bluuebunny/crossref_metadata_2025_split huggingface dataset:
Race and Sex Disparities Among Emergency Medicine Chief Residents
Authors: Tsai Jennifer W. , Nguyen Mytien , Dudgeon Sarah N. , McDade William , Kim Jung G. , Agrawal Pooja , Boatright Dowin 
Published: September 2024

ImportancePhysicians who belong to minoritized racial and ethnic groups remain underrepresented and underpromoted. Serving as a chief resident is an important position of leadership and prestige, and indicates a benchmark for future professional success. However, it is unknown if disparities in race and/or sex exist in the chief resident selection process.ObjectiveTo describe race, ethnicity, and sex of emergency medicine (EM) chief residents and determine the association of racial identity and the intersectionality of race and sex for selecting chief residents in US emergency medicine departments.Design, Setting, and ParticipantsThis cohort study analyzed data collected from the Association of American Medical Colleges and the Electronic Residency Application Service in the graduating classes of 2017 and 2018. Data were analyzed between December 2021 and January 2023.Main Outcomes and MeasuresRelative risk (RR) of selection for chief residency for Black, Asian, and Hispanic EM residents in comparison with White counterparts.ResultsAmong 3408 studied residents, 738 (21.7%) served as chief resident (2253 male [66.1%]; 451 Asian [13.2%], 144 Black [4.2%], 158 Hispanic [4.6%], 239 more than 1 race [7.0%], 46 other [1.3%], and 2370 White [69.5%]). Of chiefs, 81 (11.0%) identified as Asian, 17 (2.3%) as Black, and 26 (3.5%) Hispanic. Asian residents were 78% (95% CI, 63%-96%) as likely to be promoted to chief resident compared with White peers, and Black residents were 51% (95% CI, 32%-80%) as likely as White residents. In our fully adjusted model, racial differences remained significant for Black residents, who were half as likely as white residents to be selected for chief residency (adjusted risk ratio [aRR], 0.55; 95% CI, 0.36-0.82). Overall, White women were most likely to be selected for chief residency and 20% more likely to be selected than White men counterparts (aRR, 1.20; 95% CI, 1.03-1.39). In comparison, women underrepresented in medicine (a category that included residents identified as Black, Hispanic, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander) were least likely to be selected for chief promotion, and 50% as likely to be selected for chief resident compared with White men (aRR, 0.50; 95% CI, 0.06-0.66).Conclusions and RelevanceIn this 2024 nationally representative study of EM residents, chief promotion was lower among residents identifying as Asian or Black, and in particular, women underrepresented in medicine. This study’s findings suggest further review of chief resident selection process by residency programs and accreditation bodies is needed to ensure workforce equity for promotion and opportunities for leadership.
Rural-Urban Disparities in Hospital Services and Outcomes for Children With Medical Complexity
Authors: Leyenaar JoAnna K. , Freyleue Seneca D. , Arakelyan Mary , Schaefer Andrew P. , Moen Erika L. , Austin Andrea M. , Goodman David C. , O’Malley A. James 
Published: September 2024

