Natural Language Processing of Learners' Evaluations of Attendings to Identify Professionalism Lapses.

Unprofessional faculty behaviors negatively impact the well-being of trainees yet are infrequently reported through established reporting systems. Manual review of narrative faculty evaluations provides an additional avenue for identifying unprofessional behavior but is time- and resource-intensive, and therefore of limited value for identifying and remediating faculty with professionalism concerns. Natural language processing (NLP) techniques may provide a mechanism for streamlining manual review processes to identify faculty professionalism lapses. In this retrospective cohort study of 15,432 narrative evaluations of medical faculty by medical trainees, we identified professionalism lapses using automated analysis of the text of faculty evaluations. We used multiple NLP approaches to develop and validate several classification models, which were evaluated primarily based on the positive predictive value (PPV) and secondarily by their calibration. A NLP-model using sentiment analysis (quantifying subjectivity of the text) in combination with key words (using the ensemble technique) had the best performance overall with a PPV of 49% (CI 38%-59%). These findings highlight how NLP can be used to screen narrative evaluations of faculty to identify unprofessional faculty behaviors. Incorporation of NLP into faculty review workflows enables a more focused manual review of comments, providing a supplemental mechanism to identify faculty professionalism lapses.

Comparing the drivers of medical student emigration intention across two African nations.

BACKGROUND: Sub-Saharan Africa faces the highest relative need for health care workers in the world and the emigration of physicians significantly contributes to this deficit. Few studies have explored development of these patterns during medical education. This study investigates career aspirations of medical students in two African nations with similar Human Development Indices, but distinct differences in training structure to better inform retention strategies. METHODS: A cross-sectional survey was administered in 2018 to medical students in Madagascar (University of Antananarivo, University of Mahajanga) and Tanzania (Kilimanjaro Christian Medical College, KCMC). Outcomes included emigration/career intentions, and factors influencing these decisions. Analysis utilised chi-square and Fisher's exact tests (α < 0.05, two-tailed) for statistical differences, logistic regression and qualitative content analysis of free text data. RESULTS: A total of 439 students responded to the survey with a response rate of 12.9% from Antananarivo (n = 142/1097), 11.6% from Mahajanga (n = 43/370), and 60.0% from KCMC (n = 254/423). Significantly more Malagasy (49.7%, n = 90/181) than Tanzanian (25.2%, n = 54/214) students expressed emigration intent (P < .001). Malagasy students indicating research, possibility of working abroad, or work intensity as influencing career choice more frequently expressed a desire to emigrate. Satisfaction with computer/internet access was inversely correlated with a desire to work abroad. In comparison, Tanzanian students reporting income potential as influential in their career choice or attending a private high school were more likely to express a desire to work abroad. Qualitative content analysis of free text data demonstrated deficits in faculty availability, diversity of training locations and a particular emphasis on infrastructure challenges within Madagascar. INTERPRETATION: A significant number of students desire to work abroad. Emigration interests are influenced by access to postgraduate training, infrastructure and opportunities in academia, which differ across countries. Efforts to retain physicians should consider these country and institution-specific factors that influence medical student desire to emigrate.

1 < 2 and 2 < 3: non-linguistic appreciations of numerical order.

Ordinal understanding is involved in understanding social hierarchies, series of actions, and everyday events. Moreover, an appreciation of numerical order is critical to understanding number at a highly abstract, conceptual level. In this paper, we review findings concerning the development and expression of ordinal numerical knowledge in preverbal human infants in light of literature about the same cognitive abilities in non-human animals. We attempt to reconcile seemingly contradictory evidence, provide new directions for prospective research, and evaluate the shared basis of ordinal knowledge among non-verbal organisms. Our review of the research leads us to conclude that both infants and non-human animals are adapted to respond to monotonic progressions in numerical order, consonant with mathematical definitions of numerical order. Further, we suggest that patterns in the way that infants and non-human animals process numerical order can be accounted for by changes across development, the conditions under which representations are generated, or both.

