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Patient Satisfaction (PS) is a commonly used metric in health care settings to assess the quality of care given by physicians. Monitoring physicians in this way may impact physician quality of life. #link# Studies evaluating this impact are not available. This study sought to examine the physician experience of measuring PS among practicing otolaryngologists.
Using an online survey platform, a 34-item survey was given to practicing otolaryngologists through email distribution. The survey included questions about physician, practice and patient demographics, as well as inquiries regarding the way in which PS was measured and how it affected physician work and personal life. Data from these questions were reviewed and analyzed.
174 otolaryngologists responded to the survey. A majority of physicians' (55.3%) PS scores had been tracked with 89.9% reporting being tracked for a length of at least 1year. PS scores for individual physicians were noted to be inconsistent and vary significantly between reports. Measuring patient satisfaction led to increased occupational stress, yet most physicians (63.8%) felt the monitoring did not lead to improvements in their practice. Some physicians (36.2%) reported that the collection of patient satisfaction scores had negatively influenced the way they practiced medicine, including the pressure to order superfluous tests or to prescribe unnecessary medications.
Overall, physicians are negatively affected by the tracking of patient satisfaction scores. Occupational stress caused by the collection of patient satisfaction scores may contribute to physician burnout.
Overall, physicians are negatively affected by the tracking of patient satisfaction scores. Occupational stress caused by the collection of patient satisfaction scores may contribute to physician burnout.Large-scale cultivation of Haematococcus pluvialis is frequently contaminated by the destructive fungus Paraphysoderma sedebokerense, which can cause huge losses in astaxanthin production. link2 Here, we propose the use of four commercial surfactants to control P. sedebokerense contamination in H. pluvialis cultures. In laboratory experiments, sodium dodecylbenzene sulfonate, sodium dodecyl sulfate and primary alcohol ethoxylate treatments showed inhibitory effects on fungal contamination. Moreover, sodium dodecylbenzene sulfonate was the most promising because treatment at 7 mg L-1 was effective against fungal infection without negatively affecting the growth or astaxanthin contents of H. pluvialis. This could be ascribed to their different cell coverings and structures. Additionally, applying sodium dodecylbenzene sulfonate to open raceway ponds prevented fungal contamination, and astaxanthin production reached 1.82 g m-2. Therefore, sodium dodecylbenzene sulfonate can be used as an effective and economical control agent for commercial production of astaxanthin fromH. pluvialis.To enhance the biomass conversion efficiency, the R17L mutant of the lytic polysaccharide monooxygenase (LPMO) MtC1LPMO with improved catalytic efficiency was constructed via rational point mutation based on the HotSpot Wizard 3.0 and dezyme web servers. Compared with the wild-type (WT) MtC1LPMO, R17L exhibited a 1.8-fold increase of specific activity and 1.92-fold increase of catalytic efficiency (kcat/Km). The degree of increase of the reducing sugar yield from microcrystalline cellulose and three plant biomass materials during synergistic hydrolysis using cellulase in combination with R17L was about 2 times higher than with the WT. Molecular dynamics simulations revealed that the R17L mutation reduced the stability of the region R18-I36, which then weakened the direct interactions between region N24-V31 and the substrate cellohexaose. Consequently, the deflection time of the cellohexaose conformation in R17L was prolonged compared to the WT, which enhanced its catalytic efficiency.Complicated production procedures and superior characteristics of nano-sized sulfur elevate its price to 25-40 fold higher than micrograde kind. Also, natural gas hydrogen sulfide levels are restricted because of its toxic environmental consequences. Thioalkalivibrio versutus is a polyextremophilic industrial autotroph with high natural gas desulfurization capability. link3 Here, nanometric (>50 nm) sulfur bioproduction using T. versutus while desulfurizing natural gas was validated. Also, this production was enhanced by 166.7% via lowering sulfate production by 55.1%. A specially-developed CRISPR system, with 42% editing efficiency, simplified the genome editing workflow scheme for this challenging bacterium. In parallel, sulfur metabolism was uncovered using proteins mining and transcriptome studies for defining sulfate-producing key genes (heterodisulfide reductase-like complex, sulfur dioxygenase, sulfite dehydrogenase and sulfite oxidase). This study provided cost-effective nanometric sulfur production and improved this production using a novel CRISPR strategy, which could be suitable for industrial polyextremophiles, after uncovering sulfur pathways in T. versutus.The effects of long-term acclimatization on the optimum food waste to cow manure ratio (FW/CM) and substrate to inoculum ratio (S/I) in anaerobic codigestion with FW and CM were investigated by batch trials. For the unacclimated sludge, the highest CH4 yields of 646.6 and 653.4 mL/g VS were achieved under the optimum FW/CM (2.5 VS/VS) and S/I (0.07 VS/VS) ratios, respectively. After more than 550 days of acclimatization, the optimum FW/CM and S/I of the acclimated sludge were improved to 3.4 and 0.68 VS/VS with more anaerobic digestion enzymes and lignocellulose, respectively. Based on high-throughput sequencing analysis, the microbial community structures of bacteria, fungi, and archaea were changed, which was the main reason for the change in the optimum FW/CM and S/I. Therefore, the FW/CM and S/I should be periodically optimized during the long-term operation of codigestion to improve the codigestion efficiency for biogas production.The influence of compound microbial agents on antibiotic resistance genes (ARGs) in pig manure composting was investigated. selleck chemical show that the addition of microbial agents promoted the reduction of total ARGs and the maximum removal efficiencies for absolute abundance (77.2%) and relative abundance (64.5%) were observed in the repeated dose and high dose groups, respectively. Four categories of ARGs declined with the reduction of Firmicutes and Tn916/1545, whereas two categories increased with the proliferation of intI1 and various potential hosts in the composting. The ARG profiles and bacterial communities were shaped by composting stages (mesophilic-thermophilic and cooling-maturation stages) in all groups. However, the addition of microbial agents accelerated the variation of composting stages, and may change the potential ARG hosts which influences the removal of ARGs. Of note, intI1 and two potential pathogens (Mycobacterium and Bacillus) correlated positively to several increased ARGs, implying the possible risks of compost products.
