Do incoming residents vary in measures of emotional status even prior to residency training?

Objectives: To determine whether Empathy, Emotional Intelligence, and Burnout scores differ by specialty in incoming residents. Methods: This is a single-site, prospective, cross-sectional study. Three validated survey instruments, the Jefferson Scale of Physician Empathy, Maslach Burnout Inventory, and Emotional and Social Competency Inventory, were written into a survey platform as a single 125-question Qualtrics survey. Over three academic years, 2015-2017, 229 incoming residents across all specialties were emailed the survey link during orientation. Residents were grouped by incoming specialty with anonymity assured. A total of 229 responses were included, with 121 (52.8%) identifying as female. Statistical analysis was performed using the Analysis of Variance or Kruskal-Wallis test, Chi-Square or Fisher\u27s Exact test, and Independent Samples t-test or Mann Whitney U test. A Bonferroni correction was applied for pairwise comparisons. Results: Family Medicine had a higher median Jefferson Scale of Physician Empathy score (127) compared to Emergency Medicine (115), (U=767.7, p=0.0330). Maslach Burnout Inventory depersonalization and personal accomplishment subcategory scores showed a significant difference between specialties when omnibus tests were performed, but pairwise comparisons with emergency medicine residents showed no differences. Differences were found in the Maslach Burnout Inventory categories of Depersonalization (χ Conclusions: Differences in measures of well-being exist across specialties, even prior to the start of residency training. The implication for educators of residency training is that some incoming residents, regardless of specialty, already exhibit troublesome features of burnout, and resources to effectively deal with these residents should be developed and utilized

A new measurement of the properties of the rare decay K -> pi+ e+ e-

A large low-background sample of events (10300) has been collected for the rare decay of kaons in flight K+ -> pi+ e+ e- by experiment E865 at the Brookhaven AGS. The decay products were accepted by a broad band high-resolution charged particle spectrometer with particle identification. The branching ratio (2.94 +- 0.05(stat.) +- 0.13(syst.) +- 0.05(model))*10**{-7} was determined normalizing to events from the decay chain K+ -> pi+ pi0; pi0 -> e+ e- gamma. From the analysis of the decay distributions the vector nature of this decay is firmly established now, and limits on scalar and tensor contributions are deduced. From the (e+ e-) invariant mass distribution the decay form factor f(z)=f0(1+ delta*z) (z=M(ee)**2/m(K)**2) is determined with delta=2.14 +- 0.13 +- 0.15. Chiral QCD perturbation theory predictions for the form factor are also tested, and terms beyond leading order O(p**4) are found to be important.Comment: 4 pages, 5 figure

Spectral Theory for Perturbed Krein Laplacians in Nonsmooth Domains

We study spectral properties for $H_{K,\Omega}$, the Krein--von Neumann extension of the perturbed Laplacian $-\Delta+V$ defined on $C^\infty_0(\Omega)$, where $V$ is measurable, bounded and nonnegative, in a bounded open set $\Omega\subset\mathbb{R}^n$ belonging to a class of nonsmooth domains which contains all convex domains, along with all domains of class $C^{1,r}$, $r>1/2$. In particular, in the aforementioned context we establish the Weyl asymptotic formula #\{j\in\mathbb{N} | \lambda_{K,\Omega,j}\leq\lambda\} = (2\pi)^{-n} v_n |\Omega| \lambda^{n/2}+O\big(\lambda^{(n-(1/2))/2}\big) {as} \lambda\to\infty, where $v_n=\pi^{n/2}/ \Gamma((n/2)+1)$ denotes the volume of the unit ball in $\mathbb{R}^n$, and $\lambda_{K,\Omega,j}$, $j\in\mathbb{N}$, are the non-zero eigenvalues of $H_{K,\Omega}$, listed in increasing order according to their multiplicities. We prove this formula by showing that the perturbed Krein Laplacian (i.e., the Krein--von Neumann extension of $-\Delta+V$ defined on $C^\infty_0(\Omega)$) is spectrally equivalent to the buckling of a clamped plate problem, and using an abstract result of Kozlov from the mid 1980's. Our work builds on that of Grubb in the early 1980's, who has considered similar issues for elliptic operators in smooth domains, and shows that the question posed by Alonso and Simon in 1980 pertaining to the validity of the above Weyl asymptotic formula continues to have an affirmative answer in this nonsmooth setting.Comment: 60 page

Vertebrate Vitellogenin Gene Duplication in Relation to the “3R Hypothesis”: Correlation to the Pelagic Egg and the Oceanic Radiation of Teleosts

The spiny ray-finned teleost fishes (Acanthomorpha) are the most successful group of vertebrates in terms of species diversity. Their meteoric radiation and speciation in the oceans during the late Cretaceous and Eocene epoch is unprecedented in vertebrate history, occurring in one third of the time for similar diversity to appear in the birds and mammals. The success of marine teleosts is even more remarkable considering their long freshwater ancestry, since it implies solving major physiological challenges when freely broadcasting their eggs in the hyper-osmotic conditions of seawater. Most extant marine teleosts spawn highly hydrated pelagic eggs, due to differential proteolysis of vitellogenin (Vtg)-derived yolk proteins. The maturational degradation of Vtg involves depolymerization of mainly the lipovitellin heavy chain (LvH) of one form of Vtg to generate a large pool of free amino acids (FAA 150–200 mM). This organic osmolyte pool drives hydration of the ooctye while still protected within the maternal ovary. In the present contribution, we have used Bayesian analysis to examine the evolution of vertebrate Vtg genes in relation to the “3R hypothesis” of whole genome duplication (WGD) and the functional end points of LvH degradation during oocyte maturation. We find that teleost Vtgs have experienced a post-R3 lineage-specific gene duplication to form paralogous clusters that correlate to the pelagic and benthic character of the eggs. Neo-functionalization allowed one paralogue to be proteolyzed to FAA driving hydration of the maturing oocytes, which pre-adapts them to the marine environment and causes them to float. The timing of these events matches the appearance of the Acanthomorpha in the fossil record. We discuss the significance of these adaptations in relation to ancestral physiological features, and propose that the neo-functionalization of duplicated Vtg genes was a key event in the evolution and success of the teleosts in the oceanic environment