bluuebunny/crossref_metadata_2025_split huggingface dataset:
Academic self-efficacy as a mediating variable between mental mindfulness and psychological and cognitive engagement of university students
Authors: Badawy Reda Rabie Abdel Halim 
Published: February 2023

University students play a significant role in shaping the future of nations and an effective university environment that can achieve psychological and cognitive engagement is very important. This research aims at identifying the mediating role of mental mindfulness between academic self-efficacy and engagement (psychological and cognitive) of university students. The self-efficacy scale, the mental mindfulness scale, and the university students' psychological and cognitive engagement scale were applied to a sample of (340) university students. Results demonstrated that academic self-efficacy mediates the relationship between mental mindfulness and psychological and cognitive engagement of university students. These results can be utilized in developing university students' mental mindfulness and providing those in charge of educational planning and policies with practical results that are beneficial in enhancing university students' self-efficacy, mental mindfulness, and engagement.
Keywords: Self-efficacy, mental mindfulness, engagement, mediating variable
Bilateral Sprengel Deformity With Bilateral Omovertebral Bone: An Unusual Case in an Adult Patient
Authors: Páscoa Pinheiro Joana , Fernandes Pedro , Sarmento Marco 
Published: February 2023

Case:
We describe an adult patient with bilateral Sprengel deformity (BSD) with bilateral omovertebral bone and thoracic spinal failure of segmentation (T2-T4) successfully surgically treated only at 19-year-old. After resection of the bilateral omovertebral bone and simultaneous relocation of the scapula, disabilities of the arm, shoulder, and hand score improved from 26.7 preoperatively to 2.5 at the 3-year follow-up.

Conclusion:
The surgical treatment of Sprengel deformity is typically recommended between 3 and 7 years of age when significant shoulder impairment and/or severe cosmetic concerns are present. The authors were able to achieve a successful surgical outcome in a patient with BSD despite an unusual late presentation.
Treatment of Advanced Kienböck's Disease Using 3D Printing Assisted Autologous Costochondral Transplantation
Authors: Zhu Zhenzhong , Tang Qian , Xu Jia , Gao Yun , Chen Yixuan , Yang Kai , Du Dajiang , Sheng Jiagen , Zhang Changqing 
Published: February 2023

Case:
We describe a patient with advanced Kienböck's disease, treated with 3-dimensional (3D) printing assisted costochondral transplantation. Cartilage shaping was achieved according to a biomimetic 3D-printed prosthesis designed by mirror symmetry of the healthy wrist. The inserted cartilage spacer was fixed using the autologous palmar longus tendon. After 14 months of follow-up, the patient had significant pain relief and had recovered nearly the full range of wrist motion. No significant absorption or osseous metaplasia of the cartilage was seen on the radiographic and magnetic resonance images.

Conclusion:
This costochondral transplantation strategy may offer a feasible treatment option for patients with severe Kienböck's disease.
Demographic Factors and Medical School Experiences Associated with Students' Intention to Pursue Orthopaedic Surgery and Practice in Underserved Areas
Authors: Cerasani Michele , Omoruan Moje , Rieber Carolyn , Nguyen Mytien , Mason Hyacinth R.C. , Clair Brian , Stain Steven C. , Mason Amadeus R. , Levin L Scott 
Published: February 2023

Introduction:
Physician shortages across the United States will affect access to orthopaedic care for patients. Orthopaedic surgery is predicted to have one of the largest shortages among surgical subspecialties by 2025, which will disproportionally affect patients in medically underserved areas. This study examines characteristics and experiences of graduating medical students interested in orthopaedic surgery who intend to practice in underserved areas (IPUAs).

Methods:
We analyzed deidentified data of AAMC Graduation Questionnaire respondents who matriculated between 2007 to 2008 and 2011 to 2012. Forty-eight thousand ninety-six (83.91%) had complete demographic, financial, and medical school elective data and were included in the study cohort. Multivariable logistic regression was performed to determine the correlation between student characteristics and intention to pursue orthopaedic surgery and IPUAs.

