bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Knowledge on Clubfoot Among Parents Having Children with Clubfoot Deformity
Authors: Alam Zobaer , Haque Md Monoarul , Bhuiyan Md Rijwan , Islam Md Shahinoor , Haque Monirul , Islam ASM Mazharul , Pradhania Md Shafiullah
Published: April 2015

Background: The burden of childhood disability as a public health problem in developing countries remains relatively unrecognized. One out of 750 children born in the world suffer from club foot among them 80% are in low and middle income countries. Most of these babies have limited access to receive effective treatment for their clubfoot due to lack o knowledge, awareness and some barriers. We actually dont know the level of knowledge of parents who have child with clubfoot deformity. The purpose of this study was to assess the level of knowledge of parents who have children with clubfoot during clubfoot treatment. Materials and Methods: This cross sectional study was conducted among 102 parents who have children with clubfoot deformity during its treatment in a selected clinic. The samples were selected purposively from the clinics where clubfoot treatment was given and face to face interview was done by using semi-structured questionnaire. Results: The mean (±SD) age of the respondents were 24.7 (±6.0) years where 87.3% (n=89) respondents ware female and 59.8 %(n=61) respondents educational status ware up to primary level. About 44.1% respondents started treatment of their child within 6 months of birth and 33% within 6 to 12 months where 57% (n=58) respondents are referred by health care professional to this clinics. About 93.1% of parents (n=95) said that they knew nothing about clubfoot deformity before their child was diagnosed where 97% are aware after diagnosis of their child. About 93.1% respondents knew the best time for treatment initiation where 59.8% respondents know the correct follow up time of clubfoot management. In case of knowledge of parents roles in the treatment of clubfoot about 91.2%, parents have knowledge weekly visit for treatment and 86.3% know the plaster care where 52.9% (n=54) parents have lack of knowledge about how to use the brace Conclusion: There is need to improve the communication skills of clinicians/health care providers offering treatment to children with clubfoot at the Clinics. Need to share information with the parents about the condition. Finally, there is need to emphasize of educating parents about plaster care and how to use brace. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22882 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 42-46
Diastrophic Dysplasia: A Case Report
Authors: Radia Umme Ayman , Talukder Mishu , Badruddoza M
Published: April 2015

Diastrophic Dysplasia (DTD) is a rare and non-lethal skeletal dysplasia, autosomal in recessive in inheritance, recognized at birth by dysmorphic changes in the infant. The defect lies in the failure to add sulphate ions to cartilage extra-cellular matrix resulting in skeletal dysplasia.The reported case here presented with short limbs ,deformed ear, bilateral club foot, micromelia, proximally displaced thumb and short stature consistent with DTD. X-ray of upper limb revealed short & broad long bone with flat, irregular epiphyses & flared metaphyses, ulnar bone is shorter than radius, 1st metacarpal is typically ovoid.Lamy and Maroteaux first delineated this syndrome in 1960 and coined the term diastrophic dwarfism.The term diastrophic is derived from a Greek root meaning distorted, it is a geologic term used to describe the bending and twisting of the earth's crust during geomorphogenesis. This name seems appropriate for this disorder, in which the skeleton appears twisted, especially the metatarsals. In 1977, at the Second International Conference for Nomenclature for Constitutional Diseases of Bone, the name was changed from diastrophic dwarfism to diastrophic dysplasia. Although diastrophic dysplasia is not a commonheritable disorder, the occurrence of more than 140 cases in the literature suggests it is common enough that pediatrician , particularly at a major medical center should know the characteristics of this condition and establish effective management guidance. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22885 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 55-58
A Longitudinal Study of the Health Status of a Community of Religious Sisters: Addressing the Advantages, Challenges, and Limitations
Authors: Gaspar Phyllis Meyer , Bautch Judith C. , Strodthoff Sister Caritas M.
Published: April 2015

Longitudinal studies are recognized as contributing to understanding the complexity of aging and generating insights that cannot be gained using other research methods. However, conducting longitudinal studies is recognized as challenging, especially among older adults. The purpose of the current review is to describe how the authors addressed the limitations and challenges of longitudinal studies in a study of the health status of a community of religious sisters. Methods of this specific longitudinal study are presented to provide background to the discussion. Challenges, limitations, and advantages of the current longitudinal study are organized into three categories (i.e., sample, method, and data analysis) that have been addressed in the literature as contributing to the fidelity of longitudinal studies. The unique characteristics of the current study sample, particularly their access to health care, creates a comparison group for the study of older women in general.

[Res Gerontol Nurs. 2015; 8(2):77–84.]
Short-Wave Diathermy Pretreatment and Inflammatory Myokine Response After High-Intensity Eccentric Exercise
Authors: Vardiman John P. , Moodie Nicole , Siedlik Jacob A. , Kudrna Rebecca A. , Graham Zachary , Gallagher Philip
Published: April 2015

Context

Various modalities have been used to pretreat skeletal muscle to attenuate inflammation.

Objective

To determine the effects of short-wave diathermy (SWD) preheating treatment on inflammation and stress markers after eccentric exercise.

Design

Controlled laboratory study.

Setting

University laboratory setting.

Patients or Other Participants

Fifteen male (age = 22 ± 4.9 years, height = 179.75 ± 9.56 cm, mass = 82.22 ± 12.67 kg) college-aged students.

Intervention(s)

Seven participants were selected randomly to receive 40 minutes of SWD heat treatment (HT), and 8 participants served as the control (CON) group and rested without SWD. Both groups completed 7 sets of 10 repetitions of a high-intensity eccentric exercise protocol (EEP) at 120% of the 1-repetition maximum (1-RM) leg extension.

