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1. Decentralizing healthcare in Norway to improve patient-centered outpatient clinic management of rheumatoid arthritis – a conceptual model

Author

Alen Brkic, Jung G. Kim, Glenn Haugeberg, and Andreas P. Diamantopoulos

Subjects
Decision making, Chronic disease management, Telehealth, Empowerment, Rheumatology, Cost reduction, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract A growing population of older adults and improved effective treatments for inflammatory rheumatic diseases will increase the demand for more healthcare resources that already struggle with staggering outpatient clinic waiting times. Transformative delivery care models that provide sustainable healthcare services are urgently needed to meet these challenges. In this mini-review article, a proposed Lifelong Treatment Model for a decentralized follow-up of outpatient clinic patients living with rheumatoid arthritis is presented and discussed. Our conceptual model follows four steps for a transformative care delivery model supported by an Integrated Practice Unit; (1) Diagnosis, (2) Treatment, (3) Patient Empowered Disease Management, and (4) Telehealth. Through an Integrated Practice Unit, a multidisciplinary team could collaborate with patients with rheumatoid arthritis to facilitate high-value care that addresses most important outcomes of the patients; (1) Early Remission, (2) Decentralization, (3) Improved Quality of Life, and (4) Lifelong Sustain Remission. The article also addresses the growing challenges for the healthcare delivery system today for patients with rheumatoid arthritis and proposes how to reduce outpatient clinic visits without compromising quality and safety.

Published
2021
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2. Vascular risk modulates the relationship between cerebral amyloid deposition and subjective memory complaints

Author

Kim JW, Byun MS, Yi D, Lee JH, Ko K, Jung G, and Lee DY

Subjects
Subjective memory complaints, Amyloid beta (A), Vascular risk, Alzheimer’s disease (AD), Cognitively normal., Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
Abstract

Jee Wook Kim,1,2 Min Soo Byun,3 Dahyun Yi,3 Jun Ho Lee,4 Kang Ko,4 Gijung Jung,5 Dong Young Lee3,4,6 On behalf of the KBASE Research Group 1Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; 2Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea; 3Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea; 4Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; 5Department of Nursing, Graduate School, Kyung Hee University, Seoul, Republic of Korea; 6Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea Purpose: We aimed to investigate the relationships of cerebral amyloid beta (Aβ) deposition and neurodegeneration (ND) with subjective memory complaints (SMCs) in cognitively normal (CN) individuals, focusing specially on the modulating effects of vascular risk (VR) on those relationships. Participants and methods: A total of 230 CN elderly individuals underwent comprehensive clinical assessments including the Subjective Memory Complaints Questionnaire (SMCQ), VR assessment, and multimodal brain imaging including [11C] Pittsburgh compound B positron emission tomography (PET), [18F] fluorodeoxyglucose-PET, and magnetic resonance imaging. Results: We found a significant overall positive association between cerebral Aβ retention and SMCQ score. In addition, we found a significant cerebral Aβ retention × VR interaction effect on the SMCQ score. Subgroup analyses showed that the Aβ–SMC association was found only in VR-negative, and not in VR-positive, individuals. We found no relationship between ND and SMCQ. Conclusion: Our findings suggest that SMC in CN elderly individuals reflects early accumulation of Aβ in the brain. Given the modulating effect of VR on the Aβ–SMC relationship, SMC can be used as a meaningful marker of early Aβ deposition in individuals without VR. Keywords: subjective memory complaints, amyloid beta, vascular risk, Alzheimer’s disease, cognitively normal

Published
2019

3. Guided vortex motion in a ferromagnet-superconductor bilayer

Author

Gierlowski, P, Abaloszewa, I, Przyslupski, P, and Jung, G

Subjects
Condensed Matter - Superconductivity
Abstract

Vortex motion in ferromagnetic-superconducting bilayers constituted by thin YBa$_2$Cu$_3$O$_{7-\delta}$ film deposited on the top of thin manganite La$_{0.67}$Sr$_{0.33}$MnO$_3$ film has been investigated. Both films were deposited on uniformly twinned single-crystalline substrates and patterned into strips directed at different angles to the twin lines pattern. These conditions lead to the guided vortex motion at different angles to the periodic pinning potential. It has been established that critical current and flux flow resistance in such an anisotropic pinning landscape-scale follow the elliptic dependence on the angle of the direction of the strip. For vortex flow at the directions close to the perpendicular to magnetic domain walls, signatures of the coherence in the vortex motion have been observed., Comment: 10 pages, 6 figures

Published
2023

5. The Reliability of Graduate Medical Education Quality of Care Clinical Performance Measures.

Author

Kim, Jung G, Rodriguez, Hector P, Holmboe, Eric S, McDonald, Kathryn M, Mazotti, Lindsay, Rittenhouse, Diane R, Shortell, Stephen M, and Kanter, Michael H

Subjects
Curriculum and Pedagogy, Education, Clinical Research, Health Services, Digestive Diseases, Education, Medical, Education, Medical, Graduate, Family Practice, Humans, Internship and Residency, Reproducibility of Results, United States, Curriculum and pedagogy
Abstract

BackgroundGraduate medical education (GME) program leaders struggle to incorporate quality measures in the ambulatory care setting, leading to knowledge gaps on how to provide feedback to residents and programs. While nationally collected quality of care data are available, their reliability for individual resident learning and for GME program improvement is understudied.ObjectiveTo examine the reliability of the Healthcare Effectiveness Data and Information Set (HEDIS) clinical performance measures in family medicine and internal medicine GME programs and to determine whether HEDIS measures can inform residents and their programs with their quality of care.MethodsFrom 2014 to 2017, we collected HEDIS measures from 566 residents in 8 family medicine and internal medicine programs under one sponsoring institution. Intraclass correlation was performed to establish patient sample sizes required for 0.70 and 0.80 reliability levels at the resident and program levels. Differences between the patient sample sizes required for reliable measurement and the actual patients cared for by residents were calculated.ResultsThe highest reliability levels for residents (0.88) and programs (0.98) were found for the most frequently available HEDIS measure, colorectal cancer screening. At the GME program level, 87.5% of HEDIS measures had sufficient sample sizes for reliable measurement at alpha 0.7 and 75.0% at alpha 0.8. Most resident level measurements were found to be less reliable.ConclusionsGME programs may reliably evaluate HEDIS performance pooled at the program level, but less so at the resident level due to patient volume.

Published
2022

6. Inactivation of hnRNP K by expanded intronic AUUCU repeat induces apoptosis via translocation of PKCdelta to mitochondria in spinocerebellar ataxia 10.

Author

Misti C White, Rui Gao, Weidong Xu, Santi M Mandal, Jung G Lim, Tapas K Hazra, Maki Wakamiya, Sharon F Edwards, Salmo Raskin, Hélio A G Teive, Huda Y Zoghbi, Partha S Sarkar, and Tetsuo Ashizawa

Subjects
Genetics, QH426-470
Abstract

We have identified a large expansion of an ATTCT repeat within intron 9 of ATXN10 on chromosome 22q13.31 as the genetic mutation of spinocerebellar ataxia type 10 (SCA10). Our subsequent studies indicated that neither a gain nor a loss of function of ataxin 10 is likely the major pathogenic mechanism of SCA10. Here, using SCA10 cells, and transfected cells and transgenic mouse brain expressing expanded intronic AUUCU repeats as disease models, we show evidence for a key pathogenic molecular mechanism of SCA10. First, we studied the fate of the mutant repeat RNA by in situ hybridization. A Cy3-(AGAAU)(10) riboprobe detected expanded AUUCU repeats aggregated in foci in SCA10 cells. Pull-down and co-immunoprecipitation data suggested that expanded AUUCU repeats within the spliced intronic sequence strongly bind to hnRNP K. Co-localization of hnRNP K and the AUUCU repeat aggregates in the transgenic mouse brain and transfected cells confirmed this interaction. To examine the impact of this interaction on hnRNP K function, we performed RT-PCR analysis of a splicing-regulatory target of hnRNP K, and found diminished hnRNP K activity in SCA10 cells. Cells expressing expanded AUUCU repeats underwent apoptosis, which accompanied massive translocation of PKCdelta to mitochondria and activation of caspase 3. Importantly, siRNA-mediated hnRNP K deficiency also caused the same apoptotic event in otherwise normal cells, and over-expression of hnRNP K rescued cells expressing expanded AUUCU repeats from apoptosis, suggesting that the loss of function of hnRNP K plays a key role in cell death of SCA10. These results suggest that the expanded AUUCU-repeat in the intronic RNA undergoes normal transcription and splicing, but causes apoptosis via an activation cascade involving a loss of hnRNP K activities, massive translocation of PKCdelta to mitochondria, and caspase 3 activation.

Published
2010
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8. Position-Dependent Correlation Function of Weak Lensing Convergence

Author

Munshi, D., Jung, G., Kitching, T. D., McEwen, J., Liguori, M., Namikawa, T., and Heavens, A.

