Specific Choice Research Articles

A divergence-free and [formula omitted]-conforming embedded-hybridized DG method for the incompressible resistive MHD equations

We present a divergence-free and Hdiv-conforming hybridized discontinuous Galerkin (HDG) method and a computationally efficient variant called embedded-HDG (E-HDG) for solving stationary incompressible viso-resistive magnetohydrodynamic (MHD) equations. The proposed E-HDG approach uses continuous facet unknowns for the vector-valued solutions (velocity and magnetic fields) while it uses discontinuous facet unknowns for the scalar variable (pressure and magnetic pressure). This choice of function spaces makes E-HDG computationally far more advantageous, due to the much smaller number of degrees of freedom, compared to the HDG counterpart. The benefit is even more significant for three-dimensional/high-order/fine mesh scenarios. On simplicial meshes, the proposed methods with a specific choice of approximation spaces are well-posed for linear(ized) MHD equations. For nonlinear MHD problems, we present a simple approach exploiting the proposed linear discretizations by using a Picard iteration. The beauty of this approach is that the divergence-free and Hdiv-conforming properties of the velocity and magnetic fields are automatically carried over for nonlinear MHD equations. We study the accuracy and convergence of our E-HDG method for both linear and nonlinear MHD cases through various numerical experiments, including two- and three-dimensional problems with smooth and singular solutions. The numerical examples show that the proposed methods are pressure robust, and the divergence of the resulting velocity and magnetic fields is machine zero for both smooth and singular problems.

Learning from the best: How medical-students construct role models in general practice during the COVID-19 pandemic and what factors influence this process, a qualitative study.

Background Role-modelling has been found to strongly influence speciality choice for medical students either positively or negatively. There is a deficit in recruitment toward general practice, set to exacerbate the shortfall in GP numbers over the coming decade in the face of spiralling demand. In medical school, students acquire knowledge, skills and start to form their professional identity by observation and interaction with medical educators through the process of role-modelling. Given the significance of this process, the present study attempted to explore the “lived experience” of medical students encountering potential role models during their GP placement using a qualitative method. Methods Following a design based upon the principles of Grounded Theory 10 qualitative interviews were conducted with third-year medical student volunteers at Warwick Medical School. Interviews were recorded, transcribed and analysed using theoretical axial coding demonstrating data saturation in key themes. Results Analysis of data gave insights regarding student perception of positive and negative role modelling in three corresponding domains: Personal Attributes, Student Relationship and Patient Relationships. Conclusions The findings offer unique insights into the influence and impact of GP role-modelling on medical student’s experiences and perceptions during a time of the Covid-19 pandemic and the immediate post-pandemic period and add to the wider body of literature by exploring the influences GP role-modelling has on medical student training experience. The findings support easily implementable recommendations to strengthen positive role modelling in the GP medical student placement context.

A new weighted means of failure rate and associated quantile versions

Abstract In this paper, we define weighted failure rate and their means from the stand point of an application. We begin by emphasizing that the formation of n independent component series system having weighted failure rates with sum of weight functions being unity is same as a mixture of n distributions. We derive some parametric and non-parametric characterization results. We discuss on the form invariance property of baseline failure rate for a specific choice of weight function. Some bounds on means of aging functions are obtained. Here, we establish that weighted increasing failure rate average (IFRA) class is not closed under formation of coherent systems unlike the IFRA class. An interesting application of the present work is credited to the fact that the quantile version of means of failure rate is obtained as a special case of weighted means of failure rate.

Specialty choices among new generation of doctors - insights from a Polish survey study.

