Professional Competency Development Utilizing Emotional Intelligence In Medical Programs

The purpose of this mixed methods study was to examine the perceptions of physician assistant faculty about emotional intelligence. The study sought to determine PA educators’ familiarity with EI as a construct and to elicit perceived barriers in implementing EI within PA educational programs. The data were collected from a both a focus group of physician assistant faculty was convened from a university in New England and an online cross-sectional survey of randomized physician assistant faculty throughout the United States. The quantitative portion of the research investigated the perceptions faculty held about emotional intelligence. Additionally, the survey asked participants to identify the professional competencies students struggle with most often. Finally, the survey asked about faculty perceptions of barriers to implementing curriculum that addresses the development of emotional intelligence. Findings from the research determined physician assistant faculty were aware of emotional intelligence as a concept. The focus group and those participating in the online survey perceived professionalism as the most significant struggle for students. Additionally, both groups identified time as the greatest barrier in adopting emotional intelligence as a construct within the curriculum. The findings contribute to the gap of knowledge that exists in physician assistant educational literature on emotional intelligence and its use in graduate medical programs. The research serves as a springboard to examine ways to efficiently implement emotional intelligence training within the graduate medical school curriculum

HSCT integrated propulsion control issues

The propulsion control system affects the economics of the HSCT through the mechanisms indicated. Weight reduction is paramount in an aircraft of this type. Significant reductions are possible relative to the SST or even current technology if improvements are made in areas such as high temperature electronics. Dependability is an increasingly important parameter in all aircraft, but the higher capital cost of the HSCT makes it doubly important. Conversely the more difficult HSCT design problem makes it more difficult to achieve. Integration of propulsion controls will make it possible to improve both the static and dynamic performance of the HSCT propulsion system. Noise and emissions requirements may introduce novel control system requirements such as automatically programmed takeoff thrust for noise abatement. Control system development technology is evolving. For HSCT, highly automated and thoroughly validated tools will be required to reliably achieve desired system performance at introduction, and to reduce development costs. A technology plan was developed to prepare for HSCT development. This presentation addresses the portion of the plan required to demonstrate technology readiness for the HSCT in the late 1990's rather than the technology development currently in progress

Predicting sleep disordered breathing in outpatients with suspected OSA

Objective To validate the utilities of Berlin, STOP and STOP-BANG Questionnaires, other patient characteristics, comorbidities, Epworth Sleepiness Scale (ESS), fractional exhaled nitric oxide (FENO) and blood markers for the prediction of sleep disordered breathing (SDB) on limited polygraphy. Setting North Glasgow Sleep Service (a tertiary referral centre). Participants 129 consecutive patients, aged ≥16 years, referred to the sleep clinic for assessment of possible obstructive sleep apnoea. Interventions We selected cut-points of apnoea hypopnoea index (AHI) of ≥5 and ≥15/h from their home polygraphy and determined associations of these with individual symptoms, questionnaire scores and other results. Receiver operating characteristic analysis and univariate and multivariate logistic regression were used to explore these. Primary and secondary outcomes measures Primary: The utility of STOP, STOP-BANG and Berlin Questionnaires for prediction of SDB. Secondary: The utility of other measures for prediction of SDB. Results AHI was ≥5 in 97 patients and ≥15 in 56 patients. STOP and STOP-BANG scores were associated with both AHI cut-points but results with ESS and Berlin Questionnaire scores were negative. STOP-BANG had a negative predictive value 1.00 (0.77–1.00) for an AHI ≥15 with a score ≥3 predicting AHI ≥5 with sensitivity 0.93 (95% CI 0.84 to 0.98) and accuracy 79%, while a score ≥6 predicted AHI ≥15 with specificity 0.78 (0.65 to 0.88) and accuracy 72%. Neck circumference ≥17 inch and presence of witnessed apnoeas were independent predictors of SDB. Conclusions STOP and STOP-BANG Questionnaires have utility for the prediction of SDB in the sleep clinic population. Modification of the STOP-BANG Questionnaire merits further study in this and other patient groups.</p

Deconvolution of pro- and antiviral genomic responses in Zika virus-infected and bystander macrophages.

Genome-wide investigations of host-pathogen interactions are often limited by analyses of mixed populations of infected and uninfected cells, which lower sensitivity and accuracy. To overcome these obstacles and identify key mechanisms by which Zika virus (ZIKV) manipulates host responses, we developed a system that enables simultaneous characterization of genome-wide transcriptional and epigenetic changes in ZIKV-infected and neighboring uninfected primary human macrophages. We demonstrate that transcriptional responses in ZIKV-infected macrophages differed radically from those in uninfected neighbors and that studying the cell population as a whole produces misleading results. Notably, the uninfected population of macrophages exhibits the most rapid and extensive changes in gene expression, related to type I IFN signaling. In contrast, infected macrophages exhibit a delayed and attenuated transcriptional response distinguished by preferential expression of IFNB1 at late time points. Biochemical and genomic studies of infected macrophages indicate that ZIKV infection causes both a targeted defect in the type I IFN response due to degradation of STAT2 and reduces RNA polymerase II protein levels and DNA occupancy, particularly at genes required for macrophage identity. Simultaneous evaluation of transcriptomic and epigenetic features of infected and uninfected macrophages thereby reveals the coincident evolution of dominant proviral or antiviral mechanisms, respectively, that determine the outcome of ZIKV exposure

