bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inter- and Intra-observer Variation of Schatzker Classification of Tibial Plateau Fractures and Morphological Characteristics of Each Fracture Subtype on Computed Tomography Scan
Authors: Gupta Siddharth , Malhotra Raskesh , Srivastava Amit , Arora Rajesh , Aggarwal Aditya N. , Mishra Puneet 
Published: June 2022

Background:
There is little information regarding inter- and intra-observer variation when classifying tibial plateau fractures using Schatzker classification system. There is paucity of literature regarding morphological characteristics of each Schatzker subtype on computerized tomography.

Materials and Methods:
Fifty-three patients (age 18–70 years) of either sex with fresh (<3 weeks old), closed tibial plateau fracture were included after obtaining their informed consent. Patients with previous surgery around tibia or knee and the ones with pathological fractures were excluded from the study. Standard plain radiographs (anterior, posterior, and lateral views) and an additional noncontrast computed tomography (CT) scan (with three-dimensional reconstruction) of knee and leg of the affected side were done. Five different surgeons classified these fractures as per Schatzker classification on two separate occasions. The intra- and inter-observer variations were calculated using the kappa test of Cohen. Additional morphological characteristics were also evaluated on CT scan.

Results:
The mean kappa values for five observers (A to E) for inter-observer agreement on Schatzker classification were 0.41 (moderate). The mean kappa value for intra-observer agreement was 0.71 (substantial). Six morphological characteristics were defined on CT scan-lateral condylar impaction (79.2%), tibial tuberosity fracture (3.8%), coronal plane (3.8%), tibial spine avulsion (22.6%), medial condylar impaction (17%), and posteromedial shear fracture (7.5%).

Conclusion:
There is inter- and intra-observer variation in Schatzker classification of tibial plateau fracture. The intra-observer variation (kappa 0.71) was found to be greater than the inter-observer variation (kappa 0.41). The additional morphological characteristics of tibial plateau fractures are better evaluated on CT scan. The articular depression, splits, and fracture geometry are better delineated on a CT scan than on plain X-rays alone.
The Safety and Efficacy of Biceps Tenodesis Performed using a Novel Suture Anchor
Authors: Johnson Andrea H. , Fowler M. Brook , West Michaline , Turcotte Justin J. , Redziniak Daniel E. 
Published: June 2022

Introduction:
Biceps tendon degeneration or tearing is a significant cause of shoulder discomfort and dysfunction. Biceps tenodesis is commonly performed to treat symptomatic biceps tendon pathology. A variety of fixation techniques can be used including screw fixation, endobutton, or suture anchor techniques. This study examines the patient outcomes when the FOOTPRINT™ Ultra suture anchor system is used for biceps tenodesis.

Materials and Methods:
Retrospective review of consecutive patients undergoing biceps tenodesis was conducted. All patients underwent biceps tenodesis using the FOOTPRINT™ Ultra suture anchor. The primary endpoint was any device-related complication during the intraoperative or postoperative period. Descriptive and inferential statistics were performed to assess patient characteristics and outcomes.

Results:
Twenty-nine patients were included in this study; 20 (69.0%) underwent arthroscopic biceps tenodesis and the remainder underwent open surgery. The mean follow-up time was 8.51 ± 5.28 months postoperatively. One patient experienced a postoperative infection within the first 30 days requiring a return to the operating room. Two patients experienced a complication within the first 6 months postoperatively. No patients experienced a device-related complication. No patients experienced a retear of their biceps tendon; two patients experienced a retear to their rotator cuff repair. The mean pain Numeric Rating Scale improved from 5.88 ± 2.58 on a scale of 0–10 preoperatively to 1.94 ± 2.32 postoperatively (P < 0.001).

Conclusion:
The FOOTPRINT™ Ultra suture anchor appears to be safe for the use in patients undergoing arthroscopic or open biceps tenodesis.
To Evaluate the Role of Intralesional Injection of Platelet-Rich Plasma versus Corticosteroid (Triamcinolone) in Plantar Fasciitis
Authors: Solanki Mahendra , Kelkar Rajeev , Baghel Pawan 
Published: June 2022

Introduction:
Plantar fasciitis is an aseptic inflammation of the plantar fascia and also the most common cause of plantar heel pain. Approximately more than 10% of the population is affected by it over their lifetime.

Aims and Objectives:
The aim of this study is to evaluate the role of platelet-rich plasma (PRP) versus corticosteroid (triamcinolone) therapy in plantar fasciitis and to study the complications associated with both the procedures and their management.

Materials and Methods:
The study included 36 patients of plantar fasciitis (fulfilling the inclusion criteria) who presented to the OPD/Casualty of Department of Orthopaedics and Traumatology, M.G.M. Medical College and M.Y. Hospital, Indore, between September 2018 and August 2020. The study was a prospective and interventional type.

Results:
The mean Roles and Maudsley Subjective Pain score (RMSPS) score at pretreatment was 3.72 ± 0.46 for PRP and 3.72 ± 0.46 for steroids; at 1 month, it was 1.61 ± 0.78 for PRP and 1.44 ± 0.70 for steroids; and at 6 months, it was 1.22 ± 0.55 for PRP and 1.94 ± 0.73 for steroids. The mean Visual Analog Scale (VAS) score at pretreatment was 7.72 ± 0.96 for PRP and 7.78 ± 1.0 for steroids; at 1 month, it was 2.89 ± 1.68 for PRP and 2.50 ± 1.47 for steroids; and at 6 months, it was 1.28 ± 1.49 for PRP and 2.61 ± 1.69 for steroids. PRP injections have shown effectiveness in providing pain relief, improving function in plantar fasciitis patients. As a result, VAS and RMSPS score was significantly reduced (P = 0.015) at 6 months as compared to preprocedure and thus proved the effectiveness of the PRP therapy. It also shows that PRP is a better method in reducing pain in plantar fasciitis compared to steroid injection.

Conclusion:
Our study demonstrates PRP injection to be an effective and well-tolerated alternative to corticosteroid injection in the management of chronic plantar fasciitis with an added advantage of almost no side effects due to its biological nature and better patient compliance.
Insights into Plasmodium vivax Asymptomatic Malaria Infections and Direct Skin-Feeding Assays to Assess Onward Malaria Transmission in the Amazon
Authors: Moreno Marta , Torres Katherine , Tong Carlos , García Castillo Stefano S. , Carrasco-Escobar Gabriel , Guedez Gerson , Torres Lutecio , Herrera-Varela Manuela , Guerra Layné , Guzman-Guzman Mitchel , Wong Daniel , Ramirez Roberson , Llanos-Cuentas Alejandro , Conn Jan E. , Gamboa Dionicia , Vinetz Joseph M. 
Published: June 2022

ABSTRACT.
Understanding the reservoir and infectivity of Plasmodium gametocytes to vector mosquitoes is crucial to align strategies aimed at malaria transmission elimination. Yet, experimental information is scarce regarding the infectivity of Plasmodium vivax for mosquitoes in diverse epidemiological settings where the proportion of asymptomatically infected individuals varies at a microgeographic scale. We measured the transmissibility of clinical and subclinical P. vivax malaria parasite carriers to the major mosquito vector in the Amazon Basin, Nyssorhynchus darlingi (formerly Anopheles). A total of 105 participants with natural P. vivax malaria infection were recruited from a cohort study in Loreto Department, Peruvian Amazon. Four of 18 asymptomatic individuals with P. vivax positivity by blood smear infected colony-grown Ny. darlingi (22%), with 2.6% (19 of 728) mosquitoes infected. In contrast, 77% (44/57) of symptomatic participants were infectious to mosquitoes with 51% (890 of 1,753) mosquitoes infected. Infection intensity was greater in symptomatic infections (mean, 17.8 oocysts/mosquito) compared with asymptomatic infections (mean, 0.28 oocysts/mosquito), attributed to parasitemia/gametocytemia level. Paired experiments (N = 27) using direct skin-feeding assays and direct membrane mosquito-feeding assays showed that infectivity to mosquitoes was similar for both methods. Longitudinal studies with longer follow-up of symptomatic and asymptomatic parasite infections are needed to determine the natural variations of disease transmissibility.
Case Report: Community-Acquired Burkholderia cepacia Pneumonia of a Patient with Pulmonary Tuberculosis
Authors: Li Qiang , Ma Li-Ping 
Published: June 2022

