bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of clinical clerkship integrated with clinical ladder on attending physicians’ self-efficacy
Authors: Arai Yuto , Yoshino Go , Ohta Kento , Okanishi Tohru , Kakee Sosuke , Mino Yoichi , Komatsu Hiroaki , Yamada Nanako , Ueki Masaru , Maegaki Yoshihiro 
Published: February 2024

Abstract
Background
Self-efficacy plays an important role in enhancing the teaching capabilities of attending physicians (APs). The clinical ladder (CL) is an educational approach developed in the field of nursing education that increases difficulty in an incremental manner. However, no previous study has confirmed the effectiveness of CL in medical education. Therefore, this study aimed to examine the effect of clinical clerkship integrated with clinical ladder (CC-CL) on the self-efficacy of APs.
Methods
Sixth year medical students participated in CC-CL for 6 months from April 2023, and the changes in the self-efficacy of APs were retrospectively evaluated. The students were trained by the APs concurrently, and the achievement levels of each student were shared. The primary outcome measure was the physician teaching self-efficacy questionnaire (PTSQ) score. The PTSQ scores before and after CC-CL were analyzed using the Wilcoxon matched-pair signed-rank test.
Results
Fifteen APs from the Department of Pediatric and Child Neurology were included in this study. No significant difference was observed in the total PTSQ scores of the APs before and after CC-CL. However, a significant increase was observed in the PTSQ score of APs who participated for a duration of 2 hours per week for > 3 months (n = 8) after CC-CL (p = 0.022). Furthermore, APs who had received their pediatrician certification < 10 years prior (n = 8) showed a significant increase in the total PTSQ score after CC-CL (p = 0.022).
Conclusions
CC-CL may play an important role in cultivating the self-efficacy of less experienced APs. Further comparative studies must be conducted in the future to validate the findings of this study.
RAB18 Regulates Extrahepatic SiRNA-Mediated Gene Silencing Efficacy
Authors: Lu Jiamiao , Lee Jasper , Yuan Eric , Wakefield Devin , Kanke Matt , Pruitt Danielle , Barreda Jose , Rulifson Ingrid , Xie Jiansong , Ferbas John , Long Jason , Meade Bryan , Homann Oliver , Guo Wei , Gomes Tina , Zhou Hong , Wu Bin , Cui Jixin , Wang Songli 
Published: February 2024

Abstract

Small interfering RNAs (siRNAs) hold considerable therapeutic potential to selectively silence previously “undruggable” disease-associated targets, offering new opportunities to fight human diseases. This therapeutic strategy, however, is limited by the inability of naked siRNAs to passively diffuse across cellular membranes due to their large molecular size and negative charge. Delivery of siRNAs to liver through conjugation of siRNA to N-acetylgalactosamine (GalNAc) has been a success; providing robust and durable gene knockdown specifically in hepatocytes. Yet, the poor delivery and silencing efficacy of siRNAs in other cell types has hindered their applications outside the liver. We previously reported that a genome-wide CRISPR screen identified RAB18 as a major modulator of GalNAc-siRNA conjugates. Herein, we demonstrate RAB18 knockout/knockdown efficaciously enhances siRNA-mediated gene silencing in hepatic, extrahepatic cell lines, and in vivo. Our results reveal a mechanism by which retrograde Golgi-ER transport and the intracellular lipid droplets (LDs) positively regulate siRNA-mediated gene silencing.
Longitudinal Association between Stressful Life Events and Suicidal Ideation in Adults with Major Depression Disorder: The Mediating Effects of Insomnia Symptom
Authors: chen ya , Han Xue , Jiang Yingchen , Jiang Yunbin , Huang Xinyu , Wang Wanxin , Guo Lan , Xia Ruirui , Liao Yuhua , Zhang Huimin , Teopiz Kayla M. , McIntyre Roger S. , Fan Beifang , Lu Ciyong 
Published: February 2024

