Specific Choice Research Articles

Science and values: a two-way direction

In the science and values literature, scholars have shown how science is influenced and shaped by values, often in opposition to the ‘value free’ ideal of science. In this paper, we aim to contribute to the science and values literature by showing that the relation between science and values flows not only from values into scientific practice, but also from (allegedly neutral) science to values themselves. The extant literature in the ‘science and values’ field focuses by and large on reconstructing, post hoc, how values have influenced science; our reconstruction of the case studies, instead, aims to show that scientific concepts and methods too, because of specific identifiable characteristics, can promote some values rather than (or at the expense of) others. We explain this bidirectional relation in analogy to debates on the normativity of technical artifacts and on feminist approaches in science, and we illustrate our claims with cases from the health sciences and machine learning. While our arguments in this paper also draw on post hoc reconstructions, we intend to show where, in the science in the making, we should engage not only with the question whether a practice is value-laden, but also how specific conceptual and methodological choices can influence values down the road. All in all, these considerations expand the ways in which philosophers can contribute to more value-aware scientific practices.

Factors affecting young doctors' choice of medical specialty-A qualitative study.

Young doctors' choice of medical specialty is essential to maintaining a sufficient health workforce and developing a sustainable healthcare system. The choice of specialization is the result of numerous factors, including doctors' preferences, population needs, and the number of available residency slots. The aim of this article is to explore the factors taken into consideration by young Polish physicians in choosing their future specialty. We have conducted 30 structured interviews with randomly selected recent medical school graduates (17 female and 13 male). The study was conducted from December 2022 until February 2023 using online platforms. Data from in-depth interviews were coded using NVivo Release 1.6.1. Then thematic analysis was performed. Respondents indicated remuneration and career-associated factors as the main determinants, emphasizing that work-life balance, personal motivations, and the flexibility to choose the type of workplace (hospital vs. outpatient clinic) were even more important. Young doctors expect flexibility in working hours and better working conditions in future work, and these factors are important when choosing a medical specialty. Significant difficulties during the selection of medical specialty include limited residency slots in preferred specializations and lack of knowledge concerning the everyday aspects of work in a particular specialty. Factors and limitations influencing the choice of medical specialty should be taken into account by policymakers to address the shortages of doctors in deficit specialties. Knowledge about doctors' preferences regarding their medical specialty could support the development of targeted policies to increase the attractiveness of deficit specialties and reduce the uneven distribution of medical staff.

Effects of In-House Calls on Medical Students' Perspectives of Surgical Education and Future Career Opportunities.

Background: It has been shown that surgical residents who took few or no in-house calls during medical school felt less prepared for the residency. In this study, our objective was to assess the impact of in-house calls carried out by medical students on their perceptions of medical training, including the influence on specialty choice. Methods: The students were asked to complete an anonymized questionnaire at the first and last day of their general surgery clerkship. Students were asked regarding importance for medical training and education, preparation for the internship, learning opportunities, skills acquisition; negative effects, including fatigue, negative effect over medical training, personal life, and physical and mental health derangements; and the student's perception of the residents' in-house calls and parameters affecting specialty selection: difficulty of the residency, prestige, and future career opportunities. Results: A total of 42 medical students responded to 84 questionnaires. There was a significant difference in the importance of calls among male students before the beginning of the clerkships compared with the end of the clerkship (4.53 versus 4.21, P = .034). At the end of general surgery clerkship, students indicated that the calls less impaired studying during the clerkship (2.5 versus 2.21, P < .05) compared with the beginning of the clerkship. Female students ranked the calls as less demanding at the end of the clerkship (2.53 versus 2.12, P < .05). The impact of the residency difficulty on the selection of their future specialty was rated higher by the students at the end of the clerkship compared with their expectations at the beginning (3.13 versus 2.85, P = .033). Conclusions: In conclusion, our study demonstrates that in-house calls performed by medical students during their general surgery clerkships have a significant influence on their perceptions of medical training and choice of specialty. The study also highlights the importance of gender differences in the students' perception of the importance and impact of calls on their well-being.