Subjects
Astrophysics - Cosmology and Nongalactic Astrophysics
Abstract

We provide a systematic study of the position-dependent correlation function in weak lensing convergence maps and its relation to the squeezed limit of the three-point correlation function (3PCF) using state-of-the-art numerical simulations. We relate the position-dependent correlation function to its harmonic counterpart, i.e., the position-dependent power spectrum or equivalently the integrated bispectrum. We use a recently proposed improved fitting function, BiHalofit, for the bispectrum to compute the theoretical predictions as a function of source redshifts. In addition to low redshift results ($z_s=1.0-2.0$), we also provide results for maps inferred from lensing of the cosmic microwave background, i.e., $z_s=1100$. We include a {\em Euclid}-type realistic survey mask and noise. In agreement with the recent studies on the position-dependent power spectrum, we find that the results from simulations are consistent with the theoretical expectations when appropriate corrections are included. Performing a rough estimate, we find that the (S/N) for the detection of the position-dependent correlation function from {\em Euclid}-type mask with $f_{sky}=0.35$, can range between $6-12$ depending on the value of the intrinsic ellipticity distribution parameter $\sigma_{\epsilon} = 0.3-1.0$. For reconstructed $\kappa$ maps using an ideal CMB survey the (S/N) $\approx 1.8$. We also found that a $10\%$ deviation in $\sigma_8$ can be detected using IB for the optimistic case of $\sigma_\epsilon=0.3$ with a (S/N) $\approx 5$. The (S/N) for such detection in case of $\Omega_M$ is lower., Comment: 7 pages, 7 figures (PRD in press)

Published
2021
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9. Planck 2018 results. IX. Constraints on primordial non-Gaussianity

Author

Planck Collaboration, Akrami, Y., Arroja, F., Ashdown, M., Aumont, J., Baccigalupi, C., Ballardini, M., Banday, A. J., Barreiro, R. B., Bartolo, N., Basak, S., Benabed, K., Bernard, J. -P., Bersanelli, M., Bielewicz, P., Bond, J. R., Borrill, J., Bouchet, F. R., Bucher, M., Burigana, C., Butler, R. C., Calabrese, E., Cardoso, J. -F., Casaponsa, B., Challinor, A., Chiang, H. C., Colombo, L. P. L., Combet, C., Crill, B. P., Cuttaia, F., de Bernardis, P., de Rosa, A., de Zotti, G., Delabrouille, J., Delouis, J. -M., Di Valentino, E., Diego, J. M., Doré, O., Douspis, M., Ducout, A., Dupac, X., Dusini, S., Efstathiou, G., Elsner, F., Enßlin, T. A., Eriksen, H. K., Fantaye, Y., Fergusson, J., Fernandez-Cobos, R., Finelli, F., Frailis, M., Fraisse, A. A., Franceschi, E., Frolov, A., Galeotta, S., Ganga, K., Génova-Santos, R. T., Gerbino, M., González-Nuevo, J., Górski, K. M., Gratton, S., Gruppuso, A., Gudmundsson, J. E., Hamann, J., Handley, W., Hansen, F. K., Herranz, D., Hivon, E., Huang, Z., Jaffe, A. H., Jones, W. C., Jung, G., Keihänen, E., Keskitalo, R., Kiiveri, K., Kim, J., Krachmalnicoff, N., Kunz, M., Kurki-Suonio, H., Lamarre, J. -M., Lasenby, A., Lattanzi, M., Lawrence, C. R., Jeune, M. Le, Levrier, F., Lewis, A., Liguori, M., Lilje, P. B., Lindholm, V., López-Caniego, M., Ma, Y. -Z., Macías-Pérez, J. F., Maggio, G., Maino, D., Mandolesi, N., Marcos-Caballero, A., Maris, M., Martin, P. G., Martínez-González, E., Matarrese, S., Mauri, N., McEwen, J. D., Meerburg, P. D., Meinhold, P. R., Melchiorri, A., Mennella, A., Migliaccio, M., Miville-Deschênes, M. -A., Molinari, D., Moneti, A., Montier, L., Morgante, G., Moss, A., Münchmeyer, M., Natoli, P., Oppizzi, F., Pagano, L., Paoletti, D., Partridge, B., Patanchon, G., Perrotta, F., Pettorino, V., Piacentini, F., Polenta, G., Puget, J. -L., Rachen, J. P., Racine, B., Reinecke, M., Remazeilles, M., Renzi, A., Rocha, G., Rubiño-Martín, J. A., Ruiz-Granados, B., Salvati, L., Savelainen, M., Scott, D., Shellard, E. P. S., Shiraishi, M., Sirignano, C., Sirri, G., Smith, K., Spencer, L. D., Stanco, L., Sunyaev, R., Suur-Uski, A. -S., Tauber, J. A., Tavagnacco, D., Tenti, M., Toffolatti, L., Tomasi, M., Trombetti, T., Valiviita, J., Van Tent, B., Vielva, P., Villa, F., Vittorio, N., Wandelt, B. D., Wehus, I. K., Zacchei, A., and Zonca, A.

Subjects
Astrophysics - Cosmology and Nongalactic Astrophysics, General Relativity and Quantum Cosmology, High Energy Physics - Phenomenology, High Energy Physics - Theory
Abstract

We analyse the Planck full-mission cosmic microwave background (CMB) temperature and E-mode polarization maps to obtain constraints on primordial non-Gaussianity (NG). We compare estimates obtained from separable template-fitting, binned, and modal bispectrum estimators, finding consistent values for the local, equilateral, and orthogonal bispectrum amplitudes. Our combined temperature and polarization analysis produces the following results: f_NL^local = -0.9 +\- 5.1; f_NL^equil = -26 +\- 47; and f_NL^ortho = - 38 +\- 24 (68%CL, statistical). These results include the low-multipole (4 <= l < 40) polarization data, not included in our previous analysis, pass an extensive battery of tests, and are stable with respect to our 2015 measurements. Polarization bispectra display a significant improvement in robustness; they can now be used independently to set NG constraints. We consider a large number of additional cases, e.g. scale-dependent feature and resonance bispectra, isocurvature primordial NG, and parity-breaking models, where we also place tight constraints but do not detect any signal. The non-primordial lensing bispectrum is detected with an improved significance compared to 2015, excluding the null hypothesis at 3.5 sigma. We present model-independent reconstructions and analyses of the CMB bispectrum. Our final constraint on the local trispectrum shape is g_NLl^local = (-5.8 +\-6.5) x 10^4 (68%CL, statistical), while constraints for other trispectra are also determined. We constrain the parameter space of different early-Universe scenarios, including general single-field models of inflation, multi-field and axion field parity-breaking models. Our results provide a high-precision test for structure-formation scenarios, in complete agreement with the basic picture of the LambdaCDM cosmology regarding the statistics of the initial conditions (abridged)., Comment: 50 pages, 20 figures

Published
2019

10. Planck 2018 results

Author

Akrami, Y, Arroja, F, Ashdown, M, Aumont, J, Baccigalupi, C, Ballardini, M, Banday, AJ, Barreiro, RB, Bartolo, N, Basak, S, Benabed, K, Bernard, J-P, Bersanelli, M, Bielewicz, P, Bond, JR, Borrill, J, Bouchet, FR, Bucher, M, Burigana, C, Butler, RC, Calabrese, E, Cardoso, J-F, Casaponsa, B, Challinor, A, Chiang, HC, Colombo, LPL, Combet, C, Crill, BP, Cuttaia, F, de Bernardis, P, de Rosa, A, de Zotti, G, Delabrouille, J, Delouis, J-M, Di Valentino, E, Diego, JM, Doré, O, Douspis, M, Ducout, A, Dupac, X, Dusini, S, Efstathiou, G, Elsner, F, Enßlin, TA, Eriksen, HK, Fantaye, Y, Fergusson, J, Fernandez-Cobos, R, Finelli, F, Frailis, M, Fraisse, AA, Franceschi, E, Frolov, A, Galeotta, S, Galli, S, Ganga, K, Génova-Santos, RT, Gerbino, M, González-Nuevo, J, Górski, KM, Gratton, S, Gruppuso, A, Gudmundsson, JE, Hamann, J, Handley, W, Hansen, FK, Herranz, D, Hivon, E, Huang, Z, Jaffe, AH, Jones, WC, Jung, G, Keihänen, E, Keskitalo, R, Kiiveri, K, Kim, J, Krachmalnicoff, N, Kunz, M, Kurki-Suonio, H, Lamarre, J-M, Lasenby, A, Lattanzi, M, Lawrence, CR, Le Jeune, M, Levrier, F, Lewis, A, Liguori, M, Lilje, PB, Lindholm, V, López-Caniego, M, Ma, Y-Z, Macías-Pérez, JF, Maggio, G, Maino, D, Mandolesi, N, Marcos-Caballero, A, Maris, M, Martin, PG, Martínez-González, E, and Matarrese, S

Subjects
Particle and High Energy Physics, Physical Sciences, cosmic background radiation, cosmology: observations, cosmology: theory, early Universe, inflation, methods: data analysis, astro-ph.CO, gr-qc, hep-ph, hep-th, Astronomical and Space Sciences, Astronomy & Astrophysics, Astronomical sciences, Particle and high energy physics, Space sciences
Abstract

We analyse the Planck full-mission cosmic microwave background (CMB) temperature and E-mode polarization maps to obtain constraints on primordial non-Gaussianity (NG). We compare estimates obtained from separable template-fitting, binned, and optimal modal bispectrum estimators, finding consistent values for the local, equilateral, and orthogonal bispectrum amplitudes. Our combined temperature and polarization analysis produces the following final results: flocalNL= -0.9 ± 5.1; fequilNL= -26 ± 47; and forthoNL= -38 ± 24 (68% CL, statistical). These results include low-multipole (4 ≤ ℓ < 40) polarization data that are not included in our previous analysis. The results also pass an extensive battery of tests (with additional tests regarding foreground residuals compared to 2015), and they are stable with respect to our 2015 measurements (with small fluctuations, at the level of a fraction of a standard deviation, which is consistent with changes in data processing). Polarizationonly bispectra display a significant improvement in robustness; they can now be used independently to set primordial NG constraints with a sensitivity comparable to WMAP temperature-based results and they give excellent agreement. In addition to the analysis of the standard local, equilateral, and orthogonal bispectrum shapes, we consider a large number of additional cases, such as scale-dependent feature and resonance bispectra, isocurvature primordial NG, and parity-breaking models, where we also place tight constraints but do not detect any signal. The nonprimordial lensing bispectrum is, however, detected with an improved significance compared to 2015, excluding the null hypothesis at 3.5σ. Beyond estimates of individual shape amplitudes, we also present model-independent reconstructions and analyses of the Planck CMB bispectrum. Our final constraint on the local primordial trispectrum shape is glocalNL= (-5.8 ± 6.5) × 104(68% CL, statistical), while constraints for other trispectrum shapes are also determined. Exploiting the tight limits on various bispectrum and trispectrum shapes, we constrain the parameter space of different early-Universe scenarios that generate primordial NG, including general single-field models of inflation, multi-field models (e.g. curvaton models), models of inflation with axion fields producing parity-violation bispectra in the tensor sector, and inflationary models involving vector-like fields with directionally-dependent bispectra. Our results provide a high-precision test for structure-formation scenarios, showing complete agreement with the basic picture of the CDM cosmology regarding the statistics of the initial conditions, with cosmic structures arising from adiabatic, passive, Gaussian, and primordial seed perturbations.

