Underutilization of surgical treatment for epilepsy is multifactorial, and the multidisciplinary nature of caring for these patients represents a significant hurdle in expanding surgical treatment of ...epilepsy.
To develop internal and external surgical referral relationships for patients with medically refractory epilepsy with the goal of improving access to care.
To expand access to surgical epilepsy treatment at University of California (UC)-Irvine, 4 broad approaches focused on developing referral relationships and process improvement of surgical evaluation were undertaken in 2015 and 2016. The authors performed a retrospective review of all surgical epilepsy case referrals of the senior author from 2014 through 2020.
Epilepsy surgical volume at UC-Irvine increased from an average of 5.2 cases annually to 32 cases in the first year (2015) of implementation. There was continued case volume growth from 2015 through 2020 to 52 procedures in the most recent year (P = .03). Hospital payments for epilepsy procedures increased from $1.09M in 2015 to $2.02M and $1.8M in 2019 and 2020 (P < .01), respectively, while maintaining a diverse payer mix. 79.4% of these patients did not have a previously established option for surgical epilepsy care.
We outline strategies that level 4 epilepsy centers may use to strengthen collaborations and improve patient access for surgical epilepsy treatment. Increased collaboration can both improve the number of patients with epilepsy with access to specialized surgical care and produce reimbursement benefits for the centers caring for these patients, regardless of insurance source.
In the present study we sought to clarify the functional distinctions between organization identity strength, organizational identification, and organizational commitment. Data were obtained from ...10948 employees of a large steel manufacturer. First, confirmatory factor analysis was used to test the discriminant validity of the three focal constructs. Next, drawing on research that suggests hierarchical differentiation may influence individuals' conceptual frame of reference, we examined each focal construct's measurement equivalence across three hierarchical levels (officers, n = 1,056, middle-management, n = 1049, workers, n = 1050). Finally, multigroup structural equation modeling was used to simultaneously estimate the between-group correlations between turnover intention and organization identity strength, organizational identification, and organizational commitment. Results indicated that (a) the measures used to reflect the three focal constructs were empirically distinct, (b) the focal constructs were conceptually equivalent across hierarchical levels, and (c) the pattern of correlations with turnover intention was different for employees with management responsibilities versus workers with no management responsibility. The present findings suggest perceptions of a strong organizational identity, organizational identification, and organizational commitment may influence employees' turnover intention in unique ways, depending on their hierarchical level within the organization.
The Ribosome-associated Quality Control (RQC) pathway co-translationally marks incomplete polypeptides from stalled translation with two signals that trigger their proteasome-mediated degradation. ...The E3 ligase Ltn1 adds ubiquitin and Rqc2 directs the large ribosomal subunit to append carboxy-terminal alanine and threonine residues (CAT tails). When excessive amounts of incomplete polypeptides evade Ltn1, CAT-tailed proteins accumulate and can self-associate into aggregates. CAT tail aggregation has been hypothesized to either protect cells by sequestering potentially toxic incomplete polypeptides or harm cells by disrupting protein homeostasis. To distinguish between these possibilities, we modulated CAT tail aggregation in Saccharomyces cerevisiae with genetic and chemical tools to analyze CAT tails in aggregated and un-aggregated states. We found that enhancing CAT tail aggregation induces proteotoxic stress and antagonizes degradation of CAT-tailed proteins, while inhibiting aggregation reverses these effects. Our findings suggest that CAT tail aggregation harms RQC-compromised cells and that preventing aggregation can mitigate this toxicity.
Future thinking is defined as the ability to withdraw from reality and mentally project oneself into the future. The primary aim of the present study was to examine whether functions of future ...thoughts differed depending on their mode of elicitation (spontaneous or voluntary) and an attribute of goal-relatedness (selected-goal-related or selected-goal-unrelated). After producing spontaneous and voluntary future thoughts in a laboratory paradigm, participants provided ratings on four proposed functions of future thinking (self, directive, social, and emotional regulation). Findings showed that spontaneous and voluntary future thoughts were rated similarly on all functions except the directive function, which was particularly relevant to spontaneous future thoughts. Future thoughts classed as goal-related (selected-goal-related) were rated higher across all functions, and there was largely no interaction between mode of elicitation and goal-relatedness. A higher proportion of spontaneous future thoughts were selected-goal-related compared with voluntary future thoughts. In general, these results indicate that future thinking has significant roles across affective, behavioural, self and social functions, and supports theoretical views that implicate spontaneous future thought in goal-directed cognition and behaviour.
