bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of proprioceptive training and conventional physical therapy in treating adhesive capsulitis
Authors: Shabbir Rida , Arsh Aatik , Darain Haider , Aziz Sadaf 
Published: April 2021

Objective: To determine effectiveness of proprioceptive training and conventional physical therapy in managing patients with adhesive capsulitis.
Methods: A pre-test post-test control group study was conducted at Rehman Medical Institute from June to December 2019. Thirty-eight patients, aged 30 to 60 years, with diagnosis of adhesive capsulitis for more than four months were divided into two groups. Subjects in Group-I (conventional group; n=19) received conventional physical therapy protocols for one month while subjects in Group-II (proprioceptive group; n=19) received proprioceptive training along with conventional physical therapy for one month. Disability of Arm Shoulder & Hand questionnaire, Shoulder Pain & Disability Index and goniometer were used at baseline and post-treatment to assess functional activity level, pain & disability and range of motion respectively. Data was analyzed using SPSS version 20.
Results: The mean age of the participants was 53.13 ± 9.12 years. Baseline characteristics were balanced between the two groups. After the treatment, all measures (functional activity level, pain, disability, ROM) improved in both groups. Post treatment, between group analysis showed that functional activity (DASH) and pain (SPADI pain) significantly (P-value <0.05) improved in proprioceptive group as compared to conventional group. However, there were no significant differences (P-value≥ 0.05) in post treatment SPADI disability, SPADI total and ROM (flexion, abduction, external rotation) scores of both groups.
Conclusion: Proprioceptive exercises along with conventional physical therapy are more effective in managing pain and improving functional activities in adhesive capsulitis patients as compared to conventional physical therapy alone.
doi: https://doi.org/10.12669/pjms.37.4.3874
How to cite this:Shabbir R, Arsh A, Darain H, Aziz S. Effectiveness of proprioceptive training and conventional physical therapy in treating adhesive capsulitis. Pak J Med Sci. 2021;37(4):1196-1200. doi: https://doi.org/10.12669/pjms.37.4.3874
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective Structured Clinical Examination? How students perceive their learning after OSCE
Authors: Yusuf Lamia 
Published: April 2021

Objective: Assessment of skills is an important part of medical education. The objective was to find out how students perceive their learning after being assessed through OSCE.
Methods: It was a mixed convergent parallel study. The study was carried out in the gynaecology department of a private medical college in Lahore. Five groups of final year students posted for rotation in gynae wards were included in this study. Each group comprised of 18 students. They were exposed to OSCE once daily. After completion of one month, students were given a feedback questionnaire (developed and validated by medical educationists) and a focus group discussion was carried out. Eight participants were selected from each group randomly and interviews were recorded. Interviews were transcribed verbatim.
Results: Quantitative data calculated by SPSS 21 and results were calculated as frequencies. Qualitative analysis was based on word frequency count and thematic analysis was followed. Almost 65.2% of the student Shows agreement to the response that OSCE should be part of internal assessments. Whereas 15% shows disagreement and 9% remain neutral. The themes extracted after interviews were, better assessment tool, exam fear, knowledge, confidence and change learning style. thus, triangulating the data. The outcome measured was the result of the final professional of obstetrics and gynaecology year 2017-2018 batch. The success rate was 100% in gynae/obs and one student was able to get a distinction.
Conclusion: Students perceived OSCE as a better assessment tool that increased their knowledge and confidence level. Thus, they were an opinion that OSCE should be part of examinations held in college.
doi: https://doi.org/10.12669/pjms.37.4.4005
How to cite this:Yusuf L. Objective Structured Clinical Examination? How students perceive their learning after OSCE. Pak J Med Sci. 2021;37(4):1206-1210. doi: https://doi.org/10.12669/pjms.37.4.4005
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The possible link between Fetuin-A Protein and Neuro-inflammation in Children with Autism Spectrum Disorder
Authors: Al-Ayadhi Laila Yousif , Alghamdi Farah Ali , Altamimi Lamees Abdula , Alsughayer Luluh Yousef , Alhowikan Abdulrahman Mohammad , Halepoto Dost Muhammad 
Published: April 2021

