The musculoskeletal problems and psychosocial status of teachers giving online education during the COVID-19 pandemic and preventive telerehabilitation for musculoskeletal problems

BACKGROUND

Musculoskeletal and psychosocial problems have tended to increase during the COVID-19 pandemic.

OBJECTIVE

To evaluate the changes in musculoskeletal problems and psychosocial status of teachers during the COVID-19 pandemic due to online education and to investigate the effects of preventive telerehabilitation applications for musculoskeletal problems.

METHODS

Forty teachers who conducted online education during the pandemic volunteered to participate in the study. All assessments were performed via online methods. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), ProFitMap-Neck questionnaire, Oswestry Disability Index (ODI), and Upper Extremity Functional Index (UEFI) were used to evaluate musculoskeletal problems; the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to evaluate anxiety and depression, respectively; and the Work-Life Balance Scale (WLBS) was used to evaluate how well individuals achieve this balance. Information about before online education, during online education, and after training was obtained with the assessments. After the first assessment, telerehabilitation, which involved presentations and brochures, was applied to 18 participants willing to participate in the training.

RESULTS

The ProFitMap, UEFI, and WLBS scores during the online education decreased significantly, while the scores of the CMDQ, ODI, BDI, and BAI during the online education increased significantly compared to the pre-online education scores (p < 0.05). In addition, the total CMDQ, ProFitMap, and ODI scores improved significantly after the training (p < 0.05).

CONCLUSION

Musculoskeletal and psychosocial problems increased in teachers during online education. Preventive telerehabilitation methods will be beneficial for individuals who do not have access to face-to-face physiotherapy.

Assessment of dental anxiety levels among dental emergency patients during the COVID‑19 pandemic through the Modified Dental Anxiety Scale

BACKGROUND

Coronavirus disease 2019 (COVID‑19) continues to affect dental emergency services worldwide. Dental anxiety (DA) is described as a common and distressing problem in terms of oral health maintenance.

OBJECTIVES

The present study aimed to evaluate DA levels as well as the COVID‑19 fear and perception of control (COVID‑19 FPC) in patients attending dental emergency clinics during the COVID‑19 pandemic.

MATERIAL AND METHODS

Sociodemographic, dental and medical data was obtained from the participants. A face-to-face questionnaire with questions referring to the reasons for the emergency dental visit, the visual pain scale, the Modified Dental Anxiety Scale (MDAS), and the COVID‑19 Fear and Perception of Control Scale (COVID‑19 FPCS) as well as additional questions concerning bruxism and a previous diagnosis of anxiety/panic attacks or depression was administered. The χ2 test was used to analyze the data.

RESULTS

A total of 1,439 patients were included in the study. The most common reason for the dental visit was pain (47.5%). The prevalence of DA was 5.1% (74/1,439). A significant association was found between DA and gender (p = 0.020). The incidence of severe pain was higher in patients with DA than in those without DA (p = 0.002). No significant differences in the MDAS scores were found between patients with and without a chronic disease (p = 0.804), with regard to the educational status (p = 0.364), or between the age groups (p = 0.600). The prevalence of a 'strongly agree' response to all questions in COVID‑19 FPCS was higher in patients with DA as compared to those without DA.

CONCLUSIONS

Females and patients with severe pain were more likely to exhibit DA. In general, patients with DA strongly agreed with the statements of COVID‑19 FPCS, which may indicate a correlation between the 2 scales.

Cephalometric Mandibular Dimensions in Growing Turkish Children: Trends of Change, Sex-Specific Differences, and Comparisons with Published Norms

OBJECTIVE

The aims of this study were to investigate cephalometric mandibular dimensions in growing Anatolian Turkish children and to identify the periods of rapid growth for boys and girls. Furthermore, the secondary aim was to compare obtained values with published standards in the literature.

METHODS

A total of 528 pretreatment lateral cephalometric radiographs, grouped according to age and sex, were analyzed. Effective mandibular length, ramus height, and corpus lengths were comparatively evaluated within age groups for boys and girls and between sexes for the same age group. Data acquired from this study were compared with American, Canadian, Chinese, and European norms. Growth curves for mandible were constructed for each sex group.

RESULTS

Effective mandibular length was almost always significantly longer in boys, except for 9- and 12-year-age groups. Effective mandibular length in girls increased significantly between ages 8 and 10, 10 and 12, and 11 and 13 years, while in boys between ages 8 and 10, 9 and 11, and 13 and 15 years. Turkish girls had significantly shorter effective mandibular lengths than American girls at age 14. No significant difference was found between Turkish and Chinese girls and boys. Turkish girls and boys had significantly shorter corpus lengths from their Norwegian counterparts at age 12.