Main Outcome Measure(s)

We biopsied muscles on days 1, 3 (24 hours post-EEP), and 4 (48 hours post-EEP) and collected blood samples on days 1, 2 (4 hours post-EEP), 3, and 4. We determined 1-RM on day 2 (24 hours post-SWD) and measured 1-RM on days 3 and 4. We analyzed the muscle samples for interleukin 6 (IL-6), tumor necrosis factor α, and heat shock protein 70 and the blood for serum creatine kinase.

Results

We found a group × time interaction for intramuscular IL-6 levels after SWD (F2,26 = 7.13, P = .003). The IL-6 decreased in HT (F1,6 = 17.8, P = .006), whereas CON showed no change (P > .05). We found a group × time interaction for tumor necrosis factor α levels (F2,26 = 3.71, P = .04), which increased in CON (F2,14 = 7.16, P = .007), but saw no changes for HT (P > .05). No group × time interactions were noted for 1-RM, heat shock protein 70, or creatine kinase (P > .05).

Conclusions

The SWD preheating treatment provided a treatment effect for intramuscular inflammatory myokines induced through high-intensity eccentric exercise but did not affect other factors associated with intense exercise and inflammation.
Attitudes toward people with mental illness among medical students
Authors: Poreddi Vijayalakshmi , Thimmaiah Rohini , Math Suresh Bada
Published: April 2015

Background: Globally, people with mental illness frequently encounter stigma, prejudice, and discrimination by public and health care professionals. Research related to medical students’f attitudes toward people with mental illness is limited from India. Aim: The aim was to assess and compare the attitudes toward people with mental illness among medical students’. Materials and Methods: A cross-sectional descriptive study design was carried out among medical students, who were exposed (n = 115) and not exposed (n = 61) to psychiatry training using self-reporting questionnaire. Results: Our findings showed improvement in students’ attitudes after exposure to psychiatry in benevolent (t = 2.510, P < 0.013) and stigmatization (t = 2.656, P < 0.009) domains. Further, gender, residence, and contact with mental illness were the factors that found to be influencing students’ attitudes toward mental illness. Conclusion: The findings of the present study suggest that psychiatric education proved to be effective in changing the attitudes of medical students toward mental illness to a certain extent. However, there is an urgent need to review the current curriculum to prepare undergraduate medical students to provide holistic care to the people with mental health problems.
Transvaginal Aspiration of Ectopic Gestational Sac: A Novel Treatment Option in Tubal Ectopic Pregnancies
Authors: Mishra Vineet V , Sharma Urmila , Agarwal Ritu
Published: April 2015

Objective

To present five cases of unruptured tubal ectopic pregnancies treated with ultrasound-guided aspiration with local potassium chloride (KCl) or systemic methotrexate (MTX) administration.

Design

Case series.

Setting

A hospital-based prospective study.

Patients

Five women with unruptured tubal ectopic pregnancy.

Interventions

Transvaginal ultrasound-guided aspiration of tubal ectopic pregnancy followed by local KCl or intramuscular injection of MTX (50 mg/m2).

Main outcome measures

Successful conservative treatment of tubal ectopic pregnancies with preservation of fallopian tubes.

Results

Four (80%) out of five women weres uccessfully treated, without the need for operative intervention. One patient required salpingectomy for ruptured ectopic pregnancy during the course of treatment.

Conclusion

Transvaginal ultrasound-guided aspiration of ectopic gestational sac along with either local KCl or systemic methotrexate administration can be safely used to treat unruptured tubal ectopic pregnancies in selected patient population.

How to cite this article

Mishra VV, Choudhary S, Sharma U, Agarwal R. Transvaginal Aspiration of Ectopic Gestational Sac: A Novel Treatment Option in Tubal Ectopic Pregnancies. J South Asian Feder Obst Gynae 2015;7(1):1-4.
Nuchal Cord and Perinatal Outcome
Authors: Shereen K , Patil K
Published: April 2015

Aims

To establish the incidence of nuchal cord at the time of delivery and to assess its impact on the intrapartum and perinatal outcome.

Materials and methods

This was a cross-sectional study conducted at KLES Dr Prabhakar Kore Hospital and Medical Research Centre, Belgaum, India, from January 2011 to March 2011. A sample size of 429 was calculated. Informed consent was obtained and eligible women were enrolled. The babies born with a cord around the neck were compared to those without. The particulars noted were age, BMI, parity, loops of cord around the neck (single or multiple), type of loop, mode of delivery, weight of the baby and Apgar score at birth and 5 minutes. The parameters were then compared and statistically analyzed using Chi-square test.

Results

Incidence of nuchal cord at the time of delivery was 13.75%, of which single nuchal cord was highest (76.66%). The study revealed that age, BMI (in kg/m2), parity, gestational age and birth weight were not statistically significant to the presence of nuchal cord. Though instrumental deliveries were more in babies with nuchal cord, it was not statistically significant (p = 0.932). Apgar score < 7 at 1 minute was significantly low in nuchal cord group and Apgar score at 5 minutes and admission to neonatal unit was equivalent to those babies born without nuchal cord (p = 0.947).

Conclusion

Nuchal cord is not associated with adverse perinatal outcome.

