Psychobiology of Resilience

Nurse managers experience high levels of stress due to the complex bureaucratic and chaotic nature of the job, which can lead to burnout. In nurse managers, burnout negatively impacts the ability to meet the strategic goals of the quadruple aim: patient quality, patient satisfaction, cost savings, and employee well-being. Strategies to address burnout include minimizing or removing unnecessary causes of stress and provide the skills to protect against burnout. Resilience is a competency nurse leaders must have to withstand overwhelming job-related stress. Resilience-enhancing strategies have psychobiologic underpinnings and can be easily incorporated into nurse managers’ work schedules

Enhancing Nurse Manager Resilience with a Resilience-Enhancing Toolkit

Background: Nurse managers have one of the most stressful jobs in nursing leadership. They experience more burnout and are more likely to leave the job or leave the nursing profession altogether, leading to vacancies or burned-out leaders. Local Problem: The organization experienced high nurse manager turnover. Of 12 positions, four have more than two years of experience, three have less than two years, and five are filled with interims. Context: Strategies to address burnout are decreasing stressors or arming leaders with skills to withstand stressors. The organization offers programs that address burnout but are designed to be used outside of work. Intervention: An evidence-based, resilience-enhancing toolkit for nurse leaders was designed to be easy to use at work. The toolkit contained techniques on mindfulness, cognitive reframing, and gratitude, which are strategies demonstrated to enhance resilience. Methods: The program took place between August and December 2022. Pre- and post-surveys were created to evaluate the effectiveness of the toolkit. Results: There was no difference in the Connor-Davidson Resilience mean pre- and post-intervention score. Mindfulness (50.0% to 87.5%), cognitive reframing (40.0% to 75.0%), and gratitude practices (90.0% to 100.0%) increased. Conclusions: Although mean resilience scores did not change, resilience-enhancing practices increased. More time may be needed to develop resilience. Post-intervention surveys were administered at a relatively more stressful time than pre-intervention surveys. Using the toolkit, post-intervention scores may have been positively affected

Denoising Autoencoders for fast Combinatorial Black Box Optimization

Estimation of Distribution Algorithms (EDAs) require flexible probability models that can be efficiently learned and sampled. Autoencoders (AE) are generative stochastic networks with these desired properties. We integrate a special type of AE, the Denoising Autoencoder (DAE), into an EDA and evaluate the performance of DAE-EDA on several combinatorial optimization problems with a single objective. We asses the number of fitness evaluations as well as the required CPU times. We compare the results to the performance to the Bayesian Optimization Algorithm (BOA) and RBM-EDA, another EDA which is based on a generative neural network which has proven competitive with BOA. For the considered problem instances, DAE-EDA is considerably faster than BOA and RBM-EDA, sometimes by orders of magnitude. The number of fitness evaluations is higher than for BOA, but competitive with RBM-EDA. These results show that DAEs can be useful tools for problems with low but non-negligible fitness evaluation costs.Comment: corrected typos and small inconsistencie

Stochastic stability versus localization in chaotic dynamical systems

We prove stochastic stability of chaotic maps for a general class of Markov random perturbations (including singular ones) satisfying some kind of mixing conditions. One of the consequences of this statement is the proof of Ulam's conjecture about the approximation of the dynamics of a chaotic system by a finite state Markov chain. Conditions under which the localization phenomenon (i.e. stabilization of singular invariant measures) takes place are also considered. Our main tools are the so called bounded variation approach combined with the ergodic theorem of Ionescu-Tulcea and Marinescu, and a random walk argument that we apply to prove the absence of ``traps'' under the action of random perturbations.Comment: 27 pages, LaTe

Dependency structure matrix, genetic algorithms, and effective recombination

In many different fields, researchers are often confronted by problems arising from complex systems. Simple heuristics or even enumeration works quite well on small and easy problems; however, to efficiently solve large and difficult problems, proper decomposition is the key. In this paper, investigating and analyzing interactions between components of complex systems shed some light on problem decomposition. By recognizing three bare-bones interactions-modularity, hierarchy, and overlap, facet-wise models arc developed to dissect and inspect problem decomposition in the context of genetic algorithms. The proposed genetic algorithm design utilizes a matrix representation of an interaction graph to analyze and explicitly decompose the problem. The results from this paper should benefit research both technically and scientifically. Technically, this paper develops an automated dependency structure matrix clustering technique and utilizes it to design a model-building genetic algorithm that learns and delivers the problem structure. Scientifically, the explicit interaction model describes the problem structure very well and helps researchers gain important insights through the explicitness of the procedure.This work was sponsored by Taiwan National Science Council under grant NSC97- 2218-E-002-020-MY3, U.S. Air Force Office of Scientific Research, Air Force Material Command, USAF, under grants FA9550-06-1-0370 and FA9550-06-1-0096, U.S. National Science Foundation under CAREER grant ECS-0547013, ITR grant DMR-03-25939 at Materials Computation Center, grant ISS-02-09199 at US National Center for Supercomputing Applications, UIUC, and the Portuguese Foundation for Science and Technology under grants SFRH/BD/16980/2004 and PTDC/EIA/67776/2006

