bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trainee Physician Milestone Ratings and Patient Complaints in Early Posttraining Practice
Authors: Han Misop , Hamstra Stanley J. , Hogan Sean O. , Holmboe Eric , Harris Kelly , Wallen Eric , Hickson Gerald , Terhune Kyla P. , Brady Donald W. , Trock Bruce , Yamazaki Kenji , Bienstock Jessica L. , Domenico Henry J. , Cooper William O. 
Published: April 2023

ImportanceEvaluation of trainees in graduate medical education training programs using Milestones has been in place since 2013. It is not known whether trainees who have lower ratings during the last year of training go on to have concerns related to interactions with patients in posttraining practice.ObjectiveTo investigate the association between resident Milestone ratings and posttraining patient complaints.Design, Setting, and ParticipantsThis retrospective cohort study included physicians who completed Accreditation Council for Graduate Medical Education (ACGME)–accredited programs between July 1, 2015, and June 30, 2019, and worked at a site that participated in the national Patient Advocacy Reporting System (PARS) program for at least 1 year. Milestone ratings from ACGME training programs and patient complaint data from PARS were collected. Data analysis was conducted from March 2022 to February 2023.ExposuresLowest professionalism (P) and interpersonal and communication skills (ICS) Milestones ratings 6 months prior to the end of training.Main Outcomes and MeasuresPARS year 1 index scores, based on recency and severity of complaints.ResultsThe cohort included 9340 physicians with median (IQR) age of 33 (31-35) years; 4516 (48.4%) were women physicians. Overall, 7001 (75.0%) had a PARS year 1 index score of 0, 2023 (21.7%) had a score of 1 to 20 (moderate), and 316 (3.4%) had a score of 21 or greater (high). Among physicians in the lowest Milestones group, 34 of 716 (4.7%) had high PARS year 1 index scores, while 105 of 3617 (2.9%) with Milestone ratings of 4.0 (proficient), had high PARS year 1 index scores. In a multivariable ordinal regression model, physicians in the 2 lowest Milestones rating groups (0-2.5 and 3.0-3.5) were statistically significantly more likely to have higher PARS year 1 index scores than the reference group with Milestones ratings of 4.0 (0-2.5 group: odds ratio, 1.2 [95% CI, 1.0-1.5]; 3.0-3.5 group: odds ratio, 1.2 [95% CI, 1.1-1.3]).Conclusions and RelevanceIn this study, trainees with low Milestone ratings in P and ICS near the end of residency were at increased risk for patient complaints in their early posttraining independent physician practice. Trainees with lower Milestone ratings in P and ICS may need more support during graduate medical education training or in the early part of their posttraining practice career.
Research on dynamic temporal and spatial distribution characteristics of electrical power system voltage based on random forest algorithm
Authors: Fan Jiaqi , Shang Tongjun , Yang Tianyu 
Published: April 2023

AbstractThe theme of this study is to find a method that can more accurately classify the spatiotemporal distribution characteristics of power system voltage dynamics. As more and more new energy power generation devices are added to the power network, the accuracy of traditional methods for classifying the spatiotemporal distribution characteristics of power system voltage dynamics has gradually decreased. It is significant to reduce the power loss caused by error in identifying voltage dynamic spatiotemporal distribution characteristics. Hence it is necessary to design methods that can more accurately classify power system voltage dynamic spatiotemporal distribution characteristics data. This study proposes a method for studying the spatiotemporal distribution characteristics of power system voltage dynamics based on an improved random forest algorithm. The information entropy calculation method of decision tree in random forest algorithm is improved. According to the experimental results, the classification accuracy of the method for voltage dynamic spatiotemporal distribution characteristics is 99.55%. It can effectively achieve the dynamic spatiotemporal distribution of power system voltage.
Realizing p‐Type and n‐Type Doping of a Single Conjugated Polymer via Incorporation of a Thienoisatin‐Terminated Quinoidal Unit
Authors: Geng Xiaokang , Du Tian , Xu Chenhui , Liu Yingying , Deng Yunfeng , Geng Yanhou 
Published: April 2023

