human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The chair-side work posture of dental hygienists has long been a concern because of health-related problems potentially caused or exacerbated by poor posture . The purpose of this study was to investigate if using magnification loupes improved dental hygiene students ' posture during provision of treatment . The treatment chosen was h and -scaling , and the effect of the timing of introduction of the loupes to students was also examined . Thirty-five novice dental hygiene students took part in the study . Each student was assessed providing dental hygiene care with and without loupes , thus controlling for innate differences in natural posture . Students were r and omized into two groups . Group one used loupes in the first session and did not use them for the second session . Group two reversed this sequence . At the end of each session , all students were videotaped while performing scaling procedures . Their posture was assessed using an adapted version of Branson et al. 's Posture Assessment Instrument ( PAI ) . Four raters assessed students at three time periods for nine posture components on the PAI . A paired t-test compared scores with and without loupes for each student . Scores showed a significant improvement in posture when using loupes ( p<0.0001 ) , and these improvements were significantly more pronounced for students starting loupes immediately on entering the program compared with students who delayed until the second session ( p<0.1 ) . These results suggest a significant postural benefit is realized by requiring students to master the use of magnification loupes as early as possible within the curriculum Background Synthesis of multiple r and omized controlled trials ( RCTs ) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions . Filtering of search es is time consuming , and no single method fulfills the principal requirements of speed with accuracy . Automation of systematic review s is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making . We developed Rayyan ( http://rayyan.qcri.org ) , a free web and mobile app , that helps expedite the initial screening of abstract s and titles using a process of semi-automation while incorporating a high level of usability . For the beta testing phase , we used two published Cochrane review s in which included studies had been selected manually . Their search es , with 1030 records and 273 records , were uploaded to Rayyan . Different features of Rayyan were tested using these two review s. We also conducted a survey of Rayyan ’s users and collected feedback through a built-in feature . Results Pilot testing of Rayyan focused on usability , accuracy against manual methods , and the added value of the prediction feature . The “ taster ” review ( 273 records ) allowed a quick overview of Rayyan for early comments on usability . The second review ( 1030 records ) required several iterations to identify the previously identified 11 trials . The “ suggestions ” and “ hints , ” based on the “ prediction model , ” appeared as testing progressed beyond five included studies . Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements . The survey respondents reported 40 % average time savings when using Rayyan compared to others tools , with 34 % of the respondents reporting more than 50 % time savings . In addition , around 75 % of the respondents mentioned that screening and labeling studies as well as collaborating on review s to be the two most important features of Rayyan . As of November 2016 , Rayyan users exceed 2000 from over 60 countries conducting hundreds of review s totaling more than 1.6 M citations . Feedback from users , obtained mostly through the app web site and a recent survey , has highlighted the ease in exploration of search es , the time saved , and simplicity in sharing and comparing include-exclude decisions . The strongest features of the app , identified and reported in user feedback , were its ability to help in screening and collaboration as well as the time savings it affords to users . Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of review ers Background Work-related musculoskeletal disorders commonly experienced by dental professionals are one of the main occupational health problem affecting their health and well-being . This study was conducted to evaluate  ergonomic factors and profession-related postures  and also investigate relationship between demographic factors and work condition with pain in dental students . Material and Methods 60 freshman and sophomore dentistry students were r and omly chosen as the subjects of control group , and 60 of 5th and 6th-year students were selected as the members of exposure group . Data related to the subjects such as sex , doing exercise , severity of musculoskeletal pain were obtained through question naire . Students ’ postures were directly observed while treating patients and they were scored by REBA method . Data were analyzed by SPSS software using Man-Whitney , Kruskal-Wallis , Spearman and Kendall correlation tests . Results 80.8 % of the subjects were not aware of the correct ergonomic postures for dental procedures . Severity of musculoskeletal pain in the exposure group ( 15.9± 4.2 ) was significantly higher than the control group ( 10.5 ±3.2 ) , ( p < 0.001 ) . Risk of the most