Search Results (94)

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

This research aims to establish the prevalence of imposter syndrome among Sultan Qaboos University (SQU) undergraduate students while assessing its association with depression symptoms and anxiety symptoms. A cross-sectional design recruited 504 undergraduate students selected through stratified random sampling. Data collection employed the Clance Imposter Phenomenon Scale (CIPS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Data analysis included Pearson’s correlation, chi-square tests, and logistic regression analyses. In total, 56% of participants had imposter syndrome. The CIPS scores showed a moderate relationship with depression (r = 0.486, p < 0.001) and anxiety (r = 0.472, p < 0.001). Students who experienced imposter syndrome showed a higher probability of developing depressive symptoms (χ² = 45.63, p < 0.001, OR = 3.49) and anxiety symptoms (χ² = 32.96, p < 0.001, OR = 2.86). The logistic regression analysis showed that depression (B = 0.096, p < 0.001) and anxiety (B = 0.075, p = 0.003) acted as significant predictors for imposter syndrome. This study reveals a strong link between imposterism, depression, and anxiety among students. This highlights the need for university counseling programs to address imposter feelings and the role of clinical psychology in managing this phenomenon in academic and clinical settings. Full article

Background: Synthetic and pseudosynthetic images can be used to extend colonoscopy datasets, which, in turn, are used to train AI-detection models, yet their clinical acceptability depends on whether medical professionals can still recognize non-real content. Aim: To quantify the ability of practicing gastroenterologists to discriminate real, pseudosynthetic, and synthetic polyp images and to determine how training level and synthesis method impact detection. Materials and Methods: A total of 32 Romanian gastroenterologists (18 residents and 14 seniors) reviewed 24 images (8 real, 8 augmented, 4 CycleGAN, and 4 diffusion) via an online form. Classification accuracy, 95% confidence intervals (CI), class sensitivity and precision, 3 × 3 confusion matrices, and Fleiss’ κ were calculated. Resident vs. senior differences were tested with Pearson χ²; CycleGAN versus diffusion detectability was analyzed with the Wilcoxon signed-rank test (α = 0.05). Results: Overall accuracy was 61.2% (95% CI 57.7–64.6). Residents and seniors performed similarly (62.3% vs. 59.8%; χ²₁ = 0.38, p = 0.54). Sensitivity/precision were 70.7%/62.2% for real, 51.6%/58.9% for augmented, and 61.3%/62.1% for synthetic images. Collapsing to “real vs. non-real” yielded 70.7% sensitivity and 78.5% specificity for real images. CycleGAN images were always recognized as synthetic (128/128; 97.1–100% CI), whereas diffusion images were correctly classified only 22.7% of the time (16.3–30.6%; Wilcoxon p < 0.001). The training level did not impact detection performance (χ²₂ < 1.2, p > 0.5). Inter-rater agreement was fair (κ = 0.30, 95% CI 0.15–0.43). Conclusions: Clinicians detect non-real colonoscopy images only slightly above chance, irrespective of experience. The diffusion synthesis method creates images that escape human scrutiny, suggesting the need for automated authenticity safeguards before synthetic datasets are applied in clinical or AI-validation contexts. Full article

Background and Objectives: Low back pain (LBP) is a leading cause of disability worldwide. Core stabilization exercises such as the plank are often prescribed in rehabilitation settlings to improve neuromuscular control and spinal support. However, it remains unclear whether plank performance -accurately reflects trunk function or disability in individuals with LBP. The purpose of this study was to evaluate the relationship between plank endurance and low back pain in adults. Methods: A cross-sectional study was conducted with 117 adults aged 20–61 years (mean 26.0 ± 9.3), including both individuals with and without LBP. Participants completed a plank endurance test and the Modified Oswestry Disability Index (MODI). A subset of fifty-four participants with LBP also completed single-leg bridge tests to assess posterior chain endurance. Statistical analyses included Mann–Whitney U tests to compare plank times by LBP status, logistic regression to evaluate predictors of LBP, and correlation analyses to examine associations between the bridge-to-plank ratio and MODI scores. Results: Contrary to the initial hypothesis, individuals with LBP demonstrated significantly longer plank hold times than those without (U = 1861.00, p = 0.036). Logistic regression indicated that the overall model was statistically significant (χ² = 12.39, p = 0.030), but plank duration was not an independent predictor of LBP (p = 0.070). Among participants with LBP, a higher bridge-to-plank ratio, reflecting relatively greater posterior chain endurance, was significantly associated with lower disability scores (Pearson r = −0.31, p = 0.023; Spearman ρ = −0.32, p = 0.018). Conclusions: These findings suggest that, while plank duration differs by LBP status, longer plank times may not indicate lower risk or severity of back pain. A greater balance of posterior chain to anterior core endurance may be more intricately linked to reduced disability, highlighting the importance of comprehensive core assessment and training strategies in rehabilitation. Full article

