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The timeliness of patient care is often subject to the requirements of the prior authorization process for health insurance. From the perspective of insurance denials and administrative burdens, each stakeholder, including the patient, healthcare organization, and the payor, experience a degree of risk that requires the need to remove barriers affecting the prior authorization process. These challenges, however, can be combatted by seeking to enhance the communication between all stakeholders and integrating technology in a manner that creates a more efficient and effective prior authorization process.

Independent reports note the significance of gut microbiota on lung disease severity; however, studies using murine models to define the role of the gut microbiome in pulmonary fibrosis progression are missing. We used the bleomycin murine model to quantify lung fibrosis in C57BL/6J mice housed in germ-free, animal biosafety level 1 (ABSL-1), or animal biosafety level 2 (ABSL-2) environments. Mice housed in gnotobiotic facilities are protected from bleomycin-induced pulmonary fibrosis, while ABSL-1 and ABSL-2 mice develop mild fibrosis and severe lung fibrosis, respectively. Metagenomic analysis of the gut microbiota revealed greater microbial diversity in ABSL-1 compared to ABSL-2 mice, with an increased presence of Lactobacilli and Bifidobacterium in ABSL-1 mice. Flow cytometric analysis of single-cell lung suspensions revealed enhanced IL-6/STAT3 /IL-17A signaling in CD4+ T cells of ABSL-2 mice, compared to ABSL-1 or germ-free mice. Fecal microbiota transplantation (FMT) of low microbial diverse stool (ABSL-2) into germ-free mice before bleomycin administration recapitulated the severe fibrosis phenotype, whereas FMT of ABSL-1 stool induced minimal fibrosis. These findings strongly support a causal role of the gut microbiota in augmenting pulmonary fibrosis severity after acute lung injury.

To gain a deeper understanding of pancreatic β-cell development, we used iterative weighted gene correlation network analysis to calculate a gene co-expression network (GCN) from 11 temporally and genetically defined murine cell populations. The GCN, which contained 91 distinct modules, was then used to gain three new biological insights. First, we found that the clustered protocadherin genes are differentially expressed during pancreas development. Pcdhγ genes are preferentially expressed in pancreatic endoderm, Pcdhβ genes in nascent islets, and Pcdhα genes in mature β-cells. Second, after extracting sub-networks of transcriptional regulators for each developmental stage, we identified 81 zinc finger protein (ZFP) genes that are preferentially expressed during endocrine specification and β-cell maturation. Third, we used the GCN to select three ZFPs for further analysis by CRISPR mutagenesis of mice. Zfp800 null mice exhibited early postnatal lethality, and at E18.5 their pancreata exhibited a reduced number of pancreatic endocrine cells, alterations in exocrine cell morphology, and marked changes in expression of genes involved in protein translation, hormone secretion and developmental pathways in the pancreas. Together, our results suggest that developmentally oriented GCNs have utility for gaining new insights into gene regulation during organogenesis.

Purpose – The purpose of this paper is to provide information regarding the ways in which the authors’ College’s faculty use paper within their pedagogical practice. A related purpose was to ascertain faculty interest in professional development initiatives related to reducing paper usage through technological affordances. Design/methodology/approach – A survey was developed and administered to the faculty within the university’s Teachers College. The survey was built to assess faculty pedagogical use of paper. Both quantitative and qualitative data were collected via the survey. Findings – The results suggested that digital resources are widely used by faculty, and students are encouraged to conserve paper. However, many faculty are uncomfortable with the complete elimination of paper. Originality/value – Modeling and promoting environmentally sustainable pedagogical practice is imperative within institutions charged with preparing the next generation of educators.

The human mind is quite adept at modifying and regulating thoughts, judgments, and behaviors. Recent research has demonstrated that depletion of self-regulatory resources can impair executive function through restriction of working memory capacity. The current work explored whether the mere perception of resource depletion (i.e., illusory fatigue) is sufficient to directly produce these deficits in executive control. To manipulate illusory fatigue, participants were exposed to a depleting or nondepleting task before being presented with false feedback about the effects of the initial task on their state of resource depletion. Participants then completed a well-established index of working memory capacity. Findings revealed that individuals provided with feedback that led to perceptions of low depletion exhibited greater working memory capacity. This effect was independent of individuals' actual state of depletion and was furthermore mediated by their perceived level of depletion. Implications for spontaneous resource replenishment are discussed.