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Assessments, diagnostic criteria and outcome measures for growing pains and persistent pain in the presence of restless leg syndrome in children: a scoping review

Por: Smith · M. · Pacey · V. · Davies · L. M. · Coventry · J. · Ilhan · E. · Williams · C. M.
Objective

To identify the assessments, diagnostic criteria and outcome measures reported in peer-reviewed literature for children with growing pains and persistent lower limb pain in the presence of restless leg syndrome (RLS).

Study design

Scoping review completed in line with Joanna Briggs Institute methodological guidance

Data sources

Five online databases were searched—MEDLINE, Embase, CINAHL, PsycINFO and AMED—for records up to 14 October 2024.

Eligibility criteria

Records reporting on the use of assessments, diagnostic criteria or outcome measures in children (aged 0–18 years) with growing pains or persistent lower limb pain in the presence of RLS. Articles were required to have a sample size of ≥10 and be available in English language.

Data extraction and synthesis

Data were extracted by two independent reviewers and analysed using descriptive statistics.

Results

Following review of 19 806 records, 61 unique records were included. Most were observational cross-sectional or case–control designs. Assessments were varied and primarily focused on body functions and pain characteristics rather than activities and participation. There were 15 unique diagnostic criteria reported for growing pains with limited consistency and sometimes conflict between included items. Outcomes measures were only reported in eight records and typically measured pain presence and intensity.

Conclusions

Assessment and subsequent diagnosis of growing pains and persistent pain in the presence of RLS lack consistency. Outcome measures were seldom used as most records were not designed to measure change over time. Standardised practices for assessment and management of these conditions may benefit clinicians and optimise patient care.

Deep learning-based automated detection of supernumerary teeth in pediatric panoramic radiographs

by İlhan Uzel, Behrang Ghabchi, Dilşah Çoğulu

Introduction

Supernumerary teeth are a common developmental anomaly in pediatric patients, potentially leading to complications such as impaction, crowding, and delayed eruption. Accurate and early detection is critical to prevent these sequelae and guide appropriate intervention strategies. This study aims to evaluate the diagnostic accuracy and clinical applicability of a convolutional neural networks-based deep learning model (YOLOv8) for the automated localization and binary classification of supernumerary teeth on pediatric panoramic radiographs.

Materials and methods

A retrospective analysis was conducted on 2000 pediatric panoramic radiographs following ethical approval. Three calibrated pediatric dentists independently examined the dataset and annotated a representative subset of 140 radiographs (71 positive, 69 negative), achieving substantial inter-rater agreement (Cohen’s κ = 0.92). Performance was assessed in two stages: (1) segmentation of supernumerary teeth and (2) binary classification of radiographs. An independent validation set of 20 radiographs was used for secondary evaluation. Evaluation metrics included precision, recall, F1-score, and McNemar’s test to compare model predictions with expert labelling.

Results

The mean age of the patients was 9.6 ± 2.3 years; 52% were male, 48% were female. The segmentation model yielded 100% precision, 38% recall, and an F1-score of 55%, indicating strong localization when detections were made but limited sensitivity. The classification model achieved 100% accuracy, precision, recall, and F1-score on both internal and external datasets. McNemar’s test revealed no statistically significant discrepancy between the model and expert decisions (p > 0.05). The segmentation model demonstrated high precision in localizing supernumerary teeth; however, recall performance was more modest, indicating occasional under-detection. Due to the limited validation sample size, these findings should be interpreted with caution.

Conclusions

The YOLOv8-based pipeline demonstrated robust diagnostic accuracy in classifying panoramic radiographs for supernumerary teeth and promising but preliminary results in lesion-level segmentation. These findings highlight the potential utility of advanced deep learning systems in augmenting early diagnosis and streamlining pediatric dental radiology workflows.

Is exposure to cement dust and heavy metals associated with reduced pulmonary function? A cross-sectional study among cement factory workers in Türkiye

Por: Cetintepe · S. P. · Demirbas · O. B. · Dinke · B. · Ilhan · M. N.
Objectives

To assess the relation of exposure to cement dust and heavy metal (aluminium, cadmium and lead) exposures to pulmonary function among male cement plant workers. The study also aimed to evaluate dose–response relationships and prevalence and severity of respiratory symptoms among exposure categories compared with a control group.

Design

Cross-sectional study.

Setting

Secondary-level occupational health clinic in Ankara, Türkiye.

Participants

461 male non-smoking cement plant employees were included in total. Participants were categorised into packaging (n=101), milling (n=162) and office unexposed workers (n=198). Inclusion criteria were more than 70% work history in the cement industry and exclusion of pre-existing respiratory disease and missing data from the participants.

Interventions

Not applicable.

Primary and secondary outcome measures

Pulmonary function tests (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and peak expiratory flow (PEF)) and urinary, cadmium and blood lead concentrations were measured. Lung function impairment was the primary outcome measure; secondary outcomes included metal exposure—pulmonary measure correlations.

Results

Significant negative correlations existed between FEV1 and urine aluminium (r=–0.622, p

Conclusions

Occupational cement dust and heavy metal exposure is closely linked to impaired pulmonary function in cement plant employees, particularly those who work in higher exposure jobs. The implications are robust endorsement of targeted monitoring and preventive interventions. Long-term longitudinal research is necessary to identify long-term outcome and efficacy of exposure reduction approaches.

The Relationship Between Discomfort Intolerance And the Fear Of Self‐Injection And Testing In Patients With Diabetes Using Insulin: A Cross‐Sectional Study

ABSTRACT

Background

Diabetes is a global problem. Diabetes nurses, in particular, take great responsibility in reducing and controlling the fears of individuals using insulin and increasing their capacity to tolerate discomfort.

Aim

This study was conducted to examine the effects of the capacity to tolerate discomfort on the fear of self-injection and the status of testing blood glucose levels in patients with type 1 and type 2 diabetes using insulin.

Methods

This cross-sectional study was conducted between December 2022 and February 2023 with 320 adult patients with type 1 and type 2 diabetes using insulin who were followed up in the Endocrinology and Internal Medicine Clinics of a university hospital in Turkey. The data analysis process included analyses of the frequency, independent-samples t-tests, one-way ANOVA, the Kruskal–Wallis H test, and Pearson's correlation analysis. Data were analysed using the IBM SPSS v27.0 software, considering alpha as 0.05.

Results

The mean total Discomfort Intolerance Scale score of the patients was 22.78 ± 6.74, and the mean Fear of Self-Injecting and self-testing was 21.1 ± 6.7. A negative significant correlation was found between the discomfort intolerance levels of the patients and their levels of fear of self-injection and self-testing (p < 0.05).

Conclusion

Individuals with a higher capacity to tolerate discomfort have lower levels of fear of self-testing and self-injection. Therefore, the fear of self-testing and self-injection in patients using insulin injections may affect diabetes self-management.

Relevance to Clinical Practice

Individuals with low tolerance for discomfort should be identified, interventions to increase tolerance in individuals at risk should be planned, and diabetes self-management should be better supported.

Reporting Method

The reporting of the results of the study adhered to the STROBE guidelines.

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