AbstractSelective doping of a single conjugated polymer (CP) to obtain p‐type and n‐type conductive materials would be highly attractive for organic thermoelectric applications, because it will greatly reduce the time and costs of synthesizing different types of CPs. However, this strategy has rarely been investigated. In this study, two CPs are synthesized, designated PTQDPP‐T and PTQDPP‐2FT, based on a newly developed quinoidal unit with thienoisatin as the termini and a thiophene‐flanked diketopyrrolopyrrole (ThDPP) unit as the quinoidal core. The electron‐rich thiophene rings in thienoisatin and the electron delocalization induced by thienoisatin resulted in polymers with high‐lying highest occupied molecular orbital, and the electron‐deficient nature of ThDPP unit and its quinoidal backbone endowed the polymers with low‐lying lowest unoccupied molecular orbitals. As a result, both polymers can be p‐type and n‐type doped. Because of its high mobility, doped PTQDPP‐2FT performed better in organic thermoelectric devices than the doped PTQDPP‐T. After being doped with FeCl3 and N‐DMBI, PTQDPP‐2FT showed p‐type and n‐type power factors of 278.2 and 2.37 µW m−1 K−2, respectively. These are the best for bipolar (p‐type and n‐type) performances that obtained by selective doping of a single polymer.
Innovative Design Strategies Advance Biomedical Applications of Phthalocyanines
Authors: Li Dong , Cai Shundong , Wang Peiyu , Cheng Hongwei , Cheng Bingwei , Zhang Yang , Liu Gang 
Published: April 2023

AbstractOwing to their long absorption wavelengths, high molar absorptivity, and tunable photosensitivity, phthalocyanines have been widely used in photodynamic therapy (PDT). However, phthalocyanines still face the drawbacks of poor targeting, “always‐on” photosensitizing properties, and unsatisfactory therapeutic efficiency, which limit their wide applications in biomedical fields. Thus, new design strategies such as modification of targeting molecules, formation of nanoparticles, and activating photosensitizers are developed to improve the above defects. Notably, recent studies have shown that novel phthalocyanines are not only used in fluorescence imaging and PDT, but also in photoacoustic imaging, photothermal imaging, sonodynamic therapy, and photothermal therapy. This review focuses on recent design strategies, applications in biomedicine, and clinical development of phthalocyanines, providing ideas and references for the design and application of phthalocyanine, so as to promote their future transformation into clinical applications.
Magnetically Responsive Melt Electrowritten Structures
Authors: G. Saiz Paula , Reizabal Ander , Luposchainsky Simon , Vilas‐Vilela Jose Luis , Lanceros‐Mendez Senentxu , Dalton Paul D. 
Published: April 2023

AbstractWhile melt electrowriting (MEW) can result in complex microstructures, research demonstrating such fabrication with active materials is limited. Herein, magnetoresponsive poly(ε‐caprolactone) (PCL) inks containing up to 10 wt% of iron‐oxide (Fe3O4) nanoparticles are used to produce fiber with diameters of 9.2 ± 0.6 µm in ordered microstructures when processed by MEW. Introducing the Fe3O4 nanoparticles has a minimal overall effect on printing quality compared to pure PCL under similar conditions. The magnetic response of Fe3O4 containing fibers allows magnetic actuation, which is one of the first steps to control movement in such structures. Printed samples show different magnetic responses that can be controlled by the micro‐ and macro‐structure design, the nanoparticle concentration, and multi‐material design. The potential of MEW to print active magnetic complex micro‐ and macro‐structures for 4D printing designs is demonstrated, in which active properties can be further tailored with magnetoresponsive fillers with varying characteristics and by changing MEW fiber diameters.
All‐Trans Retinoic Acid Promotes a Tumor Suppressive OTUD6B‐β‐TrCP‐SNAIL Axis in Esophageal Squamous Cell Carcinoma and Enhances Immunotherapy
Authors: Li Lei , Zhu Rui , Zhou Honghong , Cui Chun‐Ping , Yu Xiao , Liu Yuhao , Yin Yin , Li Yang , Feng Riyue , Katz Jonathan P. , Zhao Yahui , Zhang Yun , Zhang Lingqiang , Liu Zhihua 
Published: April 2023