Results:
Of the 48,096 students with complete information, 2,517 (5.2%) intended to pursue a career in orthopaedic surgery. Among the orthopaedic students, men were less likely than women to report IPUAs (adjusted odds ratio [aOR], 0.6; 95% CI, 0.4-0.8). Students who identified as Black/African American (aOR, 5.0; 95% CI, 3.0-8.2) or Hispanic (aOR, 2.0; 95% CI, 1.1-3.5) were more likely than White students to report IPUAs. Medical students who intend to pursue orthopaedics and received a scholarship (aOR, 1.5; 95% CI, 1.1-2.0), participated in community research (aOR, 1.8; 95% CI, 1.4-2.3), or had a global health experience (aOR, 1.9; 95% CI, 1.5-2.5) were more likely to report IPUAs.

Discussion:
If orthopaedic surgeons who reported as medical students who reported IPUAs actually do so, recruiting and retaining more sex and race/ethnically diverse orthopaedic surgeons could reduce the impact of the impending shortage of orthopaedic surgeons in underserved areas. IPUA is correlated to medical school experiences related to cultural competency including global health experiences and community-based research projects.
AAMC Guidance on Interviewing for the 2022-2023 Residency Application Cycle
Authors: Mun Frederick , Badin Daniel , Snow Morgan , Harris Andrew B. , LaPorte Dawn M. , Aiyer Amiethab A. 
Published: February 2023

Background:
In May 2022, the Association of American Medical Colleges (AAMC) published guidelines regarding interviews for the 2022-2023 residency application cycle. These guidelines recommended virtual interviews and discouraged “hybrid” interviewing. We conducted a survey of orthopaedic program directors (PDs) to understand their perspectives on these new guidelines and their plans for the upcoming cycle.

Methods:
A 19-question multicenter, cross-sectional research survey was emailed to 98 PDs (38.8% response rate) through Qualtrics XM. Contact information was obtained from a public national database.

Results:
Most orthopaedic residency programs (60.5%) were planning on conducting in-person interviews before any AAMC and hospital guidelines, and most (65.8%) will likely be conducting virtual interviews post-guidelines. PDs voiced mixed opinions about virtual interviews (39.4% in favor vs. 47.4% against). PDs were also split on whether forgoing the AAMC guidance would be irresponsible for residency programs (47.4% believe it would be irresponsible vs. 44.8% believe it would not); however, a plurality are in favor of the AAMC's guidance (42.1%). Furthermore, PDs agreed that virtual interviews have disadvantages including favoring top-tier applicants, students from home institutions, and in-person rotators, making ranking applicants and learning about a program's culture more difficult. Most PDs (84.2%) felt that hybrid interviews would disadvantage applicants who would choose the virtual option.

Conclusion:
AAMC guidance seems to be influencing how most orthopaedic surgery programs will conduct residency interviews for the 2022-2023 cycle. Most PDs agreed with the AAMC guidelines but voiced concerns regarding several disadvantages for all 3 proposed interview options (virtual, in-person, and hybrid). Our results indicate that the recent AAMC guidelines may have contributed to a shift in opinions among PDs but are not sufficient to create a consensus on the best practices for residency interviews. Our findings should encourage solutions focused on the deeper systemic issues within the orthopaedic application process in the post-coronavirus 2019 pandemic era.
Analyses of Orthopaedic Surgery Residency Interviews
Authors: Adams Alexander J. , Sherman Matthew , Purtill James J. 
Published: February 2023

Background:
Interviews are a critical component of orthopaedic surgery residency selection for both the applicant and the program. Some institutions no longer report Alpha Omega Alpha (AOA) designation or class rank, and US Medical Licensing Examination (USMLE) Step 1 recently switched to pass/fail scoring. During the coronavirus disease 2019 (COVID-19) pandemic, all Accreditation Council for Graduate Medical Education programs conducted virtual interviews and subinternship rotations were restricted. These changes offer significant challenges to the residency match process. The purpose of this study was to examine the residency applicant interview and ranking process at a large urban academic university setting. We hypothesized that large variability exists among evaluations submitted by faculty interviewers and also that applicant academic factors (i.e., USMLE Step 1 score) would show association with final ranking.

