Investigation of the predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality in patients with endoprosthesis after hip fracture.

In this research, we aimed to investigate the predictive value of the systemic immune inflammation index and prognostic nutritional index on mortality among patients with an endoprosthesis after a hip fracture. In this retrospective, cross-sectional study, a total of 915 patient files applied to our hospital between 2020 and 2023 with an endoprosthesis after a hip fracture were subjected to the study. The patients were divided into 2 groups: alive (n = 396; 43.3%) and deceased (n = 519; 56.7%). The eosinophil-to-lymphocyte ratio, hemoglobin-to-red cell distribution width ratio (HRR), mean platelet volume-to-platelet ratio (MPVPR), neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, monocyte-to-eosinophil ratio (MER), neutrophile-to-monocyte ratio, systemic inflammation index (SII), and prognostic nutritional index (PNI) parameters of the patients were evaluated. The mortality rate was higher among male patients, with a statistically significant difference (P < .05). The follow-up duration, albumin, HGB, eosinophil, lymphocyte, eosinophil %, eosinophil-to-lymphocyte ratio, HRR, and PNI means were significantly higher in the living group (P < .05). Age, MPV, MPVPR, neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, MER, and systemic inflammation index were significantly higher in the deceased group (P < .05). The predictive value of gender (B = -0.362; P < .01), age (B = 0.036; P < .01), HRR (B = -1.100; P < .01), MPVPR (B = 8.209; P < .01), MER (B = 0.006; P < .01), and PNI (B = -0.078; P < .01) were statistically significant at the multivariate level. The time of death was significantly predicted by gender (B = 0.10; P < .05), age (B = -0.02; P < 0 = 1), HRR (B = 0.61; P < .01), MPVPR (r = -4.16; P < .01), MER (B = -0.01; P < .05), and PNI (B = 0.03; P < .01). The predictive value of PNI for the 30-day mortality rate was statistically significant (AUC: 0.643; P < .01). For a PNI cutoff value of 34.475, sensitivity was 69.7%, and specificity was 51.1%. The PNI has predictive value both in estimating overall mortality and in predicting the 30-day mortality rates among patients undergoing endoprosthesis after a hip fracture.

Intracranial aneurysm wall displacement depicted by amplified Flow predicts growth.

BACKGROUND: Abnormal intracranial aneurysm (IA) wall motion has been associated with IA growth and rupture. Recently, a new image processing algorithm called amplified Flow (aFlow) has been used to successfully track IA wall motion by combining the amplification of cine and four-dimensional (4D) Flow MRI. We sought to apply aFlow to assess wall motion as a potential marker of IA growth in a paired-wise analysis of patients with growing versus stable aneurysms. METHODS: In this retrospective case-control study, 10 patients with growing IAs and a matched cohort of 10 patients with stable IAs who had baseline 4D Flow MRI were included. The aFlow was used to amplify and extract IA wall displacements from 4D Flow MRI. The associations of aFlow parameters with commonly used risk factors and morphometric features were assessed using paired-wise univariate and multivariate analyses. RESULTS: aFlow quantitative results showed significantly (P=0.035) higher wall motion displacement depicted by mean±SD 90th% values of 2.34±0.72 in growing IAs versus 1.39±0.58 in stable IAs with an area under the curve of 0.85. There was also significantly (P<0.05) higher variability of wall deformation across IA geometry in growing versus stable IAs depicted by the dispersion variables including 121-150% larger standard deviation ([Formula: see text]) and 128-161% wider interquartile range [Formula: see text]. CONCLUSIONS: aFlow-derived quantitative assessment of IA wall motion showed greater wall motion and higher variability of wall deformation in growing versus stable IAs.

The challenges faced by patients with hereditary myopathy during the COVID-19 pandemic.

