A 2-Question Summative Score Correlates with the Maslach Burnout Inventory

Introduction: There is a high prevalence of burnout among emergency medicine (EM) residents. The Maslach Burnout Inventory - Human Services Survey (MBI-HSS) is a widely used tool to measure burnout. The objective of this study was to compare the MBI-HSS and a two-question tool to determine burnout in the EM resident population.Methods: Based on data from the 2017 National Emergency Medicine Resident Wellness Survey study, we determined the correlation between two single-item questions with their respective MBI subscales and the full MBI-HSS. We then compared a 2-Question Summative Score to the full MBI-HSS with respect to primary, more restrictive, and more inclusive definitions of burnout previously reported in the literature.Results: Of 1,522 residents who completed the survey 37.0% reported “I feel burned out from my work,” and 47.1% reported “I have become more callous toward people since I took this job” once a week or more (each item >3 on a scale of 0-6). A 2-Question Summative Score totaling >3 correlated most closely with the primary definition of burnout (Spearman’s rho 0.65 [95% confidence interval 0.62-0.68]). Using the summative score, 77.7% of residents were identified as burned out, compared to 76.1% using the full MBI-HSS, with a sensitivity and specificity of 93.6% and 73.0%, respectively.Conclusion: An abbreviated 2-Question Summative Score correlates well with the full MBI-HSS tool in assessing EM resident physician burnout and could be considered a rapid screening tool to identify at-risk residents experiencing burnout

Cerebral aneurysm treatment: modern neurovascular techniques.

Endovascular treatment of cerebral aneurysm continues to evolve with the development of new technologies. This review provides an overview of the recent major innovations in the neurointerventional space in recent years

Resonant Scattering of Surface Plasmon Polaritons by Dressed Quantum Dots

The resonant scattering of surface plasmon-polariton waves by embedded semiconductor quantum dots above the dielectric/metal interface is explored in the strong-coupling regime. In contrast to non-resonant scattering by a localized dielectric surface defect, a strong resonant peak in the scattering field spectrum is predicted and accompanied by two side valleys. The peak height depends nonlinearly on the amplitude of surface plasmon-polariton waves, reflecting the feedback dynamics from a photon-dressed electron-hole plasma inside the quantum dots. This unique behavior in the scattering field peak strength is correlated with the occurrence of a resonant dip in the absorption spectrum of surface plasmon-polariton waves due to interband photon-dressing effect. Our result on the scattering of surface plasmon-polariton waves may be experimentally observable and applied to spatially selective illumination and imaging of individual molecules.Comment: 15 pages, 3 figure

Controlling quantum-dot light absorption and emission by a surface-plasmon field

The possibility for controlling the probe-field optical gain and absorption switching and photon conversion by a surface-plasmon-polariton near field is explored for a quantum dot above the surface of a metal. In contrast to the linear response in the weak-coupling regime, the calculated spectra show an induced optical gain and a triply-split spontaneous emission peak resulting from the interference between the surface-plasmon field and the probe or self-emitted light field in such a strongly-coupled nonlinear system. Our result on the control of the mediated photon-photon interaction, very similar to the `gate' control in an optical transistor, may be experimentally observable and applied to ultra-fast intrachip/interchip optical interconnects, improvement in the performance of fiber-optic communication networks and developments of optical digital computers and quantum communications.Comment: 7 pages, 15 figure

Fibulin-4 is essential for maintaining arterial wall integrity in conduit but not muscular arteries

Homozygous or compound heterozygous mutations in fibulin-4 (FBLN4) lead to autosomal recessive cutis laxa type 1B (ARCL1B), a multisystem disorder characterized by significant cardiovascular abnormalities, including abnormal elastin assembly, arterial tortuosity, and aortic aneurysms. We sought to determine the consequences of a human disease-causing mutation in FBLN4 (E57K) on the cardiovascular system and vascular elastic fibers in a mouse model of ARCL1B. Fbln4E57K/E57K mice were hypertensive and developed arterial elongation, tortuosity, and ascending aortic aneurysms. Smooth muscle cell organization within the arterial wall of large conducting vessels was abnormal, and elastic fibers were fragmented and had a moth-eaten appearance. In contrast, vessel wall structure and elastic fiber integrity were normal in resistance/muscular arteries (renal, mesenteric, and saphenous). Elastin cross-linking and total elastin content were unchanged in large or small arteries, whereas elastic fiber architecture was abnormal in large vessels. While the E57K mutation did not affect Fbln4 mRNA levels, FBLN4 protein was lower in the ascending aorta of mutant animals compared to wild-type arteries but equivalent in mesenteric arteries. We found a differential role of FBLN4 in elastic fiber assembly, where it functions mainly in large conduit arteries. These results suggest that elastin assembly has different requirements depending on vessel type. Normal levels of elastin cross-links in mutant tissue call into question FBLN4\u27s suggested role in mediating lysyl oxidase-elastin interactions. Future studies investigating tissuespecific elastic fiber assembly may lead to novel therapeutic interventions for ARCL1B and other disorders of elastic fiber assembly. 2017 © The Authors, some rights reserved

Development of Advanced High Lift Leading Edge Technology for Laminar Flow Wings

This paper describes the Advanced High Lift Leading Edge (AHLLE) task performed by Northrop Grumman Systems Corporation, Aerospace Systems (NGAS) for the NASA Subsonic Fixed Wing project in an effort to develop enabling high-lift technology for laminar flow wings. Based on a known laminar cruise airfoil that incorporated an NGAS-developed integrated slot design, this effort involved using Computational Fluid Dynamics (CFD) analysis and quality function deployment (QFD) analysis on several leading edge concepts, and subsequently down-selected to two blown leading-edge concepts for testing. A 7-foot-span AHLLE airfoil model was designed and fabricated at NGAS and then tested at the NGAS 7 x 10 Low Speed Wind Tunnel in Hawthorne, CA. The model configurations tested included: baseline, deflected trailing edge, blown deflected trailing edge, blown leading edge, morphed leading edge, and blown/morphed leading edge. A successful demonstration of high lift leading edge technology was achieved, and the target goals for improved lift were exceeded by 30% with a maximum section lift coefficient (Cl) of 5.2. Maximum incremental section lift coefficients ( Cl) of 3.5 and 3.1 were achieved for a blown drooped (morphed) leading edge concept and a non-drooped leading edge blowing concept, respectively. The most effective AHLLE design yielded an estimated 94% lift improvement over the conventional high lift Krueger flap configurations while providing laminar flow capability on the cruise configuration

Effective Field Theory for Bound State Reflection

Elastic quantum bound-state reflection from a hard-wall boundary provides direct information regarding the structure and compressibility of quantum bound states. We discuss elastic quantum bound-state reflection and derive a general theory for elastic reflection of shallow dimers from hard-wall surfaces using effective field theory. We show that there is a small expansion parameter for analytic calculations of the reflection scattering length. We present a calculation up to second order in the effective Hamiltonian in one, two, and three dimensions. We also provide numerical lattice results for all three cases as a comparison with our effective field theory results. Finally, we provide an analysis of the compressibility of the alpha particle confined to a cubic lattice with vanishing Dirichlet boundaries.Comment: 43 pages, 9 figures, 16 tables, published versio