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Locked Down After A School Shooting
After a school shooting disrupts his family's life, a physician calls for action on gun control and gun violence.After a school shooting disrupts his family's life, a physician calls for action on gun control and gun violence.
Journal Article
Black Lightning. Cold dead hands
\"In his home town of Cleveland, high school teacher Jefferson Pierce is a role model for his students. As Black Lightning, he's fighting to keep them safe, even as his city's streets are invaded by local gangs with deadly super-weapons. And wait until you see who their supplier is\"-- Provided by publisher.
Book
BETTER PATIENT FLOW BY MANAGING CHANGE
As health care demands more efficiency within hospitals, it's possible to adapt existing teams to respond to the challenge in a transformative way. Here's how physician leaders and administrators at one facility did it.
Journal Article
First Radial Velocity Results From the MINiature Exoplanet Radial Velocity Array (MINERVA)
The MINiature Exoplanet Radial Velocity Array (MINERVA) is a dedicated observatory of four 0.7 m robotic telescopes fiber-fed to a KiwiSpec spectrograph. The MINERVA mission is to discover super-Earths in the habitable zones of nearby stars. This can be accomplished with MINERVA's unique combination of high precision and high cadence over long time periods. In this work, we detail changes to the MINERVA facility that have occurred since our previous paper. We then describe MINERVA's robotic control software, the process by which we perform 1D spectral extraction, and our forward modeling Doppler pipeline. In the process of improving our forward modeling procedure, we found that our spectrograph's intrinsic instrumental profile is stable for at least nine months. Because of that, we characterized our instrumental profile with a time-independent, cubic spline function based on the profile in the cross dispersion direction, with which we achieved a radial velocity precision similar to using a conventional \"sum-of-Gaussians\" instrumental profile: 1.8 m s−1 over 1.5 months on the RV standard star HD 122064. Therefore, we conclude that the instrumental profile need not be perfectly accurate as long as it is stable. In addition, we observed 51 Peg and our results are consistent with the literature, confirming our spectrograph and Doppler pipeline are producing accurate and precise radial velocities.
Journal Article
Preliminary predictive criteria for COVID-19 cytokine storm
ObjectivesTo develop predictive criteria for COVID-19-associated cytokine storm (CS), a severe hyperimmune response that results in organ damage in some patients infected with COVID-19. We hypothesised that criteria for inflammation and cell death would predict this type of CS.MethodsWe analysed 513 hospitalised patients who were positive for COVID-19 reverse transcriptase PCR and for ground-glass opacity by chest high-resolution CT. To achieve an early diagnosis, we analysed the laboratory results of the first 7 days of hospitalisation. We implemented logistic regression and principal component analysis to determine the predictive criteria. We used a ‘genetic algorithm’ to derive the cut-offs for each laboratory result. We validated the criteria with a second cohort of 258 patients.ResultsWe found that the criteria for macrophage activation syndrome, haemophagocytic lymphohistiocytosis and the HScore did not identify the COVID-19 cytokine storm (COVID-CS). We developed new predictive criteria, with sensitivity and specificity of 0.85 and 0.80, respectively, comprising three clusters of laboratory results that involve (1) inflammation, (2) cell death and tissue damage, and (3) prerenal electrolyte imbalance. The criteria identified patients with longer hospitalisation and increased mortality. These results highlight the relevance of hyperinflammation and tissue damage in the COVID-CS.ConclusionsWe propose new early predictive criteria to identify the CS occurring in patients with COVID-19. The criteria can be readily used in clinical practice to determine the need for an early therapeutic regimen, block the hyperimmune response and possibly decrease mortality.
Journal Article
DISCUSSION ARTICLE EMPOWERMENT AND LEADER-MEMBER EXCHANGE QUALITY IN PHYSICIANS
Physician empowerment as clinical leaders of interprofessional healthcare teams can drive culture. Organizational culture can reduce safety events and enhance quality when successfully instituted in healthcare organizations. This study examined the association between leader-member exchange quality and a physician's ability to empower team members at U.S. academic medical centers. Data collection included survey responses from 20 physicians at 15 academic medical centers in the United States and 93 of their team members who completed empowering leadership and leader-member exchange quality surveys. Analysis of the results suggests a statistically significant relationship exists between empowerment behavior in physicians and leader-member exchange quality between physicians and their team members. Understanding how interpersonal relationships can empower frontline clinical team members may lead to improved healthcare outcomes.
Journal Article
Empowerment, Personality, and Leader-Member Exchange Quality in Physicians
Nearly 100,000 people suffer injury or death each year due to errors in the United States healthcare system. Researchers have identified that empowerment by physicians can address this significant social issue. Despite this knowledge, qualifications to empowering behaviors in physicians have not been identified. A quantitative nonexperimental correlation approach was used to determine the role that personality type and high-quality leader-member exchange may play in the physician’s ability to create empowerment at academic medical centers in the United States. The theoretical framework of empowering leadership, Jung’s psychological types, and leader-member exchange quality informed the research design and contributed to the understanding of the findings. Data collection included the Myers-Briggs Type Indicator responses from 20 physicians at academic medical centers in the United States. In addition, 93 followers completed the empowering leadership and the leader-member exchange quality surveys. Analysis of covariance and partial correlation analysis using Pearson’s correlation coefficient were used to answer the study questions. The results of the study demonstrate that no statistically significant relationship exists between empowering behavior and personality type or between leader-member exchange quality and personality type. A statistically significant relationship exists between empowering behavior and leader-member exchange quality. The social change implications include an opportunity to enhance physicians’ skills as leaders of interprofessional teams. Those enhanced skills may contribute to improved healthcare outcomes, decreased societal morbidity, and increased life expectancy, thereby contributing positively to social change.
Dissertation
First Radial Velocity Results From the MINiature Exoplanet Radial Velocity Array (MINERVA)
The MINiature Exoplanet Radial Velocity Array (MINERVA) is a dedicated observatory of four 0.7 m robotic telescopes fiber-fed to a KiwiSpec spectrograph. The MINERVA mission is to discover super-Earths in the habitable zones of nearby stars. This can be accomplished with MINERVA’s unique combination of high precision and high cadence over long time periods. In this work, we detail changes to the MINERVA facility that have occurred since our previous paper. We then describe MINERVA’s robotic control software, the process by which we perform 1D spectral extraction, and our forward modeling Doppler pipeline. In the process of improving our forward modeling procedure, we found that our spectrograph’s intrinsic instrumental profile is stable for at least nine months. Because of that, we characterized our instrumental profile with a time-independent, cubic spline function based on the profile in the cross dispersion direction, with which we achieved a radial velocity precision similar to using a conventional “sum-of-Gaussians” instrumental profile: 1.8 m s−1 over 1.5 months on the RV standard star HD 122064. Therefore, we conclude that the instrumental profile need not be perfectly accurate as long as it is stable. In addition, we observed 51 Peg and our results are consistent with the literature, confirming our spectrograph and Doppler pipeline are producing accurate and precise radial velocities.
Journal Article