Published
2020

11. Planck 2018 results: IX. Constraints on primordial non-Gaussianity

Author

Akrami, Y, Arroja, F, Ashdown, M, Aumont, J, Baccigalupi, C, Ballardini, M, Banday, AJ, Barreiro, RB, Bartolo, N, Basak, S, Benabed, K, Bernard, JP, Bersanelli, M, Bielewicz, P, Bond, JR, Borrill, J, Bouchet, FR, Bucher, M, Burigana, C, Butler, RC, Calabrese, E, Cardoso, JF, Casaponsa, B, Challinor, A, Chiang, HC, Colombo, LPL, Combet, C, Crill, BP, Cuttaia, F, De Bernardis, P, De Rosa, A, De Zotti, G, Delabrouille, J, Delouis, JM, Di Valentino, E, Diego, JM, Doré, O, Douspis, M, Ducout, A, Dupac, X, Dusini, S, Efstathiou, G, Elsner, F, Enßlin, TA, Eriksen, HK, Fantaye, Y, Fergusson, J, Fernandez-Cobos, R, Finelli, F, Frailis, M, Fraisse, AA, Franceschi, E, Frolov, A, Galeotta, S, Galli, S, Ganga, K, Génova-Santos, RT, Gerbino, M, González-Nuevo, J, Górski, KM, Gratton, S, Gruppuso, A, Gudmundsson, JE, Hamann, J, Handley, W, Hansen, FK, Herranz, D, Hivon, E, Huang, Z, Jaffe, AH, Jones, WC, Jung, G, Keihänen, E, Keskitalo, R, Kiiveri, K, Kim, J, Krachmalnicoff, N, Kunz, M, Kurki-Suonio, H, Lamarre, JM, Lasenby, A, Lattanzi, M, Lawrence, CR, Le Jeune, M, Levrier, F, Lewis, A, Liguori, M, Lilje, PB, Lindholm, V, López-Caniego, M, Ma, YZ, Maciás-Pérez, JF, Maggio, G, Maino, D, Mandolesi, N, Marcos-Caballero, A, Maris, M, Martin, PG, Martínez-González, E, and Matarrese, S

Subjects
cosmic background radiation, cosmology: observations, cosmology: theory, early Universe, inflation, methods: data analysis, astro-ph.CO, gr-qc, hep-ph, hep-th, Astronomical and Space Sciences, Astronomy & Astrophysics
Abstract

We analyse the Planck full-mission cosmic microwave background (CMB) temperature and E-mode polarization maps to obtain constraints on primordial non-Gaussianity (NG). We compare estimates obtained from separable template-fitting, binned, and optimal modal bispectrum estimators, finding consistent values for the local, equilateral, and orthogonal bispectrum amplitudes. Our combined temperature and polarization analysis produces the following final results: flocalNL= -0.9 ± 5.1; fequilNL= -26 ± 47; and forthoNL= -38 ± 24 (68% CL, statistical). These results include low-multipole (4 ≤ ℓ < 40) polarization data that are not included in our previous analysis. The results also pass an extensive battery of tests (with additional tests regarding foreground residuals compared to 2015), and they are stable with respect to our 2015 measurements (with small fluctuations, at the level of a fraction of a standard deviation, which is consistent with changes in data processing). Polarizationonly bispectra display a significant improvement in robustness; they can now be used independently to set primordial NG constraints with a sensitivity comparable to WMAP temperature-based results and they give excellent agreement. In addition to the analysis of the standard local, equilateral, and orthogonal bispectrum shapes, we consider a large number of additional cases, such as scale-dependent feature and resonance bispectra, isocurvature primordial NG, and parity-breaking models, where we also place tight constraints but do not detect any signal. The nonprimordial lensing bispectrum is, however, detected with an improved significance compared to 2015, excluding the null hypothesis at 3.5σ. Beyond estimates of individual shape amplitudes, we also present model-independent reconstructions and analyses of the Planck CMB bispectrum. Our final constraint on the local primordial trispectrum shape is glocalNL= (-5.8 ± 6.5) × 104(68% CL, statistical), while constraints for other trispectrum shapes are also determined. Exploiting the tight limits on various bispectrum and trispectrum shapes, we constrain the parameter space of different early-Universe scenarios that generate primordial NG, including general single-field models of inflation, multi-field models (e.g. curvaton models), models of inflation with axion fields producing parity-violation bispectra in the tensor sector, and inflationary models involving vector-like fields with directionally-dependent bispectra. Our results provide a high-precision test for structure-formation scenarios, showing complete agreement with the basic picture of the CDM cosmology regarding the statistics of the initial conditions, with cosmic structures arising from adiabatic, passive, Gaussian, and primordial seed perturbations.