Enhanced Security in Public Key Cryptography: A Novel Approach Combining Gaussian Graceful Labeling and NTRU Public Key Cryptosystem

This research explores an encryption system that combines the Nth-degree Truncated Polynomial Ring Unit (NTRU) public key cryptosystem with Gaussian Graceful Labeling. This process assigns distinct labels to a graph's vertices, resulting in successive Gaussian integers. The NTRU method offers enhanced security and efficient key exchange. The communication encryption process depends on integers P, a, and b, with P being the largest prime number in the vertex labeling. The original receivers are the vertex labeling with the largest prime number coefficient, while all other receivers receive messages from the sender. A polynomial algebraic mixing system and a clustering principle based on the abecedarian probability proposition are used in NTRU encryption and decryption. The choice of relatively prime integers p and q in NTRU plays a role in the construction of polynomial rings used for encryption and decryption, with specific choices and properties designed to ensure scheme security.

Unified Supersymmetric Description of Shape-Invariant Potentials within and beyond the Natanzon Class

The transformations of supersymmetric quantum mechanics are discussed within a formalism that employs a six-parameter function, from which the superpotential and the supersymmetric partner potentials V−(x) and V+(x) are constructed in a general form. By specific choice of the parameters, V−(x) and V+(x) are matched with the general form of PI class potentials and their rationally extended versions. The choice of the parameters also determines which of the four possible SUSY transformations Ti, i=1,…4 is in effect. After this general discussion, the formulae are specified to the three members of this potential class, the Scarf I, Scarf II and generalized Pöschl–Teller potentials. Due to the different domains of definition and their consequences on the boundary conditions, the results turn out to be rather diverse for the three potentials, while the mathematical formalism and the network of the potentials interconnected by the SUSYQM transformations still remains common to a large extent. The general framework allows a unified and consistent interpretation of earlier isolated findings. It also helps to connect the results to further potential classes and to place them into a more general context within the zoo of exactly solvable potentials.

Faber polynomial coefficient inequalities for bi-Bazilevič functions associated with the Fibonacci-number series and the square-root functions

Two new subclasses of the class of bi-Bazilevič functions, which are related to the Fibonacci-number series and the square-root functions, are introduced and studied in this article. Under a special choice of the parameter involved, these two classes of Bazilevič functions reduce to two new subclasses of star-like biunivalent functions related with the Fibonacci-number series and the square-root functions. Using the Faber polynomial expansion (FPE) technique, we find the general coefficient bounds for the functions belonging to each of these classes. We also find bounds for the initial coefficients for bi-Bazilevič functions and demonstrate how unexpectedly these initial coefficients behave in relation to the square-root functions and the Fibonacci-number series.

Gender trends in Canadian medicine and surgery: the past 30 years

BackgroundWhile the number of women entering medicine has steadily increased since the 1970s in Canada, the gender composition along each stage of the medical training pathway has not been comprehensively reported. We therefore sought to systematically examine the gender composition of students, residents, and practicing physicians over the past 30 years in Canada.ResultsIn this cross-sectional analysis of Canadian medical trainees including MD applicants (137,096 male, 169,099 female), MD students (126,422 male, 152, 967 female), MD graduates (29,413 male, 34,173 female), residents by the decade (24,425 male, 28,506 female) and practicing surgeons (total 7,457 male, 3,457 female), we find that increased female representation in medicine is not matched by representation in surgery, with the key being the specialty choice process. The likelihood of female applicants matriculating to medical school was less than male applicants in the 90s (OR 0.92, 95% CI 0.92–0.93), greater in the early 2000s (OR 1.03, 95% CI 1.03–1.04), and has since balanced out (OR 1.00, 95% CI 1.00-1.01), with medical school classes being nearly 60% female for the past two decades. Despite this, females have remained underrepresented in most surgical residency programs, with odds of female medical students entering surgical residency other than Ob/Gyn being about half that of male students (OR 0.56, 95% CI 0.44–0.71), resulting in a slow increase in practicing female surgeons of less than 0.5% per year in many surgical disciplines and projected parity decades or centuries in the future.ConclusionsWhile undergraduate medical education has been majority female in Canada for nearly three decades, females remain greatly underrepresented in the physician workforce within surgical specialties. To build a representative medical workforce equipped to care for diverse patient populations, factors influencing the specialty choices of early career physicians will need to be examined and addressed.