ImportanceLimited availability of inpatient pediatric services in rural regions has raised concerns about access, safety, and quality of hospital-based care for children. This may be particularly important for children with medical complexity (CMC).ObjectivesTo describe differences in the availability of pediatric services at acute care hospitals where rural- and urban-residing CMC presented for hospitalization; identify rural-urban disparities in health care quality and in-hospital mortality; and determine whether the availability of pediatric services at index hospitals or the experience of interfacility transfer modified rural-urban differences in outcomes.Design, Setting, and ParticipantsThis retrospective cohort study examined all-payer claims data from Colorado, Massachusetts, and New Hampshire from 2012 to 2017. Analysis was conducted from May 2023 to July 2024. Participants included CMC younger than 18 years residing in these states and hospitalized during the study period.ExposuresRural or urban residence was determined using Rural-Urban Commuting Area codes. Hospitals were categorized as children’s hospitals or general hospitals with comprehensive, limited, or no dedicated pediatric services using American Hospital Association survey data. Interfacility transfers between index and definitive care hospitals were identified using health care claims.Main Outcomes and MeasuresIn-hospital mortality, all-cause 30-day readmission, medical-surgical safety events, and surgical safety events were operationalized using Agency for Healthcare Research and Quality measure specifications.ResultsAmong 36 943 CMC who experienced 79 906 hospitalizations, 16 525 (44.7%) were female, 26 034 (70.5%) were Medicaid-insured, and 34 008 (92.1%) were urban-residing. Rural-residing CMC were 6.55 times more likely to present to hospitals without dedicated pediatric services (rate ratio [RR], 6.55 [95% CI, 5.86-7.33]) and 2.03 times more likely to present to hospitals without pediatric beds (RR, 2.03 [95% CI, 1.88-2.21]) than urban-residing CMC, with no significant differences in interfacility transfer rates. In unadjusted analysis, rural-residing CMC had a 44% increased risk of in-hospital mortality (RR, 1.44 [95% CI, 1.03-2.02]) with no significant differences in other outcomes. Adjusting for clinical characteristics, the difference in in-hospital mortality was no longer significant. Index hospital type was not a significant modifier of observed rural-urban outcomes, but interfacility transfer was a significant modifier of rural-urban differences in surgical safety events.Conclusions and RelevanceIn this cohort study, rural-residing CMC were significantly more likely to present to hospitals without dedicated pediatric services. These findings suggest that efforts are justified to ensure that all hospital types are prepared to care for CMC.
A Strategy Involving Microporous Microneedles Integrated with CAR‐TREM2‐Macrophages for Scar Management by Regulating Fibrotic Microenvironment
Authors: Liu Min , Zhou Xin , Wang Yu , Zhao Wenyan , Zhao Xingli , Li Lang , Xue Fangchao , Zhang Qiao , Yan Juan , Su Yang , Zeng Wen 
Published: September 2024

AbstractDipeptidyl peptidase 4 (DPP4) positive fibroblasts play a pivotal role in scar development following skin injury. Heterogeneous vascular endothelial cells (ECs) within scarred areas retain the capacity to drive tissue regeneration and repair. Simultaneously, TREM2 macrophages play a crucial role in the progression and resolution of fibrosis by engaging in mutual regulation with ECs. However, effective strategies to inhibit scar formation through multi‐factor regulation of the scar microenvironment remain a challenge. Here, CAR‐TREM2‐macrophages (CAR‐TREM2‐Ms) capable of targeting DPP4+ fibroblasts and modulating ECs subtype within the scar microenvironment are engineered to effectively prevent scarring. Hydrogel microporous microneedles (mMNs) are employed to deliver CAR‐TREM2‐Ms, which can effectively alleviate scar. Single‐cell transcriptome sequencing (scRNA‐seq) analysis reveals that CAR‐TREM2‐Ms can modify ECs fibrotic phenotype and regulate fibrosis by suppressing the profibrotic gene leucine‐rich‐alpha‐2‐glycoprotein 1 (Lrg1). In vitro experiments further demonstrate that CAR‐TREM2‐Ms improve the scar microenvironment by phagocytosing DPP4+ fibroblasts and suppressing TGFβ secretion. This, in turn, inhibits the phenotypic conversion of LRG1 ECs and provides multifactorial way of alleviating scars. This study uncovers the evidence that mMNs attached to CAR‐TREM2‐Ms may exert vital influences on skin scarring through the regulation of the skin scar microenvironment, providing a promising approach for treating posttraumatic scarring.
A Novel Self‐Amplifying mRNA with Decreased Cytotoxicity and Enhanced Protein Expression by Macrodomain Mutations
Authors: Gong Yue , Yong Danni , Liu Gensheng , Xu Jiang , Ding Jun , Jia William 
Published: September 2024

AbstractThe efficacy and safety of self‐amplifying mRNA (saRNA) have been demonstrated in COVID‐19 vaccine applications. Unlike conventional non‐replicating mRNA (nrmRNA), saRNA offers a key advantage: its self‐replication mechanism fosters efficient expression of the encoded protein, leading to substantial dose savings during administration. Consequently, there is a growing interest in further optimizing the expression efficiency of saRNA. In this study, in vitro adaptive passaging of saRNA is conducted under exogenous interferon pressure, which revealed several mutations in the nonstructural protein (NSP). Notably, two stable mutations, Q48P and I113F, situated in the NSP3 macrodomain (MD), attenuated its mono adenosine diphosphate ribose (MAR) hydrolysis activity and exhibited decreased replication but increased payload expression compared to wild‐type saRNA (wt saRNA). Transcriptome sequencing analysis unveils diminished activation of the double‐stranded RNA (dsRNA) sensor and, consequently, a significantly reduced innate immune response compared to wt saRNA. Furthermore, the mutant saRNA demonstrated less translation inhibition and cell apoptosis than wt saRNA, culminating in higher protein expression both in vitro and in vivo. These findings underscore the potential of reducing saRNA replication‐dependent dsRNA‐induced innate immune responses through genetic modification as a valuable strategy for optimizing saRNA, enhancing payload translation efficiency, and mitigating saRNA cytotoxicity.
SPARK mentorship program for emergency services assistants underrepresented in medicine interested in physician assistant programs
Authors: Snietka Aline , Preiksaitis Carl , González‐Marqués Catalina , Landry Adaira 
Published: September 2024