How to cite this article

Shereen K, Patil K, Swamy MK. Nuchal Cord and Perinatal Outcome. J South Asian Feder Obst Gynae 2015;7(1):15-17.
Etiquetado social: un modelo de representación de la información en la blogosfera
Authors: Pérez Sanchidrián Elaine , Campos Posada Raúl , Campos Posada Gloria Elisa
Published: April 2015

Objetivo: El estudio aborda los aspectos teóricos conceptuales asociados al etiquetado social. Presenta las ventajas del etiquetas en diferentes plataformas de la Web 2.0. Expone algunos de los principales sitios con sistema de etiquetado social entre los que se destacan Flickr, Delicious, Technorati, entre otros. Analiza terminológicamente el uso de las etiquetas en la blogosfera como modelo de representación de la información. Métodos: La investigación tomó como métodos el análisis de contenido cualitativo para identificar el comportamiento de la bibliografía internacional sobre esta temática y el análisis métrico con el objetivo de caracterizar el uso del etiquetado social en la blogosfera. Resultados: El estudio permitió describir cualitativamente el uso de las etiquetas en los blogs y sus particularidades terminológicas asociadas a los siguientes aspectos: la creación de las etiquetas en estos espacios esta relacionada con una serie de temáticas sociales entre las que se pueden destacar: Política, Cultura, Economía, Género, Historia, Sexualidad, Discriminación, Salud, Medio Ambiente, Tecnología. Las etiquetas en estas plataformas se definen de lo general a lo particular y no existe un límite de concurrencias para su creación, generalmente los autores citan para cada post entre 4-7 etiquetas con el objetivo de difundir lo más posible sus contenidos en la comunidad. Conclusión: El presente estudio posibilita reflejar el impacto social del uso de las etiquetas en plataformas como los blogs.
Claire Renzetti (2013) Feminist Criminology. London, UK: Routledge.
Authors: Quadrelli Carol Anne
Published: April 2015

Not applicable
Kerry Carrington (2015) Feminism and Global Justice. London: Routledge.
Authors: Walklate Sandra
Published: April 2015

Not applicable
Desorption Isotherms and Isosteric Heats of Fermented Cocoa Beans (Theobroma cocoa)
Authors: Akmel Djedjro C. , Kakou Kouassi E. , Kone Kisselmina Y. , Assidjo Nogbou E. , Kouame Patrice
Published: April 2015

Water desorption isotherms of fermented cocoa beans from Ivory Coast were determined using the gravimetric static method of saturated salts solutions at 30 °C, 40 °C and 60 °C, and isosteric heats of desorption were calculated from Clausius-Clapeyron equation. The experimental data were fitted to several isotherm equations. The best fittings were obtained for the BET equation for aw<0.50 (with an average mean relative deviation (MRD) value of 1.56%) and for the Harkins-Jura equation for aw?0.50 (with an average value MRD equation of 4.17%). The isotherms obtained at 30 °C and 40 °C are practically coincident and overlapped for aw below 0.40. Fermented cocoa beans presented a monolayer moisture content of 0.083 dry basis (d.b.) at 30 °C and this value decreases with increasing temperature. The net isostheric heats of desorption for fermented cocoa beans for the temperature range studied (30-60 °C) were estimated as a function of moisture content. The maximum net isosteric heat of desorption for fermented cocoa beans was estimated at around 13.51 kJ/mol corresponding to a moisture content value of 2.85%. The energy requirement for maintaining the moisture content low of 8.7% (d.b.) or 8% wet basis (w.b.) for safe storage of this product or for reducing the moisture content during drying was estimated at around 9.58 kJ/mol.
On Co-screen Conformality of 1-lightlike Submanifolds in a Lorentzian Manifold
Authors: Kilic Erol , Keles Sadik , Gulbahar Mehmet
Published: April 2015

In this paper, the co-screen conformal 1-lightlike submanifolds of a Lorentzian manifoldare introduced as a generalization of co-screen locally half-lightlike submanifolds in(Wang,  Wang {\&} Liu, 2013; Wang {\&} Liu, 2013) and two examples are given whichone is co-screen locally conformal andthe other is not. Some results are obtained on these submanifolds whichthe co-screen distribution is conformal Killing on the ambient manifold.The induced Ricci tensor of  co-screen conformal 1-lightlike submanifolds isinvestigated.
EFICIÊNCIA RELATIVA DE FOSFATOS NATURAIS NA ADUBAÇÃO DE PLANTIO DE MUDAS DE Eucalyptus dunnii MAIDEN E Eucalyptus benthamii MAIDEN ETCAMBAGEM EM SOLO SEM E COM CALAGEM
Authors: Dias Luciana Patrícia Rosa , Gatiboni Luciano Colpo , Brunetto Gustavo , Simonete Márcia Aparecida , Bicaratto Bruna
Published: April 2015

