Development of high Tc (greater than 110K) Bi, Tl and Y-based materials as superconducting circuit elements

This report is presented in two parts. Part 1 deals primarily with Bi-based materials and a small amount of work on a Y-based composition while Part 2 covers work on Tl-based materials. In Part 1, a reliable and reproducible process for producing bulk bismuth-based superconductors has been developed. It is noted however, that a percentage of the tapecast material experiences curling and fracturing after a 30 hour sintering period and is thus in need of further examination. The Bi-Sr-Ca-Cu-O (BSCCO) material has been characterized by critical temperature data, X-ray diffraction data, and surface morphology. In the case of T sub c, it is not critical to anneal the material. It appears that the BSCCO material has the possibility of producing a better grounding strap than that of the 123 material. Attempts to reproduce near room temperature superconductors in the Y-Ba-Cu-O system were unsuccessful. In Part 2, several methods of processing the high temperature superconductor Tl2Ba2Ca2Cu3O10 were investigated; i.e., different precursor compositions were sintered at various sintering times and temperatures. The highest superconductig temperature was found to be 117.8K when fired at 900 C for three hours. Higher sintering temperatures produced a melted sample which was nonsuperconducting at liquid nitrogen temperature. Also, a preliminary study found Li2O substitutions for copper appeared to increase the transition temperature and create fluxing action upon sintering. It was suggested that lower sintering temperatures might be obtained with lithium additions to produce reliable Tl2Ba2Ca2Cu3O10 processing methods

Evaluation of House Staff Candidates for Program Fit: A Cohort-Based Controlled Study

Background: Medical school academic achievements do not necessarily predict house staff job performance. This study explores a selection mechanism that improves house staff-program fit that enhances the Accreditation Council for Graduate Medical Education Milestones performance ratings. Objective: Traditionally, house staff were selected primarily on medical school academic performance. To improve residency performance outcomes, the Program designed a theory-driven selection tool to assess house staff candidates on their personal values and goals fit with Program values and goals. It was hypothesized cohort performance ratings will improve because of the intervention. Methods: Prospective quasi-experimental cohort design with data from two house staff cohorts at a university-based categorical Internal Medicine Residency Program. The intervention cohort, comprising 45 house staff from 2016 to 2017, was selected using a Behaviorally Anchored Rating Scales (BARS) tool for program fit. The control cohort, comprising 44 house staff from the prior year, was selected using medical school academic achievement scores. House staff performance was evaluated using ACGME Milestones indicators. The mean scores for each category were compared between the intervention and control cohorts using Student\u27s t-tests with Bonferroni correction and Cohen\u27s d for effect size. Results: The cohorts were no different in academic performance scores at time of Program entry. The intervention cohort outperformed the control cohort on all 6 dimensions of Milestones by end-PGY1 and 3 of 6 dimensions by mid-PGY3. Conclusion: Selecting house staff based on compatibility with Residency Program values and objectives may yield higher job performance because trainees benefit more from a better fit with the training program

Factors That Promote Perceived Usefulness of and Clinical Outcomes From Sign-Outs at the National University Hospital

