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Traditional ergonomic risk assessment tools such as the Rapid Upper Limb Assessment (RULA) are often not sensitive enough to evaluate well-optimized work routines. An implementation of kinematic data captured by inertial sensors is applied to compare two work routines in dentistry. The surgical dental treatment was performed in two different conditions, which were recorded by means of inertial sensors (Xsens MVN Link). For this purpose, 15 (12 males/3 females) oral and maxillofacial surgeons took part in the study. Data were post processed with costume written MATLAB® routines, including a full implementation of RULA (slightly adjusted to dentistry). For an in-depth comparison, five newly introduced levels of complexity of the RULA analysis were applied, i.e., from lowest complexity to highest: (1) RULA score, (2) relative RULA score distribution, (3) RULA steps score, (4) relative RULA steps score occurrence, and (5) relative angle distribution. With increasing complexity, the number of variables times (the number of resolvable units per variable) increased. In our example, only significant differences between the treatment concepts were observed at levels that are more complex: the relative RULA step score occurrence and the relative angle distribution (level 4 + 5). With the presented approach, an objective and detailed ergonomic analysis is possible. The data-driven approach adds significant additional context to the RULA score evaluation. The presented method captures data, evaluates the full task cycle, and allows different levels of analysis. These points are a clear benefit to a standard, manual assessment of one main body position during a working task.
Objectives: Symmetrical dental occlusion blocking is used in dentistry as a quick diagnostic tool to test for potential influences of the craniomandibular system on body sway and weight distribution. This study presents the changes of body sway and pressure distribution in healthy subjects, free of a temporomandibular dysfunction (TMD). Immediate effects between occlusal blocking and rest position on body sway and body weight distribution in general, as well as for both genders and for four age decades will be evaluated.
Materials and methods: 725 (396f/329 m) subjects (neither subjective signs of TMD nor acute/chronic complaints in the musculoskeletal system) volunteered (21 to 60 years) while both genders were divided into four age groups according to decades. A pressure measuring platform was used. Body sway and weight distribution were recorded in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking (bicuspid region) by cotton rolls.
Results: Both, the frontal sway and the sagittal sway reduced by 0.67 mm (t(724) = − 3.9 (p < 0.001)) and by 0.33 mm (t(724) = − 3.4 (p < 0.001)). The relative pressure under the left forefoot increased by 0.33% (t(724) = 2.88 (p < 0.001)) and the relative pressure overall under the forefoot increased by 0.67% (t(724) = − 3.4 (p < 0.001)). Gender-specific, age-specific and BMI-specific reactions could not be identified.
Conclusions: Subjects, free of any TMD and with no complaints of the musculoskeletal system, show small changes of the body sway and weight distribution when biting symmetrically on a cotton roll. These changes are independent of age, gender or body mass index (BMI). Due to the relative large sample size, the presented results can also be seen as norm values when body sway is used as an additional assessment of a TMD.
As knowledge derived from scientific theory can be helpful for teachers to reflect on their everyday teaching, universities have the challenging task of teaching this knowledge in such a way that pre-service teachers are able to apply it to their later teaching. Case-based learning has emerged as a promising method to foster pre-service teachers’ scientific knowledge application throughout university teacher education. However, surprisingly, empirical evidence for its effectiveness as compared to more traditional instructional interventions in teacher education is still inconclusive, partly being due to constraints concerning the employed comparison groups. The present quasi-experimental study (conducted in the field of classroom management) investigated the effect of studying exactly the same theoretical content with and without text-based cases on scientific knowledge application (as measured by a vignette test) in a sample of 101 pre-service teachers. Although the study found a small advantage for the case-based learning group, it demonstrated that scientific knowledge application may also be effectively fostered in a more traditional instructional course. The findings and their implications are discussed against the background of cognitive theories on inert knowledge and how to prevent it in teacher education.