The choice of medical specialty for future doctors is a multidimensional issue, associated with many factors. This study aimed to explore the factors influencing the specialty choices of doctors entering the Polish healthcare system. A nationwide cross-sectional survey was conducted from May until August 2023. The data was gathered via an online nationwide survey among recent medical school graduates. We explored respondents' preferences regarding medical specialties (in two categories: surgical and non-surgical), and the factors that drive their choices. The U-Mann Whitney test was used to compare the distribution of 19 analysed factors, and the chi-squared test was used if a trend was not observed. 737 responses were collected, and 698 were included in the study. The respondents (60.5% female) preferred non-surgical specialties over surgical ones. The main factors influencing doctors' choices were remuneration, the ability to maintain work-life balance, interest in the medical field, the ability to start a private practice, skills possessed, and doctor-patient interactions. Doctors pursuing a career in surgical fields are driven by slightly different factors than those who chose a non-surgical specialty. The youngest generation values a healthy work-life balance, and their non-professional life remains crucial.

The main motivational and value attitudes of pediatricians in choosing a vocation

Introduction. Determining the trajectory of a future career and understanding one’s occupational mission imposes responsibility on the life in the individual and society as a whole. Among many vocations, one of the most difficult, not only in terms of maste­ring, the need for constant updating of special knowledge, but also because of many moral and ethical aspects, is the occupation of a doctor. The purpose of the work is to identify the leading factors of motivation for professional self-determination of pediatricians. Materials and methods. One hundred six pediatricians practicing in Moscow, graduated from 35 medical universities of the country took part in the work. An online questionnaire was used for sociological analysis. The respondents were selected using the “snowball” method. Results. Leading factors encouraging the choice of pediatrics as a an vocation were found to be the interest of the person himself in the profession (67%) and the opportunity to help people (19.8%). This indicates the psychological motives of a person in choosing a profession to dominate over social motives. The prestige of the profession and the influence of parents are not considered the main motives for choosing (4.7% and 2.8%, respectively). Most of the pediatricians surveyed (63.2%) are completely satisfied with their chosen profession, which indicates a conscious decision at the time of admission and a desire to develop further within the chosen vocation. Due to their own choice, 95.3% of respondents plan to work in pediatrics in the future. 64.2% of respondents see the main benefit for other people and society in improving children’s health. Conclusion. The dominant motives of professional self-determination of pediatricians, determining the choice of a future specialty, are personal conscious goal-setting in choosing a medical vocation and the opportunity to help children. Working as a pediatrician guarantees a high degree of satisfaction from the chosen path and daily activities.

Industrial Specialization in China: Effects of Central Tools Governing Subnational Agency

Abstract We examine how the central government's management of subnational governments' agency influences the smartness of the latter's industrial specialization choices. Based on smart industrial specialization theory and agency theory, we hypothesize how two central government tools governing subnational governments' agency – facilitating their organizational efficacy and promoting their officials to higher ranks – explain recent industrial specialization choices by China's 31 provincial governments. We find that provincial governments with greater organizational efficacy, measured by access to better-resourced local state-owned enterprises in focal industries, make smarter specialization policies. In addition, we show that provincial governments with greater numbers of officials previously promoted to the central government make, contrary to conventional wisdom, potentially less smart specialization policies. Our research extends smart specialization theory by explaining that central government tools governing subnational agency problems can have knock-on effects making subnational governments' industrial specialization choices smart or unsmart.

Specification Choices in Quantile Regression for Empirical Macroeconomics

ABSTRACTQuantile regression has become widely used in empirical macroeconomics, in particular for estimating and forecasting tail risks. This paper examines various choices in the specification of quantile regressions for macro applications, including how and to what extent to include shrinkage and whether to apply shrinkage in a classical or Bayesian framework. We focus on forecasting accuracy, measured with quantile scores and quantile‐weighted continuous ranked probability scores at a range of quantiles from the left to right tail. Across applications, we find that shrinkage is generally helpful to quantile forecast accuracy, with Bayesian quantile regression dominating frequentist quantile regression.JEL Classification: C53, E17, E37, F47