http://dx.doi.org/10.5902/1980509817443O eucalipto possui uma grande exigência de fósforo (P) na fase de implantação do povoamento. Por isso o seu nível crítico de P é mais alto na fase inicial de desenvolvimento, diminuindo com o aumento da idade. O trabalho objetivou avaliar a resposta no crescimento inicial de eucalipto à adubação fosfatada e a eficiência relativa (ER) de fosfatos naturais (FNs) em solos sem e com calagem. Para isso, foram conduzidos, no período de outubro de 2010 a fevereiro de 2011, dois experimentos em casa de vegetação, na Universidade do Estado de Santa Catarina (UDESC), em Lages (SC), um com mudas de Eucalyptus dunnii e outro com Eucalyptus benthamii, utilizando os FNs Bayovar, Gafsa e Djebel, além do superfosfato triplo e testemunha (sem P), em um Cambissolo Húmico sem e com calagem. O delineamento experimental utilizado foi o inteiramente casualizado em arranjo fatorial 5 x 2 (cinco fontes de P e dois níveis de calagem), com quatro repetições. As plantas foram cultivadas por 110 dias e após a colheita, foram determinados a produção de matéria seca (por diferença de peso úmido e peso seco) e o acúmulo de P no tecido vegetal das diferentes partes da planta (determinado por espectrofotometria em comprimento de onda de 882 nm, após redução do complexo fosfomolibidato com ácido ascórbico). A eficiência relativa dos FNs (%) foi calculada a partir dos dados obtidos de matéria seca de parte aérea e matéria seca total. Para a correlação entre os parâmetros de teor de P acumulado na planta e os teores de P disponível no solo foi aplicado o Teste de Correlação de Pearson (P<0,05). Todas as fontes de P apresentaram comportamento semelhante entre si, mas foram superiores à testemunha, entretanto, o uso destas fontes provocou aumento na produção de matéria seca e no teor de P acumulado na parte aérea das plantas de Eucalyptus benthamii e Eucalyptus dunnii aos 110 dias de crescimento em relação ao tratamento testemunha independente da correção do solo. No solo sem calagem, as ERs médias foram 75, 91 e 94% respectivamente para os FNs Bayovar, Gafsa e Djebel. Para os solos com calagem, as ERs médias foram 65, 24 e 25%, para os mesmos fosfatos. Nos tratamentos sem adição de calcário, a eficiência relativa dos FNs foi maior em comparação aos solos com calagem.
FAUNA EDÁFICA NA DINÂMICA SUCESSIONAL DA MATA ATLÂNTICA EM FLORESTA ESTACIONAL SEMIDECIDUAL NA BACIA DO RIO PARAÍBA DO SUL - RJ
Authors: Machado Deivid Lopes , Pereira Marcos Gervasio , Correia Maria Elizabeth Fernandes , Diniz Anderson Ribeiro , Menezes Carlos Eduardo Gabriel
Published: April 2015

http://dx.doi.org/10.5902/1980509817466A fauna edáfica, pela sua diversidade e magnitude das funções que realiza no ambiente solo, pode refletir o estado de funcionamento dos ecossistemas. Neste sentido, este estudo teve como objetivo avaliar a atividade, composição estrutural e diversidade da comunidade da fauna do solo, em diferentes estádios sucessionais da Mata Atlântica, em Pinheiral - RJ. Para tanto, foram estudadas três áreas de Floresta Estacional Semidecidual Submontana em diferentes estádios sucessionais: Floresta em Estádio Inicial (FEI), Floresta em Estádio Médio (FEM) e Floresta em Estádio Avançado (FEA). Em cada área foi demarcada uma parcela de 30 m x 30 m. Para captura dos organismos epígeos da mesofauna e macrofauna, utilizaram-se armadilhas do tipo “pitfall-traps”, sendo distribuídas, aleatoriamente, 10 armadilhas em cada área. Foram realizadas amostragens em abril e agosto de 2009. A atividade dos organismos (ind arm-1 dia-1) e os índices ecológicos de riqueza e equidade de Pielou foram calculados a partir da quantificação e identificação dos indivíduos amostrados. A partir da análise dos resultados, contatou-se que o mês de agosto, caracterizado com maior precipitação, influiu diretamente na atividade, composição estrutural e diversidade da fauna do solo. A estrutura populacional foi influenciada pelos estádios sucessionais, sendo que a atividade dos grupos Acari, Araneae, Diptera, Formicidae, Hymenoptera e Isopoda aumentou em função do avanço sucessional. A atividade total e o índice de riqueza média também responderam ao processo de sucessão. O grupo Entomobryomorpha foi o mais abundante em todas as áreas, sendo o responsável pelas variações do índice de Pielou. De maneira geral, verificaram-se maiores valores da atividade dos grupos, atividade total e riqueza média na FEA, e menores na FEI, confirmando, assim, o potencial uso desses organismos como indicadores da dinâmica sucessional em florestas secundárias.
PRESERVAÇÃO DE MADEIRAS NO BRASIL: HISTÓRICO, CENÁRIO ATUAL E TENDÊNCIAS
Authors: Vidal Jackson Marcelo , Evangelista Wescley Viana , Silva Jose de Castro , Jankowsky Ivaldo Pontes
Published: April 2015

http://dx.doi.org/10.5902/1980509817484O objetivo deste trabalho foi apresentar uma revisão de literatura sobre o setor de preservação de madeiras no Brasil, desde seu início até o ano de 2011. O Brasil é rico em recursos naturais e a madeira sempre ocorreu de forma abundante. Com o crescimento industrial, houve a necessidade de utilizar madeiras de baixa durabilidade natural, mas dependentes de um tratamento preservativo. O tratamento de madeiras iniciou-se no final do século XIX, para atendimento da demanda de dormentes para as ferrovias. Somente na década de 1960, o setor de preservação de madeiras ganhou impulso com aumento significativo das pesquisas científicas, normalização técnica e unidades industriais de preservação de madeira. A partir daí, poucos avanços foram observados. No ano de 2011, as usinas de preservação utilizam basicamente madeiras dos gêneros calyptus e Pinus, realizando, principalmente, o tratamento preservativo em usinas sob pressão. Em pequena escala, utiliza-se o método de substituição de seiva. Os principais preservativos utilizados são o arseniato de cobre cromatado (CCA) e o borato de cobre cromatado (CCB); o creosoto também é utilizado, em reduzida escala. A produção de madeira tratada concentra-se, essencialmente, na produção de moirões de cerca, postes e dormentes. Como tendência, o setor deverá alcançar novos mercados, como o de construção civil, cruzetas e embalagens, bem como intensificar o consumo dos produtos tradicionais. A despeito de inúmeras pesquisas sobre vários produtos, o CCA deverá se manter no mercado por vários anos, pela inexistência de produtos alternativos que apresentem a mesma eficácia, bem como à inexistência de provas que o produto apresente efeitos nocivos à saúde humana e ao meio ambiente.
Development and Initial Validation of a Program Director's Evaluation Form for Medical School Graduates
Authors: Dong Ting , Durning Steven J. , Gilliland William R. , Swygert Kimberly A. , Artino Anthony R.
Published: April 2015