The effects of statins on hypoxia-induced proliferation and cell signalling pathways in pulmonary artery fibroblasts

Chronic hypoxia, in animals and man, results in remodelling of the pulmonary vasculature with consequent pulmonary hypertension. The pulmonary artery fibroblast (PAF) has been shown to play an early and important role in hypoxia-induced pulmonary vascular remodelling. In acute and chronic hypoxia there is excess proliferation of PAFs. Morevoer, it is likely that cell-cell interactions between hypoxia-stimulated PAFs and other vascular cells – particularly smooth muscle cells - initiates and progresses the changes that occur in pulmonary vascular remodelling in the other vessel compartments. Although hypoxic proliferation of PAFs has been shown to be circulation specific and dependant on phosphorylation of p38 mitogen-activated protein (MAP) kinase, the cell signalling pathway(s)underlying this are incompletely characterised. Hypoxic activation of PAFs is a potential therapeutic target but, as p38 MAP kinase inhibitors are not established for clinical use, work was proposed to better characterise this pathway and identify agent(s) which may inhibit p38 MAPK indirectly. The HMG-CoA reductase inhibitor simvastatin was recently shown to inhibit hypoxic pulmonary vascular remodelling in rats, but the applicability of this finding to clinical practice is incompletely established and the mechanism of action of the statin is unclear. Statins have been shown to influence MAP kinase pathways in other cell types and, as their modes of action are well established, they can be used to interrogate uncharacterised upstream cell signalling pathways. On this basis, the aims of this study were firstly to determine whether statins had a therapeutically useful inhibitory effect on hypoxia-induced, p38 MAP kinase-mediated PAF proliferation. A second aim was to exploit the known effects of statins to better characterise hypoxic cell signalling upstream of p38 MAP kinase in PAFs. Lastly, comparison of the effects of statins with established pulmonary hypertension therapeutics and a preliminary assessment – also using statins as an experimental tool - of cell-cell interactions between PAFs and pulmonary artery smooth muscle cells (PASMCs) was proposed. 1μM of fluvastatin was found to selectively inhibit acute and chronic hypoxia-induced p38 MAP kinase phosphorylation and proliferation in rat PAFs. At this dose, fluvastatin had no effect on serum-induced proliferation in PAFs, no effect on systemic adventitial fibroblast proliferation, and no effect on the phosphorylation status of other MAP kinases. Selective use of mediators and inhibitors related to the HMG-CoA pathway indicated that a geranylgeranylated protein, probably Rac1, had an obligatory role upstream of p38 MAPK, in this signalling pathway. Co-culture and conditioned media experiments with bovine PAFs and PASMCs demonstrated the release of PASMC mitogens from hypoxic PAFs. 1μM fluvastatin and the p38 MAP kinase inhibitor SB203580 selectively blocked the hypoxic PAF-PASMC interaction. Results with hypoxic PAF proliferation with the prostacyclin analogue treprostinil, the phosphodiesterase-5 inhibitor sildenafil and the endothelin-1 antagonist bosentan were negative. Bosentan, however, inhibited the hypoxic PAF-PASMC interaction, suggesting endothelin-1 release by hypoxic PAFs, with proproliferative effects on PASMCs. The results reported in this thesis provide new information on hypoxic signalling,PAF proliferation and PAF cell-cell interactions in hypoxic states. A circulation and stimulus specific anti-proliferative effect of fluvastatin on PAFs was identified and this may be of clinical relevance in hypoxia-associated pulmonary hypertension

A quantum optical study of thresholdless lasing features in high-β nitride nanobeam cavities

Exploring the limits of spontaneous emission coupling is not only one of the central goals in the development of nanolasers, it is also highly relevant regarding future large-scale photonic integration requiring energy-efficient coherent light sources with a small footprint. Recent studies in this field have triggered a vivid debate on how to prove and interpret lasing in the high-β regime. We investigate close-to-ideal spontaneous emission coupling in GaN nanobeam lasers grown on silicon. Such nanobeam cavities allow for efficient funneling of spontaneous emission from the quantum well gain material into the laser mode. By performing a comprehensive optical and quantum-optical characterization, supported by microscopic modeling of the nanolasers, we identify high-β lasing at room temperature and show a lasing transition in the absence of a threshold nonlinearity at 156 K. This peculiar characteristic is explained in terms of a temperature and excitation power-dependent interplay between zero-dimensional and two-dimensional gain contributions.EC/FP7/615613/EU/External Quantum Control of Photonic Semiconductor Nanostructures/EXQUISIT