Published
2020

12. The Sac Evolution Imaging Follow-Up after EVAR: an international expert opinion-based Delphi consensus study

Author

Tinelli, G, D'Oria, M, Sica, S, Mani, K, Rancic, Z, Resch, T, Beccia, F, Azizzadeh, A, Da Volta Ferreira, M, Gargiulo, M, Lepidi, S, Tshomba, Y, Oderich, G, Haulon, S, Beck, A, Hertault, A, Savlania, A, Froio, A, Giaquinta, A, Zimmermann, A, Psyllas, A, Wanhainen, A, Marchetti, A, Queiroz, A, Kahlberg, A, Reyes-Valdivia, A, Schanzer, A, Tambyraja, A, Freyrie, A, Lorido, A, Millon, A, Ippoliti, A, Abai, B, Mees, B, Reutersberg, B, Maurel, B, Michel, B, Wahlgren, C, Cavazzini, C, Setacci, C, Lee, C, Ferrer, C, Bicknell, C, Raphael, C, Clair, D, Dawson, D, Arnaoutakis, D, Bockler, D, Kotelis, D, Mujagic, E, Chisci, E, Cieri, E, Gallitto, E, Marone, E, Ducasse, E, Verzini, F, Pecoraro, F, Serracino-Inglott, F, Benedetto, F, Speziale, F, Stilo, F, Alvarez-Marcos, F, Pagliariccio, G, Piffaretti, G, Lanza, G, Philipp, G, Geenberg, G, Jung, G, Melissano, G, Veraldi, G, Parlani, G, Faggioli, G, de Donato, G, Simonte, G, Colacchio, G, De Caridi, G, Pratesi, G, Spinella, G, Torsello, G, Leong Tan, G, Magee, G, Verhagen, H, Andrew, H, Koleilat, I, Ohman, J, de Vries, J, Budtz-Lilly, J, Black, J, Eldrup-Jorgensen, J, Hockley, J, Bath, J, Sobocinski, J, van Herwaarden, J, Reinhard, K, Orion, K, Amankwah, K, Bertoglio, L, di Marzo, L, Garriboli, L, Rizzo, L, Hakimi, M, Sheahan, M, Khashram, M, Schermerhorn, M, Lescan, M, Conrad, M, Davies, M, Czerny, M, Orrico, M, Eagleton, M, Smeds, M, Taurino, M, Wohlauer, M, Sharafuddin, M, Anna-Leonie, M, Reijnen, M, Antonello, M, Piazza, M, Settembre, N, Mouawad, N, Tsilimparis, N, Dias, N, Martinelli, O, Frigatti, P, Sirignano, P, Chong, P, Bevis, P, Dimuzio, P, Henke, P, Duppers, P, Holt, P, Helmio, P, Vriens, P, Pulli, R, Bellosta, R, Micheli, R, Veeraswamy, R, Cuff, R, Chiappa, R, Gattuso, R, Pini, R, Dalman, R, Milner, R, Scali, S, Bahia, S, Laukontaus, S, Trimarchi, S, Fernandez-Alonso, S, Deglise, S, Bellmunt-Montoya, S, Hofer, S, Yusuf, S, Ronchey, S, Bartoli, S, Bonvini, S, Camparini, S, Fazzini, S, Pirrelli, S, Horer, T, Bisdas, T, Vasudevan, T, Lattmann, T, Wyss, T, Maldonado, T, Pfammatter, T, Kolbel, T, Jakimowicz, T, Donati, T, Tracci, M, Bracale, U, Tolva, V, Riambau, V, Palazzo, V, Makaloski, V, Von Allmen, R, Dorigo, W, Mansour, W, Van den Eynde, W, Tinelli G., D'Oria M., Sica S., Mani K., Rancic Z., Resch T. A., Beccia F., Azizzadeh A., Da Volta Ferreira M. M., Gargiulo M., Lepidi S., Tshomba Y., Oderich G. S., Haulon S., Beck A. W., Hertault A., Savlania A., Froio A., Giaquinta A., Zimmermann A., Psyllas A., Wanhainen A., Marchetti A. A., Queiroz A. B., Kahlberg A., Reyes-Valdivia A., Schanzer A., Tambyraja A., Freyrie A., Lorido A., Millon A., Ippoliti A., Abai B., Mees B., Reutersberg B., Maurel B., Michel B., Wahlgren C. M., Cavazzini C., Setacci C., Lee C. J., Ferrer C., Bicknell C., Raphael C., Clair D., Dawson D. L., Arnaoutakis D. J., Bockler D., Kotelis D., Mujagic E., Chisci E., Cieri E., Gallitto E., Marone E. M., Ducasse E., Verzini F., Pecoraro F., Serracino-Inglott F., Benedetto F., Speziale F., Stilo F., Alvarez-Marcos F., Pagliariccio G., Piffaretti G., Lanza G., Philipp G., Geenberg G., Jung G., Melissano G., Veraldi G. F., Parlani G., Faggioli G., de Donato G., Simonte G., Colacchio G., De Caridi G., Pratesi G., Spinella G., Torsello G., Leong Tan G. W., Magee G. A., Verhagen H., Andrew H., Koleilat I., Ohman J. W., de Vries J. P. P. M., Budtz-Lilly J., Black J., Eldrup-Jorgensen J., Hockley J., Bath J., Sobocinski J., van Herwaarden J. A., Reinhard K., Orion K. C., Amankwah K., Bertoglio L., di Marzo L., Garriboli L., Rizzo L., Hakimi M., Sheahan M., Khashram M., Schermerhorn M., Lescan M., Conrad M., Davies M. G., Czerny M., Orrico M., Eagleton M. J., Smeds M. R., Taurino M., Wohlauer M., Sharafuddin M. J., Anna-Leonie M., Reijnen M., Antonello M., Piazza M., Settembre N., Mouawad N. J., Tsilimparis N., Dias N., Martinelli O., Frigatti P., Sirignano P., Chong P., Bevis P., DiMuzio P., Henke P., Duppers P., Holt P., Helmio P., Vriens P., Pulli R., Bellosta R., Micheli R., Veeraswamy R., Cuff R., Chiappa R., Gattuso R., Pini R., Dalman R. L., Milner R., Scali S. T., Bahia S., Laukontaus S., Trimarchi S., Fernandez-Alonso S., Deglise S., Bellmunt-Montoya S., Hofer S., Yusuf S. W., Ronchey S., Bartoli S., Bonvini S., Camparini S., Fazzini S., Pirrelli S., Horer T., Bisdas T., Vasudevan T., Lattmann T., Wyss T. R., Maldonado T., Pfammatter T., Kolbel T., Jakimowicz T., Donati T., Tracci M., Bracale U. M., Tolva V. S., Riambau V., Palazzo V., Makaloski V., Von Allmen R. S., Dorigo W., Mansour W., Van den Eynde W., Tinelli, G, D'Oria, M, Sica, S, Mani, K, Rancic, Z, Resch, T, Beccia, F, Azizzadeh, A, Da Volta Ferreira, M, Gargiulo, M, Lepidi, S, Tshomba, Y, Oderich, G, Haulon, S, Beck, A, Hertault, A, Savlania, A, Froio, A, Giaquinta, A, Zimmermann, A, Psyllas, A, Wanhainen, A, Marchetti, A, Queiroz, A, Kahlberg, A, Reyes-Valdivia, A, Schanzer, A, Tambyraja, A, Freyrie, A, Lorido, A, Millon, A, Ippoliti, A, Abai, B, Mees, B, Reutersberg, B, Maurel, B, Michel, B, Wahlgren, C, Cavazzini, C, Setacci, C, Lee, C, Ferrer, C, Bicknell, C, Raphael, C, Clair, D, Dawson, D, Arnaoutakis, D, Bockler, D, Kotelis, D, Mujagic, E, Chisci, E, Cieri, E, Gallitto, E, Marone, E, Ducasse, E, Verzini, F, Pecoraro, F, Serracino-Inglott, F, Benedetto, F, Speziale, F, Stilo, F, Alvarez-Marcos, F, Pagliariccio, G, Piffaretti, G, Lanza, G, Philipp, G, Geenberg, G, Jung, G, Melissano, G, Veraldi, G, Parlani, G, Faggioli, G, de Donato, G, Simonte, G, Colacchio, G, De Caridi, G, Pratesi, G, Spinella, G, Torsello, G, Leong Tan, G, Magee, G, Verhagen, H, Andrew, H, Koleilat, I, Ohman, J, de Vries, J, Budtz-Lilly, J, Black, J, Eldrup-Jorgensen, J, Hockley, J, Bath, J, Sobocinski, J, van Herwaarden, J, Reinhard, K, Orion, K, Amankwah, K, Bertoglio, L, di Marzo, L, Garriboli, L, Rizzo, L, Hakimi, M, Sheahan, M, Khashram, M, Schermerhorn, M, Lescan, M, Conrad, M, Davies, M, Czerny, M, Orrico, M, Eagleton, M, Smeds, M, Taurino, M, Wohlauer, M, Sharafuddin, M, Anna-Leonie, M, Reijnen, M, Antonello, M, Piazza, M, Settembre, N, Mouawad, N, Tsilimparis, N, Dias, N, Martinelli, O, Frigatti, P, Sirignano, P, Chong, P, Bevis, P, Dimuzio, P, Henke, P, Duppers, P, Holt, P, Helmio, P, Vriens, P, Pulli, R, Bellosta, R, Micheli, R, Veeraswamy, R, Cuff, R, Chiappa, R, Gattuso, R, Pini, R, Dalman, R, Milner, R, Scali, S, Bahia, S, Laukontaus, S, Trimarchi, S, Fernandez-Alonso, S, Deglise, S, Bellmunt-Montoya, S, Hofer, S, Yusuf, S, Ronchey, S, Bartoli, S, Bonvini, S, Camparini, S, Fazzini, S, Pirrelli, S, Horer, T, Bisdas, T, Vasudevan, T, Lattmann, T, Wyss, T, Maldonado, T, Pfammatter, T, Kolbel, T, Jakimowicz, T, Donati, T, Tracci, M, Bracale, U, Tolva, V, Riambau, V, Palazzo, V, Makaloski, V, Von Allmen, R, Dorigo, W, Mansour, W, Van den Eynde, W, Tinelli G., D'Oria M., Sica S., Mani K., Rancic Z., Resch T. A., Beccia F., Azizzadeh A., Da Volta Ferreira M. M., Gargiulo M., Lepidi S., Tshomba Y., Oderich G. S., Haulon S., Beck A. W., Hertault A., Savlania A., Froio A., Giaquinta A., Zimmermann A., Psyllas A., Wanhainen A., Marchetti A. A., Queiroz A. B., Kahlberg A., Reyes-Valdivia A., Schanzer A., Tambyraja A., Freyrie A., Lorido A., Millon A., Ippoliti A., Abai B., Mees B., Reutersberg B., Maurel B., Michel B., Wahlgren C. M., Cavazzini C., Setacci C., Lee C. J., Ferrer C., Bicknell C., Raphael C., Clair D., Dawson D. L., Arnaoutakis D. J., Bockler D., Kotelis D., Mujagic E., Chisci E., Cieri E., Gallitto E., Marone E. M., Ducasse E., Verzini F., Pecoraro F., Serracino-Inglott F., Benedetto F., Speziale F., Stilo F., Alvarez-Marcos F., Pagliariccio G., Piffaretti G., Lanza G., Philipp G., Geenberg G., Jung G., Melissano G., Veraldi G. F., Parlani G., Faggioli G., de Donato G., Simonte G., Colacchio G., De Caridi G., Pratesi G., Spinella G., Torsello G., Leong Tan G. W., Magee G. A., Verhagen H., Andrew H., Koleilat I., Ohman J. W., de Vries J. P. P. M., Budtz-Lilly J., Black J., Eldrup-Jorgensen J., Hockley J., Bath J., Sobocinski J., van Herwaarden J. A., Reinhard K., Orion K. C., Amankwah K., Bertoglio L., di Marzo L., Garriboli L., Rizzo L., Hakimi M., Sheahan M., Khashram M., Schermerhorn M., Lescan M., Conrad M., Davies M. G., Czerny M., Orrico M., Eagleton M. J., Smeds M. R., Taurino M., Wohlauer M., Sharafuddin M. J., Anna-Leonie M., Reijnen M., Antonello M., Piazza M., Settembre N., Mouawad N. J., Tsilimparis N., Dias N., Martinelli O., Frigatti P., Sirignano P., Chong P., Bevis P., DiMuzio P., Henke P., Duppers P., Holt P., Helmio P., Vriens P., Pulli R., Bellosta R., Micheli R., Veeraswamy R., Cuff R., Chiappa R., Gattuso R., Pini R., Dalman R. L., Milner R., Scali S. T., Bahia S., Laukontaus S., Trimarchi S., Fernandez-Alonso S., Deglise S., Bellmunt-Montoya S., Hofer S., Yusuf S. W., Ronchey S., Bartoli S., Bonvini S., Camparini S., Fazzini S., Pirrelli S., Horer T., Bisdas T., Vasudevan T., Lattmann T., Wyss T. R., Maldonado T., Pfammatter T., Kolbel T., Jakimowicz T., Donati T., Tracci M., Bracale U. M., Tolva V. S., Riambau V., Palazzo V., Makaloski V., Von Allmen R. S., Dorigo W., Mansour W., and Van den Eynde W.

Abstract

Objective: Management of follow-up protocols after endovascular aortic repair (EVAR) varies significantly between centers and is not standardized according to sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution. Methods: Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process. Based on the experts' responses, only those statements reaching a grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final document. Results: One-hundred and seventy-four participants were included in the final analysis, and each voted the initial 29 statements related to the definition of sac regression (Q1-Q9), EVAR follow-up (Q10-Q14), and the assessment and role of sac regression during follow-up (Q15-Q29). At the end of the process, 2 statements (6.9%) were rejected, 9 statements (31%) received a grade B consensus strength, and 18 (62.1%) reached a grade A consensus strength. Of 27 final statements, 15 (55.6%) were classified as grade I, whereas 12 (44.4%) were classified as grade II. Experts agreed that sac regression should be considered an important indicator of EVAR success and always be assessed during follow-up after EVAR. Conclusions: Based on the elevated strength and high consistency of this international expert-based Delphi consensus, most of the statements might guide the current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.

