University Faculty Research Articles

P.333: Interferon-gamma release test results in organ transplant recipients and donors at Başkent University Faculty of Medicine Hospital.

P.333: Interferon-gamma release test results in organ transplant recipients and donors at Başkent University Faculty of Medicine Hospital.

Dipping Your Toe in The CURE Pool: Longitudinal Tracking of Instructors Suggests Use of a Short-Duration CURE Can Catalyze Expansion to Longer CURE Experiences.

Course-based undergraduate research experiences (CUREs) are an effective method of engaging large numbers of students in authentic research but are associated with barriers to adoption. Short CURE modules may serve as a low-barrier entryway, but their effectiveness in promoting expansion has not been studied. The Prevalence of Antibiotic Resistance in the Environment (PARE) project is a modular CURE designed to be a low-barrier gateway into CURE use. In a series of interviews, we track and characterize use of PARE in 19 PARE-interested instructors throughout the Innovation-Decision Process described by Rogers' Diffusion of Innovations theory. The majority (16/19) implement PARE at least once, and a majority of these implementers (11/16) expanded use by the final interview. Three of four cases of discontinuance were due to a disruption such as moving institutions or a change in course assignment and occurred for community college faculty. Expanders expressed fewer personal challenges than nonexpanders. Overall analysis shows that perception of barriers is nuanced and impacted by the innovation itself, the institutional context, and one's own experiences. These results suggest that a short duration, low barrier CURE can serve as a catalyst for implementation of a longer duration CURE.

Researching Student Profiles in the Department of Child Development at Istanbul Gelişim University

Aim: This research is a descriptive study aimed at determining the profile of students enrolled in the Department of Child Development within Istanbul Gelisim University's Faculty of Health Sciences. Method: The study group consists of 389 students studying in the child development departments providing education in Turkish and English. In the study, 259 students who agreed to participate in the study were included without any sample selection. Result: Research findings have shown that the majority of child development department students are satisfied with both the department and the university. They choose the child development department voluntarily and rank it among their top three choices in the university preference form. Additionally, they have positive feelings towards both the department and the university. Conclusion: As a result of the research, it was determined that the students were satisfied with their departments and the university. Personality characteristics, professional knowledge, skills, and attitudes of child development professionals directly affect the target audiences with whom they will interact. For this reason, to train qualified child development experts, it is thought that it would be beneficial to take encouraging measures for candidates who will choose the child development profession and to support existing child development experts while doing their profession and help them solve the problems they encounter.

Persepsi Mahasiswa Terhadap Pelayanan Akademik oleh Tenaga Kependidikan pada Fakultas Ilmu Pendidikan Universitas Negeri Padang

The purpose of this study is to ascertain and evaluate how State University of Padang's Faculty of Education's students feel about academic services. This research employs a quantitative descriptive methodology. There were 1168 students in the study's population, and 308 students were selected at random using the Proportional Random Sampling approach, with the sample size calculated using the Slovin formula at a 5% error rate. The data analysis's conclusions demonstrate how students view the academic services provided by FIP UNP's education staff from the following perspectives: 1) tangible, with an average score of 3.99; 2) reliable, with an average score of 3.90; 3) responsive, with an average score of 3.84; 4) assured, with an average score of 3.93; and 5) emphatic, with an average score of 3.48. Overall, students' perceptions of the academic services provided by FIP UNP educators fall into the good category, with an average score of 3.83.

A novel software for method comparison: MCS (method comparison software)—assessing agreement between estimated fetal weights calculated by Hadlock I–V formulas and birth weight

