Engaging Healthcare Users through Gamification in Knowledge Sharing of Continuous Improvement in Healthcare

Knowledge management systems are key for capturing, retaining, and communicating results from projects and presenting information to staff. The purpose of a knowledge management system is to tap into the vast wisdom from projects and experts across an organization. This research focuses on the knowledge management system within the Veterans Health Administration that was developed as a repository of information on continuous improvement tools such as flowcharts, value stream mapping, 5S, and the application of these in healthcare projects. The use of social network analysis and gamification improves website organization, user participation, and dissemination of shared knowledge related to continuous improvement of operations. The purpose of gamification is to engage, teach, entertain, measure, and improve the ease of use of information systems. The goal of this research is to utilize gamification theory within the knowledge management system to drive behaviors in a targeted audience and engage users in aspects such as writing, contributing, getting the feedback, which will create a more robust, cohesive system. A thorough review of the current knowledge management system was conducted, and a gap analysis was performed comparing the goals and objectives for the system to the current results. Next, gamification techniques with the potential to improve performance were identified and strategies to implement these were developed

Anti-inflammatory activity and neutrophil reductions mediated by the JAK1/JAK3 inhibitor, CP-690,550, in rat adjuvant-induced arthritis

<p>Abstract</p> <p>Background</p> <p>The Janus kinase (JAK) family of tyrosine kinases includes JAK1, JAK2, JAK3 and TYK2, and is required for signaling through Type I and Type II cytokine receptors. CP-690,550 is a potent and selective JAK inhibitor currently in clinical trials for rheumatoid arthritis (RA) and other autoimmune disease indications. In RA trials, dose-dependent decreases in neutrophil counts (PBNC) were observed with CP-690,550 treatment. These studies were undertaken to better understand the relationship between JAK selectivity and PBNC decreases observed with CP-690,550 treatment.</p> <p>Methods</p> <p>Potency and selectivity of CP-690,550 for mouse, rat and human JAKs was evaluated in a panel of <it>in vitro </it>assays. The effect of CP-690,550 on granulopoiesis from progenitor cells was also assessed <it>in vitro </it>using colony forming assays. <it>In vivo </it>the potency of orally administered CP-690,550 on arthritis (paw edema), plasma cytokines, PBNC and bone marrow differentials were evaluated in the rat adjuvant-induced arthritis (AIA) model.</p> <p>Results</p> <p>CP-690,550 potently inhibited signaling through JAK1 and JAK3 with 5-100 fold selectivity over JAK2 in cellular assays, despite inhibiting all four JAK isoforms with nM potency in <it>in vitro </it>enzyme assays. Dose-dependent inhibition of paw edema was observed <it>in vivo </it>with CP-690,550 treatment. Plasma cytokines (IL-6 and IL-17), PBNC, and bone marrow myeloid progenitor cells were elevated in the context of AIA disease. At efficacious exposures, CP-690,550 returned all of these parameters to pre-disease levels. The plasma concentration of CP-690,550 at efficacious doses was above the <it>in vitro </it>whole blood IC50 of JAK1 and JAK3 inhibition, but not that of JAK2.</p> <p>Conclusion</p> <p>Results from this investigation suggest that CP-690,550 is a potent inhibitor of JAK1 and JAK3 with potentially reduced cellular potency for JAK2. In rat AIA, as in the case of human RA, PBNC were decreased at efficacious exposures of CP-690,550. Inflammatory end points were similarly reduced, as judged by attenuation of paw edema and cytokines IL-6 and IL-17. Plasma concentration at these exposures was consistent with inhibition of JAK1 and JAK3 but not JAK2. Decreases in PBNC following CP-690,550 treatment may thus be related to attenuation of inflammation and are likely not due to suppression of granulopoiesis through JAK2 inhibition.</p

