Effective Physician Engagement Strategies for Improving Healthcare

Middle and senior-level healthcare managers lack physician engagement strategies to help avoid physician burnout. Many physicians leave the healthcare profession due to disengagement, which could cause a significant healthcare crisis. Grounded in the transformational leadership theory, the purpose of this qualitative single case study was to explore the engagement strategies healthcare middle and senior-level managers used to help avoid physician burnout. Participants comprised seven middle and senior-level healthcare managers with a minimum of five years of employee management experience who effectively used physician engagement strategies to help avoid physician burnout at a Central Pacific United States healthcare organization. Data were collected from semistructured interviews via telephone, reflective journal, and publicly available media and organizational documents. Thematic analysis was used to analyze the data. Three themes emerged: developing meaningful relationships, encouraging career progression and professional development, and fostering a culture of understanding. A key recommendation for middle and senior-level healthcare managers is to take the time initially to get to know the goals of each physician. The implication for positive social change includes implementing success strategies for increased physician engagement in helping to address socioeconomic disparities for patients within the community who can benefit from healthier lifestyle

Optimal client recommendation for market makers in illiquid financial products

The process of liquidity provision in financial markets can result in prolonged exposure to illiquid instruments for market makers. In this case, where a proprietary position is not desired, pro-actively targeting the right client who is likely to be interested can be an effective means to offset this position, rather than relying on commensurate interest arising through natural demand. In this paper, we consider the inference of a client profile for the purpose of corporate bond recommendation, based on typical recorded information available to the market maker. Given a historical record of corporate bond transactions and bond meta-data, we use a topic-modelling analogy to develop a probabilistic technique for compiling a curated list of client recommendations for a particular bond that needs to be traded, ranked by probability of interest. We show that a model based on Latent Dirichlet Allocation offers promising performance to deliver relevant recommendations for sales traders.Comment: 12 pages, 3 figures, 1 tabl

Core-Level Shifts at the Pt/W(110) Monolayer Bimetallic Interface

We have measured W and Pt 4f7/2 core-level photoemission spectra from interfaces formed by ultrathin Pt layers on W(110), completing our core-level measurements of W(110)-based bimetallic interfaces involving the group-10 metals Ni, Pd, and Pt. With increasing Pt coverage the sequence of W spectra can be described using three interfacial core-level peaks with binding-energy (BE) shifts (compared to the bulk) of −0.220 ± 0.015, −0.060 ± 0.015, and +0.110 ± 0.010 eV. We assign these features to 1D, 2D pseudomorphic (ps), and 2D closed-packed (cp) Pt phases, respectively. For ~1 ps ML the Pt 4f7/2 BE is 71.40 ± 0.02 eV, a shift of +0.46 ± 0.09 eV with respect to the BE of bulk Pt metal. The W 4f7/2 core-level shifts induced by all three adsorbates are semiquantitatively described by the Born-Haber-cycle based partial-shift model of Nilsson et al. [Phys. Rev. B 38 (1988) 10357]. As with Ni/W(110), the difference in W 4f7/2 binding energies between ps and cp Pt phases has a large structural contribution. The Pt 4f lineshape is consistent with a small density of states at the Fermi level, reflective of the Pt monolayer having noble-metal-like electronic structure

11 x 11 Domineering is Solved: The first player wins

We have developed a program called MUDoS (Maastricht University Domineering Solver) that solves Domineering positions in a very efficient way. This enables the solution of known positions so far (up to the 10 x 10 board) much quicker (measured in number of investigated nodes). More importantly, it enables the solution of the 11 x 11 Domineering board, a board up till now far out of reach of previous Domineering solvers. The solution needed the investigation of 259,689,994,008 nodes, using almost half a year of computation time on a single simple desktop computer. The results show that under optimal play the first player wins the 11 x 11 Domineering game, irrespective if Vertical or Horizontal starts the game. In addition, several other boards hitherto unsolved were solved. Using the convention that Vertical starts, the 8 x 15, 11 x 9, 12 x 8, 12 x 15, 14 x 8, and 17 x 6 boards are all won by Vertical, whereas the 6 x 17, 8 x 12, 9 x 11, and 11 x 10 boards are all won by Horizontal

Regulation of stanniocalcin-1 secretion by BeWo cells and first trimester human placental tissue from normal pregnancies and those at increased risk of developing preeclampsia.

Stanniocalcin-1 (STC-1) is a multi-functional glycosylated peptide present in the plasma of healthy women postpartum and increased further in pregnancies complicated by preeclampsia. Although the STC-1 gene is expressed by the placenta what regulates its secretion and from which cells at the feto-maternal interface is unknown. Here, we demonstrate for the first time that the syncytiotrophoblast and cytotrophoblast are a major site of STC-1 protein expression in first trimester placental tissue. Further, in response to low oxygen, first trimester chorionic villous tissue from pregnancies at increased risk of developing preeclampsia secreted significantly more STC-1 than normal tissue under the same conditions. Using the human trophoblast cell line BeWo we have shown that low oxygen increased the secretion of STC-1 but it required co-stimulation with the Adenosine-3', 5'-cyclic monophosphate (cAMP) analogue, 8-Bromo adenosine-3', 5'-cyclic monophosphate cAMP (8 Br-cAMP) to reach significance. Inhibition of Hypoxia inducible factor 2α (HIF-2α) and the Phosphatidylinositol-3 kinase (PI3 -Kinase)/AKT/Serum and glucocorticoid-induced kinase-1(SGK-1) pathway resulted in significant inhibition of STC-1 secretion. As both low oxygen and cAMP are known to play a central role in placental function, their regulation of STC-1 points to a potentially important role in the maintenance of a normal healthy pregnancy and we would hypothesize that it may act to protect against prolonged placental hypoxia seen in preeclampsia

A Upf3b-mutant mouse model with behavioral and neurogenesis defects.

Nonsense-mediated RNA decay (NMD) is a highly conserved and selective RNA degradation pathway that acts on RNAs terminating their reading frames in specific contexts. NMD is regulated in a tissue-specific and developmentally controlled manner, raising the possibility that it influences developmental events. Indeed, loss or depletion of NMD factors have been shown to disrupt developmental events in organisms spanning the phylogenetic scale. In humans, mutations in the NMD factor gene, UPF3B, cause intellectual disability (ID) and are strongly associated with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and schizophrenia (SCZ). Here, we report the generation and characterization of mice harboring a null Upf3b allele. These Upf3b-null mice exhibit deficits in fear-conditioned learning, but not spatial learning. Upf3b-null mice also have a profound defect in prepulse inhibition (PPI), a measure of sensorimotor gating commonly deficient in individuals with SCZ and other brain disorders. Consistent with both their PPI and learning defects, cortical pyramidal neurons from Upf3b-null mice display deficient dendritic spine maturation in vivo. In addition, neural stem cells from Upf3b-null mice have impaired ability to undergo differentiation and require prolonged culture to give rise to functional neurons with electrical activity. RNA sequencing (RNAseq) analysis of the frontal cortex identified UPF3B-regulated RNAs, including direct NMD target transcripts encoding proteins with known functions in neural differentiation, maturation and disease. We suggest Upf3b-null mice serve as a novel model system to decipher cellular and molecular defects underlying ID and neurodevelopmental disorders

Absolute quantitation of DNA methylation of 28 candidate genes in prostate cancer using pyrosequencing

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Aberrant DNA methylation plays a pivotal role in carcinogenesis and its mapping is likely to provide biomarkers for improved diagnostic and risk assessment in prostate cancer (PCa). We quantified and compared absolute methylation levels among 28 candidate genes in 48 PCa and 29 benign prostate hyperplasia (BPH) samples using the pyrosequencing (PSQ) method to identify genes with diagnostic and prognostic potential. RARB, HIN1, BCL2, GSTP1, CCND2, EGFR5, APC, RASSF1A, MDR1, NKX2-5, CDH13, DPYS, PTGS2, EDNRB, MAL, PDLIM4, HLAa, ESR1 and TIG1 were highly methylated in PCa compared to BPH (p < 0.001), while SERPINB5, CDH1, TWIST1, DAPK1, THRB, MCAM, SLIT2, CDKN2a and SFN were not. RARB methylation above 21% completely distinguished PCa from BPH. Separation based on methylation level of SFN, SLIT2 and SERPINB5 distinguished low and high Gleason score cancers, e.g. SFN and SERPINB5 together correctly classified 81% and 77% of high and low Gleason score cancers respectively. Several genes including CDH1 previously reported as methylation markers in PCa were not confirmed in our study. Increasing age was positively associated with gene methylation (p < 0.0001). Accurate quantitative measurement of gene methylation in PCa appears promising and further validation of genes like RARB, HIN1, BCL2, APC and GSTP1 is warranted for diagnostic potential and SFN, SLIT2 and SERPINB5 for prognostic potential

Evaluating Similarity Metrics for Latent Twitter Topics

Topic modelling approaches such as LDA, when applied on a tweet corpus, can often generate a topic model containing redundant topics. To evaluate the quality of a topic model in terms of redundancy, topic similarity metrics can be applied to estimate the similarity among topics in a topic model. There are various topic similarity metrics in the literature, e.g. the Jensen Shannon (JS) divergence-based metric. In this paper, we evaluate the performances of four distance/divergence-based topic similarity metrics and examine how they align with human judgements, including a newly proposed similarity metric that is based on computing word semantic similarity using word embeddings (WE). To obtain human judgements, we conduct a user study through crowdsourcing. Among various insights, our study shows that in general the cosine similarity (CS) and WE-based metrics perform better and appear to be complementary. However, we also find that the human assessors cannot easily distinguish between the distance/divergence-based and the semantic similarity-based metrics when identifying similar latent Twitter topics

Sorghum cobalt analysis on not determined wave length with atomic absorption spectrophotometer on background correction mode

This study was to know the better wave length on measuring cobalt content in forage sorghum hybrid (Sorghum bicolor) with an atomic absorption spectrophotometer. The analysis was on background correction mode with three wave lengths; 240.8, 240.7 (determined wave length or recommended wave length) and 240.6 nm, respectively. The larger absorbance value on the 240.7 nm, apparently, it might be considered as a good wave length but the smaller background value was a more important factor for the analysis as was shown on 240.6 nm. Correlation coefficients between the values on 240.7 nm: 240.6 nm and between them (240.8 nm: 240.6 nm) were higher and this common 240.6 nm was considered the better wave length.Key words: Atomic absorption spectrophotometer; background correction mode, cobalt analysis, forage sorghum, not determined wave lengths