Methods:
We retrospectively reviewed the 2020-2021 and 2021-2022 residency interview cycles, both conducted virtually due to the COVID-19 pandemic. Residency application (i.e., applicant demographic and academic backgrounds) and interview data (i.e., faculty interviewer scores) were recorded. Interobserver reliability among faculty interviewers was calculated. Statistical analysis was performed to determine factors associated with ranking of applicants.

Results:
There were 195 included applicants from the 2020 and 2021 interview cycles. There was no true agreement of interviewers' scoring of shared applicants (kappa intraclass coefficient range 0-0.2). Applicant factors associated with being ranked include applying to the match for the first time, USMLE Step 1 and 2 scores, educational break (vs. consecutive completion of college and medical school in 4 years each), higher class rank, and greater interviewer scores. Factors associated with better rank included additional degrees (i.e., PhD or MBA), couples match, AOA designation, educational break, underrepresented minority status, and notable attributes (i.e., collegiate athletics or Eagle Scout participation). Factors associated with worse rank included male sex, international medical graduate, prior match history, science major, extended research (i.e., >1 year spent in a research role), and home medical school students.

Conclusions:
There was significant variability and no reliability at our institution among faculty interviewers' applicant ratings. Being ranked was based more on academic record and interview performance while final rank number seemed based on applicant qualities. The removal of merit-based objective applicant measurements offers challenges to optimal residency applicant and program match.

Level of Evidence:
III (retrospective cohort study)
Where Do Orthopaedic Surgery Applicants Match on Their Rank Lists? A Survey of Incoming Residents
Authors: Imbergamo Casey , Sequeira Sean , Pizzo Dane , Wright Melissa , Boucher Henry 
Published: February 2023

Background:
The National Resident Matching Program reports match results by rank list position for all specialties in aggregate, but these data have not been previously reported for orthopaedic surgery specifically. The purpose of this study was to determine where orthopaedic applicants match on their rank lists in comparison to the national average for all specialties and to evaluate which factors may influence match results.

Methods:
This was a cross-sectional survey study distributed to all applicants to a single institution's orthopaedic surgery residency program. Metrics such as match result, USMLE scores, Alpha Omega Alpha (AOA) status, and research productivity, in addition to other applicant-specific traits were captured. Results were stratified by match status and rank list position, with subgroup analyses completed for applicants matching at highly ranked programs (1-3) vs. lower ranked programs (≥ 4).

Results:
The survey was distributed to 698 applicants with a response rate of 32% (n = 224), with a match rate of 85% (n = 191). Thirty-four percent of respondents matched at their top choice program, 15.2% at their second choice, 9.9% at their third, and 40.8% at their fourth or lower. When comparing the matched to unmatched applicant cohorts, there was a significant difference in number of programs ranked, AOA status, and sex. When comparing applicants who matched at highly ranked (1-3) vs. lower ranked (≥ 4) programs, there was a significant difference in USMLE board scores.

Conclusions:
Orthopaedic surgery residency applicants are significantly less likely to match at their first choice or within their top 3 choices when compared to the national average for all specialties. Number of contiguous ranks, AOA status, and female sex were found to be associated with successfully obtaining an orthopaedic residency position, whereas USMLE board scores were associated with matching higher on one's rank list, thus resulting in greater match satisfaction.

Level of Evidence:
III.
Interpretation of PROMIS Depression and Anxiety Measures Compared with DSM-5 Diagnostic Criteria in Musculoskeletal Patients
Authors: Cheng Abby L. , Downs Dana L. , Brady Brian K. , Hong Barry A. , Park Peter , Prather Heidi , Hunt Devyani M. 
Published: February 2023

Background:
There is growing awareness among orthopaedic clinicians that mental health directly impacts clinical musculoskeletal outcomes. The Patient-Reported Outcomes Measurement Information System (PROMIS) is increasingly used for mental health screening in this context, but proper interpretation of patient scores remains unclear. The purpose of the present study was to compare musculoskeletal patients’ PROMIS Depression and Anxiety scores with a board-certified clinical psychologist’s assessment of their depression and/or anxiety diagnoses, as defined by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.

