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Hospitalists are physicians trained in internal medicine and play a critical role in delivering care in in-patient settings. They work across and interact with a variety of sub-systems of the hospital, collaborate with various specialties, and spend their time exclusively in hospitals. ALK inhibitor Research shows that hospitalists report burnout rates above the national average for physicians and thus, it is important to understand the key factors contributing to hospitalists' burnout and identify key priorities for improving hospitalists' workplace.

Hospitalists at an academic medical center and a community hospital were recruited to complete a survey that included demographics, rating the extent to which socio-technical (S-T) factors contributed to burnout, and 22-item Maslach Burnout Inventory - Human Services Survey (MBI-HSS). Twelve contextual inquiries (CIs) involving shadowing hospitalists for ∼60h were conducted varied by shift type, length of tenure, age, sex, and location. Using data from the survey and CIs,tify workplace factors contributing to provider burnout and consider targeting the factors identified by providers to best optimize scarce resources.

This mixed-method study utilizes participatory and data-driven approaches to provide evidence-based prioritization of key factors contributing to hospitalists' burnout. Healthcare systems may utilize this approach to identify workplace factors contributing to provider burnout and consider targeting the factors identified by providers to best optimize scarce resources.Network psychometric models are often estimated using a single indicator for each node in the network, thus failing to consider potential measurement error. In this study, we investigate the impact of measurement error on cross-sectional network models. First, we conduct a simulation study to evaluate the performance of models based on single indicators as well as models that utilize information from multiple indicators per node, including average scores, factor scores, and latent variables. Our results demonstrate that measurement error impairs the reliability and performance of network models, especially when using single indicators. The reliability and performance of network models improves substantially with increasing sample size and when using methods that combine information from multiple indicators per node. Second, we use empirical data from the STAR*D trial (n = 3,731) to further evaluate the impact of measurement error. In the STAR*D trial, depression symptoms were assessed via three questionnaires, providing multiple indicators per symptom. Consistent with our simulation results, we find that when using sub-samples of this dataset, the discrepancy between the three single-indicator networks (one network per questionnaire) diminishes with increasing sample size. Together, our simulated and empirical findings provide evidence that measurement error can hinder network estimation when working with smaller samples and offers guidance on methods to mitigate measurement error.Fine motor impairments are frequent complaints in people with Parkinson's disease (PD). While they may develop at an early stage of the disease, they become more problematic as the disease progresses. Tremors and fine motor symptoms may seem related, but evidence suggests two distinct phenomena. The purpose of our study was to investigate the relationships between fine motor skills and clinical characteristics of PD patients. We hypothesized worse fine motor skills to be associated with greater motor severity that is independent of tremor. We measured fine motor abilities using the Grooved Pegboard test (GPT) in each hand separately and collected clinical and demographics data in a cohort of 82 persons with PD. We performed regression analyses between GPT scores and a range of outcomes motor severity, time from diagnosis, age and tremors. We also explored similar associations using finger and hand dexterity scores from a standardized PD rating scale. Our results indicate that scores on the GPT for each hand, as measures of manual dexterity, are associated with motor severity and time from diagnosis. The presence of tremors was not a confounding factor, as hypothesized, but age was associated with GPT scores for the dominant hand. Motor severity was also associated with hand and finger dexterity as measured by single items from the clinical Parkinson's rating scale. These findings suggest that the GPT to be useful tool for motor severity assessments of people with PD.A simple aptasensor is embedded in the internal surface of a micropipette tip as the aptasensor substrate for the label-free monitoring of acrylamide. The aptasensor is based on the formation of the triple-helix molecular switch (THMS) structure of the DNA strands that induces the salt-enforced aggregation of gold nanoparticles (AuNPs). A smartphone imaging readout-based strategy is applied to quantify acrylamide. The developed aptasensor is novel for the naked-eye monitoring of the target through the color change of the solution inside the micropipette tip. The colorimetric aptasensor detects acrylamide in the concentration range of 0.05-200 nmol L-1 and at the trace level of 0.038 nmol L-1 with the comparable selectivity. The aptasensor can successfully quantify acrylamide in the chips, coffee, and bread samples with recoveries range from 92 to 102 %. The designed aptasensor paves an efficient device for the portable, on-site, facile, and real-time target sensing, superior for food safety control.

While previous studies have described psychiatric profiles in patients with psychogenic non-epileptic seizures (PNES) and epileptic seizures (ES), a well-matched comparison between males and females has been lacking. To address this shortcoming, the present study sought to explore sex differences between male and female Veterans with ES and PNES in terms of psychiatric diagnoses, trauma histories, and psychiatric treatment.