subjects ( 84 % ) was at the medium level . Students who were more involved in clinical activities experienced more muscular pains . Conclusions The musculoskeletal disorders are probable prolonged in working hours in static positions , incorrect work postures , implying more force and even tools and instruments . Therefore , students who are aware of ergonomic principals of their own profession would be able to maintain their health through activities and lifelong . Key words : Posture , dentistry , students , musculoskeletal pain OBJECTIVE To study the relation between neck pain and work related neck flexion , neck rotation , and sitting . METHODS A prospect i ve cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies . Work related physical load was assessed by analysing objective ly measured exposure data ( video recordings ) of neck flexion , neck rotation , and sitting posture .  Neck pain was assessed by a question naire . Adjustments were made for various physical factors that were related or not related to work , psychosocial factors , and individual characteristics . RESULTS A significant positive relation was found between the percentage of the working time in a  sitting position  and neck pain , implying an increased risk of neck pain for workers who were sitting for more than 95 % of the working time ( crude relative risk ( RR ) 2.01 , 95 % confidence interval ( 95 % CI ) 1.04 to 3.88 ; adjusted RR 2.34 , 95 % CI 1.05 to 5.21 ) . A trend for a positive relation between neck flexion and neck pain was found , suggesting an increased risk of neck pain for people working with the neck at a minimum of 20 ° of flexion for more than 70 % of the working time ( crude RR 2.01 , 95 % CI 0.98 to 4.11 ; adjusted RR 1.63 , 95 % CI 0.70 to 3.82 ) . No clear relation was found between neck rotation and neck pain . CONCLUSION Sitting at work for more than 95 % of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain . No clear relation was found between neck rotation and neck pain A joint study was conducted by a manufacturer of dental stools in the Midwest of the United States and Marquette University to measure the occupational postures of dentists and dental hygienists . The postures of 10 dentists and 10 dental hygienists were assessed using work sampling and video techniques .  Postural data of the neck , shoulders and lower back were recorded from video and categorized into 30-degree intervals : o ( neutral posture of respective joint ) , 30 , 60 and 90 degrees . Each subject 's postures were observed while they were treating patients during a four-hour period , during which 100 observations of postures were recorded at r and om times . Compared to st and ing , dentists and dental hygienists were seated 78 percent and 66 percent of the time , respectively . Dentists and dental hygienists flexed their trunk at least 30 degrees more than 50 percent of the time . They flexed their neck at least 30 degrees 85 percent of the time during the four-hour duration , and their shoulders were elevated to the side of their trunk ( abducted ) at least 30 degrees more half of the time . The postures of the trunk , shoulders , and neck were primarily static . This data base of postures can be used by dental professionals and ergonomists to assess the risk dentists and dental hygienists are exposed to musculoskeletal disorders , such as low back pain or shoulder tenosynovitis , from deviated joint postures . They could use these data to select dental furniture or dental devices that promote good body posture , i.e. , reduce the magnitude and duration of deviated joint postures , which , in theory , would decrease the risk of musculoskeletal disorders OBJECTIVE optical magnifying devices such as magnification loupes are increasingly used in clinical practice and educational setting s. However , scientific evidence to vali date their benefits is limited . This study assessed the effect of dental magnification loupes on psychomotor skill acquisition during a pre clinical operative dentistry course . METHOD AND MATERIAL S the performance of first-year dental students was assessed during an Advanced Simulation Course ( AS ) using virtual reality-based technology ( VRBT ) training . The test group consisted of 116 dental students using magnification loupes ( + MAG ) , while students not using them ( -MAG , n = 116 ) served as the control . The following parameters were evaluated : number of successfully passing preparation procedures per course rotation , amount of time per tooth preparation , number of times students needed computer assistance and evaluation , and amount of time spent in the computer assistance and evaluation mode per procedure . Data were collected on each student through VRBT during the preparation procedure and stored on a closed network server computer . Unpaired t tests were used to analyze mean differences between the groups . In addition , student acceptance of magnification loupes was measured and evaluated through survey interpretation . RESULTS + MAG students completed more preparations , worked faster per procedure , and used the computer-assisted evaluation less frequently and for shorter periods , therefore displaying greater overall performance . The survey revealed a high degree of student acceptance of using magnification . CONCLUSION dental magnification loupes significantly