bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful Prednisolone Therapy in Elderly Patients with Severe Forms of Henoch–Schönlein Purpura Nephritis
Authors: Kato-Okada Saiko , Suzuki Hiromichi , Inoue Tsutomu , Kikuta Tomohiro , Okada Hirokazu 
Published: April 2015

Introduction Recently, Henoch–Schönlein purpura (HSP) has been observed in elderly people, although it was believed to be uncommon in these subjects. The increased risks of developing end-stage renal disease (ESRD) in adults in comparison with children were highlighted by different studies; however, limited data are available on the treatment of HSP nephritis in adults. Methods Between 2002 and 2008, five elderly Japanese patients (>65 years old) (mean age, 68 years, ranging from 65 to 72) with severe forms of HSP nephritis were entered into a prospective study to evaluate prednisolone therapy on the outcome of nephropathy in terms of clinical symptoms and histopathological changes. The patients were considered at risk of developing chronic renal failure when they presented with a nephrotic syndrome and crescentic glomeruli. Results At the last follow-up, 4–10 years after initiation of the therapy, four patients had clinically recovered and one died of lung cancer. No patients developed ESRD. The clinical outcome seemed to be correlated with glomerular activity (massive proteinuria and crescent formation). In spite of a relatively large dose of prednisolone, a few adverse effects, such as insomnia and skin lesions, were observed. Discussion Our preliminary small study suggests that renal outcome as well as survival of elderly patients with severe forms of HSP might be altered by aggressive prednisolone therapy.
Knowledge, Attitude and Behavior of Women toward Abnormal Menstrual Bleeding and Its Impact on Quality of Life
Authors: Kaur Harpreet , Sharma Sushmita , Goraya SPS 
Published: April 2015

ABSTRACT
Abnormal menstrual bleeding (AMB) is a common gynecological complaint. It may have serious repercussions on women's quality of life. Most of the studies on abnormal menstrual bleeding focus on the quantity of blood loss with little emphasis on the effect, it has on the quality of women's life. Recent research in the area of abnormal menstrual bleeding has recognized the importance of the ‘patient experience’ as an outcome that should be measured. So, it is very important to know about women's perception about the problem so that the healthcare professional can provide them appropriate care. The present study was undertaken to assess effect of AMB on various aspects of women's life and to assess their knowledge toward causes and management of AMB and its health impacts. Though majority of women know about abnormal bleeding as something serious, but still they lack in depth understanding of its consequences and various treatment modalities available.

Significance for public research
The article gives us valuable inputs regarding patient's viewpoint about abnormal uterine bleeding. Knowing the patients perceptions, their attitude toward abnormal menstrual bleeding and various social factors affecting it may be very helpful for the health professionals and researchers in knowing the impact of abnormal bleeding on quality of life and hence selecting the treatment strategies that will improve patient's satisfaction.

How to cite this article
Kaur H, Sharma S, Goraya SPS. Knowledge, Attitude and Behavior of Women toward Abnormal Menstrual Bleeding and Its Impact on Quality of Life. J South Asian Feder Obst Gynae 2015;7(1):5-9.
A Comparative Study to Evaluate the Efficacy and Safety of Single Dose Intravenous Iron Carboxymaltose vs Multidose Iron Sucrose in Postpartum Cases of Severe Iron Deficiency Anemia
Authors: Garg Ruchika , Rajvanshi Renu 
Published: April 2015

ABSTRACT

Objective
To evaluate the efficacy and safety of single dose intravenous iron carboxymaltose vs multidose iron sucrose in postpartum cases of severe iron deficiency anemia.

Materials and methods
One hundred cases with iron deficiency anemia in postpartum patient were selected from postpartum wards and assigned in two groups of 50 each. In group A, iron carboxymaltose injection administered by intravenous infusion upto a maximum single dose of 20 ml of iron carboxymaltose injection (1000 mg of iron). In group B Iron sucrose was given as 200 mg elemental iron (2 ampules of 5 ml) in 100 ml of 0.9% normal saline infusion over 15 minute alternate days up to 5 days. All the patients were monitored for rise in hemoglobin level at 2, 4, 8 and 12 weeks of iron therapy, adverse effect and rise in hematological parameter at 4 weeks.