AbstractBackgroundIncreasing diversity in the health care workforce has been shown to improve patient health care and create psychological safety for employees who feel marginalized and underrepresented. While several measures exist for increasing racial and ethnic diversity in the physician workforce, few programs target expanding representation among physician assistants (PAs). Despite increasing the role and responsibility of PAs in the emergency department (ED), there remains a significant lack of diversity within this group. The SPARK mentorship program, a combined mentorship and educational opportunity for emergency services assistants (ESAs; also called aides and technicians) who are underrepresented in medicine (UiM), may create a pathway to recruiting diverse individuals to PA careers in emergency medicine.MethodsOur goal was to implement and evaluate a combined didactic and mentorship curriculum focused on recruiting ESAs UIM to become PAs in the ED. Using Kern's framework, an interprofessional group created a 3‐month mentorship program including individualized mentorship from senior PAs, didactic content covering the roles of PAs in the ED, and strategies to apply to PA school. This curriculum was implemented in 2022 for five ESAs following an application process. Outcomes were measured using the NIH Mentoring Evaluation Form and Munich Evaluation of Mentoring Questionnaire as well as longitudinal monitoring after the program to determine progress of ESAs toward a career as PAs.ResultsAll five mentees completed the mentorship program. Postprogram surveys showed all participants described the program as meeting their expectations and being goal oriented. One‐year follow‐up demonstrated progress in all participants along their desired career path.ConclusionsThe SPARK mentorship program appears to be a feasible approach to creating a pathway for recruitment of ESAs UIM into the PA profession. Preliminary outcome data suggest that this curriculum was highly acceptable to participants and may have a positive impact on recruiting ESAs to become PAs. Continued evaluation is needed to determine what effect programs such as this one have on increasing diversity in the PA workforce.
Modeling the aspect ratio of commercial catalysts
Authors: Beeckman Jean W. L. 
Published: September 2024

AbstractMathematical modeling plays a diverse and crucial role in the chemical industry and academia. This manuscript describes how the physical and mechanical engineering disciplines help the commercialization of catalysts from evaluation to scale‐up and manufacturing. Forming and shaping the catalyst is the first basic step in the catalyst manufacturing industry. Part A shows some of the classic process methods that are employed for this purpose. Catalyst extrudates require proper engineering and process control of their aspect ratio. Catalyst extrudates with a high aspect ratio tend to yield a low reactor fill due to a loose packing. Catalyst extrudates with a low aspect ratio tend to yield high pressure drop. Part B introduces the tensile strength of the catalyst in order to predict the aspect ratio of catalyst extrudates in commercial plants. A force‐balance between the tensile strength of the catalyst and the impact forces due to collision experienced during manufacture leads to the dimensionless group . The group allows to introduce and quantify the severity of equipment and the severity of entire commercial plants.
Observer‐based output feedback control for a rotating beam with a general exosystem
Authors: Meng Tingting , Fu Qiang , He Xiuyu 
Published: September 2024

AbstractThis paper considers a rotating Euler‐Bernoulli beam system with no dampings, where disturbances and references are generated from a block diagonalizable exosystem. Two tracking errors are the only measurable outputs for the output regulation of the beam system. Firstly, a nominal exosystem is chosen to generate the same signals, and a nominal beam is obtained by finding the specially known coefficients of the disturbances and references. This makes a tracking error‐based observer easily designed for the nominal partial differential equation‐ordinary differential equation (PDE‐ODE) system. Observer‐based robust controls are then designed for the nominal beam system and further proved to guarantee the asymptotic convergence of the tracking errors and the boundedness of the states, although under unknown disturbances and references. Two simulation examples are provided to describe the effectiveness of the controls.
Dysregulated plasma autoantibodies are associated with B cell dysfunction in young Arab children with autism spectrum disorder in Qatar
Authors: Ltaief Samia M. , Nour‐Eldine Wared , Manaph Nimshitha Pavathuparambil Abdul , Tan Ti‐Myen , Anuar Nur Diana , Bensmail Ilham , George Jilbin , Abdesselem Houari B. , Al‐Shammari Abeer R. 
Published: September 2024

AbstractAutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interaction and communication, as well as the occurrence of stereotyped and repetitive behaviors. Previous studies have provided solid evidence of dysregulated immune system in ASD; however, limited studies have investigated autoantibody profiles in individuals with ASD. This study aims to screen plasma autoantibodies in a well‐defined cohort of young children with ASD (n = 100) and their matched controls (n = 60) utilizing a high‐throughput KoRectly Expressed (KREX) i‐Ome protein‐array technology. We identified differential protein expression of 16 autoantibodies in ASD, which were correlated with differential gene expression of these markers in independent ASD cohorts. Meanwhile, we identified a distinct list of 33 autoantibodies associated with ASD severity; several of which were correlated with maternal age and birth weight in ASD. In addition, we found dysregulated numbers of circulating B cells and activated HLADR+ B cells in ASD, which were correlated with altered levels of several autoantibodies. Further in‐depth analysis of B cell subpopulations revealed an increased frequency of activated naïve B cells in ASD, as well as an association of resting naïve B cells and transitional B cells with ASD severity. Pathway enrichment analysis revealed disrupted MAPK signaling in ASD, suggesting a potential relevance of this pathway to altered autoantibodies and B cell dysfunction in ASD. Finally, we found that a combination of eight autoantibodies associated with ASD severity showed an area under the curve (ROC‐AUC) of 0.937 (95% CI = 0.890, 0.983; p < 0.001), which demonstrated the diagnostic accuracy of the eight‐marker signature in the severity classification of ASD cases. Overall, this study determined dysregulated autoantibody profiles and B cell dysfunction in children with ASD and identified an eight‐autoantibody panel for ASD severity classification.
Additive Fließfertigung von leichtbaugerechten Präzisions‐Betonelementen
Authors: Lindner Marco , Gliniorz Ralf , Funke Henrik , Gelbrich Sandra 
Published: September 2024

AbstractIm Kontext der Industrie 4.0 steht in der modernen Fließfertigung die durchgängig digital gesteuerte Wertschöpfungskette im Fokus. Insbesondere die Kombination nach den Leichtbauprinzipien mit einer dünnen Spritzbetonschicht und rippenförmigen Stützkonstruktionen, z. B. für Fassadenelemente, führt zu hocheffizienten Bauteilen mit hoher Tragfähigkeit und hochwertigen Oberflächen. Die entwickelte kombinierte Betonspritz‐Extrusion‐Multitool‐Düse bietet die Möglichkeit sowohl des Spritzens als auch des Extrudierens. Darüber hinaus steht die automatisierte Integration von Ankern im Fokus der Fließfertigung, für die spezielle Anker und Werkzeugsysteme entwickelt wurden. Anhand der ermittelten Kennwerte konnten die Praktikabilität und die Produktivitätssteigerung nachgewiesen werden. Diese Daten bilden die Grundlage für einen Digitalen Zwilling in Vorbereitung auf Industrie 4.0. Die Produktivitätssteigerung in der additiven Fertigung führt zu positiven wirtschaftlichen Effekten. Anwendungen von hochfesten Leichtbaustrukturen im Bauwesen werden attraktiver und ermöglichen die Serienumsetzung freiformmodularer Konstruktionen.
Dunkelverfärbungen im unteren Wandbereich von Sichtbetonflächen
Authors: Deiters Macielle , Schack Tobias , Fischer Matthias , Kiltz Denis , Haist Michael 
Published: September 2024