Abstract
Background: Stressful life events (SLEs) and suicidal ideation (SI) are prevalent in persons with major depression disorder (MDD). Less is known about the underlying role of insomnia symptoms in the association between SLEs and SI. This study sought to investigate the longitudinal association among SLEs, insomnia symptoms and SI in persons with MDD.
Methods: This three-wave prospective study used data collected between December 2020 and September 2022 from the Depression Cohort in China (DCC), which is a large, ongoing cohort study targeting at persons aged 18-64 years with MDD. The study population included 511 persons with MDD (mean [SD] age, 28.7 [6.7] years, 67.1% were females). A structured questionnaire and validated scales were utilized to assess the cumulative numbers and multiple types of SLEs, insomnia symptoms and SI. Generalized estimated equation (GEE) was utilized to explore prospective association among exposure of SLEs, insomnia symptoms and SI. Besides, the structural equation model (SEM) was performed to estimate the longitudinal mediating effect of insomnia symptoms in the relationship between SLEs and SI.
Results: After adjusting for control variables, three or more SLEs (adjusted β estimate = 1.299, 95% CI=1.016-1.662) and childhood physical abuse (adjusted βestimate = 1.301, 95% CI=1.020-1.658) were related to an elevated risk of SI. Additionally, the association between SLEs and SI was significantly mediated by insomnia symptoms (standardized β estimate = 0.026, 95% CI = 0.003 - 0.053).
Conclusions: Cumulative SLEs were determined to be longitudinally associated with SI in persons with MDD. We further observed that insomnia symptoms were highly associated with SLEs and SI. Clinicians assessing persons with MDD, especially with history of SLE and insomnia symptoms, should carefully evaluate for the presence of suicidality as part of a personalized assessment of their depressive illness.
Gohteikhimyces, a novel hyphomycete genus from submerged wood, based on three collections in Taiwan
Authors: Ou Jie-Hao , Hsieh Sung-Yuan , Kuo Chang-Hsin 
Published: February 2024

Abstract

Gohteikhimyces, a new genus of dematiaceous hyphomycete occurring on decaying wood submerged in a freshwater stream of Taiwan, is proposed based on morphological and molecular data. It produces effuse, black, and somewhat glistening colonies on the surface of natural substratum, which mainly composed of solitary, dry, dark, cymbiform or ellipsoidal to obovoid, 3–4-euseptate conidia, and secede rhexolytically from semi-macronematous conidiophores with percurrent regeneration. The conidia resemble those of Bactrodesmium species but they are not produced from sporodochial conidiomata. Phylogenetically, this new genus is placed in the Savoryellomycetidae incertae sedis, closely related to Flammispora, but is distant from the Fucosporellales which contains the Bactrodesmium species. This new genus is proposed based on three collections from different localities in Taiwan, with descriptions of two novel species, G. bactrodesmioides and G. taroides, which differ in geographical conditions of collection sites and conidial morphology. The two species are supported by sufficient differences in their LSU, SSU, and the ITS sequences. In this paper, the genus Gohteikhimyces is illustrated with line diagrams, light micrographs, and scanning electron micrographs.
Safety of Physician-staffed Medical Service in Rendering Prehospital emergency medicine among Assault Cases in Japan: A Single-center, Retrospective, Case-Control Study
Authors: Kikuta Shota , Kai Soichiro , Nakayama Haruki , Matsuyama Shigenari , Kawase Tetsunori , Ishihara Satoshi 
Published: February 2024

Abstract
Purpose
The current study aimed to investigate assault cases involving prehospital emergency care, focusing on safety aspects.
Methods
This single-center, retrospective case-control study reviewed our facility’s physician-staffed medical care, including consecutive assault cases to patients injured by a perpetrator's intentional attack from January 2005 to October 2020. The study relied on our institution’s medical and prehospital emergency care and communication records with the fire department. The patients were divided into two groups, “problem group” and “control group”, based on the viewpoint of operational safety.
Results
Of the 4,957 prehospital emergency care cases during the study period, 65 (1.3%) were identified as assault cases, with 10 in the problem group and 55 in the control group. A multivariate analysis using logistic regression analysis revealed non-penetrating injury (odds ratio [OR]: 6.97, 95% confidence interval [CI]: 1.37–35.4, P = 0.019) and shorter interval from the request for physician dispatch to contact with the injured person (request-to-contact interval) (OR: 0.762, 95% CI: 0.580–0.996, P = 0.047) as the independent risk factors to predict the problem group.
Conclusion
The attack method was a penetrating mechanism in most of the assault cases. Conversely, cases with non-penetrating injuries or shorter request-to-contact interval may cause problems in prehospital emergency care and therefore require particular attention.
X-ray Chemical Imaging of Mn-doped Co/TiO2 Pellets reveals the significance of Cobalt Carbide Formation and Distribution on CO conversion and Alcohol Selectivity during Fischer Tropsch Synthesis
Authors: Beale Andrew , Farooq Danial , Potter Matthew , Stockenhuber Sebastian , Pritchard Jay , Vamvakeros Antonis , Price Stephen , Drnec Jakub , Ruchte Ben , Paterson James , Peacock Mark 
Published: February 2024