Factors facilitating research: a survey of zoo and aquarium professionals.

The purpose of this survey was to assess the background, training, and perceptions of professionals conducting and coordinating research at North American zoos and aquariums accredited by the Association of Zoos and Aquariums (AZA) and to identify the factors they considered critical to successful scientific programs. We analyzed responses to a 57-item questionnaire from 231 professionals at AZA zoos and aquariums. The majority of those surveyed conducted behavioral research, conducted research only in a captive setting, held curatorial positions, had their salaries supported by their institutions' operating budget, and considered themselves part of a successful scientific program. About 30% of those we surveyed possessed a doctoral research degree in comparison to 55% possessing lesser level degrees-19% with master's, 34% with bachelor's, and 2% with other degrees. Support from the chief executive officer and personnel dedicated to conducting scientific programs were judged as the two most important factors contributing to the successful scientific programs. The information provided in this report may be used to develop and improve both established and newly initiated scientific programs in zoos and aquariums.

KCNQ currents and their contribution to resting membrane potential and the excitability of interstitial cells of Cajal from the guinea pig bladder.

PURPOSE: The presence of novel KCNQ currents was investigated in guinea pig bladder interstitial cells of Cajal and their contribution to the maintenance of the resting membrane potential was assessed. MATERIALS AND METHODS: Enzymatically dispersed interstitial cells of Cajal were patch clamped with K(+) filled pipettes in voltage clamp and current clamp modes. Pharmacological modulators of KCNQ channels were tested on membrane currents and the resting membrane potential. RESULTS: Cells were stepped from -60 to 40 mV to evoke voltage dependent currents using a modified K(+) pipette solution containing ethylene glycol tetraacetic acid (5 mM) and adenosine triphosphate (3 mM) to eliminate large conductance Ca activated K channel and K(adenosine triphosphate) currents. Application of the KCNQ blockers XE991, linopirdine (Tocris Bioscience, Ellisville, Missouri) and chromanol 293B (Sigma) decreased the outward current in concentration dependent fashion. The current-voltage relationship of XE991 sensitive current revealed a voltage dependent, outwardly rectifying current that activated positive to -60 mV and showed little inactivation. The KCNQ openers flupirtine and meclofenamic acid (Sigma) increased outward currents across the voltage range. In current clamp mode XE991 or chromanol 293B decreased interstitial cell of Cajal resting membrane potential and elicited the firing of spontaneous transient depolarizations in otherwise quiescent cells. Flupirtine or meclofenamic acid hyperpolarized interstitial cells of Cajal and inhibited any spontaneous electrical activity. CONCLUSIONS: This study provides electrophysiological evidence that bladder interstitial cells of Cajal have KCNQ currents with a role in the regulation of interstitial cell of Cajal resting membrane potential and excitability. These novel findings provide key information on the ion channels present in bladder interstitial cells of Cajal and they may indicate relevant targets for the development of new therapies for bladder instability.

Twenty-five years of Zoo Biology: a publication analysis.

To expand on earlier publication analyses of the journal Zoo Biology, information from 991 articles published within the journal's first 25 years was compiled and evaluated. Most articles were applied, descriptive accounts that included inferential statistics and/or biological analyses. In addition, most articles focused on captive animals and concentrated on the behavior and reproduction of mammals, with particular emphasis on primates. With respect to authors, the majority of first authors were affiliated with zoos or universities within the United States and collaborated with co-authors at different institutions. Nearly two-fifths of articles acknowledged receiving external funding and external funding increased over the years, however, collaboration did not significantly change receipt of external funding. In addition, first authors with zoo affiliations published more descriptive, applied science articles and acknowledged receipt of external funding significantly less often than first authors with university affiliations. Publication latency was comparable to other scientific journals and increased significantly over the 25-year publication period. Longitudinal trends indicated that experimental, applied science, diet and nutrition, and collaborative articles also increased significantly, whereas descriptive, basic science, behavior, and population biology articles decreased significantly. By describing historical trends in zoo research through an analysis of papers published in Zoo Biology, this article may help to bridge gaps and identify new opportunities. Zoo Biol 27:444-457, 2008. (c) 2008 Wiley-Liss, Inc.

