Average Score Research Articles

Evaluation of occupational health literacy of health workers in Adana, Türkiye

Objective: The importance of occupational health and safety (OHS) and related health literacy is increasing. The aim of this study was to evaluate the occupational health literacy status of healthcare workers in Adana (Turkey). Method: The population of the study consists of health workers in Adana province (N=18,660). Between April 29 and June 13, four researchers visited the workplaces of health workers and asked them to answer online survey questions through the WhatsApp application in face-to-face meetings. The study was completed with 179 individuals determined using non-probability sampling method. The analyses were performed using the SPSS 22 software. The Kolmogorov-Smirnov, t-test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test were used in the analyses. A significance level of p < 0.05 was considered statistically significant. Results: The study included 179 healthcare workers with an average age of 32.36±7.97 years. Pre-employment medical examinations and periodic examinations were reported to have been performed in 65.9% and 50.3%, respectively. The "Occupational Health Literacy Scale" that was administered to the participants with a resulting avarage score was 80.30±11.68. Participants who underwent workplace periodic examinations had higher scores in Factor 1 and Factor 4 compared to those who did not undergo any periodic examination. Conclusion: Participants who underwent periodic examinations and those who were informed about health risks had higher occupational health literacy. It is recommended that health workers be informed about health risks in the institutions they work, periodic examinations are carried out regularly, OHS trainings are planned, and these trainings are repeated periodically.

Deep Peroneal Neurectomy for Midfoot Arthritis: A Comprehensive Review, Surgical Technique, and Case Series

Patients with painful midfoot arthritis unsuccessfully treated with conservative measures have been historically left with the surgical option of midfoot arthrodesis as a definitive treatment. In recent years, excision of the deep peroneal nerve has been offered as a potential alternative. Existing literature on the outcomes of patients undergoing deep peroneal neurectomy for the treatment of midfoot arthritis is limited and piecemeal. In this comprehensive review, technique guide, and retrospective case series, we consolidate the evidence around deep peroneal neurectomy for midfoot arthritis, review operative technique, and determine the outcomes of 4 patients who underwent deep peroneal neurectomy from February 2021 to December 2022 using Patient-Reported Outcome Measurement Information System Physical Function and Pain Interference scores. Four original articles from National Center for Biotechnology Information Medline, published through May 2023, were included. The outcomes of patients treated with deep peroneal neurectomy for midfoot arthritis are discussed. In our case series, the average amount of time between surgery and final postoperative Patient-Reported Outcome Measurement Information System scores was 289 days. The average preoperative physical function score was 36.8. Three patients showed a minimal clinically important difference in physical function; postoperative average was 41.3. Three patients had a minimally clinical important reduction in pain levels (average preoperative pain interference score was 65.8; average postoperative pain interference score was 59.3). One patient underwent a revision neurectomy for inadequate pain relief, and another sought additional treatment for inadequate pain relief. All patients returned to walking in a shoe within 1 month. The outcomes of our case series are similar to those of previously published case series, which demonstrate satisfactory results and acceptable complication rates. For patients with symptomatic midfoot arthritis, deep peroneal neurectomy can be an effective treatment option to reduce pain and improve physical function while requiring minimal postoperative recovery time.

Sleep quality of Chinese designers and the effects of digital screen time, stress, and job responsibility

The aim of this study was to describe the sleep status of Chinese designers and to identify the factors that affect their sleep quality. A total of 393 Chinese designers participated in the survey, which collected data on demographic information, digital screen time, stress, and the pittsburgh sleep quality index (PSQI). The average PSQI score of Chinese designers was 6.77, with 29% scoring equal to or higher than 9, indicating poor sleep quality. The most common sleep problem was difficulty falling asleep. Designers with management responsibilities had poorer sleep quality: the PSQI scores for those in design project management (M=8.74, SD=3.829) and design and management (M=9.05, SD=3.475) were significantly higher than for those in dedicated design (M=5.34, SD=2.908). There was a positive correlation between digital screen time for entertainment, work stress, other stress, and PSQI. The model equation was PSQI=1.160+0.276 * entertainment+0.675 * work stress+0.569 * other stress, with an r square of 0.232. Chinese designers should improve their sleep quality by reducing electronic entertainment and relieving stress. Managers in the design industry should pay special attention to their own sleep quality.