IntroductionThe evaluation of the performance of new methods, expected to provide cheaper and faster results than existing (reference) methods in the health field, is based on comparing the results obtained with this new method to those obtained with the existing method. The primary aim of this study is to examine the correlational and absolute agreement between measurement methods in clinical studies using Bland–Altman analysis and methodological (Ordinary Least Squares, Weighted Ordinary Least Squares, Deming, Weighted Deming, Passing–Bablok, Theil-Sen, and Passing–Bablok for Large Data Sets.) methods, and the secondary aim is to compare the accuracy and precision of Hadlock (I–V) formulas used for fetal weight estimation.Materials and methodsThe study was conducted on singleton pregnancies examined in the Prenatal Diagnosis and Treatment Unit of the Department of Obstetrics and Gynecology at Inonu University Faculty of Medicine and who gave birth in the Obstetrics Unit between 01.01.2020 and 01.09.2023, whose gestational ages were confirmed by first-trimester ultrasonography. Estimated fetal weights were calculated using Hadlock (I–V) formulas, and the agreement of these weights with birth weight was evaluated with Bland–Altman method.ResultsThe comparison of estimated fetal weights calculated using Hadlock formulas with birth weight was analyzed using Bland–Altman analysis, ICC, and CCC values along with regression analyses. According to the mean difference values obtained by Bland–Altman analysis, the estimated fetal birth weights obtained by the Hadlock IV formula were most consistent with the actual birth weights.ConclusionsThe estimated fetal weights obtained using the Hadlock IV formula resulted in the closest measurements to the birth weight. This study showcases the efficacy of a new web-based software, Method Comparison Software (MCS), which can be utilized for evaluating the agreement between different methods in clinical measurements.

Profile Photograph Classification Performance of Deep Learning Algorithms Trained Using Cephalometric Measurements: A Preliminary Study.

Extraoral profile photographs are crucial for orthodontic diagnosis, documentation, and treatment planning. The purpose of this study was to evaluate classifications made on extraoral patient photographs by deep learning algorithms trained using grouped patient pictures based on cephalometric measurements. Cephalometric radiographs and profile photographs of 990 patients from the archives of Kocaeli University Faculty of Dentistry Department of Orthodontics were used for the study. FH-NA, FH-NPog, FMA and N-A-Pog measurements on patient cephalometric radiographs were carried out utilizing Webceph. 3 groups for every parameter were formed according to cephalometric values. Deep learning algorithms were trained using extraoral photographs of the patients which were grouped according to respective cephalometric measurements. 14 deep learning models were trained and tested for accuracy of prediction in classifying patient images. Accuracy rates of up to 96.67% for FH-NA groups, 97.33% for FH-NPog groups, 97.67% for FMA groups and 97.00% for N-A-Pog groups were obtained. This is a pioneering study where an attempt was made to classify clinical photographs using artificial intelligence architectures that were trained according to actual cephalometric values, thus eliminating or reducing the need for cephalometric X-rays in future applications for orthodontic diagnosis.

Strategies for Implementing GlobalConsent to Prevent Sexual Violence in University Men (SCALE): study protocol for a national implementation trial

BackgroundGlobally, women 15–24 years are at heightened risk of sexual violence victimization, a risk factor for adverse mental, physical, and behavioral health outcomes. Sexual violence is common at universities and most often perpetrated by men, yet few evidence-based prevention strategies targeting men have been tested in low- and middle-income countries. GlobalConsent is a six-module, web-based educational program adapted from an efficacious U.S.-based program. Nine months post-treatment in a randomized trial in Vietnam, GlobalConsent reduced men’s sexually violent behavior (odds ratio [OR] = 0.71, 95%CI 0.50–1.00) and increased prosocial intervening behavior (OR = 1.51, 1.00–2.28) relative to an attention-control. Evidence regarding optimal implementation strategies for scale up is needed.MethodsWe will randomize six medical universities in North, Central, and South Vietnam to deliver GlobalConsent using two different packages of implementation strategies that vary in intensity. Higher-intensity strategies will include greater (1) pre- and post-implementation engagement with university leaders and faculty and (2) greater pre-implementation outreach, follow-up, and incentives for students to promote engagement and completion of GlobalConsent. Higher intensity universities will receive additional training and support for their added activities. We will compare implementation drivers and outcomes, intervention effectiveness, and cost-effectiveness across the two implementation bundles. Our mixed-methods comparative interrupted time series design includes (1) qualitative interviews and quantitative surveys with university leaders and implementation teams to assess implementation barriers and facilitators; (2) repeated surveys with leaders and faculty, implementation teams, and male students to assess multilevel implementation drivers and outcomes; (3) repeated surveys with male students to assess behavioral outcomes (sexual violence and intervening behavior) and mediating variables (knowledge, attitudes, affect, and capacities); and (4) time diaries and cost tracking to assess cost-effectiveness of the two implementation-strategies bundles.DiscussionThis project is the first to assess packages of implementation strategies to deliver an efficacious web-based sexual violence prevention program for undergraduate men across all regions of Vietnam and synergizes with a violence-prevention training initiative (D43TW012188). This approach will produce rigorous evidence about how to disseminate GlobalConsent nationally, which holds promise to reduce gender-based health inequities linked to sexual violence as GlobalConsent is brought to scale.Trial registrationNCT06443541. Retrospectively registered with ClinicalTrials.gov. Registered on June 05, 2024.

