Abstract
Objective
Growth in big data and its potential impact on the healthcare industry have driven the need for more data scientists. In health care, big data can be used to improve care quality, ...increase efficiency, lower costs, and drive innovation. Given the importance of data scientists to U.S. healthcare organizations, I examine the qualifications and skills these organizations require for data scientist positions and the specific focus of their work.
Materials and Methods
A content analysis of U.S. healthcare data scientist job postings was conducted using an inductive approach to capture and categorize core information about each posting and a deductive approach to evaluate skills required. Profiles were generated for 4 job focus areas.
Results
There is a spectrum of healthcare data scientist positions that varies based on hiring organization type, job level, and job focus area. The focus of these positions ranged from performance improvement to innovation and product development with some positions more broadly defined to address organizational-specific needs. Based on the job posting sample, the primary skills these organizations required were statistics, R, machine learning, storytelling, and Python.
Conclusions
These results may be useful to organizations as they deepen our understanding of the qualifications and skills required for data scientist positions and may aid organizations in identifying skills and knowledge areas that have been overlooked in position postings.
Microplastic pollution within the marine environment is of pressing concern globally. Accordingly, spatial monitoring of microplastic concentrations, composition and size distribution may help to ...identify sources and entry pathways, and hence allow initiating focused mitigation. Spatial distribution patterns of microplastics were investigated in two compartments of the southern North Sea by collecting sublittoral sediment and surface water samples from 24 stations. Large microplastics (500−5000 μm) were detected visually and identified using attenuated total reflection (ATR) Fourier transform infrared (FTIR) spectroscopy. The remaining sample was digested enzymatically, concentrated onto filters and analyzed for small microplastics (11−500 μm) using Focal Plane Array (FPA) FTIR imaging. Microplastics were detected in all samples with concentrations ranging between 2.8 and 1188.8 particles kg−1 for sediments and 0.1–245.4 particles m−3 for surface waters. On average 98% of microplastics were <100 μm in sediments and 86% in surface waters. The most prevalent polymer types in both compartments were polypropylene, acrylates/polyurethane/varnish, and polyamide. However, polymer composition differed significantly between sediment and surface water samples as well as between the Frisian Islands and the English Channel sites. These results show that microplastics are not evenly distributed, in neither location nor size, which is illuminating regarding the development of monitoring protocols.
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•All 46 analyzed sediment and surface water samples contained microplastics.•Microplastic concentrations were higher in sediment than surface water samples.•Polymer composition differed significantly between surface waters and sediments.•Microplastics <500 μm were more abundant and divers in polymer type than large ones.•Particles smaller 100 μm dominated clearly in both environmental compartments.
Capsule: Microplastic concentrations and compositions differ significantly between environmental compartments. Geographic distribution patterns are revealed by a statistical approach. Microplastics <500 μm are more abundant and diverse than >500 μm ones, rendering the exclusive analysis of later ones insufficient for environmental risk assessment.
Changes in economic conditions and healthcare delivery models have shifted more healthcare costs to patients, resulting in greater patient financial responsibilities. As a result, it is important to ...understand the potential impact of financial literacy on patients' healthcare behavior. With the focus on delivering better health outcomes at lower costs, factors that influence patient behavior are important considerations for healthcare providers. Although researchers have proposed a variety of conceptual models that identify influential factors, those models do not fully address financial literacy and its potential impact patients' healthcare decisions. This article examines existing models of patient healthcare decision-making and current research on factors affecting patient decision-making and behavior and then presents recommendations for closing the identified gap in our current knowledge.
Microglia and central nervous system (CNS)-associated macrophages (CAMs), such as perivascular and meningeal macrophages, are implicated in virtually all diseases of the CNS. However, little is known ...about their cell-type-specific roles in the absence of suitable tools that would allow for functional discrimination between the ontogenetically closely related microglia and CAMs. To develop a new microglia gene targeting model, we first applied massively parallel single-cell analyses to compare microglia and CAM signatures during homeostasis and disease and identified hexosaminidase subunit beta (Hexb) as a stably expressed microglia core gene, whereas other microglia core genes were substantially downregulated during pathologies. Next, we generated Hexb
mice to stably monitor microglia behavior in vivo. Finally, the Hexb locus was employed for tamoxifen-inducible Cre-mediated gene manipulation in microglia and for fate mapping of microglia but not CAMs. In sum, we provide valuable new genetic tools to specifically study microglia functions in the CNS.
