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Background: Increasingly, patient satisfaction scores are being used to assess emergency physicians. We sought to determine whether the patient satisfaction scores collected by our hospital system are lower for patients who are treated in the emergency department (ED) on night shifts as compared to those treated on day shifts.Methods: We performed a cross-sectional analysis of patient satisfaction scores from three EDs in Florida. We obtained satisfaction data from NRC Health (the company that provides our surveys) using a random sample of 1,000 completed surveys from patients treated in 2022; we also performed manual chart review to obtain clinical data. The satisfaction surveys asked patients how likely they would be to recommend the facility (from 0–10). Patients who provided a score of 9 or 10 were considered “promoters.” For our primary analysis, we compared the percentage of promoters for the day shift encounters (7 AM to 7 PM) to the night shift encounters (7 PM to 7 AM). We also performed a multivariable logistic regression analysis using several demographic and clinical variables to further assess the association between night shift arrival and satisfaction scores.Results: Of the 1,000 surveys analyzed, 66.3% of patients arrived during the day shift, and 33.7%arrived during the night shift. Of those who arrived during the day shift, 525 (79.2%) were promoters compared to 228 (67.7%) of those who arrived during the night shift, a difference of 11.5% (95%confidence interval [CI] 5.7–17.4%), P < 0.001. On multivariable analysis, night shift arrival was associated with a lower chance of a patient being a promoter, with adjusted odds ratio 0.60 (95% CI 0.43–0.84), P = 0.003.Conclusion: Patients who presented to the ED during the night shift were less likely to be promoters than patients who arrived during the day shift. Assessments of patient satisfaction data should account for time of visit and other facility-related and operational characteristics.

Abstract We present a method for improving the performance of microwave coplanar resonators in magnetic fields, by using narrow superconducting strips of width close to the London penetration depth. In a range of low fields, the narrow strips inhibit the presence of magnetic vortices, thus preventing the generation of losses caused by their motion, leading to enhanced resistance to magnetic fields. Our method provides a more straightforward solution compared to previously proposed techniques designed to restrict vortex motion, holding potential for the development of improved devices based on microwave resonators.

Background: Increasingly, patient satisfaction scores are being used to assess emergency physicians. We sought to determine whether the patient satisfaction scores collected by our hospital system are lower for patients who are treated in the emergency department (ED) on night shifts as compared to those treated on day shifts. Methods: We performed a cross-sectional analysis of patient satisfaction scores from three EDs in Florida. We obtained satisfaction data from NRC Health (the company that provides our surveys) using a random sample of 1,000 completed surveys from patients treated in 2022; we also performed manual chart review to obtain clinical data. The satisfaction surveys asked patients how likely they would be to recommend the facility (from 0–10). Patients who provided a score of 9 or 10 were considered “promoters.” For our primary analysis, we compared the percentage of promoters for the day shift encounters (7 AM to 7 PM) to the night shift encounters (7 PM to 7 AM). We also performed a multivariable logistic regression analysis using several demographic and clinical variables to further assess the association between night shift arrival and satisfaction scores. Results: Of the 1,000 surveys analyzed, 66.3% of patients arrived during the day shift, and 33.7% arrived during the night shift. Of those who arrived during the day shift, 525 (79.2%) were promoters compared to 228 (67.7%) of those who arrived during the night shift, a difference of 11.5% (95% confidence interval [CI] 5.7–17.4%), P

Abstract Tetrapyrroles such as heme, chlorophyll, and vitamin B12 are essential for various metabolic pathways. They derive from 5-aminolevulinic acid (5-ALA), which can be synthesized by a single enzyme (5-ALA synthase or AlaS, Shemin pathway) or by a two-enzyme pathway. The genomes of some bacteriophages from aquatic environments carry various tetrapyrrole biosynthesis genes. Here, we analyze available metagenomic datasets and identify alaS homologs (viral alaS, or valaS) in sequences corresponding to marine and freshwater phages. The genes are found individually or as part of complete or truncated three-gene loci encoding heme-catabolizing enzymes. Amino-acid sequence alignments and three-dimensional structure prediction support that the valaS sequences likely encode functional enzymes. Indeed, we demonstrate that is the case for a freshwater phage valaS sequence, as it can complement an Escherichia coli 5-ALA auxotroph, and an E. coli strain overexpressing the gene converts the typical AlaS substrates glycine and succinyl-CoA into 5-ALA. Thus, our work identifies valaS as an auxiliary metabolic gene in phage sequences from aquatic environments, further supporting the importance of tetrapyrrole metabolism in bacteriophage biology.