Determination of the Factors Affecting the Department Preferences of Selcuk University Faculty of Agriculture Students

Determination of the Factors Affecting the Department Preferences of Selcuk University Faculty of Agriculture Students

C-reactive protein, fibrinogen, prothrombin time and international normalized ratio levels as indicators of chronic inflammation in patients with metabolic syndrome

Aims: Although it has been stated in studies conducted in patients with metabolic syndrome (MetS) that elevated serum fibrinogen and C-Reactive Protein (CRP) may be due to chronic inflammation, sufficient studies have not been conducted on International normalized ratio (INR) and prothrombin time (PT). The aim of this study is to examine the fibrinogen, INR and PT levels of patients with MetS and to investigate the relationship between these parameters and MetS components. Methods: A total of 56 patients, 19 males and 37 females were included in our study who applied to the Internal Medicine outpatient clinic of Ondokuz Mayıs University Faculty of Medicine and met the MetS diagnostic criteria. The control group consists of a total of 64 people, 35 men and 29 women, who have at least one of the MetS criteria and do not have a chronic disease. Fasting blood glucose, total cholesterol (Total-C), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine, thyroid stimulating hormone (TSH), PT, INR and fibrinogen levels were examined from the available samples. Data were compared between healthy and patient groups. Results: As a result of our study, it was determined that the CRP level was significantly higher in the patient group (p<0.01). The average fibrinogen level was calculated as 3.56 g/l in the patient group and 2.95 g/l in the control group, and a significant difference was detected when the two groups were compared (p<0.001). The average PT value was 13.1 in the patient group and 12.04 in the control group and a significant difference was detected between both groups (p<0.001). The average INR level was 1.14 in the patient group and 1.04 in the control group and a significant difference was detected between both groups (p<0.001). Conclusion: MetS is associated with high CRP. In patients with MetS, PT, INR and fibrinogen levels are also high. In the follow-up and treatment of patients with MetS, the presence of chronic inflammation and factors affecting the coagulation system should be taken into consideration.

Faculty perceptions of the impact of professional development on online teaching practices

The COVID-19 pandemic prompted a global shift toward online education, underscoring the need for quality faculty professional development to support educators in designing and delivering effective online courses. This study explores the impact of professional development utilizing the Universal Design for Learning (UDL) framework on faculty’s pedagogical practices in online learning environments. The Online Teaching Fellows Program, a 14-week professional development series, engaged 20 graduate and undergraduate university faculty members from diverse disciplines (Engineering, Education, Law, Occupational Therapy, Nursing, Humanities, Social Science, Business, and Criminal Justice) in a collaborative exploration of UDL principles to create authentic and equitable learning experiences. Qualitative data collection included interviews, exit tickets, faculty professional development artifacts (CANVAS course sites), and researcher notes. Faculty were introduced to diverse teaching strategies, including effective online information presentation, collaboration facilitation, and online assessment enhancement. The study underscores the potential of UDL principles to promote equitable educational opportunities and create transformative spaces in higher education globally.

The Predictive Power of Students' Metacognition and Perceptions of Instructional Competencies of Instructors on Academic Life Satisfaction

In university education, change and development occur due to environmental factors and the individual's efforts. Students' awareness of their cognitions, the instructors they interact with, and their qualifications play an essential role in this development and change process and determine academic life satisfaction. This study aims to assess university students' metacognitive skill perception and their perceptions of instructors' instructional competencies and to reveal the predictive power of these two variables on academic life satisfaction. The practical implications of this study's findings can empower educators and students to enhance academic life satisfaction. Based on the relational survey model, the study's data were obtained from 405 students at a state university's Faculty of Humanities and Social Sciences. Academic Life Satisfaction Scale, Metacognitive Skill Perceptions Scale, and Instructor’s Instructional Competence Scale were used to collect data. In the data analysis, the Pearson Product Moment Correlation coefficient was calculated to examine the relationship between the scores obtained from the scales. Hierarchical Regression Analysis was used to solve the sub-problems related to prediction. The hierarchical regression included the student's achievement perception as a control variable. As a result of the data analysis, it was determined that there was a moderate positive significant relationship between students' academic life satisfaction and their perception of instructors' instructional competencies and metacognitive skill perception levels. When students' achievement perceptions were controlled, it was determined that metacognitive skill perception explained 15% of academic life satisfaction. When achievement perception and metacognitive skill perception were controlled, it was found that the perception of the instructor's instructional competence explained 10% of academic life satisfaction. Based on the research findings, it was concluded that the effect of students' metacognitive skill perception on academic life satisfaction was higher than their perceptions of the instructor's instructional competence.