An evaluation of AI generated literature reviews in musculoskeletal radiology

PurposeThe use of artificial intelligence (AI) tools to aid in summarizing information in medicine and research has recently garnered a huge amount of interest. While tools such as ChatGPT produce convincing and naturally sounding output, the answers are sometimes incorrect. Some of these drawbacks, it is hoped, can be avoided by using programmes trained for a more specific scope. In this study we compared the performance of a new AI tool (the-literature.com) to the latest version OpenAI's ChatGPT (GPT-4) in summarizing topics that the authors have significantly contributed to. MethodsThe AI tools were asked to produce a literature review on 7 topics. These were selected based on the research topics that the authors were intimately familiar with and have contributed to through their own publications. The output produced by the AI tools were graded on a 1–5 Likert scale for accuracy, comprehensiveness, and relevance by two fellowship trained consultant radiologists. ResultsThe-literature.com produced 3 excellent summaries, 3 very poor summaries not relevant to the prompt, and one summary, which was relevant but did not include all relevant papers. All of the summaries produced by GPT-4 were relevant, but fewer relevant papers were identified. The average Likert rating was for the-literature was 2.88 and 3.86 for GPT-4. There was good agreement between the ratings of both radiologists (ICC = 0.883). ConclusionSummaries produced by AI in its current state require careful human validation. GPT-4 on average provides higher quality summaries. Neither tool can reliably identify all relevant publications.

Exploring relational aggression and gender dynamics: a global and Indonesian perspective

Girls generally use less physical aggression than boys. However, does this mean that girls are more likely to use relational aggression. With this question in mind, our study aims to analyze the relational aggression of students in Indonesia based on gender. This type of research used is comparative research. The sample in this study was 510 respondents consisting of 19.6% male and 80.4% female. The relational aggression scale (RAS) was used to collect data on student relational aggression in various regions in Indonesia. The analysis technique used is descriptive and differences with the Welch test. The results show that there are significant differences in male and female relational aggression, with an average score difference of -0.30 logit between men and women. In addition, there are fluctuations in the level of relational aggression in the context of gender from year to year in some countries, such as the United States, China, Australia, and others. Recommendations for future research are to integrate a more in-depth social and cultural analysis in Indonesia.

Investigation of the Relationship Between Psychological Well-Being and Problem Solving Skills of Faculty of Health Sciences Students

Objective: The aim of this study was to determine the psychological well-being of health sciences students; their problem-solving skills and to examine the relationship between them. Methods: The research was carried out in descriptive cross-sectional design. The population of the research consists of students studying in the field of health sciences at two foundation universities in Turkey. 'Descriptive Information Form', 'Psychological Well-Being Scale (PWBS)' and 'Problem Solving Inventory (PSI)' were used to collect data. The data were analyzed in SPSS program. Results: The students' PSI total score average was 100.4±17.22; PSI sub-dimension total score averages were determined as 'Personal Control' 15.89 ±3.92, 'Problem Solving Confidence' 29.40±8.13 and 'Approach Avoidance Style' 44.97±9.73. The mean total score of PWBS was found to be 42.7±8.54. Conclusion: In line with the results obtained, it was found that there was a significant relationship between psychological well-being and problem-solving skills, and that as students' psychological well-being increased wtih their problem-solving skills. Consistent with these findings, it was concluded that problem solving sub-dimensions, psychological well-being and total problem solving score were positively related. Psychological well-being and problem solving skills are directly related to each other and affect each other.

Can We Differentiate a Latent Growth Curve Model from Competitors? Evidence Based on Individual Case Residuals

In latent growth curve modeling (LGCM), overall fit indices have garnered increased disputation for model selection, and model fit evaluation based on the mean structure has becoming popularity. The present study developed a versatile fit index, named Weighted Root Mean Squared Errors (WRMSE), based on individual case residuals (ICRs) with the aim of facilitating model selection. Through comparing to various fit indices, this study demonstrated that WRMSE could provide effective model fit information beyond previous indices. Due to higher sensitivity to misspecification in the mean structure, WRMSE was suggested to be utilized as a supplement for the traditional overall fit indices in the process of model selection. The limitation of WRMSE was that for complex models beyond the commonly used polynomial models, an increased number of repeated measurement occasions was required to ensure the precision of WRMSE.