Results
In group A, mean Hb level rise is 3.95 g/dl and in group B, it is 3.32 g/dl at 4 weeks of initial therapy. In group A, 100% cases achieved target Hb at 12 weeks after therapy while in group B 98% cases achieved target Hb at 12 weeks after therapy. In group A, 12% cases have grade 1 adverse reaction while in group B, 20% cases have adverse reaction.

Conclusion
Administration of intravenous iron has a good clinical result, with minimum adverse reactions. Thus, we can conclude that intravenous iron carboxymaltose therapy is safe, convenient, more effective and faster acting than intravenous iron sucrose for treatment of severe iron deficiency anemia in postpartum patient.

How to cite this article
Garg R, Singh S, Singh S, Rajvanshi R. A Comparative Study to Evaluate the Efficacy and Safety of Single Dose Intravenous Iron Carboxymaltose vs Multidose Iron Sucrose in Postpartum Cases of Severe Iron Deficiency Anemia. J South Asian Feder Obst Gynae 2015;7(1):18-21.
Cabergoline for Ovarian Hyperstimulation: A Review of Clinical Evidence
Authors: Garg Ruchika , Jain Meenal 
Published: April 2015

How to cite this articleGarg R, Singh S, Jain M. Cabergoline for Ovarian Hyperstimulation: A Review of Clinical Evidence. J South Asian Feder Obst Gynae 2015;7(1):30-32.
A Rare Case of Acute Axonal Motor Neuropathy in a Puerperal Woman
Authors: Sundari N , Swarup Asha , Nayak Ashwini , Girish Jyothi 
Published: April 2015

ABSTRACT
We report the case of a puerperal woman who presented to us with sepsis, multiorgan dysfunction and motor weakness of both lower limbs. On detailed evaluation, patient was found to have axonal neuropathy establishing the diagnosis of critical illness polyneuropathy (CIP). A high index of suspicion is required to arrive at the diagnosis as this condition is not only associated with high mortality and morbidity rates but also can affect the quality of life of the individual in the long-term. This case has been reported to highlight the importance of recognition of this common, but rarely diagnosed condition as it can help us to portend the prognosis.

How to cite this article
Nayak A, Sundari N, Swarup A, Girish J. A Rare Case of Acute Axonal Motor Neuropathy in a Puerperal Woman. J South Asian Feder Obst Gynae 2015; 7(1):48-49.
Malignant (Diffuse) Mesothelioma in Patients With Hematologic Malignancies: A Clinicopathologic Study of 45 Cases
Authors: Li Xin , Brownlee Noel A. , Sporn Thomas A. , Mahar Annabelle , Roggli Victor L. 
Published: April 2015

ContextIonizing radiation has a role in the development of malignant mesothelioma, in several epidemiologic studies, including patients with hematologic malignancies.ObjectiveTo study the clinicopathologic characteristics of patients with malignant mesothelioma and hematologic malignancies with and without a history of radiotherapy.DesignFrom a database of approximately 3600 patients with malignant mesothelioma, we identified 45 patients (1%) who also had hematologic malignancies. We examined clinicopathologic features and noted whether the patient had received radiotherapy for malignancy, comparing those with and those without such exposure.ResultsAmong the 45 cases, 18 (40%) had Hodgkin lymphoma, 15 (33%) had non-Hodgkin lymphoma, 10 (4%) had chronic lymphocytic leukemia, and 2 (22%) had chronic myelogenous leukemia; 20 patients (44%) had a history of radiotherapy, and 23 (51%) did not. Most patients with Hodgkin lymphoma (16 of 18; 90.0%) received radiation, whereas none of the patients with leukemia (0 of 12) and only 20% (3 of 15) of the patients with non-Hodgkin lymphoma did so. Patients without radiation were older than patients who received radiotherapy (median, 73 versus 54 years, respectively; P &lt; .001), had a shorter interval from diagnosis of hematologic malignancy to that of mesothelioma (median, 2 versus 24 years, respectively; P &lt; .001), and had a shorter survival period (median, 6.0 versus 14.0 months, respectively; P = .02). Epithelial mesotheliomas were proportionately more common in patients with a history of radiotherapy.ConclusionsPatients with mesothelioma and hematologic malignancies with a history of radiation tended to be younger, had a longer interval from diagnosis of hematologic malignancy to that of mesothelioma, had a longer survival period, and were more likely to have the epithelial variant compared with patients without radiotherapy.
Development and Initial Validation of a Program Director's Evaluation Form for Third-Year Residents
Authors: Artino Anthony R. , Dong Ting , Cruess David F. , Gilliland William R. , Durning Steven J. 
Published: April 2015

