A study of physician collaborations through social network and exponential random graph

Background: Physician collaboration, which evolves among physicians during the course of providing healthcare services to hospitalised patients, has been seen crucial to effective patient outcomes in healthcare organisations and hospitals. This study aims to explore physician collaborations using measures of social network analysis (SNA) and exponential random graph (ERG) model. Methods. Based on the underlying assumption that collaborations evolve among physicians when they visit a common hospitalised patient, this study first proposes an approach to map collaboration network among physicians from the details of their visits to patients. This paper terms this network as physician collaboration network (PCN). Second, SNA measures of degree centralisation, betweenness centralisation and density are used to examine the impact of SNA measures on hospitalisation cost and readmission rate. As a control variable, the impact of patient age on the relation between network measures (i.e. degree centralisation, betweenness centralisation and density) and hospital outcome variables (i.e. hospitalisation cost and readmission rate) are also explored. Finally, ERG models are developed to identify micro-level structural properties of (i) high-cost versus low-cost PCN; and (ii) high-readmission rate versus low-readmission rate PCN. An electronic health insurance claim dataset of a very large Australian health insurance organisation is utilised to construct and explore PCN in this study. Results: It is revealed that the density of PCN is positively correlated with hospitalisation cost and readmission rate. In contrast, betweenness centralisation is found negatively correlated with hospitalisation cost and readmission rate. Degree centralisation shows a negative correlation with readmission rate, but does not show any correlation with hospitalisation cost. Patient age does not have any impact for the relation of SNA measures with hospitalisation cost and hospital readmission rate. The 2-star parameter of ERG model has significant impact on hospitalisation cost. Furthermore, it is found that alternative-k-star and alternative-k-two-path parameters of ERG model have impact on readmission rate. Conclusions: Collaboration structures among physicians affect hospitalisation cost and hospital readmission rate. The implications of the findings of this study in terms of their potentiality in developing guidelines to improve the performance of collaborative environments among healthcare professionals within healthcare organisations are discussed in this paper. © 2013 Uddin et al.; licensee BioMed Central Ltd.published_or_final_versio

Aplicações da aproximação quase-newtoniana da Relatividade Geral a problemas em astrofísica

Dissertação de Mestrado apresentada ao Programa de Pós- Graduação em Fı́sica Aplicada da Universidade Federal da Integração Latino-Americana (PPGFISA-UNILA) como parte dos requisitos ncessários para obtenção do tı́tulo de Mestre em (Fı́sica). Orientador: Prof. Dr. Abraão Jessé Capistrano de Souza Coorientador: Prof. Dr. Luı́s Antonio CabralNo presente trabalho, investigamos o movimento lento na Relatividade Geral (RG) sob ação de um campo gravitacional arbitrário. Trata-se do uso de uma aproximação conhecida por aproximação quase Newtoniana (NNA). Nossa intenção é apresentar um novo paradigma para a Astrofísica, uma vez que o modelo pode auxiliar no entendimento da gravidade na cinemática e dinâmica de corpos celestes, mas não representa uma modificação da RG. Primeiro, usamos a métrica de Weyl para analisar o desvio do periastro de 34 exoplanetas. Em segundo lugar, a métrica oblata de Zipoy, em termos da solução do monopólo, também, faz parte do escopo deste trabalho. Mostramos que a métrica de Zipoy pode ser muito útil para propósitos astrofísicos, mesmo quando comparada a solução padrão de Einstein ou via formalismo pós-newtoniano parametrizado (PPN), porque satisfaz o valor da precessão observada para o periélio de Mercúrio, a solução fornece órbitas elípticas e, também, permite o estudo de precessões retrógradas.In the present work, we investigate the slow motion in General Relativity (GR) under an arbitrary gravitational field. It is about the use of an approximation known by nearly Newtonian approximation (NNA). Our intent is to present a new paradigm for Astrophy- sics, since the model can assist the understanding of gravity in kinematic and dynamics of celestial bodies but does not represent a modification of GR. First, we use Weyl’s me- tric to analyze the deviation of periastron of 34 exoplanets. Secondly, the oblate Zipoy’s metric, in terms by monopole solution, is also part of the scope of this work. We show that Zipoy’s metric may be very useful for astrophysical purposes, even when compared to Einstein’s standard solution or by formalism of parameterized post-Newtonian (PPN), because it satisfies the observed precession value for Mercury’s perihelion, the solution provides elliptical orbits and also allows the study of retrograde precessio

Hubungan Hiperurisemia, Obesitas Dan Riwayat Merokok Dengan Kejadian Hipertensi

Hypertension is a common clinical problem. Hyperuricemia, obesity, and smoking history are assumed to have a relationship with hypertension in adult. This study was conducted to figure out the association between hyperuricemia, obesity and smoking history with hypertension. Observational method with cross-sectional approach was used in this study. The study was conducted in Laboratorium Klinik Prodia Kendari. Sixty-two samples consist of men and women aged 18-65 years were taken by quota sampling. Blood pressure, body mass index, and blood chemistry result were collected during medical check-up. Smoking history data was collected with direct interview. Chi-square and binary logistic regression analysis were used to analyze the data (α=0,05). There were 50% hypertensive subjects and 50% non-hypertensive subjects. Hyperuricemia had a moderate association with hypertension (p=0,000; r=0,455). Obesity had a weak association with hypertension (p=0,020 ; r=0,248). Smoking history also had a weak association with hypertension (p=0,022 ; r=0,279). In multivariate analysis with confounding factors, only hyperuricemia that had an independent influence to hypertension (p= 0,00 ; OR 25,4 ; 95% CI 4,1-156,1), followed by HDL abnormality (p=0,04 ; OR=14,15 ; 95% CI=2,3-84,2) and total cholesterol (p=0,02 ; OR=22,4 ; 95% CI=3,2-153,8). Hyperuricemia, obesity, and smoking history, were associated with hypertension. Only hyperuricemia had the independent influence to hypertension