Balanced opioid-free anesthesia with lidocaine and esketamine versus balanced anesthesia with sufentanil for gynecological endoscopic surgery: a randomized controlled trial

In this randomized controlled trial, 74 patients scheduled for gynecological laparoscopic surgery (American Society of Anesthesiologists grade I/II) were enrolled and randomly divided into two study groups: (i) Group C (control), received sufentanil (0.3 μg/kg) and saline, followed by sufentanil (0.1 μg/kg∙h) and saline; and (ii) Group F (OFA), received esketamine (0.15 mg/kg) and lidocaine (2 mg/kg), followed by esketamine (0.1 mg/kg∙h) and lidocaine (1.5 mg/kg∙h). The primary outcome was the 48-h time-weighted average (TWA) of postoperative pain scores. Secondary outcomes included time to extubation, adverse effects, and postoperative sedation score, pain scores at different time points, analgesic consumption at 48 h, and gastrointestinal functional recovery. The 48-h TWAs of pain scores were 1.32 (0.78) (95% CI 1.06–1.58) and 1.09 (0.70) (95% CI 0.87–1.33) for Groups F and C, respectively. The estimated difference between Groups F and C was − 0.23 (95% CI − 0.58 − 0.12; P = 0.195). No differences were found in any of the secondary outcomes and no severe adverse effects were observed in either group. Balanced OFA with lidocaine and esketamine achieved similar effects to balanced anesthesia with sufentanil in patients undergoing elective gynecological laparoscopic surgery, without severe adverse effects.Clinical Trial Registration: ChiCTR2300067951, www.chictr.org.cn 01 February, 2023.

#1419 A single, easy-to-use question to assess pruritus intensity in daily dialysis practice

Abstract Background and Aims Chronic kidney disease-associated pruritus (CKD-aP) has been shown to negatively impact certain clinical outcomes and quality of life (QoL) in patients with kidney failure. However, regular screening for CKD-aP is not yet routine dialysis practice and no consensus on the preferred instrument exists. To facilitate implementation of regular screening for CKD-aP we assessed the performance of two different instruments validated in patients with CKD-aP. Method The Worst Itching Intensity Numerical Rating Scale (WI-NRS) asks patients to indicate the worst itch intensity in the past 24 hours (range 0 [no itch] to 10 [worst itch imaginable]). The 5-D Itch scale assesses itch-related QoL (range 5-25 where higher values indicate worse QoL) and includes one question on itch intensity over the past 2 weeks (5-D ‘degree’ domain, range 1 [not present] to 5 [unbearable]). Both instruments were included in two phase-3 clinical trials, KALM-1 and KALM-2, that established the favourable benefit-risk profile of difelikefalin over placebo in patients on haemodialysis with moderate to severe CKD-aP. WI-NRS was collected daily during the trial and 5-D Itch at the first dialysis visit in weeks 5, 9, 11 and 13. We assessed the correlations between both the 5-D total score and degree domain and a) the single WI-NRS measurement collected on the same day and b) the average of daily WI-NRS scores collected over the previous 2 weeks in all patients independent of treatment exposure. Results The two instruments demonstrated moderate to strong correlations (range 0.5635-0.7039, p < 0.0001) independent of whether the total 5-D Itch score or the 5-D itch degree question were compared with a single, same-day WI-NRS measurement or with the mean WI-NRS scores over the 2-week recall period of the 5-D Itch (Table). In addition, correlations remained consistent over time, supporting the reliability of the findings. Conclusion Using the WI-NRS to ask patients about their worst itch in the past 24 hours is a simple and swift approach for reliably identifying those with bothersome pruritus that also affects their itch-related QoL.