enhanced student performance during pre clinical dental education and were considered an effective adjunct by the students who used them Objectives To assess dental students ' posture on two different seats in order to determine if one seat predisposes to a difference in working posture . Design A between-subject experimental design was selected . Setting The study was undertaken at the University of Birmingham School of Dentistry in 2006 . Subjects ( material s ) and methods Sixty second year dental students at the University of Birmingham who were attending their fi rst classes in the phantom head laboratory were r and omly selected and allocated to two different seats ( 30 Bambach Saddle Seats and 30 conventional seats ) . Students were trained in the use of the seats . After ten weeks , the students were observed , photographs were taken by the research er and these were assessed using Rapid Upper Limb Assessment ( RULA ) . Main outcome measures The posture of the students was assessed using the RULA . Each student was given a risk score . A Mann Whitney test was used for statistical analysis . Results The results indicated that the students using the conventional seat recorded signifi cantly higher risk scores ( p < 0.05 ) when compared with the students using Bambach Saddle Seat , suggesting an improvement in posture when using the Bambach Saddle Seat . Conclusion RULA has identifi ed that dental students using a Bambach Saddle Seat were able to maintain an acceptable working posture during simulated dental treatment and this seating may reduce the development of work-related musculoskeletal disorders BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application A distinct body of literature supports the association between clinical postures of the dental practitioner and work-related musculoskeletal disorders ( WRMD ) . Several aids or devices have been tested to improve clinical posture in the interest of decreasing WRMD . The use of magnification lenses while performing dental procedures may increase the quality of work and decrease the likelihood of musculoskeletal problems . To date , only anecdotal and personal opinions had existed regarding the benefits of using magnification lenses , and no empirical evidence had authenticated the contention that use of magnification lenses exerts a positive change in operator posture . The objective of this study was to assess the effect magnification lenses had on the posture of dental hygiene students 
    Output:
    
agent
CONCLUSIONS Based on a limited number of studies , the use of ergonomic saddle seats and dental loupes leads to improved working postures .
The use of loupes appears to relieve shoulder , arm and h and pain .
However , their effect on neck pain is scarce .
None of the studies reported on the effect of the saddle seats on musculoskeletal pain .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The chair-side work posture of dental hygienists has long been a concern because of health-related problems potentially caused or exacerbated by poor posture . The purpose of this study was to investigate if using magnification loupes improved dental hygiene students ' posture during provision of treatment . The treatment chosen was h and -scaling , and the effect of the timing of introduction of the loupes to students was also examined . Thirty-five novice dental hygiene students took part in the study . Each student was assessed providing dental hygiene care with and without loupes , thus controlling for innate differences in natural posture . Students were r and omized into two groups . Group one used loupes in the first session and did not use them for the second session . Group two reversed this sequence . At the end of each session , all students were videotaped while performing scaling procedures . Their posture was assessed using an adapted version of Branson et al. 's Posture Assessment Instrument ( PAI ) . Four raters assessed students at three time periods for nine posture components on the PAI . A paired t-test compared scores with and without loupes for each student . Scores showed a significant improvement in posture when using loupes ( p<0.0001 ) , and these improvements were significantly more pronounced for students starting loupes immediately on entering the program compared with students who delayed until the second session ( p<0.1 ) . These results suggest a significant postural benefit is realized by requiring students to master the use of magnification loupes as early as possible within the curriculum Background Synthesis of multiple r and omized controlled trials ( RCTs ) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions . Filtering of search es is time consuming , and no single method fulfills the principal requirements of speed with accuracy . Automation of systematic review s is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making . We developed Rayyan ( http://rayyan.qcri.org ) , a free web and mobile app , that helps expedite the initial screening of abstract s and titles using a process of semi-automation while incorporating a high level of usability . For the beta testing phase , we used two published Cochrane review s in which included studies had been selected manually . Their search es , with 1030 records and 273 records , were uploaded to Rayyan . Different features of Rayyan were tested using these two review s. We also conducted a survey of Rayyan ’s users and collected feedback through a built-in feature . Results Pilot testing of Rayyan focused on usability , accuracy against manual methods , and the added value of the prediction feature . The “ taster ” review ( 273 records ) allowed a quick overview of Rayyan for early comments on usability . The second review ( 1030 records ) required several iterations to identify the previously identified 11 trials . The “ suggestions ” and “ hints , ” based on the “ prediction model , ” appeared as testing progressed beyond five included studies . Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements . The survey respondents reported 40 % average time savings when using Rayyan compared to others tools , with 34 % of the respondents reporting more than 50 % time savings . In addition , around 75 % of the respondents mentioned that screening and labeling studies as well as collaborating on review s to be the two most important features of Rayyan . As of November 2016 , Rayyan users exceed 2000 from over 60 countries conducting hundreds of review s totaling more than 1.6 M citations . Feedback from users , obtained mostly through the app web site and a recent survey , has highlighted the ease in exploration of search es , the time saved , and simplicity in sharing and comparing include-exclude decisions . The strongest features of the app , identified and reported in user feedback , were its ability to help in screening and collaboration as well as the time savings it affords to users . Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of review ers Background Work-related musculoskeletal disorders commonly experienced by dental professionals are one of the main occupational health problem affecting their health and well-being . This study was conducted to evaluate  ergonomic factors and profession-related postures  and also investigate relationship between demographic factors and work condition with pain in dental students . Material and Methods 60 freshman and sophomore dentistry students were r and omly chosen as the subjects of control group , and 60 of 5th and 6th-year students were selected as the members of exposure group . Data related to the subjects such as sex , doing exercise , severity of musculoskeletal pain were obtained through question naire . Students ’ postures were directly observed while treating patients and they were scored by REBA method . Data were analyzed by SPSS software using Man-Whitney , Kruskal-Wallis , Spearman and Kendall correlation tests . Results 80.8 % of the subjects were not aware of the correct ergonomic postures for dental procedures . Severity of musculoskeletal pain in the exposure group ( 15.9± 4.2 ) was significantly higher than the control group ( 10.5 ±3.2 ) , ( p < 0.001 ) . Risk of the most subjects ( 84 % ) was at the medium level . Students who were more involved in clinical activities experienced more muscular pains . Conclusions The musculoskeletal disorders are probable prolonged in working hours in static positions , incorrect work postures , implying more force and even tools and instruments . Therefore , students who are aware of ergonomic principals of their own profession would be able to maintain their health through activities and lifelong . Key words : Posture , dentistry , students , musculoskeletal pain OBJECTIVE To study the relation between neck pain and work related neck flexion , neck rotation , and sitting . METHODS A prospect i ve cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies . Work related physical load was assessed by analysing objective ly measured exposure data ( video recordings ) of neck flexion , neck rotation , and sitting posture .  Neck pain was assessed by a question naire . Adjustments were made for various physical factors that were related or not related to work , psychosocial factors , and individual characteristics . RESULTS A significant positive relation was found between the percentage of the working time in a  sitting position  and neck pain , implying an increased risk of neck pain for workers who were sitting for more than 95 % of the working time ( crude relative risk ( RR ) 2.01 , 95 % confidence interval ( 95 % CI ) 1.04 to 3.88 ; adjusted RR 2.34 , 95 % CI 1.05 to 5.21 ) . A trend for a positive relation between neck flexion and neck pain was found , suggesting an increased risk of neck pain for people working with the neck at a minimum of 20 ° of flexion for more than 70 % of the working time ( crude RR 2.01 , 95 % CI 0.98 to 4.11 ; adjusted RR 1.63 , 95 % CI 0.70 to 3.82 ) . No clear relation was found between neck rotation and neck pain . CONCLUSION Sitting at work for more than 95 % of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain . No clear relation was found between neck rotation and neck pain A joint study was conducted by a manufacturer of dental stools in the Midwest of the United States and Marquette University to measure the occupational postures of dentists and dental hygienists . The postures of 10 dentists and 10 dental hygienists were assessed using work sampling and video techniques .  