IMPORTANCE OF THE STUDY. Currently, there is a paucity of evidence in the literature to show that handoff strategies improve the quality of handoff outcomes. Studies that show the usefulness and outcomes obtained from sign-outs may motivate junior clinicians, who have limited time to perform their clinical responsibilities, to support sign-out improvement efforts. OBJECTIVE. To test a research model that embeds the Technology Acceptance Model and the Theory of Planned Behavior to explore factors that enhance the perceived (a) usefulness of and (b) clinical outcomes from sign-outs among junior medical officers. DESIGN, SETTING, AND PARTICIPANTS. A retrospective study was conducted in the Division of General Medicine in November 2012. 17 residents volunteered to participate in a theoretically validated survey. MEASURES AND ANALYSES. The predictor variables were Perceived Ease of Sign-outs, Perceived Benefits from Sign-outs, Attitudes towards Sign-outs, Social Norms to Sign-out, and Perceived Behavior Control over Sign-outs. Partial Least Squares with bootstrapping to 1000 cases was utilized to analyze the data from a small sample. RESULTS. The results showed that perceived benefits from sign-outs enhanced the perceived usefulness of sign-outs. Perceived ease of sign-outs enhanced attitudes towards sign-outs, which was significantly related to perceptions of positive clinical outcomes from sign-outs. Neither the social pressure to sign-out nor the provision of conditions to facilitate sign-outs had any significant relationships to perceived usefulness of or clinical outcomes derived from sign-outs. CONCLUSION AND RELEVANCE. A two-prong approach involving minimal effort and hard evidence from clinical outcomes may be required to motivate adoption of sign-outs by busy residents

Handoffs, Safety Culture, and Practices: Evidence from the Hospital Survey on Patient Safety Culture

Background: The context of the study is the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture (HSOPSC). The purpose of the study is to analyze how different elements of patient safety culture are associated with clinical handoffs and perceptions of patient safety. Methods: The study was performed with hierarchical multiple linear regression on data from the 2010 Survey. We examine the statistical relationships between perceptions of handoffs and transitions practices, patient safety culture, and patient safety. We statistically controlled for the systematic effects of hospital size, type, ownership, and staffing levels on perceptions of patient safety. Results: The main findings were that the effective handoff of information, responsibility, and accountability were necessary to positive perceptions of patient safety. Feedback and communication about errors were positively related to the transfer of patient information; teamwork within units and the frequency of events reported were positively related to the transfer of personal responsibility during shift changes; and teamwork across units was positively related to the unit transfers of accountability for patients. Conclusions: In summary, staff views on the behavioral dimensions of handoffs influenced their perceptions of the hospital’s level of patient safety. Given the known psychological links between perception, attitude, and behavior, a potential implication is that better patient safety can be achieved by a tight focus on improving handoffs through training and monitoring

Genetic Associations in Four Decades of Multienvironment Trials Reveal Agronomic Trait Evolution in Common Bean

Multienvironment trials (METs) are widely used to assess the performance of promising crop germplasm. Though seldom designed to elucidate genetic mechanisms, MET data sets are often much larger than could be duplicated for genetic research and, given proper interpretation, may offer valuable insights into the genetics of adaptation across time and space. The Cooperative Dry Bean Nursery (CDBN) is a MET for common bean (Phaseolus vulgaris) grown for . 70 years in the United States and Canada, consisting of 20–50 entries each year at 10–20 locations. The CDBN provides a rich source of phenotypic data across entries, years, and locations that is amenable to genetic analysis. To study stable genetic effects segregating in this MET, we conducted genome-wide association studies (GWAS) using best linear unbiased predictions derived across years and locations for 21 CDBN phenotypes and genotypic data (1.2 million SNPs) for 327 CDBN genotypes. The value of this approach was confirmed by the discovery of three candidate genes and genomic regions previously identified in balanced GWAS. Multivariate adaptive shrinkage (mash) analysis, which increased our power to detect significant correlated effects, found significant effects for all phenotypes. Mash found two large genomic regions with effects on multiple phenotypes, supporting a hypothesis of pleiotropic or linked effects that were likely selected on in pursuit of a crop ideotype. Overall, our results demonstrate that statistical genomics approaches can be used on MET phenotypic data to discover significant genetic effects and to define genomic regions associated with crop improvement

