bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examination on joining of 2 mm thick dissimilar stainless steel plates using resistance spot welding
Authors: Vignesh K 
Published: September 2023

Abstract
In the present study, dissimilar metals such as austenitic stainless steel (ASS) and duplex stainless steel (DSS) with a thickness of 2 mm are joined by resistance spot welding process to investigate the welding metallurgy and failure behavior under different heat inputs. Non-uniform electrode impressions are observed on ASS and DSS sides due to their different thermal conductivity and electrical resistivity. The microstructure of the Fusion Zone (FZ) shows that higher heat input accelerates the growth of Intra Granular Austenite (IGA) due to faster cooling. Scanning electron microscopy (SEM) - Energy Dispersive x-ray (EDX) investigation at FZ showed that Chromium & Molybdenum decrease with increasing heat input due to a decrease in ferrite content. X-ray diffraction analysis confirmed that ferrite formation is limited at higher heat input. Microhardness study revealed that the higher hardness is in the middle of the weld nugget, which is due to the presence of equiaxed grains and IGA. The lowest hardness on the ASS side of Heat Affected Zone (HAZ) is due to the phenomenon of grain growth, and the HAZ DSS side has a higher hardness than DSS Base Metal (BM) due to the mechanism of solid solution strengthening. The tensile shear test showed that the tensile shear strength increases with the addition of heat. SEM Examination of the fracture surface revealed the presence of an equiaxed dimple structure on the ASS side, confirming ductile fracture, and torn bonds on the DSS side, confirming quasi-gap fracture due to the work-hardening ability of both plates. This study is carried out to understand the relationship between mechanical, metallurgical, and failure behaviours, because, researches on joining of dissimilar (AISI 316 L and DSS 2205) stainless steel sheets using Resistance Spot Welding process is very limited and need to be studied in detail.
Multi objective optimization of process parameters in hard turning of AISI 52100 steel with surface irregularities using GRA-PCA
Authors: Ponugoti Umamaheswarrao , Koka Naga Sai Suman , Dantuluri Ranga Raju 
Published: September 2023

Abstract
Dry hard-turning is a cost-effective, efficient manufacturing method for AISI 52100 hardened bearing steel. Surface Defect Machining (SDM) is a novel approach to address surface roughness, deteriorations, residual stresses, and metallurgical changes on machined steel. SDM involves exposing workpieces to surface irregularities, reducing cutting resistance, and enhancing surface integrity and finish. In the present work, surface irregularities are formed on the surface of the workpiece in the form of indentations. Using the response surface method’s central composite design (CCD), 32 experimental runs were conducted to determine the optimal process parameters by varying the cutting and tool geometry parameters while AISI52100 steel hard turning (HT). Due to its complexity, multi-objective optimization is more challenging to study. The present work aims to evaluate the effects of input parameters on maching force, surface roughness, and workpiece surface temperature. Further, machining parameters optimization is performed employing the Grey relational analysis integrated with principal component analysis (GRA-PCA). Analysis of variance (ANOVA) was used to examine the impact of cutting and tool geometry parameters on grey relational grade (GRG). ANOVA revealed that feed has the highest influence on GRG, followed by depth of cut, nose radius, cutting speed, and negative rake angle. Cutting speed of 800 rpm, feed rate of 0.04 mm/rev, depth of cut of 0.5 mm, nose radius of 1 mm, and negative rake angle of 15° are the optimum combination of process parameters.
Uniform L∞-bounds for energy-conserving higher-order time integrators for the Gross–Pitaevskii equation with rotation
Authors: Döding Christian , Henning Patrick 
Published: September 2023

