bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Instruction On Demand for Educational Orientation of Graduate Medical Education Trainees During The COVID-19 Pandemic
Authors: Holliday Scott , Hussain Nasir , Lang Matthew , Burt Coranita , Clevenger Amber , Barbee Jeffery , Start Amanda , Fiorda-Diaz Juan , Clinchot Daniel , Essandoh Michael 
Published: September 2021

Abstract
Background: Graduate medical education (GME) orientation is traditionally an in-person endeavor. The COVID-19 pandemic has prompted virtual approaches to trainee onboarding to reduce viral transmission; however, virtual orientation has not been well-described in GME. This study assesses the effectiveness of virtual orientation of GME trainees using data from an electronic survey.Objectives: We aimed to determine the usefulness of virtual instruction on demand for GME trainee onboarding at a large sponsoring institution.Methods: We conducted a retrospective analysis of de-identified electronic survey responses by residents and fellows who underwent GME orientation at our institution from June to August 2020. The primary outcome was to determine the effectiveness of virtual GME orientation for onboarding, and secondary outcomes included identifying barriers to implementation and weaknesses associated with virtual GME orientation. We conducted orientation sessions for the incoming residents and fellows using CarmenCanvas, our institutional learning management system (LMS).Results: 272 of 337 incoming trainees completed the virtual GME orientation survey. 97% of respondents reported that the contents of the orientation modules would help them perform their duties. 79% of trainees rated the overall quality as very good or good, 91% responded that virtual orientation provided effective learning, 94% reported accessing the course content easily, 92% reported easy navigation of the modules, 91% described it as well-organized, and 87% said that the modules supported their learning.Conclusions: Virtual instruction on demand is a safe, effective, and practical approach to resident and fellow onboarding into a GME sponsoring institution in the COVID-19 pandemic era.
Characteristics, Hospital Referrals and 60-Day Mortality of Older Patients Living In Nursing Homes With Covid-19 Assessed by a Liaison Geriatric Team During The First Wave: A Research Article.
Authors: García-Cabrera Lorena , Pérez-Abascal Noelia , Montero-Errasquín Beatriz , Cano Lourdes Rexach , Mateos-Nozal Jesús , Cruz-Jentoft Alfonso 
Published: September 2021

Abstract
Background: The infection by SARS-CoV-2 (COVID-19) has been especially serious in older patients. The aim of this study is to describe baseline and clinical characteristics, hospital referrals, 60-day mortality, factors associated with hospital referrals and mortality in older patients living in nursing homes (NH) with suspected COVID-19.Methods: A retrospective observational study was performed during March and April 2020 of institutionalized patients assessed by a liaison geriatric hospital-based team. Were collected all older patients living in 31 nursing homes of a public hospital catchment area assessed by a liaison geriatric team due to the suspicion of COVID-19 during the first wave, when the hospital system was collapsed. Sociodemographic variables, comprehensive geriatric assessment, clinical characteristics, treatment received including care setting, and 60-days mortality were recorded from electronic medical records. A logistic regression analysis was performed to analyze the factors associated with mortality. Results: 419 patients were included in the study (median age 89 years old, 71.6% women, 63.7% with moderate-severe dependence, and 43.8% with advanced dementia). 31.1% were referred to the emergency department in the first assessment, with a higher rate of hospital referral in those with better functional and mental status. COVID-19 atypical symptoms like functional decline, delirium, or eating disorders were frequent. 36.9% had died in the 60 days following the first call. According to multivariate logistic regression age (p 0.010), Barthel index <60 (p 0.002), presence of tachypnea (p 0.021), fever (p 0.006) and the use of ceftriaxone (p 0.004) were associated with mortality. No mortality differences were found between those referred to the hospital or cared at the nursing home.Conclusions and implications: 31% of the nursing home patients assessed by a liaison geriatric hospital-based team for COVID-19 were referred to the hospital, being more frequently referred those with a better functional and cognitive situation. The 60-days mortality rate due to COVID-19 was 36.8% and was associated with older age, functional dependence, the presence of tachypnea and fever, and the use of ceftriaxone. Geriatric comprehensive assessment and coordination between NH and the hospital geriatric department teams were crucial.
Slope Aspect Affects The Soil Microbial Communities In Karst Tiankeng Negative Landforms
Authors: Jiang Cong , Shui Wei , Zhu Su-Feng , Feng Jie 
Published: September 2021