ABSTRACT
Background: Using a previously developed postgraduate year (PGY)-1 program director's evaluation survey, we developed a parallel form to assess more senior residents (PGY-3). The PGY-3 survey, which aligns with the core competencies established by the Accreditation Council for Graduate Medical Education, also includes items that reflect our institution's military-unique context. Purpose: To collect feasibility, reliability, and validity evidence for the new PGY-3 evaluation. Methods: We collected PGY-3 data from program directors who oversee the education of military residents. The current study's cohort consisted of Uniformed Services University of the Health Sciences students graduating in 2008, 2009, and 2010. We performed exploratory factor analysis (EFA) to examine the internal structure of the survey and subjected each of the factors identified in the EFA to an internal consistency reliability analysis. We then performed correlation analysis to examine the relationships between PGY-3 ratings and several outcomes: PGY-1 ratings, cumulative medical school grade point average (GPA), and performance on U.S. Medical Licensing Examinations (USMLE) Step 1, Step 2 Clinical Knowledge, and Step 3. Results: Of the 510 surveys we distributed, 388 (76%) were returned. Results from the EFA suggested four factors: “Medical Expertise,” “Professionalism,” “Military-unique Practice,” and “Systems-based Practice.” Scores on these four factors showed good internal consistency reliability, as measured by Cronbach's α (α ranged from 0.92 to 0.98). Further, as expected, “Medical Expertise” and “Professionalism” had small to moderate correlations with cumulative medical school GPA and performance on the USMLE Step examinations. Conclusions: The new program director's evaluation survey instrument developed in this study appears to be feasible, and the scores that emerged have reasonable evidence of reliability and validity in a sample of third-year residents.
America's Medical School: 5,000 Graduates Since the “First Class”
Authors: Artino Anthony R. , Gilliland William R. , Cruess David F. , Durning Steven J. 
Published: April 2015

ABSTRACT
In 1980, the Uniformed Services University of the Health Sciences (USU) graduated its first class of medical students. As a national university intended to produce “career-committed” military officers and future leaders of the Military Health System, USU functions as the service academy for military medicine and public health. More than 40 years after the school's charter and 5,000 graduates since the first class, we describe the original purpose of USU and provide an update on its achievements. In particular, we address the question of the “staying power” of the University's alumni—the degree to which graduation from the nation's military medical school is associated with long years of devoted service to military medicine. At a time when the MHS is confronting the challenge of extended deployments, rising health care costs, and a growing array of threats to our nation's health, we suggest that America needs USU now more than ever.
Longitudinal Effects of Medical Students' Communication Skills on Future Performance
Authors: Dong Ting , LaRochelle Jeffrey S. , Durning Steven J. , Saguil Aaron , Swygert Kimberly , Artino Anthony R. 
Published: April 2015

ABSTRACT
Background: The Essential Elements of Communication (EEC) were developed from the Kalamazoo consensus statement on physician–patient communication. The Uniformed Services University of the Health Sciences (USU) has adopted a longitudinal curriculum to use the EEC both as a learning tool during standardized patient encounters and as an evaluation tool culminating with the end of preclerkship objective-structured clinical examinations (OSCE). Medical educators have recently emphasized the importance of teaching communication skills, as evidenced by the United States Medical Licensing Examination testing both the integrated clinical encounter (ICE) and communication and interpersonal skills (CIS) within the Step 2 Clinical Skills exam (CS). Purpose: To determine the associations between students' EEC OSCE performance at the end of the preclerkship period with later communication skills assessment and evaluation outcomes in the context of a longitudinal curriculum spanning both undergraduate medical education and graduate medical education. Methods: Retrospective data from preclerkship (overall OSCE scores and EEC OSCE scores) and clerkship outcomes (internal medicine [IM] clinical points and average clerkship National Board of Medical Examiners [NBME] scores) were collected from 167 USU medical students from the class of 2011 and compared to individual scores on the CIS and ICE components of Step 2 CS, as well as to the communication skills component of the program directors' evaluation of trainees during their postgraduate year 1 (PGY-1) residency. In addition to bivariate Pearson correlation analysis, we conducted multiple linear regression analysis to examine the predictive power of the EEC score beyond the IM clerkship clinical points and the average NBME Subject Exams score on the outcome measures. Results: The EEC score was a significant predictor of the CIS score and the PGY-1 communication skills score. Beyond the average NBME Subject Exams score and the IM clerkship clinical points, the EEC score explained an additional 13% of the variance in the Step 2 CIS score and an additional 6% of the variance in the PGY-1 communication skills score. In addition, the EEC score was more closely associated with the CIS score than the ICE score. Conclusion: The use of a standardized approach with a communication tool like the EEC can help explain future performance in communication skills independent of other education outcomes. In the context of a longitudinal curriculum, this information may better inform medical educators on learners' communication capabilities and more accurately direct future remediation efforts.
Using Concept Maps in a Modified Team-Based Learning Exercise
Authors: Knollmann-Ritschel Barbara E.C. , Durning Steven J. 
Published: April 2015

