Examining the Factors Influencing Applicants’ Placement on One General Surgery Program’s Rank Order List

Purpose Surgery residency applications include variables that determine an individual’s rank on a program’s match list. We performed this study to determine which residency application variables are the most impactful in creating our program’s rank order list. Methods We completed a retrospective examination of all interviewed applicants for the 2019 match. We recorded United States Medical Licensing Examinations (USMLE) step I and II scores, class quartile rank from the Medical Student Performance Evaluation (MSPE), Alpha Omega Alpha (AOA) membership, geographic region, surgery clerkship grade, and grades on other clerkships. The MSPE and letters of recommendation were reviewed by two of the authors and assigned a score of 1 to 3, where 1 was weak and 3 was strong. The same two authors reviewed the assessments from each applicant’s interview and assigned a score from 1-5, where 1 was poor and 5 was excellent. Univariate analysis was performed, and the significant variables were used to construct an adjusted multivariate model with significance measured at P < .05. Results Univariate analysis for all 92 interviewed applicants demonstrated that USMLE step 2 scores ( P = .002), class quartile rank ( P = .004), AOA status ( P = .014), geographic location ( P < .001), letters of recommendation ( P < .001), and interview rating ( P < .001) were significant in predicting an applicant’s position on the rank list. On multivariate analysis only USMLE step 2 ( P = .018) and interview ( P < .001) remained significant. Conclusion USMLE step 2 and an excellent interview were the most important factors in constructing our rank order list. Applicants with a demonstrated strong clinical fund of knowledge that develop a rapport with our faculty and residents receive the highest level of consideration for our program.

Factors Associated with Levels of Organophosphate Pesticides in Household Dust in Agricultural Communities

Organophosphate (OP) pesticides are associated with numerous adverse health outcomes. Pesticide use data are available for California from the Pesticide Use Report (PUR), but household- and individual-level exposure factors have not been fully characterized to support its refinement as an exposure assessment tool. Unique exposure pathways, such as proximity to agricultural operations and direct occupational contact, further complicate pesticide exposure assessment among agricultural communities. We sought to identify influencing factors of pesticide exposure to support future exposure assessment and epidemiological studies. Household dust samples were collected from 28 homes in four California agricultural communities during January and June 2019 and were analyzed for the presence of OPs. Factors influencing household OPs were identified by a data-driven model via best subsets regression. Key factors that impacted dust OP levels included household cooling strategies, secondary occupational exposure to pesticides, and geographic location by community. Although PUR data demonstrate seasonal trends in pesticide application, this study did not identify season as an important factor, suggesting OP persistence in the home. These results will help refine pesticide exposure assessment for future studies and highlight important gaps in the literature, such as our understanding of pesticide degradation in an indoor environment.

Assessing Relations between Cultural Ecosystem Services, Physical Landscape Features and Accessibility in Central-Eastern Europe: A PPGIS Empirical Study from Hungary

Despite the growing quantity of ecosystem-services-related research, there is still a lack of deeper understanding on cultural ecosystem services (CES). This is mainly due to the perception of CES, which can vary by geographic location and population. In this study, we present a Public Participation Geographic Information System (PPGIS) method in a Hungarian microregion. Our goal is to increase understanding on how cultural services are perceived in this geographical context and level, and how this relative importance is related to biophysical landscape features. We also consider the influence of accessibility on the perceived landscape and compare our findings with the results of other studies with different sociocultural backgrounds. The research consists of participatory mapping with 184 persons that were digitized and analyzed with GIS and statistical software. During the analysis, we identified CES hotspots and compared CES with landscape features, as well as CES perception with accessibility. Our results showed positive correlation of CES with land covers related to built-up areas, as well as aesthetic and recreational services with water bodies. Compared to other studies, we found different spatial relationships in the case of spiritual services, and higher importance of agricultural land covers during the CES perception, thanks to the Central-Eastern European (CEE) sociocultural background. Our study highlights the effect of accessibility on CES perception; nevertheless, these relationships varied by different infrastructural elements. We conclude by discussing the implications and limitations of our study and encouraging future landscape research to apply the PPGIS method in this geographical context.