Background: In the early 1990s, our group of interdepartmental academicians at the Uniformed Services University (USU) developed a PGY-1 (postgraduate year 1) program director evaluation form. Recently, we have revised it to better align with the core competencies established by the Accreditation Council for Graduate Medical Education. We also included items that reflected USU's military-unique context. Purpose: To collect feasibility, reliability, and validity evidence for our revised survey. Method: We collected PGY-1 data from program directors (PD) who oversee the training of military medical trainees. The cohort of the present study consisted of USU students graduating in 2010 and 2011. We performed exploratory factor analysis (EFA) to examine the factorial validity of the survey scores and subjected each of the factors identified in the EFA to an internal consistency reliability analysis. We then performed correlation analysis to examine the relationship between PD ratings and students' medical school grade point averages (GPAs) and performance on U.S. Medical Licensing Examinations Step assessments. Results: Five factors emerged from the EFA–—Medical Expertise, Military-unique Practice, Professionalism, System-based Practice, and Communication and Interpersonal Skills.” The evaluation form also showed good reliability and feasibility. All five factors were more strongly associated with students' GPA in the initial clerkship year than the first 2 years. Further, these factors showed stronger correlations with students' performance on Step 3 than other Step Examinations. Conclusions: The revised PD evaluation form seemed to be a valid and reliable tool to gauge medical graduates' first-year internship performance.
Assessing Task Importance and Anxiety in Medical School: An Instrument Development and Initial Validation Study
Authors: Phillips Henry L. , Dong Ting , Durning Steven J. , Artino Anthony R.
Published: April 2015

Recent research in medical education suggests that students' motivational beliefs, such as their beliefs about the importance of a task, and their emotions are meaningful predictors of learning and performance. The primary purpose of this study was to develop a self-report measure of “task importance” and “anxiety” in relation to several medical education competencies and to collect validity evidence for the new measures. The secondary purpose was to evaluate differences in these measures by year of medical school. Exploratory factor analysis of scores from 368 medical school students suggested two task importance factors and three anxiety factors. The task importance and anxiety subscales were weakly related to each other and exhibited consistently negative and positive correlations, respectively, with three self-efficacy subscales. The task importance subscales were positively related to “metacognition,” whereas “interpersonal skills anxiety” and “health knowledge anxiety” were positively related to “procrastination.” All three anxiety factors were positively related to “avoidance of help seeking,” whereas “interpersonal skills and professionalism importance” was negatively related to help avoidance behaviors. Finally, comparisons across the 4 years of medical school indicated that some aspects of task importance and anxiety varied significantly. Overall, findings from this study provide validity evidence for the psychometric quality of these scales, which capture task importance and anxiety in medical students. Limitations and implications for medical education research are discussed.
Medical Student Attitudes Toward the Medically Underserved: The USU Perspective
Authors: Stephens Mark B. , Landers Grace , Davis Stephen W. , Durning Steven J. , Crandall Sonia J.
Published: April 2015

This study examined a cohort of students attending the Uniformed Services University regarding their attitudes toward medical care in underserved populations. Using the previously validated Medical Student Attitudes Toward the Underserved (MSATU), repeated measures analysis of variance showed that student attitudes toward care in underserved populations was less favorable than limited national data at entry and declined over time (Mean MSATU total score Year 1: 46.2 [SD 10.95]; Year 4: 41.7 [SD 12.3] p < 0.01). Differences in medical school debt, exposure to underserved populations, and the definition of “service” in the context of active duty military status might explain some of our findings. Providing broad service learning opportunities within the curriculum could increase student exposure to underserved populations and strengthen the social contract between community and institution.
Physical Fitness and Academic Performance: A Pilot Investigation in USU Medical Students
Authors: Stephens Mark B. , Dong Ting , Durning Steven J.
Published: April 2015

This study examined the correlations between physical fitness parameters and standard measures of academic performance in a cohort of students at the Uniformed Services University. Significant positive correlations were noted between the average aerobic fitness score and preclerkship grade point average (GPA; r = 0.37, p < 0.05) and cumulative GPA (r = 0.38, p < 0.05). Positive correlations were also noted between the average overall fitness score and preclerkship GPA (r = 0.34, p < 0.05), medical school cumulative GPA (r = 0.34, p < 0.05), and the score on Step 1 of the national board examination (r = −0.33, p < 0.05). Physical fitness may serve as one indicator to predict which students will succeed in medical school and to identify those who are at risk for poor performance and might benefit from a wellness intervention.
The Clinical Integrative Puzzle for Teaching and Assessing Clinical Reasoning: Preliminary Feasibility, Reliability, and Validity Evidence
Authors: Capaldi Vincent F. , Durning Steven J. , Pangaro Louis N. , Ber Rosalie
Published: April 2015