Investigation of the Relationship between the Patience Levels and Personality Traits of Faculty of Health Sciences Students

Aim: This study was conducted descriptively to examine the correlation between the patience levels and personality characteristics of Faculty of Health Sciences students. Materials and Methods: The study was carried out with 420 nursing students in the 2019 - 2020 academic year. The study data was collected using the ‘Socio - demographic Data Collection Form’, ‘Patience Scale’ and ‘Adjective - Based Personality Test’. In evaluation of the data; descriptive statistics, Shapiro - Wilk test, Kruskal Wallis test and Spearman’s Correlation coefficient analysis were used. Results: The students’ Patience Scale score average was 35.24 ± 6.11. In the comparison of the Patience Scale subscales and total score according to grades, no statistically significant difference was found (p > 0.05). There was a significant difference between the Patience Scale and Adjective - Based Personality Test score averages. It was determined that students with personality characteristics such as extroversion, openness to experience, tender - mindedness and responsibility would have higher interpersonal patience, patience in life difficulties and general patience, whereas students with neurotic personality characteristics would have lower patience in daily life, interpersonal patience, patience in life difficulties and general patience. Conclusion: As a consequence; it was seen that there was a significant differentiation between the Patience Scale and Adjective - Based Personality Test score averages.

Robust kernel extreme learning machines with weighted mean of vectors and variational mode decomposition for forecasting total dissolved solids

A stable and accurate forecast of water quality parameters is crucial for planning and managing future investment programs. A well-known water quality indicator is the total dissolved solids (TDS), which measures the number of metals, minerals, and salts dissolved in a particular volume of water. This paper introduces an innovative approach, which combines the kernel extreme learning machine (KELM) with the robust weight mean of vectors (INFO) algorithm. The proposed technique stands out for its strategic integration of Boruta-XGBoost (B-XGB) as an exceptional feature selection method, along with variational mode decomposition (VMD) to decompose the input variables and enhance the accuracy of forecasting. The integrated model is termed V-KELM-INFO. INFO is an essential component that incorporates a complex exploration process. It utilizes a weighted mean of vectors, a vector combining operator to enhance population variety, and a localized search operator to expedite convergence. INFO, a potent tool, is included in the V-KELM training stage. It efficiently extracts optimum parameters and dramatically improves the accuracy of monthly TDS predictions at the Idenak station in southwest Iran. Also, the multi-criteria decision-making (MCDM) approach of weighted aggregated sum product assessment (WASPAS) is used to rank models. The V-KELM-INFO model was chosen based on the WASPAS results and statistical metrics (R = 0.962, RMSE = 57.84, WHD = 7.01, and U95 = 160.74) as the best model to forecast the TDS. In addition, the superiority of the proposed model was assessed against the metaheuristic-based V-KELM models, comprising the V-KELM grey wolf optimizer (V-KELM-GWO), V-KELM slime mold algorithm (V-KELM-SMA), and V-KELM equilibrium optimizer (V-KELM-EO). This work provided insight into improving the accuracy of modeling-based methodologies and spurred water quality modeling technology to develop sustainable and clean practices.

Postpartum Depression in Women Gave Birth in the Shadow of the Pandemic

Objective: This study aimed to evaluate the level of postpartum depression and related factors in women who gave birth during the COVID-19 epidemic. Materials and Methods: This is a descriptive cross-sectional study. The study was carried out between January and April 2021 with 351 participants. Data collection instruments included an information form, Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale (OCS), and Edinburgh Postnatal Depression Scale (EPDS). Results: The average age of the participants was 28.37±6.74. The number of pregnancies was 2.68±1.48. Primary school graduates were 47.3%, and 92% were not working. 7% of the participants had an EPDS cut-off score of 10 or above. A difference was found between the groups in terms of education level, smoking, COVID-19 experience relative to COVID-19 status and CAS and OCS score average (p

Determining the Relationship Between Quality of Life and Perceived Stress in Liver Transplant Patients Receiving Immunosuppression Therapy

Objective: This study was conducted to evaluate the relationship between quality of life and perceived stress in liver transplant patients receiving immunosuppression therapy. Materials and Methods: This study is a cross-sectional study with the participation of 124 liver transplant patients hospitalized in the liver transplantation center of a university hospital. Results: The results of the correlation analysis between the perceived stress scale (PSS) and the 36-item Short Form Health Survey (SF-36) subscales of the participants: A negative and weak significant relationship was found between physical function, physical role difficulty, emotional role difficulty, energy/vitality, social functioning, general health perception, and pain sub-dimensions (r=-0.209 and -0.480). A negative, moderate and significant relationship was found between PSS and the mental health sub-dimension (r=-0.563). As a result of the regression analysis, the effect of the PSS total score average on SF-36 sub-dimensions was examined, and it was found that it had the highest and negative effect on the mental health sub-dimension with a rate of 31.7% (R2=.317; B=-1.962; p

History of periodontitis as a risk factor for implant failure and incidence of peri-implantitis: A systematic review, meta-analysis, and trial sequential analysis of prospective cohort studies.