Simulation is well-documented as an effective pedagogy in teaching social work practice. However, the financial and human resources needed to provide simulation-based teaching in large social work programs are prohibitive. Partnering with other disciplines with established simulation programs is one way to bring simulation to social work students through interprofessional education. This teaching note presents a pedagogical initiative designed to enhance social work, nursing, and pharmacy students' collaboration on acute care teams. Leveraging social work's perspectives, the simulation scenario used in this initiative was modified to incorporate a biopsychosocial perspective for assessing and engaging with issues of race, ethnicity, and economic hardship often seen in acute care settings. Implications for curriculum development, pedagogical strategies, and interprofessional education opportunities are discussed.

Many experiments at radioactive ion beam (RIB) facilities suffer from isobaric contamination, i.e. unwanted ions of similar mass. During the last decade, Multi-Reflection Time-of-Flight (MR-ToF) devices have gained remarkable attention for mass separation of short-lived, low-intensity beams of radionuclides at RIB facilities throughout the world. They exceed mass resolving powers m/Δm of 105 within a processing time of some (tens of) milliseconds. Due to space-charge effects, however, the mass separation remains an experimental challenge when many ions are simultaneously confined in the MR-ToF device. This limits the wider application of MR-ToF mass separators at RIB facilities. By performing ion-optical simulations including space-charge effects, we investigate different schemes of ion preparation in a Paul trap upstream of the MR-ToF device as well as MR-ToF operation and study their influence on mass separation and maximal ion flux. The validity of these simulations are benchmarked by time-of-flight and collision-induced fluorescence measurements with a 1.5 keV MR-ToF device. More advanced ion-beam preparation techniques such as the use of laser cooling, buffer-gas cooling at cryogenic temperatures or specific electric-field parameters for ion trapping and ejection from the Paul trap can significantly reduce the processing time needed to reach a given mass resolving power. However, the simulations of these methods also indicate that space-charge effects in the MR-ToF device become relevant at lower ion numbers compared to ’standard’ ion preparation. Thus, the overall amount of mass separated ions per unit of time remains essentially the same. In contrast, the simulations suggest that increasing the kinetic energy of typically just a few kiloelectronvolts in present MR-ToF instruments to 30 keV results in a significant increase of the attainable maximal ion flux.

On March 15, 2024, in Moscow, the Russian Phlebological Association and the National Association of Specialists in Thrombosis, Clinical Hemostasiology and Hemorheology organized a meeting of the Council of Experts during the Russian Forum on Thrombosis and Hemostasis on the acute issues of venous thromboembolism (VTE) primary prevention using low molecular weight heparins (LMWH) in surgical patients with different body weight. The participants reviewed the relevance and prevalence of this problem in surgical practice, discussed risk factors and the frequency of VTE development, including bleeding in the postoperative period, and the Caprini risk score for complications. The discussion also focused on standard and personalized LMWH doses for primary prophylaxis of VTE in the perioperative period in surgical patients, depending on body weight, and the role of laboratory tests, including assessment of LMWH anti-Xa activity for monitoring the efficacy and safety of VTE primary prevention in clinical practice.

Due to COVID-19, the world has encountered new challenges regarding pedagogy, learning, assessment, and evaluation. In meeting these challenges, there have been rapid changes in learning, and the gap between pedagogy and evaluation has grown. The purpose of this paper is to develop a new evaluative model suitable for the technologically enhanced, multicultural environment of the 21st century. In this article, we develop a unique multidimensional model of Culturally Relevant Academic Evaluation (CRAE) that fills a gap in the scientific literature on evaluation in higher education. The model depicts evaluation as an integrated process of four dimensions: two of them based on the well-established dimensions of learning and curriculum, and two based on the novel dimensions of inclusive multiculturalism and technology. We consider evaluation in its broad context in higher education, and we analyze the interrelations between the four dimensions of the evaluation process, discussing their contribution to the enhancement of evaluation in higher education.

Comentario de Agrietar la Uni-versidad. Reflexiones interculturales y decoloniales por/para la vida de Catherine Walsh.