Abstract
Background: Karst tiankeng is a large-scale negative surface terrain, and slope aspect affect the soil conditions, vegetation and microbial flora in the tiankeng. However, the influence of the slope aspect on the soil microbial community in tiankeng has not been elucidated. Methods: In this study, metagenomic sequencing technology was used to analyzed the soil microbial communities and metabolic function on the shady and sunny slopes of karst tiankeng. Results: The Shannon-Wiener diversity of microbial communities on shady slopes was significantly higher than that on shady slopes. Shady and sunny slopes have similar microbial community composition, but there are differences in abundance. The linear discriminate analysis (LDA) results showed that biomarkers mainly belongs to Actinobacteria, Chloroflexi and Proteobacteria. Functional pathways and CAZy (Carbohydrate-Active Enzymes) genes also had a remarkable response to slope aspect change. LEfSe results indicated several biomarker pathways in sunny slope involved in human disease. Moreover, the abundance of CAZy genes was higher in shady slope and had stronger ability in decomposing litter. The microbial communities were mainly correlation with the vegetation characteristics (species richness and coverage) and soil properties (SOM and pH). Conclusions: These results indicate slope aspect has a pronounced influence on microbial community composition, structure and function at karst tiankeng. In the future, the conservation of karst tiankeng biodiversity should pay more attention to topographical factors.
Selected Skill Sets As Building Blocks for Secondary-To-Tertiary Education Bridge: A Retrospective Longitudinal Study Among Undergraduate Medical Students
Authors: Alsuwaidi Laila , Otaki Farah , Khamis Amar Hassan , AlGurg Reem , Lakhtakia Ritu 
Published: September 2021

Abstract
Background: The secondary-to-tertiary education transition is a significant milestone in the students’ academic journeys. This is particularly relevant to entry into medical schools, which is characterized by multiple stressors. Although this crucial transition has been repetitively explored, the concept of proactively intervening to support this transition, by fostering Self- Regulated Learning, is still novel. Accordingly, through this study, the authors investigate the efficacy of an online Multi-dimensional Resilience Building Intervention and analyse the association between the students' proficiency of selected skill sets and their academic performance over time. Methods: A retrospective longitudinal study was conducted on one cohort of undergraduate medical students. The students were offered an online learning and development intervention around four skill sets during the first curricular year of an undergraduate Bachelor of Medicine, Bachelor of Surgery program. Deidentified data, related to the students' proficiency of the four selected skill sets and the students’ academic performance: Grade-Point-Average, were retrieved. The data was analysed using SPSS for Windows version 27.0. Results: Out of the 63 admitted students, 28 participated in the offered intervention. The correlational analysis showed how increase in the overall score of skill sets proficiency was significantly associated with Year 1 GPA and cGPA. The students’ proficiency in the respective skill sets, however, was independent from their Year 2 GPA. Additionally, the performance of the students seemed to be not associated with their proficiency scores in each of the selected skill sets, independently. Conclusions: The innovative intervention of developing selected skill sets constituted an efficacious bridge to facilitate the secondary-to-tertiary education transition. Adapting such a multi-dimensional, resilience building intervention holds the potential of facilitating the students’ entry into medical school and improving their performance. As the medical student progresses, the acquired skills need to be continuously reinforced and effectively built upon.
Intraseasonal Variability and Possible Causes of Large Scale and Convective Precipitations Over the Gangetic Plain of India
Authors: Sarthi Pradhan Parth , Kumar Praveen 
Published: September 2021

Abstract
In India, summer monsoon rainfall during June-July-August-September (JJAS) along the river Ganga is the lifeline. Since its variability predominantly affects the agriculture production, drought and flood over the densely populated meteorological subdivisions of the Gangetic West Bengal, Jharkhand, Bihar, East and West Uttar Pradesh. Owing to its importance, a large number of research on the variability of Indian Summer Monsoon Rainfall (ISMR) has been conducted. However, the types of rainfall (or precipitation), i.e. Large Scale Precipitation (LSP) and Convective Precipitation (CP), is less discussed. The LSP is precipitated out from the stratus or nimbostratus clouds, while CP occurs from the cumulus and cumulonimbus clouds, and both of them coexists during summer monsoon months. The current research aims to know the climatological characteristics and possible cause of occurrence of these two types of precipitation over the meteorological subdivisions. For this purpose, the data of LSP, CP, zonal, meridonal (u and v component) wind and Relative Humidity (RH) at the spatial resolution of 0.25° x 0.25° (25km) for the period of 1980-2019 are taken from the European Centre for Medium-Range Weather Forecasts (ECMWF), UK. The Outgoing Longwave Radiation (OLR) data at a surface resolution of 1° x 1° for the same months and periods are obtained from the National Centre for Environmental Information (NOAA), USA. The observed rainfall data of the India Meteorological Department (IMD) at the same resolution and period is considered and compared with ERA data. The spatial and temporal distribution of both types of precipitation is analyzed as well as their linkage with OLR, zonal winds and RH at pressure levels of 1000, 850 and 700hPa is examined.
The Symmetric and Asymmetric impact of FDI Inflows, Economic growth, and Capital Investment on CO2 Emission in Oman-Evidence from ARDL and NARDL Approach
Authors: Hamid Ishfaq , Alam Md Shabbir , Murshed Muntasir , Jena Pabitra Kumar , Sha Nadia , Alam Mohammed Noor 
Published: September 2021