Momentum shift and on-shell constructible massive amplitudes

We construct tree-level amplitude for massive particles using on-shell recursion relations based on two classes of momentum shifts: an all-line transverse shift that deforms momentum by its transverse polarization vector, and a massive Britto-Cachazo-Feng-Witten-type shift. We illustrate that these shifts allow us to correctly calculate four-point and five-point amplitudes in massive QED, without an ambiguity associated with the contact terms that may arise from a simple “gluing” of lower-point on-shell amplitudes. We discuss various aspects and applicability of the two shifts, including the large-z behavior and complexity scaling. We show that there exists a “good” all-line transverse shift for all possible little group configurations of the external particles, which can be extended to a broader class of theories with massive particles such as massive QCD and theories with massive spin-1 particles. The massive Britto-Cachazo-Feng-Witten-type shift enjoys more simplicity, but a “good” shift does not exist for all the spin states due to the specific choice of spin axis. Published by the American Physical Society 2024

Third-Order Differential Subordination Features of Meromorphic Functions: Erdelyi–Kober Model Integral Operator Application

This study is concerned with the class of p-valent meromorphic functions, represented by the series f(ζ)=ζ−p+∑k=1−p∞dkζk, with the domain characterized by 0<|ζ|<1. We apply an Erdelyi–Kober-type integral operator to derive two recurrence relations. From this, we draw specific conclusions on differential subordination and differential superordination. By looking into suitable classes of permitted functions, we obtain various outcomes, including results analogous to sandwich-type theorems. The operator used can provide generalizations of previous operators through specific parameter choices, thus providing more corollaries.

Predictors of specialty choice of graduates from the medical course of the Federal University of Santa Catarina: cross-sectional study

Predictors of specialty choice of graduates from the medical course of the Federal University of Santa Catarina: cross-sectional study

Welcome to the operating theatre! Introductory bootcamp in operating theatre specialities for medical students.

Since the early 2000's, the appeal of certain operating room specialties has decreasedamong medical school graduate students. The recent reform of the second and third cycles of medical studies in France provides an opportunity to set up teaching programs around operating room specialties. We have organised a teaching unit which is part of the final year of medical studies. The main objectives are: (1) to examine whether a boot camp can modify students' opinions and preconceived assumptions about a surgical and/or anaesthetist career (2) to determine whether these changes in perception, have an impact on students' interest in pursuing a surgical/anaesthetic career compared with the current situation. The "working in the operating theatre" boot camp (UETB) took place after the written exams of the sixth year of medical school, before students choose their future specialty for residency. This program included practical workshops, readings and time for exchanges surgeons and anaesthetists. At the beginning and at the end of the UETB, feedback forms were collected. The cohort included 59 students from the Toulouse medical school, academic year 2023-2024. After attending the UETB, there was a significant qualitative improvement in interest in a surgical and intensive care-anaesthesia career. Feedback on how the UETB influenced the choice of a future specialty was very positive, with statistically significant qualitive improvement., Additionally, the students' perception of a work-life quality as a surgeon and/or anaesthetist improved significantly. The outcome of this study makes a strong case for integrating additional exposure to the various surgical subspecialties into the graduate medical curriculum in France. By helping to dispel misperceptions of "a surgical/anaesthetist career" early on, opportunities such as the UETB program may enable addressing the attrition rate observed among surgical and anaesthetic residency applications.

Modeling the interplay between disease spread, behaviors, and disease perception with a data-driven approach

Individuals’ perceptions of disease influence their adherence to preventive measures, shaping the dynamics of disease spread. Despite extensive research on the interaction between disease spread, human behaviors, and interventions, few models have incorporated real-world behavioral data on disease perception, limiting their applicability. In this study, we propose an approach to integrate survey data on contact patterns and disease perception into a data-driven compartmental model, by hypothesizing that perceived severity is a determinant of behavioral change. We explore scenarios involving a competition between a COVID-19 wave and a vaccination campaign, where individuals’ behaviors vary based on their perceived severity of the disease. Results indicate that behavioral heterogeneities influenced by perceived severity affect epidemic dynamics, in a way depending on the interplay between two contrasting effects. On the one hand, longer adherence to protective measures by groups with high perceived severity provides greater protection to vulnerable individuals, while premature relaxation of behaviors by low perceived severity groups facilitates virus spread. Differences in behavior across different population groups may impact strongly the epidemiological curves, with a transition from a scenario with two successive epidemic peaks to one with only one (higher) peak and overall more numerous severe outcomes and deaths. The specific modeling choices for how perceived severity modulates behavior parameters do not strongly impact the model’s outcomes. Moreover, the study of several simplified models indicate that the observed phenomenology depends on the combination of data describing age-stratified contact patterns and of the feedback loop between disease perception and behavior, while it is robust with respect to the lack of precise information on the distribution of perceived severity in the population. Sensitivity analyses confirm the robustness of our findings, emphasizing the consistent impact of behavioral heterogeneities across various scenarios. Our study underscores the importance of integrating risk perception into infectious disease transmission models and gives hints on the type of data that further extensive data collection should target to enhance model accuracy and relevance.