ABSTRACTMedical school education has traditionally been driven by single discipline teaching and assessment. Newer medical school curricula often implement an organ-based approach that fosters integration of basic science and clinical disciplines. Concept maps are widely used in education. Through diagrammatic depiction of a variety of concepts and their specific connections with other ideas, concept maps provide a unique perspective into learning and performance that can complement other assessment methods commonly used in medical schools. In this innovation, we describe using concepts maps as a vehicle for a modified a classic Team-Based Learning (TBL) exercise. Modifications to traditional TBL in our innovation included replacing an individual assessment using multiple-choice questions with concept maps as well as combining the group assessment and application exercise whereby teams created concept maps. These modifications were made to further assess understanding of content across the Fundamentals module (the introductory module of the preclerkship curriculum). While preliminary, student performance and feedback from faculty and students support the use of concept maps in TBL. Our findings suggest concept maps can provide a unique means of determining assessment of learning and generating feedback to students. Concept maps can also demonstrate knowledge acquisition, organization of prior and new knowledge, and synthesis of that knowledge across disciplines in a unique way providing an additional means of assessment in addition to traditional multiple-choice questions.
Relationship of Neuroimaging to Typical Sleep Times During a Clinical Reasoning Task: A Pilot Study
Authors: Durning Steven J. , Kelly William , Costanzo Michelle E. , Artino Anthony R. , Vleuten Cees van der , Beckman Thomas J. , Roy Michael J. , Holmboe Eric S. , Wittich Christopher M. , Schuwirth Lambert 
Published: April 2015

ABSTRACT
Background: Sleep deprivation and fatigue have been associated with medical errors, clinical performance decrements, and reduced quality of life for both practicing physicians and medical students. Greater understanding of the impact of sleep quantity on clinical reasoning could improve patient care. The purpose of our pilot study was to examine relationships between clinical reasoning (assessed by functional magnetic resonance imaging) and sleep time (measured in different ways by actigraphy) while answering multiple-choice questions (MCQs) from licensing agencies. Methods: Residents and faculty were administered a clinical reasoning exercise (MCQs from licensing bodies) during functional magnetic resonance imaging. Usual sleep patterns were sampled with actigraphy. Covariate analysis was used to examine the relationship between sleep duration (mean sleep, minimum sleep, maximum sleep) and brain activity during clinical reasoning (solving MCQs from licensing bodies). Results: The mean sleep time over the duration of monitoring for the group was 7.19 hours (SD 0.66) with a range of 6.1 to 8.1 hours (internal medicine faculty 7.1 hours, SD 0.41; internal medicine residents 7.27 hours, SD 0.92). There was a negative relationship between activation in the prefrontal cortex and minimum sleep time while reflecting on MCQs. Conclusion: Our findings provide evidence that the quantity of sleep can modulate brain activity while completing a clinically meaningful task that should be confirmed in larger studies. Our findings suggest that the construct of sleepiness may be more complex than appreciated by many and that the most important of these sleep measures in terms of outcomes remains to be determined.
A new concept for an ocean bottom pressure meter capable of precision long‐term monitoring in marine geodesy and oceanography
Authors: Gennerich Hans‐Hermann , Villinger Heinrich 
Published: April 2015