A male Veteran sample (PNES n=87, ES n=28) was identified matching age and seizure diagnosis with our previously-gathered female Veteran sample (PNES n=90, ES n=28). Retrospective chart review was used to obtain demographic, psychiatric, and seizure-related variables. Group differences between PNES and ES were first assessed among males followed by differences between males and females.

Males with PNES were more likely to receive psychiatric treatment (82.6 % vs. 60.7 %, p=0.017), be prescribed more psychotropics (1.6 vs. 0.9, p=0.003), and more likely to have childhood physical abustric burden is seen among females compared to males with PNES, especially diagnoses of borderline personality disorder and depression. Higher rates of suicidality and inpatient psychiatric hospitalization may warrant particular consideration in screening and intervention efforts among female Veterans with PNES.

Carotid atherosclerosis accounts for around 20 % of ischemic strokes. Literature on CT angiography [CTA] to study plaque morphology is limited. We studied plaque characteristics of extracranial carotid arteries using CTA to ascertain the high risk features beyond luminal stenosis.

Retrospective study design, where patients with carotid territory ischemia who underwent CTA from January 2011 till December 2015 were recruited from medical records. CT images were reviewed for plaque characteristics like attenuation, ulceration, plaque thickness and presence of intraluminal thrombus [ILT] along with percentage stenosis.

114 patients with 201 carotids [102 symptomatic and 99 asymptomatic] were reviewed. Mixed density plaques [p=0.05], ulceration [p=0.001], ILT [p=0.004] and higher soft plaque thickness [p<0.001] were significantly associated with symptomatic carotids whereas calcified plaques were seen in asymptomatic carotids [p=0.005]. Plaque characteristics were comparable in symptomatic patients with mm] are new measures to help ascertain the risk of ischemic events in carotid atherosclerotic disease.

Classically, pelvic incidence (PI) and other spinopelvic sagittal parameters are measured using plain x-ray obtained with the patient standing. However, it is difficult to obtain a perfect mid-sagittal appearance of the sacral endplate and superimposition of both femoral heads from a plain x-ray. Overlapping of the iliac wings also could obscure the appearance of the sacral endplate. Recent studies showed that MRI was more reliable than x-ray for evaluating some spinal sagittal parameters. To our knowledge, measurements of spinopelvic sagittal parameters using supine MRI have not been reported previously. We assessed the validity and reliability of measurements of spinopelvic sagittal parameters from standing lateral x-rays and supine magnetic resonance imaging (MRI).

We recruited 26 asymptomatic volunteers for this study. Standing lateral lumbosacral radiographs, including femoral heads and spinopelvic MRI images with coronal images of the femoral heads were performed. The anatomic reference point require to standing x-ray.

MRI was more reliable in the measurement of spinopelvic parameters than classic standing x-ray examination. Higher reliability and being radiation-free could make MRI a good alternative to standing x-ray.Monoclonal antibodies (mAbs) represent an important part of biological pharmaceutics. A serious challenge in their development is the formation of protein particles, which are often formed through protein aggregation at the air-liquid interface and then introduced into solution by interfacial stresses. In this paper, protein films formed at the air-liquid interface by two mAbs were disrupted by puncturing them with a microscopic needle, and the subsequent reconstitution of the film was observed in real-time by Brewster angle microscopy. Our results indicate that film reconstitution pace depends on mAb bulk concentration. Numerical modeling gives a quantitative prediction of the surface reconstitution. By extrapolating the model to concentrations typical for pharmaceutical formulations (>30 mg/mL) reconstitution timescales of the protein films can be estimated to be shorter than 0.01 s. Moreover, the effect of polysorbate 80 addition on protein film was studied. Film reconstitution measurements revealed that polysorbate 80 inhibits the film reconstitution process and breaks up the previously formed film.Magnesium (Mg) alloys are potential materials for orthopedic fixation devices but rapid degradation of the materials restricts wider clinical applications. Herein, zinc-incorporated calcium phosphate (Ca-Zn-P) coatings are prepared on the Zn-pretreated WE43 Mg alloy by a hydrothermal technique under relatively stable and favorable conditions. The hydrothermal coating consists of a compact bottom layer of CaZn2(PO4)2∙2 H2O and ZnO granular crystals and a jagged upper layer of CaHPO4. The Zn coating reduces the corrosion current density of WE43 to (3.49 ± 1.60) × 10-5 A cm-2, whereas the Ca-Zn-P/Zn composite coating further reduces it by 3 orders of magnitude in the simulated body fluid (SBF). The charge transfer resistances of the Zn-coated and Ca-Zn-P/Zn-coated alloys increase by 49 and 7176 times to 835 and 1.22 × 105 Ω cm2, respectively. The 7-day immersion results reveal that the Zn coating cannot provide long-term protection to WE43 in SBF because of the formation of galvanic couples between the Zn coating and WE43.