AbstractDie Sichtbetonbauweise stellt ein unersetzliches architektonisches Stilmittel insbesondere zur Gestaltung repräsentativer Bauwerke aus Beton dar. Trotz einer steigenden Vielfalt an Gestaltungsmöglichkeiten, z. B. mit farbigen oder strukturierten Elementen, liegt die Präferenz vieler Planer:innen und Bauherr:innen weiter auf in Ortbetonbauweise hergestellten glatten Sichtbetonflächen mit gleichmäßig heller Farbtönung. Zwar gibt es signifikante wissenschaftliche und technische Fortschritte, dennoch werden bei der Herstellung solcher Sichtbetonbauteile immer wieder optische Auffälligkeiten – und hier insbesondere Dunkelverfärbungen – beobachtet, die mit den bisherigen wissenschaftlichen Ansätzen nicht vollumfänglich erklärt werden können und die sich bislang auch technisch nicht ausschließen lassen. Im Rahmen eines vom Institut für Baustoffe der Leibniz Universität Hannover und dem Deutschen Beton‐ und Bautechnik‐Verein E. V. gemeinsam durchgeführten Forschungsprojekts wurden die Mechanismen bei der Ausbildung von Dunkelverfärbungen im unteren Wandbereich an Sichtbetonbauteilen systematisch untersucht. Hierbei konnte insbesondere ein direkter Einfluss von Schalungsvibrationen in Wechselwirkung mit den betontechnologischen Eigenschaften als zentraler Einflussparameter für Dunkelverfärbungen identifiziert werden. Die Auftretenswahrscheinlichkeit für derartige Verfärbungen nimmt stark zu, wenn bereits rücksteifende Betone (d. h. Betone, deren Alter sich dem Erstarrungsbeginn annähert) entweder direkt oder indirekt durch die Schalung zum Schwingen angeregt werden. Es konnte eine signifikante Wechselwirkung zwischen dem Zeitpunkt der Vibrationsanregung, den betontechnologischen Eigenschaften und den Vibrationsparametern (Frequenz und Amplitude) festgestellt werden.
Study on a reusable surfactant fracturing fluid and its application in Chang‐6 oil reservoir
Authors: Zhang Lei , He Xinyan , Jiang Wenxue , Yu Weichu , Zhang Ying 
Published: September 2024

AbstractIn order to improve the utilization of fracturing fluid and reduce the environmental pollution risk in large‐scale fracturing of oil reservoirs in Ordos Basin, a type of reusable surfactant fracturing fluid is developed. Its formula composition is 15 × 10−3 g/mL of the synthesized surfactant and 6 × 10−3 g/mL of composite acid. The synthesized surfactant is formed by using 13‐docosaenoic acid, 3‐dimethylaminopropylamine, sodium chloroacetate, and other raw materials. The dissolution time of the fracturing fluid is less than 1 min. Due to the reversible entanglement interactions between the surfactant micelles, it is a viscosity‐elastic fracturing fluid with good sand carrying capacity. It can remain basically unchanged after shearing. The surfactant fracturing fluid can be automatically broken to contact with the crude oil in the oil reservoir. The breaking time can be controlled within 100 min by adjusting the concentration of crude oil. After gel breaking, the viscosity is less than 2.9 mPa ∙ s and the residue content is less than 1.25 mg/L. The interfacial tension of oil and the breaking liquid is below 0.1 mN/m. Subsequently, the field application of the fracturing fluid in N190 oil well has been carried out successfully. The backflow fluid of the surfactant fracturing fluid is successfully reused three times, and the performance of the fracturing fluid prepared in the field is basically consistent with the results of laboratory experiments. The fracturing construction by using the developed surfactant fracturing fluid can achieve a good fracturing stimulation effect and save a large amount of water resources.
Identifying design criteria for implementing inherent safety in chemical process industries part 2: Design mechanism
Authors: Zakaria Zafirah , Kidam Kamarizan , Hassim Mimi H. 
Published: September 2024

AbstractInherent safety concepts are common knowledge today, but accidents with similar characteristics do recur. Research on accident causes found that design errors, especially equipment failure, contribute the highest percentage of accidents. The development of inherent safety tools has been increasing at a positive pace, but only a small number of these tools are applicable to equipment design. Ample amounts of inherent safety tools are only suitable to be used at the early design stage. This amplifies the fact that inherent safety tools are still conceptual (e.g., change process routes, change safer materials). This is in contrast to the circumstances, where tools are expected to reinforce the inherent safety of equipment. The objective of this research is to identify design mechanism that can help trigger design thinking for implementation of inherent safety in the chemical process industry. To identify such a design mechanism, 526 cases were collected, and knowledge of the mechanism was extracted from design changes and presented in this research paper. The mechanisms were classified according to equipment and inherent safety keywords. The significant design mechanisms from the overall summation were listed (turbulence, change heat transfer fluid, continuous removal, large surface area, corrosion resistance, seamless joint, thin film, dividing wall, on demand, and double wall).