As knowledge derived from scientific theory can be helpful for teachers to reflect on their everyday teaching, universities have the challenging task of teaching this knowledge in such a way that pre-service teachers are able to apply it to their later teaching. Case-based learning has emerged as a promising method to foster pre-service teachers’ scientific knowledge application throughout university teacher education. However, surprisingly, empirical evidence for its effectiveness as compared to more traditional instructional interventions in teacher education is still inconclusive, partly being due to constraints concerning the employed comparison groups. The present quasi-experimental study (conducted in the field of classroom management) investigated the effect of studying exactly the same theoretical content with and without text-based cases on scientific knowledge application (as measured by a vignette test) in a sample of 101 pre-service teachers. Although the study found a small advantage for the case-based learning group, it demonstrated that scientific knowledge application may also be effectively fostered in a more traditional instructional course. The findings and their implications are discussed against the background of cognitive theories on inert knowledge and how to prevent it in teacher education.
In several tumor entities, transketolase-like protein 1 (TKTL1) has been suggested to promote the nonoxidative part of the pentose phosphate pathway (PPP) and thereby to contribute to a malignant phenotype. However, its role in glioma biology has only been sparsely documented. In the present in vitro study using LNT-229 glioma cells, we analyzed the impact of TKTL1 gene suppression on basic metabolic parameters and on survival following oxygen restriction and ionizing radiation. TKTL1 was induced by hypoxia and by hypoxia-inducible factor-1α (HIF-1α). Knockdown of TKTL1 via shRNA increased the cells’ demand for glucose, decreased flux through the PPP and promoted cell death under hypoxic conditions. Following irradiation, suppression of TKTL1 expression resulted in elevated levels of reactive oxygen species (ROS) and reduced clonogenic survival. In summary, our results indicate a role of TKTL1 in the adaptation of tumor cells to oxygen deprivation and in the acquisition of radioresistance. Further studies are necessary to examine whether strategies that antagonize TKTL1 function will be able to restore the sensitivity of glioma cells towards irradiation and antiangiogenic therapies in the more complex in vivo environment.
The TP53-induced glycolysis and apoptosis regulator (TIGAR) has been shown to decrease glycolysis, to activate the pentose phosphate pathway, and to provide protection against oxidative damage. Hypoxic regions are considered characteristic of glioblastoma and linked with resistance to current treatment strategies. Here, we established that LNT-229 glioma cell lines stably expressed shRNA constructs targeting TIGAR, and exposed them to hypoxia, irradiation and temozolomide. The disruption of TIGAR enhanced levels of reactive oxygen species and cell death under hypoxic conditions, as well as the effectiveness of irradiation and temozolomide. In addition, TIGAR was upregulated by HIF-1α. As a component of a complex network, TIGAR contributes to the metabolic adjustments that arise from either spontaneous or therapy-induced changes in tumor microenvironment.
Background: Musculoskeletal disorders (MSD) are common among dental professionals. The most common areas affected are the trunk, neck, shoulders and wrists. Current evidence suggests that the causes of MSD can be found in the physical demands of the profession. Posture and movement during treatment is influenced by the arrangement of the treatment concept (patient chair, equipment and cabinets). It has not been investigated whether the ergonomic risk differs between the treatment concepts.
Methods: To evaluate the prevalence of MSD in dental professionals, 1000 responses will be collected from a nationwide (Germany) online questionnaire (mod. Nordic Questionnaire and mod. Meyer questionnaire). In order to assess the ergonomic risk of the treatment techniques used in the four treatment concepts, 3D movement analyses are carried out with inertial sensors. For this purpose, 20 teams of dentists and dental assistants from four dental fields of specializations (generalists, orthodontists, endodontists and oral surgeons) and a student control group will be recruited. Each team will execute field specific standardized treatments at a dummy head. Measurements are carried out in each of the four treatment concepts. The data will be analyzed using the Rapid Upper Limb Assessment (RULA) which will be modified for the evaluation of objective data.
Conclusions: On the basis of these investigations, a substantial gain of knowledge regarding work-related MSD in the field of dentistry and its potential biomechanical causes is possible. For the first time, objective and differentiated comparisons between the four treatment concepts are possible for different fields of dental specialization. Up to now, statically held positions of the trunk and proximal upper extremities, but also the repetitive movements of the hands have been considered a risk for MSD. Since both are included in the RULA, dental activities can be assessed in a detailed but also global manner with regard to ergonomic risks.