Abstract
X-ray diffraction/scattering computed tomography (XRS-CT) were used to create 2D images, with 20 µm resolution, of passivated Co/TiO2/Mn Fischer Tropsch catalyst extrudates post-reaction after 300 h on stream under industrially relevant conditions. This combination of scattering techniques provided unprecedented insights into both the spatial variation of the various cobalt phases and the influence of increasing Mn loading has on this. Also observed is the presence of a wax coating throughout the extrudate and its capacity to preserve the Co/Mn species in the same state as in the reactor. Correlating these findings with catalytic performance, highlights the crucial phases and active sites within Fischer Tropsch catalysts required for understanding the tunability of the product distribution between saturated hydrocarbons or oxygenate and olefin products. In particular a Mn loading of 3 wt. % led to an optimum equilibrium between the amount of hexagonal close-packed Co and Co2C phases resulting in maximum oxygenate selectivity. XRS-CT revealed Co2C to be located on the extrudates' periphery, while metallic Co phases were more prevalent towards the centre, possibly due to a lower [CO] ratio there. Reduction at 450°C of a 10 wt. % Mn sample resulted in MnTiO3 formation which inhibited carbide formation and alcohol selectivity. It is suggested that small MnO particles promote Co carburisation by decreasing the CO dissociation barrier and the Co2C phase promotes CO non-dissociative adsorption leading to increased oxygenate selectivity. This study highlights the influence of Mn on catalyst structure and function and the importance of studying catalysts under industrially relevant reaction times.
A novel spatial-frequency feature representation network for zero-shot incremental learning
Authors: Ren Jie , Zhao Yang , Zhang Weichuan , Sun Changming 
Published: February 2024

Abstract
Zero-shot incremental learning aims to enable the model to generalize to new classes without forgetting previously learned classes. However, the semantic gap between old and new sample classes can lead to catastrophic forgetting. Additionally, existing algorithms lack capturing significant information from each sample image domain, impairing models’ classification performance. Therefore, this paper proposes A novel Spatial-Frequency Feature Representation Network (SFFRNet) which contains a Spatial-Frequency Feature Extraction (SFFE) module and Attention Feature Alignment (AFA) module to improve the Zero-Shot Translation for Class Incremental algorithm. Firstly, SFFE module is designed which contains a dual attention mechanism for obtaining salient spatial-frequency feature information. Secondly, a novel feature fusion module is conducted for obtaining fused spatial-frequency domain features. Thirdly, the Nearest Class Mean classifier is utilized to select the most suitable category. Finally, iteration between tasks is performed using the Zero-Shot Translation model. The proposed SFFRNet has the ability to effectively extract spatial-frequency feature representation from input images, improve the accuracy of image classification, and fundamentally alleviate catastrophic forgetting. Extensive experiments on the CUB 200-2011 and CIFAR-100 datasets demonstrate that our proposed algorithm outperforms state-of-the-art incremental learning algorithms.
Sedimentological and Paleopedological Investigations of the Middle Jurassic FE Concentrations of Central Sardinia (Italy): Paleoclimatic, Paleoenvironmental and Paleotectonic Consequences
Authors: Costamagna Luca Giacomo , Vacca Andrea 
Published: February 2024