Alpha-synuclein (aSyn) aggregates in the central nervous system are the main pathological hallmark of Parkinson’s disease (PD). ASyn aggregates have also been detected in many peripheral tissues, including the skin, thus providing a novel and accessible target tissue for the detection of PD pathology. Still, a well-established validated quantitative biomarker for early diagnosis of PD that also allows for tracking of disease progression remains lacking. The main goal of this research was to characterize aSyn aggregates in skin biopsies as a comparative and quantitative measure for PD pathology. Using direct stochastic optical reconstruction microscopy (dSTORM) and computational tools, we imaged total and phosphorylated-aSyn at the single molecule level in sweat glands and nerve bundles of skin biopsies from healthy controls (HCs) and PD patients. We developed a user-friendly analysis platform that offers a comprehensive toolkit for researchers that combines analysis algorithms and applies a series of cluster analysis algorithms (i.e., DBSCAN and FOCAL) onto dSTORM images. Using this platform, we found a significant decrease in the ratio of the numbers of neuronal marker molecules to phosphorylated-aSyn molecules, suggesting the existence of damaged nerve cells in fibers highly enriched with phosphorylated-aSyn molecules. Furthermore, our analysis found a higher number of aSyn aggregates in PD subjects than in HC subjects, with differences in aggregate size, density, and number of molecules per aggregate. On average, aSyn aggregate radii ranged between 40 and 200 nm and presented an average density of 0.001–0.1 molecules/nm2. Our dSTORM analysis thus highlights the potential of our platform for identifying quantitative characteristics of aSyn distribution in skin biopsies not previously described for PD patients while offering valuable insight into PD pathology by elucidating patient aSyn aggregation status.

We present a MgB2-based Microwave Kinetic Inductance Detector (MKID) featuring a quality factor Qi ~ 105 and noise equivalent power NEP ~ 10−14 W/Hz at 2 K. In comparison to YBCO-based MKIDs, the MgB2 detector shows greater sensitivity to both temperature and magnetic field, a result of its two-gap nature and relatively low critical Hc2 field. Our data indicate that MgB2 is more advantageous for MKID applications at temperatures lower than 3 K.

Higher education acknowledges evaluation as a core component in pedagogy. However, K-12 institutions implement different applications of formative evaluation, and Higher Education Institutes (HEIs) still use traditional evaluation almost exclusively. Adjustments made for students with disabilities (SWDs) are often exam accommodations rather than modifications in the evaluation process itself. The current study aims to examine the perceptions of students from different cultural backgrounds and abilities on Culturally Responsive Academic Evaluation (CRAE), which also takes into consideration SWDs and sees them as a distinct cultural group. Universal Design for Learning (UDL) was used as a guiding framework for formative evaluation for students with and without disabilities. The study used a qualitative method through a phenomenological approach. Twelve undergraduate and graduate students were interviewed using in-depth semi-structured interviews. Results showed three themes concerning CRAE in higher education: Multiculturalism and diversity sensitivity, diversification in evaluation methods, and social responsibility. According to the participants' statements, the student population is ready for more flexible and diverse evaluation methods, as long as boundaries are set to preserve academic standards.

El xantoma óseo primario es una entidad clínica extremadamente infrecuente. Afecta en mayor proporción a hombres jóvenes, con mayor presentación en huesos planos del esqueleto axial. Esta patología puede aparecer en forma aislada (primaria) o secundaria (asociada a trastornos endocrinológicos y metabólicos como la hiperlipidemia). La causa secundaria siempre debe investigarse y descartarse, certificando normolipidemia. El abordaje terapéutico del xantoma debe adecuarse a las características de la lesión, su ubicación y la afectación de las estructuras vecinas. Presentamos el caso de una paciente de sexo femenino sin antecedentes de relevancia, con hallazgo incidental de lesión lítica costal por tomografía computarizada. Debido al riesgo de fractura e imposibilidad de descartar malignidad se realizó resección de cuerpo de quinta costilla derecha guiado por videotoracoscopia. El estudio histopatológico informó: cavidad medular con infiltrado de macrófagos espumosos y numerosos cristales de colesterol, confirmando el diagnóstico de xantoma óseo.

Introducción: los schwannomas son tumores benignos y frecuentes de las partes blandas. Habitualmente son asintomáticos y son descubiertos por otros motivos. Materiales y métodos: presentamos el caso de un paciente masculino de 82 años con diagnóstico reciente de adenocarcinoma de colon moderadamente diferenciado y con un nódulo periaórtico hipermetabólico como hallazgo incidental. Resultados: la biopsia percutánea del nódulo periaórtico confirmó el diagnóstico de schwannoma. Al año de seguimiento, se ha demostrado crecimiento del schwannoma. No hay signos de progresión de su enfermedad oncológica. Conclusión: los schwannomas son tumores benignos, infrecuentes en el retroperitoneo y pueden ser fuentes de resultados falsos positivos en tomografía por emisión de positrones.