ABSTRACT.
Community-acquired Burkholderia cepacia pneumonia is rare. We report a 29-year-old female who suffered pulmonary tuberculosis and developed community-acquired Burkholderia cepacia pneumonia, which was confirmed by the culture of the pulmonary tissue. The patient received antitubercular therapy. Meanwhile, she was treated with meropenem and minocycline. The patient was followed up for 6 months, and she achieved complete absorption of lung lesions.
The Reliability of Graduate Medical Education Quality of Care Clinical Performance Measures
Authors: Kim Jung G. , Rodriguez Hector P. , Holmboe Eric S. , McDonald Kathryn M. , Mazotti Lindsay , Rittenhouse Diane R. , Shortell Stephen M. , Kanter Michael H. 
Published: June 2022

ABSTRACT

Background
Graduate medical education (GME) program leaders struggle to incorporate quality measures in the ambulatory care setting, leading to knowledge gaps on how to provide feedback to residents and programs. While nationally collected quality of care data are available, their reliability for individual resident learning and for GME program improvement is understudied.

Objective
To examine the reliability of the Healthcare Effectiveness Data and Information Set (HEDIS) clinical performance measures in family medicine and internal medicine GME programs and to determine whether HEDIS measures can inform residents and their programs with their quality of care.

Methods
From 2014 to 2017, we collected HEDIS measures from 566 residents in 8 family medicine and internal medicine programs under one sponsoring institution. Intraclass correlation was performed to establish patient sample sizes required for 0.70 and 0.80 reliability levels at the resident and program levels. Differences between the patient sample sizes required for reliable measurement and the actual patients cared for by residents were calculated.

Results
The highest reliability levels for residents (0.88) and programs (0.98) were found for the most frequently available HEDIS measure, colorectal cancer screening. At the GME program level, 87.5% of HEDIS measures had sufficient sample sizes for reliable measurement at alpha 0.7 and 75.0% at alpha 0.8. Most resident level measurements were found to be less reliable.

Conclusions
GME programs may reliably evaluate HEDIS performance pooled at the program level, but less so at the resident level due to patient volume.
Effects of COVID-19 on Residency and Fellowship Training: Results of a National Survey
Authors: Hogan Sean O. , Holmboe Eric S. 
Published: June 2022

ABSTRACT

Background
The COVID-19 pandemic has affected every facet of American health care, including graduate medical education (GME). Prior studies show that COVID-19 resulted in reduced opportunities for elective surgeries, lower patient volumes, altered clinical rotations, increased reliance on telemedicine, and dependence on virtual didactic conferences. These studies, however, focused on individual specialties. Because the Accreditation Council for Graduate Medical Education (ACGME) routinely collects information from all programs it has an obligation to use these data to inform the profession about important trends affecting GME.

Objective
To describe how the pandemic influenced resident training across all specialty programs in areas of clinical experiences, telemedicine, and extended trainings.

Methods
The ACGME validated a questionnaire to supplement the Annual Update reporting requirements of all accredited programs. The questionnaire was tested to ensure easy interpretation of instructions, question wording, response options, and to assess respondent burden. The questionnaire was administered through the Accreditation Data System, which is a password-protected online environment for communication between the ACGME and ACGME-accredited programs.

Results
We received a response rate of 99.6% (11 290 of 12 420). Emergency medicine, family medicine, internal medicine, and obstetrics and gynecology programs experienced the most significant impact. Most programs reported reduced opportunities for in-person didactics and ambulatory continuity rotations. Hospital-based programs on the “frontline” of COVID-19 care relied least on telemedicine. Family medicine and internal medicine programs accounted for the greatest number of extended trainings.

Conclusions
COVID-19 has affected GME training, but its consequences are unevenly distributed across program types and regions of the country.
PEMBELAJARAN PADA MASA PANDEMI COVID-19: PENGEMBANGAN MODUL BERBASIS INTEGRATIF DAN KOLABORASI BAGI ORANG TUA DALAM PENDAMPINGAN ANAK TUNARUNGU
Authors: Variani Ludfia Ida 
Published: June 2022