Dental implants are widely employed as dependable replacements for lost teeth. However, it is crucial to establish, solely through prospective cohort studies, whether a history of periodontitis indeed constitutes a significant risk factor for implant failure. A systematic literature search was conducted in October 2022 in several electronic databases with subsequent manual updates. Only original prospective cohort studies evaluating the implant (loss) rate ≥1 year after implant loading were included. Logarithmic risk ratio and weighted mean differences were calculated. Study results were summarized using random effects meta-analyses evaluated by trial sequential analyses. The Newcastle-Ottawa scale evaluated study bias and the GRADE approach assessed the certainty/quality of the evidence. A total of 14 publications reporting on 12 prospective cohort studies were included. Low evidence certainty/quality evidence due to the absence of randomized clinical trials revealed significantly greater odds of failure in patients with a history of periodontitis at follow-ups both after ≤5 years (RR = 1.62; 95% CI: 1.71-2.37; p = 0.013) and >5 years (RR = 2.26; 95% CI: 1.12-4.53; p = 0.023). The incidence of peri-implantitis (RR = 4.09; 95% CI: 1.93-8.58; p < 0.001) and the weighted mean (WM) of marginal bone loss (WM difference = 0.75 mm; 95% CI: 0.18-1.31; p < 0.05) were statistically significantly greater in the periodontally compromised group, whereas there was no significant difference between the two groups for peri-implant probing depth. A history of periodontitis can be considered a significant risk factor for incident implant failure, peri-implantitis, and greater marginal bone loss.

Strawberry Gel with a Concentration of 83% and 75% as an Extrinsic Stain Remover

Strawberries have many benefits, where the malic acid contained in strawberries acts as a substance that will erode and remove several stains on the surface of teeth, including cleaning extrinsic stains. Gel preparations are widely used in medicines, cosmetics and food products, including toothpaste and teeth whitening agents. The purpose of this study was to determine the effectiveness of strawberry gel with a concentration of 83% and 75% in cleaning teeth with extrinsic stain on academic member of the Health Polytechnic Jakarta I. This study was an Experiment on 30 people who had upper and lower anterior teeth with extrinsic stain as samples. Data collection was done by applying strawberry gel on the surface of the anterior teeth, allowed to stand for 5 minutes, then brushed and rinsed with water. This procedures was done 2 times a day for 5 consecutive days. Changes in extrinsic stain are measured using the Lobene Stain Index which measures the intensity and area of the stain, as well as a combined score of both. The average of combined score with measurements using the Lobene Stain Index for extrinsic stain before being treated with strawberries. Hopefully the score will decreased every day starting from day 1 to day 5 of treatment.

Deterioration of Hearing Due to Hearing Aids.

A primary reason for the low adoption of hearing aids (HAs) among the large population with sensorineural hearing loss is the perception that these devices may negatively impact remaining hearing ability. Research addressing this issue has yielded conflicting results. This study examined the long-term effects of HAs on standard audiometric changes in individuals with sensorineural hearing loss. We retrospectively analyzed patients who acquired unilateral HAs between 2015 and 2017 and demonstrated consistent use over a 5-year period. We examined demographics, medical comorbidities, audiometric data, and questionnaire results from the Hearing Handicap Inventory for the Elderly and the International Outcome Inventory for Hearing Aids. Additionally, we reviewed each patient's history of noise exposure and prior HA use. The study included 55 patients who used unilateral HAs, with a mean follow-up period of 5.32 years. Among them, 31 patients (56.4%) used the HA on the right side. Audiometric data from the aided side showed no significant difference from the unaided side in either the pre-fit pure-tone average of air conduction (AC) or word recognition score (WRS) (P =0.73 and P =0.11, respectively). Similarly, no significant differences were noted in the 5-year follow-up audiometry of AC and WRS (P=0.98 and P=0.07, respectively) or in the change from pre-fit to final audiometry for either parameter (AC, P=0.58; WRS, P=0.70). Eleven patients (20%) exhibited a deterioration in hearing (as measured by AC) of 5 dB or greater on the aided side compared with the unaided side, while 23 (53.5%) showed greater WRS deterioration on the aided side. No significant factors were found to contribute to the difference in hearing deterioration between groups for either AC or WRS. No significant factors were identified as contributing to hearing deterioration after prolonged HA use. Overall, the use of HAs did not adversely impact residual hearing.