Development of Organo-Dispersible Graphene Oxide via Pseudo-Surface Modification for Thermally Conductive Green Polymer Composites

Graphene has attracted lots of researchers attention because of its remarkable conductivity in both electrically and thermally. However, it has poor dispersibility in organic solvents which limited its applications. Polymers with aromatic end group which act as an intercalator were prepared by ring-opening polymerization with ε-caprolactone by utilizing 1-naphthalene methanol (1-NM) as an initiator. These intercalators will exist between graphene oxide (GO) sheets to prevent aggregation via interactions. The attachment of 1-NM on polymer chains was supported by ultraviolet–visible spectra, size exclusion chromatography profiles, and 1H nuclear magnetic resonance spectra. Exfoliated structured functionalized GO (fGO)/polycaprolactone (PCL) (synthesized fGO) nanocomposites that dispersed well in acetone, chloroform, N,N-dimethylformamide, dimethyl sulfoxide, tetrahydrofuran, and toluene were successfully synthesized. This agreed well with the enlarged interlayer spacing in the optimized fGO as compared to that of GO from density functional theory simulations using the DMol3 module that implemented in the Materials Studio 6.0. Furthermore, its potential to be applied as green electronics in electronics, aerospace, and automotive industries was presented, by trailering the thermal conductivity enhancement from the incorporation of fGO/PCL with commercialized biodegradable polymers, PCL, and poly[(R)-3-hydroxybutyric acid]

Mutant screen reveals the Piccolo's control over depression and brain-gonad crosstalk

Successful sexual reproduction involves a highly complex, genetically encoded interplay between animal physiology and behavior. Here we developed a screen to identify genes essential for rat reproduction based on an unbiased methodology involving mutagenesis via the Sleeping Beauty transposon. As expected, our screen identified genes where reproductive failure was connected to gametogenesis (Btrc, Pan3, Spaca6, Ube2k) and embryogenesis (Alk3, Exoc6b, Slc1a3, Tmx4, Zmynd8). In addition, our screen identified Atg13 (longevity) Dlg1 and Pclo (neuronal disorders), previously not associated with reproduction. Dominant Pclo traits caused epileptiform activity and affected genes supporting GABAergic synaptic transmission (Gabra6, Gabrg3), and animals exhibited a compromised crosstalk between the brain and gonads via disturbed GnRH signaling. Recessive Pclo traits disrupted conspecific recognition required for courtship/mating and were mapped to allelic markers for major depressive disorder (Grm5, Htr2a, Sorcs3, Negr1, Drd2). Thus, Pclo-deficiency in rats link neural networks controlling sexual motivation to Pclo variants that have been associated with human neurological disorders

Genetic association and characterization of FSTL5 in isolated clubfoot

ACKNOWLEDGEMENTS: The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C). The authors thank the staff and participants of the ARIC study for their important contributions. Funding for GENEVA was provided by National Human Genome Research Institute grant U01HG004402 (E.Boerwinkle). We thank H. Hobbs and J. Cohen for contributing control samples for replication genotyping, Nadav Ahituv for sharing RNA-seq data for both bat and mouse embryonic limb buds, Tommy Hyatt for designing the custom genotyping assay, and members of the UT Southwestern Transgenic Core facility, including John Ritter, Mylinh Nguyen, and Robert Hammer. Publicly available mouse embryonic expression analysis results were provided online at https://oncoscape.v3.sttrcancer.org/atlas.gs.washington.edu.mouse.rna/landing (24). The authors acknowledge the contributions and support of the Center for Excellence in Clubfoot Research at Scottish Rite for Children, including Shawne Faulks and Kristhen Atala. Fstl5 mutant rats were produced by the NIH Mutant Rat Resource at UT Southwestern Medical Center (R24RR03232601, R24OD011108, R01HD036022, and (5R01HD053889). This study was supported by funding from the Scottish Rite for Children Research Fund (J.J.R.), Shriners Hospital for Children (J.T.H), and the National Institutes of Health award R01HD043342 (J.T.H.).Peer reviewedPostprin

Lentiviral Mediated Transgenesis by In Vivo Manipulation of Spermatogonial Stem Cells

This report describes a technique for the generation of transgenic mice by in vivo manipulation of spermatogonial stem cells with a high rate of success. Spermatogonial stem cells (SSCs) in pre-pubescent animals were infected in vivo with recombinant lentiviruses expressing EGFP-f and mated with normal females. All male pre-founder mice produced transgenic pups with an overall success rate of over 60%. The transgene was heritable and the pre-founder mice could be used in multiple mating experiments. This technology could be used to perform overexpression/knockdown screens in vivo using bar-coded lentiviruses, thus permitting the design of genetic screens in the mouse. Further, this technology could be adapted to other laboratory animals resulting in the generation of model systems that closely approximate human development and disease