Relative numerousness judgment and summation in young, middle-aged, and older adult orangutans (Pongo pygmaeus abelii and Pongo pygmaeus pygmaeus).

The ability to select the larger of two quantities ranging from 1 to 5 (relative numerousness judgment [RNJ[) and the ability to select the larger of two pairs of quantities with each pair ranging from 1 to 8 (summation) were evaluated in young, middle-aged, and older adult orangutans (7 Pongo pygmaeus abelii and 2 Pongo pygmaeus pygmaeus). Summation accuracy and RNJ were similar to those of previous reports in apes; however, the pattern of age-related differences with regard to these tasks was different from that previously reported in gorillas. Older orangutans were less accurate than the young and middle-aged for RNJ, and summation accuracy was equivalent among age groups. Evidence was found to suggest that the young and middle-aged based their selection of the largest quantity pair on both quantities within each pair during the summation task. These results show a relationship between subject age and the quantitative abilities of adult orangutans.

Relative numerousness judgment and summation in young and old Western lowland gorillas.

The relationship between age, relative numerousness judgment, and summation was investigated in 11 Western lowland gorillas (Gorilla gorilla gorilla). Experiments 1 and 2 evaluated the gorillas' ability to select the larger of 2 food quantities before and with training. The majority of gorillas did not reliably select the larger quantity in Experiment 1 until receiving training to do so in Experiment 2. Experiment 3 evaluated their ability to select the larger of 2 pairs of quantities. All gorillas selected the larger pair more often than chance, and the old were less accurate and slower than were the young. For most gorillas, performance in relative numerousness judgment with training and summation was comparable with previous reports in chimpanzees and orangutans.

A close keeper-nonhuman animal distance does not reduce undesirable behavior in contact yard goats and sheep.

This study investigated the relation between zookeeper-nonhuman animal distance and the undesirable behavior goats and sheep exhibited toward visitors of Zoo Atlanta's contact yard. It hypothesized that a close distance between keeper and animal would be associated with a lower rate of undesirable behavior than would a distant keeper-animal distance. The study recorded rate of undesirable behavior exhibited, number of visitors in the yard, and number of times visitors touched an animal under near and distant keeper-animal distances. Seven African pygmy goats (Capra hircus) and 4 Romanov sheep (Ovis aries) were the subjects. The study used linear regression methods to analyze approximately 48 hr of behavioral data collected using a focal sampling technique. Findings indicated a familiar animal keeper nearby was not associated with lower rates of undesirable behavior toward visitors. Higher rates of undesirable behavior occurred when keepers were nearby than when they were distant. The study also found that undesirable behavior increased as visitors' touching of the animals increased. Applying the study's findings may improve human-animal interactions and increase animal well-being in a contact yard through animal management techniques.

Retreat space and human visitor density moderate undesirable behavior in petting zoo animals.

This study focused on the relationship between nonhuman animal behavior and envi-ronment- specifically, between the undesirable behavior exhibited by domestic pet-ting zoo animals in the presence of humans and the spatial design of the petting zoo environment. A spatial feature of a petting zoo referred to as a retreat space was ma-nipulated so that it affected the animals' opportunity for individual control over inter-action with humans. Three conditions were tested: no retreat space, semi-retreat space, and a full-retreat space. The subjects of this study were 5 African pygmy goats (Capra hircus) and 2 Romanov sheep (Ovis aries). Investigators used a focal sam-pling technique to analyze approximately 27 hr of behavioral data collected. The data were analyzed using multiple linear regression methods. The findings suggest that the full-retreat design beneficially moderated both sheep and goat behavior: Undesirable behaviors were lowest in the full-retreat condition. This study provides information that may improve human-animal interactions in a petting zoo setting and may in-crease animal well-being through exhibit design and management techniques.