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Most companies around the world have a leader, whether that title is a President, CEO, or Founder. There’s almost always someone at the very top of a corporate food chain, and from that position down, the company is structured hierarchically, with multiple levels of leadership supervising other employees. It’s a structure with which most people in the working world are familiar, and it dates back as long as one can remember. The word itself—leader—dates back to as far as the 12th Century and is derived from the Old English word “laedere,” or one who leads. But in 2001, a group of software engineers developed the Agile Workflow Methodology, a project development process that puts a priority on egalitarian teamwork and individual independence in searching for solutions. A number of businesses are trying to embrace a flatter internal structure, like the agile workflow. But is it necessarily the best way to develop business processes? That’s the question posed by researchers, including Goizueta Business School’s Özgecan Koçak, associate professor of organization and management, and fellow researchers Daniel A. Levinthal and Phanish Puranam in their recently published paper on organizational hierarchies. “Realistically, we don’t see a lot of non-hierarchical organizations,” says Koçak. “But there is actually a big push to have less hierarchy in organizations.” Part of it is due to the demotivating effects of working in authoritarian workplaces. People don’t necessarily like to have a boss. We place value in being more egalitarian, more participatory. Özgecan Koçak, Associate Professor of Organization & Management “So there is some push to try and design organizations with flatter hierarchies. That is specifically so in the context of knowledge-based work, and especially in the context of discovery and search.” Decoding Organizational Dynamics While the idea of an egalitarian workplace is attractive to many people, Koçak and her colleagues wanted to know if, or when, hierarchies were actually beneficial to the health of organizations. They developed a computational agent-based model, or simulation, to explore the relationships between structures of influence and organizational adaptation. The groups in the simulation mimicked real business team structures and consisted of two types of teams. In the first type, one agent had influence over the beliefs of rest of the team. For the second type, no one individual had any influence over the beliefs of the team. The hierarchical team vs. the flat structured team. “When you do simulations, you want to make sure that your findings are robust to those kinds of things like the scale of the group, or the how fast the agents are learning and so forth,” says Koçak. What’s innovative about this particular simulation is that all the agents are learning from their environment. They are learning through trial and error. They are trying out different alternatives and finding out their value. Özgecan Koçak Koçak is very clear that the hierarchies in the simulation are not exactly like hierarchies in a business organization. Every agent was purposefully made to be the same without any difference in wisdom or knowledge. “It’s really nothing like the kinds of hierarchies you would see in organizations where there is somebody who has a corner office, or somebody who is has a management title, or somebody’s making more than the others. In the simulation, it’s nothing to do with those distributional aspects or control, and nobody has the ability to control what others do in (the simulation). All control comes through influence of beliefs.” Speed vs. Optimal Solutions What they found in the simulation was that while both teams solved the same problems presented to them, they achieved different results at different speeds. We find that hierarchical teams don’t necessarily find the best solution, but they find the good enough solution in the shorter term. So if you are looking at the really long term, crowds do better. The crowds where individuals are all learning separately, they find the best solution in the long run, even though they are not learning from each other. Özgecan Koçak Özgecan Koçak (pronounced as ohz-gay-john ko-chuck) is associate professor of Organization & Management at Emory University’s Goizueta Business School. She holds a Ph.D. in organizational behavior from the Graduate School of Business at Stanford University. For example, teams of scientists looking for cures or innovative treatments for diseases work best with a flat structure. Each individual works on their own timeline, with their own search methodologies. The team only comes together for status updates or to discuss their projects without necessarily getting influence or direction from colleagues. The long-term success of the result is more important in some cases than the speed at which they arrive to their conclusion. That won’t work for an organization that answers to a board of directors or shareholders. Such parties want to see rapid results that will quickly impact the bottom line of the company. This is why the agile methodology is not beneficial to large-scale corporations. Koçak says, “When you try to think about an entire organization, not just teams, it gets more complicated. If you have many people in an organization, you can’t have everybody just be on the same team. And then you have to worry about how to coordinate the efforts of multiple teams. That’s the big question for scaling up agile. We know that the agile methodology works pretty well at the team level. However, when firms try to scale it