Abstract

In Central Sardinia (Italy), sub-economic concentrations of iron ore are diffuse along and close to the Middle Jurassic “Alpine Tethyan Unconformity”, featured by Variscan metamorphic rocks covered by the unconformable Middle Jurassic Genna Selole Fm. Sedimentological and paleopedological investigations have been carried out to assess the areal extent and the nature of those concentrations, their origins, and their paleoclimatic, paleoenvironmental, and paleotectonic meanings. Transformation processes showing complex features such as alteration halos, mineral dissolution, reprecipitation, or pedogenetic profiles have been documented. Thus, several processes suggesting phases of variable duration of uplift, exposition to the external agents and erosion of the Variscan basement, and periods of sediment starvation of the superposed Genna Selole Fm deposits have been noted. Additionally, pedological processes occurred during the slowing down of the superposed Genna Selole Fm sedimentation. The alteration deposits differ according to their stratigraphic location. They are from solid, discrete masses to thin beds, crusts, and veins of Fe oxides. They may be of supergenic origin or related to sedimentary processes. The paleosols are Plinthosols related to warm-humid climates with a short dry season. These results provide additional data to 1) better define the depositional environments of the Genna Selole Fm, 2) indicate the episodic presence of ephemeral subarid periods in a dominantly humid Jurassic climate, and 3) document the tectonic evolution of a well-delimited area during this period. This investigation shows how the interdisciplinary use of sedimentological and paleopedological data can be helpful for paleotectonic, paleoenvironmental, and paleoclimatic reconstructions.
Utilization of Cardiac Point-of-care Ultrasonography in Evaluating a Case of Heart Failure Secondary to an Intracardiac Mass, a Case Report
Authors: AlQarni Najeeb , Almalki Faisal Ghazi , Algrigri Osama 
Published: February 2024

Abstract

Intracardiac mass is a rare medical emergency and may present with signs of heart failure like syncope. We report a case of a previously well child who presented with a history of cardiac syncope, with other symptoms of heart failure. Using cardiac point-of-care ultrasound, we were able to identify sonographic signs of heart failure and also to accidentally identify a mass in the right ventricle. Confirmation was followed using echocardiography, computed tomography angiography, and cardiac magnetic resonant imaging. The patient underwent medical treatment for his heart failure and then surgical removal and histopathological examination of the mass which was found to be an organized hematoma. A cardiac point-of-care ultrasound has been emerging as a readily available tool to evaluate global cardiac systolic function and both ventricle size for emergency physicians. Mitral valve closure is the main goal for using focused cardiac point-of-care ultrasound in the emergency department but assessing other valves in terms of closure, appearance, and regurgitation can also be addressed. We suggest in our case some modification to the view of cardiac point-of-care ultrasound that may be used by pediatric emergency medicine physicians to visualize any pathologies to the pulmonic.
A penetrating aortic ulcer rapidly evolving into aortic dissection in a patient presenting with respiratory tract infection to the emergency department: an acute aortic syndrome case report
Authors: Karaki Victoria Al , Saab Aed 
Published: February 2024

Abstract

Background: Penetrating aortic ulcers (PAU) are life-threatening conditions which derive from severely advanced atherosclerotic lesions of the aorta. The clinical course is unpredictable; thus clinical vigilance should be maintained. It is very challenging to separate PAU from co-existing AAS as predisposing factors and findings overlap.
Case presentation: Case of 58-year-old gentleman, who presented for atypical chest pain in the setting of respiratory tract infection. Computed Tomographic angiography (CTA) of the chest showed a large PAU and intramural hematoma which rapidly progressed into an acute aortic dissection in the emergency department. Close follow up with cardiac point of care ultrasound one hour later detected an intimal flap which was not initially present on CTA. Patient underwent surgical aortic graft replacement and had an uneventful in-hospital stay.
Conclusions: This case underlines the importance of broadening differential diagnoses in atypical presentations in chest pain patients with risk factors. Prompt intervention and careful management are imperative to optimize patient outcomes and prevent complications of aortic lesions. Cardiac point of care ultrasound can help in detecting progression of dynamic atherosclerotic diseases such as acute aortic syndrome.
Optimal Harmonic Mitigation Technique for High Power IM Drives
Authors: Yadav Shivam , Mallik Sanjeev Kumar , Mishra Ambarisha 
Published: February 2024