Football is a low-scoring sport where a single goal can determine a team’s success. Understanding shot effectiveness and goalkeeper performance is crucial for optimizing match success. This study aimed to evaluate the effectiveness of shots and goalkeeper interventions by identifying the most favorable areas on the field and within the goal. An observational notational analysis was conducted on 15,266 on-target shots from five major European leagues (Premier League, LaLiga, Bundesliga, Serie A, Ligue 1) during the 2022/2023 season. Data were extracted from FotMob and analyzed in SPSS using Pearson’s chi-square test (χ²) and adjusted residuals (AR) to determine significant patterns. Field and goal zones were divided based on previous studies, with the penalty area receiving further subdivisions due to its relevance to the analysis. The results indicated that match context, target areas within the goal, field zones, and previously identified high-effectiveness areas significantly influenced shot success (χ² < 0.001). Similarly, a significant association was found between the shooting foot and the side of attack (χ² < 0.001), while the body part used did not significantly affect the outcome (χ² = 0.077). Understanding these patterns helps coaches and players optimize team performance. Future studies should analyze additional seasons to confirm these results. Full article

Background/Objectives: Sepsis has a high mortality rate, with septic shock exceeding 50%. The most common score for diagnosis and prognosis in sepsis is the Sepsis-related Organ Failure Assessment (SOFA). This study aimed to identify hematological parameters for the prediction of intensive care unit (ICU) mortality. Methods: This study collected demographic and clinical data from sepsis patients, including age, sex, infection site, length of stay, the SOFA, and ICU mortality. The standard laboratory panel included, among others, complete blood count with differential and reticulocyte panel. Intergroup differences were analyzed using Student’s t-test, Mann–Whitney U test, Pearson’s χ², and Fisher’s test where applicable. The AUROC was used for evaluating the predictive value of hematological parameters. Multiple logistic regression was performed to exclude the impact of potential confounding factors. Results: This study analyzed data from 190 sepsis patients hospitalized in the ICU, excluding patients with other conditions significantly affecting mortality. The median age was 65.0 (IQR 51.0–71.0) years. The sexes were almost perfectly balanced. The sites of infection were mostly the abdominal cavity, lungs, and urinary tract. The short-term mortality rate was 30%, with higher SOFA scores and significant differences in leukocyte, platelet, and erythrocyte parameters between survivors and non-survivors. The percentage of nucleated red blood cells (NRBCs) showed the highest AUROC. Conclusions: The only reliable hematological parameter for predicting ICU mortality in sepsis patients may be the percentage of NRBCs. The presence of NRBCs in a blood smear is linked to a worse prognosis. Full article

Introduction: Cephalometric analysis is an essential tool used in orthodontic diagnosis and treatment planning. Aim: The aim of this study was to compare the measurement reliabilities (repeatability and reproducibility) of the Tau and Yen angles and compare them to the results obtained for the ANB angle. Methods: Repeatability and reliability assessments for the seven points (N, A, B, S, W, M, G) used in the analysis of ANB, Yen and Tau angles were performed twice with an interval of 7 days by 22 orthodontists. The measurement results for ANB, Yen and Tau angles were assessed using the Bland–Altman formula, Dahlberg formula, intraclass correlation coefficients (ICCs), R² coefficients and R&R. In order to assess the number of individual skeletal classes of sagittal discrepancy, the Pearson chi-squared test was used. With common parameters of df = 4, p < 0001, for the ANB angle, the result was χ² = 9104; for the Tau angle, χ² = 4556; and for the Yen angle, χ² = 4207. In order to determine the inter-rater reliability based on two-way ANOVA analysis without repetitions, the ICC (2,2) was used. The ICC (2,2) index at the 95% confidence level was 0.998 for the ANB angle, 0.997 for Tau and 0.998 for Yen. High values of the ICC index close to 1 indicate the agreement of the measurements and their high reliability. Results: The orthodontists in the study measured sagittal discrepancy significantly more accurately using the ANB angle compared to the Yen and Tau angles. Using a Bland–Altman plot, the bias and range of agreement within which 95% of the differences between measurements were accounted for were determined. For the ANB angle, the mean difference between measurements was 0.07 with a confidence interval of −1.55 to +1.69; for the Tau angle, the mean difference between measurements was 0.19 with a confidence interval of −2.92 to 3.30; and for the Yen angle, the mean difference was 0.09 with a confidence interval of −2.71 to +2.89. Using regression analysis, the measurements were assessed using the R2 index, which for the ANB angle was 0.952 (p < 0.001); for the Tau angle, R2 = 0.928 (p < 0.001), and for the Yen angle, R2 = 0.942 (p < 0.001). Conclusions: The obtained results of the assessment of the ANB, Tau and Yen angles confirm the thesis of the highest reliability, including repeatability and reproducibility, in the assessment of sagittal discrepancy in orthodontic diagnostics using the ANB angle, previously considered the gold standard. One of the basic factors attributed to the poorer repeatability and reproducibility of Tau and Yen measurements is human error related to the precision of determining new anthropometric points. Further studies to assess the usefulness of using the new Tau and Yen angle measurements in orthodontic diagnostics for sagittal discrepancy should be correlated with other measurements used so far, depending on the type of defects in the vertical dimension. It is necessary to consider enlarging the study group and performing longitudinal studies. Full article