Perceptions of homelessness: Is there variation across medical careers and specialties?

Medical students, residents and faculty are all capable of holding biases towards stigmatised groups like people experiencing homelessness. This study sought to investigate how the level of training may influence perceptions of homelessness among medical students, residents and faculty. Additionally, we sought to understand how different specialities perceive people experiencing homelessness and whether this changes at various points in a career. The Health Professionals' Attitudes Towards the Homeless Inventory (HPATHI) was administered to medical students, residents and faculty at one institution in the United States. Basic demographics as well as length of time spent in practice were collected in addition to HPATHI responses. A total of 1,141 individuals were invited to complete the survey, including 736 medical students, 214 residents and 191 faculty. Two hundred and ninety individuals participated in the survey and 238 recorded complete responses were analysed for a sample response rate of 238/1141 (20.9%.) Overall perceptions of homelessness across the entire sample were positive and not greatly influenced by the level of training during a medical career. Medical students across classes were largely in agreement and there was a noticeable increase in positive perceptions for students engaged in clinical rotations. However, clinical specialties demonstrated wide variation in perceptions, with the most prominent differences amongst individuals from surgical subspecialties of General Surgery and Obstetrics & Gynaecology. Our study demonstrates the largely favourable attitudes physicians, residents and students have towards people experiencing homelessness with implications for future work to support greater exposure to underserved populations during training. Specialty choice appears to play a larger role in the formation of attitudes towards underserved populations rather than the length of time spent in a particular specialty.

Decrease in decision noise from adolescence into adulthood mediates an increase in more sophisticated choice behaviors and performance gain.

Learning and decision-making undergo substantial developmental changes, with adolescence being a particular vulnerable window of opportunity. In adolescents, developmental changes in specific choice behaviors have been observed (e.g., goal-directed behavior, motivational influences over choice). Elevated levels of decision noise, i.e., choosing suboptimal options, were reported consistently in adolescents. However, it remains unknown whether these observations, the development of specific and more sophisticated choice processes and higher decision noise, are independent or related. It is conceivable, but has not yet been investigated, that the development of specific choice processes might be impacted by age-dependent changes in decision noise. To answer this, we examined 93 participants (12 to 42 years) who completed 3 reinforcement learning (RL) tasks: a motivational Go/NoGo task assessing motivational influences over choices, a reversal learning task capturing adaptive decision-making in response to environmental changes, and a sequential choice task measuring goal-directed behavior. This allowed testing of (1) cross-task generalization of computational parameters focusing on decision noise; and (2) assessment of mediation effects of noise on specific choice behaviors. Firstly, we found only noise levels to be strongly correlated across RL tasks. Second, and critically, noise levels mediated age-dependent increases in more sophisticated choice behaviors and performance gain. Our findings provide novel insights into the computational processes underlying developmental changes in decision-making: namely a vital role of seemingly unspecific changes in noise in the specific development of more complex choice components. Studying the neurocomputational mechanisms of how varying levels of noise impact distinct aspects of learning and decision processes may also be key to better understand the developmental onset of psychiatric diseases.