Objectives: To investigate the blood plasma levels of Fetuin-A protein in children with Autism Spectrum Disorder (ASD) and healthy controls that could offer novel diagnostic biomarkers of disease development in ASD. Another objective was to investigate the severity of autistic children by Childhood Autism Rating Scale (CARS) and Short Sensory Profile (SSP).
Methods: This case control study was carried out at Autism Research and Treatment (ART) Center, King Saud University, Riyadh, Saudi Arabia, from October 2019 to February 2020. Plasma concentration of Fetuin-A was analyzed by enzyme-linked immunosorbent assay (ELISA) in ASD subjects (n=46) and normal controls (n=44). Correlation among Fetuin-A levels, CARS and SSP was established by Spearman’s correlation coefficient (r).
Results: Overall, autistic children had significantly (p= 0.0.02) lower Fetuin-A concentration [50.76 (22.2-68.5) ng/ml] than those of healthy controls [53.7 (35.6-99.7) ng/ml] [median (interquartile range)]. Children with mild to moderate autism (n=24, 52%) also showed significantly lower Fetuin-A levels [50.0 (30.0-68.2) ng/ml], (p =0.02} than healthy controls [53.7 (35.6-99.7) ng/ml] [median (IQR)]. However, there was no significant change (p = 0.71) observed between the Fetuin-A levels of children with severe autism [51.8 (22.2-68.5)] ng/ml, mild to moderate autism [50 (30-68.2)] ng/ml [median (IQR)] and healthy controls (p=0.12). Also no significant correlations between Fetuin-A, CARS and SSP were observed (CARS, r= 0.024, p=0.88; SSP, r= -0.003, p=0.98).
Conclusion: Overall the low Fetuin-A plasma values in ASD subjects, most likely show that Fetuin-A could be associated in the physiology of autism. Further studies with larger patient and control cohorts will be necessary to determine whether Fetuin-A can be used as a biomarker for ASD.
doi: https://doi.org/10.12669/pjms.37.4.4032
How to cite this:Al-Ayadhi LY, Alghamdi FA, Altamimi LA, Alsughayer LY, Alhowikan AM, Halepoto DM. The possible link between Fetuin-A Protein and Neuro-inflammation in Children with Autism Spectrum Disorder. Pak J Med Sci. 2021;37(4):1166-1171. doi: https://doi.org/10.12669/pjms.37.4.4032
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Saliva: Both a Threat and an Opportunity in Covid-19 Pandemic
Authors: Sadıkoğlu Ismail Serhat , Caymaz Mehmet Gagari 
Published: April 2021

Covid-19 pandemic, continues all over the world with the increasing number of confirmed cases and performed tests day by day. It has been shown that collecting nasopharyngeal samples, as the most commonly prefered method to perform RT-PCR, has disadvantages like causing discomfort and bleeding in patients. Sample collecting procedure also renders healthcare professionals by exposing them to the risk of transmission of the virus related to the direct contact with patients. These disadvantages make this procedure undesirable for the researchers and forces them to search for an alternative technique. At this point, saliva appears as an opportunity, regarding its high viral load. On the other hand, this high viral load poses a threat, especially for professions such as dental practitioners, with too much aerosol exposure. Since dentistry is a branch of health that constantly needs direct operations, it is necessary to be protected from the virus as much as possible while caring for the patient. A literature review was done using electronic databases “PubMed,” “Google Scholar,” and “Cochrane Database,” on January 2021. Studies have proposed many different preventive measures in this regard. Therefore, the purpose of this review is to draw attention to the saliva by bringing together the recent research and also to provide information and a perspective to dental clinicians about both prevention and a potential diagnostic technique.
doi: https://doi.org/10.12669/pjms.37.4.4263
How to cite this:Sadikoglu IS, Caymaz MG. Saliva: Both a Threat and an Opportunity in Covid-19 Pandemic. Pak J Med Sci. 2021;37(4):1215-1220. doi: https://doi.org/10.12669/pjms.37.4.4263
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Politoligwistyka dyplomatyczna
Authors: Popławski Błażej 
Published: April 2021

