Effects of COVID-19 Pandemic and Post-Vaccination Period on Gastroenterology Practice in Turkey.

BACKGROUND: The sudden and intense burden due to the novel coronavirus (coronavirus disease 2019) pandemic has changed the priority of many health services. The highly contagious new variants and vaccination services have greatly impacted the daily practice of gastroenterologists. In the present study, we tried to evaluate the change in the daily practice of Turkish gastroenterologists in the coronavirus disease 2019 pandemic and the post-vaccination periods. METHODS: A questionnaire was prepared using Google forms and sent online to 214 gastroenterologists registered with the Turkish Gastroenterology Association. RESULTS: Approximately half of the gastroenterologists moved their endoscopy unit or gastroenterology clinic to another location in the hospital during the pandemic and about one-third of the endoscopy units were completely closed. About 56% of the respondents reported the interruption of endoscopic procedures and inpatient services. In total, 85% of gastroenterologists thought that follow-up and treatment of chronic patients were disrupted due to patients obtaining their medicine directly from pharmacies. After the first case in Turkey, 74% of gastroenterologists worked in coronavirus disease 2019 patient care services, 28% of gastroenterologists were infected with coronavirus disease 2019, and 3% believed they had a cross-infected patient(s). A total of 78% of gastroenterologists reported that patient management became difficult due to the change in the priority of other departments, and 60% of gastroenterologists confirmed that they experienced a decrease in income. In the post-vaccination period, 70% of gastroenterologists returned to their pre-pandemic working schedule and 31% noticed an increase in endoscopic cancer detection. CONCLUSION: Prolongation of the pandemic has seriously damaged the practice of gastroenterology and multidisciplinary patient management.

Determination of an Optimal Threshold Value for Muscle Activity Detection in EMG Analysis.

It is commonly agreed that one needs to use a threshold value in the detection of muscle activity timing in electromyographic (EMG) signal analysis. However, the algorithm for threshold determination lacks an agreement between the investigators. In this study we aimed to determine a proper threshold value in an incremental cycling exercise for accurate EMG signal analysis. Nine healthy recreationally active male subjects cycled until exhaustion. EMG recordings were performed on four low extremity muscle groups; gastrocnemius lateralis (GL), gastrocnemius medialis (GM), soleus (SOL) and vastus medialis (VM). We have analyzed our data using three different threshold levels: 25%, 35% and 45% of the mean RMS EMG value. We compared the appropriateness of these threshold values using two criteria: (1) significant correlation between the actual and estimated number of bursts and (2) proximity of the regression line of the actual and estimated number of bursts to the line of identity. It had been possible to find a significant correlation between the actual and estimated number of bursts with the 25, 35 and 45% threshold values for the GL muscle. Correlation analyses for the VM muscle had shown that the number of bursts estimated with the 35% threshold value was found to be significantly correlated with the actual number of bursts. For the GM muscle, it had been possible to predict the burst number by using either the 35% or 45% threshold value and for the SOL muscle the 25% threshold value was found as the best predictor for actual number of burst estimation. Detailed analyses of the actual and estimated number of bursts had shown that success of threshold estimation may differ among muscle groups. Evaluation of our data had clearly shown that it is important to select proper threshold values for correct EMG signal analyses. Using a single threshold value for different exercise intensities and different muscle groups may cause misleading results. Key pointsα priori accepted threshold value may cause erroneous results in EMG analysis.Using a single threshold value for different exercise intensities and different muscle groups may cause misleading results.The investigators may need to use different threshold selection strategies for different workloads.The investigators have to justify the choice of threshold selection with valid arguments before detailed EMG signal analyses.