The Role of Digital Education in Overcoming the Challenges Facing the Teaching Of Islamic Culture, Perspective of Jordanian University Faculty Members

This research investigates the problems encountered in teaching Islamic culture from the faculty members' point of view within faculties of Sharia law at Jordanian universities and determines the role of digital education in solving these problems. With a view to achieving these objectives, a questionnaire was designed containing 36 items and various fields related to the different challenges and the role of digital education with the descriptive analytical method. The research sample consisted of faculty members in the Sharia faculties of Yarmouk University, Al-Bayt University, and Mu'tah University. Results showed there were a lot of challenges that faced teaching Islamic culture, and how digital education is influential in surmounting them. These results support the null hypothesis of the study, that all faculty members face similar challenges in the implementation of digital education; therefore, no significant impact from demographic variables such as gender, department, or even years of experience. It means that other factors might be more conducive to surmounting the problems facing teaching Islamic culture, such as providing suitable technological infrastructure, technical and training support to faculty members, and the development of engaging and attractive digital educational materials compatible with the requirements of Islamic culture.

The response of the pepper with and without Me1 gene to Mi-1.2-virulent Meloidogyne incognita (Kofoid & White,1919) (Tylenchida: Meloidogynidae) isolates

Root-knot nematodes are important organisms that infect vegetables. Due to the intense use of Mi-1.2, virulent populations that break resistance have become widespread and have become an important factor limiting the use of this gene. Me1 resistance gene on pepper provides resistance against Meloidogyne arenaria (Neal, 1889) Chitwood, 1949 Meloidogyne incognita (Kofoid & White,1919) Chitwood, 1949 and Meloidogyne javanica (Treub, 1885) Chitwood, 1949 (Tylenchida: Meloidogynidae) species. However, there is limited information on the effectiveness of the Me1 gene against Mi-1.2 virulent populations. Therefore, it is important to know the reaction of pepper cultivars carrying the Me1 resistance gene against Mi-1.2 virulent populations. In this study, the response of resistant pepper cultivar MT-01 F1 (bearing Me1) and susceptible pepper cultivar Safran F1 against both Mi-1.2 natural virulent M. incognita isolates and Mi-1.2 selected virulent M. incognita isolate was investigated under controlled conditions. This study was conducted in Akdeniz University Faculty of Agriculture Department of Plant Protection Nematology Laboratory in 2021. All isolates caused many egg masses and galls on the resistant tomato cultivar Seval F1 as expected, and the susceptible pepper cultivar Safran F1. Five isolates were found to cause egg masses and gall formation, while the V3 isolate did not multiply on the resistant pepper cultivar MT-01 F1. The results showed that pepper cultivars carrying the Me1 gene exhibited different responses against Mi-1.2 virulent isolates.

The Prevalence of Tobacco Product Use Among Students in the Faculty of Medicine at Pamukkale University and Their Views on the Smoke-Free Campus Implementation.