Der vorliegende Band dokumentiert die Erhebungsinstrumente der dritten Phase des BilWiss-Forschungsprogramms BilWiss-UV1 ("Ertrag und Entwicklung des universitären bildungswissenschaftlichen Wissens - Validierung eines Kompetenztests für Lehrkräfte") zu wissenschaftlichen Zwecken. Ziel dieser letzten Projektphase ist die Weiterentwicklung und Verbesserung des in den Vorgängerprojekten "BilWiss" und "BilWiss-Beruf" entwickelten Kompetenztests zur Erfassung des bildungswissenschaftlichen Wissens bei Lehramtsstudierenden und -absolvent(inn)en. Dieses Skalenhandbuch dokumentiert ausschlieÿlich den im Rahmen von BilWiss-UV erhobenen Studierendenlängsschnitt (LSII) der vorwiegend der Frage nachgeht, inwieweit sich bildungswissenschaftliches Wissen als Folge der Instruktion im Lehramtsstudium verändert. Ziel des Studierendenlängsschnittes ist es, eine Verteilung der Studierenden über den kompletten Studienverlauf abzubilden, da davon ausgegangen wird, dass je nach Fortschritt im Studium ein unterschiedlicher Bildungswissenschaftlicher Wissensstand zu erwarten ist. Das Projekt wird im Rahmen des BMBF-Förderprogramms "KoKoHS - Kompetenzmodelle und Instrumente der Kompetenzerfassung im Hochschulsektor-Validierung und methodische Innovationen" gefördert. Das Forschungsprogramm ist ein Verbundprojekt der Goethe-Universität Frankfurt (Prof. Dr. Mareike Kunter, Koordination), der Universität Duisburg-Essen (Prof. Dr. Detlev Leutner) sowie der Technischen Universität München (Prof. Dr. Tina Seidel). Das gesamte Programm zielt darauf ab, zu untersuchen, inwieweit angehende Lehrkräfte durch das Studium der Bildungswissenschaften unterstützt werden, mit den vielfältigen Herausforderungen ihres Berufs professionell umzugehen. Die zentrale Annahme dabei ist, dass konzeptuelles Wissen über bildungswissenschaftliche Inhalte die professionelle Entwicklung im Vorbereitungsdienst und im Berufseinstieg unterstützt. Die Grundhypothese des Projekts lautet: Bildungswissenschaftliche Inhalte und Zusammenhänge stellen einen begrifflichen Rahmen dar, den Lehrkräfte benötigen, um Unterrichts- und Schulereignisse angemessen zu interpretieren, zu reflektieren und so für die eigene Kompetenzentwicklung zu nutzen. Die in der Studie eingesetzten Instrumente sollen öffentlich für wissenschaftliche Zwecke zugänglich gemacht werden und sind vor allem als Hilfestellung für die Arbeit mit dem Längsschnittdatensatz anzusehen. Bereits veröffentlicht unter ISBN: 978-3-00-055380-6 finden Sie die Erhebungsinstrumente der Projektphasen des BilWiss-Forschungsprogramms von 2009-2016. Weiterführende Informationen zum theoretischen Ansatz der Studie und Ergebnissen der Studie können der Internetseite http://www.bilwiss.uni-frankfurt.de sowie den im Literaturverzeichnis aufgeführten Publikationen entnommen werden.