Background/Objectives: Functional near-infrared spectroscopy (fNIRS) may help quantify changes in brain haemodynamics during sport-related concussions (SRCs). This study compared post-match prefrontal cortex (PFC) brain haemodynamics measured by fNIRS during the King–-Devick test (K-DT) with players suspected of having sustained an SRC. It was hypothesized that changes in the K-DT would correspond with brain haemodynamic processes. Methods: Twenty-two male and female collegiate rugby players (six males and twenty-two females; age range: 18–22) completed a baseline K-DT+fNIRS assessment. Over the course of two to three matches, all participants were invited to complete at least one post-match K-DT+fNIRS assessment. If a player was suspected of having sustained an SRC, they were re-assessed with the K-DT+fNIRS. If a participant who was not suspected of having sustained an SRC performed worse on the K-DT post-match, they were included in the participant category of ‘concussion’ for the analysis. A repeated measures ANOVA was performed. Test–retest reliability was calculated using the intra-class correlation coefficient (ICC). A Pearson correlation coefficient (r) assessed the linear relationship between the changes in the K-DT and the measurements of the left and right PFC. Results: Differences were identified in the K-DT for the players with a suspected concussive injury post-match (χ2(1) =5.0; p = 0.0253; z = −2.0; p = 0.0431; d = 0.16). There were also significant differences between the baseline and post-match results for all concussed players in the right PFC (t(8) = 250; p = 0.0371; d = 0.92) and for the concussed females in the right PFC (t(6) = 2.78; p = 0.0319; d = 0.52). There were no correlations between the K-DT and PFC values in the suspected concussed group. Conclusions: The SRC group had decreased cognitive performance and a notable change in PFC activation, while the non-concussed group showed an increase in the activation in the PFC and no change in cognitive performance scores. This represents a possible acute adjustment in brain haemodynamics and provides insight into how SRCs can negatively impact cognitive performance. Full article

Background/Objectives: Atezolizumab, an immune checkpoint inhibitor (ICI), was used in a phase III clinical trial, i.e., the OAK trial, of previously treated patients with non-small cell lung cancer. We aimed to evaluate the real-world efficacy and safety of atezolizumab in a non-selected population and identify the clinical characteristics that influence its efficacy. Methods: This was a multicenter, retrospective, single-arm observational study. Seventy-four patients with advanced non-small cell lung cancer, who received atezolizumab monotherapy at Keio University and affiliated hospitals in Japan between April 2018 and March 2019, were enrolled. The follow-up period was until 28 February 2024. The efficacy of treatment and adverse events were reviewed retrospectively. Statistical analyses using Pearson’s χ² test, Fisher’s exact test, log-rank test, and Student’s t-test were performed. Results: The median age of patients was 70 (range, 45–85) years. The overall survival duration was 7.54 (95% confidence interval [CI], 5.14–11.3) months, and the median time to treatment failure (TTF) was 2.00 (95% CI, 1.75–2.54) months. Patients treated with atezolizumab as their first ICI had a longer TTF than those treated with atezolizumab as their second or subsequent ICI (p = 0.04). Conclusions: Atezolizumab may be more effective when used as the first ICI for previously treated patients and may be safely used in elderly patients with non-small cell lung cancer in real-world settings. Full article