Identification of Microbial and Proteomic Biomarkers in Early Childhood Caries

The purpose of this study was to provide a univariate and multivariate analysis of genomic microbial data and salivary mass-spectrometry proteomic profiles for dental caries outcomes. In order to determine potential useful biomarkers for dental caries, a multivariate classification analysis was employed to build predictive models capable of classifying microbial and salivary sample profiles with generalization performance. We used high-throughput methodologies including multiplexed microbial arrays and SELDI-TOF-MS profiling to characterize the oral flora and salivary proteome in 204 children aged 1–8 years (n = 118 caries-free, n = 86 caries-active). The population received little dental care and was deemed at high risk for childhood caries. Findings of the study indicate that models incorporating both microbial and proteomic data are superior to models of only microbial or salivary data alone. Comparison of results for the combined and independent data suggests that the combination of proteomic and microbial sources is beneficial for the classification accuracy and that combined data lead to improved predictive models for caries-active and caries-free patients. The best predictive model had a 6% test error, >92% sensitivity, and >95% specificity. These findings suggest that further characterization of the oral microflora and the salivary proteome associated with health and caries may provide clinically useful biomarkers to better predict future caries experience

Single Cell Transcriptomics Implicate Novel Monocyte and T Cell Immune Dysregulation in Sarcoidosis

Sarcoidosis is a systemic inflammatory disease characterized by infiltration of immune cells into granulomas. Previous gene expression studies using heterogeneous cell mixtures lack insight into cell-type-specific immune dysregulation. We performed the first single-cell RNA-sequencing study of sarcoidosis in peripheral immune cells in 48 patients and controls. Following unbiased clustering, differentially expressed genes were identified for 18 cell types and bioinformatically assessed for function and pathway enrichment. Our results reveal persistent activation of circulating classical monocytes with subsequent upregulation of trafficking molecules. Specifically, classical monocytes upregulated distinct markers of activation including adhesion molecules, pattern recognition receptors, and chemokine receptors, as well as enrichment of immunoregulatory pathways HMGB1, mTOR, and ephrin receptor signaling. Predictive modeling implicated TGFβ and mTOR signaling as drivers of persistent monocyte activation. Additionally, sarcoidosis T cell subsets displayed patterns of dysregulation. CD4 naïve T cells were enriched for markers of apoptosis and Th17/T(reg) differentiation, while effector T cells showed enrichment of anergy-related pathways. Differentially expressed genes in regulatory T cells suggested dysfunctional p53, cell death, and TNFR2 signaling. Using more sensitive technology and more precise units of measure, we identify cell-type specific, novel inflammatory and regulatory pathways. Based on our findings, we suggest a novel model involving four convergent arms of dysregulation: persistent hyperactivation of innate and adaptive immunity via classical monocytes and CD4 naïve T cells, regulatory T cell dysfunction, and effector T cell anergy. We further our understanding of the immunopathology of sarcoidosis and point to novel therapeutic targets

Symmetry breaking perturbations and strange attractors

The asymmetrically forced, damped Duffing oscillator is introduced as a prototype model for analyzing the homoclinic tangle of symmetric dissipative systems with \textit{symmetry breaking} disturbances. Even a slight fixed asymmetry in the perturbation may cause a substantial change in the asymptotic behavior of the system, e.g. transitions from two sided to one sided strange attractors as the other parameters are varied. Moreover, slight asymmetries may cause substantial asymmetries in the relative size of the basins of attraction of the unforced nearly symmetric attracting regions. These changes seems to be associated with homoclinic bifurcations. Numerical evidence indicates that \textit{strange attractors} appear near curves corresponding to specific secondary homoclinic bifurcations. These curves are found using analytical perturbational tools