Diplomatic Politolinguistics. The Analysis of the Perception of Sub-Saharan Africa in the Exposé of the Ministers of Foreign Affairs of the Second and Third Polish Republics
The aim of the article is to present the image of sub-Saharan Africa in the exposé of the ministers of foreign affairs of the Second andThird Republics of Poland, in the context of changes in the ideological imaginary of the Polish diplomacy. The introduction describes a political linguistic perspective which was adopted in the work, treating the discourse of political actors as one of the main determinants of the political universe. Then the “parliamentary custom” of delivering an exposé was characterised. The next part discusses the perception of the colonial and imperial idea in the Second Polish Republic. Research on the information provided by the chiefs of the diplomacy after 1989 was focused on the description of the transfer of democracy to the South, the clash of civilizations, and securitization in the international relations.
Material jet printing of transparent ceramic Yb:YAG planar waveguides
Authors: Seeley Zachary M. , Phillips Ian R. , Rudzik Thomas J. , Cherepy Nerine J. , Drobshoff Alexander D. , Payne Stephen A. 
Published: April 2021

A new, to the best of our knowledge, 3D additive manufacturing technique utilizing particle-loaded ink jet printing to fabricate transparent ceramic Yb:YAG planar waveguides for laser gain media was demonstrated. Rheological optimization of YAG particle-loaded inks resulted in successful droplet formation and printing resolution. Planar waveguides composed of a Yb:YAG guide encased in undoped YAG cladding were printed with guide thicknesses ranging between 25 and 350 µm and consolidated to high optical quality via solid-state sintering. Sufficiently low optical (1–3%/cm) and intermodal scatter allowed single-mode propagation with a core/clad index difference of

Δ

n

∼

5.0

×

10

−
4

(corresponding to 3 at.% Yb). The waveguides were cladding-pumped longitudinally with a 940 nm diode array resulting in 23.6% slope efficiency in 2 ms pulsed operation.
LED-pumped femtosecond Cr:LiSAF regenerative amplifier system
Authors: Taleb Hussein , Pichon Pierre , Druon Frédéric , Balembois François , Georges Patrick 
Published: April 2021

We report on the first, to the best of our knowledge, LED-pumped femtosecond regenerative amplifier. It is based on a Cr:LiSAF crystal pumped by 2240 blue LEDs via a Ce:YAG luminescent concentrator. The amplifier was seeded by pulses from a Ti:sapphire oscillator at 835 nm temporally stretched from 90 fs to 100 ps. At the output of the regenerative amplifier, we obtain 1 mJ pulse energy at a 10 Hz repetition rate, given by the frequency of the LED-pumping module. After compression, we obtain 100 fs pulses with a spectral bandwidth of 10 nm at 835 nm.
Angiotensin II receptor blocker or angiotensin-converting enzyme inhibitor use and COVID-19-related outcomes among US Veterans
Authors: Derington Catherine G. , Cohen Jordana B. , Mohanty April F. , Greene Tom H. , Cook James , Ying Jian , Wei Guo , Herrick Jennifer S. , Stevens Vanessa W. , Jones Barbara E. , Wang Libo , Zheutlin Alexander R. , South Andrew M. , Hanff Thomas C. , Smith Steven M. , Cooper-DeHoff Rhonda M. , King Jordan B. , Alexander G. Caleb , Berlowitz Dan R. , Ahmad Faraz S. , Penrod M. Jason , Hess Rachel , Conroy Molly B. , Fang James C. , Rubin Michael A. , Beddhu Srinivasan , Cheung Alfred K. , Xian Weiming , Weintraub William S. , Bress Adam P. 
Published: April 2021

Background
Angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) may positively or negatively impact outcomes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We investigated the association of ARB or ACEI use with coronavirus disease 2019 (COVID-19)-related outcomes in US Veterans with treated hypertension using an active comparator design, appropriate covariate adjustment, and negative control analyses.

