Gamma-Ray Background from Structure Formation in the Intergalactic Medium

The universe is filled with a diffuse and isotropic extragalactic background of gamma-ray radiation, containing roughly equal energy flux per decade in photon energy between 3 MeV-100 GeV. The origin of this background is one of the unsolved puzzles in cosmology. Less than a quarter of the gamma-ray flux can be attributed to unresolved discrete sources, but the remainder appears to constitute a truly diffuse background whose origin has hitherto been mysterious. Here we show that the shock waves induced by gravity during the formation of large-scale structure in the intergalactic medium, produce a population of highly-relativistic electrons with a maximum Lorentz factor above 10^7. These electrons scatter a small fraction of the microwave background photons in the present-day universe up to gamma-ray energies, thereby providing the gamma-ray background. The predicted diffuse flux agrees with the observed background over more than four decades in photon energy, and implies a mean cosmological density of baryons which is consistent with Big-Bang nucleosynthesis.Comment: 7 pages, 1 figure. Accepted for publication in Nature. (Press embargo until published.

Exome Sequencing Implicates Impaired GABA Signaling and Neuronal Ion Transport in Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a common, debilitating neuropathic face pain syndrome often resistant to therapy. The familial clustering of TN cases suggests that genetic factors play a role in disease pathogenesis. However, no unbiased, large-scale genomic study of TN has been performed to date. Analysis of 290 whole exome-sequenced TN probands, including 20 multiplex kindreds and 70 parent-offspring trios, revealed enrichment of rare, damaging variants in GABA receptor-binding genes in cases. Mice engineered with a TN-associated de novo mutation (p.Cys188Trp) in the GABAA receptor Cl− channel γ-1 subunit (GABRG1) exhibited trigeminal mechanical allodynia and face pain behavior. Other TN probands harbored rare damaging variants in Na+ and Ca+ channels, including a significant variant burden in the α-1H subunit of the voltage-gated Ca2+ channel Cav3.2 (CACNA1H). These results provide exome-level insight into TN and implicate genetically encoded impairment of GABA signaling and neuronal ion transport in TN pathogenesis

Financial and Business Management for the Doctor of Nursing Practice

Awarded second place in the 2013 AJN Book of the Year Awards in the Advanced Practice Nursing category “Finally, a definitive financial management book geared to nursing professionals who need to know health care finance in non-CPA terms. Dr. Waxman has organized excellent authors who are knowledgeable about their topic and address the issues using real-life examples that make sense to nursing professionals…I am thrilled to see [that] Dr. Waxman has used her knowledge and skills in producing a book that has been on my to-do list for years.” -Roxanne Spitzer, PhD, MBA, RN, FAAN Editor in Chief, Nurse Leader Now more than ever, nurse leaders must be proficient in understanding the financial aspects of health care. This unique text, designed specifically for the DNP course in health care economics and finance, is the only book to embed economic and financial concepts in the context of nursing practice and nursing care systems. It offers a practical approach to business, finance, economics, and health policy that is designed to foster sound business and leadership skills within our complex health care system―skills that will enable the DNP graduate to improve the quality of health care delivery while reducing costs and improving outcomes. Key Topics Covered: Economics of health care • Insurance coverage • Reimbursement • Policy • Budgeting •Strategic planning • Quality • Data analysis • Ethics • Entrepreneurship • Marketing • Business plan development • Project management • Grant writing • Teaching financial management • Global health Key Features: Offers multiple real-life examples Examines the economic and financial implications of evidence-based practice and quality improvement by focusing on ambulatory and acute care clinical research and quality initiatives Enables students to understand the cost of care as it relates to the quality of care and ethics Includes special section on finance for independent practitioners Incorporates critical thinking questions for students at different levels Addresses the required competencies designated in the AACN Essentials of Doctoral Education for Advanced Nursing Practice, as well as those set forth by the AONEhttps://repository.usfca.edu/read_books/1045/thumbnail.jp

A practical guide to finance and budgeting: skills for nurse managers

As of June 20, 2014, contact hours for nurses are no longer available with this product. Nurses don\u27t go into healthcare because they like crunching numbers! But when they become nurse managers, they have to learn a new language of confusing financial jargon and terminology often with little training. A Practical Guide to Finance and Budgeting: Skills for Nurse Managers, Second Edition is a comprehensive guide specifically designed to help new managers save time and produce, present, and defend the departmental budget. Author KT Waxman, DNP, MBA, RN, CNL, offers tips and tools that breakdown the confusing and often foreign, financial side of healthcare. The book helps you: - Comprehend the financial side of healthcare through easy-to-understand advice - Eliminate guesswork with straightforward descriptions of each section of important financial forms and reports - Save time with plain English definitions of potentially confusing financial terminology - Secure executive buy-in with concise explanations of how the nursing department\u27s financial performance affects the entire organization - Handle the new role of manager with quick and helpful field-tested tips and reminders - Prepare budget presentations and build business plans with simple and easy-to-follow instructions - Obtain adequate financial support for the department through right-way, wrong-way tips - Provide time-saving insight to ancillary leaders who also need financial training Guidance for ancillary leaders Not only does this guide help nurse managers, it also provides useful advice and tools for ancillary leaders who also need to plan staffing, create business plans, and justify budgets. It offers timely, need-to-know information to help managers of various types create solid business plans without spending time searching through multiple sources. This unique guide offers everything a new manager needs to effectively maintain a department s financial planning. Bonus CD-ROM with customizable forms and tools! This book comes with a CD-ROM packed with forms, critical thinking activities, and helpful handouts to help managers meet their financial responsibilities throughout their careers. The realities of today\u27s healthcare environment mean nursing and ancillary managers need to understand and interpret fiscal concerns to earn their place at the table. Rely on A Practical Guide to Finance and Budgeting: Skills for Nurse Managers, Second Edition to help your managers master their financial responsibilities with ease. Who should buy this book? A perfect resource for nurse managers, VPs of nursing, chief nursing officers, directors of nursing, nursing home administrators, ASC, home health, and rehab nursing administrators, staff educators, directors of education, and ancillary managers.https://repository.usfca.edu/read_books/1044/thumbnail.jp

The Importance and Impact of Nurse Leader Engagement With State Nursing Workforce Centers: Lessons From the COVID-19 Pandemic.

The COVID-19 pandemic caused unparalleled morbidity and mortality across the globe. Health care agencies, public health departments, and academic institutions experienced widespread disruption to usual operations. These events had an adverse impact on the nursing workforce. Nurse leaders in California rallied to identify and remediate the effects of COVID-19 on the nursing workforce. This article describes the strategy and interventions. Nurse leaders should invest resources in state workforce centers to ensure the health and supply of a strong nursing workforce