Background: Expertise in clinical reasoning is essential for high-quality patient care. The Clinical Integrative Puzzle (CIP) is a novel assessment method for clinical reasoning. The purpose of our study was to further describe the CIP, providing feasibility, reliability, and validity evidence to support this tool for teaching and evaluating clinical reasoning. Methods: We conducted a prospective, randomized crossover trial assessing the CIP in second-year medical students from a single institution. Feasibility was estimated through the time taken to complete a CIP during a CIP session and through comments from faculty developers. Reliability was addressed through calculating odd–even item reliability (split-half procedure) for grid questions within each CIP. Evidence for content, concurrent, and predictive validity was also measured. Results: 36 students participated in the study. Data suggested successful randomization of participants and nonparticipants. The CIP was found to have high feasibility, acceptable reliability (0.43–0.73 with a mean of 0.60) with a short time for CIP completion. Spearman–Brown correction estimated a reliability of 0.75 with completing two grids (estimated time of 50 minutes) and 0.82 for three grids (estimated time of 75 minutes). Validity evidence was modest; the CIP is consistent with clinical reasoning literature and the CIP modestly correlated with small group performance (r = 0.3, p < 0.05). Conclusions: Assessing clinical reasoning in medical students is challenging. Our data provide good feasibility and reliability evidence for the use of CIPs; validity data was less robust.
Are Commonly Used Premedical School or Medical School Measures Associated With Board Certification?
Authors: Durning Steven J. , Dong Ting , Hemmer Paul A. , Gilliland William R. , Cruess David F. , Boulet John R. , Pangaro Louis N.
Published: April 2015

Purpose: To determine if there is an association between several commonly obtained premedical school and medical school measures and board certification performance. We specifically included measures from our institution for which we have predictive validity evidence into the internship year. We hypothesized that board certification would be most likely to be associated with clinical measures of performance during medical school, and with scores on standardized tests, whether before or during medical school. Methods: Achieving board certification in an American Board of Medical Specialties specialty was used as our outcome measure for a 7-year cohort of graduates (1995–2002). Age at matriculation, Medical College Admissions Test (MCAT) score, undergraduate college grade point average (GPA), undergraduate college science GPA, Uniformed Services University (USU) cumulative GPA, USU preclerkship GPA, USU clerkship year GPA, departmental competency committee evaluation, Internal Medicine (IM) clerkship clinical performance rating (points), IM total clerkship points, history of Student Promotion Committee review, and United States Medical Licensing Examination (USMLE) Step 1 score and USMLE Step 2 clinical knowledge score were associated with this outcome. Results: Ninety-three of 1,155 graduates were not certified, resulting in an average rate of board certification of 91.9% for the study cohort. Significant small correlations were found between board certification and IM clerkship points (r = 0.117), IM clerkship grade (r = 0.108), clerkship year GPA (r = 0.078), undergraduate college science GPA (r = 0.072), preclerkship GPA and medical school GPA (r = 0.068 for both), USMLE Step 1 (r = 0.066), undergraduate college total GPA (r = 0.062), and age at matriculation (r = −0.061). In comparing the two groups (board certified and not board certified cohorts), significant differences were seen for all included variables with the exception of MCAT and USMLE Step 2 clinical knowledge scores. All the variables put together could explain 4.1% of the variance of board certification by logistic regression. Conclusions: This investigation provides some additional validity evidence that measures collected for purposes of student evaluation before and during medical school are warranted.
Successful Strategies for Integrating Bedside Ultrasound Into Undergraduate Medical Education
Authors: Palma James K.
Published: April 2015

Nearly all physician specialties currently utilize bedside ultrasound, and its applications continue to expand. Bedside ultrasound is becoming a core skill for physicians; as such, it should be taught during undergraduate medical education. When ultrasound is integrated in a longitudinal manner beginning in the preclerkship phase of medical school, it not only enhances teaching the basic science topics of anatomy, physiology, and pathology but also ties those skills and knowledge to the clerkship phase and medical decision-making. Bedside ultrasound is a natural bridge from basic science to clinical science. The Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine is currently in its fourth year of implementing an integrated ultrasound curriculum in the school of medicine. In our experience, successful integration of a bedside ultrasound curriculum should: align with unique focuses of a medical schools' mission, simplify complex anatomy through multimodal teaching, correlate to teaching of the physical examination, solidify understanding of physiology and pathology, directly link to other concurrent content, narrow differential diagnoses, enhance medical decision-making, improve procedural skills, match to year-group skillsets, develop teaching and leadership abilities, and have elective experiences for advanced topics.
El nuevo pasado mexicano: estrategias de representación en Atzimba de Ricardo Castro
Authors:   Pontificia Universidad Católica de Chile, Saavedra Leonora
Published: April 2015

