Impact of a brief faculty training to improve patient-centered communication while using electronic health records

Objective Despite rapid EHR adoption, few faculty receive training in how to implement patient-centered communication skills while using computers in exam rooms. We piloted a patient-centered EHR use training to address this issue. Methods Faculty received four hours of training at Cleveland Clinic and a condensed 90-minute version at the University of Chicago. Both included a lecture and a Group-Objective Structured Clinical Exam (GOSCE) experience. Direct observations of 10 faculty in their clinical practices were performed pre- and post-workshop. Results Thirty participants (94%) completed a post-workshop evaluation assessing knowledge, attitude, and skills. Faculty reported that training was important, relevant, and should be required for all providers; no differences were found between longer versus shorter training. Participants in the longer training reported higher GOSCE efficacy, however shorter workshop participants agreed more with the statement that they had gained new knowledge. Faculty improved their patient-centered EHR use skills in clinical practice on post- versus pre-workshop ratings using a validated direct-observation rating tool. Conclusion A brief lecture and GOSCE can be effective in training busy faculty on patient-centered EHR use skills. Practice Implications Faculty training on patient-centered EHR skills can enhance patient-doctor communication and promotes positive role modeling of these skills to learners

Chiral transition and monopole percolation in lattice scalar QED with quenched fermions

We study the interplay between topological observables and chiral and Higgs transitions in lattice scalar QED with quenched fermions. Emphasis is put on the chiral transition line and magnetic monopole percolation at strong gauge coupling. We confirm that at infinite gauge coupling the chiral transition is described by mean field exponents. We find a rich and complicated behaviour at the endpoint of the Higgs transition line which hampers a satisfactory analysis of the chiral transition. We study in detail an intermediate coupling, where the data are consistent both with a trivial chiral transition clearly separated from monopole percolation and with a chiral transition coincident with monopole percolation, and characterized by the same critical exponent $\nu \simeq 0.65$. We discuss the relevance (or lack thereof) of these quenched results to our understanding of the \chupiv\ model. We comment on the interplay of magnetic monopoles and fermion dynamics in more general contexts.Comment: 29 pages, 13 figures included, LaTeX2e (elsart

Branching annihilating random walks with parity conservation on a square lattice

Using Monte Carlo simulations we have studied the transition from an "active" steady state to an absorbing "inactive" state for two versions of the branching annihilating random walks with parity conservation on a square lattice. In the first model the randomly walking particles annihilate when they meet and the branching process creates two additional particles; in the second case we distinguish particles and antiparticles created and annihilated in pairs. Quite distinct critical behavior is found in the two cases, raising the question of what determines universality in this kind of systems.Comment: 4 pages, 4 EPS figures include

Anti-Inflammatory properties of injectable Betamethasone-Loaded Tyramine-Modified Gellan Gum/Silk Fibroin Hydrogels

Rheumatoid arthritis is a rheumatic disease for which a healing treatment does not presently exist. Silk fibroin has been extensively studied for use in drug delivery systems due to its uniqueness, versatility and strong clinical track record in medicine. However, in general, natural polymeric materials are not mechanically stable enough, and have high rates of biodegradation. Thus, synthetic materials such as gellan gum can be used to produce composite structures with biological signals to promote tissue-specific interactions while providing the desired mechanical properties. In this work, we aimed to produce hydrogels of tyramine-modified gellan gum with silk fibroin (Tyâ GG/SF) via horseradish peroxidase (HRP), with encapsulated betamethasone, to improve the biocompatibility and mechanical properties, and further increase therapeutic efficacy to treat rheumatoid arthritis (RA). The Tyâ GG/SF hydrogels presented a β-sheet secondary structure, with gelation time around 2â 5 min, good resistance to enzymatic degradation, a suitable injectability profile, viscoelastic capacity with a significant solid component and a betamethasone-controlled release profile over time. In vitro studies showed that Tyâ GG/SF hydrogels did not produce a deleterious effect on cellular metabolic activity, morphology or proliferation. Furthermore, Tyâ GG/SF hydrogels with encapsulated betamethasone revealed greater therapeutic efficacy than the drug applied alone. Therefore, this strategy can provide an improvement in therapeutic efficacy when compared to the traditional use of drugs for the treatment of rheumatoid arthritis.Norte2020 project (“NORTE-08-5369-FSE000044”), REMIX project (GA 778078—REMIX—H2020-MSCA-RISE-2017) Gilson Lab, Chonbuk National University, Republic of Korea and the Frontiers of technology for theranostics of cancer, metabolic and neurodegenerative diseases (FROnTHERA), Structural Project NORTE-01-0145-FEDER-000023. The FCT distinction attributed to J.M.O. under the Investigator FCT program (number IF/01285/2015) is also greatly acknowledged. C.G. also wishes to acknowledge FCT for supporting her research (number SFRH/BPD/94277/201