Published
2024

14. Conductivity fluctuations in proton-implanted ZnO microwires

Author

Dolgin, B., Lorite, I., Kumar, Y., Esquinazi, P., Jung, G., Straube, B., and de Heluani, S. Perez

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

The electric noise can be an important limitation for applications of conducting elements of size in the nanometer range. The intrinsic electrical noise of prospective materials for opto-spintronics applications like ZnO has not been characterized yet. In this study we have investigated the conductivity fluctuations in 10~nm thick current paths produced by proton implantation of ZnO microwires at room temperature. The voltage noise under a constant dc current bias in undoped as well as in Li-doped microwires is characterized by $1/f^a$ power spectra with $a \sim 1$. The noise intensity scales with the square of the bias current pointing out to bias-independent resistivity fluctuations as a source of the observed noise. The normalized power spectral density appears inversely proportional to the number of carriers in the probed sample volume, in agreement with the phenomenological Hooge law. For the proton-implanted ZnO microwire and at 1~Hz we obtain a normalized power spectral density as low as $\sim 10^{-11}~$Hz$^{-1}$., Comment: 10 pages,3 figures to be published in Nanotechnology (2016)

Published
2016
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15. Impact of Longitudinal Electronic Health Record Training for Residents Preparing for Practice in Patient-Centered Medical Homes

Author

Kim, Jung G, Rodriguez, Hector P, Estlin, Katherine At, and Morris, Carl G

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Management of diseases and conditions, 7.3 Management and decision making, Good Health and Well Being, Adult, Clinical Competence, Electronic Health Records, Family Practice, Humans, Internship and Residency, Male, Patient-Centered Care, Regression Analysis, Health services and systems
Abstract

IntroductionCompetence in using an electronic health record (EHR) is considered a critical skill for physicians practicing in patient-centered medical homes (PCMHs), but few studies have examined the impact of EHR training for residents preparing to practice in PCMHs. This study explored the educational outcomes associated with comprehensive EHR training for family medicine residents.MethodsThe PCMH EHR training consisted of case-based routine clinic visits delivered to 3 resident cohorts (N = 18). Participants completed an EHR competency self-assessment between 2011 and 2016 (N = 127), examining 6 EHR/PCMH core skills. We compared baseline characteristics for residents by low vs high exposure to EHR training. Multivariate regression estimated whether self-reported competencies improved over time and whether high PCMH EHR training exposure was associated with incremental improvement in self-reported competencies over time.ResultsResidents completed an average of 8.2 sessions: low-exposure residents averaged 5.3 sessions (standard deviation = 1.5), and high-exposure residents averaged 9.0 sessions (standard deviation = 0.9). High-exposed residents had higher posttest scores at training completion (84.4 vs 70.7). Over time, adjusted mean scores (confidence interval) for both groups improved (p < 0.001) from 12.2 (9.6-14.8), with low-exposed residents having greater score improvement (p < 0.001) because of their much lower baseline scores.ConclusionComprehensive training designed to improve EHR competencies among residents practicing in a PCMH resulted in improved assessment scores. Our findings indicate EHR training as part of resident exposure to the PCMH measurably improves self-assessed competencies, even among residents less engaged in EHR training.

Published
2017

18. Metastable Resistivity States and Conductivity Fluctuations in Low-doped La$_{1-x}$Ca$_{x}$MnO$_3$ Manganite Single Crystals

Author

Dolgin, B., Belogolovskii, M., Wu, X. D., Markovich, V., and Jung, G.

Subjects
Condensed Matter - Strongly Correlated Electrons, Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

Conductivity noise in dc current biased La_{0.82}Ca_{0.18}MnO_{3} single crystals has been investigated in different metastable resistivity states enforced by applying voltage pulses to the sample at low temperatures. Noise measured in all investigated resistivity states is of 1/f-type and its intensity at high temperatures and low dc bias scales as a square of the bias. At liquid nitrogen temperatures for under bias exceeding a threshold value, the behavior of the noise deviates from above quasi- equilibrium modulation noise and depends in a non monotonic way on applied bias. The bias range of nonequilibrium 1/f noise coincides with the range at which the conductance increases linearly with bias voltage. This feature is attributed to a broad continuity of states enabling indirect inelastic tunneling across intrinsic tunnel junctions. The nonequilibrium noise has been ascribed to indirect intrinsic tunneling mechanism while resistivity changes in metastable states to variations in the energy landscape for charge carriers introduced by microcracks created by the pulse procedures employed, Comment: 10 pages, 5 figures

Published
2012
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19. Bias Dependent 1/f Conductivity Fluctuations in Low-Doped La$_{1-x}$Ca$_{x}$MnO$_3$ Manganite Single Crystals

Author

Belogolovskii, M., Jung, G., Markovich, V., Dolgin, B., Wu, X. D., and Yuzhelevski, Y.

Subjects
Condensed Matter - Strongly Correlated Electrons, Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

Low frequency noise in current biased La$_{0.82}$Ca$_{0.18}$MnO$_{3}$ single crystals has been investigated in a wide temperature range from 79 K to 290 K. Despite pronounced changes in magnetic properties and dissipation mechanisms of the sample with changing temperature, the noise spectra were found to be always of the 1/f type and their intensity (except the lowest temperature studied) scaled as a square of the bias. At liquid nitrogen temperatures and under bias exceeding some threshold value, the behavior of the noise deviates from the quasi-equilibrium modulation noise and starts to depend in a non monotonic way on bias. It has been verified that the observed noise obeys Dutta and Horn model of 1/f noise in solids. The appearance of nonequilibrium 1/f noise and its dependence on bias have been associated with changes in the distribution of activation energies in the underlying energy landscape. These changes have been correlated with bias induced changes in the intrinsic tunneling mechanism dominating dissipation in La$_{0.82}$Ca$_{0.18}$MnO$_{3}$ at low temperatures., Comment: Accepted for publication in the Journal of Applied Physics

Published
2011
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20. Collective effects in charge transfer within a hybrid organic-inorganic system

Author

Paltiel, Y., Jung, G., Aqua, T., Mocatta, D., Banin, U., and Naaman, R.

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

A collective electron transfer (ET) process was discovered by studying the current noise in a field effect transistor with light-sensitive gate formed by nanocrystals linked by organic molecules to its surface. Fluctuations in the ET through the organic linker are reflected in the fluctuations of the transistor conductivity. The current noise has an avalanche character. Critical exponents obtained from the noise power spectra, avalanche distributions, and the dependence of the average avalanche size on avalanche duration are consistent with each other. A plausible model is proposed for this phenomenon, Comment: 15 pages 4 figures. Accepted for publication in Physical Review Letters

Published
2009
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22. Nonequilibrium 1/f Noise in Low-doped Manganite Single Crystals

Author

Wu, X. D., Dolgin, B., Jung, G., Markovich, V., Yuzhelevski, Y., Belogolovskii, M., and Mukovskii, Ya. M.

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

1/f noise in current biased La0.82Ca0.18MnO3 crystals has been investigated. The temperature dependence of the noise follows the resistivity changes with temperature suggesting that resistivity fluctuations constitute a fixed fraction of the total resistivity, independently of the dissipation mechanism and magnetic state of the system. The noise scales as a square of the current as expected for equilibrium resistivity fluctuations. However, at 77 K at bias exceeding some threshold, the noise intensity starts to decrease with increasing bias. The appearance of nonequilibrium noise is interpreted in terms of bias dependent multi-step indirect tunneling., Comment: 4pages, 3figures,APL accepted

Published
2007
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23. V-I characteristics in the vicinity of order-disorder transition in vortex matter

Author

Paltiel, Y., Myasoedov, Y., Zeldov, E., Jung, G., Rappaport, M. L., Feldman, D. E., Higgins, M. J., and Bhattacharya, S.

Subjects
Condensed Matter - Superconductivity
Abstract

The shape of the V-I characteristics leading to a peak in the differential resistance r_d=dV/dI in the vicinity of the order-disorder transition in NbSe2 is investigated. r_d is large when measured by dc current. However, for a small Iac on a dc bias r_d decreases rapidly with frequency, even at a few Hz, and displays a large out-of-phase signal. In contrast, the ac response increases with frequency in the absence of dc bias. These surprisingly opposite phenomena and the peak in r_d are shown to result from a dynamic coexistence of two vortex matter phases rather than from the commonly assumed plastic depinning., Comment: 12 pages 4 figures. Accepted for publication in PRB rapid

Published
2002
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24. Dynamic Creation and Annihilation of Metastable Vortex Phase as a Source of Excess Noise

Author

Paltiel, Y., Jung, G., Myasoedov, Y., Rappaport, M. L., Zeldov, E., Higgins, M. J., and Bhattacharya, S.

Subjects
Condensed Matter - Superconductivity
Abstract

The large increase in voltage noise, commonly observed in the vicinity of the peak-effect in superconductors, is ascribed to a novel noise mechanism. A strongly pinned metastable disordered vortex phase, which is randomly generated at the edges and annealed into ordered phase in the bulk, causes large fluctuations in the integrated critical current of the sample. The excess noise due to this dynamic admixture of two distinct phases is found to display pronounced reentrant behavior. In the Corbino geometry the injection of the metastable phase is prevented and, accordingly, the excess noise disappears, Comment: 5 pages 3 figures. Accepted for publication in Europhysics letters

Published
2002
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25. Conductivity Oscillations in Current-Induced Metastable States in Low-Doped Manganite Single Crystals

Author

Dikovsky, V., Yuzhelevski, Y., Markovich, V., Gorodetsky, G., and Jung, G.

Subjects
Condensed Matter - Strongly Correlated Electrons, Condensed Matter - Materials Science
Abstract

Deterministic oscillations of current-induced metastable resistivity in changing voltage have been detected in La$_{0.82}$Ca$_{0.18}$MnO$_3$ single crystals. At low temperatures, below the Curie point, application of specific bias procedures switches the crystal into metastable resistivity state characterized by appearance of pronounced reproducible and random structures in the voltage dependence of the differential conductivity. In certain bias range equally spaced broad conductivity peaks have been observed. The oscillating conductivity has been tentatively ascribed to resonances in a quantum well within the double tunnel barrier of intrinsic weak-links associated with twin-like defect boundaries., Comment: 4 pages, 4 figures, to appear in Phys. Rev. B

Published
2002
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26. Giant nonlinear response of superconducting single crystal niobium in a sweeping magnetic field

Author

Tsindlekht, M. I., Felner, I., and Jung, G.

Subjects
Condensed Matter - Superconductivity
Abstract

Giant enhancement of the nonlinear response of a single crystal of Nb placed in a sweeping magnetic field has been experimentally observed. The rectified signal from Nb ($Tc=9.15$ K) has been measured by means of an inductive method as a function of temperature, dc field, dc field sweep rate, and the amplitude of ac field. The Nb sample was excited by an amplitude modulated ac field. Under a stationary regime, the rectified signal appears only for magnetic fields ($H_0$) in the range $H_{c2}H_{c1}$. This experiment shows that the amplitude of the rectified signal is two orders of magnitude larger than the amplitude of the signal seen under stationary field conditions. Moreover, the amplitude of the rectified signal is a power function of the sweep rate, with the power exponent close to 1., Comment: 3 pages, 3 figures, presented to EUCAS 2001

Published
2001
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27. Instabilities and disorder-driven first-order transition of the vortex lattice

Author

Paltiel, Y., Zeldov, E., Myasoedov, Y., Rappaport, M. L., Jung, G., Bhattacharya, S., Higgins, M. J., Xiao, Z. L., Andrei, E. Y., Gammel, P. L., and Bishop, D. J.

