Radical Technological Innovation and Perception: A Non-Physician Practitioners’ Perspective

Radical technological innovations, such as chatbots, fundamentally alter many aspects of healthcare organizations. For example, they transform how clinicians care for their patients. Despite the potential benefits, they cannot be integrated into practice without the support of the clinicians whose jobs are affected. While previous research shed important light on physicians’ perceptions, little is known on nonphysician practitioners view said innovations. This paper reports on a qualitative study, involving 10 nonphysician clinicians from Ontario, Canada, conducted to determine the perceptions and cognitions of clinicians regarding radical innovation and their previous experiences with technological change. Results indicate that clinicians as semi-autonomous agents can interpret and act upon their environment with regard to determining how innovations such as chatbots are implemented

Tests for Cosmological Evolution of a Brane Universe Model

The relativistic Friedmann Lemaitre cosmology model (FLCM) is very sucessful to describe the evolution history of the Universe from the " First three Minutes". Any alternative model should be consistent with the FLCM explanations to the later stage evolutions of the Universe at certain points. An noncompact extra dimension model was recently proposed by Randall and Sundrum. Binetruy et al. obtained the modified Friedmann equation, in which the energy density of the brane appears quadratically in contrast with the linear behavior of the standard Friedmann equation. We investigate kinds of classical cosmological effects of the new models and get a general solution of the cosmic evolution for this extended model, with more detail discussions of the brane tension parameter on these cosmological tests.Comment: 12 pages, 5 figures, to appear in IJMP

Patient Trust and Resistance towards Patient Portals

Health information technologies (HITs) as facilitators of chronic disease self-management remains an ongoing topic for information system researchers. This research addresses a gap in knowledge surrounding patient trust and resistance towards using these technologies, specifically patient portals. The method used to accomplish this study is through the dispersion of a quantitative survey to participants in Ontario, Canada. This survey focused on questions related to the four variables that have been identified through the literature to be important in determining patient resistance of HITs. The results indicate the importance of patient trust in mitigating their resistance to using these technologies

Thermoelectric effect and temperature-gradient-driven electrokinetic flow of electrolyte solutions in charged nanocapillaries

A systematic theoretical study of thermoelectric effect and temperature-gradient-driven electrokinetic flow of electrolyte solutions in charged nanocapillaries is presented. The study is based on a semianalytical model developed by simultaneously solving the non-isothermal Poisson-Nernst-Planck-Navier-Stokes equations with the lubrication theory. Particularly, this paper clarifies the interplay and relative importance of the thermoelectric mechanisms due to (a) the convective transport of ions caused by the fluid flow, (b) the dependence of ion electrophoretic mobility on temperature, (c) the difference in the intrinsic Soret coefficients of cation and anion. Additionally, synergy conditions for the three thermoelectric mechanisms to fully cooperate are proposed for thermo-phobic/philic electrolytes. The temperature-gradient-driven electrokinetic flow is shown to be a nearly unidirectional flow whose axial velocity profiles vary with the axial location. Also, the flow can be regarded as a consequence of the counteraction or cooperation between a thermoelectric-field-driven electroosmotic flow and a thermo-osmotic flow driven by the osmotic pressure gradient and dielectric body force. Moreover, the Seebeck coefficient and the fluid average velocity are demonstrated to be affected by electrolyte-related parameters. The results are beneficial for understanding the temperature-gradient-driven electrokinetic transport in nanocapillaries and also serve as theoretical foundation for the design of low-grade waste heat recovery devices and thermoosmotic pumps.Comment: 17 pages, 11 figures, with some correction

Ion steric effect induces giant enhancement of thermoelectric conversion in electrolyte-filled nanochannels

Ionic Seebeck effect has received increasing attention because of its advantages such as high Seebeck coefficient and low cost. However, theoretical study on the ionic Seebeck coefficient is still in its infancy and mainly focuses on diluted simple electrolytes excluding the contributions of ion steric effects and short-range electrostatic correlation. Here, we show that the coupling of the steric effects due to finite ion sizes and ion thermodiffusion in electric double layers can significantly enhance the thermoelectric response in confined electrolytes via both theory and simulation. The Seebeck coefficient can reach 100% or even one order of magnitude enhancement as compared to previous theoretical models depending on the degree of the ion steric effects and the sum of ion Soret coefficients. In addition, we demonstrate that the short-range electrostatic correlation is beneficial to achieving the maximum Seebeck coefficient at weaker confinement or more concentrated electrolytes. These findings can provide a strategy for achieving high Seebeck coefficient and high electric conductivity simultaneously to improve the efficiency of the ionic thermoelectric conversion.Comment: 12 pages, 6 figure

Transmissible ST3-IncHI2 Plasmids Are Predominant Carriers of Diverse Complex IS26-Class 1 Integron Arrangements in Multidrug-Resistant Salmonella

Diverse mobile genetic elements (MGEs) including plasmids, insertion sequences, and integrons play an important role in the occurrence and spread of multidrug resistance (MDR) in bacteria. It was found in previous studies that IS26 and class 1 integrons integrated on plasmids to speed the dissemination of antibiotic-resistance genes in Salmonella. It is aimed to figure out the patterns of specific genetic arrangements between IS26 and class 1 integrons located in plasmids in MDR Salmonella in this study. A total of 74 plasmid-harboring Salmonella isolates were screened for the presence of IS26 by PCR amplification, and 39 were IS26-positive. Among them, 37 isolates were resistant to at least one antibiotic. The thirty-seven antibiotic-resistant isolates were further involved in PCR detection of class 1 integrons and variable regions, and all were positive for class 1 integrons. Six IS26-class 1 integron arrangements with IS26 inserted into the upstream or downstream of class 1 integrons were characterized. Eight combinations of these IS26-class 1 integron arrangements were identified among 31 antibiotic-resistant isolates. Multidrug-resistance plasmids of the IncHI2 incompatibility group were dominant, which all belonged to ST3 by plasmid double locus sequence typing. These 21 IncHI2-positive isolates harbored six complex IS26-class 1 integron arrangement patterns. Conjugation assays and Southern blot hybridizations confirmed that conjugative multidrug-resistance IncHI2 plasmids harbored the different complex IS26-class 1 integron arrangements. The conjugation frequency of IncHI2 plasmids transferring alone was 10−5-10−6, reflecting that different complex IS26-class 1 integron arrangement patterns didn't significantly affect conjugation frequency (P > 0.05). These data suggested that class 1 integrons represent the hot spot for IS26 insertion, forming diverse MDR loci. And ST3-IncHI2 was the major plasmid lineage contributing to the horizontal transfer of composite IS26-class 1 integron MDR elements in Salmonella

Prediction of upcoming urinary tract infection after intracerebral hemorrhage: a machine learning approach based on statistics collected at multiple time points

PurposeAccurate prediction of urinary tract infection (UTI) following intracerebral hemorrhage (ICH) can significantly facilitate both timely medical interventions and therapeutic decisions in neurocritical care. Our study aimed to propose a machine learning method to predict an upcoming UTI by using multi-time-point statistics.MethodsA total of 110 patients were identified from a neuro-intensive care unit in this research. Laboratory test results at two time points were chosen: Lab 1 collected at the time of admission and Lab 2 collected at the time of 48 h after admission. Univariate analysis was performed to investigate if there were statistical differences between the UTI group and the non-UTI group. Machine learning models were built with various combinations of selected features and evaluated with accuracy (ACC), sensitivity, specificity, and area under the curve (AUC) values.ResultsCorticosteroid usage (p < 0.001) and daily urinary volume (p < 0.001) were statistically significant risk factors for UTI. Moreover, there were statistical differences in laboratory test results between the UTI group and the non-UTI group at the two time points, as suggested by the univariate analysis. Among the machine learning models, the one incorporating clinical information and the rate of change in laboratory parameters outperformed the others. This model achieved ACC = 0.773, sensitivity = 0.785, specificity = 0.762, and AUC = 0.868 during training and 0.682, 0.685, 0.673, and 0.751 in the model test, respectively.ConclusionThe combination of clinical information and multi-time-point laboratory data can effectively predict upcoming UTIs after ICH in neurocritical care

Simultaneous thermoosmotic and thermoelectric responses in nanoconfined electrolyte solutions: Effects of nanopore structures and membrane properties

Hypothesis: Nanofluidic systems provide an emerging and efficient platform for thermoelectric conversion and fluid pumping with low-grade heat energy. As a basis of their performance enhancement, the effects of the structures and properties of the nanofluidic systems on the thermoelectric response (TER) and the thermoosmotic response (TOR) are yet to be explored. Methods: The simultaneous TER and TOR of electrolyte solutions in nanofluidic membrane pores on which an axial temperature gradient is exerted are investigated numerically and semi-analytically. A semi-analytical model is developed with the consideration of finite membrane thermal conductivity and the reservoir/entrance effect. Findings: The increase in the access resistance due to the nanopore-reservoir interfaces accounts for the decrease of short circuit current at the low concentration regime. The decrease in the thermal conductivity ratio can enhance the TER and TOR. The maximum power density occurring at the nanopore radius twice the Debye length ranges from several to dozens of mW K$^{-2}$ m$^{-2}$ and is an order of magnitude higher than typical thermo-supercapacitors. The surface charge polarity can heavily affect the sign and magnitude of the short-circuit current, the Seebeck coefficient, and the open-circuit thermoosmotic coefficient, but has less effect on the short-circuit thermoosmotic coefficient. Furthermore, the membrane thickness makes different impacts on TER and TOR for zero and finite membrane thermal conductivity.Comment: 38 pages, 10 figure

Enhancing Hydrogen Evolution Electrocatalytic Performance in Neutral Media via Nitrogen and Iron Phosphide Interactions

It remains a challenge to develop efficient electrocatalysts in neutral media for hydrogen evolution reaction (HER) due to the sluggish kinetics and switch of the rate determining step. Although metal phosphides are widely used HER catalysts, their structural stability is an issue due to oxidization, and the HER performance in neutral media requires improvement. Herein, a new material, i.e., grapevine-shaped N-doped iron phosphide on carbon nanotubes, as an efficient HER catalyst in neutral media is developed. The optimized catalyst shows an overpotential of 256 mV at a large current density of 65 mA cm−2, which is even 10 mV lower than that of the commercial 20% Pt/C catalyst. The excellent performance of the catalyst is further studied by combined computational and experimental techniques, which proves that the interaction between nitrogen and iron phosphides can provide more efficient active structures and stabilize the metal phosphide electrocatalysts for HER