Unequal access to advanced learning opportunities is among the most complex and controversial issues in American K–12 schools. Interventions that address policy, programming, and instruction can ...provide opportunities for students with advanced learning needs in school systems that prioritize minimum grade-level standards. Excellence gaps are differences in advanced performance among student subgroups that result from inequities in education and society. In this systematic review of the literature, the authors identified 80 empirical research studies on strategies for reducing excellence gaps published between 2010 and 2021 and identified themes related to the seven facets of the Excellence Gap Intervention Model (K–12 school accountability support, teacher professional learning, expanded advanced learning opportunities, universal screening with local norms, frontloading, flexible ability grouping, psychosocial interventions). This analysis revealed substantial evidence of intervention development over the past decade and suggests a revised approach to equitable, advanced education that begins with preparation (e.g., teacher professional learning, student frontloading) and is followed by placement, evaluation, and adjustment as students’ learning needs change.
Aggregation of amyloid‐β (Aβ) that leads to the formation of plaques in Alzheimer's disease (AD) occurs through the stepwise formation of oligomers and fibrils. An earlier onset of aggregation is ...obtained upon intracerebral injection of Aβ‐containing brain homogenate into human APP transgenic mice that follows a prion‐like seeding mechanism. Immunoprecipitation of these brain extracts with anti‐Aβ oligomer antibodies or passive immunization of the recipient animals abrogated the observed seeding activity, although induced Aβ deposition was still evident. Here, we establish that, together with Aβ monomers, Aβ oligomers trigger the initial phase of Aβ seeding and that the depletion of oligomeric Aβ delays the aggregation process, leading to a transient reduction of seed‐induced Aβ deposits. This work extends the current knowledge about the role of Aβ oligomers beyond its cytotoxic nature by pointing to a role in the initiation of Aβ aggregation in vivo. We conclude that Aβ oligomers are important for the early initiation phase of the seeding process.
The patient's financial experience is often complex and confusing.
Recent regulations support bringing more transparency to healthcare billing processes.
A patient journey map illustrates the patient ...experience in a healthcare process helping to identify improvement opportunities to better support patient-centered care.
Price transparency can be increased by communicating the patient's financial responsibility early in the care process as well as simplifying patient communications.
Digital health applications can help improve the patient financial experience and ultimately engagement in the payment process.
Greater clarity and improved processes may occur if the patient's journey is visualized.
The COVID-19 pandemic has led to rapid change in health care, accelerating the use of digital health services, including telehealth. Moreover, growth in value-based care has compelled consumers to ...become more engaged in care processes. It has also provided opportunities to enhance patient experiences by increasing patients’ access to online health information and services. This study assessed online patient engagement practices for 6 common patient touchpoints by reviewing the websites of the top 32 hospitals, including the top 10 children’s hospitals. The great majority of these hospitals provided some information related to these patient touchpoints. However, the scope and extent of task automation varied significantly and many options were not convenient. Based on this study, it is clear that patient experience can be enhanced by improving online patient engagement, particularly during the current global pandemic.
The study of subduction-related high-pressure- and ultra-high-pressure metamorphic rocks exposed in orogenic belts is critical for unraveling the tectonothermal evolution of an orogen. The South ...Tianshan Orogen of the southwestern Central Asian Orogenic Belt, one of the world's largest accretionary orogens, contains several Paleozoic (ultra-)high-pressure ((U)HP) metamorphic terranes. (U)HP eclogites, blueschists and associated (U)HP metasedimentary rocks of continental and oceanic origin were reported from two localities in the Northern Tianshan (NTS) of Kazakhstan and Kyrgyzstan, namely from the Ordovician Aktyuz and Makbal metamorphic terranes. Furthermore Lower Carboniferous (U)HP eclogites and blueschists of oceanic origin are located in the Southern Tianshan Accretionary Complex (STAC) of southern Kyrgyzstan (Atbashi) and northwestern China (Akeyazi).