BACKGROUND: Neuromuscular diseases are inherited and the prevalance of neuromuscular disease is estimated to be around 1:2000. METHODS: This cross-sectional research was conducted with a qualitative research model. Data were collected from patients with an online survey using the snowball sampling method. The study was conducted in accordance with the STROBE checklist methodology. Frequencies and percentages were used to analyse demographic data, and content analysis was used for qualitative opinions. RESULTS: Most of the participants were men and their education levels were low. Participants reported experiencing physical and socio-economic barriers to accessing healthcare. Participants also stated that these barriers have worsened since COVID-19. CONCLUSIONS: Patients with hereditary myopathy are stigmatised by society and face different problems depending on the type of disease and level of function. It is recommended that decision-makers enable patients with hereditary myopathy in exceptional situations to access healthcare services and take steps to resolve their problems.

A 30-year bibliometric analysis of the literature in the disciplines of orthopedics, surgery, or oncology on chondrosarcoma from 1993 to 2023.

BACKGROUND: A thorough bibliometric analysis of publications published in the field of chondrosarcoma research has not yet been performed using the Web of Science database, especially for publications published between 1993 and 2023. This study, with a focus on the fields of orthopedics, surgery, and oncology, aims to fill this knowledge gap by providing a thorough analysis of current knowledge in the field of chondrosarcoma. METHODS: In this bibliometric study, a literature search was performed using the Web of Science database to find all publications on chondrosarcoma. A bibliometric software program was used for data visualization and analysis (opensource visualization application, Vosviewer). The Web of Science Core Collection data used for this retrospective bibliometric study, which covers the period from January 1993 to September 2023, revealed interesting trends in chondrosarcoma research. RESULTS: As the most popular fields of study, orthopedics, surgery, and oncology account for a sizable portion of publications. A noteworthy increase in research output from 2014 to 2023, accounting for 41.74% of the papers, reflects the thriving research environment. The leading countries for publication were China, Japan, and the United States, demonstrating cross-border cooperation in chondrosarcoma research. Their contributions were highlighted by their important affiliations with institutions such as Harvard University, Leiden University, and China Medical University Taiwan. A thorough keyword mapping analysis also highlighted research priorities and encouraged interdisciplinary cooperation. The field's scholarly importance and ongoing relevance are highlighted by the study's high citation count (30,076) and highly cited articles. CONCLUSION: Overall, this study offers crucial insights into the development and collaborative nature of the chondrosarcoma research landscape and its long-lasting influence on academic research and clinical practice.

retrospective evaluation of condylar morphology using panoramic radiography in a sample of Turkish population.

BACKGROUND: The temporomandibular joint is one of the most complex anatomic structures. It takes a great role in masticatory system and helps to make possible some functions such as speaking, chewing and swallowing. Clinicians should have sufficient anatomical knowledge to assess relationships of the hard and soft tissues, including the mandibular condyle, glenoid fossa, articular eminence of the temporal bone, the articular disc and its attachments. The aim of this study was to evaluate the frequency of different types of mandibular condyles and its distribution according to the age and gender. It was also evaluated whether the condyle types were bilaterally symmetrical or not. MATERIALS AND METHODS: A total of 1315 digital panoramic images which obtained from the patients suffering from the dental problems were assessed. Demographic data, condylar morphology were noted. All obtained data were analysed by using descriptive statistics. Morphology of mandibular condyles were classified into four shapes as identified in other studies, namely: type I - oval shape, type II - diamond shape, type III - bird beak shape, type IV - crooked finger shape. Two independent examiners, who have 19 and 7 years of experience in oral and dentomaxillofacial radiology, made a consensus and evaluated all images. RESULTS: A total of 1315 digital panoramic images were assessed. Seven hundred sixty-seven [58.3%] the patients were female and 548 [41.6%] were male. The age range of patients was from 18 to 84 years. Right-left condyle types were found to be symmetrical in the range of 67% of the subpopulation examined in the study. For the consensus, 'oval' condyle was common on both the right and left, while 'crooked finger' condyle was the rarest. CONCLUSIONS: The temporomandibular joint is the most important structure for all jaw functions such as speech, swallowing. In order for all these functions to continue in a healthy way, the anatomical structure should be known very well down to the finest detail. Identification of anatomical structures and their variations can play an important role in implant dentistry. Clinicians commonly prefer conventional radiologic methods to evaluate dentomaxillofacial region. Although the most of the variations are asymptomatic and require no treatment,correct identification of these findings will reduce unnecessary further diagnostic assessments and will provide more appropriate treatment plans.