Abstract
In this paper, we consider an energy-conserving continuous Galerkin discretization of the Gross–Pitaevskii equation with a magnetic trapping potential and a stirring potential for angular momentum rotation. The discretization is based on finite elements in space and time and allows for arbitrary polynomial orders. It was first analyzed by O. Karakashian and C. Makridakis (SIAM J. Numer. Anal., 36(6),1779–1807, 1999) in the absence of potential terms and corresponding a priori error estimates were derived in $2D$. In this work we revisit the approach in the generalized setting of the Gross–Pitaevskii equation with rotation and we prove uniform $L^{\infty }$-bounds for the corresponding numerical approximations in $2D$ and $3D$ without coupling conditions between the spatial mesh size and the time step size. With this result at hand, we are particularly able to extend the previous error estimates to the $3D$ setting while avoiding artificial CFL conditions.
Secretome from myoblasts statically loaded at low intensity promotes tenocyte proliferation via the IGF‐1 receptor pathway
Authors: Li Junhong , Zhou Xin , Chen Jialin , Eliasson Pernilla , Kingham Paul J. , Backman Ludvig J. 
Published: September 2023

AbstractExercise is widely recognized as beneficial for tendon healing. Recently, it has been described that muscle‐derived molecules secreted in response to static exercise influence tendon healing. In this study, the optimal static loading intensity for tendon healing and the composition of secretome released by myoblasts in response to different intensities of static strain were investigated. In an in vitro coculture model, myoblasts were mechanically loaded using a Flexcell Tension System. Tenocytes were seeded on transwell inserts that allowed communication between the tenocytes and myoblasts without direct contact. Proliferation and migration assays, together with RNA sequencing, were used to determine potential cellular signaling pathways. The secretome from myoblasts exposed to 2% static loading increased the proliferation and migration of the cocultured tenocytes. RNA‐seq analysis revealed that this loading condition upregulated the expression of numerous genes encoding secretory proteins, including insulin‐like growth factor‐1 (IGF‐1). Confirmation of IGF‐1 expression and secretion was carried out using qPCR and enzyme‐linked immunosorbt assay (ELISA), revealing a statistically significant upregulation in response to 2% static loading in comparison to both control conditions and higher loading intensities of 5% and 10%. Addition of an inhibitor of the IGF‐1 receptor (PQ401) to the tenocytes significantly reduced myoblast secretome‐induced tenocyte proliferation. In conclusion, IGF‐1 may be an important molecule in the statically loaded myoblast secretome, which is responsible for influencing tenocytes during exercise‐induced healing.
Pearls for surviving unprecedented healthcare challenges
Authors: Bosek Marcia Sue Dewolf , Ware Catherine , Laramee Ann , Hoffman Sarah 
Published: September 2023

Abstract

Purpose:
Before the COVID-19 pandemic, nurses had little experience providing care during a pandemic. This project aimed to identify Pearls (suggestions) to survive a pandemic as a nurse.

Methods:
A phenomenologic design was implemented. Narrative comments were analyzed using Braun & Clarke's Six Phases of Summative Concept Analysis. This paper focuses on responses to a secondary question of this design.

Results:
One hundred thirty-four professional nurses provided 150 Pearls; of these, 123 Pearls reflected a positive sentiment. The Pearls fit into four themes: take care of yourself and find a balance, work as a team, practice safety, and appreciate that this is a hard time.

Conclusion:
The COVID-19 pandemic provides a valuable lesson for how nurses can survive future pandemics. Further research is warranted to investigate how useful the Pearls are for nurses in future pandemics and other crises threatening healthcare.
Using Theory-Informed Group Processes to Make TIMELESS Promotion Decisions
Authors: Kinnear Benjamin , Santen Sally A. , Schumacher Daniel J. , Kelleher Matthew , Awosika Bi , Edje Louito , Warm Eric J. 
Published: September 2023

Abstract
Competency-based medical education (CBME) depends on effective programs of assessment to achieve the desired outcomes and goals of training. Residency programs must be able to defend clinical competency committee (CCC) group decisions about learner readiness for practice, including decisions about time-variable resident promotion and graduation. In this article, the authors describe why CCC group decision-making processes should be supported by theory and review 3 theories they used in designing their group processes: social decision scheme theory, functional theory, and wisdom of crowds. They describe how these theories were applied in a competency-based, time-variable training pilot—Transitioning in Internal Medicine Education Leveraging Entrustment Scores Synthesis (TIMELESS) at the University of Cincinnati internal medicine residency program in 2020–2022—to increase the defensibility of their CCC group decision-making. This work serves as an example of how use of theory can bolster validity arguments supporting group decisions about resident readiness for practice.
Scaffolding the Transition to Residency: A Qualitative Study of Coach and Resident Perspectives
Authors: Park Agnes , Gillespie Colleen , Triola Marc , Buckvar-Keltz Lynn , Greene Richard E. , Winkel Abigail F. 
Published: September 2023