Abstractβ‐TrCP is an E3 ubiquitin ligase that plays important roles in multiple human cancers including esophageal squamous cell carcinoma (ESCC). Analysis of ESCC patient samples reveal that only protein level but not transcript level of β‐TrCP associated with patient prognosis, suggesting regulators of β‐TrCP protein stability play an essential role in ESCC progression and may be novel targets to develop ESCC therapies. Although β‐TrCP stability is known to be mediated by the ubiquitin‐proteasome system, it is unclear which enzymes play a major role to determine β‐TrCP stability in the context of ESCC. In this study, OTUD6B is identified as a potent deubiquitinase of β‐TrCP that suppress ESCC progression through the OTUD6B‐β‐TrCP‐SNAIL axis. Low OTUD6B expression is associated with a poor prognosis of ESCC patients. Importantly, all‐trans retinoic acid (ATRA) is found to promote OTUD6B translation and thus suppress ESCC tumor growth and enhance the response of ESCC tumors to anti‐PD‐1 immunotherapies. These findings demonstrate that OTUD6B is a crucial deubiquitinase of β‐TrCP in ESCC and suggest combination of ATRA and anti‐PD‐1 immune checkpoint inhibitor may benefit a cohort of ESCC patients.
Positron Emission Tomography with [18F]‐DPA‐714 Unveils a Smoldering Component in Most Multiple Sclerosis Lesions which Drives Disease Progression
Authors: Hamzaoui Mariem , Garcia Jeanne , Boffa Giacomo , Lazzarotto Andrea , Absinta Martina , Ricigliano Vito A.G. , Soulier Theodore , Tonietto Matteo , Gervais Philippe , Bissery Anne , Louapre Céline , Bottlaender Michel , Bodini Benedetta , Stankoff Bruno 
Published: April 2023

ObjectiveTo determine the prognostic value of persisting neuroinflammation in multiple sclerosis (MS) lesions, we developed a 18 kDa‐translocator‐protein‐positron emission tomography (PET) ‐based classification of each lesion according to innate immune cell content and localization. We assessed the respective predictive value of lesion phenotype and diffuse inflammation on atrophy and disability progression over 2 years.MethodsThirty‐six people with MS (disease duration 9 ± 6 years; 12 with relapsing–remitting, 13 with secondary‐progressive, and 11 with primary‐progressive) and 19 healthy controls (HCs) underwent a dynamic [18F]‐DPA‐714‐PET. At baseline and after 2 years, the patients also underwent a magnetic resonance imaging (MRI) and neurological examination. Based on a threshold of significant inflammation defined by a comparison of [18F]‐DPA‐714 binding between patients with MS and HCs, white matter lesions were classified as homogeneously active (active center), rim‐active (inactive center and active periphery), or nonactive. Longitudinal cortical atrophy was measured using Jacobian integration.ResultsPatients with MS had higher innate inflammation in normal‐appearing white matter (NAWM) and cortex than HCs (respective standardized effect size = 1.15, 0.89, p = 0.003 and < 0.001). Out of 1,335 non‐gadolinium‐enhancing lesions, 53% were classified as homogeneously‐active (median = 17 per patient with MS), 6% rim‐active (median = 1 per patient with MS), and 41% non‐active (median = 14 per patient with MS). The number of homogenously‐active lesions was the strongest predictor of longitudinal changes, associating with cortical atrophy (β = 0.49, p = 0.023) and Expanded Disability Status Scale (EDSS) changes (β = 0.35, p = 0.023) over 2 years. NAWM and cortical binding were not associated to volumetric and clinical changes.InterpretationThe [18F]‐DPA‐714‐PET revealed that an unexpectedly high proportion of MS lesions have a smoldering component, which predicts atrophy and clinical progression. This suggests that following the acute phase, most lesions develop a chronic inflammatory component, promoting neurodegeneration and clinical progression. ANN NEUROL 2023;94:366–383
Investigating interindividual variability in corticomotor reorganization during sustained hamstring pain: A randomized experimental study
Authors: Cavaleri Rocco , Imam Jawwad , Rio Ebonie , Moukhaiber Nadia , Thomson Daniel , Suhood Ariane , Summers Simon J. 
Published: April 2023