Tobacco use is an important risk factor for more than 20 types of cancer, especially cardiovascular and respiratory diseases, and many other health problems. Cigarettes are one of the most commonly used tobacco products in the world, and they can cause both physical and mental addiction. Adolescence is known to be the highest-risk period in terms of addiction among all age groups. As a result, smoke-free campus practices have become even more important in universities. This study investigates the prevalence of smoking among Pamukkale Medical School students and their views and behaviors regarding smoke-free campus practices. This cross-sectional study was conducted with 548 medical students at Pamukkale Universıty Faculty of Medicine during the academic year 2021-2022, between April 1-29, 2022. A face-to-face interview was conducted. Students' smoking status and their views about a smoke-free campus were assessed. In the questionnaire, the independent variables were socio-demographic characteristics, duration of staying in a smoke-free environment, smoking status in the place of residence, areas where smoking is most common, Fagerström nicotine dependence level, knowledge about smoke-free campus applications and campuses with the smokefree application. The Statistical Package for the Social Sciences version 21.0 package program was used to analyze the data. Descriptive statistics are presented with numbers and percentages for categorical variables, while the arithmetic mean and standard deviation are used for continuous variables. The chi-square test was used to compare categorical variables,and the Kolmogorov-Smirnov analysis was used to test the compatibility of data to normal distribution. The student smoking rate increased significantly as the number of semesters increased (P = .021). The smoking rate of male students was higher than that of female students (P = .001). The smoking rate of students living with their family or relatives was lower (P = .020). Smokers (14.7%) were more likely to have heard about the introduction of smoke-free zones on campus than nonsmokers (11%) (P = .280). 81.4% of students affirmed the statement, "The number of smoke-free rooms should be increased," and 84.3% responded, "I support the existence of smoke-free spaces." Nonsmoking students (90.8%) are more likely to agree that smoke-free spaces should be increased than those who smoke (57.7%) (P < .001). Among the students, 17.6% of nonsmokers and 37.8% of smokers find the information about smoke-free spaces sufficient (P < .001). The rate of those who consider smoke-free space inspections to be sufficient is lower for nonsmoking students than for nonsmokers (P = .017). Nonsmokers (89.5%) support the existence of smoke-free spaces to a higher degree than smokers (71.2%) (P < .001). One-third of Pamukkale University Faculty of Medicine students smoke, and smoking rates are higher among men and those who do not live with family or relatives. All participants strongly support the existence of smoke-free zones (84.3%), while a proportion of tobacco users (31.4%) support the implementation of a smoke-free campus. Student opinions of the smoke-free zones and the smoke-free campus application are more positive among nonsmokers than smokers.

Managing academic library as a multigenerational workplace: a field study of generational diversity management at Alexandria University faculty libraries

The work environment in its various variables plays a vital role in stabilizing work and raising productivity; researchers in management sciences and work behaviours have noted the role of individual variables of workers (age, educational level, years of experience) in influencing the personal characteristics and behaviours of the workers, which has drawn attention to the multigenerational work environment, where it includes a number of generational groups. Each group is characterized by different characteristics, which make it imperative for tensions in relationships and conflicts to occur unless the management of institutions pays attention to the rapid adoption of appropriate foundations and strategies for the management of those generational groups. This gave rise to the idea of the current study, which focused on the fact that the Multigenerational workplace Management is one of the most important factors affecting the functioning and productivity of the library.The aim of the study is to introduce the concept of Multigenerational workplace Management into Academic libraries in order to properly manage the various generations of their staff. The management of staff from different generations of librarians is imperative and requires a clear strategy and a vision of its application, so that libraries can make the most of their available generational diversity and build good relationships among them, thereby increasing morale and thus improving the career satisfaction of the staff, moreover increasing their performance efficiency, as well as achieving the aims of the library and the satisfaction of their users.

The libraries of Kaunas university faculties and their subunits

In this article, the work of the libraries of Kaunas University faculties up to 1940 is analyzed. Their principal task was to provide readers with scientific and educational literature. The Technical Faculty, Theological-Philosophical Faculty, Faculty of Law, and Faculty of Humanities possessed the largest libraries. Other faculties organized libraries and collections of printed materials (no more than 1000 copies) in departments, laboratories, and for studies and seminars. The acquisition funds were assigned by the State Budget. Acquisition sources included bookstores, international library loans, and gifts. The libraries of the faculties operated independently until 1940. They assisted the Central Library of Kaunas University in providing its readers with literature necessary for studies. The libraries also took part in the pedagogical and scientific work of Kaunas University.

Enhancing university-industry collaboration in the United Arab Emirates

This study examines the nature of University-Industry collaborations (UI collaboration) in the United Arab Emirates (UAE) and proposes policy recommendations to enhance the collaboration process. Despite the importance of UI collaborations for nations to improve education, foster economic growth, and innovation, there is limited research on UI collaboration development and management in the UAE and Gulf Cooperation Council (GCC) countries. The study uses qualitative research methods to explore the perspectives and experiences of university faculty and industry practitioners involved in UI collaborations. The findings identify drivers of effective collaborations, such as institutional policies, funding opportunities, and research interests, as well as barriers including organizational culture, limited development of collaboration culture, and trust issues. To improve outcomes, institutions must change mindsets, seek partnerships, and prioritise relationship-building based on trust and the exchange of ideas.