Utilizando modelos teóricos desarrollados en las ciencias sociales que proponen que los movimientos nacionalistas engendran a la nación, el arte nacionalista se define no como aquel que expresa la esencia nacional sino como aquel que contribuye eficazmente a crear a la nación, independientemente de su estilo o de su relación, fidedigna o no, con el folklor o “el pueblo.” La ópera Atzimba (1900) del compositor mexicano Ricardo Castro (1864-1907) contribuyó a la creación de la nación mexicana al ayudar al público letrado y burgués de principios del siglo XX (antes de la Revolución Mexicana de 1910) a imaginar las extintas culturas prehispánicas de México y a interiorizarlas como el pasado histórico de la nación. Castro utilizó estrategias de representación de lo prehispánico mediadas por convenciones operísticas exoticistas con las cuales su público estaba familiarizado, estrategias ancladas asimismo en la necesidad política de las élites dirigentes de re-presentar a México internacionalmente como una nación civilizada y soberana con una historia antigua propia y grandiosa. Este trabajo cultural y político es lo que la convierte en una ópera nacionalista.
The 2016 Severe Floods and Incidence of Hemorrhagic Fever With Renal Syndrome in the Yangtze River Basin
Authors: Ji Haoqiang , Li Ke , Shang Meng , Wang Zhenxu , Liu Qiyong
Published: August 2024

Importance

Hemorrhagic fever with renal syndrome (HFRS), a neglected zoonotic disease, has received only short-term attention in postflood prevention and control initiatives, possibly because of a lack of evidence regarding the long-term association of flooding with HFRS.

Objectives

To quantify the association between severe floods and long-term incidence of HFRS in the Yangtze River basin and to examine the modifying role of geographical factors in this association.

Design, Setting, and Participants

This cross-sectional study collected data on HFRS cases between July 1, 2013, and June 30, 2019, from 58 cities in 4 provinces (Anhui, Hubei, Hunan, and Jiangxi) in the Yangtze River basin of China, with a breakpoint of flooding in July 2016, generating monthly data. The 3 years after July 2016 were defined as the postflood period, while the 3 years before the breakpoint were defined as the control period. Statistical analysis was performed from October to December 2023.

Exposures

City-level monthly flooding, elevation, ruggedness index, and closest distance from each city to the Yangtze River and its tributaries.

Main Outcomes and Measures

The primary outcomes were the number of city-level monthly HFRS cases and the number of type 1 (spring or summer) and type 2 (autumn or winter) HFRS cases.

Results

A total of 11 745 patients with HFRS were reported during the study period: 5216 patients (mean [SD] age, 47.1 [16.2] years; 3737 men [71.6%]) in the control period and 6529 patients (mean [SD] age, 49.8 [15.8] years; 4672 men [71.6%]) in the postflood period. The pooled effects of interrupted time series analysis indicated a long-term association between flooding and HFRS incidence (odds ratio, 1.38; 95% CI, 1.13-1.68), with type 1 cases being at highest risk (odds ratio, 1.71; 95% CI, 1.40-2.09). The metaregression results indicated that elevation and ruggedness index were negatively associated with the risk of HFRS, while the distance to rivers interacted with these associations.

Conclusions and Relevance

This cross-sectional study of the long-term association between flooding and HFRS incidence, as well as the modification effects of geographical factors, suggests that severe floods were associated with an increased risk of HFRS within 3 years. This study provides evidence for the development of HFRS prevention and control strategies after floods.
An age‐stage structured population model for the coexistence of alternative migratory tactics in salmonid fishes
Authors: Horita Jun‐nosuke , Takada Takenori , Tachiki Yuuya
Published: August 2024

Alternative tactics refer to the discontinuous patterns of phenotypic variation, often expressed as an association of several phenotypes. These tactics are widely observed in several taxa, with individuals in a population choosing a phenotype from multiple options depending on their status. In salmonids, alternative migratory tactics‐where some individuals undergo feeding migration to the ocean and others remain in their natal streams are associated with exaggerated phenotypic variations. Such discrete alternative phenotypes can have complex impacts on ecological and evolutionary processes (e.g., reproduction and the trait changes due to natural selection) owing to the large differences in demographic rates between tactics. In this study, to explore the eco‐evolutionary consequences of alternative migratory tactics in salmonid fishes, we constructed an age‐stage structured population model focusing on females. As individuals choose a tactic based on their own status, we incorporated the size structure of juveniles into the population dynamics and explored the evolution of the threshold trait. At the evolutionary endpoint, the threshold trait maximized the population size. Furthermore, the coexistence of resident and migrant tactics within a population occurred when the river environment was relatively poor and/or the ocean environment was rich; otherwise, all individuals adopted the resident tactic. This model provides several insights into the eco‐evolutionary response of the population to environmental change. For example, the increase in survivorship during migration increased the population size and the fraction of migrants as an ecological and evolutionary response, respectively.
Dynamic event‐triggered H∞ control for switched T‐S fuzzy systems under multiple cyber attacks
Authors: Tan Xiangtong , Li Xiehuan , Zong Guangdeng
Published: August 2024

This article studies the dynamic event‐triggered control problem for switched Takagi‐Sugeno (T‐S) fuzzy systems against multiple cyber attacks. A new multiple cyber attack model is established by considering random false data injection attacks and aperiodic denial‐of‐service attacks. Then, to further efficiently utilize network communication resources, a dynamic event‐triggered mechanism (ETM), which includes a nonnegative dynamic variable, is constructed. Furthermore, the time‐delay switched T‐S fuzzy system considering dynamic ETM and multiple cyber attacks is derived by utilizing model transformation methods. Moreover, sufficient conditions for globally asymptotically stability and performance are derived by utilizing multiple Lyapunov functions and average dwell time method. Finally, an example is provided to validate the effectiveness of dynamic ETM.
High Photoresponsivity and Fast Response Speed Ferroelectric Photomemristor for Artificial Visual System Application
Authors: Zhao Zhen , Wang Zhanfeng , Xu Jikang , Zhao Pengli , Wang Jianning , Wang Yongrui , Zhang Weifeng , Li Changliang , Cui Haozhen , Wang Jiacheng , Zhang Yinxing , Sun Jiameng , Pei Yifei , Guo Zhenqiang , Faraj Yousef , Chen Jingsheng , Li Shushen , Yan Xiaobing
Published: August 2024

