bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental Leave Policies in Canadian Residency Education
Authors: Stratton Tara , Cook-Chaimowitz Lauren , Pardhan Alim , Snelgrove Natasha , Chan Teresa M. 
Published: April 2021

ABSTRACT

Background
In recent decades, the gender makeup of Canadian medical residents has approached parity. As residency training years coincide closely with childbearing years and paid parental leave is associated with numerous benefits for both parents and children, it is important for there to be clarity about parental leave benefits.

Objectives
We aimed to conduct a comprehensive review of maternity and parental leave policies in all residency education programs in Canada, to highlight gaps that might be improved or areas in which Canadian programs excel.

Methods
We searched websites of the 8 provincial housestaff organizations (PHOs) for information regarding pregnancy workload accommodations, maternity leave, and parental leave policies in each province in effect as of January 2020. We summarized the policies and analyzed their readability using the Flesch Reading Ease.

Results
All Canadian PHOs provide specific accommodations around maternity and parental leave for medical residents. All organizations offer at least 35 weeks of total leave, while only 3 PHOs offer extended leave of about 63 weeks, in line with federal regulations. All but 2 PHOs offer supplemental income to their residents, although not for the full duration of offered leave. All PHOs offer workplace accommodations for pregnant residents in their second and/or third trimester.

Conclusions
Although all provinces had some form of leave, significant variability was found in the accommodations, duration of leave, and financial benefits provided to medical residents on maternity and parental leave across Canada. There is a lack of clarity in policy documents, which may be a barrier to optimal uptake.
Simulation-Based Assessments and Graduating Neurology Residents' Milestones: Status Epilepticus Milestones
Authors: Mikhaeil-Demo Yara , Holmboe Eric , Gerard Elizabeth E. , Wayne Diane B. , Cohen Elaine R. , Yamazaki Kenji , Templer Jessica W. , Bega Danny , Culler George W. , Bhatt Amar B. , Shafi Neelofer , Barsuk Jeffrey H. 
Published: April 2021

ABSTRACT

Background
The American Board of Psychiatry and Neurology and the Accreditation Council for Graduate Medical Education (ACGME) developed Milestones that provide a framework for residents' assessment. However, Milestones do not provide a description for how programs should perform assessments.

Objectives
We evaluated graduating residents' status epilepticus (SE) identification and management skills and how they correlate with ACGME Milestones reported for epilepsy and management/treatment by their program's clinical competency committee (CCC).

Methods
We performed a cohort study of graduating neurology residents from 3 academic medical centers in Chicago in 2018. We evaluated residents' skills identifying and managing SE using a simulation-based assessment (26-item checklist). Simulation-based assessment scores were compared to experience (number of SE cases each resident reported identifying and managing during residency), self-confidence in identifying and managing these cases, and their end of residency Milestones assigned by a CCC based on end-of-rotation evaluations.

Results
Sixteen of 21 (76%) eligible residents participated in the study. Average SE checklist score was 15.6 of 26 checklist items correct (60%, SD 12.2%). There were no significant correlations between resident checklist performance and experience or self-confidence. The average participant's level of Milestone for epilepsy and management/treatment was high at 4.3 of 5 (SD 0.4) and 4.4 of 5 (SD 0.4), respectively. There were no significant associations between checklist skills performance and level of Milestone assigned.

Conclusions
Simulated SE skills performance of graduating neurology residents was poor. Our study suggests that end-of-rotation evaluations alone are inadequate for assigning Milestones for high-stakes clinical skills such as identification and management of SE.
Analysis of Supervisors' Feedback to Residents on Communicator, Collaborator, and Professional Roles During Case Discussions
Authors: Lafleur Alexandre , Côté Luc , Witteman Holly O. 
Published: April 2021

ABSTRACT

Background
Literature examining the feedback supervisors give to residents during case discussions in the realms of communication, collaboration, and professional roles (intrinsic roles) focuses on analyses of written feedback and self-reporting.