A Transcriptomic View of the Proteome Variability of Newborn and Adult Bothrops jararaca Snake Venoms

Bothrops jararaca is one of the most abundant venomous snake species in Brazil. It is primarily a nocturnal and generalist animal, however, it exhibits a notable ontogenetic shift in diet, feeding mainly on arthropods, lizards, and amphibians (ectothermic prey) through its juvenile phase and on small mammals (endothermic animals) during adult life. Due to its broad geographical distribution, this species is responsible for the majority of the accidents by Bothrops genus in Brazil. Studies on envenomation cases with newborn and adult B. jararaca snakes have shown distinct patterns, mainly related to blood coagulation disorders, which seems to be prominent in accidents with newborn specimens. Moreover, it has been demonstrated that the Brazilian commercial antibothropic antivenom, which is produced by immunization with adult venom, is less effective in neutralizing newborn venom effects. In this study we analyzed the venom gland transcriptome of newborn snake specimens and compared the content of toxin transcripts with that of adult specimens. We demonstrate that upon B. jararaca development, its repertoire of mRNAs encoding toxins changes both qualitatively and quantitatively and these alterations are associated with the venom proteome profiles and pharmacological activities displayed by newborn and adult specimens

Ageing in the critical contact process: a Monte Carlo study

The long-time dynamics of the critical contact process which is brought suddenly out of an uncorrelated initial state undergoes ageing in close analogy with quenched magnetic systems. In particular, we show through Monte Carlo simulations in one and two dimensions and through mean-field theory that time-translation invariance is broken and that dynamical scaling holds. We find that the autocorrelation and autoresponse exponents lambda_{Gamma} and lambda_R are equal but, in contrast to systems relaxing to equilibrium, the ageing exponents a and b are distinct. A recent proposal to define a non-equilibrium temperature through the short-time limit of the fluctuation-dissipation ratio is therefore not applicable.Comment: 18 pages, 7 figures, Latex2e with IOP macros; final for

Surface functionalization of surfactant-free particles : a strategy to tailor the properties of nanocomposites for enhanced thermoelectric performance

Altres ajuts: MCS acknowledge MINECO Juan de la Cierva Incorporation fellowship (JdlCI 2019) and Severo Ochoa. ICN2 is funded by the CERCA Programme/Generalitat de Catalunya. This study was supported by MCIN with funding from European Union NextGenerationEU (PRTR-C17.I1) and Generalitat de Catalunya.The broad implementation of thermoelectricity requires high-performance and low-cost materials. One possibility is employing surfactant-free solution synthesis to produce nanopowders. We propose the strategy of functionalizing "naked" particles' surface by inorganic molecules to control the nanostructure and, consequently, thermoelectric performance. In particular, we use bismuth thiolates to functionalize surfactant-free SnTe particles' surfaces. Upon thermal processing, bismuth thiolates decomposition renders SnTe-BiS nanocomposites with synergistic functions: 1) carrier concentration optimization by Bi doping; 2) Seebeck coefficient enhancement and bipolar effect suppression by energy filtering; and 3) lattice thermal conductivity reduction by small grain domains, grain boundaries and nanostructuration. Overall, the SnTe-BiS nanocomposites exhibit peak z T up to 1.3 at 873 K and an average z T of ≈0.6 at 300-873 K, which is among the highest reported for solution-processed SnTe

State and trait characteristics of anterior insula time-varying functional connectivity.

The human anterior insula (aINS) is a topographically organized brain region, in which ventral portions contribute to socio-emotional function through limbic and autonomic connections, whereas the dorsal aINS contributes to cognitive processes through frontal and parietal connections. Open questions remain, however, regarding how aINS connectivity varies over time. We implemented a novel approach combining seed-to-whole-brain sliding-window functional connectivity MRI and k-means clustering to assess time-varying functional connectivity of aINS subregions. We studied three independent large samples of healthy participants and longitudinal datasets to assess inter- and intra-subject stability, and related aINS time-varying functional connectivity profiles to dispositional empathy. We identified four robust aINS time-varying functional connectivity modes that displayed both "state" and "trait" characteristics: while modes featuring connectivity to sensory regions were modulated by eye closure, modes featuring connectivity to higher cognitive and emotional processing regions were stable over time and related to empathy measures