Postural data of the neck , shoulders and lower back were recorded from video and categorized into 30-degree intervals : o ( neutral posture of respective joint ) , 30 , 60 and 90 degrees . Each subject 's postures were observed while they were treating patients during a four-hour period , during which 100 observations of postures were recorded at r and om times . Compared to st and ing , dentists and dental hygienists were seated 78 percent and 66 percent of the time , respectively . Dentists and dental hygienists flexed their trunk at least 30 degrees more than 50 percent of the time . They flexed their neck at least 30 degrees 85 percent of the time during the four-hour duration , and their shoulders were elevated to the side of their trunk ( abducted ) at least 30 degrees more half of the time . The postures of the trunk , shoulders , and neck were primarily static . This data base of postures can be used by dental professionals and ergonomists to assess the risk dentists and dental hygienists are exposed to musculoskeletal disorders , such as low back pain or shoulder tenosynovitis , from deviated joint postures . They could use these data to select dental furniture or dental devices that promote good body posture , i.e. , reduce the magnitude and duration of deviated joint postures , which , in theory , would decrease the risk of musculoskeletal disorders OBJECTIVE optical magnifying devices such as magnification loupes are increasingly used in clinical practice and educational setting s. However , scientific evidence to vali date their benefits is limited . This study assessed the effect of dental magnification loupes on psychomotor skill acquisition during a pre clinical operative dentistry course . METHOD AND MATERIAL S the performance of first-year dental students was assessed during an Advanced Simulation Course ( AS ) using virtual reality-based technology ( VRBT ) training . The test group consisted of 116 dental students using magnification loupes ( + MAG ) , while students not using them ( -MAG , n = 116 ) served as the control . The following parameters were evaluated : number of successfully passing preparation procedures per course rotation , amount of time per tooth preparation , number of times students needed computer assistance and evaluation , and amount of time spent in the computer assistance and evaluation mode per procedure . Data were collected on each student through VRBT during the preparation procedure and stored on a closed network server computer . Unpaired t tests were used to analyze mean differences between the groups . In addition , student acceptance of magnification loupes was measured and evaluated through survey interpretation . RESULTS + MAG students completed more preparations , worked faster per procedure , and used the computer-assisted evaluation less frequently and for shorter periods , therefore displaying greater overall performance . The survey revealed a high degree of student acceptance of using magnification . CONCLUSION dental magnification loupes significantly enhanced student performance during pre clinical dental education and were considered an effective adjunct by the students who used them Objectives To assess dental students ' posture on two different seats in order to determine if one seat predisposes to a difference in working posture . Design A between-subject experimental design was selected . Setting The study was undertaken at the University of Birmingham School of Dentistry in 2006 . Subjects ( material s ) and methods Sixty second year dental students at the University of Birmingham who were attending their fi rst classes in the phantom head laboratory were r and omly selected and allocated to two different seats ( 30 Bambach Saddle Seats and 30 conventional seats ) . Students were trained in the use of the seats . After ten weeks , the students were observed , photographs were taken by the research er and these were assessed using Rapid Upper Limb Assessment ( RULA ) . Main outcome measures The posture of the students was assessed using the RULA . Each student was given a risk score . A Mann Whitney test was used for statistical analysis . Results The results indicated that the students using the conventional seat recorded signifi cantly higher risk scores ( p < 0.05 ) when compared with the students using Bambach Saddle Seat , suggesting an improvement in posture when using the Bambach Saddle Seat . Conclusion RULA has identifi ed that dental students using a Bambach Saddle Seat were able to maintain an acceptable working posture during simulated dental treatment and this seating may reduce the development of work-related musculoskeletal disorders BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application A distinct body of literature supports the association between clinical postures of the dental practitioner and work-related musculoskeletal disorders ( WRMD ) . Several aids or devices have been tested to improve clinical posture in the interest of decreasing WRMD . The use of magnification lenses while performing dental procedures may increase the quality of work and decrease the likelihood of musculoskeletal problems . To date , only anecdotal and personal opinions had existed regarding the benefits of using magnification lenses , and no empirical evidence had authenticated the contention that use of magnification lenses exerts a positive change in operator posture . The objective of this study was to assess the effect magnification lenses had on the posture of dental hygiene students 
    Output:
    