21 research outputs found

    Urologist burnout: Frequency, causes, and potential solutions to an unspoken entity

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    Physician burnout has been linked to decreased job performance, increased medical errors, interpersonal conflicts, and depression. Recent multispecialty studies suggest that urologists have higher rates (up to 63.6%) of burnout compared to physicians in other specialties; however, these reports were limited by low sample sizes.1 We aimed to evaluate the prevalence of urologist burnout, verify risk factors, and recommend preventative measures and solutions for colleagues at risk or suffering from burnout. Urologist burnout is a true entity that transcends level of training and nationality. Its roots appear to be deep-seated in our tireless efforts to strive for excellence in care for our patients, our growing academic and research pursuits, and surmounting administrative responsibilities; these virtues, which are regarded as the foundations of our career successes, are often obtained at the expense of personal health and wellbeing, as well as family sacrifice. Various other medical societies have become increasingly vocal about the issue of physician burnout and have actively initiated successful strategies to minimize its impact on their members. As an organization with a strong national presence, the Canadian Urological Association (CUA) should promote tools to prevent and interventions to assist those at risk for and suffering from burnout. Increased awareness in the general medical community has led to strategies and tools that can help prevent, identify, or assist physicians in their recovery from burnout. The CUA should develop and facilitate access to information and offer comprehensive support for urologists struggling with burnout

    American Cancer Society guidelines for breast cancer screening: update 2003

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    In 2003, the American Cancer Society updated its guidelines for early detection of breast cancer based on recommendations from a formal review of evidence and a recent workshop. The new screening recommendations address screening mammography, physical examination, screening older women and women with comorbid conditions, screening women at high risk, and new screening technologies

    Amiloride derivatives enhance insulin release in pancreatic islets from diabetic mice

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    BACKGROUND: Amiloride derivatives, commonly used for their diuretic and antihypertensive properties, can also cause a sustained but reversible decrease of intracellular pH (pH(i)). Using dimethyl amiloride (DMA) on normal rodent pancreatic islets, we previously demonstrated the critical influence of islet pH(i )on insulin secretion. Nutrient-stimulated insulin secretion (NSIS) requires a specific pH(i)-range, and is dramatically enhanced by forced intracellular acidification with DMA. Furthermore, DMA can enable certain non-secretagogues to stimulate insulin secretion, and induce time-dependent potentiation (TDP) of insulin release in mouse islets where this function is normally absent. The present study was performed to determine whether pH(i)-manipulation could correct the secretory defect in islets isolated from mice with type 2 diabetes. METHODS: Using two mouse models of type 2 diabetes, we compared a) pHi-regulation, and b) NSIS with and without treatment with amiloride derivatives, in islets isolated from diabetic mice and wild type mice. RESULTS: A majority of the islets from the diabetic mice showed a slightly elevated basal pH(i )and/or poor recovery from acid/base load. DMA treatment produced a significant increase of NSIS in islets from the diabetic models. DMA also enabled glucose to induce TDP in the islets from diabetic mice, albeit to a lesser degree than in normal islets. CONCLUSION: Islets from diabetic mice show some mis-regulation of intracellular pH, and their secretory capacity is consistently enhanced by DMA/amiloride. Thus, amiloride derivatives show promise as potential therapeutic agents for type 2 diabetes

    Ab initio modelling of plasmons in metal-semiconductor bilayer transition-metal dichalcogenide heterostructures

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    Two-dimensional transition-metal dichalcogenides (TMDs) have attracted enormous interest, due to the richness of their optical and electronic properties. Here, we consider two prototypical two-dimensional TMD metal-semiconductor bilayer heterostructures, VSe-MoSe and VSe-WSe, and investigate the effect of the semiconducting layer on the plasmons supported by the metallic layer using first principles time-dependent density functional theory (TDDFT) calculations. We focus on the flat region of the plasmon dispersion, where momentum transfer is larger than 0.05 Ã… and the interband transitions gain importance. With the addition of the semiconducting layer, we show that the electronic band structure undergoes significant changes close to the Fermi level, and hybridization occurs, which leads to strengthening of the interband transitions and a significant redshift in the plasmon energy.We acknowledge financial support from the European Research Council (ERC-2015-AdG-694097), Grupos Consolidates (IT578-13), Spanish grant (FIS2013-46159-C3-1-P), AFOSR Grant No. FA2386-15-1-006, AOARD 144088, and COST Action MP1306 (EUSpec). Steven G. Louie and Felipe H. da Jornada acknowledge support by National Science Foundation EFRI Program Grant No. EFMA-1542741.Peer Reviewe
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