AbstractLong‐term vertical seafloor displacements and geostrophic changes in the water column height could be easily monitored if pressure meters were less susceptible to drift. Currently, these signals, which have typical amplitudes from decimeters to less than 1 mm/yr, cannot be differentiated from instrumental drift. In this paper, we introduce and outline a new constructional concept for an ocean bottom pressure meter that aims for unequivocal detection and monitoring of long‐term trends. The concept is based on a differential pressure sensor that measures the pressure difference between the environment and a reference pressure within a sealed volume. This sealed volume conserves the instantaneous pressure at the moment of its closure at the monitoring location in a temperature‐compensated manner. Furthermore, the approach enables easy in situ calibration of the differential pressure gauge by simply opening the reference pressure chamber to the environment and checking the zero point offset.
Eastern termination of the Altyn Tagh Fault, western China: Constraints from a magnetotelluric survey
Authors: Xiao Qibin , Shao Guihang , Liu‐Zeng Jing , Oskin Michael E. , Zhang Jin , Zhao Guoze , Wang Jijun 
Published: April 2015

AbstractThe left‐lateral Altyn Tagh Fault forms the northern boundary of the Tibetan Plateau. The strike‐slip rate of the active Altyn Tagh Fault decreases northeastward and reduces close to zero as it passes north of the Qilian Shan. This geometry raises controversies on whether and how the fault terminates or extends further east. To address these controversies, wide‐band magnetotelluric data were collected along four profiles across the Altyn Tagh Fault ranging from 135 to 261 km in length. All four profiles are located in the foreland of the Qilian Shan Ranges and are oriented perpendicular to the inferred fault zone that could be the continuation of Altyn Tagh Fault. Both the two‐dimensional and three‐dimensional electrical resistivity models derived from our magnetotelluric data show that the Hexi Corridor crust is generally of low resistivity, whereas the crust of the Huahai–Jinta basin is, in general, of high resistivity with a local and isolated low‐resistivity anomaly within the mid‐lower crust. The generally high‐resistivity crust of the Huahai–Jinta basin may be rheologically unfavorable for the Altyn Tagh Fault passing through the basin toward the northeast. The entirely different electrical structure between the Hexi Corridor and its northern neighbors indicates the existence of a tectonic boundary that coincides with the Altyn Tagh Fault in the west and reverse faults in the east. The two‐dimensional electrical conductivity models suggest that the Altyn Tagh Fault transfers from a single fault in the west to a branching set of mainly dip‐slip faults in the east.
Processes and mechanisms for the model SST biases in the North Atlantic and North Pacific: A link with the Atlantic meridional overturning circulation
Authors: Zhang Liping , Zhao Chuanhu 
Published: April 2015

AbstractAlmost all of CMIP5 climate models show cold SST biases in the extratropical North Atlantic (ENA) and tropical North Atlantic (TNA) as well as in the North Pacific which are commonly linked with the weak simulated Atlantic meridional overturning circulation (AMOC). A weak AMOC and its associated reduced northward oceanic heat transport are associated with a cooling of the ENA Ocean, whereas the TNA cooling is attributable to both weak AMOC and surface heat flux. The cold biases in the ENA and TNA have remote impacts on the SST bias in the North Pacific. Here we use coupled ocean‐atmosphere model experiments to show the mechanisms and pathways by which the ENA and TNA affect the North Pacific. The model simulations demonstrate that the cooling SST bias in the North Pacific is largely due to the remote effect of the cooling SST bias in the ENA, while the remote impact of the TNA cooling SST bias is of secondary importance. The ENA cooling bias triggers the circumglobal teleconnection via the Northern Hemisphere annular mode, producing a strengthening of the Aleutian low, an enhancement of the southward Ekman and Oyashio cold advection, and thus a cooling SST in the North Pacific. In contrast, the TNA cooling produces a surface high extending to the eastern tropical North Pacific, inducing the northeasterly wind anomalies north, northerly cross‐equatorial wind anomalies, and northwesterly wind anomalies south of the equator. This C‐shape wind anomaly pattern generates an SST warming in the tropical southeastern Pacific, which eventually leads to an SST warming in the tropical central and western Pacific by the wind‐evaporation‐SST feedback. The tropical Pacific warming in turn leads to an SST cooling in the North Pacific by the Pacific North American teleconnection pattern.