Background: The issue of the relation betweeen training loads on the shape of the spine of young players is of significant importance, as with the advancement of training seniority, unfavorable changes may be perpetuated resulting in possible consequences in the next stages of ontogenesis. The aim of this study was to assess the formation of the sagittal curvatures of the spine in girls practicing volleyball versus their nonpractising peers. Methods: We examined 60 girls aged 10–13 years, including 30 volleyball players and 30 untrained peers. The Baseline Bubble inclinometer was applied as a research. The data were analyzed based on Mann–Whitney U test and Pearson Chi-square test. Results. There were statistically significant intergroup differences in lumbar lordosis curvature values (Z = −2.67; p = 0.007). The prevalence of correctness values of the thoracic kyphosis curvature, was group-dependent (χ²(1) = 4.34; p = 0.037). Group also determined the prevalence of lumbar lordosis normalities (χ²(1) = 5.41; p = 0.020). Conclusions. Volleyball has a beneficial effect on the formation of the thoracic kyphosis, while the lumbar lordosis is shallowed under the influence of training. This indicates the need for a holistic approach to player training and the need to supplement the technique and tactics training with exercises to strengthen the muscles that stabilize the lumbar spine, improve spinal mobility, learn how to control the anterior tilt of the pelvis and train the fascia. Full article

Background: Toothbrushing is important for maintaining oral health and preventing periodontal disease. However, the association between toothbrushing and systemic diseases remains unclear in adolescence. In this study, the association between dental self-care (frequency and duration of toothbrushing) and systemic diseases/disorders in adolescents was examined. Methods: We conducted a retrospective review of mandatory medical questionnaires administered during legally mandated freshman medical checkups between 2017 and 2019 at the University of Tokyo, Japan. Out of 9376 total responses, 9098 cases involving individuals under the age of 20 were included in the analysis. Respondents were classified into three groups based on their daily toothbrushing frequency: “1 time or less”, “twice”, and “3 times or more”. For the duration of each toothbrushing session, they were classified into three groups: “1 min or less”, “2–3 min”, and “4 min or more”. A statistical analysis was performed by Pearson’s χ² test and multinomial logistic regression analysis. Results: Regarding frequency of daily toothbrushing: The χ² test showed no significant relationship between frequency of toothbrushing and 17 systemic diseases/disorders. A multivariate analysis found that gingival bleeding and sex were independent factors. The risk of gingival bleeding decreased dramatically with increased frequency of toothbrushing (odds ratio (OR): 0.428; 95% confidence interval (CI), 0.366–0.501; p < 0.001). Regarding the amount of time spent on toothbrushing: The χ² test showed atopic dermatitis and arrhythmia were significantly associated with the duration of toothbrushing (p = 0.032 and p = 0.016, respectively). In the multivariate analysis, atopic dermatitis, gingival bleeding, and sex were independent factors regarding the duration of toothbrushing; longer brushing time was associated with a lower risk of atopic dermatitis (OR: 0.731, 95% CI: 0.578–0.924, p = 0.009) and a lower risk of gingival bleeding (OR: 0.643, 95% CI: 0.567–0.729, p < 0.001). Conclusions: Dental self-care was most strongly associated with gingival bleeding, while the risk of atopic dermatitis was found to increase with shorter toothbrushing times. The results suggest that dental self-care during adolescence is important not only for oral health but also for general health. Full article

Fish are vital in enhancing the stability of marine ecosystems. Therefore, understanding the ecological niches and interspecific correlation characteristics of their dominant species provides a good scientific basis for the protection and management of marine biodiversity. In this study, on the basis of survey data from trawls conducted in the waters off Xiamen in the spring (April) and autumn (November) of 2021, the ecotopes and interspecies connectivity of the dominant fish species were investigated using the relative importance index (IRI), χ² tests, the association coefficient (AC), and Pearson and Spearman analyses. According to the IRI, there were 23 fish species with higher values, including 15 species in spring and 15 species in autumn. The 15 dominant fish species could be subdivided into wide-, medium-, and narrow-ecotope species, of which there were 2 and 3 wide-ecotope types in spring and autumn. The niche overlap indices exhibited a range of 0.000–0.809 in the spring and 0.000–0.915 in the autumn, showing small differences between the two seasons. The interspecific correlations between the dominant fishes in Xiamen’s waters in spring and autumn were weak, and both showed non-significant positive correlations, indicating that the correlations between the dominant fishes in this sea area are relatively independent. The findings of this investigation provide a fundamental database and theoretical framework for researching the adaptive mechanisms of marine fish in the Xiamen Seas. Full article