Development of the self-efficacy scale in caregivers of Duchenne muscular dystrophy patients.

BACKGROUND: It is important to measure the self-efficacy knowledge of the caregiver of Duchenne muscular dystrophy (DMD) patients in order to overcome the problems that arise and carry out the care process in a healthy manner. OBJECTIVE: This research was carried out to develop a self-efficacy scale in caregivers of individuals with DMD. METHODS: The study was conducted with 99 volunteer DMD caregivers to evaluate the psychometric properties of the developed scale. Exploratory Factor Analysis (EFA) was performed with the SPSS 25 Package Program to determine the factors of the scale. Confirmatory Factor Analysis (CFA) analysis was performed with AMOS 23 to confirm the factors obtained by EFA. Cronbach's alpha coefficient was used for the internal consistency of the DMD-CSES. RESULTS: A valid and reliable scale was obtained to measure the self-efficacy of caregivers of DMD patients. CONCLUSION: Although some scales have been developed to evaluate the care burden of family members who care for patient-centered symptoms and functional changes in patients with DMD, there is no single scale that adequately describes the conditions and resources of caregivers on a global scale. The search for a definitive scale is expected to continue until a definitive treatment for the disease is found. Developing a valid and reliable scale to identify the self-efficacy, knowledge, skills and resources of caregivers with a common perspective of physicians and health management team centred on patients with DMD will be effective in practice.

Effectiveness of gonarthrosis treatment via intra-articular injections of linear vs. cross-linked hyaluronic acids.

OBJECTIVES: The study aimed to compare the outcomes of single-dose cross-linked hyaluronic acid and the linear regimen of three doses of HA knee injections among patients with gonarthrosis. PATIENTS AND METHODS: This single-center, retrospective study was conducted with 60 patients (47 females, 13 males; mean age: 57.9±4.29 years; range, 50 to 65 years) with Kellgren-Lawrence Grade 2 or 3 gonarthrosis between February 2020 and February 2022. Patients were either subjected to intra-articular cross-linked hyaluronic acid (n=30) or linear hyaluronic acid (n=30) injection treatments. Comprehensive assessments of the patients were conducted prior to the injections, as well as at three and six months after injection. The two injection groups were compared regarding the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Score. RESULTS: Both injections showed a statistically significant improvement from baseline in both WOMAC and Oxford Knee Score at three and six months (p<0.001). There was no notable distinction in the alteration of WOMAC knee scores between the two injection types. However, a notable discrepancy was observed in the elevation of Oxford Knee Score among patients who received cross-linked knee injections compared to those who underwent linear hyaluronic acid knee injections, signifying a significant increase in the former group (p<0.001). CONCLUSION: The advantage of a single-dose administration of cross-linked HA knee injections, as opposed to the three-dose regimen required for linear hyaluronic acid, translates into reduced time and cost for the injection process. Moreover, this approach minimizes injection-associated discomfort for patients due to the singular dose administration.

Predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality after below-knee amputation.