Methods:
In this cross-sectional analysis, existing medical records were reviewed for 50 patients who presented to an interdisciplinary program within a tertiary care orthopaedic department for the treatment of ≥1 musculoskeletal condition. All patients completed PROMIS Depression and Anxiety measures and were evaluated by a board-certified clinical psychologist. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic accuracy of PROMIS Depression and Anxiety scores as compared with the psychologist’s diagnosis of a DSM-5 depressive or anxiety disorder.

Results:
Twenty-eight patients (56%) were diagnosed by the psychologist with a DSM-5 depressive disorder, and 15 (30%) were diagnosed with a DSM-5 anxiety disorder. The ROC analysis for PROMIS Depression had an area under the curve (AUC) of 0.82. The optimal score cutoff to predict a diagnosis of a DSM-5 depressive disorder was ≥53 (sensitivity, 79% [95% CI, 63% to 94%]; specificity, 86% [72% to 100%]; positive predictive value [PPV], 88% [75% to 100%]; negative predictive value [NPV], 76% [59% to 93%]). The ROC analysis for PROMIS Anxiety had an AUC of 0.67. The optimal score cutoff to predict a diagnosis of a DSM-5 anxiety disorder was ≥59 (sensitivity, 60% [95% CI, 35% to 85%]; specificity, 74% [60% to 89%]; PPV, 50% [27% to 73%]; and NPV, 81% [68% to 95%]).

Conclusions:
Modestly elevated PROMIS Depression scores were suggestive of the presence of a DSM-5 depressive disorder, whereas elevations in PROMIS Anxiety scores seemed to have less association with DSM-5 anxiety disorders. Nevertheless, neither PROMIS measure demonstrated adequate discriminant ability to definitively identify patients who met DSM-5 criteria.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Luminescent properties of Tb3+ doped sodium silica germanate glasses
Authors: Alvarez-Ramos Mario Enrique , Carrillo-Torres Roberto Carlos 
Published: February 2023

Abstract
Tb3+-doped sodium silica germanate glasses were fabricated by conventional melt quenching technique with dopant concentrations of 0.3 %mol and 0.9 %mol. Their structural characteristics were analyzed by means of X-ray diffraction and Raman spectroscopy. The study of their optical properties was carried out through steady-state and time-resolved fluorescence spectroscopies. The emission spectra of both glasses are dominated by 5D4 → 7FJ manifold transitions. The most intense band, associated to 5D4 → 7F5 transition, shows a clear split into two peaks (545 nm 549 nm) due to crystal field splitting. The decay of Tb3+ emission at 458 nm exhibits a non-exponential evolution accompanied by a shortening of its lifetime as the concentration of Tb3+ increases, due to a non-radiative Tb3+-Tb3+ energy transfer through the cross-relaxation mechanism [5D3, 7F6] → [5D4, 7F0] between two terbium ions. The color coordinates at different excitation wavelengths lie in the yellow-green region of the Commission International de lˊEclairage chromaticity diagram. The results indicate that the studied glasses can be used in applications as solid-state lighting and display devices.
Human Gait Modeling with Step Length Estimation based on Single Foot Mounted Inertial Sensors
Authors: Gayen Bibhas , Sadhukhan Pampa , Chowdhury Chandreyee , Mukherjee Nandini , Das Pradip K. 
Published: February 2023