Ribosome Distribution in HeLa Cells during the Cell Cycle

In this study, we employed a surface-specific antibody against the large ribosome subunit to investigate the distribution of ribosomes in cells during the cell cycle. The antibody, anti-L7n, was raised against an expansion segment (ES) peptide from the large subunit ribosomal protein L7, and its ribosome-surface specificity was evident from the positive immuno-reactivity of ribosome particles and the detection of 60 S immune-complex formation by an immuno-electron microscopy. Using immunofluorescent staining, we have microscopically revealed that ribosomes are dispersed in the cytoplasm of cells throughout all phases of the cell cycle, except at the G2 phase where ribosomes show a tendency to gather toward the nuclear envelope. The finding in G2 cells was confirmed by electron microscopy using a morphometric assay and paired t test. Furthermore, further observations have shown that ribosomes are not distributed immune-fluorescently with nuclear envelope markers including the nuclear pore complex, the integral membrane protein gp210, the inner membrane protein lamin B2, and the endoplasm reticulum membrane during cell division we propose that the mechanism associated with ribosome segregation into daughter cells could be independent of the processes of disassembly and reassembly of the nuclear envelope

First narrow-band search for continuous gravitational waves from known pulsars in advanced detector data

Spinning neutron stars asymmetric with respect to their rotation axis are potential sources of continuous gravitational waves for ground-based interferometric detectors. In the case of known pulsars a fully coherent search, based on matched filtering, which uses the position and rotational parameters obtained from electromagnetic observations, can be carried out. Matched filtering maximizes the signalto- noise (SNR) ratio, but a large sensitivity loss is expected in case of even a very small mismatch between the assumed and the true signal parameters. For this reason, narrow-band analysis methods have been developed, allowing a fully coherent search for gravitational waves from known pulsars over a fraction of a hertz and several spin-down values. In this paper we describe a narrow-band search of 11 pulsars using data from Advanced LIGO’s first observing run. Although we have found several initial outliers, further studies show no significant evidence for the presence of a gravitational wave signal. Finally, we have placed upper limits on the signal strain amplitude lower than the spin-down limit for 5 of the 11 targets over the bands searched; in the case of J1813-1749 the spin-down limit has been beaten for the first time. For an additional 3 targets, the median upper limit across the search bands is below the spin-down limit. This is the most sensitive narrow-band search for continuous gravitational waves carried out so far

Development and psychometric properties the Barriers to Access to Care Evaluation scale (BACE) related to people with mental ill health

Many people with mental illness do not seek or delay seeking care. This study aimed to develop, and provide an initial validation of, a comprehensive measure for assessing barriers to access to mental health care including a 'treatment stigma' subscale, and to present preliminary evidence about the prevalence of barriers experienced by adults currently or recently using secondary mental health services in the UK

Quantum correlation measurements in interferometric gravitational-wave detectors

Quantum fluctuations in the phase and amplitude quadratures of light set limitations on the sensitivity of modern optical instruments. The sensitivity of the interferometric gravitational-wave detectors, such as the Advanced Laser Interferometer Gravitational-Wave Observatory (LIGO), is limited by quantum shot noise, quantum radiation pressure noise, and a set of classical noises. We show how the quantum properties of light can be used to distinguish these noises using correlation techniques. Particularly, in the first part of the paper we show estimations of the coating thermal noise and gas phase noise, hidden below the quantum shot noise in the Advanced LIGO sensitivity curve. We also make projections on the observatory sensitivity during the next science runs. In the second part of the paper we discuss the correlation technique that reveals the quantum radiation pressure noise from the background of classical noises and shot noise. We apply this technique to the Advanced LIGO data, collected during the first science run, and experimentally estimate the quantum correlations and quantum radiation pressure noise in the interferometer.National Science Foundation (U.S.)Kavli Foundation (Kavli Foundation

Identification and mitigation of narrow spectral artifacts that degrade searches for persistent gravitational waves in the first two observing runs of Advanced LIGO

Searches are under way in Advanced LIGO and Virgo data for persistent gravitational waves from continuous sources, e.g. rapidly rotating galactic neutron stars, and stochastic sources, e.g. relic gravitational waves from the Big Bang or superposition of distant astrophysical events such as mergers of black holes or neutron stars. These searches can be degraded by the presence of narrow spectral artifacts (lines) due to instrumental or environmental disturbances. We describe a variety of methods used for finding, identifying and mitigating these artifacts, illustrated with particular examples. Results are provided in the form of lists of line artifacts that can safely be treated as non-astrophysical. Such lists are used to improve the efficiencies and sensitivities of continuous and stochastic gravitational wave searches by allowing vetoes of false outliers and permitting data cleaning