Abstract
This study examines the symmetric and asymmetric nexus between capital investment, economic growth, foreign direct investment, and CO2 emissions in Oman during 1980- 2019. For this purpose, we applied ARDL Model for linear cointegration and NARDL model for nonlinear cointegration between capital investment, economic growth, foreign direct investment, and CO2 emissions. The bound test shows the long-term equilibrium relationship among CO2 emissions, capital investment, economic growth, and FDI in both models. The error correction mechanism demonstrates that CO2 emissions congregate to their long-run equilibrium level at a 50.1 percent annual pace of adjustment by integrating capital investment, economic growth, and FDI under the symmetric model. The causality test results show that carbon emissions and FDI, economic growth, and CO2 emissions exhibit bidirectional causal links. While, on the other hand, unidirectional causal links are running from capital investment to GDP. The asymmetric results show that positive shocks to FDI and economic growth have significant tumbling consequences on Oman's carbon dioxide emissions.In contrast, negative shocks in FDI and economic growth substantially increase carbon dioxide emissions. The research findings also reveal that carbon dioxide emissions are more resilient to negative shocks in FDI and economic growth. Based on these results, this study accomplishes that abatement measures should consist of strategies to enhance the deepness of FDI and economic growth in the Oman economy.JEL Classification: F21, Q56, C22
Session-by-Session Improvements in Subjective Wellbeing and Satisfaction with Life Prospectively Predicts Session-by-Session Improvements in Bulimia Nervosa Symptoms.
Authors: Boyajian Laura E , Srivast Paakhi , Pitts Alexandra L. , Juarascio Adrienne S. 
Published: September 2021

Abstract
PurposeBehavioral treatments (BT) have been credited for improving both subjective wellbeing (SWB) and satisfaction with life (SWL) among those with bulimia nervosa (BN); However, researchers have yet to examine whether the improvements in SWB and SWL during BTs occur prior to or after BN symptom reduction. The current study examines session-by-session change in SWB and SWL and BN symptoms.MethodsThe sample was comprised of 35 patients with BN-spectrum disorders. Participants received 20 sessions of BT and completed weekly pre-session surveys assessing their symptom frequency, SWB, and SWL. Data was analysed using linear mixed effect modelling.ResultsBN symptom reduction during preceding sessions prospectively predicted improvements in SWB and SWL during succeeding sessions. In addition, improvements in SWB and SWL during preceding sessions prospectively predicted reductions in BN symptoms in succeeding sessions.ConclusionThis study provides preliminary evidence of a bidirectional relationship between SWB and SWL and BN symptoms. Future research should test whether incorporating content focused on improving SWB and SWL into BT models could optimize treatment outcomes for BN.Level I, randomized controlled trials
Maximum Glacier Extent of the Penultimate Glacial Cycle in the Upper Garonne Basin (Pyrenees): New Chronological Evidence
Authors: Fernandes Marcelo Vieira , Oliva Marc , Vieira Gonçalo , Palacios David , Fernández-Fernández José María , Delmas Magali , García-Oteyza Julia , Schimmelpfennig Irene , Ventura Josep , Team Aster 
Published: September 2021

Abstract
The Upper Garonne Basin included the longest glacier in the Pyrenees during the Late Pleistocene. During major glacial advances, the Garonne palaeoglacier flowed northwards along ~ 90 km from peaks of the axial Pyrenees exceeding 2,800-3,000 m until the foreland of this mountain range at the Loures-Barouse-Barbazan basin, at only 420–440 m. Here, the palaeoglacier formed a terminal moraine complex that is examined in this work. Based on geomorphological observations and a 12-sample dataset of 10Be Cosmic-Ray Exposure (CRE) ages, we have constrained the timing of the maximum glacial extent as well as the onset of the deglaciation from the end of the Last Glacial Cycle (LGC). Chronological data shows evidence that the external moraines in this basin were abandoned by the ice at the end of the Penultimate Glacial Cycle (PGC) and the onset of the Eemian Interglacial, at ~ 129 ka. No evidence of subsequent glacial advances or standstills occurred during the LGC in this basin were found, as the few existing datable boulders provided in the internal moraine showed inconsistent ages, thus probably being affected by post-glacial processes. The terminal basin was already deglaciated during the global Last Glacial Maximum at 24 − 21 ka, as revealed by exposure ages of polished surfaces at the confluence of the Garonne-La Pique valleys, 13 km south of the entrance of the Loures-Barousse-Barbazan basin. This study introduces the first CRE ages in the Pyrenees for the glacial advance occurred during the PGC and provides also new evidence that glaciers had already significantly shrunk during the LGM.
Effect of Flipped Classroom Approach in The Teaching of A Haematology Course
Authors: Qutob Haitham Mohammed Habib 
Published: September 2021