This retrospective cross-sectional study aimed to evaluate the predictive value of SII (Systemic Immune Inflammation Index) and PNI (Prognostic Nutritional Index) with blood ratios on mortality in diabetic foot patients who underwent below-knee amputation. A total of 231 living (n = 71; 30.7%) and exitus (n = 160; 69.3%) patients were evaluated. The mortality group was divided into 3 groups: 30-day mortality (n = 62; 38.8%), 1-year mortality (n = 62; 38.8%), and over-1-year mortality (n = 36; 22.5%). The hemogram, SII, and PNI parameters of the patients were evaluated. Age, some blood count parameters and SII were significantly higher in the exitus group (P < .05). The lymphocyte, monocyte, eosinophil, albumin, and PNI levels were significantly higher in the living group (P < .05). Mortality was significantly predicted by age (B [regression coefficient] = 0.026, P < .05), NLR (neutrophil lymphocyte ratio) (B = -0.065, P < .05), PNI (B = -0.100, P < .01), and SII (B = 0.00000024, P < .01). The predictive values of CAR (C reactive protein albumin ratio), PNI, and SII were 77.3%, 77.0%, and 76.1%, respectively. For CAR of 30.88 cutoff value, the sensitivity and specificity were 79.4% and 64.8%, respectively. For the PNI 22.0143 cutoff value, the sensitivity and specificity were 66.9% and 5.6%, respectively. For the SII 732249.2481 cutoff value, the sensitivity and specificity were 91.9% and 31.0%, respectively. The predictive value of the PNI was significant for mortality time (B = 0.058; P < .01). The predictive value of PNI for 30-day mortality was significant (AUC (area under curve):0.632; P < .01), whereas its predictive value for 1-year mortality and over-1-year mortality after below-knee amputation was statistically insignificant (P > .05). Both the SII and PNI may be evaluated and used to predict mortality after below-knee amputation. The SII had a significant predictive value for 30-day mortality after below-knee amputation.

The Length of Incision in Unicondylar Knee Arthroplasty Is More Affected by the Patient's Height Than Their Weight.

Objective Obesity leads to osteoarthritis due to increased loading forces on joint cartilage and inflammatory agents released from adipose tissue. In patients with a high body mass index (BMI), during hip and total knee arthroplasty, surgical technical challenges such as longer incisions and wider exposure are encountered, resulting in increased postoperative complications (wound healing problems and infection, venous thromboembolism (VTE)- pulmonary embolism (PE), dislocation, early implant failure) and ultimately decreased patient satisfaction and implant survival. This study investigates whether BMI, height, weight, and patient age are associated with longer incisions in patients undergoing unicondylar knee prosthesis (UKP) placement. Method Between January 2017 and December 2018, 30 patients (29 females and 1 male) who underwent UKP surgery due to medial gonarthrosis were included in the study. The UKP used in the procedures was the Oxford Knee Phase III by Biomet Ltd., UK. The study comprised 43 knees, 13 being bilateral cases, 8 on the right, and 9 on the left. Data regarding the patient's height, weight, BMI, age, and the operated side were collected and compiled. The relationships between these variables and the surgical incision length were statistically analyzed. Results The average age of the patients was 66.3 years, with an average weight and height of 77.6 kg (ranging from 62 to 98 kg) and 167 cm (ranging from 150 to 184 cm), respectively. The lengths of the surgical incisions ranged from 70 mm to 160 mm, with an average length of 124.5 mm. When comparing the incision lengths between the right and left sides, it was observed that the incisions on the left side were longer. The average incision length on the right side was 122.09 mm, while on the left, it was 126.86 mm. Moreover, in the 13 patients who underwent bilateral surgery, this difference in incision length was even more pronounced. The average incision length on the right side was 117.15 mm, whereas on the left, it was 124.23 mm. Bivariate correlation analyses were performed to examine the relationship between the length of the incision and BMI and age. However, no significant relationship was found between the incision length and BMI or age. On the other hand, there was a correlation between the patient's weight values and the incision length (p < 0.05, correlation 0.335). Furthermore, a higher correlation was observed between the patient's height and the incision length (p < 0.01, correlation 0.595). Conclusion The latest advances in surgical techniques and instrumentation have enabled surgeons to perform the procedure using a reliable mini-incision approach. Mid-term evaluation of UKP with mini-incision shows faster recovery and lower morbidity. The findings show that in UKP, the length of the surgical incision is more strongly related to the patient's height than their weight.