Evaluation of Dental Anxiety Levels on Oral and Dental Health Quality of Life in Patients with Hashimoto Thyroiditis

Aim: This study aimed to evaluate the effect of anxiety level, dental fear, anxiety on oral health quality of life oral, and dental health in Hashimoto's thyroiditis patients. Materials and Methods: Ninety adult individuals were included from Gaziantep University Faculty of Dentistry. All participants were asked about demographic parameters (age, gender), socio-economic status (education, marital status), and oral hygiene habits. The OHIP-14 and OHRQoL-UK questionnaires were used to asses the effect of individuals' oral health on their quality of life. Dental anxiety levels were evaluation with the Modified Dental Anxiety Scale (MDAS). Statistical analysis was performed using IBM SPSS Statistics 22.0. Result: There were no significant differences for Sociodemographic data, dental habits, age, marital status, educational status, smoking, frequency of brushing tooth, frequency of visiting the dental clinic in OHIP-14, OHRQoL, and MDAS survey scores (p &gt; 0.005). However, there was a statistically moderate positive correlation between the total OHIP-14 scores and the MDAS scores (r = 0.309; p &lt; 0.003). Additionally, a moderate negative correlation was showed between the total OHRQoL and the MDAS scale (r = 0.307; p &lt; 0.003). Conclusion: In conclusion, this study showed that patients' quality of life regarding oral and dental health was low, regardless of individual factors. It was found that dental anxiety was lower in patients with HT, and a significant correlation betwen the quality of life and anxiety level was observed.

Secondary Healing Following Trauma-Induced Partial Glossectomy: Case Report of an Arabian Horse

The tongue serves as an organ of food prehension, mastication, grooming, deglutition, taste, and vocalization, and is suspected to play a role in upper airway stability. A seven-year-old riding horse, weighing 350 kg and employed for load-carrying purposes, was brought to Atatürk University Faculty of Veterinary Medicine Hospital due to a transversal injury in the rostral part of the tongue caused by trauma from the bridle's rope. During the general examination, it was observed that the tongue protruded outside the mouth, there was a presence of necrotic odor, paralysis in the apex lingualis region, and bloodstains on the mouth corner and front limbs. After the removal of the tongue tissue, debridement of the necrotic areas in the remaining caudal portion was performed, and it was left for secondary wound healing. Postoperatively, intramuscular injections of 200,000 IU benzylpenicillin procaine were administered every 24 hours for 7 days, along with flunixin meglumine given for 3 days. Additionally, a 0.12% chlorhexidine gluconate solution was used as an oral antiseptic three times daily for a duration of 7 days. Daily phone calls were made to the patient owner to inquire about the overall condition of the patient. Upon the follow-up appointment on the seventh day, improvement in the healing of the tongue was observed.

Clinical Features in Boys with Duchenne/Becker Muscular Dystrophy: A Tertiary Center Experience

Background: Dystrophin-related muscular dystrophies are a group of diseases caused by mutations in the dystrophin gene that are inherited in an X-linked recessive manner. Objectives: We aimed to discuss the clinical, laboratory, genetic, treatment, and prognostic features, as well as diagnostic clues, of our DMD/BMD patients. Methods: The medical records of 39 children who were followed up with DMD/BMD diagnoses at Bursa Uludağ University Faculty of Medicine Child Neurology Clinic between August 2018 and September 2023 were evaluated retrospectively. DMD or BMD is diagnosed by genetic testing or muscle biopsy. Results: All patients were male, and the age of symptom onset was 3.44 ± 2.7 years (range: 1 - 12.2 years). Twenty-two cases were symptomatic, presenting with difficulty walking (N = 17), difficulty climbing stairs (N = 14), and getting tired quickly (N = 11). Seventeen cases were initially asymptomatic, identified through elevated CK, AST, and ALT levels. Conclusions: Early recognition that increased serum transaminase and CK levels reflect muscle disease accelerates the diagnosis of underlying conditions and protects patients from unnecessary, invasive, and costly diagnostic testing.