UC Merced

The remote Objective Structured Clinical Examination (OSCE) is a cornerstone of medical education, enabling structured and objective assessment of clinical skills, communication, and patient-centered care. However, its widespread adoption has introduced challenges related to cost-effectiveness and efficient use of rater resources. Traditional double scoring (DS) ensures reliability but is labor-intensive and costly, especially in large-scale assessments. To address these challenges, this study introduces Targeted Double Scoring (TDS), a novel methodology that selectively applies DS to specific score ranges, particularly those near the pass/fail threshold. The study was conducted using data from a pilot remote OSCE administered to 550 clinical medicine undergraduates in China. The OSCE consisted of three stations: Clinical Reasoning (CR), Physical Examination (PE), and Fundamental Skills (FS). Each station was scored remotely by two raters, with a cut-off score of 60 out of 100. The TDS methodology was modeled based on the OSCEs DS design and fitted with scoring data. A decision-theoretic approach identified optimal Critical Score Ranges (CSRs) for targeted double scoring, balancing reliability and cost-effectiveness. The findings show that TDS significantly reduces rater workload and costs while maintaining high reliability and fairness. For instance, TDS achieved up to 70% cost savings compared to traditional DS under certain configurations. The study also highlights the flexibility of TDS, which can be tailored to different OSCE designs and scoring rubrics. These results have broad implications for medical education, especially in resource-constrained settings where optimizing assessment efficiency is critical. This study provides a practical solution to the cost-related challenges of remote OSCEs and offers a framework for adopting TDS in assessments. By focusing raters on critical score ranges, TDS maintains rigorous and fair evaluations without overburdening faculty or exceeding budgets. Future research should explore TDS scalability and its integration with emerging technologies like artificial intelligence to enhance efficiency and reliability.

The tuning of the Fermi level in tin telluride, a topological crystalline insulator, is essential for accessing its unique surface states and optimizing its electronic properties for applications such as spintronics and quantum computing. In this study, we demonstrate that the Fermi level in tin telluride can be effectively modulated by controlling the tin concentration during chemical vapor deposition synthesis. By introducing tin-rich conditions, we observed a blue shift in the x-ray photoelectron spectroscopy core-level peaks of both tin and tellurium, indicating an upward shift in the Fermi level. This shift is corroborated by a decrease in work function values measured via ultraviolet photoelectron spectroscopy, confirming the suppression of Sn vacancies. Our findings provide a low-cost, scalable method to achieve tunable Fermi levels in tin telluride, offering a significant advancement in the development of materials with tailored electronic properties for next-generation technological applications.

Music traditions worldwide are subject to remarkable diversity but the origins of this variation are not well understood. Musical behaviour is the product of a multicomponent collection of abilities, some possibly evolved for music but most derived from traits serving nonmusical functions. Cultural evolution has stitched together these systems, generating variable normative practices across cultures and musical genres. Here, we describe the cultural evolution of musical distortion, a noisy manipulation of instrumental and vocal timbre that emulates nonlinear phenomena (NLP) present in the vocal signals of many animals. We suggest that listeners sensitivity to NLP has facilitated technological developments for altering musical instruments and singing with distortion, which continues to evolve culturally via the need for groups to both coordinate internally and differentiate themselves from other groups. To support this idea, we present an agent-based model of norm evolution illustrating possible dynamics of continuous traits such as timbral distortion in music, dependent on (i) a functional optimum, (ii) intra-group cohesion and inter-group differentiation and (iii) groupishness for assortment and social learning. This account illustrates how cultural transmission dynamics can lead to diversity in musical sounds and genres, and also provides a more general explanation for the emergence of subgroup-differentiating norms.This article is part of the theme issue Nonlinear phenomena in vertebrate vocalizations: mechanisms and communicative functions.

Collisson et al. (2020) found Dark Triad traits and gender role beliefs predicted foodie calls, a phenomenon where people go on a date with others, to whom they are not attracted, for a free meal. Because gender roles and dating norms differ across cultures, we conducted a registered replication across different cultures by surveying 1838 heterosexual women from Poland, the United Kingdom (UK), and the United States (US). Relying on the structural equation modeling, as conducted in the original study, our findings revealed gender role beliefs best predicted foodie calls and their perceived acceptability, whereas the Dark Triads general factor was nonsignificant. Analyses at the country level yielded mixed results. The original findings were replicated in the UK and Poland, but not in the US, where only narcissism predicted foodie calls. In the US, gender role beliefs predicted foodie call acceptability, but the Dark Triad general factor did not. Potential reasons for why traditional gender roles, but not the Dark Triad, predicted foodie calls in the US are discussed.

Previous research suggests that adults' essentialist beliefs depend on their own social-group membership. However, these studies have examined the effects of one social-group membership at a time (e.g., the influence of race on essentialism of race), even though all individuals belong to multiple social groups. It is therefore unclear whether membership in one social category (e.g., ethnicity) predicts essentialism of another category (e.g., SES). To address this question, the present study simultaneously explored the relationship between individuals' racial and ethnic background and subjective SES and their essentialism of ethnicity and SES. Results showed that participants' racial and ethnic background predicted their essentialist beliefs about ethnicity, but their subjective SES did not. In contrast, participants' subjective SES and ethnicity interacted to predict their essentialist beliefs about SES: for non-Hispanic White individuals, higher subjective SES predicted stronger essentialist beliefs about SES across multiple dimensions of essentialism, but no such pattern emerged for members of racial and ethnic minority groups. These findings suggest that adults' essentialist beliefs are influenced by a complex interplay of their multiple social-group memberships.

Objective: Distinctive stressors facing pregnant and postpartum individuals during the COVID-19 pandemic may have affected their emergency department (ED) care-seeking for behavioral health concerns and violence victimization. We tested whether the incidence of postpartum behavioral health and assault injury ED visits differed for individuals according to their months of postpartum pandemic exposure. Methods: We used statewide, longitudinally linked hospital and ED administrative claims data from California to classify all individuals with hospital deliveries between January 1, 2016, and December 31, 2020, according to their months of postpartum pandemic exposure. Outcomes comprised 12-month incidence of any ED visit for a psychiatric disorder, drug use disorder/overdose, alcohol use disorder/intoxication, or assault injury, defined using International Classification of Diseases-Clinical Modification, version 10 codes. Risk ratios compared the incidence of each outcome among people with 1-12 months of postpartum pandemic exposure to those with 0 months of exposure. Results: Compared to people with 0 months of postpartum pandemic exposure (n = 1,163,215), delivering people with 1-12 month' exposure (range: n = 26,836 to n = 273,561) were approximately equally likely to have a postpartum ED visit for a psychiatric disorder, drug use disorder, or alcohol use disorder, after adjusting for demographic differences (most p > 0.10). The incidence of assault injury was significantly lower among delivering individuals with 11 or 12 months of pandemic exposure (RR_adj = 0.70 and 0.91, respectively; both p < 0.01) compared to those with 0 months. Conclusions: Contrary to expectations, the pandemic did not appear to have affected ED utilization for most behavioral health conditions among postpartum individuals, but assault injury ED visits declined.