Contours of modern didactics of professional education: an analysis of foreign studies

Introduction. Vocational education plays a special role in a global policy agenda focused on technological development worldwide. Quality vocational education makes an effective contribution to innovative economic development and equitable sustainable development of human capital. The analysis of trends in the development of educational technologies becomes a source of research of didactic and organizational aspects of professional education as a necessary condition for solving the tasks of Russia's state policy in the sphere of formation of innovation economy. The purpose of the study is to analyze foreign research in the field of didactics and organization of vocational education. Materials and methods. We conducted the study based on content analysis of foreign studies that took place between 2013 and 2023. We analyzed reports and scientific articles posted on open information platforms. The study presents the results of the analysis of 30 information sources. These are materials from the European Union's analytical data portal CEDEFOP, NMC Horizon Project Sector Analysis monitoring on technological solutions in STEM+ education, materials from the report of the Swiss Economic Institute (KOF), results of the analysis of scientific articles. Results. The analysis of sources made it possible to outline the external (invariant) contour of pedagogical approaches and technologies in the sphere of didactics and organization of vocational training and education (VET) in different countries. We also established that the internal didactic contour in each educational organization is formed considering the specifics of the choice of specialties for training and has a variable character. Because of the analysis of foreign sources, we systematized strong technological solutions that have a significant impact on the development of didactics of vocational education in the context of the request to prepare specialists for activities in the field of high-tech production. Prospects for further research. The results obtained can be useful for researchers in the field of professional education in designing the design of the educational process with modern educational technologies.

Conservative wormholes in generalized [formula omitted]- function

We present an exhaustive study of wormhole configurations in κ(R,T) gravity with linear and non-linear functions. The model assumed Morrison-Thorne spacetime where the redshift and shape functions linked with the matter contain and geometry of the spacetime through non-covariant conservation equation of the stress-energy tensor. The first solution was explored assuming a constant redshift function that leads to a wormhole (WH) which is asymptotically non-flat. The remaining solutions were explored in two cases. Firstly, assuming a linear equation of state p(r)=ωρ(r) along with different forms of κ(R,T)-function. This proved enough to derive a shape function of the form b(r)=r0(r0r)1/ω. Secondly, by assuming specific choices of the shape function consistent with the wormhole configuration requirements. All the solutions fulfill flare-out condition, asymptotically flat and supported by phantom energy. Further, the embedding surface and its revolution has been generated using numerical method to see how the length of the throat is affected of the coupling parameters through κ(R,T) function. At the end, we have also calculated the average null energy condition, which is satisfied by all the WH models signifying minimum exotic matter is required to open the WH throats.

Personality traits, interests, and values in medical students: a proposal for a vocational assessment tool for specialty choice

Choosing a medical specialty is a complex, multifactorial process, influenced by a range of factors, including personal motivations, experiences during medical school, job opportunities and remuneration, career stability, availability of residency positions, personality traits, cultural values, sociodemographic factors, and others. The increasing number of medical graduates directly impacts this decision, intensifying competition for residency positions. Universities play a key role in guiding graduates through this decision-making process. However, further research is needed to assist both teachers and students in identifying the most relevant factors influencing this choice. This study aims to explore these factors, considering the individual characteristics of both the medical student and the specialist doctor. It represents the initial step in a research agenda that seeks to develop a psychometric vocational tool to aid in selecting a medical specialty.

From books to the bedside: post-graduation impact of 'Week On the Wards' on medical education

BackgroundThe transition between preclinical and clinical years during medical school has been shown to be challenging. Cooper Medical School of Rowan University (CMSRU) implements one required two-week-long shadowing program for first and one one-week-long shadowing program for second-year medical students called Week On the Wards (WOW). The goal of this study is to ascertain whether students who completed the WOW curriculum found it beneficial over the long-term. Specifically, we want to evaluate alumni’s impression of the program’s influence on career, specialty choice, professional development, personal development, and confidence.MethodsTo evaluate our program, we developed, validated, and distributed a survey via email in the autumn of 2023. Our population included alumni from the classes of 2019–2022, irrespective of race and gender. After following steps for survey development, it was validated via focus group using qualitative methods. The survey consisted of 19 questions answerable on a 5-point Likert scale, a “Yes/No/Unsure/Maybe” section, and an optional open-ended response question. Descriptive analysis was done to report the percent responses.ResultsThe survey was emailed to 353 alumni, with 72 completed responses returned. Majority of respondents agreed or strongly agreed that the WOW program showcased the importance of teamwork in medicine (80.6%), helped them learn to apply medical knowledge (77.8%), influenced their decision regarding which residency/specialty they chose (72.2%), provided an example of how teamwork in medicine is necessary for patient safety and effective care (66.6%), and increased their confidence in their networking skills (66.6%). Alumni nearly unanimously agreed that the WOW program was a useful part of their medical school education (93.1%) and that it should be continued for future classes (94.4%).ConclusionOur results highlight the sustained importance of early preclinical exposure to clinical environments in students’ future career decisions, in their understanding of the clinical applications of learned preclinical topics, and the importance of teamwork in medicine.