Metacognitive self regulation integrated with science technology society to improving problem solving ability in microbiology courses

The purpose of this study was to improve students’ problem-solving ability and metacognitive self-regulation (MSR) by applying science technology society (STS) learning model integrated with metacognitive self-regulation. The participants were 13 students from Department of Biology Education who took microbiology courses. A quasi-experimental method with one-group pre and posttest design was used in this study. Data were collected through pre and posttest with eight open ended questions to measure students’ problem-solving ability on four microbiology topics (food, pathogen, waste and water microbiology). These topics were studied sequentially in two months. The instrument used to measure MSR is a questionnaire with open-ended questions. This questionnaire was developed based on three aspects of MSR namely, planning, monitoring and evaluation. MSR questionnaire was administered to students at the end of each topic. The N-gain test was used to analyze the improvement of students' problem-solving ability on each topic. The average score of all aspects in MSR questionnaire was used to explore students’ metacognitive self-regulation. The correlation between MSR and problem-solving ability was analyzed using Pearson correlation. The results revealed that the N gain score of problem-solving ability was increased from 0.56 in the first topic to 0.7 in the next three topics. The average of MSR score also increased from 66.15 in the first topic to 87.23 in fourth topic. There was a positive correlation between students’ MSR and problem-solving ability. These results indicated that application of Science Technology Society integrated with MSR is an effective strategy in improving students’ problem-solving ability and MSR. The implementation of this research is to develop a lecture program as an effort to improve the learning process

The relationship of vitamin D to the MHAQ index, activity disease, and inflammation in a sample of Syrian rheumatoid disease patients

Background: Vitamin D has an immunomodulatory and anti-inflammatory role, and its deficiency has been linked with many autoimmune disorders, including rheumatoid arthritis (RA). The correlation ship between the severity of RA and serum levels of vitamin D is a subject of immense interest and therapeutic implications. Patients and Methods: A total of 100 patients previously diagnosed with RA were collected from visitors to the rheumatology clinic at the university hospital and their ages were over 18 years. The serum vitamin D value and the C-reactive protein (CRP) value were measured, and the Disease Activity Score CRP28 (DAS28CRP) and Modified Health Assessment Questionnaire (MHAQ) score were calculated to determine the severity and effectiveness of the disease and its relationship to vitamin D deficiency. Results: The average age of the patients ranged according to the patient’s age (46.03±11.291), we note that individuals whose ages ranged from 26 to 65 accounted for the largest percentage (94%), 83% of women (83) and 17% men (17), and the mean score for sun exposure was 15.80±5.446. Patients were individuals diagnosed with the disease between 5 and 10 years were the highest group, with a percentage of 31%. A total of 72% of the patients were not treated with corticosteroids, and 43% of the patients were treated with vitamin D. We found that the number of patients using biologic medications was 18%, and the number of patients using disease-modifying anti-rheumatic drugs was 88%. The mean of DAS28 was moderate in 63% of patients, and the average of the MHAQ score was 0.80±0.334. We found that there is no statically significant correlation between the serum vitamin D level and DAS28/CRP (P=0.733), and there is also no statically significant correlation between the serum value of vitamin D and the medications used, whether biological or disease-modifying anti-rheumatic drugs (P=0.361). In addition, there is also no significant correlation between the serum vitamin D level and MHAQ score (P=0.100). Conclusion: There was no significant relationship between vitamin D deficiency and the disease activity or severity in a sample of patients with RA.