Objectives
We quantified how much of the supervisors' verbal feedback time targeted residents' intrinsic roles and how well feedback time was aligned with the role targeted by each case. We analyzed the educational goals of this feedback. We assessed whether feedback content differed depending on whether the residents implied or explicitly expressed a need for particular feedback.

Methods
This was a mixed-methods study conducted from 2017 to 2019. We created scripted cases for radiology and internal medicine residents to present to supervisors, then analyzed the feedback given both qualitatively and quantitatively. The cases were designed to highlight the CanMEDS intrinsic roles of communicator, collaborator, and professional.

Results
Radiologists (n = 15) spent 22% of case discussions providing feedback on intrinsic roles (48% aligned): 28% when the case targeted the communicator role, 14% for collaborator, and 27% for professional. Internists (n = 15) spent 70% of discussions on intrinsic roles (56% aligned): 66% for communicator, 73% for collaborator, and 72% for professional. Radiologists' goals were to offer advice (66%), reflections (21%), and agreements (7%). Internists offered advice (41%), reflections (40%), and clarifying questions (10%). We saw no consistent effects when residents explicitly requested feedback on an intrinsic role.

Conclusions
Case discussions represent frequent opportunities for substantial feedback on intrinsic roles, largely aligned with the clinical case. Supervisors predominantly offered monologues of advice and agreements.
Surveying Obstetrics and Gynecology Residents About Their Residency Applications, Interviews, and Ranking
Authors: George Karen E. , Gressel Gregory M. , Ogburn Tony , Woodland Mark B. , Banks Erika 
Published: April 2021

ABSTRACT

Background
Residency applications have increased in the last decade, creating growing challenges for applicants and programs.

Objective
We evaluated factors associated with application and match into obstetrics and gynecology residency.

Methods
During the annual in-training examination administered to all obstetrics and gynecology residents in the United States, residents were surveyed on the residency application process.

Results
Ninety-five percent (5094 of 5347) residents responded to the survey. Thirty-six percent reported applying to 30 or fewer programs, 26.7% applied to more than 31 programs, and 37.1% opted not to answer this question. Forty-nine percent of residents received honors in their obstetrics and gynecology clerkship and 37.1% did not. The majority of residents (88.6%) reported scoring between 200 and 250 on USMLE Step 1. Eighty-six percent matched into one of their top 5 programs. The only factor associated with matching in residents' top 5 programs was receiving honors in their clerkship (OR 1.29; 95% CI 1.08–1.54; P &lt; .005). The only factor associated with matching below the top 5 programs was a couples match (OR 0.56; 95% CI 0.43–0.72; P &lt; .001). In choosing where to apply, residents identified program location and reputation as the most important factors, while for ranking, location and residency culture were the most important.

Conclusions
Most obstetrics and gynecology residents reported matching into their top 5 choices. Receiving an honors grade in the clerkship was the only factor associated with matching in applicants' top 5 programs. Location was the most important factor for applying to and ranking of programs.
Understanding SARS-CoV-2 features of infectivity, aggressiveness, and transmissibility: an insect-vector theory for SARS-CoV-2 dissemination
Authors: Lazar Angela Madalina 
Published: April 2021

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a ribonucleic acid–based (RNA-based) lineage B β-coronavirus characterized by 10-20 times higher infectivity and transmissibility even across species than previous coronaviruses. The significant infectivity rate of SARS-CoV-2 is due to its different host cell entry mechanisms that are mainly via angiotensin-converting enzyme 2 (ACE2) receptors contrasting earlier coronaviruses that used mainly the endosomal route. Due to the widespread distribution of ACE2 receptors throughout our body, various routes of infectivity are possible, highlighting the necessity of employing multiple forms of protection besides face masks to limit inter-human transmissibility. SARS-CoV-2 exhibits other remarkable features such as the ability to escape the immune system repeated genomic mutations that make it difficult to design a vaccine to address all viral strains and form huge host cell syncytia leading to massive tissue destruction. If we accept SARS-CoV-2 primary reservoir from bats, we should investigate the routes of viral inter-species propagation. In this article, a new theory is proposed- that the dissemination of the virus from the bats to other species and humans could have been possible via an insect vector, as insects possess significant amounts of both ACE2 receptors and a disintegrin and metalloprotease 17 (ADAM-17) enzymes that are essential for virus infectivity.
.
Addressing Puberty Challenges for Adolescents With Autism Spectrum Disorder: A Survey of Occupational Therapy Practice Trends
Authors: Larson Sydney Krause , Nielsen Sarah , Hemberger Kelsey , Klug Marilyn G. 
Published: April 2021