Abstract

Purpose
This study explores coaching during transition from medical school to residency through the perspectives of residents and faculty coaches participating in a coaching program from residency match through the first year of residency.

Method
From January to September 2020, 15 faculty coaches in internal medicine, obstetrics and gynecology, emergency medicine, orthopedics, and pathology participated in a synchronous, in-person coaching training course. All 94 postgraduate year 1 residents in these 5 training programs participated. Between November 2021 and March 2022, focus groups were held with interns from all residency programs participating in the program. Interviews were conducted with faculty coaches in February 2022. Faculty and residents discussed their experiences with and perceptions of coaching. Deidentified transcripts were coded, and researchers organized these codes into broader categories, generated cross-cutting themes from the concepts described in both cohorts, and proposed a model for the potential of coaching to support the transition to residency. Descriptive themes were constructed and analytic themes developed by identifying concepts that crossed the data sets.

Results
Seven focus groups were held with 39 residents (42%). Residents discussed the goals of a coaching program, coach attributes, program factors, resident attributes, and the role of the coach. Coaches focused on productivity of coaching, coaching skills and approach, professional development, and scaffolding the coaching experience. Three analytic themes were created: (1) coaching as creating an explicit curriculum for growth through the transition to residency, (2) factors contributing to successful coaching, and (3) ways in which these factors confront graduate medical education norms.

Conclusions
Learner and faculty perspectives on coaching through the transition to residency reveal the potential for coaching to make an explicit and modifiable curriculum for professional growth and development. Creating structures for coaching in graduate medical education may allow for individualized professional development, improved mindset, self-awareness, and self-directed learning.
Preliminary Workforce Outcomes of an Urban Longitudinal Integrated Clerkship
Authors: Adams Jennifer E. , Ard Catherine , Cunningham John M. , Jiménez Sheilah , Lockspeiser Tai , Hirsh David A. , Kulasekaran Vishnu 
Published: September 2023

Abstract

Purpose
The authors examined whether students participating in an urban longitudinal integrated clerkship (LIC) with a curriculum focused on care for underserved populations have a sustained commitment to urban underserved care through residency training and into practice.

Method
This mixed-methods study collected data from medical student application essays to the Denver Health LIC (DH-LIC), end-of-course surveys, residency match outcomes, and postgraduation surveys annually for academic years 2014 to 2022. The authors analyzed students' responses to the surveys on interest in working with underserved patients, understanding the rewards and challenges of working in safety net institutions, working in the community to improve health, and working at DH. The authors qualitatively coded the 70 application essays of all selected students using summative content analysis.

Results
Seventy DH-LIC students were compared with 1,450 medical students between 2014 and 2022. Qualitative analysis of LIC application essays revealed 3 themes: interest in working with underserved populations, work experience with underserved populations, and personal experience with medical vulnerability. Fifty-seven DH-LIC participants (81.4%) expressed high levels of career interest in working with underserved populations, 45 (64.3%) had high levels of work experience with underserved populations, and 18 (25.7%) expressed high levels of personal experience. Graduates of the DH-LIC program demonstrated a high degree of continuing interest in practicing in urban underserved settings throughout medical school and postgraduate training. Ten graduates (71.4%) in practice work in urban underserved settings. Participants reported a high or very high level of interest and commitment to working with underserved populations (96.7%–100%), understanding the safety net health care system (91.7%–98.6%), and working in communities (95.0%–100%) at all time points studied.