Research on Personalized Minority Tourist Route Recommendation Algorithm Based on Deep Learning

With the improvement of living standards, more and more people are pursuing personalized routes. This paper uses personalized mining of interest points of ethnic minority tourism demand groups, extracts customer data features in social networks, and constructs data features of interesting topic factors, geographic location factors, and user access frequency factors, using LDA topic models and matrix decomposition models to perform feature vectorization processing on user sign-in records and build deep learning recommendation model (DLM). Using this model to compare with the traditional recommendation model and the recommendation model of a single data feature module, the experimental results show the following: (1) The fitting error of DLM recommendation results is significantly reduced, and its recommendation accuracy rate is 50% higher than that of traditional recommendation algorithms. The experimental results show that the DLM constructed in this paper has good learning and training performance, and the recommendation effect is good. (2) In this method, the performance of the DLM is significantly higher than other POI recommendation methods in terms of the accuracy or recall rate of the recommendation algorithm. Among them, the accuracy rates of the top five, top ten, and top twenty recommended POIs are increased by 9.9%, 7.4%, and 7%, respectively, and the recall rate is increased by 4.2%, 7.5%, and 14.4%, respectively.

Trust in pathways? Professionals’ sensemaking of care pathways in the Norwegian mental health services system

Background In January 2019, care pathways within specialist mental health and substance abuse treatment services were officially launched in Norway. The care pathway introduced timeframes for assessment and treatment, allowing a maximum of 6 weeks to finish assessment and provide the patient with a diagnosis, in addition to allowing a maximum of 6 weeks from diagnosis to the first evaluation. The different action points required coding. The system was based on goals to improve services by focusing on user participation, coordinated patient flow, avoidance of unnecessary waiting time, improvement of equal access to services regardless of geographic location, and increased emphasis on physical health and lifestyle. The purpose of our study was to examine how mental health professionals made sense of care pathways and furthermore, how issues of trust affected the process of implementation. Methods Our multiple case study included four outpatient clinics for adults in four community mental health centres (CMHCs) in different parts of Norway. Qualitative data were collected through in-depth individual and focus group interviews and analysed using systematic text condensation. The informants were treatment personnel and leaders in four different outpatient clinics for adults. Results The results indicated four distinct themes or reactions to the care pathway and its implementation: 1) lack of clarity regarding the overall goals and content of the care pathway; 2) the increased burden of coding, registration and administrative work, which professionals experienced as a stressor; 3) an IT and medical record system that did not correspond to the coding of the care pathway; and 4) an unrealistic distinction between assessment and treatment. These themes/reactions increased the health professionals’ distrust towards the care pathway, and a process of sensemaking encouraged them to reduce the importance of the care pathway system and its implementation. Conclusion Theories of trust help in understanding how mental health professionals interpret care pathway implementation. Distrust and resistance towards the care pathways overshadow some of the overall quality goals of the care pathway, a view that was indeed shared by mental health professionals.

Otolaryngology residency program websites in a socially distanced application cycle

Objective To provide an updated evaluation of otolaryngology residency program websites during a socially distanced application cycle. Criteria were selected to evaluate for level of comprehensiveness, new content accommodating a virtual interview cycle, and stated commitment to diversity and inclusion. Study design Review of otolaryngology residency program websites. Setting Online websites between December 2020 and January 2021. Methods Otolaryngology residency program websites were evaluated for selected criteria. Programs were categorized by geographic location, size, and Doximity rankings. Differences between groups were analyzed using Student’s t-test and analysis of variance with a significance level of P < .05. Results 118 otolaryngology residency program websites contained a mean (SD) of 16.3 (4.7) of 31 criteria (52.6%). Fewer than one third included virtual/video tours of facilities or the surrounding area. Only 33% had a stated commitment to diversity and inclusion. There was no difference in number of criteria included when categorized by geographic location ( P = .22). Larger programs (17.9 vs 14.5, P < .001) and programs ranked in the top 50 by Doximity (17.7 vs 15.2, P = .003) included a significantly greater number of criteria. Conclusion While the comprehensiveness of otolaryngology residency program websites has improved, considerable room for improvement remains. Programs should strive to maintain updated websites that highlight training opportunities, program culture, and commitment to diversity and inclusion. Programs also should consider prioritizing the development of new online resources that may be especially useful to applicants during a virtual interview cycle.