Architecture of the Mass Spectrometry Data Management Pipeline in the SMART-CARE Project.

In the SMART-CARE project- a systems medicine approach to stratification of cancer recurrence in Heidelberg, Germany - a streamlined mass-spectrometry (MS) workflow for identification of cancer relapse was developed. This project has multiple partners from clinics, laboratories and computational teams. For optimal collaboration, consistent documentation and centralized storage, the linked data repository was designed. Clinical, laboratory and computational group members interact with this platform and store meta- and raw-data. The specific architectural choices, such as pseudonymization service, uploading process and other technical specifications as well as lessons learned are presented in this work. Altogether, relevant information in order to provide other research groups with a head-start for tackling MS data management in the context of systems medicine research projects is described.

Quantum retrodiction in Gaussian systems and applications in optomechanics

What knowledge can be obtained from the record of a continuous measurement about the quantum state of the measured system at the beginning of the measurement? The task of quantum state retrodiction, the inverse of the more common state prediction, is rigorously addressed in quantum measurement theory through retrodictive positive operator-valued measures (POVMs). This introduction to this general framework presents its practical formulation for retrodicting Gaussian quantum states using continuous-time homodyne measurements and applies it to optomechanical systems. We identify and characterize achievable retrodictive POVMs in common optomechanical operating modes with resonant or off-resonant driving fields and specific choices of local oscillator frequencies in homodyne detection. In particular, we demonstrate the possibility of a near-ideal measurement of the quadrature of the mechanical oscillator, giving direct access to the position or momentum distribution of the oscillator at a given time. This forms the basis for complete quantum state tomography, albeit in a destructive manner.

P865 Screening for low-processed breads - compositional analysis of food additives used in commercially available breads

Abstract Background Ultra-processed food (UPF) intake has been associated with the development of inflammatory bowel diseases (IBD), particularly Crohn’s disease (CD). Of UPF subgroups, commercially available breads showed greater risk, possibly due to the increasing presence of food additives (FA) like emulsifiers. As bread is a staple food worldwide, often consumed daily, we aimed to screen the ingredients and FA used in bread industry and to assess the availability of low processed breads. Methods We consecutively screened breads available at supermarket and health food store chains popular and widely distributed in Israel. Breads, pita breads and buns (excluding products without food labels), were analyzed by dietitians and categorized into one of three categories according to their processing level and FA types. Low processed category included ingredients used in traditional, home-made breads; medium processed category included FA like malt and added fibers; high processed category included FA like emulsifiers and preservatives, previously associated with impact on microbiota composition or implications on IBD. Results A total of 233 breads were screened, 160 are available at the supermarket, 56 at the health food store, and 17 in both. We categorized 195 (84%) as highly processed, 9 (4%) as medium processed and 29 (12%) as low processed. We identified 36 different types of FA and ingredients used. Most breads contained emulsifiers- 178 (76%) and –preservatives-189 (81%). The most used emulsifier was sodium stearoyl-2-lactylate (SSL, E-481), present in 86 breads (37%), followed by mono- and diglycerides of fatty acids (E-471), DATEM (E-472e) and carboxymethyl cellulose (CMC, E-466), found in 22%, 16% and 2% of breads, respectively. Interestingly, the emulsifier E-481, previously shown to induce microbial alterations, was found in 86 breads (52%) sold in the supermarket compared to none of the breads available in the health food store. Out of the 5 common preservatives, most of the breads contained calcium propionate (E-282) found in 112 (48%) and potassium sorbate (E-202) found in 42 (18%). Additives like enzymes were present in 159 (68%), gluten was added to 148 (64%) and 88 (38%) breads had added fibers. A greater portion of the breads contained yeast (85%) compared to sourdough (47%), with 30 (13%) containing only sourdough. Conclusion Most of the commercially available breads in Israel are highly processed. The use of emulsifiers, preservatives, added gluten and fibers is very common, yet low processed breads are available. These may be more recommended to patients with IBD. Further understanding of the role of FA in IBD etiology may potentially guide dietary recommendations for specific food choices.

Utility of genetic testing in the pre-surgical evaluation of children with drug-resistant epilepsy.