CONCLUSION

Except for 9- and 12-year-age groups, effective mandibular length was almost always significantly longer in boys compared to the girls. It is suggested to use norm values from more recently conducted studies and which are representative of the studied population. Growth curves can be used to predict the approximate mandibular dimensions at a particular age.

Effects of Two Exercise Regimes on Patients with Chiari Malformation Type 1: a Randomized Controlled Trial

This study aims to measure the effects of two different exercise programs on neck pain, proprioception, balance, coordination, posture, and quality of life in patients with Chiari malformation (CM) type 1. Sixteen patients were randomized to two different exercise programs: a tailored exercise protocol for CM (TEP-CM) and cervical spinal stabilization exercises (CSSE). Both exercise programs were implemented by a physiotherapist 3 days a week for 6 weeks. The primary outcome was Neck Disability Index. Secondary outcomes were visual analogue scale for pain, joint position sense error measurement, Berg Balance Scale, Time Up and Go Test, International Coordination Ataxia Rating Scale, PostureScreen Mobile, and Short Form-36. Assessments were done immediately before and after the intervention programs. Both groups showed significant improvement in Neck Disability Index, and some secondary outcome measures (P < 0.05). However, there were no statistical differences in post-intervention changes between the groups (P > 0.05). This is the first study to examine the effects of different exercise programs on symptoms in patients with CM type 1. Our preliminary findings indicate that exercise programs can improve pain, balance, proprioception, posture, coordination, and quality of life in CM type 1. Therefore, exercise should be considered safe, beneficial, and low-cost treatment option for CM type 1 patients without surgical indications.

Survival Prediction in Brain Metastasis Patients Treated with Stereotactic Radiosurgery: A Hybrid Machine Learning Approach

OBJECTIVES

Accurate survival prediction for brain metastasis patients undergoing stereotactic radiotherapy (SRT) is crucial for personalized treatment planning and improving patient outcomes. This study aimed to develop a machine learning model to estimate survival times, providing clinicians with a reliable tool for making informed decisions based on individual patient characteristics. The goal was to compare the performance of multiple algorithms and identify the most effective model for clinical use.

METHODS

We applied a hybrid machine learning approach to predict survival in brain metastasis patients treated with SRT, utilizing real-world data. Four algorithms-XGBoost, CatBoost, Random Forest, and Gradient Boosting-were compared within a meta-model framework to identify the most accurate for survival prediction. Model performance was evaluated using metrics such as MSE, MAE, MAPE, and C index.

RESULTS

XGBoost outperformed all other algorithms, achieving an MSE of 0.14%, MAE of 0.10%, and MAPE of 0.093%, with a high C-index of 100%. CatBoost showed reasonable performance, while Gradient Boosting had higher error rates (MSE of 6.99%, MAE of 21.04%, MAPE of 19.29%). Random Forest performed the weakest, with the highest MSE (14.39%), MAE (30.23%), and MAPE (33.58%).

CONCLUSION

Inputting relevant clinical variables into the model enables clinicians to obtain highly accurate survival predictions for patients with brain metastasis. This enhances clinical decision making by providing a more precise understanding of expected outcomes. The XGBoost-based hybrid model showed exceptional accuracy in predicting survival for brain metastasis patients after SRT, offering valuable support for clinical decision making. Integrating machine learning into clinical practice can improve treatment planning and personalize care for these patients.

Added Value of CT Pelvic Bone Unfolding Software to Radiologist Performance in Detecting Osteoblastic Pelvic Bone Lesions in Patients With Prostate Cancer

PURPOSE

To evaluate the contribution of CT Bone Unfolding software to the diagnostic accuracy and efficiency for the detection of osteoblastic pelvic bone lesions in patients with prostate cancer.

METHODS

A total of 102 consecutive (January 2016-September 2019) patients who underwent abdominopelvic CT with prostate cancer were retrospectively evaluated for osteoblastic pelvic bone lesions, using commercially available the post-processing-pelvic bone flattening-image software package "CT Bone Unfolding." Two radiologists with 3 and 15 years of experience in abdominal radiology evaluated CT image data sets independently in 2 separate reading sessions. At the first session, only MPR images and at the second session MPR images and additionally unfolded reconstructions were assessed. Reading time for each patient was noted. A radiologist with 25 years of experience, established the standard of reference.