Subjects
Condensed Matter - Superconductivity
Abstract

Transport studies in a Corbino disk geometry suggest that the Bragg glass phase undergoes a first-order transition into a disordered solid. This transition shows a sharp reentrant behavior at low fields. In contrast, in the conventional strip configuration, the phase transition is obscured by the injection of the disordered vortices through the sample edges, which results in the commonly observed vortex instabilities and smearing of the peak effect in NbSe2 crystals. These features are found to be absent in the Corbino geometry, in which the circulating vortices do not cross the sample edges., Comment: 12 pages 3 figures. Accepted for publication in Physical Review Letters

Published
2000
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28. Quiet and Noisy Metastable Voltage States in High-Tc Superconductors

Author

Jung, G., Savo, B., and Yuzhelevski, Y.

Subjects
Condensed Matter - Superconductivity
Abstract

The interaction between the telegraph noise and background voltage fluctuations in the current induced dissipative state of high-Tc BiSrCaCuO thin films has been investigated. Experimental time records of the voltage drop across current biased thin film strips show markedly different background noise traces in the up and down telegraph states. Detailed analysis demonstrates that fluctuations around the telegraph voltage levels are due to a unique background noise process. The apparent quiet and noisy voltage states are due only to differences in the effective frequency bandwidth at which background noise is seen at distinct telegraph levels. Changes of the background noise variance ratio with changing bias current follow changes of the statistical average lifetimes of the random telegraph process., Comment: submitted to Phys. Rev. B

Published
2000
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29. The Spectrum of Diffuse Cosmic Hard X-Rays Measured with HEAO-1

Author

Gruber, D. E., Matteson, J. L., Peterson, L. E., and Jung, G. V.

Subjects
Astrophysics
Abstract

The spectrum of the diffuse isotropic component of cosmic X-rays over the 13-180 keV range was determined by the UCSD/MIT Hard X-Ray and Gamma-Ray instrument (HEAO A4) on the High Energy Astronomical Observatory-1 (HEAO-1). The instrument consists of a complex of actively shielded and collimated scintillation counters, including the Low Energy Detector set from which the data reported here were obtained. These data join smoothly with the spectrum at lower energies reported by the GSFC HEAO A2 instrument and with that measured to 400 keV by the HEAO A4 Medium Energy Detectors. The HEAO data set also joins the recent results from COMPTEL on the Compton Gamma-Ray Observatory in the 1-10 MeV range, which failed to confirm the existence of an "MeV bump" in this range. Although the spectrum over the entire range 3 keV < E < 100 GeV can be fit by a simple empirical analytic expression, the origin is likely due to a number of distinct source components. The prevailing idea for the origin is that the hard X-ray spectrum is due to X-rays from various AGN components, particularly Seyfert galaxies extending to cosmological distances, and that the low energy gamma-rays may be due to emission from type 1a Supernovae, also integrated to cosmological distances. The higher energy gamma-ray spectrum defined by EGRET, also on the CGRO, may be due to unresolved gamma-ray emitting blazars. Models of production by these source components, extrapolated to the present epoch, must reproduce the observationally derived spectrum., Comment: LaTeX, 16pp, 3figs

Published
1999
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32. OSSE Observations of the Soft Gamma Ray Continuum from the Galactic Plane at Longitude 95 Degrees

Author

Skibo, J. G., Johnson, W. N., Kurfess, J. D., Kinzer, R. L., Jung, G., Grove, J. E., Purcell, W. R., Ulmer, M. P., Gehrels, N., and Tueller, J.

Subjects
Astrophysics
Abstract

We present the results of OSSE observations of the soft gamma ray continuum emission from the Galactic plane at longitude 95 degrees. Emission is detected between 50 and 600 keV where the spectrum is fit well by a power law with photon index -2.6+-0.3 and flux (4.0+-0.5) 10^{-2} photons/s/cm^2/rad/MeV at 100 keV. This spectral shape in this range is similar to that found for the continuum emission from the inner Galaxy but the amplitude is lower by a factor of four. This emission is either due to unresolved and previously unknown point sources or it is of diffuse origin, or a combination of the two. Simultaneous observations with OSSE and smaller field of view instruments operating in the soft gamma ray energy band, such as XTE or SAX, would help resolve this issue. If it is primarily diffuse emission due to nonthermal electron bremsstrahlung, as is the >1 MeV Galactic ridge continuum, then the power in low energy cosmic ray electrons exceeds that of the nuclear component of the cosmic rays by an order of magnitude. This would have profound implications for the origin of cosmic rays and the energetics of the interstellar medium. Alternatively, if the emission is diffuse and thermal, then there must be a component of the interstellar medium at temperatures near 10^9 K., Comment: 11 pages, Latex, requires AASTEX macros and psfig.tex, 2 postscript figures, Accepted for publication in the Astrophysical Journal Letters

Published
1997
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35. Comparative associations of MASLD and MAFLD with the presence and severity of coronary artery calcification

Author

Min Kyu Kang, Jeong Eun Song, Rohit Loomba, Soo Young Park, Won Young Tak, Young Oh Kweon, Yu Rim Lee, and Jung Gil Park

Subjects
Metabolic dysfunction-associated steatotic liver disease, Metabolic dysfunction-associated fatty liver disease, Coronary artery calcification, Cardiovascular disease, Medicine, Science
Abstract

Abstract We aimed to compare the associations of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) with coronary artery calcification (CAC). Patients who simultaneously underwent ultrasonography to diagnose hepatic steatosis and cardiac computed tomography to detect CAC were included. The presence and severity of CAC were defined with CAC-score thresholds of > 0 and > 300, respectively, and patients were divided into the following groups: no MASLD or MAFLD (reference), MASLD-only, MAFLD-only, and overlapping groups. Overall, 1,060/2,773 (38.2%) patients had CAC, of which 196 (18.5%) had severe CAC. The MASLD and MAFLD prevalence rates were 32.6% and 45.2%, respectively, with an overlap of 30.7%. In an ASCVD risk score-adjusted model, both MASLD (adjusted odd ratios [aOR], 1.21; 95% confidence interval [CI], 1.02–1.44; p = 0.033) and MAFLD (aOR 1.20; 95% CI 1.01–1.42, p = 0.034) were associated with CAC, whereas only MASLD (aOR 1.38; 95% CI 1.01–1.89, p = 0.041) was associated with severe CAC. Compared to the reference group, the overlapping group showed an association with CAC (aOR 1.22; 95% CI 1.01–1.47; p = 0.038); however, the MASLD and MAFLD subgroups did not differ in their association with CAC. MASLD may predict a higher risk of ASCVD more effectively than MAFLD.

Published
2024
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36. Racial and Ethnic Differences in Internal Medicine Residency Assessments

Author

Boatright, Dowin, primary, Anderson, Nientara, additional, Kim, Jung G., additional, Holmboe, Eric S., additional, McDade, William A., additional, Fancher, Tonya, additional, Gross, Cary P., additional, Chaudhry, Sarwat, additional, Nguyen, Mytien, additional, Nguemeni Tiako, Max Jordan, additional, Colson, Eve, additional, Xu, Yunshan, additional, Li, Fangyong, additional, Dziura, James D., additional, and Saha, Somnath, additional

Published
2022
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40. The Reliability of Graduate Medical Education Quality of Care Clinical Performance Measures

Author

Jung G. Kim, Hector P. Rodriguez, Eric S. Holmboe, Kathryn M. McDonald, Lindsay Mazotti, Diane R. Rittenhouse, Stephen M. Shortell, and Michael H. Kanter

Subjects
Education, Medical, Reproducibility of Results, Internship and Residency, General Medicine, Health Services, United States, Education, Education, Medical, Graduate, Clinical Research, Medical, Humans, Family Practice, Graduate, Digestive Diseases, Curriculum and Pedagogy, Original Research
Abstract

Background Graduate medical education (GME) program leaders struggle to incorporate quality measures in the ambulatory care setting, leading to knowledge gaps on how to provide feedback to residents and programs. While nationally collected quality of care data are available, their reliability for individual resident learning and for GME program improvement is understudied. Objective To examine the reliability of the Healthcare Effectiveness Data and Information Set (HEDIS) clinical performance measures in family medicine and internal medicine GME programs and to determine whether HEDIS measures can inform residents and their programs with their quality of care. Methods From 2014 to 2017, we collected HEDIS measures from 566 residents in 8 family medicine and internal medicine programs under one sponsoring institution. Intraclass correlation was performed to establish patient sample sizes required for 0.70 and 0.80 reliability levels at the resident and program levels. Differences between the patient sample sizes required for reliable measurement and the actual patients cared for by residents were calculated. Results The highest reliability levels for residents (0.88) and programs (0.98) were found for the most frequently available HEDIS measure, colorectal cancer screening. At the GME program level, 87.5% of HEDIS measures had sufficient sample sizes for reliable measurement at alpha 0.7 and 75.0% at alpha 0.8. Most resident level measurements were found to be less reliable. Conclusions GME programs may reliably evaluate HEDIS performance pooled at the program level, but less so at the resident level due to patient volume.