Abstract
The rapid growth of mobile communication and pervasive computing technology has expanded the demand for location-based services in urban areas, which necessitate accurate localization and tracking of the user. Due to very poor performances of global positioning system (GPS) in indoor areas and urban canyons, various radio frequency (RF) technologies have been exploited by many researchers to design indoor positioning systems (IPSs) over the years. However, such RF based IPSs would work only in the presence of certain infrastructure. The emergence of low-cost inertial sensors like accelerometer, gyroscope etc., on the other hand, has motivated the researchers to design pedestrian dead reckoning (PDR) based IPSs as they do not depend on availability of any sort of infrastructure in the surrounding environment. Step length estimation (SLE) is an integral part of PDR based localization. We, thus, aim to design a SLE technique in this paper, by processing signal measurements collected from the inertial sensors attached to some body parts.
Our proposed SLE method requires only a simple foot-mounted inertial sensor unit integrating three-axis accelerometer and gyroscope and it uses Butterworth low-pass filter to remove the noises from both acceleration and angular velocity signals. A normalized threshold and minimum time constraint-based peak-valley detection algorithm is also employed by our proposed method to calculate the swing phase duration. The proposed SLE technique uses only one user-specific parameter which is also calibrated for five different users in this paper. The performances of the proposed SLE technique are then evaluated and compared with some existing method in terms of accuracy to demonstrate the efficacy of the proposed method. Moreover, the relationships between the gait features and step length of the pedestrians as well as the same between their body mass index and the calibrated parameter are also examined in this paper.
Different intensities of electroacupuncture for peripheral facial paralysis sequelae: study protocol for a randomized placebo-controlled trial
Authors: Huang Jianpeng , Cheng Weili , Chen Zizhen , Lai Meiqi , Li Wenting , Chen Mingquan , Li Sheng , Li Kai , Liu Jianhua 
Published: February 2023

Abstract
Background: Peripheral facial paralysis (PFP) is a common neurological disease. Many patients have obtained benefits from the treatment of PFP sequelae by electroacupuncture (EA). However, there is limited evidence for the efficacy between different EA intensities. Hence, this study presents a new approach based on different EA intensities to verify the effectiveness by combining neurological function scales in the sequelae of PFP.
Methods: In this placebo-controlled trial, a total of 66 patients with peripheral facial paralysis sequelae will be randomly divided into sensory threshold stimulation, motor threshold stimulation and sham EA groups. All patients undergo two periods in this study, including the treatment period (56 days) and the follow-up period (30 days). House-Brackmann grade and facial disability index scale will be measured as primary outcome before, 4 weeks treatment, after treatment and follow-up. The secondary outcome measures will be facial nerve electromyography (EMG) and blink reflex (BR) detection before and after treatments.
Conclusion: This trial will evaluate the effect of different EA intensities for treating sequelae of PFP compared to sham EA. We hope this trial will provide effective treatment parameters for PFP sequelae.
Trial registration: ClinicalTrials.gov Identifier: ChiCTR2200062310. Date: August 1, 2022.
Sustainable land management enhances ecological and economic multifunctionality under ambient and future climate
Authors: Scherzinger Friedrich , Schädler Martin , Reitz Thomas , Yin Rui , Auge Harald , Merbach Ines , Roscher Christiane , Harpole William , Berger Sigrid , Blagodatskaya Evgenia , Siebert Julia , Ciobanu Marcel , Quaas Martin , Eisenhauer Nico 
Published: February 2023

Abstract

Anthropogenic activity is threatening ecosystem multifunctionality, i.e. the ability of ecosystems to provide multiple functions and services which are vital for human well-being. Here we assess how multifunctionality of agroecosystems in Central Germany depends on land-use type and climate change. Our analysis included 13 ecosystem functions in a large-scale field experiment with five different land-use types (three grassland and two farmland types either sustainably or intensively managed) under two different climate scenarios (ambient and future climate). We consider ecological measures of multifunctionality using averaging approaches with different weights, i.a. reflecting preferences of farmers and environmentalists, and assess an economic multifunctionality measure based on the total value of ecosystem services. Results show that intensive management and future climate decrease ecological multifunctionality for multiple weighting
scenarios in both grassland and farmland. Only under a weighting according to farmers' preferences, intensively-managed grassland shows higher multifunctionality as compared to sustainably-managed grassland. The economic multifunctionality measure, which includes economic benefits for society at large, reveals a multifunctionality about ~1.7 times higher for sustainable compared to intensive management for both grassland and farmland. Above-belowground biodiversity correlates positively with ecosystem multifunctionality and is expected to be one of its main drivers. Based on these findings, we suggest to promote and economically incentivise sustainable land management that enhances both ecological and economic multifunctionality, also under future climatic conditions.