RESULTS

In the evaluations performed with the MPR-Unfold method, the diagnostic accuracy were found to be 2.067 times higher compared to the MPRs method (P < 0.001). The location of the lesions or the reader variabilities did not show any influence on accuracy (P > 0.05) For all readers the reading time for MPR was significantly longer than for MPR-Unfold (P < 0.05). For both methods substantial to almost-perfect inter-reader agreement was found (0.686-0.936).

CONCLUSIONS

The use of unfolded pelvic bone reconstructions increases diagnostic accuracy while decreasing the reading times in the evaluation of pelvic bone lesions. Therefore, our findings suggest that utilizing unfolded reconstructions in addition to MPR images may be preferable in patients with prostate cancer for the screening of osteoblastic pelvic bone lesions.

Biomarker detection using corrected degree of domesticity in hybrid social network feature selection for improving classifier performance

BACKGROUND

Dimension reduction, especially feature selection, is an important step in improving classification performance for high-dimensional data. Particularly in cancer research, when reducing the number of features, i.e., genes, it is important to select the most informative features/potential biomarkers that could affect the diagnostic accuracy. Therefore, researchers continuously try to explore more efficient ways to reduce the large number of features/genes to a small but informative subset before the classification task. Hybrid methods have been extensively investigated for this purpose, and research to find the optimal approach is ongoing. Social network analysis is used as a part of a hybrid method, although there are several issues that have arisen when using social network tools, such as using a single environment for computing, constructing an adjacency matrix or computing network measures. Therefore, in our study, we apply a hybrid feature selection method consisting of several machine learning algorithms in addition to social network analysis with our proposed network metric, called the corrected degree of domesticity, in a single environment, R, to improve the support vector machine classifier's performance. In addition, we evaluate and compare the performances of several combinations used in the different steps of the method with a simulation experiment.

RESULTS

The proposed method improves the classifier's performance compared to using the whole feature set in all the cases we investigate. Additionally, in terms of the area under the receiver operating characteristic (ROC) curve, our approach improves classification performance compared to several approaches in the literature.

CONCLUSION

When using the corrected degree of domesticity as a network degree centrality measure, it is important to use our correction to compare nodes/features with no connection outside of their community since it provides a more accurate ranking among the features. Due to the nature of the hybrid method, which includes social network analysis, it is necessary to investigate possible combinations to provide an optimal solution for the microarray data used in the research.

Evaluation of undergraduate dental students' awareness, knowledge, and attitudes towards teledentistry: does a course enhance this?

BACKGROUND

Teledentistry is a part of telemedicine and can be used for dental diagnosis, dental care, consultation, and dental education. The objective of this study was to assess the awareness, knowledge, and attitudes of undergraduate dental students toward teledentistry, as well as to investigate the influence of enrolling in a teledentistry course on these variables.

METHODS

A structured questionnaire-based online survey (Google Form) was used as the survey tool to evaluate the undergraduate dental students' awareness, knowledge, and attitudes towards teledentistry. All undergraduate dental students during the 2022-2023 academic year, were invited to join this questionnaire. The questionnaire was posted to the students who agreed to answer the survey online. Associations between categorical variables were evaluated using the Pearson Chi-square test or Fisher-Freeman-Halton Exact test. The Mann-Whitney U test was used to compare two independent groups, and the Kruskal-Wallis test was used to compare more than two independent groups. All analyses were conducted using IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp. Released 2015, Armonk, NY: IBM Corp.). The significance level was set at p < 0.05 for all analyses. Explanatory factor analysis and item analysis were used for the evaluation of the validity of the questionnaire.

RESULTS

There were 293 participants from five classes, with a 36.08% response rate; 190 (64.8%) were female and 103 (35.2%) were male, with a median age of 21 years (minimum 17 years, maximum 44 years). In this study, 37.9% of the participants had heard of teledentistry, 30.7% knew what teledentistry is, approximately one-third of the students were aware that there is a course called teledentistry in our faculty, and only 11.6% took the course. Undergraduate dental students had high levels of knowledge and awareness about the advantages and limitations of teledentistry. Dental students who had taken the course had a more positive attitude towards using teledentistry.

CONCLUSIONS

Enhancing dental students' knowledge and awareness of teledentistry could beneficially influence their utilization of teledentistry in their future careers.