Ferroelectric photoelectric devices show promising applications in artificial vision systems. However, this type of devices used in artificial vision systems exhibits low photoresponsivity and this limited cyclability of photocurrents, which hinders the progress of artificial vision systems. In this study, an artificial vision system is constructed with high photoresponsivity, fast photoresponse speed, and high read/write speed based on the Pd/PbZr0.4Ti0.6O3/La0.3Sr0.7MnO3/LaAlO3 ferroelectric photomemristor. The high optical response (18.86 nanoamperes) and read/write speeds (50 nanoseconds) of the device significantly improve the robustness and speed of the neuromorphic visual system while reducing power consumption for recognition. The artificial vision system developed in this study provides excellent real‐time image processing capabilities, including edge detection and classification with 100% accuracy for musical key patterns, and it is expected to offer great potential for the development of high‐performance self‐powered artificial vision systems.
Rare Earth‐Induced CoO6 Octahedral Distortion in Perovskite: An Efficient Catalytic Platform for RuO2‐Catalyzed Water Oxidation
Authors: Jiang Kunhong , Jiang Yong , Liang Zhong , Gu Chao , Shen Zhurui , Du Yaping
Published: August 2024

Rare earth (RE)‐based perovskites are considered as promising platform for oxygen evolution reaction (OER) due to their low cost and tunable structures. However, the systematic synthesis of perovskite catalysts with satisfactory performance has rarely been reported. Herein, a general synthetic protocol for RE‐substituted LaCoO3 (RE‐LCO) perovskites is demonstrated. Particularly, after loaded with RuO2, the as‐prepared RuO2:0.2Ce‐LCO hybrid structures exhibit OER performance with a low overpotential of 135 mV at 10 mA cm−2 in 1.0 m KOH, together with remarkable long‐term operation, representing one of the most efficient and robust Ru‐based catalysts. Comprehensive experimental results indicate that the enhanced OER mechanism is attributed to the Ce‐substitution, which alters the geometric configuration of CoO6 octahedra and generates more oxygen vacancies. Furthermore, the robust interaction between Ce‐LCO and RuO2 stabilizes the valence state of Ru site. Theoretical calculations corroborate that Co 3d orbitals overlap with Ce 4f orbitals near the Fermi level, greatly improving the electron transfer between Co and Ce atoms.
Novel Iontronic Pressure Sensor Coupling High Sensitivity and Wide‐Range for Stiffness Identification and Long‐Distance Precise Motion Control
Authors: Wang Dakai , Li Bo , Niu Shichao , Han Zhiwu , Ren Luquan
Published: August 2024

High‐performance flexible pressure sensors have garnered widespread applications across numerous vital fields, encompassing flexible robotics, artificial intelligence, and brain‐computer interfaces. However, the small compressibility range of flexible materials and the easy saturation characteristics of microstructures greatly limit their practical applications. Therefore, achieving high sensitivity over an extensive pressure range remains a challenge. Here, inspired by the skin, a raised structure with graded features is designed as the sensitive layer. A flexible pressure sensor with high performance is manufactured by combining iontronic interfaces. The results indicate that this sensor can stably maintain a high sensitivity of 161.26 kPa−1 even at a pressure of 320 kPa. Moreover, this sensor also has a fast response time and recovery time of 26 and 85 ms, respectively. As a demonstration, these sensors are applied to materials stiffness recognition, human motion monitoring, and control of long‐distance four‐wheel vehicles. This work will offer valuable insights and serve as a useful reference for achieving high sensitivity and a broadened sensing range in sensors.
Proximal High‐Index Metamaterials based on a Superlattice of Gold Nanohexagons Targeting the Near‐Infrared Band
Authors: Shin Dong‐In , Kim Jeongwon , Im Seong‐Gyun , Kang Taewoo , Wang Ke , Lee Gaehang , Kwon Seok Joon , Park Sungho , Yi Gi‐Ra
Published: August 2024

Plasmonic nanoparticles can be assembled into a superlattice, to form optical metamaterials, particularly targeting precise control of optical properties such as refractive index (RI). The superlattices exhibit enhanced near‐field, given the sufficiently narrow gap between nanoparticles supporting multiple plasmonic resonance modes only realized in proximal environments. Herein, the planar superlattice of plasmonic Au nanohexagons (AuNHs) with precisely controlled geometries such as size, shape, and edge‐gaps is reported. The proximal AuNHs superlattice realized over a large area with selective edge‐to‐edge assembly exhibited the highest‐ever‐recorded RI values in the near‐infrared (NIR) band, surpassing the upper limit of the RI of the natural intrinsic materials (up to 10.04 at λ = 1.5 µm). The exceptionally enhanced RI is derived from intensified in‐plane surface plasmon coupling across the superlattices. Precise control of the edge‐gap of neighboring AuNHs systematically tuned the RI as confirmed by numerical analysis based on the plasmonic percolation model. Furthermore, a 1D photonic crystal, composed of alternating layers of AuNHs superlattices and low‐index polymers, is constructed to enhance the selectivity of the reflectivity operating in the NIR band. It is expected that the proximal AuNHs superlattices can be used as new optical metamaterials that can be extended to the NIR range.