Methods and findings
In this retrospective cohort study of Veterans with treated hypertension in the Veterans Health Administration (01/19/2020-08/28/2020), we compared users of (A) ARB/ACEI vs. non-ARB/ACEI (excluding Veterans with compelling indications to reduce confounding by indication) and (B) ARB vs. ACEI among (1) SARS-CoV-2+ outpatients and (2) COVID-19 hospitalized inpatients. The primary outcome was all-cause hospitalization or mortality (outpatients) and all-cause mortality (inpatients). We estimated hazard ratios (HR) using propensity score-weighted Cox regression. Baseline characteristics were well-balanced between exposure groups after weighting. Among outpatients, there were 5.0 and 6.0 primary outcomes per 100 person-months for ARB/ACEI (n = 2,482) vs. non-ARB/ACEI (n = 2,487) users (HR 0.85, 95% confidence interval [CI] 0.73–0.99, median follow-up 87 days). Among outpatients who were ARB (n = 4,877) vs. ACEI (n = 8,704) users, there were 13.2 and 14.8 primary outcomes per 100 person-months (HR 0.91, 95%CI 0.86–0.97, median follow-up 85 days). Among inpatients who were ARB/ACEI (n = 210) vs. non-ARB/ACEI (n = 275) users, there were 3.4 and 2.0 all-cause deaths per 100 person months (HR 1.25, 95%CI 0.30–5.13, median follow-up 30 days). Among inpatients, ARB (n = 1,164) and ACEI (n = 2,014) users had 21.0 vs. 17.7 all-cause deaths, per 100 person-months (HR 1.13, 95%CI 0.93–1.38, median follow-up 30 days).

Conclusions
This observational analysis supports continued ARB or ACEI use for patients already using these medications before SARS-CoV-2 infection. The novel beneficial association observed among outpatients between users of ARBs vs. ACEIs on hospitalization or mortality should be confirmed with randomized trials.
Six-month follow-up of minimally invasive nerve-sparing complete excision of endometriosis: What about dyspareunia?
Authors: Crispi Claudio Peixoto , Crispi Claudio Peixoto , de Oliveira Bruna Rafaela Santos , de Nadai Filho Nilton , Peixoto-Filho Fernando Maia , Fonseca Marlon de Freitas 
Published: April 2021

Study objectiveTo assess individual changes of deep dyspareunia (DDyspareunia) six months after laparoscopic nerve-sparing complete excision of endometriosis, with or without robotic assistance.MethodsThis preplanned interdisciplinary observational study with a retrospective analysis of intervention enrolled 126 consecutive women who underwent surgery between January 2018 and September 2019 at a private specialized center. Demographics, medical history and surgery details were recorded systematically. DDyspareunia (primary outcome), dysmenorrhea and acyclic pelvic pain were assessed on self-reported 11-point numeric rating scales both preoperatively and at six-month follow-up. Cases with poor prognosis in relation to dyspareunia were described individually in greater detail.ResultsPreoperative DDyspareunia showed weak correlation with dysmenorrhea (rho = .240; P = .014) and pelvic pain (rho = .260; P = .004). Although DDyspareunia improved significantly (P < .001) by 3 points or more in 75.8% (95%CI: 64.7–86.2) and disappeared totally in 59.7% of cases (95%CI:47.8–71.6), individual analysis identified different patterns of response. The probability of a preoperative moderate/severe DDyspareunia worsening more than 2 points was 4.8% (95%CI: 0.0–10.7) and the probability of a woman with no DDyspareunia developing “de novo” moderate or severe DDyspareunia was 7.7% (95%CI: 1.8–15.8) and 5.8% (95%CI: 0.0–13.0), respectively. In a qualitative analysis, several conditions were hypothesized to impact the post-operative DDyspareunia response; these included adenomyosis, mental health disorders, lack of hormone therapy after surgery, colporrhaphy, nodule excision in ENZIAN B compartment (uterosacral ligament/parametrium), the rectovaginal septum or the retrocervical region.ConclusionEndometriosis surgery provides significant improvement in DDyspareunia. However, patients should be alerted about the possibility of unsatisfactory results.
Assessing anaesthesiology and intensive care specialty physicians: An Italian language multisource feedback system
Authors: Carenzo Luca , Cena Tiziana , Carfagna Fabio , Rondi Valentina , Ingrassia Pier Luigi , Cecconi Maurizio , Violato Claudio , Della Corte Francesco , Vaschetto Rosanna 
Published: April 2021

Background
Physician professionalism, including anaesthesiologists and intensive care doctors, should be continuously assessed during training and subsequent clinical practice. Multi-source feedback (MSF) is an assessment system in which healthcare professionals are assessed on several constructs (e.g., communication, professionalism, etc.) by multiple people (medical colleagues, coworkers, patients, self) in their sphere of influence. MSF has gained widespread acceptance for both formative and summative assessment of professionalism for reflecting on how to improve clinical practice.