We evaluated the utility of genetic testing in the pre-surgical evaluation of pediatric patients with drug-resistant focal epilepsy. This single-center retrospective study reviewed the charts of all pediatric patients referred for epilepsy surgery evaluation over a 5-year period. We extracted and analyzed results of genetic testing as well as clinical, EEG, and neuroimaging data. Of 125 patients referred for epilepsy surgical evaluation, 86 (69%) had some form of genetic testing. Of these, 18 (21%) had a pathogenic or likely pathogenic variant identified. Genes affected included NPRL3 (3 patients, all related), TSC2 (3 patients), KCNH1, CHRNA4, SPTAN1, DEPDC5, SCN2A, ARX, SCN1A, DLG4, and ST5. One patient had ring chromosome 20, one a 7.17p12 duplication, and one a 15q13 deletion. In six patients, suspected epileptogenic lesions were identified on brain MRI that were thought to be unrelated to the genetic finding. A specific medical therapy choice was allowed due to genetic diagnosis in three patients who did not undergo surgery. Obtaining a molecular diagnosis may dramatically alter management in pediatric patients with drug-resistant focal epilepsy. Genetic testing should be incorporated as part of standard investigations in the pre-surgical work-up of pediatric patients with drug-resistant focal epilepsy.

Medical students’ career preferences in Bangladesh

AimThis study aimed to investigate the career preferences among Bangladeshi medical students, identify the factors that influence their present choices, and additionally report the role of gender and academic year behind their decisions.MethodsThis cross-sectional study conducted in Bangladesh from August 2022 to April 2023 included 801 medical students conveniently selected from medical colleges in eight divisions. Data were collected using a web-based survey and analysed using STATA version 16.0. Statistical tests included the Kolmogorov-Smirnov test, arithmetic mean, standard deviation, frequency, and Kruskal-Wallis H test. The response rate was 94.6%, and the CHERRIES guideline was followed for reporting the results.ResultThe majority of the participants were female (64.42%) and under the age of 23 years (58.8%). The study revealed that medicine was the preferred career choice for the majority of students (65%), with surgery being the most popular first choice (30.21%) among them. Female medical students showed a significantly higher preference for gynaecology & obstetrics (p < 0.001), while male students had a significantly higher tendency to choose general practice (p = 0.002). There is a significant gender difference (p < 0.05) in the career preference factors, including professional prestige, role model influence, easy money, family time, promotion opportunities, income for lifestyle, and research opportunities. Academic year differences were also observed, with increasing interest in medicine and public health (p < 0.001), a decrease in interest in surgery (p < 0.001), and a decline in preference for non-medical careers as students progressed through their MBBS life (p < 0.05).ConclusionOverall, medicine was the most popular speciality choice, however, male students preferred general practice and female students preferred gynaecology and obstetrics more. Personal passion, opportunities for contribution to society, professional prestige, having a direct dealing with patients, and income will allow an enjoyable lifestyle were the most important factors in the choice of their career.

The Hilbert space of de Sitter quantum gravity

We obtain solutions of the Wheeler-DeWitt equation with positive cosmological constant for a closed universe in the large-volume limit. We argue that this space of solutions provides a complete basis for the Hilbert space of quantum gravity in an asymptotically de Sitter spacetime. Our solutions take the form of a universal phase factor multiplied by distinct diffeomorphism invariant functionals, with simple Weyl transformation properties, that obey the same Ward identities as a CFT partition function. The Euclidean vacuum corresponds to a specific choice of such a functional but other choices are equally valid. Each functional can be thought of as specifying a “theory” and, in this sense, the space of solutions is like “theory space”. We describe another basis for the Hilbert space where all states are represented as excitations of the vacuum that have a specific constrained structure. This gives the finite GN generalization of the basis proposed by Higuchi in terms of group averaging, which we recover in the nongravitational limit.