Der vorliegende Band dokumentiert die Erhebungsinstrumente der dritten Phase des BilWiss-Forschungsprogramms BilWiss-UV1 ("Ertrag und Entwicklung des universitären bildungswissenschaftlichen Wissens - Validierung eines Kompetenztests für Lehrkräfte"), zu wissenschaftlichen Zwecken. Das Projekt wird im Rahmen des BMBF-Förderprogramms "KoKoHS - Kompetenzmodelle und Instrumente der Kompetenzerfassung im Hochschulsektor-Validierung und methodische Innovationen" gefördert. Das Forschungsprogramm ist ein Verbundprojekt der Goethe-Universität Frankfurt (Prof. Dr. Mareike Kunter, Koordination), der Universität Duisburg-Essen (Prof. Dr. Detlev Leutner) sowie der Technischen Universität München (Prof. Dr. Tina Seidel). Das gesamte Programm zielt darauf ab, zu untersuchen, inwieweit angehende Lehrkräfte durch das Studium der Bildungswissenschaften unterstützt werden, mit den vielfältigen Herausforderungen ihres Berufs professionell umzugehen. Die zentrale Annahme dabei ist, dass konzeptuelles Wissen über bildungswissenschaftliche Inhalte die professionelle Entwicklung im Vorbereitungsdienst und im Berufseinstieg unterstützt. Die Grundhypothese des Projekts lautet: Bildungswissenschaftliche Inhalte und Zusammenhänge stellen einen begrifflichen Rahmen dar, den Lehrkräfte benötigen, um Unterrichts- und Schulereignisse angemessen zu interpretieren, zu reflektieren und so für die eigene Kompetenzentwicklung zu nutzen. Für die seit 2009 bestehende Längsschnittstichprobe der Vorgängerprojekte BilWiss und BilWiss-Beruf fand Mitte des Jahres 2017 der fünfte MZP statt. Alle Teilnehmer(innen), die sich zur Teilnahme an weiteren Befragungen bereit erklärt hatten, wurden per Email kontaktiert und zur Teilnahme an der Onlineumfrage eingeladen. Es konnten 136 Personen erneut befragt werden, davon sind 124 derzeit aktiv als Lehrkraft im Schuldienst tätig (120 Lehrkräfte in Vollzeit). Im Rahmen des fünften Messzeitpunktes wurde neben Fragebogenskalen zum professionellen Verhalten, auch die im Rahmen von Meilenstein 3 entwickelte Verhaltenscheckliste eingesetzt. Durch deren Einsatz konnte ermittelt werden, dass nahezu alle der befragten Lehrkräfte Sonderfunktionen im Schuldienst übernehmen. Um einige wenige Beispiele herauszugreifen: Es sind 7 befragte Lehrkräfte in der Stufenkoordination beschäftigt, 111 Lehrer(innen) sind Klassenleitung. Als Mentor(in) engagieren sich 34 Personen und ebenfalls 34 Lehrer(innen) kooperieren mit außerschulischen Partnern. Die Durchführung des Observers wurde vom Standort München administriert und betreut. Ende des Jahres 2018 fand schlieÿlich der sechste und letzte Messzeitpunkt als Onlineerhebung statt. Bei der Bearbeitung standen neben der aktuellen beruflichen Situation auch das Erleben und das professionelle Verhalten im Lehrerberuf im Fokus. Zur Erfassung der Professional Vision in Elternberatungssituationen wurde das in 2017 entwickelte Videotool eingesetzt. Ergänzend wurde der Szenariotest zur Elternberatungskompetenz in einer Kurzversion eingesetzt (Bruder, Keller, Klug & Schmitz, 2011). Zur Erfassung des proaktiven Engagements in der Schulentwicklung wurde auch bei diesem Messzeitpunkt die Verhaltenscheckliste eingesetzt. Zur Erfassung der diagnostischen Kompetenz wurde ein neu entwickelter Vignetten-Test eingesetzt. Insgesamt konnten im Online-Fragebogen (inkl. Videotool, Szenariotest, Verhaltenscheckliste und diagnostischen Fallvignetten) 68 Personen befragt werden, davon sind 56 derzeit aktiv als Lehrkraft im Schuldienst tätig (51 Lehrkräfte in Vollzeit). Die in der Studie eingesetzten Instrumente sollen öffentlich für wissenschaftliche Zwecke zugänglich gemacht werden und sind vor allem als Hilfestellung für die Arbeit mit dem Längsschnittdatensatz anzusehen. Bereits veröffentlicht unter ISBN: 978-3-00-055380-6 finden Sie die Erhebungsinstrumente der Projektphasen des BilWiss-Forschungsprogramms von 2009-2016. Weiterführende Informationen zum theoretischen Ansatz der Studie und Ergebnissen der Studie können der Internetseite http://www.bilwiss.uni-frankfurt.de sowie den im Literaturverzeichnis aufgeführten Publikationen entnommen werden.