Bag of On-Phone ANNs to Secure IoT Objects Using Wearable and Smartphone Biometrics

The introduction of the Internet of Things (IoT) has made several emerging applications, from financial transactions to property access, possible through IoT-connected smart wearables (smartwatches). This creates an immediate need for an authentication system that can validate a user seamlessly, compared to knowledge-based approaches. In this work, we present an implicit authentication system that utilizes a bag of on-phone artificial neural network (ANN) models to validate a user based on the availability of three soft-biometrics (heart rate, gait, and breathing patterns) collected from smartphones and Fitbits. We find that using all three biometrics we can achieve an average accuracy of up to <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$.973 \pm . 004$</tex-math></inline-formula> . Next, we implement the bag of models on smartphones using Google's TensorFlow Lite framework-supported <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">TFL Auth</i> application, which requires around 56-65 KB memory and can verify a user in 5 seconds. Finally, we evaluate the system <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">TFL Auth</i> using two cohorts of 25 subjects in total, and we find that the system has average understandability and importance scores of around 4.0 and 4.3 on a 1 – 5 scale.

Acute Ankle Diastasis Injuries Treated with Dynamic, Static Fixation or Anatomic Repair: A Meta-Analysis and Systematic Review of Comparison Studies.

Acute ankle diastasis injuries are complex and debilitating. These injuries occur when the syndesmotic complex becomes compromised. Treatments of acute syndesmotic injuries include static fixation with screws, dynamic fixation with an elastic device, or anatomic repair of the damaged ligament. However, there is disagreement over which method is most effective. The primary purpose of this study was to compare the 3 treatment methods for acute syndesmotic injuries. A systematic literature search was conducted on Embase and PubMed. Studies that compared at least 2 groups with relevant American Orthopaedic Foot & Ankle Society (AOFAS), Visual Analog Scale (VAS), reoperation rate, and complication (implant failure, implant irritation, and infection) data were analyzed. Statistical analysis for this study was performed using Review Manager 5.4, with a standard p-value of ≤0.05 for statistical significance. Twenty-one studies including a total of 1,059 patients (452 dynamic, 529 static, and 78 anatomic) were included for analysis. Dynamic fixation had significantly higher mean AOFAS scores at 3 months postoperation by 5.12 points (95% confidence interval [CI], 0.29-9.96, p = 0.04) as well as at 1 year postoperation by 4.64 points (95% CI, 1.74-7.55, p = 0.002) than static fixation. Anatomic repair had significantly higher AOFAS scores at 6 months postoperation by 3.20 points (95% CI, 1.06-5.34, p = 0.003) and 1 year postoperation by 1.86 points (95% CI, 0.59-3.14, p = 0.004) than static fixation. Dynamic fixation had significantly higher AOFAS scores at 6 months postoperation by 2.81 points (95% CI, 0.76-4.86, p = 0.007), 12 months postoperation by 3.17 points (95% CI, 0.76-5.58, p = 0.01), and at 2 years postoperation by 5.56 points (95% CI, 3.80-7.32, p < 0.001) than anatomic repair. Dynamic fixation also had a lower VAS score average (favorable), only significant at 12 months postoperation, than static fixation by 0.7 points (95% CI -0.99 to -0.40, p < 0.001). Anatomic repair did not have significant difference in VAS scores compared with static fixation. Anatomic repair had significantly lower VAS scores at 12 months postoperation by 0.32 points (95% CI -0.59 to -0.05, p = 0.02) than dynamic fixation. Dynamic fixation had significantly less implant failures (odds ratio [OR], 0.13, 95% CI, 0.05-0.32, p < 0.001) than static fixation. Anatomic repair was not significantly different from static fixation in the complication metrics. Dynamic fixation and anatomic repair were not significantly different in the complication metrics either. Dynamic fixation had a significantly lower reoperation rate than static fixation (OR, 0.23, 95% CI, 0.09-0.54, p < 0.001). Anatomic repair did not have a significantly different reoperation rate compared with static fixation. However, dynamic fixation had a significantly lower reoperation rate than anatomic repair (OR, 4.65, 95% CI, 1.10-19.76, p = 0.04). Dynamic fixation seems to demonstrate superior early clinical outcomes. However, these advantages become negligible in the long term when compared with alternative options. Dynamic fixation is associated with a lower risk for complications, specifically seen with the decrease in implant failures. This method also presents a significantly lower reoperation rate compared with the other treatment approaches. Apart from showing improved early clinical outcomes in comparison with static fixation, anatomic repair did not have significant distinctions in other metrics, including complications or reoperation rate. Level III. See Instructions for Authors for a complete description of levels of evidence.