Tujuan penulisan Best Practise ini adalah untuk 1) mengetahui gambaran kesiapan orang tua dalam mendampingi anak belajar di rumah 2) mengembangkan modul berbasis inkola sebagai panduan kesiapan orang tua dalam pendampingan anak tunarungu belajar di rumah, 3) mengetahui efektifitas modul berbasis inkola sebagai panduan orang tua dalam pendampingan anak tunarungu belajar di rumah di masa pandemi covid-19. Penelitian dilaksanakan pada bulan Februari-Maret 2021 di SLB Negeri 1 Mataram. Sampel penelitian ini adalah 5 peserta didik tunarungu kelas 1 SDLB . Penelitian ini menggunakan pendekatan eksperimen dengan pretest posttest one group design. Tahapan penelitian ini dilakukan dengan 1) menemukan kebutuhan pembelajaran bagi orang tua , 2) merancang modul , dan 3) melakukan ujicoba modul untuk menemukan efektivitas modul. Teknik yang digunakan wawancara dengan orang dan tes. Hasil penelitian menunjukkan terdapat peningkatan kesiapan orang tua dalam mendampingi anak belajar. Pada aspek fisik sebesar 24% , aspek psikis 32% dan aspek material 71,93 %. Modul pembelajaran efektif untuk memberikan kemudahkan orang tua pada aspek kesiapan baik fisik, psikis dan material dengan baik. Tingginya intensitas kesiapan orang tua dalam mendampingi anak belajar di rumah berdampak pada meningkatnya pemahaman orang tua terhafdap peserta didik tunarungu kelas I SDLB dalam menyelesaikan modul yang diberikan sekolah selama mendampingi belajar di rumah di masa pandemic covid-19.
Pseudobasophilia: A Helpful Screening Tool in Diagnosis of Dengue
Authors: Mavra Fatima  , Ayesha Younas  , Ayisha Imran  , Asma Nasir  , Nauman Aslam Malik  , Omar Rasheed Chughtai  , Akhtar Sohail Chughtai  
Published: June 2022

Introduction: Pakistan is dealing with an epidemic situation of dengue. Serological testing for its diagnosis is not available everywhere across the country. So, in the current scenario, basophilia flagged by automated hematology analyzer can be a helpful screening tool in early diagnosis and prognosis of dengue in a resource limited country like ours.
Aims & Objectives: To assess the utilization of basophilia flag as a screening tool in early diagnosis of dengue by studying the frequency of basophilia flag and it's prognostic significance by correlating absolute basophil count with severity of thrombocytopenia.
Place and duration of study: It was a cross sectional study and conducted at Chughtai Institute of Pathology from August 2021 to October 2021.
Material & Methods: Total 1007 patients who had NS1 positive confirmed dengue infection were included in the study and EDTA blood samples were run on Mindray BC-6800 six-part hematology analyzer. Basophilia flag was noted, its frequency was calculated and expressed as percentage. Also, correlation of absolute basophil count with platelet count was calculated. Statistical analysis was performed using SPSS 23.0, p value <0.05 was taken as significant.
Results: WBC flag showing “basophilia” was seen in 136 patients (13.6%) and a significant correlation was seen between raised absolute basophil count and thrombocytopenia using Pearson test.
Conclusion: Pseudobasophilia is an important screening tool in diagnosing dengue patients and as significant prognostic marker as increased absolute basophilic count correlates with severity of thrombocytopenia.
Therapeutic Effect of Berberine Versus Methotrexate on Histopathology in a Rat Model of Pristane-Induced Arthritis
Authors: Nisar Ahmed  , Amer Hassan Siddiqui  , Ambereen Anwar  , Muhammad Nauman Shad  , Abdul Karim  
Published: June 2022