Background: Temporary occlusal changes and their influence on the upper body statics are still controversially discussed. Furthermore, concrete statements on whether age- or gender-specific differences in neurophysiological reactions exist are missing. Therefore, it is the aim of this study to evaluate the immediate effects of a symmetrical occlusion blocking on the upper body posture. These effects shall be investigated for both genders and for a larger age range.
Methods: In this study, 800 (407f/393 m) subjects volunteered aged from 21 to 60 years. Both genders were divided into four age groups according to decades. The three-dimensional upper body posture was measured by using the rasterstereography (ABW-Bodymapper). The habitual static posture was measured in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking in the bicuspid region by cotton rolls.
Results: A significant reduction of the trunk length (0.72 mm; p < 0.001), an increase of the lumbar (0.30°; p < 0.001) and the thoracic bending angle (0.14°; p = 0.001), a reduction of the spinal forward decline (0.16°; p < 0.001) and a reduction of the scapular distance (0.36 mm; p = 0.001) was found. Gender-specific reactions can only be recorded in scapular distance, in that regard men reduce this distance while over all age groups women did not show a significant change.
Discussion: Slight gender- and age-independent reactions due to a symmetric occlusion blockade are shown: A gender independent reaction of the spinal related variables in the sagittal plane (thoracic and lumbar flexion angle, trunk length, spinal forward decline). In addition, a gender specific change of the shoulder blade distance could be observed, where men reduced the distance while female did not show a change. However, since these reactions are of a minimum amount, it can be concluded that neurophysiological compensation mechanisms work equally well regardless of age and sex, and the upper body posture of healthy people changes only very slightly due to a temporarily symmetrical altered bite position.
Standard values of the upper body posture in healthy adults with special regard to age, sex and BMI
(2023)
In order to classify and analyze the parameters of upper body posture in clinical or physiotherapeutic settings, a baseline in the form of standard values with special regard to age, sex and BMI is required. Thus, subjectively healthy men and women aged 21–60 years were measured in this project. The postural parameters of 800 symptom-free male (n = 397) and female (n = 407) volunteers aged 21–60 years (Ø♀: 39.7 ± 11.6, Ø ♂: 40.7 ± 11.5 y) were studied. The mean height of the men was 1.8 ± 0.07 m, with a mean body weight of 84.8 ± 13.1 kg and an average BMI of 26.0 ± 3.534 kg/m2. In contrast, the mean height of the women was 1.67 ± 0.06 m, with a mean body weight of 66.5 ± 12.7 kg and an average BMI of 23.9 ± 4.6 kg/m2. By means of video rasterstereography, a 3-dimensional scan of the upper back surface was measured when in a habitual standing position. The means or medians, confidence intervals, tolerance ranges, the minimum, 2.5, 25, 50, 75, 97.5 percentiles and the maximum, plus the kurtosis and skewness of the distribution, were calculated for all parameters. Additionally, ANOVA and a factor analyses (sex, BMI, age) were conducted. In both sexes across all age groups, balanced, symmetrical upper body statics were evident. Most strikingly, the females showed greater thoracic kyphosis and lumbar lordosis angles (kyphosis: Ø ♀ 56°, Ø♂ 51°; lordosis: Ø ♀ 49°, Ø♂ 32°) and lumbar bending angles (Ø ♀ 14°, Ø♂ 11°) than the males. The distance between the scapulae was more pronounced in men. These parameters also show an increase with age and BMI, respectively. Pelvic parameters were independent of age and sex. The upper body postures of women and men between the ages of 21 and 60 years were found to be almost symmetrical and axis-conforming with a positive correlation for BMI or age. Consequently, the present body posture parameters allow for comparisons with other studies, as well as for the evaluation of clinical (interim) diagnostics and applications.