Published
2022

41. Temporal trends and long-term outcomes of radiofrequency ablation for hepatocellular carcinoma within the Milan criteria

Author

Se Young Jang, Soo Young Park, Young Oh Kweon, Yu Rim Lee, Hun Kyu Ryeom, Jung Guen Cha, Sungmin Kim, Won Kee Lee, Ae Jeong Jo, and Won Young Tak

Subjects
Medicine, Science
Abstract

Abstract No study has analysed the temporal trends of the long-term results and clinical characteristics of patients with hepatocellular carcinoma (HCC) treated using radiofrequency ablation (RFA). Therefore, we examined temporal trends of characteristics of patients and treatment-naïve HCCs within the Milan criteria treated by RFA over 20 years. We retrospectively analysed 1099 patients with HCC within the Milan criteria treated with percutaneous RFA from January 2000 to December 2019. The overall survival (OS), recurrence-free survival (RFS), and factors affecting survival and local tumor progression were analysed using the Kaplan‒Meier method and Cox proportional hazards model. A trend test was performed to analyse the changing trends in participants and treatment outcomes. The overall and RFS of patients improved during the later period. In addition, viral hepatitis-related HCC incidence decreased, whereas that of alcohol- or non-alcoholic fatty liver disease-related HCC increased from the earlier to the later period (P for trend

Published
2024
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42. Re-heat treatment effect on the microstructure and mechanical properties of the Inconel 706 alloy for repair

Author

Ho Seoung Kang, Hyogeon Kim, Eun Yoo Yoon, Young-Seon Lee, Sangshik Kim, and Jung Gi Kim

Subjects
Inconel alloy, Heat treatment, Mechanical property, Microstructure, Plastic deformation, Mining engineering. Metallurgy, TN1-997
Abstract

Although the understanding of microstructure and mechanical property changes in re-heat-treated Inconel alloys is important to evaluate the performance of repaired components, recent research has mainly focused on the heat treatment effect of as-fabricated products. Thus, in this work, the performance change of the used Inconel 706 rotor-disks under varying re-heat treatment conditions was investigated. Because of the heat exposure of the used rotor-disk component, a high fraction of plate-like η phase (6.36%) and compact γ'/γ'' co-precipitate structure were initiated in the as-received sample. After re-heat treatment, η phase dissolution breakage and compact to non-compact γ'/γ'' co-precipitate structure transition occur, resulting in mechanical properties changes of the Inconel 706 alloy. As a result, η phase fraction affects the tensile strength and ductility of Inconel 706 alloy, while the non-compact γ'/γ'' co-precipitate structure in the matrix degrades the creep lifetime. These results indicate that re-heat treatment during the repair of operated components induces microstructural and mechanical properties changes. However, to investigate the detailed history of used Inconel 706 components, additional research on the microstructural degradation during operation of Inconel components is required.

Published
2024
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43. Dynamic analysis of acute deterioration in chronic liver disease patients using modified quick sequential organ failure assessment

Author

Do Seon Song, Hee Yeon Kim, Young Kul Jung, Tae Hyung Kim, Hyung Joon Yim, Eileen L Yoon, Ki Tae Suk, Jeong-ju Yoo, Sang Gyune Kim, Moon Young Kim, Young Chang, Soung Won Jeong, Jae Young Jang, Sung-Eun Kim, Jung-Hee Kim, Jung Gil Park, Won Kim, Jin Mo Yang, Dong Joon Kim, Korean Acute-on-Chronic Liver Failure (KACLiF) study group, Ashok Kumar Choudhury, Vinod Arora, Shiv Kumar Sarin, and APASL ACLF Research Consortium (AARC) for APASL ACLF working party

Subjects
qsofa, acute-on-chronic liver failure, organ failure, survival, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background/Aims Quick sequential organ failure assessment (qSOFA) is believed to identify patients at risk of poor outcomes in those with suspected infection. We aimed to evaluate the ability of modified qSOFA (m-qSOFA) to identify high-risk patients among those with acutely deteriorated chronic liver disease (CLD), especially those with acute-onchronic liver failure (ACLF). Methods We used data from both the Korean Acute-on-Chronic Liver Failure (KACLiF) and the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) cohorts. qSOFA was modified by replacing the Glasgow Coma Scale with hepatic encephalopathy, and an m-qSOFA ≥2 was considered high. Results Patients with high m-qSOFA had a significantly lower 1-month transplant-free survival (TFS) in both cohorts and higher organ failure development in KACLiF than those with low m-qSOFA (Ps

Published
2024
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44. Machine learning in ceramics & glasses [Webinar]

Author

Gonzalez Sanchez S. chair, Institute of Materials, Minerals & Mining, Bouzid A., Oses C., Tandia A., Jung G., Gonzalez Sanchez S. chair, Institute of Materials, Minerals & Mining, Bouzid A., Oses C., Tandia A., and Jung G.

Abstract

This programme covers basic concepts such as modelling to discovery of new metal-carbide systems with high hardness values. It additionally covered applied aspects about glass science, ceramics science and their manufacturing to develop life-changing innovations and products. This webinar is focused on the use of machine learning in the area of ceramics and glasses and therefore will have an impact on academics working in the area and on industry. Three important take away benefits for participants: Fundamental knowledge on the use of machine learning in the discovery and design of ceramics/glasses; Understanding digitalization in ceramic/glass industry; Knowledge about the development of machine learning the ceramic/glass field in UK., First-principles and machine learning modelling of ceramic materials: the case of AsTe3 thermoelectric material. Presented by Assil Bouzid, Researcher, CNRS. The search for high performing thermoelectric materials led recently to the development of a new crystalline compound with composition AsTe3, that exhibits a very low thermal conductivity and an interesting figure of merit (ZT) peak value of 0.3 at 405 K, indicative of its thermoelectric performance. Nevertheless, the atomic-scale structure of both crystalline and amorphous AsTe3 remain unknown which hinders further improvement of the properties of this compound. In this talk, Assil will show how first-principles molecular dynamics can be combined to machine-learning interatomic potentials to achieve an accurate determination of the atomic-scale structure of this ceramic material. A particular focus will be put on the use of machine learning to extend time- and size-scales beyond those achieved solely by resorting to state-of-the-art ab-initio modelling. Finally, they will show an example of high-throughput calculation used to determine the previously unknown structure of the crystalline phase of AsTe3., Formation Descriptors for High-Entropy High-Hardness Metal Carbides. Presented by Corey Oses, Postdoctoral Fellow, Duke University. Disorder is both intrinsic to all materials, and also a route to enhanced functionality. A combination of 1) high chemical disorder and 2) metal-nonmetal bonding offers a new direction for thermal protection materials, wear-resistant coatings, batteries, and catalysts. Engineering these materials for applications demands an understanding of the mechanisms governing synthesizability and other entropy-driven behaviour, a challenging task often resolved within a limited context or neglected altogether. A simple modeling paradigm is presented that has already led to the discovery of new metal-carbide systems achieving high hardness values as predicted. Additional factors within the framework are being considered to address the delicate balance between entropy maximization and induced enthalpic penalties that become important in other ceramic systems., Artificial Intelligence for materials design: advances and remaining challenges. Presented by Adama Tandia, Senior Research Associate, Corning Incorporated. Use of artificial intelligence with materials data sets has significantly improved the speed of discovery of new materials with improved attributes. In the field of glass and polymer design, combinations of different regression methods, such as genetic algorithm, Gaussian processes, and neural networks, and data generation methods, such as molecular dynamics and density functional theory, has led to robust design methods, and near defect free manufacturing processes. Yet, despite the many successes, many serious challenges for faster and more robust algorithms remain before the design and manufacture of materials with optimal characteristics., Machine-learning correlations between structure and dynamics in supercooled liquids and glasses. Presented by Dr Gerhard Jung, PostDoc, CNRS. One of the most fundamental problems in the field of glass physics is understanding the connection between amorphous, microscopic structure and structural relaxation. While for crystals it is well know that relaxation is induced by well-defined `defects' in the ordered structure, finding an analogous definition for `amorphous defects' in glasses remains to be a great challenge. Many physically-motivated structural descriptors have been suggested to predict dynamical properties from structure with good success but it could be shown in recent years that machine-learned descriptors have the potential to be far superior. In my talk, I will give a brief summary on different machine-learning technique that have recently been applied to study the physics of the glass transition. Based on this summary, I will discuss open challenges and potential machine-learning approaches which we are currently pursuing to work towards better characterizing structural relaxation in amorphous materials and quantifying its correlation to the microscopic structure., This programme covers basic concepts such as modelling to discovery of new metal-carbide systems with high hardness values. It additionally covered applied aspects about glass science, ceramics science and their manufacturing to develop life-changing innovations and products. This webinar is focused on the use of machine learning in the area of ceramics and glasses and therefore will have an impact on academics working in the area and on industry. Three important take away benefits for participants: Fundamental knowledge on the use of machine learning in the discovery and design of ceramics/glasses; Understanding digitalization in ceramic/glass industry; Knowledge about the development of machine learning the ceramic/glass field in UK., First-principles and machine learning modelling of ceramic materials: the case of AsTe3 thermoelectric material. Presented by Assil Bouzid, Researcher, CNRS. The search for high performing thermoelectric materials led recently to the development of a new crystalline compound with composition AsTe3, that exhibits a very low thermal conductivity and an interesting figure of merit (ZT) peak value of 0.3 at 405 K, indicative of its thermoelectric performance. Nevertheless, the atomic-scale structure of both crystalline and amorphous AsTe3 remain unknown which hinders further improvement of the properties of this compound. In this talk, Assil will show how first-principles molecular dynamics can be combined to machine-learning interatomic potentials to achieve an accurate determination of the atomic-scale structure of this ceramic material. A particular focus will be put on the use of machine learning to extend time- and size-scales beyond those achieved solely by resorting to state-of-the-art ab-initio modelling. Finally, they will show an example of high-throughput calculation used to determine the previously unknown structure of the crystalline phase of AsTe3., Formation Descriptors for High-Entropy High-Hardness Metal Carbides. Presented by Corey Oses, Postdoctoral Fellow, Duke University. Disorder is both intrinsic to all materials, and also a route to enhanced functionality. A combination of 1) high chemical disorder and 2) metal-nonmetal bonding offers a new direction for thermal protection materials, wear-resistant coatings, batteries, and catalysts. Engineering these materials for applications demands an understanding of the mechanisms governing synthesizability and other entropy-driven behaviour, a challenging task often resolved within a limited context or neglected altogether. A simple modeling paradigm is presented that has already led to the discovery of new metal-carbide systems achieving high hardness values as predicted. Additional factors within the framework are being considered to address the delicate balance between entropy maximization and induced enthalpic penalties that become important in other ceramic systems., Artificial Intelligence for materials design: advances and remaining challenges. Presented by Adama Tandia, Senior Research Associate, Corning Incorporated. Use of artificial intelligence with materials data sets has significantly improved the speed of discovery of new materials with improved attributes. In the field of glass and polymer design, combinations of different regression methods, such as genetic algorithm, Gaussian processes, and neural networks, and data generation methods, such as molecular dynamics and density functional theory, has led to robust design methods, and near defect free manufacturing processes. Yet, despite the many successes, many serious challenges for faster and more robust algorithms remain before the design and manufacture of materials with optimal characteristics., Machine-learning correlations between structure and dynamics in supercooled liquids and glasses. Presented by Dr Gerhard Jung, PostDoc, CNRS. One of the most fundamental problems in the field of glass physics is understanding the connection between amorphous, microscopic structure and structural relaxation. While for crystals it is well know that relaxation is induced by well-defined `defects' in the ordered structure, finding an analogous definition for `amorphous defects' in glasses remains to be a great challenge. Many physically-motivated structural descriptors have been suggested to predict dynamical properties from structure with good success but it could be shown in recent years that machine-learned descriptors have the potential to be far superior. In my talk, I will give a brief summary on different machine-learning technique that have recently been applied to study the physics of the glass transition. Based on this summary, I will discuss open challenges and potential machine-learning approaches which we are currently pursuing to work towards better characterizing structural relaxation in amorphous materials and quantifying its correlation to the microscopic structure.

