Improving Physician Schedules by Leveraging Equalization: Cases from Hospitals in U.S.

In this paper, we consider physician scheduling problems originating from a medical staff scheduling service provider based in the United States. Creating a physician schedule is a complex task. An optimal schedule must balance a number of goals including adequately staffing required assignments for quality patient care, adhering to a unique set of rules that depend on hospital and medical specialties, and maintaining a work-life balance for physicians. We study various types of physician and hospital requirements with different priorities, including equalization constraints to ensure that each provider will receive approximately the same number of a specified shift over a given time period. A major challenge involves ensuring an equal distribution of workload among physicians, with the end goal of producing a schedule that will be perceived by physicians as fair while still meeting all other requirements for the group. As the number of such equalization constraints increases, the physician scheduling optimization problem becomes more complex and it requires more time to find an optimal schedule. We begin by constructing mathematical models to formulate the problem requirements, and then demonstrate the benefits of a polyhedral study on a relaxation of the physician scheduling problem that includes equalization constraints. A branch-and-cut algorithm using valid inequalities derived from the relaxation problem shows that the quality of the schedules with respect to the soft constraints is notably better. An example problem from a hospitalist department is discussed in detail, and improvements for other schedules representing different specialties are also presented

Exploring The Relationship Between Individual Innovativeness And Technology Attitude Of Teacher Candidates

Bu çalışmanın amacı, öğretmen adaylarının bireysel yenilikçilik profilleri ile teknoloji tutum düzeyleri arasındaki ilişkinin incelenmesidir. Tarama modeli ile desenlenen bu araştırmada, tabakalı örnekleme yöntemi kullanılmıştır. Çalışmanın örneklemi, Anadolu Üniversitesi Eğitim Fakültesi'nde 12 farklı bölümde ve dört farklı sınıf düzeyinde eğitim almakta olan 422 öğretmen adayından oluşmaktadır. Araştırmanın verileri "Bireysel Yenilikçilik Ölçeği" ve "Teknoloji Tutum Ölçeği" ile toplanmıştır. Analizler sonucunda teknoloji tutum puanları ile yenilikçilik puanları arasında pozitif, anlamlı ve orta kuvvette bir ilişki (r=.472; p<.001) bulunmuştur. Teknoloji tutum düzeyi ve yenilikçilik profilleri arasında ise %20 oranında ve anlamlı düzeyde (Cramer's V=.200; p<.001) ilişki gözlenmiştir. Buna ek olarak bölüm ve sınıf değişkenlerinin hem bireysel yenilikçilikleri hem de teknolojiye karşı tutumları üzerinde ortak bir etkisinin bulunmadığı görülmüştür.The main purpose of this study is to investigate the correlation between individual innovativeness and technology attitudes of teacher candidates. The study was designed based on survey model and the sample was determined through the method of stratified sampling. The sample consisted of 422 teacher candidates enrolled in 12 different departments and grade levels in Faculty of Education at Anadolu University. Data were collected with &quot;Individual Innovation Scale&quot; and &quot;Technology Attitude Scale&quot; that both are valid and reliable scales. A positive, significant and moderate correlation between individual innovativeness and technology attitude was found (r=.472; p&lt;.001). In terms of categories of individual innovativeness and levels of technology attitude, there was a positive and significant association (Cramer's V=.200; p&lt;.001). In addition, no significant common effects of department and grade on teacher candidates' individual innovativeness and their technology attitudes was found

A Comparison of Ramipril and Bevacizumab to Mitigate Radiation-Induced Brain Necrosis: An Experimental Study

Background: Bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, is a new treatment approach for radionecrosis. In our study, we compared the prophylactic and therapeutic usage of a promising agent, ramipril (an angiotensin-converting enzyme inhibitor), with that of bevacizumab for reducing radiation-induced brain injury after high-dose stereotactic radiosurgery (SRS). Methods: A total of 60 Wistar rats were used. The rats were irradiated with a single dose of 50 Gy using a Leksell Gamma Knife device. Bevacizumab and ramipril were administered in the prophylactic protocol (starting the first day of SRS) and in the therapeutic protocol (starting the fourth week of SRS). Their usage was continued until 12 weeks, and the right frontal lobes of the rats were examined histologically (hematoxylin and eosin stain) and immunohistochemically (hypoxia-inducible factor [HIF]-1α, VEGF, and CD31 antibody expression). Results: The expression of VEGF, HIF-1α, and CD31 had significantly increased at 12 weeks after SRS compared with the control group. The addition of bevacizumab or ramipril to SRS significantly mitigated the histological severity of radiation injury and the expression of VEGF, HIF-1α, and CD31. However, the prophylactic use of bevacizumab and ramipril seemed to be more effective than therapeutic administration. Our results also revealed that the greatest benefit was achieved with the use of prophylactic administration of bevacizumab compared with other treatment protocols. Conclusions: Ramipril might be a promising agent for patients with radionecrosis. Clinical studies are required to investigate the effective and safe doses of ramipril, which is an inexpensive, well-tolerated drug that can cross the blood–brain barrier. © 2020 Elsevier Inc

