bluuebunny/crossref_metadata_2025_split huggingface dataset:
Into the Unknown: Characterizing Fellow Uncertainty During the Transition to Unsupervised Practice
Authors: Herchline Daniel , Cohen Margot E. , Ambrose Marietta , Hwang Jennifer , Kaminstein Daniel , Kilberg Marissa , Rosenblatt Samuel , Ziemba Justin , Boyer Donald 
Published: April 2023

ABSTRACT

Background
Helping fellows confront and manage uncertainty in the course of diagnosis and treatment of patients has been a growing focus of medical education. How these same fellows confront uncertainty as they make a transition in their professional development is less commonly a focus of training programs. Better understanding of how fellows experience these transitions will allow fellows, training programs, and hiring institutions to navigate transitions more easily.

Objective
This study aimed to explore how fellows in the United States experience uncertainty during the transition to unsupervised practice.

Methods
Using constructivist grounded theory, we invited participants to engage in semi-structured interviews exploring experiences with uncertainty as they navigate the transition to unsupervised practice. Between September 2020 and March 2021, we interviewed 18 physicians in their final year of fellowship training from 2 large academic institutions. Participants were recruited from adult and pediatric subspecialties. Data analysis was conducted using an inductive coding approach.

Results
Experiences with uncertainty during the transition process were individualized and dynamic. Primary sources of uncertainty identified included clinical competence, employment prospects, and career vision. Participants discussed multiple strategies for mitigating uncertainty, including structured graduated autonomy, leveraging professional networks locally and non-locally, and utilizing established program and institutional supports.

Conclusions
Fellows' experiences with uncertainty during their transitions to unsupervised practice are individualized, contextual, and dynamic with several shared overarching themes.
Caring for Each Other: A Resident-Led Peer Debriefing Skills Workshop
Authors: Lee Grace S. , Dizon Samantha E. , Feeney Colby D. , Lee Yu-Lin Amy , Jordan Megan , Galanos Anthony N. , Trinh Jane V. 
Published: April 2023

ABSTRACT

Background
Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediatrics residents had participated in a debrief.

Objective
The primary objective was to increase resident comfort in participation in peer debriefs after critical incidents from 30% to 50% with implementation of a resident-led peer debriefing skills workshop. Secondary objectives included increasing resident likelihood of leading debriefs and comfort in identifying symptoms of emotional distress.

Methods
Internal medicine, pediatrics, and medicine-pediatrics residents were surveyed for baseline participation in debriefs and comfort in leading peer debriefs. Two senior residents became trained debrief facilitators and led a 50-minute peer debriefing skills workshop for co-residents. Pre- and post-workshop surveys assessed participant comfort in and likelihood of leading peer debriefs. Surveys distributed 6 months post-workshop assessed resident debrief participation. We implemented the Model for Improvement from 2019 to 2022.

Results
Forty-six (77%) and 44 (73%) of the 60 participants completed the pre- and post-workshop surveys. Post-workshop, residents' reported comfort in leading debriefs increased from 30% to 91%. The likelihood of leading a debrief increased from 51% to 91%. Ninety-five percent (42 of 44) agreed that formal training in debriefing is beneficial. Almost 50% (24 of 52) of surveyed residents preferred to debrief with a peer. Six months post-workshop, 22% (15 of 68) of surveyed residents had led a peer debrief.

Conclusions
Many residents prefer to debrief with a peer after critical incidents that cause emotional distress. Resident-led workshops can improve resident comfort in peer debriefing.
Efectos neurológicos en trabajadores expuestos a tolueno. Revisión sistemática
Authors: Alonso Perarnau Susana , García Yánez Tivisay , Durán Pérez Mercedes , Andrés Sanz Álvaro 
Published: April 2023

Introducción y objetivo: el tolueno es un disolvente orgánico derivado del benceno empleado en diversas industrias, con potenciales efectos nocivos para los trabajadores. Este estudio pretende conocer los posibles efectos neurológicos que presentan los trabajadores expuestos a tolueno.
Material y métodos: revisión sistemática de estudios publicados en inglés y español entre enero/2000-diciembre/2021. Las bases de datos consultadas fueron MEDLINE, WOS, Scopus, Embase, LILACS, IBECS y Cochrane Library. La calidad de los estudios se evaluó mediante la declaración STROBE y el nivel de evidencia mediante los criterios SIGN.
Resultados: Se incluyeron 14 estudios observacionales (calidad entre 13-18, nivel de evidencia entre 2+ y 3). Ocho estudios examinaron síntomas neurológicos inespecíficos y alteraciones del comportamiento encontrando un aumento de síntomas como cefalea, náuseas o vómitos, y una disminución del rendimiento motor y atención en trabajadores expuestos a tolueno (p<0,05). Cuatro estudios examinaron los efectos visuales, encontrando valores de Índice de Confusión de Color (CCI) más elevados en el grupo expuesto (p<0,05). Por último, dos estudios examinaron los efectos del tolueno sobre la audición en co-exposición con ruido, observando en uno de ellos agravamiento de la pérdida auditiva en ambiente ruidoso (concentración media 33-164,6ppm), (p<0,001); mientras que en el otro estudio no se observaron efectos a concentraciones ≤50ppm.
Conclusión: la exposición laboral a tolueno produce efectos neurológicos como síntomas inespecíficos, alteraciones del comportamiento, y efectos en la visión y en la audición. No obstante, es necesario realizar estudios con mejor diseño y calidad metodológica, ajustando factores de confusión y con mayor tamaño muestral.
BERTEOLOGI KONTEKSTUAL DARI TANGGANG-TRANGBU (TRADISI RAMAH TANAH MASYARAKAT WANGSINA)
Authors: Molebila Eunike , Tanaem Delila 
Published: April 2023

Tanah dan masyarakat yang tinggal di dalamnya memiliki interkoneksi yang intim. Hal ini dinyatakan dalam wujud kearifan lokal (lokal wisdom). lokal wisdom sendiri telah banyak memberi sumbangsih berharga bagi pengelolaan tanah dengan memperhatikan aspek ekosistem yang berkelanjutan (sustainability). Salah satu lokal wisdom tersebut adalah tranggang-trangbu yang ada pada Masyarakat Wangsina Desa Langkuru Kecamatan Pureman Kabupaten Alor.Kearifan lokal ini didasarkan pada kepercayaan bahwa tahun genap adalah tahun baik dan tahun ganjil adalah tahun keburukan. Karena itu, masyarakat Wangsina hanya akan menanam pada tahun genap, sedangkan lahan pertanian mereka diistirahatkan pada tahun ganjil. Adapun lokasi pelaksanaan tradisi ini adalah pada tiga lereng gunung besar dan akan dibersihkan satu persatu (sistem rotasi) setiap tahun genap, sehingga total waktu untuk mengistirahatkan tanah yang telah diusahakan adalah sebanyak 6 tahun. Namun timbul beberapa persoalan dalam pelaksanaan kearifan lokal ini, karena tradisi ini dibenturkan dengan pemahaman teologis maupun secara ekonomis. Hal-hal ini, membuat masyarakat Wangsina menjadi“gamang”dalam mempraktekan kearifan lokal mereka. Metode penulisan dari artikel ini adalah deskriptif kualitatif. tulisan ini bertujuan untuk mengkaji tradisi ini dari sudut pandang teologi kontekstual agar dapat menghasilkan sebuah pemahaman teologi kontekstual yang ramah tanah pada masyarakat Wangsina.
Kata Kunci: Memeliharan Tanah, Teologi Kontekstual, Tahun Genap-Tahun Ganjil.
Kisah Ayub dalam perspektif psikoanalisis
Authors: Silooy Claudie Valda 
Published: April 2023

Kerusuhan di Ambon tahun 1999 akan dikaji berdasarkan kisah dari tokoh Ayub yang mengalami pencobaan secara bertubi-tubi dalam Ayub 1:1-2; 6-12; 15-22. Peristiwa serupa dalam dua konteks yang berbeda ini akan membawa kita pada sebuah perspektif baru untuk memaknai konsep penderitaan. Artikel ini akan memperlihatkan spirtualitas orang-orang yang mengalami penderitaan dengan menggunakan studi psikoanalisis dari Sigmund Freud. Di sisi lain, artikel ini juga akan membahas tentang studi trauma dan kepedulian teologi dalam isu trauma. Teori tentang studi trauma akan dipakai untuk memahami masyarakat di Kota Ambon yang merasakan hal dampak dari peristiwa kerusuhan. Selain itu, aritkel ini juga akan menampilkan eksistensi Allah di tengah-tengah peliknya badai hidup yang dialami oleh manusia. Tulisan ini disajikan dengan tujuan untuk melihat perubahan perilaku manusia dalam konteks penderitaan, dan membantu pembaca agar memahami bahwa penderitaan bukanlah hal yang dapat dihindari. Salah satu kunci dari penderitaan yang harus dilakukan oleh manusia adalah menjalaninya dengan keyakinan dan pengharapan kepada Tuhan.
Kata kunci: Ayub 1:1-2; 6-12; 15-22; kerusuhan di Ambon; penderitaan; studi psikoanalisis; tokoh Ayub.
MARKETING PRODUCTS DURING THE COVID-19 PANDEMIC UTILIZING THE USE OF E-COMMERCE
Authors: Nst Asrindah , Rizal Muhammad 
Published: April 2023

ABSTRACT The Covid-19 outbreak causes a global crisis, causing small and medium-sized businesses to face serious challenges. As a result, small businesses must respond to crises in an efficient manner. Small and medium-sized businesses will benefit from various digital technologies that are currently in development. Using online media to transform a business will provide benefits such as increasing the value of a product from a small to medium-sized business. The digital media that is used includes social media, marketplaces, Google Business, and others. The use of online media should make product marketing more efficient and increase the sale of any given product. The method of analysis that is used is a qualitative method with a descriptive method of study using a questionnaire and some actual and factual data. keywords: product marketing, digital media, the covid-19 pandemic
Voice Biomarkers for Parkinson's Disease Prediction Using Machine Learning Models with Improved Feature Reduction Techniques
Authors: Chintalapudi Nalini , Dhulipalla Venkata Rao , Battineni Gopi , Rucco Ciro , Amenta Francesco 
Published: April 2023

As a chronic and life-threatening disease, Parkinson's disease (PD) causes people to become rigid and inactive and have shaky voices. There is an argument that current PD detection techniques are ineffective due to their high latency and low accuracy. To enhance the accuracy of PD identification, voice recordings were used as biomarkers in conjunction with the synthetic minority oversampling technique (SMOTE). Three machine learning (ML) models namely support vector machine (SVM), K-nearest neighbors (KNN), and random forest (RF)were adopted to calculate the prediction accuracy. By applying an unsupervised dimensional reduction method, the generated model eliminates redundant data and speeds up training and testing. Model performance is estimated with three parameters, including accuracy, F1 score, and area under the curve (AUC) values. Experimental outcomes suggested that the RF model outperforms other models with 97.4% of classification accuracy. This type of research aims to analyze patient voice recordings to determine the disease severity.

Received: 6 March 2023 | Revised: 6 April 2023 | Accepted: 17 April 2023

Conflicts of Interest
The authors declare that they have no conflicts of interest to this work.
Use of lidar aerosol extinction and backscatter coefficients to estimate cloud condensation nuclei (CCN) concentrations in the southeast Atlantic
Authors: Lenhardt Emily D. , Gao Lan , Redemann Jens , Xu Feng , Burton Sharon P. , Cairns Brian , Chang Ian , Ferrare Richard A. , Hostetler Chris A. , Saide Pablo E. , Howes Calvin , Shinozuka Yohei , Stamnes Snorre , Kacarab Mary , Dobracki Amie , Wong Jenny , Freitag Steffen , Nenes Athanasios 
Published: April 2023

Abstract. Accurately capturing cloud condensation nuclei (CCN) concentrations is key to understanding the aerosol–cloud interactions that continue to feature the highest uncertainty amongst numerous climate forcings. In situ CCN observations are sparse, and most non-polarimetric passive remote sensing techniques are limited to providing column-effective CCN proxies such as total aerosol optical depth (AOD). Lidar measurements, on the other hand, resolve profiles of aerosol extinction and/or backscatter coefficients that are better suited for constraining vertically resolved aerosol optical and microphysical properties. Here we present relationships between aerosol backscatter and extinction coefficients measured by the airborne High Spectral Resolution Lidar 2 (HSRL-2) and in situ measurements of CCN concentrations. The data were obtained during three deployments in the NASA ObseRvations of Aerosols above CLouds and their intEractionS (ORACLES) project, which took place over the southeast Atlantic (SEA) during
September 2016, August 2017, and September–October 2018. Our analysis of spatiotemporally collocated in situ CCN concentrations and
HSRL-2 measurements indicates strong linear relationships between both data
sets. The correlation is strongest for supersaturations (S) greater than 0.25 % and dry ambient conditions above the stratocumulus deck, where
relative humidity (RH) is less than 50 %. We find CCN–HSRL-2 Pearson
correlation coefficients between 0.95–0.97 for different parts of the
seasonal burning cycle that suggest fundamental similarities in biomass
burning aerosol (BBA) microphysical properties. We find that ORACLES
campaign-average values of in situ CCN and in situ extinction coefficients
are qualitatively similar to those from other regions and aerosol types,
demonstrating overall representativeness of our data set. We compute CCN–backscatter and CCN–extinction regressions that can be used to resolve vertical CCN concentrations across entire above-cloud lidar curtains. These lidar-derived CCN concentrations can be used to evaluate model performance, which we illustrate using an example CCN concentration curtain from the Weather Research and Forecasting Model coupled with physics packages from the Community Atmosphere Model version 5 (WRF-CAM5).
These results demonstrate the utility of deriving vertically resolved CCN concentrations from lidar observations to expand the spatiotemporal coverage of limited or unavailable in situ observations.
Evaluation of bias correction methods for a multivariate drought index: case study of the Upper Jhelum Basin
Authors: Ansari Rubina , Casanueva Ana , Liaqat Muhammad Usman , Grossi Giovanna 
Published: April 2023

Abstract. Bias correction (BC) is often a necessity to improve the applicability of
global and regional climate model (GCM and RCM, respectively) outputs to
impact assessment studies, which usually depend on multiple potentially
dependent variables. To date, various BC methods have been developed which
adjust climate variables separately (univariate BC) or jointly (multivariate
BC) prior to their application in impact studies (i.e., the component-wise
approach). Another possible approach is to first calculate the multivariate
hazard index from the original, biased simulations and bias-correct the
impact model output or index itself using univariate methods (direct
approach). This has the advantage of circumventing the difficulties
associated with correcting the inter-variable dependence of climate
variables which is not considered by univariate BC methods. Using a multivariate drought index (i.e., standardized precipitation
evapotranspiration index – SPEI) as an example, the present
study compares different state-of-the-art BC methods (univariate and
multivariate) and BC approaches (direct and component-wise) applied to
climate model simulations stemming from different experiments at different
spatial resolutions (namely Coordinated Regional Climate Downscaling Experiment (CORDEX), CORDEX Coordinated Output for Regional Evaluations (CORDEX-CORE), and 6th Coupled Intercomparison Project (CMIP6)). The BC methods
are calibrated and evaluated over the same historical period (1986–2005).
The proposed framework is demonstrated as a case study over a transboundary
watershed, i.e., the Upper Jhelum Basin (UJB) in the Western Himalayas. Results show that (1) there is some added value of multivariate BC methods
over the univariate methods in adjusting the inter-variable relationship;
however, comparable performance is found for SPEI indices. (2) The best-performing BC methods exhibit a comparable performance under both approaches
with a slightly better performance for the direct approach. (3) The added
value of the high-resolution experiments (CORDEX-CORE) compared to their
coarser-resolution counterparts (CORDEX) is not apparent in this study.
Development of an integrated socio-hydrological modeling framework for assessing the impacts of shelter location arrangement and human behaviors on flood evacuation processes
Authors: Du Erhu , Wu Feng , Jiang Hao , Guo Naliang , Tian Yong , Zheng Chunmiao 
Published: April 2023

Abstract. In many flood-prone areas, it is essential for emergency responders to use
advanced computer models to assess flood risk and develop informed flood
evacuation plans. However, previous studies have had a limited understanding of
how evacuation performance is affected by the arrangement of evacuation
shelters (with respect to their number and geographical distribution) and human
behaviors (with respect to the heterogeneity of household evacuation preparation
times and route-searching strategies). In this study, we develop an
integrated socio-hydrological modeling framework that couples (1) a
hydrodynamic model for flood simulation, (2) an agent-based model for
evacuation management policies and human behaviors, and (3) a transportation
model for simulating household evacuation processes in a road network. We
apply the model to the Xiong'an New Area and examine household evacuation
outcomes for various shelter location plans and human behavior scenarios.
The results show that household evacuation processes are significantly
affected by the number and geographical distribution of evacuation shelters.
Surprisingly, we find that establishing more shelters may not improve
evacuation results if the shelters are not strategically located. We also
find that low heterogeneity in evacuation preparation times can result in
heavy traffic congestion and long evacuation clearance times. If each
household selects their own shortest route without considering the effects
of other evacuees' route choices, traffic congestion will likely occur,
thereby reducing system-level evacuation performance. These results
demonstrate the unique functionality of our model with respect to supporting flood risk
assessment and advancing our understanding of how multiple management and
behavioral factors jointly affect evacuation performance.
Multiple mechanisms for chlorophyll a concentration variations in coastal upwelling regions: a case study east of Hainan Island in the South China Sea
Authors: Li Junyi , Li Min , Wang Chao , Zheng Quanan , Xu Ying , Zhang Tianyu , Xie Lingling 
Published: April 2023

Abstract. Using satellite observations from 2003 to 2020 and cruise
observations from 2019 and 2021, this study reveals an unexpected minor role
of upwelling in seasonal and interannual variations in chlorophyll a (Chl a)
concentrations in the coastal upwelling region east of Hainan Island (UEH)
in the northwestern South China Sea (NWSCS). The results show strong
seasonal and interannual variability in the Chl a concentration in the core
upwelling area of the UEH. Different from the strongest upwelling in summer,
the Chl a concentration in the UEH area reaches a maximum of 1.18 mg m−3
in autumn and winter, with a minimum value of 0.74 mg m−3 in summer.
The Chl a concentration in summer increases to as high as 1.0 mg m−3 with
weak upwelling, whereas the maximum Chl a concentration in October increases
to 2.5 mg m−3. The analysis of environmental factors shows that,
compared to the limited effects of upwelling, the along-shelf coastal
current from the northern shelf and the increased precipitation are
crucially important to the Chl a concentration variation in the study area.
These results provide new insights for predicting marine productivity in
upwelling areas, i.e., multiple mechanisms, especially horizontal advection,
should be considered in addition to the upwelling process.
Compression anastomoses in colon surgery (literature review)
Authors: Vasilkin D. I. , Dambaev G. Ts. , Soloviev M. M. , Fatyushina O. A. , Vlasov A. A. 
Published: April 2023

А review of domestic and foreign literature on compression methods for the formation of colonic anastomoses is presented in the paper.Despite advances in the improvement of the manual suture of the colon, the frequency of postoperative complications remains high – 68.7%, while mortality ranges from 1% to 26%. Thus, it was not possible to achieve the absolute reliability of the traditional manual suture in the formation of colonic anastomoses.Compression anastomosis has an advantage over manual. When forming an anastomosis using a compression method, a decrease in time was noted, ease of creating an anastomosis, a significant decrease in postoperative complications and a high quality of the formed anastomoses, confirmed by morphological studies.
Preclinical safety study of local use of the directed ozone gas flow in abdominal surgery
Authors: Vinnik Yu. S. , Teplyakova O. V. , Malinovskaya N. A. , Kirichenko A. K. , Yakimov S. V. , Erguleeva A. D. , Ponedelnik D. N. , Matveev I. A. 
Published: April 2023

Purpose of the study: to assess the patho-histological changes in the intact pancreas and parietal peritoneum against the background of the directed ozone gas flow.Material and methods. The prospective study was conducted in 54 adult male Wistar rats. In 1st and 2nd groups (n = 24, each) the left pancreatic lobe and parietal peritoneum, respectively, was treated with a 40 mg/L ozone gas stream at a rate of 2 L/min for 1.5 minutes. 1, 3, 30 and 120 days after the first operation 6 animals of each groups were sacrificed and tissue specimens were collected for histological analysis. In the control group (6 sham operated animals), tissue samples were collected 120 days after laparotomy.Results. A day after treatment with ozone gas stream, the pancreatic specimens of 1st group differed from the control in moderate and mild perivascular infiltration and edema. In the period from 3 to 120 days after exposure, the pancreatic specimens of 1st group and control did not differ significantly. Specimens of 2nd group differed from the control degree of edema and infiltration in the first 3 days, the level of proliferation of fibroblast-like cells and fibrosis in 120 days after treatment of the parietal peritoneum with a directed ozone gas stream.Conclusion. Local use of the directed ozone gas flow at a concentration of 40 mg/L at a rate of 2 L/min is accompanied by the same type of patho-histological changes from the intact pancreas and parietal peritoneum in the form of mild to moderate edema, perivascular polymorphic cell infiltration in the early period after exposure. Late parietal peritoneum reaction (moderate events fibroblast-like cell proliferation and fibrosis) requires additional safety studies of intraabdominal use of ozone-oxygen mixture.