Studies on creative accounting date back to the latter part of the 20th century. Creative accounting is still a big challenge in financial accounting. The problem of financial statement manipulation might be investigated, for instance, from an accounting, legal, ethical, or psychological perspective. This research aims to identify the main motives for the use of creative accounting and to find out whether corporate culture has an impact on the motives leading to the use of creative accounting. Data collection took place from 18 November 2023 to 18 December 2022. In the research, we used Pearson’s χ² test to determine the dependence of the studied variables in contingency tables. Subsequently, correspondence analysis was used. The type of corporate culture does not have an impact on the motives that lead to creative accounting. It was proven that the type of corporate culture has an impact on the performance of creative accounting actions based on the request of a senior employee. The uniqueness of the research lies in the investigation of creative accounting from a psychological and managerial point of view in the territory of the Slovak Republic. Full article

Background: Young adulthood is a critical developmental period in which individuals establish life-long health behaviors and take responsibility for their own health care. Health promotion strategies tailored to young adults, leveraging digital tools, and addressing challenges exacerbated by events like the COVID-19 pandemic are needed. The aim of this study was to adapt the post-pandemic health promotion behavior of young adults in the digital age (PS-SGD) scale to the Turkish population in order to assess and compare the health behavior of young adults after the pandemic. Methods: A total of 312 participants, aged between 19 and 29 years, were included in the study via non-probabilistic criterion sampling, while the Turkish adaptation process started with translation and back translation methods performed with three language and two health science experts. For statistical analysis, EFA and CFA were conducted to evaluate internal consistency and structural validity. Confirmatory factor analysis was utilized to confirm the structure of the six sub-dimensions. Additionally, measurement invariance was examined regarding participants’ gender to determine if the scale accurately captured similar traits across diverse groups. The relationship between the test–retest data was tested by Pearson correlation to measure consistency and its invariance over time. Results: The gender distribution of the sample was found to be 61.3% female and 38.7% male. According to the results of EFA, items 8 and 18 were removed from the Turkish-adapted version. As a result of the reliability analysis conducted with the Turkish version of the scale, the Cronbach alpha coefficient was obtained as 0.851 for the post-pandemic health promotion behavior. Additionally, the scale was rated as reliable with the following Cronbach alpha values: 0.79 for the “personal hygiene”, 0.78 for “dietary habits”, 0.72 for “using mobile devices”, 0.70 for “emotional health”, 0.68 for “health care and physical activity”, and 0.51 for “social health” sub-dimensions. To examine the six sub-dimension factor structures of the scale, fit indices were calculated as χ²/df (1.722), GFI (0.894), IFI (0.908), TLI (0.892), CFI (0.907), RMSEA (0.048), and SRMR (0.057) and were within acceptable limits. Findings of the multi-group confirmatory factor analysis for measurement invariance were less than or equal to 0.01 for the ∆CFI and ∆RMSEA values across all indices. Consequently, it was observed that the item–factor structure, factor loadings, variances, covariances, and error variances of the scale were equivalent for both male and female young adults, while test–retest results showed a high positive correlation. Conclusions: The Turkish version of the post-pandemic health promotion behavior scale of young adults in the digital age scale, consisting of 25 items and six subscales, was proven to be a valid and reliable tool to measure health promotion behavior in young adults aged 19–29 years. Full article

The tourist intermediary industry has faced multiple challenges to adapt their offers to the heterogeneity of tourists, and understanding consumer interests from a gender and age perspective is considered crucial in the design and marketing of tourist products. The aim of this article is to examine the differences generated by the gender and age variables of consumers of Spanish travel agencies when choosing travel and tourist destinations, focusing on different types of travel, the choice between national and international destinations, and specific destination types. An explanatory quantitative methodology was employed with a hypothetical-deductive approach. A questionnaire was administered to individuals who booked through Spanish travel agencies and a sample of 879 was obtained. The data were analyzed using SPSS 26 software and the main statistical tool was the Pearson Chi-Square (χ²) test. The findings show that gender implies significant differences in travel preferences, with women favoring the exploration of new destinations and men preferring relaxation travel. Age groups impact the choice between national and international travel, but have a lesser effect on specific destination preferences. This research underscores the importance of considering gender and age in understanding consumer behavior within the travel sector, with the aim of developing more effective marketing strategies and catering to diverse customer needs. Within the implications, the growing importance of the older traveler segment should be highlighted, which requires future research and comparisons with the younger traveler segment. Full article