Improving the accuracy of computational fluid dynamics simulations of coiled cerebral aneurysms using finite element modeling.

Cerebral aneurysms are a serious clinical challenge, with ∼half resulting in death or disability. Treatment via endovascular coiling significantly reduces the chances of rupture, but the techniquehas failure rates of ∼20 %. This presents a pressing need to develop a method fordetermining optimal coildeploymentstrategies. Quantification of the hemodynamics of coiled aneurysms using computational fluid dynamics (CFD) has the potential to predict post-treatment outcomes, but representing the coil mass in CFD simulations remains a challenge. We use the Finite Element Method (FEM) for simulating patient-specific coil deployment for n = 4 ICA aneurysms for which 3D printed in vitro models were also generated, coiled, and scanned using ultra-high resolution synchrotron micro-CT. The physical and virtual coil geometries were voxelized onto a binary structured grid and porosity maps were generated for geometric comparison. The average binary accuracy score is 0.8623 and the average error in porosity map is 4.94 %. We then conduct patient-specific CFD simulations of the aneurysm hemodynamics using virtual coils geometries, micro-CT generated oil geometries, and using the porous medium method to represent the coil mass. Hemodynamic parameters including Neck Inflow Rate (Qneck) and Wall Shear Stress (WSS) were calculated for each of the CFD simulations. The average relative error in Qneck and WSS from CFD using FEM geometry were 6.6 % and 21.8 % respectively, while the error from CFD using a porous media approximation resulted in errors of 55.1 % and 36.3 % respectively; demonstrating a marked improvement in the accuracy of CFD simulations using FEM generated coil geometries.

A Bibliometric Study on Charcot Foot Deformity.

In this study, we investigated the literature's publication trends related to the Charcot foot deformity. Using bibliometric analysis to examine the data of origin, this analysis was carried out by conducting an electronic search of the Web of Science database for research articles between 1970 and March 2023. We used the following search term in the search bar: TI = (Charcot foot OR Charcot foot deformity OR Charcot's foot OR Charcot Osteopathic Arthropathy) with English language and article-format filtering for documents. The bibliometric analysis was carried out using R's "Bibliometrix" package program. A total of 437 articles were found in the electronic search. A total number of 1513 authors from around the world contributed to the Charcot foot literature, with the most articles published (42.1%) originating in the United States. The United States had the highest proportion of citations (3332 citations). The highest number of articles (n = 245) on Charcot foot deformity was in the last decade. 2021 was the year with the most articles (n = 34). The authors from the United States and the United Kingdom had the highest number of international collaborations. The study offers researchers a current overview of essential data and may help direct future research by summarizing the main points and research trends on the topic of Charcot foot deformity.

Estimation of service length with the machine learning algorithms and neural networks for patients who receiving home health care.

The main purpose of the study is to develop an estimation model using machine learning algorithms and to ensure the effective and efficient implementation of home health care service planning in hospitals with these algorithms. The necessary approvals for the study were obtained. The data set was created by obtaining patient data (except for data such as Turkish Republic identification number) from 14 hospitals providing Home Health Care Services in the city of Diyarbakir. The data set was subjected to necessary pre-processing and descriptive statistics were applied. For the estimation model, Decision Tree, Random Forest and Multi-layer Perceptron Neural Network algorithms were used. It was found that the number of days of home health care service, which the patients received, varied depending on their age and gender. It was observed that the patients were generally in the disease groups that required Physiotherapy and Rehabilitation treatments. It was determined that the length of service for patients can be predicted with a high reliability rate (Multi-Layer Model Acc: 90.4%, Decision Tree Model Acc: 86.4%, Random Forest Model Acc: 88.5%) using machine learning algorithms. In the light of the findings and data patterns obtained in the study, it is thought that effective and efficient planning will be made in terms of health management. In addition, it is believed that estimating the average length of service for patients will contribute to strategic planning of human resources for health, and to reducing medical consumables, drugs and hospital expenses.