A Pilot Study on Nurse-Led Rounds: Preliminary Data on Patient Contact Time

IMPORTANCE OF THE STUDY. Ward rounding has been a historical clinical method of inter-professional collaboration to support inpatient care through the sharing of mental models by exchanging information and discussing plans of care, treatment goals, and discharge plans for the patient. The extant literature reports that rounds are frequently led by doctors with infrequent nurse-physician collaboration and patients’ interactions with doctors during ward rounds tend to be brief. OBJECTIVE. To explore the effects of nurse-led morning ward rounds on patient contact time. DESIGN. An ethnographic prospective observational study comparing nurse-led and physician-led rounds. SETTING. A General Medicine ward at the National University Hospital in Singapore. INTERVENTION. A pilot intervention of nurse-led ward rounds for one week in June 2014. In the pilot intervention, nurses used the SPICES mnemonic to present their patients’ conditions to the clinical teams during morning rounds. MEASURES AND ANALYSES. Two observers shadowed the clinical teams for 57 patients. The amount of time that the clinical teams spent at the bedside of each patient was recorded. RESULTS. The results showed that the average time spent with patients at the bedside was significantly longer for nurse-led rounds compared to physician-led rounds. Also, the average time spent with patients at the bedside trended down toward the end of the 2-hour morning round time for resident-led ward rounds but it remained relatively consistent with an upward trend near the end of the 2-hour morning round for nurse-led rounds. CONCLUSION. The preliminary data suggests that quality time spent with patients at the bedside during morning rounds may be improved by nurse-led rounds

Factors Associated With Prolonged Length of Stay for Elective Hepatobiliary and Neurosurgery Patients: A Retrospective Medical Record Review

Background: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice. Methods: A retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18　years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student\u27s t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS. Results: Factors associated with prolonged LOS for the HPB sample were age and admission after 5　pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections. Conclusion: Our findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices

Induction of p53-independent apoptosis by ectopic expression of HOXA5 in human liposarcomas

Dedifferentiated liposarcoma (DDLPS) is a highly malignant subtype of human liposarcoma (LPS), whose genomic profile is characterized by chromosomal amplification at 12q13-q22. miR-26a-2 is one of the most frequently amplified genes in the region, and inhibition of its downstream target genes likely contributes to LPS tumorigenesis. Our previous study of LPS predicted homeobox protein A5 (HOXA5) as a target of miR-26a-2, and here we explored further the function of HOXA5, and its relationship with miR-26a-2 in DDLPS cells. Compared to normal human adipocytes, all LPS cell lines showed significant downregulation of HOXA5 (p = 0.046), and inhibition of miR-26a-2 using anti-miR-26a-2 substantially upregulated HOXA5 expression in these LPS cells. Interestingly, overexpression of HOXA5 alone induced very strong apoptotic response of LPS cells. HOXA5-induced apoptosis was p53-independent and caspase-dependent. Surprisingly, overexpression of HOXA5 induced nuclear translocation of RELA (p65), which was not associated with the transcriptional activity of RELA. Rather, nucleolar sequestration of RELA was observed. Overall, our study demonstrated for the first time that the downregulation of HOXA5 in LPS cells, partly by overexpression of miR-26a-2 in DDLPS, confers LPS cells resistance to apoptotic death. Further studies are required to understand the relationship of HOXA5 and the NFκB pathway in LPS cells

Metal-coordination: using one of nature's tricks to control soft material mechanics

Growing evidence supports a critical role of dynamic metal-coordination crosslinking in soft biological material properties such as self-healing and underwater adhesion. Using bio-inspired metal-coordinating polymers, initial efforts to mimic these properties have shown promise. Here we demonstrate how bio-inspired aqueous polymer network mechanics can be easily controlled via metal-coordination crosslink dynamics; metal ion-based crosslink stability control allows aqueous polymer network relaxation times to be finely tuned over several orders of magnitude. In addition to further biological material insights, our demonstration of this compositional scaling mechanism should provide inspiration for new polymer material property-control designs.National Science Foundation (U.S.). Materials Research Science and Engineering Centers (Program) (DMR-0820054)Danish Council for Independent Research (Natural Sciences for a Post-Doctoral Fellowship 272-08-0087)University of Chicago. Materials Research Science and Engineering Center (DMR 0820054