The continentally-derived Aktyuz eclogite is considered to have experienced a continuous clockwise prograde P–T path with peak metamorphic conditions of ca. 1.6–2.1GPa at 610–670°C, corresponding to a burial depth of about 70km. A peak metamorphic Lu–Hf garnet isochron age of 474±2Ma for the retrogressed eclogite of continental origin is in accordance with a Sm–Nd garnet isochron age of 462±7Ma interpreted as time of cooling and decompression of the metamorphic rock assemblage below 650 to 600°C. Quantitative P–T pseudosection modeling for peripheral Makbal HP garnet amphibolites of continental origin also revealed a continuous clockwise P–T path with peak-metamorphic conditions of ca. 1.4GPa at ca. 620°C followed by an isothermal uplift to ca. 0.7GPa. Furthermore, prograde P–T paths of oceanically-derived central Makbal high-pressure metabasic rocks revealed peak metamorphic conditions between 520°C and 560°C at 2.2GPa to 2.5GPa with subsequent isothermal decompressions. The metamorphic (P–T) evolution of a garnet–chloritoid–talc schist is exhibited by a P–T trajectory starting ca. 480°C at 2.5GPa, followed by peak pressures of ca. 2.85GPa at 525°C and peak temperatures of ca. 580°C at 2.4GPa. A Lu–Hf peak metamorphic age of 470.1±2.5Ma for a peripheral garnet amphibolite is in accordance with a garnet-growth Sm–Nd age of 475±4Ma of the UHP garnet–chloritoid–talc schist. Different and variable P–T paths show that former oceanic and continental crust at Makbal was subducted to different maximum depths (HP versus UHP conditions). The (U)HP metamorphism of oceanic and continental mafic rocks from the Aktyuz and Makbal metamorphic terranes is assumed to have occurred in a similar time frame of between 500 and 460Ma. The proposed geodynamic model for the HP Aktyuz metamorphic terrane incorporates the deep northeast-directed subduction of NTS continental crust under the Ankrakhai block of Paleo-Kazakhstan subsequent to the closure of the Djalair–Naiman Basin. At Makbal the final consumption of the oceanic crust of the Terskey Ocean to the northeast was immediately followed by the deep subduction of a (thinned) passive continental margin of the Central Tianshan Arc Terrane (CTA). Both scenarios are in accordance with continental-type subduction geodynamics producing the subduction-related (U)HP rocks during continental–continental collision processes. The exhumation of detached oceanic material by channel flow may have been initiated by the transient subduction of oceanic and subsequent continental crust. The Lower Carboniferous (U)HP metamorphic terranes (Atbashi and Akeyazi) in the Southern Tianshan Accretionary Complex are mainly composed of metasediments which host some lenses and boudins of oceanically-derived blueschists and eclogites. Most eclogites, blueschists and metasediments have experienced peak high-pressure metamorphism (480–580°C at 1.4–2.1GPa), while some slices display UHP-conditions (2.7–3.3GPa at 570–630°C). Multi-point Lu–Hf and Sm–Nd isochrons from several eclogite and blueschist samples from the Atbashi and Akeyazi metamorphic terranes revealed consistent ages of ca. 320–315Ma for the peak of metamorphism, thereby confirming that (U)HP metamorphism occurred during a single subduction event. The highly variable peak metamorphic conditions displayed by the (U)HP rocks imply that metamorphism of the metasediments and the various metabasic rocks occurred in different depths of the subduction zone. (U)HP metabasites and metasediments exhibit different P–T paths, which is consistent with the chaotic incorporation in a subduction channel resulting in the eventual exhumation as a mélange. This scenario is much in agreement with initial subduction of oceanic crust and accretionary wedge sediment removal by subduction erosion and thus is similar to accretionary-type subduction terranes, although, with higher peak P–T conditions than previously recorded. The absence of significant melting, in combination with the variable peak pressure metamorphic conditions and the intimate interlayering of high- and ultrahigh-pressure rocks, suggests that the (U)HP rocks were derived from varying depths within the subduction zone and then juxtaposed during exhumation in the subduction channel. This is in accordance with exhumation of the (U)HP rocks by channel flow.
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•Metamorphic evolution of (U)HP subduction-related transient crust in the South Tianshan•Shallow-level juxtaposition of blueschists, eclogites and paragneisses•Exhumation of the (U)HP rocks by channel flow•Geochronology of the prograde and retrograde P–T evolution of the (U)HP rocks•Accretionary-type subduction and continental-type subduction
Patient-centered care is essential for achieving high-quality and cost-effective health care. This is particularly important for patients with chronic or complex conditions who utilize more ...health-care services and require comprehensive care coordination. This case report draws on a longitudinal journey map—a valuable tool to capture patient experience and inform the care process—for a patient with multiple chronic conditions who needed a hip replacement. An analysis of the patient journey revealed 3 critical needs for a more patient-centered process: (1) making the patient health goal visible; (2) instigating transparent, shared decision-making; and (3) using a closed-loop communication process. Although key challenges exist, systems can facilitate more patient-centered care enabling health-care organizations to improve the patient experience across the continuum and provide higher quality care.
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