CLINICAL TRIAL NUMBER

This study is not a clinical trial involving medicinal products or therapeutic interventions, so the clinical trial number is not applicable.

Leptin, ghrelin, nesfatin-1, and orexin-A plasma levels in girls with premature thelarche

PURPOSE

Reducing the mean age of puberty onset in recent years has crucial public health, clinical, and social implications. This study aimed to evaluate the serum levels of appetite-related peptides (leptin, ghrelin, nesfatin-1, and orexin-A) and anthropometric data in girls with premature thelarche (PT).

METHODS

We enrolled 44 girls aged 4-8 years diagnosed with PT and 33 age-matched healthy girls as controls. The demographic data of the girls were obtained using a questionnaire. Anthropometric data were measured and fasting blood samples were collected.

RESULTS

Body weight, height, body mass index (BMI), body fat mass, and basal metabolic rate (BMR) were higher in the PT group than in the control group (p < 0.05). Serum leptin (p < 0.001), nesfatin-1 (p = 0.001), and orxein-A (p < 0.001) levels were significantly higher in the PT group than in healthy controls. However, there were no significant differences in the serum ghrelin levels between the groups (p > 0.05). The results of multivariate logistic regression revealed that serum leptin level (OR (95% CI): 42.0 (10.91, 173.06), p < 0.001), orexin-A (OR (95% CI): 1.14 (1.04, 1.24), p = 0.006), and BMI for age z-score (OR (95% CI): 6.97 (1.47, 33.4), p = 0.014) elevated the risk of incidence of PT at 4-8 girls.

CONCLUSION

These results suggest that in addition to serum leptin levels, serum orexin-A and nesaftin-1 can take part in the initiation of PT. Few studies have investigated the relationship between nesfatin-1 and orexin-A levels and age at onset of puberty; hence, it should be a subject for future studies.

Validity and intra- and inter-rater reliability of the Tinetti performance-oriented mobility assessment balance subscale using different tele-assessment methods in patients with chronic stroke

INTRODUCTION

Balance assessments are an important component of rehabilitation. Considering the increasing use of telemedicine to meet rehabilitation needs, it is important to examine the feasibility of such assessments. This study aimed to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment Balance Subscale (POMA-B) when applied via synchronous and asynchronous tele-assessment.

METHODS

Twenty-five patients with chronic stroke were included in the study. The first physiotherapist assessed the patients on the first day in a face-to-face clinical setting. Synchronous or asynchronous tele-assessment was applied the next day. The assessments were performed in the same time zone, with an interval of one day. The synchronous tele-assessment was done online in real time by the first and second physiotherapists. A reference assessment video was sent to the patients for asynchronous tele-assessment. They were asked to make a video recording while performing the evaluation activities according to the reference video. Then the first and second physiotherapists assessed these video recordings separately. All the tests were repeated 10 days later to determine the intra-rater reliability of the tele-assessment methods.

RESULTS

The intra-class correlation coefficients ranged from 0.96 to 0.98 for inter-rater reliability and from 0.97 to 0.98 for intra-rater reliability for both tele-assessment methods. Both asynchronous and asynchronous tele-assessment methods were medium correlated with the face-to-face versions.

CONCLUSIONS

We demonstrated the validity and reliability of the POMA-B in chronic stroke patients with different tele-assessment methods, typically using the internet and available devices.

Do cervical stabilization exercises change the effects of conventional exercises in patients with Parkinson's disease?

OBJECTIVES

The aim of this study was to examine whether cervical stabilization exercises (CSEs) change the effects of conventional exercises (CEs) in patients with PD.

METHODS

Twenty-five patients with PD were randomized into two groups. While the experimental group (EG) received CSEs in addition to CEs, the control group (CG) received only CEs. Both programs lasted 8 weeks. Eighteen participants were able to complete the study. The outcomes were the changes in posture, cervical joint position sense (JPS), balance assessment, 10-m walking tests (10MWT), and the Timed Up & Go (TUG) test.

RESULTS

At the end of the study, significant improvement was observed in both groups in terms of trunk rotation angle and pelvic asymmetry, the time parameter of TUG, and the 10MWT (p < 0.05). In the EG, greater improvement was detected in the Berg Balance Scale, static posturography, postural alignment, JPS, and the cadence parameter of TUG (p < 0.05).

DISCUSSION

CEs and CSEs could improve walking speed and posture in patients with PD, but if CSEs are added to CEs, greater improvements could be achieved in JPS and postural control.(Clinical Trials ID: NCT03854747).