This study examines risks and potential benefits that youth professionals experience in bargaining with adolescents. We conducted semistructured qualitative interviews with 50 experienced adult ...leaders of 27 high‐quality arts, technology, and leadership youth programs (serving ethnically‐diverse teens). Half worked with younger teens (ages 11–14), half with older (ages 14–18). Leaders reported bargaining in ways responsive to youth's wants and needs, reaching win‐win agreements. Leaders of younger youth experienced more risks in bargaining, so took greater control over what was bargained. They used bargains most often to motivate when youth's enthusiasm dropped, and these bargains sometimes helped youth develop self‐motivation. Leaders of older youth reported fewer risks and more benefits. They bargained as equals, asking youth to share decision‐making responsibility. They used bargaining as a pedagogical tool to model, support, and challenge youth, which helped build their capacities for deliberative decision‐making. The findings illuminate strategies for practitioners to use bargaining effectively.
The "orgasm gap" for women who have sex with men remains a pressing gender equity issue. Recent research found that women who pursued orgasm as a goal were more likely to have one. The current ...research replicated this relationship between orgasm goal pursuit and orgasm frequency for heterosexual women, and found that this relationship did not exist for heterosexual men (Study 1). Then, across two experimental studies, we examined how heterosexual women vary their orgasm goal pursuit across sexual encounters. In Study 2, women who read that a hypothetical sexual encounter would be "quick" reported less intent to pursue orgasm than women who were told they could "take their time" or received no time information. In Study 3, women who read that their hypothetical sexual partner seemed selfish reported less intent to pursue orgasm than women who were given a non-selfish partner or no partner information. Importantly, these effects were mediated by women's perceived orgasm likelihood in the scenario. These results suggest that women shift their pursuit of orgasm depending on cues which signal whether orgasm will be feasible. This research used self-regulation theory to understand women's motivations for pursuing orgasm during sexual encounters with men, with implications for reducing the orgasm gap.
This article describes how nursing students in a community health course transitioned to an online clinical experience when coronavirus disease 2019 limited in-person gatherings.
A weekly video ...series was created to provide content to help educate 18 at-risk women using the Plan-Do-Study-Act cycle.
Objectives for the nursing students were met. Successful implementation occurred, and objectives for the community health class were met; however, engagement was more difficult to achieve.
Transitioning to online video conferencing allowed the nursing students to still engage with the study participants. Using the PDSA cycle allowed for structured changes to be made.
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The hydrological impact of enhancing Earth's albedo by solar radiation management is investigated using simulations from 12 Earth System models contributing to the Geoengineering Model ...Intercomparison Project (GeoMIP). We contrast an idealized experiment, G1, where the global mean radiative forcing is kept at preindustrial conditions by reducing insolation while the CO2 concentration is quadrupled to a 4×CO2 experiment. The reduction of evapotranspiration over land with instantaneously increasing CO2 concentrations in both experiments largely contributes to an initial reduction in evaporation. A warming surface associated with the transient adjustment in 4×CO2 generates an increase of global precipitation by around 6.9% with large zonal and regional changes in both directions, including a precipitation increase of 10% over Asia and a reduction of 7% for the North American summer monsoon. Reduced global evaporation persists in G1 with temperatures close to preindustrial conditions. Global precipitation is reduced by around 4.5%, and significant reductions occur over monsoonal land regions: East Asia (6%), South Africa (5%), North America (7%), and South America (6%). The general precipitation performance in models is discussed in comparison to observations. In contrast to the 4×CO2 experiment, where the frequency of months with heavy precipitation intensity is increased by over 50% in comparison to the control, a reduction of up to 20% is simulated in G1. These changes in precipitation in both total amount and frequency of extremes point to a considerable weakening of the hydrological cycle in a geoengineered world.
Key Points
Geoengineering leads to a weakening of the hydrologic cycle
Evapotranspiration changes important for initial reduction of precipitation
Considerable reduction of monsoonal precipitation over land with SRM
Laser reduction of graphene oxide is a promising technology for manufacturing advanced devices such as supercapacitors, sensors and transistors, owing to its distinctive advantages in selective and ...localized GO reduction, direct micro-nanoscale patterning, and no requirement for chemicals. However, the fundamental mechanism underlying the laser induced reduction is still not well understood. In this paper, we demonstrate that by adjusting the power and scanning speed of a 780 nm femtosecond laser, not only can one distinguish, but also effectively tune, two coexisting sub-processes during the laser reduction, namely the direct conversion from sp3 to sp2 carbon and removal of oxygen functional groups. Different oxygen containing groups demonstrate varied degrees of reduction when the power of the laser was varied. Our study provides solid and direct evidence for the coexistence of two sub-processes in the laser induced reduction of graphene oxide, which is essential for both mechanistic understanding and practical adoption of this technique in real word applications.
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