Conclusions
Early data indicate high rates of graduates working in urban underserved settings. These preliminary outcomes suggest the LIC may support the development of a committed workforce for urban underserved communities.
Development of a Maternal Equity Safety Bundle to Eliminate Racial Inequities in Massachusetts
Authors: Kheyfets Anna , Vitek Kali , Conklin Claire , Tu Christianna , Larson Elysia , Zera Chloe , Iverson Ronald , Reiff Emily , Healy Andrew , Lauring Julianne , Schoen Corina , Manganaro Karen , Pomerleau Mary , Glass Bonnell , Amutah-Onukagha Ndidiamaka , Diop Hafsatou , Meadows Audra R. 
Published: September 2023

OBJECTIVE:
The PNQIN (Perinatal-Neonatal Quality Improvement Network of Massachusetts) sought to adapt the Reduction of Peripartum Racial and Ethnic Disparities Conceptual Framework and Maternal Safety Consensus Bundle by selecting and defining measures to create a bundle to address maternal health inequities in Massachusetts. This study describes the process of developing consensus-based measures to implement the PNQIN Maternal Equity Bundle across Massachusetts hospitals participating in the Alliance for Innovation on Maternal Health Initiative.

METHODS:
Our team used a mixed-methods approach to create the PNQIN Maternal Equity Bundle through consensus including a literature review, expert interviews, and a modified Delphi process to compile, define, and select measures to drive maternal equity-focused action. Stakeholders were identified by purposive and snowball sampling and included obstetrician–gynecologists, midwives, nurses, epidemiologists, and racial equity scholars. Dedoose 9.0 was used to complete an inductive analysis of interview transcripts. A modified Delphi method was used to reach consensus on recommendations and measures for the PNQIN Maternal Equity Bundle.

RESULTS:
Twenty-five interviews were completed. Seven themes emerged, including the need for 1) data stratification by race, ethnicity and language; 2) performance of a readiness assessment; 3) culture shift toward equity; 4) inclusion of antiracism and bias training; 5) addressing challenges of nonacademic hospitals; 6) a life-course approach; and 7) selection of timing of implementation. Twenty initial quality measures (structure, process, and outcome) were identified through expert interviews. Group consensus supported 10 measures to be incorporated into the bundle.

CONCLUSION:
Structure, process, and outcome quality measures were selected and defined for a maternal equity safety bundle that seeks to create an equity-focused infrastructure and equity-specific actions at birthing facilities. Implementation of an equity-focused safety bundle at birthing facilities may close racial gaps in maternal outcomes.
Basic Concepts in Nail Pathology
Authors: Fernandez-Flores Angel 
Published: September 2023

Abstract:Understanding nail pathology is complex for general pathologists and even for those dermatopathologists who do not receive many nail samples in their laboratories. In this article, we attempt to review some of the primary entities in nail pathology with the aid of modern interpretations of nail histology and embryology. We also provide diagrams that can aid in comprehending this field of pathology.
The Era of Progress on Gun Mortality: State Gun Regulations and Gun Deaths from 1991 to 2016
Authors: Sharkey Patrick , Kang Megan 
Published: September 2023

Background:
The recent rise of gun violence may lead to the perception that the problem of gun mortality in the United States is intractable. This article provides evidence to counter this perception by bringing attention to the period spanning from 1991 to 2016 when most US states implemented more restrictive gun laws. Over this period, the United States experienced a decline in household gun ownership, and gun-related deaths fell sharply.

Methods:
The main analysis examines the conditional association between the change in gun regulations at the state level and the change in gun mortality from 1991 to 2016. We include a range of robustness checks and two instrumental variable analyses to allow for stronger causal inferences.

Results:
We find strong, consistent evidence supporting the hypothesis that restrictive state gun policies reduce overall gun deaths, homicides committed with a gun, and suicides committed with a gun. Each additional restrictive gun regulation a given state passed from 1991 to 2016 was associated with −0.21 (95% confidence interval = −0.33, −0.08) gun deaths per 100,000 residents. Further, we find that specific policies, such as background checks and waiting periods for gun purchases, were associated with lower overall gun death rates, gun homicide rates, and gun suicide rates.