A VetCompass Australia Study of Antimicrobial Use in Dog-to-Dog Bite Wounds (1998–2018)

Although dog-to-dog bite wounds (DBW) are a common presentation to veterinary clinics, antimicrobial prescribing habits of Australian clinics have not been reported. This study determined the frequency and results of DBW cultures; antimicrobial selection; and importance class of antimicrobials prescribed relative to wound severity, geographic location, or year. A systematic sample of 72,507 patient records was retrieved from the VetCompass Australia database. Records for 1713 dog bite events involving 1655 dogs were reviewed for presenting signs, results of culture and susceptibility testing (C&S), antimicrobial treatment, geographical location, and outcome. A crossed random effects multivariable logistic regression model was used to determine if antimicrobial importance was associated with wound severity, year, and location, and to assess the differences in antimicrobial prescription between geographical locations, clinics, and veterinarians. Antimicrobials were prescribed in 86.1% of DBW. Amoxicillin-clavulanic acid was prescribed in 70% (1202/1713) with underdosing in 15.8% (191/1202). High-importance antimicrobial use was associated with wound severity (p < 0.001), year category (p = 0.007), and surgery (p = 0.03). C&S testing was recorded as having been performed in only one case. Differences in individual veterinarian prescribing habits were stronger than the clinic culture, suggesting that education utilizing clinic-wide antimicrobial guidelines may aid in improving antimicrobial stewardship.

Exploring the Spatiotemporal Evolution and Sustainable Driving Factors of Information Flow Network: A Public Search Attention Perspective

The promotion of information flow reinforces the interactive cooperation and evolutionary process among cities. In the information age, public online search is a typical behavior of Internet society, which is the key to information flow generation and agglomeration. In this study, we attempt to explore the evolutionary characteristics of intercity networks driven by public online social behavior in the information age and construct an information flow network (IFN) from the perspective of public search attention. We also explore the evolution of the IFN in terms of the whole network, node hierarchy, and subgroup aggregation. Meanwhile, we also discuss the impact of the sustainable driving factors on the IFN. Finally, an empirical study was conducted in Guanzhong Plain Urban Agglomeration (GPUA). Our results show that: (1) the information flow in GPUA fluctuating upward in the early study period and gradually decreasing in the later study period. However, the agglomeration degree of information flow in the urban agglomeration continues to increase. (2) The hierarchical structure of urban nodes in GPUA presents a trend of “high in the middle and low on both sides”, and the formation of subgroups is closely related to geographic location. (3) The driving factors all impacting the IFN include public ecology, resource investment, information infrastructure, and economic foundation. This study provides theoretical and practical support for exploring the intercity network and promotes the sustainable urban development.

Model for Determination of Musculoskeletal Disorder Cost/Benefit

It is generally considered that the costs related to musculoskeletal disorders (MSDs) stem from absenteeism, medical expenses, reduced productivity, and quality of life. To estimate the costs associated with MSDs in organizations and thus determine the benefits for a company of implementing an effective and sustainable prevention program, it is necessary to consider the need to know the current and future prevalence of MSDs as well as to understand whether these data vary according to the economic sector, geographic location, and demographic aspects. It is also necessary to understand whether there are comorbidities associated with MSDs as well as the direct and indirect impacts in terms of the productive and work capacity of organizations and individuals. In the development of this study, the authors wanted to generate an analysis tool to estimate the incidence of MSDs and their economic costs, which also serves as a baseline to evaluate the possible benefits derived from prevention programs for this type of work-related disease.

Systematic Review of Indexing Spatial Skyline Queries for Decision Support

Residing in the data age, researchers inferred that huge amount of geo-tagged data is available and identified the importance of Spatial Skyline queries. Spatial or geographic location in conjunction with textual relevance plays a key role in searching Point of Interest (POI) of the user. Efficient indexing techniques like R-Tree, Quad Tree, Z-order curve and variants of these trees are widely available in terms of spatial context. Inverted file is the popular indexing technique for textual data. As Spatial skyline query aims at analyzing both spatial and skyline dominance, there is a necessity for a hybrid indexing technique. This article presents the review of spatial skyline queries evaluation that include a range of indexing techniques which concentrates on disk access, I/O time, CPU time. The investigation and analysis of studies related to skyline queries based upon the indexing model and research gaps are presented in this review.