Abstract
Importance: Understanding occupational therapy practice patterns for adolescents who have autism spectrum disorder (ASD) provides a baseline to determine areas of need and effective interventions.
Objective: To identify puberty-related challenges addressed and interventions used by occupational therapy practitioners with adolescents ages 8–16 yr with ASD.
Design: A nonexperimental survey design with a stratified random sample was used.
Setting: The Occupational Therapy–Autism and Puberty Survey was distributed in the United States online through the Qualtrics platform (available October 2017–January 2018).
Participants: Occupational therapists (89%) or occupational therapy assistants with experience with adolescents who have ASD were included. The 71 eligible respondents were primarily White women with an average 16 yr of experience.
Outcomes and Measures: Nine key challenges and 11 interventions regarding puberty and ASD were identified. Hypotheses were generated before data collection.
Results: More practitioners (&gt;47%) addressed emotional regulation and personal hygiene, and fewer (&lt;26%) addressed menstruation, safety, and masturbation. Nearly all practitioners (&gt;92%) reported using social learning approaches and behavioral strategies, and most (&gt;80%) reporting having received education in these interventions. Significant differences were found between reported education and use of behavioral skills training incorporating applied behavioral analysis (p &lt; .001), parent training (p = .002), and technology (p = .003).
Conclusions and Relevance: Practitioners are neglecting to address puberty-specific challenges with adolescents who have ASD. Opportunities exist to expand the interventions used and challenges addressed by occupational therapy practitioners for adolescents with ASD.
What This Article Adds: This article expands occupational therapy literature by giving a baseline understanding of the puberty-related challenges that practitioners are addressing with adolescents who have ASD. This information can assist the profession in developing effective interventions and educational opportunities to allow practitioners to successfully address puberty-specific challenges.
Lung Cancer Screening Policy in Alaska and Occupational Therapy
Authors: Kowalski Lesleigh , Krusen Nancy E. 
Published: April 2021

Abstract
Lung cancer claims more lives than any other cancer in the world and remains difficult to diagnose in the early stages. This article examines the current state of lung cancer detection and screening via low-dose computed tomography (LDCT) in Alaska and considers potential opportunities for occupational therapy practitioners in primary care settings. Medicare requires at least one documented shared decision-making encounter between provider and patient before LDCT lung cancer screening occurs. As a result of time constraints, documentation requirements, and the plethora of preventive health services they provide, primary care physicians often lack the time and training to conduct this essential service. This provides an opportunity for occupational therapy practitioners to perform these services as part of their practice and to play a role in this area as patient educators and prevention specialists in primary care settings.
What This Article Adds: This article explores the national health crisis of lung cancer and describes how occupational therapists can participate in providing care in primary care settings.
Speech Disfluency Made by Male and Female Learners at Kampung Inggris Semarang
Authors: Abimanto Dhanan , Hidayah Yayuk , Halimah Lili , Hasyim Umar Al Faruq A 
Published: April 2021