Methods
Instrument development and psychometric analysis (feasibility, reliability, construct validity via exploratory factor analysis) for MSF questionnaires in a postgraduate specialty training in Anaesthesiology and intensive care in Italy. Sixty-four residents at the Università del Piemonte Orientale (Italy) Anesthesiology Residency Program. Main outcomes assessed were: development and psychometric testing of 4 questionnaires: self, medical colleague, coworker and patient assessment.

Results
Overall 605 medical colleague questionnaires (mean of 9.3 ±1.9) and 543 coworker surveys (mean 8.4 ±1.4) were collected providing high mean ratings for all items (> 4.0 /5.0). The self-assessment item mean score ranged from 3.1 to 4.3. Patient questionnaires (n = 308) were returned from 31 residents (40%; mean 9.9 ± 6.2). Three items had high percentages of “unable to assess” (> 15%) in coworker questionnaires. Factor analyses resulted in a two-factor solution: clinical management with leadership and accountability accounting for at least 75% of the total variance for the medical colleague and coworker’s survey with high internal consistency reliability (Cronbach’s α > 0.9). Patient’s questionnaires had a low return rate, a limited exploratory analysis was performed.

Conclusions
We provide a feasible and reliable Italian language MSF instrument with evidence of construct validity for the self, coworkers and medical colleague. Patient feedback was difficult to collect in our setting.
Addressing the maldistribution of health resources in Sichuan Province, China: A county-level analysis
Authors: Ding Li , Zhang Ning , Mao Ying 
Published: April 2021

Introduction
The equity of health resource allocation geographically is a contested topic. Sichuan Province, located in Southwest China, has varied topography, providing us with natural materials to explore the determinants of health resource distribution.

Materials and methods
Spatial panel econometric models were constructed to explore the relationship between health resources and factors such as health care service demand and socioeconomic and demographic perspectives using data from Sichuan Province for eight consecutive years (2010–2017).

Results
Health care service demands were found to be a major driving force behind the distribution of health resources, showing that an increase in health care service demands draws health resources to specific counties and surrounding areas. From a socioeconomic perspective, gross domestic product per capita and the average wage show a positive association with health resources. In addition, the total population and proportion of the urban population have diverse effects in regard to health-related human resources but have the same effects on material and financial health resources.

Conclusions
Our results provide the Chinese government with evidence needed to formulate and promulgate effective policies, especially those aiming to tackle inequity among different regions.
How far from the gold standard? Comparing the accuracy of a Local Position Measurement (LPM) system and a 15 Hz GPS to a laser for measuring acceleration and running speed during team sports
Authors: Fischer-Sonderegger Karin , Taube Wolfgang , Rumo Martin , Tschopp Markus 
Published: April 2021

Purpose
This study compared the validity and inter- and intra-unit reliability of local (LPM) and global (GPS) position measurement systems for measuring acceleration during team sports.

Methods
Devices were attached to a remote-controlled car and validated against a laser. Mean percentage biases (MPBs) of maximal acceleration (amax) and maximal running speed (vmax) were used to measure validity. Mean between-device and mean within-device standard deviations of the percentage biases (bd-SDs and wd-SDs) of amax and vmax were used to measure inter- and intra-unit reliability, respectively.

Results
Both systems tended to underestimate amax similarly (GPS: –61.8 to 3.5%; LPM: –53.9 to 9.6%). The MPBs of amax were lower in trials with unidirectional linear movements (GPS: –18.8 to 3.5%; LPM: −11.2 to 9.6%) than in trials with changes of direction (CODs; GPS: –61.8 to −21.1%; LPM: −53.9 to –35.3%). The MPBs of vmax (GPS: –3.3 to –1.0%; LPM: –12.4 to 1.5%) were lower than those of amax. The bd-SDs and the wd-SDs of amax were similar for both systems (bd-SDs: GPS: 2.8 to 12.0%; LPM 3.7 to 15.3%; wd-SDs: GPS: 3.7 to 28.4%; LPM: 5.3 to 27.2%), whereas GPS showed better bd-SDs of vmax than LPM.

Conclusion
The accuracy depended strongly on the type of action measured, with CODs displaying particularly poor validity, indicating a challenge for quantifying training loads in team sports.