2035 The Feasibility to Staff of Patient Specific Music Choice on Elderly Care Wards - A Post Intervention Survey

Abstract Introduction Receptive music listening has been shown to reduce depression, anxiety, and agitation in older adults. However, unfiltered and disruptive noise can increase confusion and agitation. Yet, during hospitalization older patients often have little control over when and for how long they are exposed to music, the genre which is heard, or they may have no access to music. Furthermore, older persons have reduced ability to use modern technology to counter this and their sensory and functional impairments may further isolate them. This study aimed to assess the feasibility of offering two one-hour daily sessions of patient specific music (PSM) choices on an elderly-care ward. Methods On a district general hospital elderly-care ward a 5-day trial of offering two one-hour daily sessions of PSM, using enhanced wireless speakers optimally positioned with daily amended music playlists based on specific patient choice. Ambient noise was minimised with regular decibel monitoring. A post-intervention staff survey was completed to assess the feasibility of continuing, the perceived impact on staff and patients and potential barriers to continuation. Thematic analyses were completed on the survey. Results In the post-intervention feasibility survey (n=14) the majority of staff (86%) agreed that it was possible, implementable and the procedure easy to use. In the impact assessment (n=19) 80% of staff stated it had a positive effect on patients and 89% stated it had a positive effect on staff. Thematic analyses on impact identified benefits to: work, engagement, enjoyment, physical activity and well-being. Barriers that were identified included patient choice, repetition of music, patients unable to engage with the process and staff availability for consistent delivery. Conclusion Playing patient specific music choice was feasible and acceptable to staff with a perceived positive influence on both staff and patients. Further studies are now required to assess the impact on patient outcomes.

AI and Human Reasoning: Qualitative Research in the Age of Large Language Models

Context: The advent of AI-driven large language models (LLMs), such as ChatGPT 3.5 and GPT-4, have stirred discussions about their role in qualitative research. Some view these as tools to enrich human understanding, while others perceive them as threats to the core values of the discipline. Problem: A significant concern revolves around the disparity between AI-generated classifications and human comprehension, prompting questions about the reliability of AI-derived insights. An “AI echo chamber” could potentially risk the diversity inherent in qualitative research. A minimal overlap between AI and human interpretations amplifies concerns about the fading human element in research. Objective: This study aimed to compare and contrast the comprehension capabilities of humans and LLMs, specifically ChatGPT 3.5 and GPT-4. Methodology: We conducted an experiment with small sample of Alexa app reviews, initially classified by a human analyst. ChatGPT 3.5 and GPT-4 were then asked to classify these reviews and provide the reasoning behind each classification. We compared the results with human classification and reasoning. Results: The research indicated a significant alignment between human and ChatGPT 3.5 classifications in one-third of cases, and a slightly lower alignment with GPT-4 in over a quarter of cases. The two AI models showed a higher alignment, observed in more than half of the instances. However, a consensus across all three methods was seen only in about one-fifth of the classifications. In the comparison of human and LLMs reasoning, it appears that human analysts lean heavily on their individual experiences. As expected, LLMs, on the other hand, base their reasoning on the specific word choices found in app reviews and the functional components of the app itself. Conclusion: Our results highlight the potential for effective human-LLM collaboration, suggesting a synergistic rather than competitive relationship. Researchers must continuously evaluate LLMs’ role in their work, thereby fostering a future where AI and humans jointly enrich qualitative research.

Genetically modified mice as a tool for the study of human diseases.

Modeling a human disease is an essential part of biomedical research. The recent advances in the field of molecular genetics made it possible to obtain genetically modified animals for the study of various diseases. Not only monogenic disorders but also chromosomal and multifactorial disorders can be mimicked in lab animals due to genetic modification. Even human infectious diseases can be studied in genetically modified animals. An animal model of a disease enables the tracking of its pathogenesis and, more importantly, to test new therapies. In the first part of this paper, we review the most common DNA modification technologies and provide key ideas on specific technology choices according to the task at hand. In the second part, we focus on the application of genetically modified mice in studying human diseases.

Gender Biases Influencing Female Medical Students' Career Choice in Orthopaedics!