Abstract
Background

Flipped classroom is a teaching strategy used to enhance the engagement of students in the learning process. Replacing didactic lectures with active learning strategies through flipped classroom sessions fosters independence and the opportunity for students to engage in different passive learning styles. Although many studies of the flipped classroom approach have been conducted with medical students, few have focused on the effect of flipped classroom sessions on students in other medical professional fields. The aim of this study was to assess the effect of the flipped classroom approach on the performance of medical laboratory science students in a haematology course and their perception of the flipped classroom as an active learning strategy. In addition, students’ perceptions regarding the flipped classroom as an active learning strategy were assessed.
Methods

Of two cohorts in haematology courses, cohort 2 attended flipped classroom sessions, whereas cohort 1 underwent traditional class sessions. Students’ learning outcomes, achievements and performance on examinations in haematology courses were assessed. In addition, a satisfaction survey was distributed to the students to evaluate their perception of the flipped classroom as a student-centred learning strategy.
Results

Students in cohort 2 performed significantly better in the knowledge and cognitive domains than did those in cohort 1 (p < 0.001). Cohort 2 students completed the course successfully with an average grade of 81%, and few students received low grades; in comparison, cohort 1 students completed the course with an average grade of 73%, and 7 students received a grade of F. Of students in cohort 2, 83% believed that the flipped classroom provided a better understanding of the subject matter and appropriate knowledge and skills.
Conclusion

The results indicate the effectiveness of flipped classroom as an active learning style in enabling students to obtain desirable knowledge and improve their academic performance. Moreover, students recognised that the flipped classroom as an active leaning style was more beneficial than the traditional teaching approach.
Cesarean Delivery in Iran: A Population-Based Analysis Using The Robson Classification System
Authors: Pourshirazi Maryam , Heidarzadeh Mohammad , Taheri Mahshid , Esmaily Habibollah , Babaey Farah , Talkhi Nasrin , Gholizadeh Leila 
Published: September 2021

Abstract
Background
The rise of Cesarean Section (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector.
Objective
To analyze the CS rates in the last two years using the Robson Classification System in Iran.
Methods
A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported.
Results
2322500 women gave birth, 53.63% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.36%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.57% and 10.78%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.23% and 33.07%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6% and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10.
Conclusion
The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity unit, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes.
Quetiapine Augmentation of Cognitive Processing Therapy in Veterans with Posttraumatic Stress Disorder. Design and Methodology of a Pilot Study
Authors: Baig Muhammad Rais , Wilson Jennifer L. , Beck Robert D. , Lemmer Jennifer A. , Meraj Adeel , Hernandez Anna , Meyer Eric C. , Mintz Jim , Peterson Alan L. , Roache John D. 
Published: September 2021

Abstract
BackgroundThe limited efficacy of first-line treatment of posttraumatic stress disorder (PTSD) with selective serotonergic reuptake inhibitors commonly leads to the use of multiple medications that still fail to achieve symptomatic remission. VA/DOD guidelines identify trauma-focused psychotherapies as the evidence-based treatment for PTSD, but overall effectiveness is limited by reduced levels of patient engagement. Cognitive processing therapy (CPT) is the most widely-used trauma-focused therapy in the VA system for Veterans with PTSD. Our previous results based on a case series suggested that quetiapine monotherapy, but not risperidone or valproate, could increase engagement in CPT, thereby improving clinical outcomes through direct medication effects and indirectly through greater engagement in CPT.Methods & ResultsWe report the study protocol of a pilot study. This randomized, double blind placebo-controlled study was designed to evaluate the feasibility, safety, and preliminary efficacy of completing a randomized trial of quetiapine vs. placebo as an adjunct to promote patient engagement in CPT treatment for PTSD.ConclusionsWe expect that the success of this ongoing study should provide us with the preliminary data necessary to design a full-scale randomized trial.Trial Registration:NCT04280965