Paula Ripamonti es doctora y profesora en Filosofía, especialista en Docencia Universitaria (UNCuyo) y postitulada en Investigación Educativa con Enfoque Socioantropológico (CEA-UNCórdoba, Ministerio de Educación de la Nación). Es docente efectiva de la cátedra de Antropología Filosófica de la carrera de Filosofía de la Facultad de Filosofía y Letras; y de Introducción a la Filosofía de la carrera de Abogacía de la Facultad de Derecho (UNCuyo). Docente titular del Instituto Superior de Formación Docente 9-001 “Gral. San Martín” y de programas de doctorado, maestría y especialización del campo de la filosofía y la educación. Trayectoria en dictado de seminarios de investigación y de narrativas pedagógicas. Actualmente es secretaria de Posgrado de la Facultad de Filosofía y Letras (UNCuyo) y evaluadora por la Región Cuyo de la Comisión Federal de Registro y Evaluación Permanente de las Ofertas de Educación a Distancia, designada por el Consejo Federal de Educación. Miembro fundadora del Centro de Investigaciones Interdisciplinarias de Filosofía en la Escuela (CIIFE-UNCuyo). Asimismo, es directora y editora responsable de Saberes y prácticas. Revista de Filosofía y Educación. La entrevista se realizó el 30 de abril de 2024 en Argentina.

This article challenges the assumptions about what spaces were actually private in the late early modern colonial world. Centered on a case of adultery amongst the Sephardic Jewish community of Curaçao in the late eighteenth century, this piece looks at the entangled lives of enslaved people, Dutch colonial officials, free people of color, Protestants, Catholics, and Jews. Gossip, private information transition, and the architecture and town planning of Willemstad, Curaçao, are integral to this story of community norms, legal systems, and colonial spaces.

Abstract Background and Aims Maintaining healthcare services and ensuring the presence of healthcare personnel (HCP) during periods of conflict and high-intensity warfare in Israel including the significant security event that occurred on May 2021, pose significant challenges for hospitals in the range of missile attacks. The May 2021 event, marked by intense hostilities and military actions, brought about heightened security escalations and increased risks in the region. Despite the prevailing threat of missile attacks and ongoing security concerns, hospitals in the affected areas were required to sustain their services and uphold care standards. In light of these circumstances, this study aims to identify the factors that influence the percentage of HCP reporting for work during these intense periods of security escalations and wartime in Israel. Specifically, it explores the relationships between resilience, sense of danger, and HCP absenteeism in the context of the ongoing conflict. The findings of this study can provide valuable insights for designing interventions aimed at decreasing HCP absenteeism during security escalations, wartime, and emergency situations, ultimately contributing to the resilience and effectiveness of healthcare delivery in this challenging environment. Methods During a relative calm period from December 2021 to January 2022, a cross-sectional study was conducted at a southern Israeli general hospital, situated within the range of missile attacks in the midst of a longstanding conflict. The study focused on HCP who were employed before May 21, which marked the end of the last war state at that time. The questionnaire, consisting of measures for resilience using the Conor-Davidson scale (CD-RISC 10) and the sense of danger assessed with the Solomon & Prager inventory, was administered online to all hospital employees at Assuta Ashdod Hospital, located in the southern city of Ashdod, Israel. This approach was chosen due to the challenging nature of conducting a study during an existing war, making it impractical to carry out the research during such periods of active war. Results In total, 390 employees completed the survey (response rate of 24%). Of this sample, 77.4% reported fully to work during the last security escalations in May 2021. Most of the sample (84.1%) felt insecure on the way to work. The HCP who reported fully to work had a higher level of resilience than employees who reported partially or did not come to work at all (p = .03). A higher sense of danger in the workplace correlated with a 73% increase in absenteeism (p

White matter bundle segmentation using diffusion MRI fiber tractography has become the method of choice to identify white matter fiber pathways in vivo in human brains. However, like other analyses of complex data, there is considerable variability in segmentation protocols and techniques. This can result in different reconstructions of the same intended white matter pathways, which directly affects tractography results, quantification, and interpretation. In this study, we aim to evaluate and quantify the variability that arises from different protocols for bundle segmentation. Through an open call to users of fiber tractography, including anatomists, clinicians, and algorithm developers, 42 independent teams were given processed sets of human whole-brain streamlines and asked to segment 14 white matter fascicles on six subjects. In total, we received 57 different bundle segmentation protocols, which enabled detailed volume-based and streamline-based analyses of agreement and disagreement among protocols for each fiber pathway. Results show that even when given the exact same sets of underlying streamlines, the variability across protocols for bundle segmentation is greater than all other sources of variability in the virtual dissection process, including variability within protocols and variability across subjects. In order to foster the use of tractography bundle dissection in routine clinical settings, and as a fundamental analytical tool, future endeavors must aim to resolve and reduce this heterogeneity. Although external validation is needed to verify the anatomical accuracy of bundle dissections, reducing heterogeneity is a step towards reproducible research and may be achieved through the use of standard nomenclature and definitions of white matter bundles and well-chosen constraints and decisions in the dissection process.