AbstractBackgroundIncreasing evidence suggests that pain drives maladaptive corticomotor changes that may increase susceptibility to injury and promote symptom recurrence. However, few studies have evaluated the influence of interindividual corticomotor responses to musculoskeletal pain. Existing research in this area has also been limited largely to the upper limb. This is a pertinent point, given the functional and neurophysiological differences between upper and lower limb muscles, as well as the fact that most acute sporting injuries occur in the lower limb. Accordingly, this study explored the variability of corticomotor responses to experimentally‐induced sustained hamstring pain and whether specific patterns of corticomotor reorganization were associated with poorer outcomes (mechanical sensitivity, pain, or functional limitation).MethodThirty‐six healthy individuals participated. Following random allocation on Day 0, the experimental group performed an eccentric exercise protocol of the right hamstring muscles to induce delayed onset muscle soreness. The control group performed repetition‐matched concentric exercise that did not induce soreness. Measures of mechanical sensitivity, pain, function, and corticomotor organization were collected at baseline and on Day 2.Results and conclusionsCorticomotor responses to sustained hamstring pain were variable. Individuals who developed corticomotor facilitation in response to hamstring pain experienced greater mechanical sensitivity than those who developed corticomotor depression. These novel data could have implications for rehabilitation following lower limb pain or injury.
Why corporate sustainability initiatives fail to reduce deforestation and what to do about it
Authors: Panwar Rajat , Pinkse Jonatan , Cashore Benjamin , Husted Bryan W. 
Published: April 2023

AbstractDeforestation is a complex environmental problem that has eluded a series of public policies and private‐sector interventions. The need to develop effective solutions to this problem is urgent because unabated deforestation exacerbates climate change, biodiversity loss, human rights violations, displacement of Indigenous communities, and breakouts of zoonotic diseases. This paper focuses on corporate‐led efforts to stop deforestation and identifies four reasons behind their failure: global trade and supply‐chain obscurity, power dynamics in supply chains, neglected consumption in emerging economies, and diluted goal setting. We call upon corporate sustainability scholars, specifically in entrepreneurship, marketing, strategy, and supply‐chain management domains, to dedicate efforts to develop novel corporate sustainability initiatives that can address the complex, rampant, and stubborn challenge of deforestation. We propose three broad areas of research to advance scholarship on the role of corporate sustainability in stopping deforestation: zero‐deforestation supply chains, zero‐deforestation consumption, and nature‐positive business models.
Preliminary clinical outcomes of head and neck squamous cell carcinoma treated with particle beam radiation therapy
Authors: Huang Qingting , Hu Jiyi , Hu Weixu , Gao Jing , Yang Jing , Qiu Xianxin , Zhang Haojiong , Lu Jiade Jay , Kong Lin 
Published: April 2023

AbstractPurposeFurther improvement in clinical outcomes is needed for patients with head and neck squamous cell carcinoma (HNSCC), as there is typically a poor prognosis at diagnosis. This study aimed to report the preliminary therapeutic outcomes and side effects in patients with HNSCC receiving particle beam radiotherapy (PBRT), owing to the physical and biological advantages of this approach.MethodsWe retrospectively analyzed 68 patients with newly diagnosed HNSCC who received PBRT at the Shanghai Proton and Heavy Ion Center (SPHIC) between August 2015 and December 2020. The Kaplan–Meier approach was used to determine overall survival (OS), disease‐specific survival (DSS), progression‐free survival (PFS), local recurrence‐free survival (LRFS), regional recurrence‐free survival (RRFS), and distant metastasis‐free survival (DMFS). Common Terminology Criteria for Adverse Events (CTCAE) 4.03 was also used to grade acute and late toxicities.ResultsWith a median follow‐up time of 24.5 months (range, 3–65), the 3‐year OS, DSS, PFS, LRFS, RRFS, and DMFS rates for the entire cohort were 79.0%, 84.7%, 67.9%, 83.5%, 83.3%, and 96.1%, respectively. Univariate and multivariate analyses showed that N category was a significant predictor of OS, PFS, and RRFS. In terms of acute toxicities, two patients demonstrated severe mucositis or dysphagia, and two patients also displayed a late toxicity of significant mucosal necrosis.ConclusionThese findings suggest that PBRT can provide patients with HNSCC with a promising therapeutic benefit and manageable toxicity. Prospective evaluation of clinical outcomes with PBRT for HNSCC is warranted, with an emphasis on clinical effectiveness as well as adverse effects and patient quality of life.
Design framework for dimethyl ether (DME)production from coal and biomass‐derived syngas via simulation approach
Authors: Tripathi Komal , Gupta Vrinda , Awasthi Varsha , Pant Kamal Kishore , Upadhyayula Sreedevi 
Published: April 2023