Conclusion:
State regulations passed from 1991 to 2016 were associated with substantial reductions in gun mortality. We estimate that restrictive state gun policies passed in 40 states from 1991 to 2016 averted 4297 gun deaths in 2016 alone, or roughly 11% of the total gun deaths that year.
A randomized, double-blind, placebo-controlled trial of aldafermin in patients with NASH and compensated cirrhosis
Authors: Rinella Mary E. , Lieu Hsiao D. , Kowdley Kris V. , Goodman Zachary D. , Alkhouri Naim , Lawitz Eric , Ratziu Vlad , Abdelmalek Manal F. , Wong Vincent Wai-Sun , Younes Ziad H. , Sheikh Aasim M. , Brannan Donald , Freilich Bradley , Membreno Fernando , Sinclair Marie , Melchor-Khan Liza , Sanyal Arun J. , Ling Lei , Harrison Stephen A. 
Published: September 2023

Background and Aims:
Aldafermin, an engineered analog of the human hormone FGF19, improves liver histology in patients with noncirrhotic NASH; however, its efficacy and safety in compensated cirrhosis is unknown. No drug has yet to demonstrate benefit in the compensated NASH population.

Approach and Results:
In this multicenter, double-blind, placebo-controlled, phase 2b trial, 160 patients with compensated NASH cirrhosis were randomized to aldafermin 0.3 mg (n = 7), 1 mg (n = 42), 3 mg (n = 55), or placebo (n = 56) for 48 weeks. The 0.3 mg group was discontinued to limit exposure to suboptimal doses. The primary end point was a change in Enhanced Liver Fibrosis from baseline to week 48. The analyses were performed in the intention-to-treat population. At week 48, the least-squares mean difference in the change in Enhanced Liver Fibrosis was −0.5 (95% CI, −0.7 to −0.2; p = 0.0003) between the 3 mg group and the placebo group. 15%, 21%, and 23% of patients in the placebo, 1 mg, and 3 mg group, respectively, achieved fibrosis improvement ≥ 1 stage; and 13%, 16%, and 20% achieved fibrosis improvement ≥ 1 stage without NASH worsening. Improvement in alanine aminotransferase, aspartate aminotransferase, neoepitope-specific N-terminal pro-peptide of type III collagen, and liver stiffness favored aldefermin groups over placebo. Diarrhea was the most frequent adverse event, occurring at 26% and 40% in the 1 mg and 3 mg groups, respectively, compared to 18% in the placebo group. Overall, 0%, 2%, and 9% of patients in the placebo, 1 mg, and 3 mg group, respectively, discontinued due to treatment-related adverse events.

Conclusions:
Aldafermin 3 mg resulted in a significant reduction in Enhanced Liver Fibrosis in patients with compensated NASH cirrhosis.
Stress and Work Performance Responses to a Multicomponent Intervention for Reducing and Breaking up Sitting in Office Workers
Authors: Maylor Benjamin D. , Hough John , Edwardson Charlotte L. , Zakrzewski-Fruer Julia K. , Bailey Daniel P. 
Published: September 2023

Objective
The aim of the study is to explore the potential of a sitting reduction workplace intervention for improving stress and work performance.

Methods
A cluster randomized controlled trial evaluated an intervention to reduce and break up occupational sitting in 12 clusters (n = 89 office workers) over 8 weeks. Outcomes were physiological stress (cortisol concentrations), perceived stress, and work performance.

Results
Linear mixed model group × time interaction effects were nonsignificant. Exploratory analyses showed a trend, with a large effect, for lower cortisol concentrations over the day in the intervention group relative to controls at 8 weeks (−0.85; 95% confidence interval, −1.70 to 0.03 nmol·L−1; P = 0.06, d = 0.79). The intervention group had higher vigor and cognitive liveliness at 8 weeks relative to controls (P ≤ 0.05).

Conclusions
This exploratory study suggests that there could be meaningful changes in physiological stress and work-related outcomes that should be investigated in future studies.