Anti-tumor necrosis factor alpha treatment does not influence serum levels of the markers associated with radiographic progression in ankylosing spondylitis.

Objectives: The study aimed to determine the levels of change of the markers related to radiographic progression, such as Dickkopf-1 (DKK-1), sclerostin (SOST), bone morphogenetic protein (BMP)-2 and -4, and interleukin (IL)-17 and -23, in ankylosing spondyloarthritis (AS) during anti-tumor necrosis factor alpha (TNF-α) treatment. Patients and methods: Fifty-three anti-TNF-α naïve AS patients (34 males, 19 females; median: 38 years; range, 20 to 52 years) refractory to conventional treatments meeting the modified New York criteria or Assessment of SpondyloArthritis International Society classification criteria were enrolled to this cross-sectional, controlled study between October 2015 and January 2017. Fifty healthy volunteers (35 males, 15 females; median: 36 years; range, 18 to 55 years) with similar age and sex characteristics were recruited. Serum DKK-1, BMP-2, BMP-4, SOST, IL-17, and IL-23 levels were measured in both groups. The serum levels of the markers were measured again after about two years (mean follow-up duration of 21.7±6.4 months) in AS patients who started anti-TNF-α treatment. Demographic, clinical characteristics, and laboratory parameters were recorded. The disease activity at the time of inclusion was assessed through the Bath Ankylosing Spondylitis Disease Activity Index. Results: Serum DKK-1, SOST, IL-17, and IL-23 levels in the AS group before anti-TNF-a treatment were significantly higher compared to the control group (p<0.01 for DKK-1, p<0.001 for others). There was no difference regarding serum BMP-4 levels, whereas BMP-2 levels were significantly higher in the control group (p<0.01). Forty (75.47%) AS patients had serum marker levels measured after anti-TNF-α treatment. No significant change was observed in the serum levels of these 40 patients measured 21.7±6.4 months after the initiation of anti-TNF-α treatment (p>0.05 for all). Conclusion: In AS patients, there was no change in DKK-1/SOST, BMP, and IL-17/23 cascade with anti-TNF-α treatment. This finding may suggest that these pathways act independently of each other, and their local effects are not influenced by systemic inflammation.

Degenerative changes of the mandibular condyle in relation to the temporomandibular joint space, gender and age: A multicenter CBCT study.

BACKGROUND: Cone-beam computed tomography (CBCT) is used to provide multiplanar views of the temporomandibular joint (TMJ) bone components as well as TMJ pathologies without superposition, magnification or distortion. OBJECTIVES: The study aimed to analyze degenerative changes in the condylar surface, and their relationship with patient age and gender, and the TMJ space measurements by using CBCT images. MATERIAL AND METHODS: A total of 258 individuals were retrospectively analyzed. The degenerative bone changes of the condylar head were evaluated and classified on the right and left sides. The shortest distances from the anterior, superior and posterior parts of the condylar head to the glenoid fossa were measured to represent the TMJ space. Univariate and multivariate logistic regression analyses then evaluated the effect of age and gender on the presence of degenerative changes. RESULTS: Condylar flattening was most frequently observed (413 TMJs, 53.5%). However, the presence or absence of the change types did not differ according to the sides. The mean values of the TMJ space measurements on the right and left sides were narrower in the group with changes than in the group without changes. Nonetheless, no statistically significant difference in the TMJ space was found between the groups (p > 0.05). CONCLUSIONS: An increased risk of radiographically detectable degenerative alterations in left TMJs was detected for males and for increasing age. Degenerative changes in the condylar surface may affect the dimensions of the TMJ space.

Myelination dictates axonal viscoelasticity.