Accumulating evidence indicates that the glutamate system contributes to the pathophysiology of major depressive disorder (MDD) and suicide. We previously reported higher mRNA expression of glutamate receptors in the dorsolateral prefrontal cortex (DLPFC) of females with MDD.
In the current study, we measured the expression of mRNAs encoding glutamate transporters in the DLPFC of MDD subjects who died by suicide (MDD-S, n=51), MDD non-suicide subjects (MDD-NS, n=28), and individuals who did not have a history of neurological illness (CTRL, n=32).
Females but not males with MDD showed higher expression of EAATs and VGLUTs relative to CTRLs. VGLUT expression was significantly higher in the female MDD-S group, relative to the other groups. EAAT expression was lower in the male violent suicides.
This study has limitations common to most human studies, including medication history and demographic differences between the diagnostic groups. We mitigated the effects of confounders by including them as covariaulnerability to suicidal behavior. These data add to accumulating support for the hypothesis that glutamatergic transmission is dysregulated in MDD and suicide. Glutamate transporters may be novel targets for the development of rapidly acting antidepressant therapies.
Studies focusing on anxiety temporal patterns and cortisol activity in older adults are scarce. The objectives of this study were to examine in older adults the relationship between anxiety temporal patterns and cortisol activity and ascertain the presence of sex differences.
Data were retrieved from the Étude sur la santé des ainés - Services study in Quebec and included N = 762 community living adults aged ≥ 65 years having participated in interviews at baseline (T
) and at 4 years follow-up (T
). A standardized questionnaire, based on DSM-5 criteria, was used to ascertain in the past 6 months the presence of anxiety (absence, remission, incidence, persistence). Cortisol activity during the interview and cortisol concentration on a regular day (at T
) were the dependent variables. Adjusted multivariable linear regression models, stratified by sex, were used.
Results showed higher cortisol activity during the interview in participants with anxiety in remission (Beta 2.59; 95% CI 0.62,4.57), specifically in males, and lower activity in participants with persistent anxiety (Beta -3.97; 95% CI -7.05, -0.88). Cortisol concentration on a regular day was higher in males reporting incident anxiety (Beta 8.07; 95% CI 2.39, 13.76).
The convenience sample with losses to follow-up may have led to a potential selection bias.
Anxiety temporal patterns were associated with cortisol activity profiles in older adults with sex being a significant moderator. Future studies are recommended to ascertain the longitudinal changes in cortisol activity and anxiety temporal patterns, which may further inform personalized treatment of anxiety.
Anxiety temporal patterns were associated with cortisol activity profiles in older adults with sex being a significant moderator. Future studies are recommended to ascertain the longitudinal changes in cortisol activity and anxiety temporal patterns, which may further inform personalized treatment of anxiety.The global COVID-19 outbreak and its management are disrupting ways of life and increasing the risk of poor mental and physical health for many. The restrictions on movement have made some forms of physical activity harder to achieve and increased the chances of more sedentary behaviour. Independent of exercise taken, sedentary behaviour can have a negative impact upon mental health, especially by lowering mood. We suggest evidence-based ways of reducing sedentary behaviour with commentary on how they may be adapted for life at home. These include ways to use external cues, moving more frequently, maximising movement whilst waiting, reallocating time, workstation alternatives, restructuring the physical environment and recruiting help from others. At a time in which our mental and physical health needs are more critical than ever, the relationship between sedentary behaviour and low mood is of particular importance. The current situation represents a good opportunity for us all to change habits to implement a less sedentary lifestyle, for now and the future.