Neurophysiological assessment of an innovative maritime safety system in terms of ship operators' mental workload, stress, and attention in the full mission bridge simulator

The current industrial environment relies heavily on maritime transportation. Despite the continuous technological advances for the development of innovative safety software and hardware systems, there is a consistent gap in the scientific literature regarding the objective evaluation of the performance of maritime operators. The human factor is profoundly affected by changes in human performance or psychological state. The difficulty lies in the fact that the technology, tools, and protocols for investigating human performance are not fully mature or suitable for experimental investigation. The present research aims to integrate these two concepts by (i) objectively characterizing the psychological state of mariners, i.e., mental workload, stress, and attention, through their electroencephalographic (EEG) signal analysis, and (ii) validating an innovative safety framework countermeasure, defined as Human Risk-Informed Design (HURID), through the aforementioned neurophysiological approach. The proposed study involved 26 mariners within a high-fidelity bridge simulator while encountering collision risk in congested waters with and without the HURID. Subjective, behavioral, and neurophysiological data, i.e., EEG, were collected throughout the experimental activities. The results showed that the participants experienced a statistically significant higher mental workload and stress while performing the maritime activities without the HURID, while their attention level was statistically lower compared to the condition in which they performed the experiments with the HURID (all p < 0.05). Therefore, the presented study confirmed the effectiveness of the HURID during maritime operations in critical scenarios and led the way to extend the neurophysiological evaluation of the HFs of maritime operators during the performance of critical and/or standard shipboard tasks

Energy Response and Longitudinal Shower Profiles Measured in CMS HCAL and Comparison With Geant4

The response of the CMS combined electromagnetic and hadron calorimeter to beams of pions with momenta in the range 5-300 GeV/c has been measured in the H2 test beam at CERN. The raw response with the electromagnetic compartment calibrated to electrons and the hadron compartment calibrated to 300 GeV pions may be represented by sigma = (1.2) sqrt{E} oplus (0.095) E. The fraction of energy visible in the calorimeter ranges from 0.72 at 5 GeV to 0.95 at 300 GeV, indicating a substantial nonlinearity. The intrinsic electron to hadron ratios are fit as a function of energy and found to be in the range 1.3-2.7 for the electromagnetic compartment and 1.4-1.8 for the hadronic compartment. The fits are used to correct the non-linearity of the e pi response to 5% over the entire measured range resulting in a substantially improved resolution at low energy. Longitudinal shower profile have been measured in detail and compared to Geant4 models, LHEP-3.7 and QGSP-2.8. At energies below 30 GeV, the data, LHEP and QGSP are in agreement. Above 30 GeV, LHEP gives a more accurate simulation of the longitudinal shower profile

Synchronization and Timing in CMS HCAL

The synchronization and timing of the hadron calorimeter (HCAL) for the Compact Muon Solenoid has been extensively studied with test beams at CERN during the period 2003-4, including runs with 40 MHz structured beam. The relative phases of the signals from different calorimeter segments are timed to 1 ns accuracy using a laser and equalized using programmable delay settings in the front-end electronics. The beam was used to verify the timing and to map out the entire range of pulse shapes over the 25 ns interval between beam crossings. These data were used to make detailed measurements of energy-dependent time slewing effects and to tune the electronics for optimal performance

Design, Performance and Calibration of the CMS Forward Calorimeter Wedges

We report on the test beam results and calibration methods using charged particles of the CMS Forward Calorimeter (HF). The HF calorimeter covers a large pseudorapidity region (3\l |\eta| \le 5), and is essential for large number of physics channels with missing transverse energy. It is also expected to play a prominent role in the measurement of forward tagging jets in weak boson fusion channels. The HF calorimeter is based on steel absorber with embedded fused-silica-core optical fibers where Cherenkov radiation forms the basis of signal generation. Thus, the detector is essentially sensitive only to the electromagnetic shower core and is highly non-compensating (e/h \approx 5). This feature is also manifest in narrow and relatively short showers compared to similar calorimeters based on ionization. The choice of fused-silica optical fibers as active material is dictated by its exceptional radiation hardness. The electromagnetic energy resolution is dominated by photoelectron statistics and can be expressed in the customary form as a/\sqrt{E} + b. The stochastic term a is 198% and the constant term b is 9%. The hadronic energy resolution is largely determined by the fluctuations in the neutral pion production in showers, and when it is expressed as in the electromagnetic case, a = 280% and b = 11%

Design, Performance, and Calibration of CMS Hadron Endcap Calorimeters

Detailed measurements have been made with the CMS hadron calorimeter endcaps (HE) in response to beams of muons, electrons, and pions. Readout of HE with custom electronics and hybrid photodiodes (HPDs) shows no change of performance compared to readout with commercial electronics and photomultipliers. When combined with lead-tungstenate crystals, an energy resolution of 8\% is achieved with 300 GeV/c pions. A laser calibration system is used to set the timing and monitor operation of the complete electronics chain. Data taken with radioactive sources in comparison with test beam pions provides an absolute initial calibration of HE to approximately 4\% to 5\%

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI