bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pilot Study on the Influence of Facial Expression on Measurements in Three-Dimensional Digital Surfaces of the Face in Infants with Cleft Lip and Palate
Authors: Hermann N.V. , Darvann T.A. , Larsen P. , Lindholm P. , Andersen M. , Kreiborg S. 
Published: April 2015

Objective Three-dimensional surface imaging is an increasingly popular modality for face measurements in infants with cleft lip and palate. Infants are noncompliant toward producing specific facial expressions, and selecting the appropriate moment of acquisition is challenging. The objective was to estimate amount and spatial distribution of deformation of the face due to facial expression in infants with cleft lip and palate and provide recommendations for an improved acquisition protocol, including a method of quality control in terms of obtaining images with true neutral expression. Material and Methods Three-dimensional surface images of ten 4-month-old infants with unrepaired cleft lip and palate were obtained using a 3dMDface stereophotogrammetric system. For each subject, five surface images judged as representing a neutral expression were obtained during the same photo session. Mean and maximum deformations were calculated. A formalized review was performed, allowing the image exhibiting the “best” neutral expression to be selected, thus decreasing errors due to residual facial expression. Results Deformation due to facial expression generally increased from forehead to chin. The amount of deformation in three selected regions were determined: nose (mean, 1 mm; maximum = 3 mm); cleft region (mean, 2 mm; maximum = 5 mm); chin region (mean, 5 mm; maximum = 12 mm). Analysis indicated that introduction of a formalized review of images could reduce these errors by a factor of 2. Conclusions The continuous change of facial expression in infants represents a substantial source of error; however, this may be reduced by incorporating a formalized review into the acquisition protocol.
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 &gt; .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 &gt; .05). No group × time interactions were noted for 1-RM, heat shock protein 70, or creatine kinase (P &gt; .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

ABSTRACT
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

ABSTRACTObjectiveTo present five cases of unruptured tubal ectopic pregnancies treated with ultrasound-guided aspiration with local potassium chloride (KCl) or systemic methotrexate (MTX) administration.DesignCase series.SettingA hospital-based prospective study.PatientsFive women with unruptured tubal ectopic pregnancy.InterventionsTransvaginal ultrasound-guided aspiration of tubal ectopic pregnancy followed by local KCl or intramuscular injection of MTX (50 mg/m2).Main outcome measuresSuccessful conservative treatment of tubal ectopic pregnancies with preservation of fallopian tubes.ResultsFour (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.ConclusionTransvaginal 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 articleMishra 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

ABSTRACT

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.
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 {\&amp;} Liu, 2013; Wang {\&amp;} 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.
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

ABSTRACT
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

ABSTRACT
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

ABSTRACT
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 &lt; 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

ABSTRACT
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 &lt; 0.05) and cumulative GPA (r = 0.38, p &lt; 0.05). Positive correlations were also noted between the average overall fitness score and preclerkship GPA (r = 0.34, p &lt; 0.05), medical school cumulative GPA (r = 0.34, p &lt; 0.05), and the score on Step 1 of the national board examination (r = −0.33, p &lt; 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

ABSTRACT
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 &lt; 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

ABSTRACT
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

ABSTRACTNearly 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.
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

ImportanceHemorrhagic 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.ObjectivesTo 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 ParticipantsThis 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.ExposuresCity-level monthly flooding, elevation, ruggedness index, and closest distance from each city to the Yangtze River and its tributaries.Main Outcomes and MeasuresThe 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.ResultsA 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 RelevanceThis 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.