AbstractA comprehensive thermodynamic study was conducted to evaluate the comparative efficacy of methanol and dimethyl ether (DME) synthesis using CO2rich syngas feed. The first part of our study included assessing the relative performances of the methanol synthesis system, two step DME synthesis system, and one step DME synthesis system in terms of the COxconversion and product yield (methanol/DME) based on the Gibbs free energy minimization approach. The wide range of composition of CO2‐enriched syngas feed produced by the coal and biomass gasification was simulated using Aspen Plus and the following evaluation parameters were analyzed for a broad parameter range: reaction temperature (180–280°C), reaction pressure (10–80 bar), stoichiometry number (SN) (0–11), and CO2/(CO2 + CO) molar feed ratio (0–1) for isothermal as well as adiabatic conditions. Based on the equilibrium yield, one‐step DME synthesis was discovered as the most viable process to utilize the co‐gasification derived syngas effectively. In the second part of our study, the overall process efficiency was inspected through the process design of 1 tonnes per day (TPD) DME plant inclusive of heat integration, resulting in significant CO2abatement and DME production with high product purity and minimum energy consumption. Consequently, one‐step DME production via CO2‐enriched syngas obtained through the coal or biomass gasification process is identified as the leading technology based on energy utilization and CO2abatement.
Shift‐invariant universal adversarial attacks to avoid deep‐learning‐based modulation classification
Authors: Lu Keyu , Qian Zhisheng , Wang Manxi , Wang Dewang , Ma Pengfei 
Published: April 2023

SummaryWith the development of deep‐learning technology, how to prevent signal modulation from being correctly classified by deep‐learning‐based intruders becomes a challenging issue. Adversarial attack provides an ideal solution as deep‐learning models are proved to be vulnerable to intentionally designed perturbations. However, applying adversarial attacks to communication systems faces several practical problems such as shift‐invariant, imperceptibility, and bandwidth compatibility. To this end, a shift‐invariant universal adversarial attack approach is proposed in this work for misleading deep‐learning‐based modulation classifiers used by intruders. Specifically, this work first introduces a convolutional neural network (CNN)‐based UAP (universal adversarial perturbation) generation model that contains an finite impulse response (FIR) filter layer to control the bandwidth of the output perturbation. Besides, this work proposes a circular shift scheme that simulates the random signal cropping in the inference phase and thus ensures the shift‐invariant property of adversarial perturbations. In addition, this work designs a composite loss function that improves the imperceptibility of the adversarial perturbation in both time and frequency domains without decreasing the effectiveness of the adversarial attack. Experimental results demonstrate the effectiveness of the proposed approach, achieving about 50% accuracy drop on the target model when the perturbation‐to‐signal ratio (PSR) is −10 dB. Furthermore, extensive experiments are conducted to validate the shift‐invariant, imperceptibility, bandwidth compatibility, and transferability of the proposed approach for modulation classification tasks.
Fulfilling the promise: Commentary on Schleider et al. (2023)
Authors: Cooper Zafra , Shafran Roz 
Published: April 2023

AbstractIn their paper on “Realizing the Untapped Promise of Single‐Session Interventions for Eating Disorders” Schleider and colleagues suggest an innovative approach to addressing a much‐ discussed critical issue in the treatment of eating disorders—how we help more people quickly and with greater efficiency. While building on the feasibility and success of program‐led approaches, they make a potentially transformative proposal for the use of single‐session, “one‐at‐a‐time” interventions freely accessible to those in need. We suggest that not only does this proposal have the potential to narrow the treatment gap, but its ability to generate informative data at scale may also contribute to improving treatment outcomes overall. We also note the need for further independent support for the claim that single sessions produce meaningful benefit especially in the field of the prevention and treatment of eating disorders. While Schleider and colleagues' proposal is potentially transformative and has heuristic value, some caution needs to be exercised. In our view, single‐session interventions should not be regarded as displacing existing treatment provision. Rather they should be seen as complementary and a potential way of improving provision overall.