Abstract

The reduction of harmonic torque and ripples in low-switching VFI-based induction motor (IM) drives is a crucial consideration for improving efficiency, service life, drive damage, potential shaft failure for high power/speed drives and overall performance. In literature, existing solutions to these issues involve the implementation of standardized pulse width modulation (PWM) techniques such as sinusoid modulation technique PWM (SMT-PWM) and selective harmonic reduction PWM (SHR-PWM). However, this research proposes a P-PWM-based approach to address the reduction of harmonic magnitude and torque ripple in low-switching VFI-based IM drives. The proposed P-PWM-based approach is specifically applied for three and four-angle switching per quarter cycle (Aq), targeting the reduction of lower-order harmonic magnitude and torque ripples ranging from 6th to 6(Aq-1)th order. By relying on independent specifications and loading states, the P-PWM approach accommodates different Aq and higher-order harmonics. Extensive comparisons with SMT-PWM and SHR-PWM, supported by findings from a 1hp VFI-based IM drive using a TYPHOON-HIL-based hardware setup, demonstrate the superior performance of the P-PWM approach in terms of reducing the harmonic magnitude and torque ripples.
Enablers and barriers to delivering tailored, whole-person care in general practice for people living with multimorbidity: implications for service redesign
Authors: Megson Molly , Hilton Andrea , Aryankhesal Aidin , Blake Jessica , Killett Anne , Horik Jayden Van , Fox Chris , Reeve Joanne 
Published: February 2024

Abstract

Background: Growing numbers of people live with multimorbidity. Healthcare needs to change to adequately address the complexity and burden of their needs Research, practice and policy have called for a shift to whole-person, tailored primary care management of multimorbidity. But we still don’t know how best to do that. Our previous research described a theoretical model of tailored primary care. In this new work, we critically examine if and how front-line practice supports and develops our proposed model and so comment on the implications for practice
Methods: Focused ethnography of 5 UK GP sites, conducting 100 hours of observations, focus groups and mini-interviews. Two-stage analysis: i) inductive thematic analysis of full data set to describe enablers/barriers to tailored care; ii) normalisation process theory informed analysis of implications to present a new implementation model.
Results: We identified three elements needed to enables tailored management : (i) resources for exploration of and practical support for beyond biomedical management of multi-morbidities, (ii) engagement of patients/carers with professional collaboration to co-create tailored management plans, and (iii) the professional training and skills required to confidently work beyond traditional condition-focused models
Conclusions: Our work supports and extends our previous work, describing the elements needed for implementation of the complex intervention needed to deliver tailored generalist management of multimorbidity in primary care. We describe our ongoing work to test the assumptions of the model within a new study of care for people living with dementia
Civilians under missile attack: Post-traumatic stress disorder among the Jewish and Bedouin population of Southern Israel
Authors: Shvartsur Rachel , Savitsky Bella 
Published: February 2024

Abstract

Background
Over the past 20 years, Jewish and Bedouin civilians in southern Israel have faced the ongoing threat of missile attacks from Gaza, with possible mental health consequences. This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD) among Jewish and Bedouin adult civilians in southern Israel in a period with few missile attacks from Gaza, and no military operations.
Methods
The study population included 389 participants (246 Jews, 143 Bedouins) living within 40 km/25 mi from Gaza for at least two years and interviewed between January and March 2023 (before the ongoing war that started on October 7th, 2023). The PTSD Checklist (PCL-5) was used, with a score of 33 as a cutoff point for the presence of PTSD.
Results
Compared to Jews, a significantly lower proportion of Bedouins reported accessibility to bomb shelters and siren warning systems. Overall, 20.3% of the respondents exhibited PTSD. Multivariate analysis revealed that after adjustment for demographic and household characteristics, Bedouins had a seven-fold significantly higher probability of PTSD in comparison to Jews (OR = 6.9, 95%CI: 3.6–13.1). Compared to participants with high socioeconomic status (SES), participants with low SES had a six-fold significantly higher probability of PTSD (OR = 5.8, 95%CI: 2.1–16.5). Being single, living in urban areas, or having a disability significantly increased the probability of PTSD.
Conclusions
The findings of this study demonstrate elevated levels of PTSD among both Jewish and Bedouin civilians residing in southern Israel, with a significantly higher prevalence among the Bedouin population. Several sociodemographic characteristics were associated with the increased prevalence of PTSD, the most prominent of which was low SES. Healthcare professionals and authorities should be proactive in screening for PTSD, and provide tailored treatment and support, taking into account ethnical and cultural background. Authorities should address the disparity in bomb shelter access and siren warning coverage between Bedouin and Jewish communities.