Pre-vocational education as a factor in the development of human resources in the healthcare system

Pre-professional medical education in high school provides not only a more in-depth study of individual subjects of general education programs, but also expands the opportunities for self-determination of students, ensures continuity of the educational process, allows boys and girls to adapt more successfully mastering higher medical professional education programs and is the basis for a successful career.Aim. To evaluate the results of the introduction and implementation of the model of pre-professional medical and pharmaceutical education using the example of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) (hereinafter referred to as the Pre-University) as a means of developing the human resources potential of the healthcare system on the territory of the Russian Federation.Materials and methods. During the work, a theoretical analysis of domestic and foreign literature on the problem of developing the human resources potential of the healthcare system was carried out. A study was conducted in the comparative aspect of the basic readiness of students in grades 8-11 at the Pre-University and specialized medical and biological classes of regional educational institutions to the choice of medical specialties using a test questionnaire with the identification of three key aspects: readiness to master medical specialties; self-assessment of capabilities and erudition in the field of modern medicine. 1465 people took part in the survey. The reliability of the results was carried using the Mann-Whitney U test. Assessment of the statistical significance of differences between the means was carried out at a critical level of p = 0.05.Results. Studying at the Pre-University of Sechenov University allowed the majority of adolescents to achieve higher levels of formation of the main indicators of basic readiness to choose medical specialties. The share of students with a high level of readiness to master medical specialties at the Pre-University is 13.8 % higher compared to students of specialized medical and biological classes, with high erudition – 13.8 % and 6.7 % higher those who highly assess their prospects for entering a medical university.Conclusion. Pre-professional education based on close interaction between the Pre-University and Sechenov University allows students to develop motivation to choose a medical profession, as well as a clear understanding of the learning process in the chosen profession and is an important link in the system of continuous educational trajectory «pre-university–university–clinic».

Factors influencing the choice of specialization - a cross-sectional study with civilian medical students and prospective medical officers in Germany

BackgroundThe recruitment of physicians is an increasing challenge. The aim of the study was to explore factors that might influence future civilian and military doctors’ choice of specialization.MethodsA 28 item author developed questionnaire was used to survey civilian medical students and prospective medical officers. The questionnaire consisted of 20 items addressing choice of specialization, and eight socio-demographic factors. Response options were available in the form of open and closed questions as well as in the form of a Likert scale (1 ‘not at all’ to 6 ‘very much’). The questionnaire was completed online by prospective medical officer from June to September 2021 and by civilian students from November 2020 to March 2021.ResultsIn total, 2,030 students (56.1% female, mean age = 24, mean semester 6.5) participated in the survey, 1,553 civilian students and 477 prospective medical officers. Regular feedback and clear structures (mean = 5.35) followed by good teamwork (mean = 5.33) during postgraduate training was rated particularly important. Moreover, a secure job after graduation (mean = 5.23) and a compatibility of family and job (mean = 5.14) were important parameters for career choice. The specializations most frequently chosen were surgery (32.0%), internal medicine (27.1%) and anesthesiology (22.1%). The regression models showed that the choice depends on own attitude concerning the specialty would be a patient-orientation job, or a job with more manual work or more career option within in the job preferred.ConclusionsConsidering the value students place on receiving feedback and the structure of their specialist training, this seems to be a promising strategy for future recruitment. Good team dynamics and job security are key concerns for prospective physicians.