Madam, The choice of specialisation by medical students is influenced by a variety of factors, including the specialty's perceived credibility, parental influence, work-life balance, money, cultural background, rotations in the clinic, mentors' experiences, etc. In various medical professions gender disparity persists, in conventionally male-dominated specialties, despite rising numbers of women in medical schools and clinical practice regions globally. Inevitably, there were statistically substantial gender variations in the medical specialties chosen by male and female doctors, with the majority of men choosing surgery and orthopaedics.1

The level of functional state of the cardiovascular and respiratory system of athletes engaged in triathlon

According to scientists, determining the features of the functional state of athletes, taking into account their heavy training and competitive loads, is an urgent problem that requires further development and detailing. The purpose of the study is to identify the level of functional state of the cardiovascular and respiratory systems of athletes engaged in triathlon. Research methods: assessment of the level of functional state of the cardiovascular and respiratory system of triathlon athletes was carried out using the computer program "ShVSM-INTEGRAL" (authors – Shapovalova V.A., Malikova M.V., Svatieva A.V.). Organization of the study: the research was conducted during 2022- 2023. according to the thematic plan of scientific research of the PDAFKiS for 2021-2025 on the topic "Theoretical and methodological foundations of training athletes in non-Olympic sports" (state registration number 0121U109266). Athletes who participated in the studies signed a consent to participate in the studies. The experience of triathlon was more than 5 years. Material. Analysis of the hemodynamics of the heart muscle by the calculation method according to the norms of the "ShVSM- INTEGRAL" program proved that all the studied components in the vast majority (58%) corresponded to the level of "above average", in 26% of athletes there was a "high" level. The rest (16%) had an "intermediate" level. This is evidence of the high level of training of the athletes who participated in the studies. Conclusions. Assessment of the functional state of the cardiovascular system and the system of external respiration made it possible to state its high level. It should be noted that this is due to the specifics of the sport, in which preference is given to the development of endurance, which, in turn, contributes to an increase in the indicators of the respiratory system. The study made it possible to confirm the rational choice of specialization of athletes and to state the normal state of the body's regulatory systems.

Exploring the Sensitivity of Antibody-Drug Conjugate Efficacy to the Selection of Payload, Antibody, and Cell line.

Antibody-drug conjugates (ADCs) make up a growing class of targeted therapeutics with important applications in cancer treatment. ADCs are highly modular in nature and thus can be engineered to target any cancer type, but their efficacy is strongly influenced by the specific choice of payload, antibody, and target cell. Considering the number of possible antibody-payload combinations, ADC development would benefit from an efficient method to narrow the number of ADC compositions to those with the highest and most universal potency prior to assessing pharmacokinetics and pharmacodynamics in animal models. To facilitate the identification of optimal ADC compositions, we describe the use of photoreactive antibody-binding domain-drug conjugates (known commercially as oYo-Link) to enable the site-specific labeling of off-the-shelf antibodies. This approach allows for the rapid generation of ADCs with a drug-to-antibody ratio of ∼2 with no subsequent purification required. As a demonstration of this approach, ADCs were generated with different combinations of tubulin-inhibitor drugs (DM1, DM4, VcMMAE, and VcMMAF) and anti-EGFR antibodies (cetuximab, panitumumab, anti-EGFR clone 425, and anti-EGFR clone 528) and were delivered to three EGFR-expressing cell lines (A431, A549, and MDA-MB-231). Real-time cytolysis assays indicated that the most effective antibody varied based on the choice of cell line: cetuximab was most potent against A431 cells, while 425 and 528 led to the greatest cytotoxicity against A549 and MDA-MB-231 cells. These results did not correlate with differences in measured anti-EGFR binding affinity as cetuximab had the highest affinity across all three cell lines, while 425 and 528 had the lowest affinities for all three cell lines. Panitumumab, which had the second-highest anti-EGFR affinity, exhibited the least effective cytolysis across A431, A549, and MDA-MB-231 cells. By demonstrating that ADC potency toward a given target is dependent on both the antibody and drug chosen, these findings can guide the selection of ADCs for further in vivo analysis.

ИССЛЕДОВАНИЕ ФАКТОРОВ, ВЛИЯЮЩИХ НА ПРОФЕССИОНАЛЬНЫЙ ВЫБОР И ПРОФЕССИОНАЛЬНУЮ ИДЕНТИЧНОСТЬ СТУДЕНТОВ

With the expansion of higher education in our country, students are paying more and more attention to choosing a specialty. The choice of a specialty can affect their identification with the specialty to varying degrees, as well as their enthusiasm, learning and the effectiveness of vocational training. Therefore, this article examines the factors influencing college students’ choice of specialty and their professional identity.