In utterance, there must be some disfluency whether in normal people or in stutterer. Moreover, the disfluency would be different if it was categorized into two based on the gender. The researchers’ figures out the disfluency based on the gender, male and female. The article was to find out any types of disfluency that appear on the male and female speeches, to find the dominant type of disfluency occured in male and female speeches, the difference between male and female speeches, and the factors causing the disfluency made by male and female speeches. The sample was 24 English learners at Kampung Inggris Semarang, 12 males and 12 females. In collecting the data the researchers used observation and interview. In analysing the data, the researchers used the theory from Clark and Wasow supported by Johnson and Bortfeld et.al. The result showed that nine types of disfluency occur in learners’ speech, i.e filler, silent pause, revision, incomplete phrase, broken word, repetition, grammatical disfluency, prolongation, and false start. The dominant disfluency occured in male and female speeches was filler. In the dominant disfluency, males produced more filers than females, whereas silent pause was more produced in female speeches. Besides, there was some factors causing disfluency made by male and female learners of Kampung Inggris Semarang, which were related to psychological factors. It included cognitive factors and affective factors. In total, male produced more disfluency than female. Besides that male learner made more factors which could affect the disfluency in their speeches than female learners, male learners were more likely not in mastering grammar and vocabularies and getting prepared in materials.
Keywords: Speech Disfulency, Factors Speech Disfluency, Disfluency
Pronoun, Personal Titles, and Variety of Java-Indonesian Language in Yowis Ben The Series Film: Contrastive Study
Authors: Prastiyono Yustri Agung , Fahmilda Yacub , Latief Suryawahyuni 
Published: April 2021

This study aimed to identify and to contrast differences in Javanese-Indonesian speech acts in the Yowis Ben The Series film. This study used a contrastive analysis study with a sociolinguistic approach, which in this context emphasizes the aspects of pronouns, personal titles, and language variations. The method used in this research was descriptive qualitative. The data in this study are speech acts in Javanese and Indonesian (translation) which are used as dialogues in the film. The data source in this study was taken from the Yowis Ben The Series film through the WeTV video streaming application. The results of this study indicated that there were differences usage of Javanese-Indonesian speech in aspects of pronouns, personal titles, and language variations. This difference was due to non-linguistic aspects, such as the speaker's background, age, position or degree of speech partners in society.
Keywords: Speech Act, Contrastive Analysis, Sociolinguistic
Onabotulinum Toxin A (Botox) for Spasticity Associated With Multiple Sclerosis
Authors: Hui Daphne , Argáez Charlene 
Published: April 2021

Evidence-based clinical practice guidelines recommend the use of botulinum toxin (which includes onabotulinum toxin A [Botox]) to treat spasticity caused by multiple sclerosis.
There is a lack of recent evidence regarding the clinical and cost-effectiveness of Botox as a treatment for spasticity caused by multiple sclerosis; thus, there is a need for well-designed studies on this topic.
Tuberculosis Stigma and Racism, Colonialism, and Migration: A Rapid Qualitative Review
Authors: Smith Andrea , Herington Elijah , Loshak Hannah 
Published: April 2021

Current experiences of tuberculosis policy and care among Indigenous people are interpreted and understood in light of the past colonial violence and cultural genocide. The expressed reluctance to seek health care was often grounded in experiences of colonial violence and racism, pointing toward colonial and racist practice in health care as an important driver of tuberculosis stigma. The ongoing presence of anti-Indigenous racism in Canada’s health care systems underscores the ways that these worries are not confined to historical events but manifest in the interactions across individuals and systems today.
For tuberculosis stigma in the context of migration, tuberculosis policies and programs targeting migrant persons or racialized groups were seen as fuelling discriminatory and exclusionary views and practices toward these groups in the wider society and exacerbating tuberculosis stigma. Migrant detention centres were 1 of the sites where tuberculosis stigma was amplified through isolation when diagnosed. Further, the twining of immigration policy with tuberculosis policy led to worries among migrant persons about one’s tuberculosis status and its impact on one’s immigration status, and subsequently a reluctance to access health care. These findings ask us to consider the ways that tuberculosis policy, in concert with immigration policy, can generate tuberculosis stigma.
Tuberculosis stigma differs across contexts. It can be both a determinant of, and determined by, other forms of discrimination. Moreover, it requires close attention to the specific setting where tuberculosis stigma is sought to be addressed. The implications of this for tuberculosis policy and care are that a universal, one-size approach to addressing tuberculosis stigma is unlikely to be successful. Rather, program-specific approaches are likely needed that engage with questions as to how different forms of tuberculosis stigma play out in the context of care.
Cutting across this review findings were widespread experiences of racism in health care. These findings suggest that, in as much as tuberculosis stigma is a barrier to the uptake of tuberculosis screening and treatment, racism against Indigenous people and racialized migrants remains endemic in Canada’s health care system and may in some cases overshadow the role or experience of tuberculosis stigma. In light of these findings, and again, depending on the particular setting, engaging with anti-racist efforts and challenging white supremacy remain necessary and urgent.
Two-dimensional monitoring of air pollution in Madrid using a Multi-AXis Differential Optical Absorption Spectroscopy two-dimensional (MAXDOAS-2D) instrument
Authors: Garcia-Nieto David , Benavent Nuria , Borge Rafael , Saiz-Lopez Alfonso 
Published: April 2021