Published
2022

45. Perovskite multifunctional logic gates via bipolar photoresponse of single photodetector

Author

Kim, W. (Woochul), Kim, H. (Hyeonghun), Yoo, T. J. (Tae Jin), Lee, J. Y. (Jun Young), Jo, J. Y. (Ji Young), Lee, B. H. (Byoung Hun), Sasikala, A. A. (Assa Aravindh), Jung, G. Y. (Gun Young), Pak, Y. (Yusin), Kim, W. (Woochul), Kim, H. (Hyeonghun), Yoo, T. J. (Tae Jin), Lee, J. Y. (Jun Young), Jo, J. Y. (Ji Young), Lee, B. H. (Byoung Hun), Sasikala, A. A. (Assa Aravindh), Jung, G. Y. (Gun Young), and Pak, Y. (Yusin)

Abstract

The explosive demand for a wide range of data processing has sparked interest towards a new logic gate platform as the existing electronic logic gates face limitations in accurate and fast computing. Accordingly, optoelectronic logic gates (OELGs) using photodiodes are of significant interest due to their broad bandwidth and fast data transmission, but complex configuration, power consumption, and low reliability issues are still inherent in these systems. Herein, we present a novel all-in-one OELG based on the bipolar spectral photoresponse characteristics of a self-powered perovskite photodetector (SPPD) having a back-to-back p⁺-i-n-p-p⁺ diode structure. Five representative logic gates (“AND”, “OR”, “NAND”, “NOR”, and “NOT”) are demonstrated with only a single SPPD via the photocurrent polarity control. For practical applications, we propose a universal OELG platform of integrated 8 × 8 SPPD pixels, demonstrating the 100% accuracy in five logic gate operations irrelevant to current variation between pixels.

Published
2022

46. Factors Associated With Family Medicine and Internal Medicine First-Year Residents’ Ambulatory Care Training Time

Author

Jung G. Kim, Hector P. Rodriguez, Stephen M. Shortell, Eric S. Holmboe, Bruce Fuller, and Diane R. Rittenhouse

Subjects
Adult, medicine.medical_specialty, Time Factors, 020205 medical informatics, education, Training time, Graduate medical education, MEDLINE, Context (language use), 02 engineering and technology, Environment, Medicare, Accreditation, Education, 03 medical and health sciences, 0302 clinical medicine, Ambulatory care, Internal medicine, Ambulatory Care, Internal Medicine, 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, 030212 general & internal medicine, Receipt, Medicaid, Internship and Residency, General Medicine, United States, Cross-Sectional Studies, Education, Medical, Graduate, Family medicine, Family Practice
Abstract

PURPOSE Despite the importance of training in ambulatory care settings for residents to acquire important competencies, little is known about the organizational and environmental factors influencing the relative amount of time primary care residents train in ambulatory care during residency. The authors examined factors associated with postgraduate year 1 (PGY-1) residents' ambulatory care training time in Accreditation Council for Graduate Medical Education (ACGME)-accredited primary care programs. METHOD U.S.-accredited family medicine (FM) and internal medicine (IM) programs' 2016-2017 National Graduate Medical Education (GME) Census data from 895 programs within 550 sponsoring institutions (representing 13,077 PGY-1s) were linked to the 2016 Centers for Medicare and Medicaid Services Cost Reports and 2015-2016 Area Health Resource File. Multilevel regression models examined the association of GME program characteristics, sponsoring institution characteristics, geography, and environmental factors with PGY-1 residents' percentage of time spent in ambulatory care. RESULTS PGY-1 mean (standard deviation, SD) percent time spent in ambulatory care was 25.4% (SD, 0.4) for both FM and IM programs. In adjusted analyses (% increase [standard error, SE]), larger faculty size (0.03% [SE, 0.01], P < .001), sponsoring institution's receipt of Teaching Health Center (THC) funding (6.6% (SE, 2.7), P < .01), and accreditation warnings (4.8% [SE, 2.5], P < .05) were associated with a greater proportion of PGY-1 time spent in ambulatory care. Programs caring for higher proportions of Medicare beneficiaries spent relatively less time in ambulatory care (< 0.5% [SE, 0.2], P < .01). CONCLUSIONS Ambulatory care time for PGY-1s varies among ACGME-accredited primary care residency programs due to the complex context and factors primary care GME programs operate under. Larger ACGME-accredited FM and IM programs and those receiving federal THC GME funding had relatively more PGY-1 time spent in ambulatory care settings. These findings inform policies to increase resident exposure in ambulatory care, potentially improving learning, competency achievement, and primary care access.

Published
2020

47. Racial and Ethnic Differences in Internal Medicine Residency Assessments

Author

Dowin, Boatright, Nientara, Anderson, Jung G, Kim, Eric S, Holmboe, William A, McDade, Tonya, Fancher, Cary P, Gross, Sarwat, Chaudhry, Mytien, Nguyen, Max Jordan, Nguemeni Tiako, Eve, Colson, Yunshan, Xu, Fangyong, Li, James D, Dziura, and Somnath, Saha

Subjects
General Medicine
Abstract

ImportancePrevious studies have demonstrated racial and ethnic inequities in medical student assessments, awards, and faculty promotions at academic medical centers. Few data exist about similar racial and ethnic disparities at the level of graduate medical education.ObjectiveTo examine the association between race and ethnicity and performance assessments among a national cohort of internal medicine residents.Design, Setting, and ParticipantsThis retrospective cohort study evaluated assessments of performance for 9026 internal medicine residents from the graduating classes of 2016 and 2017 at Accreditation Council of Graduate Medical Education (ACGME)–accredited internal medicine residency programs in the US. Analyses were conducted between July 1, 2020, and June 31, 2022.Main Outcomes and MeasuresThe primary outcome was midyear and year-end total ACGME Milestone scores for underrepresented in medicine (URiM [Hispanic only; non-Hispanic American Indian, Alaska Native, or Native Hawaiian/Pacific Islander only; or non-Hispanic Black/African American]) and Asian residents compared with White residents as determined by their Clinical Competency Committees and residency program directors. Differences in scores between Asian and URiM residents compared with White residents were also compared for each of the 6 competency domains as supportive outcomes.ResultsThe study cohort included 9026 residents from 305 internal medicine residency programs. Of these residents, 3994 (44.2%) were female, 3258 (36.1%) were Asian, 1216 (13.5%) were URiM, and 4552 (50.4%) were White. In the fully adjusted model, no difference was found in the initial midyear total Milestone scores between URiM and White residents, but there was a difference between Asian and White residents, which favored White residents (mean [SD] difference in scores for Asian residents: −1.27 [0.38]; P P P Conclusions and RelevanceIn this cohort study, URiM and Asian internal medicine residents received lower ratings on performance assessments than their White peers during the first and second years of training, which may reflect racial bias in assessment. This disparity in assessment may limit opportunities for physicians from minoritized racial and ethnic groups and hinder physician workforce diversity.

Published
2022

48. Microscopic-plastic deformation behavior of grain boundary precipitates in an Al–Zn–Mg alloy

Author

Sangyul Ha, Saif Haider Kayani, Kyungjun Lee, Suwon Park, Hyunjoo Choi, Jae Bok Seol, Jung Gi Kim, and Hyokyung Sung

Subjects
Al-Zn-Mg alloy, Grain boundary precipitates, Homogenization treatment, Micropillar compression, Crystal plasticity finite element method, Mining engineering. Metallurgy, TN1-997
Abstract

The nano-precipitates with minimal misfit strengthen Al–Zn–Mg alloys by impeding dislocation motion. However, grain boundary precipitates (GBPs) are known to have a completely incoherent relationship with the matrix, making them less effective in strengthening the alloys. Instead, GBPs are recognized for preoccupying elements such as Zn or Mg, thereby diminishing the quantity of nano-strengthening phases. GBPs significantly influence the deformation and fracture behaviors of Al–Zn–Mg alloys by accelerating stress localization and crack formation. In this study, we investigated how the accumulation of dislocations in the GBP areas leads to stress localization and subsequent cracking, using micropillar tests and crystal plasticity finite element method (CP-FEM) analysis. The dislocation pile-up in the GBPs causes stress localization around the grain boundaries, inducing crack initiation and leading to intergranular fracture. These findings enhance our understanding of the role of GBPs in the deformation and cracking of Al–Zn–Mg alloys and may pave the way for new concepts in managing GBPs.

Published
2024
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49. Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports

Author

Jihoon Hong, Gab Chul Kim, Jung Guen Cha, Jongmin Park, Byunggeon Park, Seo Young Park, and Sang Un Kim

Subjects
afferent loop syndrome, drainage, decompression, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Published
2024
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50. Effect of stabilization annealing on fatigue crack propagation behavior of inconel 706 alloy at 25 and 650 °C

Author

Youngbin Kim, Jeongbin Bae, Junmin Lee, Hoseong Kang, Jung Gi Kim, and Sangshik Kim

Subjects
Mining engineering. Metallurgy, TN1-997
Abstract

Stabilization annealing (SA) treatment is often performed on precipitation-hardened IN706 (Ni-37.7Fe-15.6Cr–3Nb-1.7Ti-0.23Al) before aging to improve the resistance to creep, while sacrificing the tensile properties. In this study, the effect of SA treatment on fatigue crack propagation (FCP) behavior of IN706 at 25 and 650 °C was examined based on detailed fractographic and micrographic analyses. IN706 specimen with SA treatment at 845 °C for 3 h showed a considerable amount of η precipitates, that were located along grain boundaries and within grains. It was found that η precipitates, particularly those linearly aligned within grains, provided easy crack path, reducing the resistance to FCP of IN706 at both 25 and 650 °C.

Published
2024
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