The aim of this study was to investigate gender-specific influences of different symmetric and asymmetric occlusion conditions on postural control during standing and walking. The study involved 59 healthy adult volunteers (41 f/19 m) aged between 22 and 53 years (30.2 ± 6.3 years). Postural control measurements were carried out using a pressure plate by measuring plantar pressure distribution during standing and walking test conditions. Seven different occlusion conditions were tested. Prior to a MANOVA model analysis, the relationship between the two test conditions were checked using a factor analysis with a varying number of factors (between 2 and 10). The plantar pressure distributions during walking and standing are independent test conditions. The coefficient of variance across all variables between the conditions and genders was not significant: t(46) = 1.51 (p = 0.13). No statement can be made whether, or not, the influence of gender is greater than the influence of the conditions. Healthy male and female test subjects did not show any difference between seven occlusion conditions on the plantar pressure distribution while standing or walking. No differences between the genders were found for any of the investigated variables. In contrast to custom-made occlusion splints, simple cotton rolls appear not to influence the neuromuscular system in a systematic manner.
Background: In general, the prevalence of work-related musculoskeletal disorders (WMSD) in dentistry is high, and dental assistants (DA) are even more affected than dentists (D). Furthermore, differentiations between the fields of dental specialization (e.g., general dentistry, endodontology, oral and maxillofacial surgery, or orthodontics) are rare. Therefore, this study aims to investigate the ergonomic risk of the aforementioned four fields of dental specialization for D and DA on the one hand, and to compare the ergonomic risk of D and DA within each individual field of dental specialization. Methods: In total, 60 dentists (33 male/27 female) and 60 dental assistants (11 male/49 female) volunteered in this study. The sample was composed of 15 dentists and 15 dental assistants from each of the dental field, in order to represent the fields of dental specialization. In a laboratory setting, all tasks were recorded using an inertial motion capture system. The kinematic data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). Results: The results revealed significantly reduced ergonomic risks in endodontology and orthodontics compared to oral and maxillofacial surgery and general dentistry in DAs, while orthodontics showed a significantly reduced ergonomic risk compared to general dentistry in Ds. Further differences between the fields of dental specialization were found in the right wrist, right lower arm, and left lower arm in DAs and in the neck, right wrist, right lower arm, and left wrist in Ds. The differences between Ds and DAs within a specialist discipline were rather small. Discussion: Independent of whether one works as a D or DA, the percentage of time spent working in higher risk scores is reduced in endodontologists, and especially in orthodontics, compared to general dentists or oral and maxillofacial surgeons. In order to counteract the development of WMSD, early intervention should be made. Consequently, ergonomic training or strength training is recommended.
Background: The Rapid Upper Limb Assessment (RULA) is used for the risk assessment of workplace-related activities. Thus far, the paper and pen method (RULA-PP) has been predominantly used for this purpose. In the present study, this method was compared with an RULA evaluation based on kinematic data using inertial measurement units (RULA-IMU). The aim of this study was, on the one hand, to work out the differences between these two measurement methods and, on the other, to make recommendations for the future use of the respective method on the basis of the available findings. Methods: For this purpose, 130 (dentists + dental assistants, paired as teams) subjects from the dental profession were photographed in an initial situation of dental treatment and simultaneously recorded with the IMU system (Xsens). In order to compare both methods statistically, the median value of the difference of both methods, the weighted Cohen’s Kappa, and the agreement chart (mosaic plot) were applied. Results: In Arm and Wrist Analysis—area A—here were differences in risk scores; here, the median difference was 1, and the agreement in the weighted Cohen’s kappa test also remained between 0.07 and 0.16 (no agreement to poor agreement). In area B—Neck, Trunk, and Leg Analysis—the median difference was 0, with at least one poor agreement in the Cohen’s Kappa test of 0.23–0.39. The final score has a median of 0 and a Cohen’s Kappa value of 0.21–0.28. In the mosaic plot, it can be seen that RULA-IMU had a higher discriminatory power overall and more often reached a value of 7 than RULA-PP. Conclusion: The results indicate a systematic difference between the methods. Thus, in the RULA risk assessment, RULA-IMU is mostly one assessment point above RULA-PP. Therefore, future study results of RULA by RULA-IMU can be compared with literature results obtained by RULA-PP to further improve the risk assessment of musculoskeletal diseases.