Abstract. Trace gases play a key role in the chemistry of urban atmospheres.
Therefore, knowledge about their spatial distribution is needed to fully
characterize air quality in urban areas. Using a new Multi-AXis Differential
Optical Absorption Spectroscopy two-dimensional (MAXDOAS-2D) instrument, along with an
inversion algorithm (bePRO), we report the first two-dimensional maps of
nitrogen dioxide (NO2) and nitrous acid (HONO) concentrations in the
city of Madrid, Spain. Measurements were made during 2 months (6 May–5 July 2019), and peak mixing ratios of 12 and 0.7 ppbv (parts per billion by volume) for NO2
and HONO, respectively, were observed in the early morning in the southern
part of the downtown area. We found good general agreement between the
MAXDOAS-2D mesoscale observations – which provide a typical spatial range of
a few kilometers – and the in situ measurements provided by
Madrid's air quality monitoring stations. In addition to
vertical profiles, we studied the horizontal gradients of NO2 in the
surface layer by applying the different horizontal light path lengths in the
two spectral regions included in the NO2 spectral analysis: ultraviolet
(UV, at 360 nm) and visible (VIS, 477 nm). We also investigate the
sensitivity of the instrument to infer vertically distributed information on
aerosol extinction coefficients and discuss possible future ways to improve
the retrievals. The retrieval of two-dimensional distributions of trace gas
concentrations reported here provides valuable spatial information for the
study of air quality in the city of Madrid.
Preprosesing dan normalisasi pada dataset kupu-kupu untuk ekstraksi fitur warna, bentuk dan tekstur
Authors: Satria Yudha Kartika Dhian , Maulana Hendra 
Published: April 2021

Penelitian dalam bidang citra digital masing terus berkembang. Perkembangan penelitian dalam bidang pertanian, kesehatan ataupun mendukung infrastruktur atau tata kelola kota. Penelitian dalam citra digital bisa membantu mendapatkan keputusan terbaik agar hasil yang didapatkan sesuai dengan prediksi. Penelitian dalam bidang citra digital yang berkembang salah satunya dalam hal serangga. Jenis serangga yang digunakan untuk penelitian ini adalah kupu-kupu sebanyak 890 data. Dataset tersebut dibagi menjadi 10 kelas, masing-masing kelas sebanyak 89 data. Dataset akan dilakukan proses ekstraksi fitur warna, fitur tekstur dan fitur bentuk. Sebelum proses ekstraksi fitur hal terpenting adalah melakukan preprosesing dan normalisasi ukuran piksel. Preprosesing dilakukan untuk menghilangkan noise pada gambar. Noise dalam penelitian citra digital merupakan hal yang harus dihilangkan agar tidak mengurangi hasil yang akan didapatkan. Selain menghilangkan noise, proses normalisasi ukuran setiap objek dataset juga disesuaikan. Ukuran masing-masing dataset disamakan sehingga hasil yang didapatkan juga mempunyai standarisasi nilai. Hasil yang didapatkan pada proses klasifikasi kupu-kupu mempunyai nilai akurasi sebesar 75% penggabungan dari ketiga ekstraksi fitur warna, fitur tekstur dan fitur bentuk pada ukuran piksel 256x160.
Keywords: citra digital; preprosesing; normalisasi piksel, ekstraksi fitur, kupu-kupu