Introduction: Treatment options for rheumatoid arthritis have potentially fatal adverse effects and failure to achieve complete cure. Alternative medicines are, therefore, being researched for this purpose. Berberine is one of such compounds with high antioxidant activity that may prove beneficial in this disease.
Aims & Objectives: To compare effects of berberine with methotrexate on pristane induced arthritis in rats.
Place and duration of study: Post Graduate Medical Institute, Lahore; March to May 2014.
Material & Methods: Forty female Sprague Dawley rats were allotted to five groups including a berberine control. Arthritis developed in 14 days with a single intradermal injection of pristane in arthritis control and experimental groups. Starting Day 15, berberine and methotrexate were administered as single daily intraperitoneal injection for next 14 days. Arthritis resolution was assessed by measuring body weight, clinical score of arthritis on day 0, 14 and 28 and joint histopathology terminally. Data was analyzed using SPSS version 20, p value <0.05 was considered significant.
Results: Arthritis induction reduced body weight in pristane administered groups (142.87 ± 3.56, 146.25 ± 7.49, 112.37 ± 6.23, 114.50 ±3.85, 113.62 ± 7.72 g in Group I, II, III, IV and V respectively) at day 14. Berberine and methotrexate treatment restored body weight in comparison to continuous loss in arthritis control animals on day 28 (155.87 ± 3.72,
162.00 ± 7.96, 105.25 ± 8.04, 133.75 ± 4.89, 133.12 ± 9.24 g in Group I, II, III, IV and V respectively). Berberine and methotrexate both reduced joint inflammation (clinical score 15±1.51, 6.75±1.48, 3.25±1.48 in arthritis control, berberine and methotrexate treated groups). Methotrexate was, however, more effective in reducing clinical arthritis score than berberine on day 28 (p value <0.001). Histopathological changes were reversed similarly by both drugs.
Conclusion: Berberine is effective in treating rheumatoid arthritis though less than methotrexate.
Reopening of Universities for On-Campus Teaching In COVID-19 Pandemic: Status of Generalized Anxiety in Medical Students
Authors: Saadia Shahzad  , Sarosh Saleem  
Published: June 2022

Introduction: Academic institutions all over the world have been closed for physical classes for a long time. This research is primarily focused upon the reopening of the institutions and the state of anxiety in medical students on this account.
Aims & Objectives: We aim to assess the status of generalized anxiety levels in medical students across the country about resuming on-campus academic activities during the ongoing COVID-19 Pandemic.
Place and duration of study: All PMC recognized undergraduate public and private medical colleges across Pakistan during the period of Sept-Nov 2020.
Material & Methods: A descriptive cross-sectional study was conducted on a target population of currently enrolled undergraduate medical students across Pakistan who could be accessed through social media. Study variables included socio-demographic variables such as age, gender, class, college type, residential status of student, stress, and anxiety. The sample size was calculated on Open Epi version 3 using 50% assumed prevalence; and sample size was 579, rounded up to 580.Data was collected from a sample of 585 across the country during Sept-Nov 2020. The data collection instrument included: a standardized and validated Generalized Anxiety Disorder-7(GAD-7) questionnaire along with a few socio-demographic questions. Mean and SD values and frequency trends of all variables were recorded. GAD level, anxiety scores and associations were determined through Chi-square test of significance, independent sample t-test, and Regression analysis model.
Results: Showed that 41% of the respondents had anxiety when assessed on the GAD-7 questionnaire; 67% of students were afraid of getting infected while on campus; 49% preferred online education in the present situation; significant associations were found between anxiety scores and respondents' age. Regression analysis revealed that the female students were 1.47 times more anxious and stressed than male students regarding the reopening of universities and continuation of physical education.
Conclusion: The students, particularly, have anxiety about the reopening of institutions amidst the pandemic. The impact on the mental health of the students requires special attention as the anxiety of being on-campus during the pandemic is markedly observed.
A SÍNDROME DE TURNER E AS PERSPECTIVAS PARA O TRATAMENTO: UMA REVISÃO INTEGRATIVA
Authors: Araújo Amanda Caroline dos Passos , Morais Shirley Cardoso , Batista Nelson Jorge Carvalho 
Published: June 2022

A Síndrome de Turner (ST) é uma anormalidade cromossômica sexual caracterizada pela ausência de um cromossomo X (cariótipo 45, X, 46 X iso), mosaicismo cromossômico (cariótipo 45, X/46, XX, XY), frequente em mulheres. O objetivo deste estudo foi analisar as produções científicas acerca das perspectivas de tratamento para a Síndrome de Turner. Trata-se de uma revisão integrativa da literatura (RIL), conduzida por dois revisores independentes, nas bases de dados LILACS, PubMed e Scielo, no período de março de 2022, utilizando-se a estratégia de busca PICo. A análise dos dados ocorreu por meio da leitura detalhada dos artigos categorizados. Utilizando os critérios de inclusão e exclusão foram selecionados 6 artigos e os resultados mostraram que os tratamentos usados para a ST, são principalmente o Hormônio do crescimento em conjunto com a Progesterona e o Estrogênio, garantindo o aumento da estatura e o desenvolvimento puberal. Contudo, é visível a importância do tratamento precoce, como também a necessidade de novos estudos acerca da temática, a fim de ampliar a rede de tratamentos para a ST, proporcionando melhoria na qualidade de vida das portadoras.