During development, dramatic changes in myelination, growth of neural networks and changes in grey-to-white matter ratio build up the astonishingly plastic brain of a child. The progressive increase in myelination insulates the nervous system, which, in turn, modifies the mechanical microenvironment of the brain spatiotemporally. A growing body of evidence demonstrates the role of mechanical forces in growth, differentiation, maturation and electrical properties of neurons. However, due to limitations in imaging resolution, the exact relationship between myelination, axonal organization and the mechanical properties of nerves at the cellular level is still unknown. Here, we propose a novel approach to study the direct relationship between axonal viscoelasticity with changing fibre anisotropy and myelination during development. With the use of atomic force microscopy (AFM) with in situ fluorescent imaging of the primary neuron-oligodendrocyte co-cultures, we found that as axons are progressively myelinated in vitro, their stiffness increases. Direct quantification of myelin along axons using immunofluorescence also demonstrated a positive correlation between increased myelination over time and increased axonal stiffness (p = .001). Notably, AFM measurements along a single axon showed that the Young's modulus measured across myelinated regions were significantly higher than those of adjacent unmyelinated segments at all time points (p < .0001). Force-relaxation analysis also demonstrated that myelin sheath dominates the regulation of viscoelasticity of axons temporally. Collectively, our findings indicate a direct link between myelination, axonal orientation and viscoelasticity, providing important insights about the mechanical environment in the paediatric brain, with direct implications for our understanding of developmental brain disorders and paediatric brain injury.

Assessment of Canalis Sinuosus located in maxillary anterior region by using cone beam computed tomography: a retrospective study.

BACKGROUND: The aim of the study is to determine the distribution, location, diameter, and distance measurements of Canalis Sinusosus (CS) in relation with age and sex. METHODS: 300 Cone-Beam Computed Tomography (CBCT) images were evaluated. The distance between CS and nasal cavity floor (NCF), buccal cortical bone margin (BCM), alveolar ridge (AR), respectively.The presence of CS smaller than 1 mm, and the diameter of CS larger than 1 mm were determined. Accessory canals (AC) were classified according to their position relative to the teeth. RESULTS: 435 CS with a diameter of at least 1 mm and 142 CS < 1 mm were identified. The most frequently observed location of CS was the region of the right central incisors. The mean diameter of the canals ( CS ≥ 1) was 1.31 ± 0.19 on the right side and 1.29 ± 0.17 on the left side. No gender differences were found in canal diameter were observed (p > 0.05). There was no significant difference between men and women in the distance between CS and the NCF on the right side, and a significant difference was found in the distance of CS-NCF on the left side (p = 0.047). There were no significant differences between age groups in all parameters. CONCLUSION: CBCT is a useful tool for identifying CS. Location and diameter of ACs could not be associated with a specific age group or sex.

Comparative evaluation of trabecular bone structures of bruxist and non-bruxist individuals with bone apposition in the mandible angle region by fractal analysis.

OBJECTIVE: This study aimed to compare the trabecular internal structure of different regions of the mandible according to the grades of appositional classification in the mandible angle region in probable bruxist individuals and non-bruxist G0(Convex course of the basal cortex, no directional change, no bone apposition) individuals by measuring fractal dimension (FD) on panoramic radiographs. METHODS: 200 sample jaws, bilaterally, of 80 probable bruxists and 20 non-bruxist G0 individuals were included in the study. According to the classification in the literature, each mandible angle apposition severity was classified as G0-G1-G2-G3. FD was calculated by selecting the region of interest (ROI) area of 7 regions from each sample. Gender differences in changes between ROIs in radiographs and independent samples t-test were evaluated. Relation between categorical variables was determined by chi-square test (p < .05). RESULTS: In the comparison of the probable bruxist and non-bruxist G0 groups, FD was found to be statistically significantly higher in the mandible angle (p = 0.013) and cortical bone (p = 0.000) regions in the probable bruxist group than in the non-bruxist G0 group. There is a statistically significant difference between probable bruxist G0 and non-bruxist G0 grades in terms of FD averages in cortical bone (p < 0.001). A statistically significant difference was found in the relationship of ROIs with gender in canine apex (p = 0.021) and canine distal (p = 0.041) regions. CONCLUSION: FD was found to be higher in the mandibular angle region and cortical bone in probable bruxist individuals than in non-bruxist G0 individuals. Morphological changes seen in the mandible angulus region may be a finding that may raise suspicion for bruxism for clinicians.

