventral tegmental area and abnormal neuronal morphology. NF1 mice also had more robust dopaminergic and behavioral responses to salient visual stimuli, which were independent of learning, and rescued by optogenetic inhibition of non-dopaminergic neurons in the VTA. Overall, these studies provide a first in vivo characterization of dopaminergic circuit function in the context of NF1 and reveal novel pathophysiological mechanisms.

Does hand grip strength decrease in chronic obstructive pulmonary disease exacerbation? A cross-sectional study

Background/aim

Respiratory and peripheral muscle strength are reduced in chronic obstructive pulmonary disease (COPD). There is a well-known correlation between handgrip strength (HGS) and strenght extremity muscles. Our aim in this study was to measure HGS and investigate the related factors in COPD patients with exacerbation.

Materials and methods

Subjects with COPD exacerbation (n = 101) and stable COPD (n = 22), and subjects without COPD (n = 201), were enrolled in this study. Age, sex, and body mass index were similar. HGS was measured using a Vigorimeter. Pulmonary function tests and 6-min walk tests were performed.

Results

The mean HGS was significantly lower in subjects with COPD exacerbation than those with stable COPD and subjects without COPD. The mean HGS was similar between stable COPD and non-COPD subjects. The mean 6-min walk distance (6MWD) was significantly lower in subjects with COPD exacerbation than stable COPD. There was a significant correlation between HGS and 6MWD but no correlation between HGS and pulmonary function tests.

Conclusion

In subjects with COPD exacerbation, the HGS was lower than that of stable COPD patients, and this difference was not explained by age, comorbidities, severity of obstruction, or smoking. Physical inactivity and steroid use during exacerbation might be possible factors affecting HGS. HGS was moderately correlated with 6MWD in cases of exacerbation. It may be used as a measure of muscle performance in COPD exacerbation, especially when the 6-min walk test cannot be performed.

Perceived social support and depression levels of women in the postpartum period in Hatay, Turkey

Objectives

Postpartum depression is one of the major problems affecting the mother and baby's health. Inadequate social support system may affect the occurrence of this problem. This study was performed to determine the depression and social support in women at the postpartum period.

Materials and Methods

This study was designed as a cross-sectional study. The research was conducted in Narlıca No. 2 family health center located in the city center of Hatay with 177 women who have given birth at least 2-4 months before and agreed to participate in the study. Edinburgh Postpartum Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Sociodemographic Information Form was utilized for data collection.

Results

It was determined that women's scores of EPDS and MSPSS were affected by the variables of intended pregnancy and obtained support for infant care (P < 0.05). A significant negative correlation (P < 0.01) was found between MSPSS and EPDS scales.

Conclusion

This study concludes that as social support levels increase there is a decrease at postpartum depression risk. It is recommended that planning of interventions should be in accordance with the factors affecting the social support and depression levels at women in the postpartum period.

Modulation of estrogen related receptor alpha activity by the kinesin KIF17

Estrogen-related receptor alpha (ERR1) is an orphan nuclear receptor that can bind transcriptional co-activators constitutively. ERR1 expression correlates with poor patient outcomes in breast cancer, heightening interest in this nuclear receptor as a therapeutic target. Because ERR1 has no known regulatory ligand, a major challenge in targeting its activity is to find cellular or synthetic modulators of its function. We identified an interaction between ERR1 and KIF17, a kinesin-2 family microtubule motor, in a yeast-2-hybrid screen. We confirmed the interaction using in vitro biochemical assays and determined that binding is mediated by the ERR1 ligand-binding/AF2 domain and the KIF17 C-terminal tail. Expression of KIF17 tail domain in either ER-negative or ER-positive breast cancer epithelial cells attenuated nuclear accumulation of newly synthesized ERR1 and inhibited ERR1 transcriptional activity. Conversely, ERR1 transcriptional activity was elevated significantly in KIF17 knock-out cells. Sequence analysis of the KIF17 tail domain revealed it contains a nuclear receptor box with a conserved LXXLL motif found in transcriptional co-activators. Expression of a 12 amino-acid peptide containing this motif was sufficient to inhibit ERR1 transcriptional activity and cell invasion, while deletion of this region from the KIF17 tail resulted in increased ERR1 activity. Together, these data suggest KIF17 modifies ERR1 function by two possible, non-exclusive mechanisms: (i) by regulating nuclear-cytoplasmic distribution or (ii) by competing with transcriptional co-activators for binding to ERR1. Thus targeting the ERR1-KIF17 interaction has potential as a novel strategy for treating breast cancer.

Dynamic labelling of neural connections in multiple colours by trans-synaptic fluorescence complementation

Determining the pattern of activity of individual connections within a neural circuit could provide insights into the computational processes that underlie brain function. Here, we develop new strategies to label active synapses by trans-synaptic fluorescence complementation in Drosophila. First, we demonstrate that a synaptobrevin-GRASP chimera functions as a powerful activity-dependent marker for synapses in vivo. Next, we create cyan and yellow variants, achieving activity-dependent, multi-colour fluorescence reconstitution across synapses (X-RASP). Our system allows for the first time retrospective labelling of synapses (rather than whole neurons) based on their activity, in multiple colours, in the same animal. As individual synapses often act as computational units in the brain, our method will promote the design of experiments that are not possible using existing techniques. Moreover, our strategies are easily adaptable to circuit mapping in any genetic system.

Reconstitution of glucosylceramide flip-flop across endoplasmic reticulum: implications for mechanism of glycosphingolipid biosynthesis

Most glycosphingolipids are synthesized by the sequential addition of monosaccharides to glucosylceramide (GlcCer) in the lumen of the Golgi apparatus. Because GlcCer is synthesized on the cytoplasmic face of Golgi membranes, it must be flipped to the non-cytoplasmic face by a lipid flippase in order to nucleate glycosphingolipid synthesis. Halter et al. (Halter, D., Neumann, S., van Dijk, S. M., Wolthoorn, J., de Mazière, A. M., Vieira, O. V., Mattjus, P., Klumperman, J., van Meer, G., and Sprong, H. (2007) Pre- and post-Golgi translocation of glucosylceramide in glycosphingolipid synthesis. J. Cell Biol. 179, 101-115) proposed that this essential flipping step is accomplished via a complex trafficking itinerary; GlcCer is moved from the cytoplasmic face of the Golgi to the endoplasmic reticulum (ER) by FAPP2, a cytoplasmic lipid transfer protein, flipped across the ER membrane, then delivered to the lumen of the Golgi complex by vesicular transport. We now report biochemical reconstitution studies to analyze GlcCer flipping at the ER. Using proteoliposomes reconstituted from Triton X-100-solubilized rat liver ER membrane proteins, we demonstrate rapid (t(½) < 20 s), ATP-independent flip-flop of N-(6-((7-nitro-2-1,3-benzoxadiazol-4-yl)amino)hexanoyl)-D-glucosyl-β1-1'-sphingosine, a fluorescent GlcCer analog. Further studies involving protein modification, biochemical fractionation, and analyses of flip-flop in proteoliposomes reconstituted with ER membrane proteins from yeast indicate that GlcCer translocation is facilitated by well characterized ER phospholipid flippases that remain to be identified at the molecular level. By reason of their abundance and membrane bending activity, we considered that the ER reticulons and the related Yop1 protein could function as phospholipid-GlcCer flippases. Direct tests showed that these proteins have no flippase activity.