A new perspective for radiologic findings of bruxism on dental panoramic radiography.

OBJECTIVE: This study aims to evaluate whether there is a relationship between the appositional classification in the mandible angle region and the mandibular cortical index (MCI) seen in bruxist individuals and to differentiate between the bruxist group without mandibular apposition and the non-bruxist group on panoramic radiographs. METHODS: The mandible angle region of 209 individuals, 170 bruxists and 39 non-bruxists, were included in the study. Each mandible angle apposition was classified as G0 (No directional change, no bone apposition)-G1 (Directional change on the basal cortex. No bone apposition)-G2 (Directional change plus generalized bone apposition with inhomogeneous surface)-G3 (Directional change plus localized bone apposition at one or more sites). The MCI of each individual was recorded according to their classified apposition. RESULTS: No statistically significant difference was found in the relationship between MCI and apposition severity in mandible angle grades in bruxist individuals (p = 0.063). A statistically significant difference was found between MCI and the bruxist G0/non-bruxist G0 groups (p < 0.001). While the MCI-C1 was higher in non-bruxist G0 individuals, the MCI-C2 was higher in bruxist G0 individuals. A statistically significant correlation was found between gender and severity of grades (p < 0.001). CONCLUSION: Although it is known that appositional changes are seen in the mandible angle region in bruxism, MCI can be used as a valuable radiologic diagnostic criterion during the evaluation of bruxist and healthy individuals in the G0 grade who have not yet radiologically demonstrated bone apposition in the mandible angle.

Validity and reliability of the Pandemic Fatigue Scale (PFS) in the Turkish population.

BACKGROUND: The measures developed to fight the COVID-19 pandemic caused fear, stress and anxiety in people over time. It was reported that pandemic fatigue, associated with the gradual loss of motivation to follow the implemented protective measures, emerged in societies. OBJECTIVE: This cross-sectional-methodological study aimed to validate the Turkish version of the Pandemic Fatigue Scale, developed by Lilleholt et al. (2020). METHODS: A web-based questionnaire was conducted to examine the validity and reliability of the Turkish version of the PFS. 1149 participants from all regions in Turkey participated. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed. RESULTS: As a result of the KMO and Bartlett's Test of Sphericity, the scale was suitable for the factor analysis. According to EFA, the scale has two sub-factors. The first sub-factor explained 48.7%, and the second sub-factor explained 16.7% of the total variance. Factor loadings of items varied between 0.67 and 0.89. CFA shows that acceptable fit values were obtained for the RMSEA, GFI, AGFI, CFI, NFI and IFI fit indices. CONCLUSIONS: The results support that PFS is a valid and reliable screening tool that can be used to measure the phenomenon of pandemic fatigue.

Stochastic Integrated Actor-Critic for Deep Reinforcement Learning.

We propose a deep stochastic actor-critic algorithm with an integrated network architecture and fewer parameters. We address stabilization of the learning procedure via an adaptive objective to the critic's loss and a smaller learning rate for the shared parameters between the actor and the critic. Moreover, we propose a mixed on-off policy exploration strategy to speed up learning. Experiments illustrate that our algorithm reduces the sample complexity by 50%-93% compared with the state-of-the-art deep reinforcement learning (RL) algorithms twin delayed deep deterministic policy gradient (TD3), soft actor-critic (SAC), proximal policy optimization (PPO), advantage actor-critic (A2C), and interpolated policy gradient (IPG) over continuous control tasks LunarLander, BipedalWalker, BipedalWalkerHardCore, Ant, and Minitaur in the OpenAI Gym.