up applied to the entire organization, then you have more coordination problems. Özgecan Koçak “You need some way to coordinate the efforts with multiple teams.” The Catch: Compensation Makes a Difference The simulation did not take into account one of the biggest parts of a corporate hierarchical structure—incentives and reward. The teams in the simulation received no monetary compensation for their leadership or influence. That is not something that happens in real life. Koçak says, “If you built up an organization with just influence, you just say we’re not going to have any authority, and we’re not going to give anybody the right to control anybody else’s actions. If we’re not going to be rewarding anyone more than the other, there’s not going to be any marks of status, etc. We’re just going to have some people influence others more. I would guess that would automatically lead to a prestige hierarchy right away. The person with more influence, you would start respecting more.” It’s almost like we’re incapable of working in a flat society, because somebody always wants to be or naturally becomes a leader and an influencer whether they planned on it or not. Özgecan Koçak The paper concludes that both methodologies, with either hierarchical and flat organization of teams, reach their goals. They just arrive at different times with different end results. If an organization has the luxury of time and money, a flat, agile methodology organization might be the right structure for that company. However, even agile workflow needs some coordination, according to Koçak. “There are also some search tasks that require coordination. You can’t always be searching on your own independently of others. There are some situations in which search needs to be done in a coordinated fashion by more than one person in teams. That’s because many of the knowledge-based settings where we do discovery require some division of labor, some specialization by expertise.” Communication is Key The key to any successful workflow, whether it be agile or hierarchical, is coordination and communication. Looking back to the example of scientific researchers, Koçak said, “You have scientific teams working independently of one another without a common boss dictating what they do research on or how they do it. Instead, they explore and experiment on their own. They write up their results, share their results, and learn from each other, because they are in the long-term game. The goal is to find the truth, however long it takes. “But when you look closely at a scientific team where everybody’s exploring, there is still some need for coordination. A lot of that happens through communication, and a lot of times projects will have a lead. Not necessarily somebody who knows better than the others, but somebody who’s going to help with coordination.” The leaner, flatter organizational structures in businesses might be gaining popularity. This simulation done by Koçak and colleagues, however, shows that it isn’t a perfect fit for every company, Further, some form of hierarchical workflow is necessary to maintain communication and coordination. Hierarchical structures don’t always find the best solution to a problem, but it’s almost always a good solution in a timelier fashion. Looking to know more? Özgecan Koçak is associate professor of Organization & Management at Emory University’s Goizueta Business School. She is available to speak with media about this topic - simply click on her icon now to arrange an interview today.
Georgia Southern University announces Cassie N. Morgan as Vice President for Enrollment Management
A seasoned leader in higher education, Morgan brings nearly two decades of experience in strategic enrollment planning, student success and organizational leadership. She returns to Georgia Southern with a proven record of innovation and impact, having previously served as associate vice president for Enrollment Management, providing strategic oversight to Financial Aid, the Registrar’s Office, and Enrollment Services. Her leadership during that time contributed directly to steady enrollment growth, improved student service delivery, and the development of a comprehensive strategic enrollment plan. Morgan consistently champions data-informed strategies, operational excellence, staff development, and a deep commitment to student-centered services and leads with a strong commitment to collaboration, innovation and service excellence. She has held significant roles at Appalachian State University, Gadsden State, Liberty University, the University of North Alabama and the University of West Georgia. “Cassie is a dynamic and visionary leader whose experience and values align perfectly with our mission,” said Alejandra C. Sosa Pieroni, Ed.D., executive vice president for Enrollment, Marketing, and Student Success. “Her return brings invaluable leadership as we build on our success and accelerate progress toward enrollment goals. Cassie leads with clarity, purpose and a student-first mindset. We are thrilled to welcome her back to Eagle Nation.” In her new role at Georgia Southern, Morgan will lead the enrollment management unit, overseeing all facets of the enrollment lifecycle, including undergraduate and graduate admissions, financial aid and enrollment services, the registrar’s office, military and veteran services, and international student services. She will also play a key role in institutional planning, marketing alignment and collaboration with academic and system partners. “I’m truly honored to return to Georgia Southern in this pivotal leadership role,” said Morgan. “It’s a privilege to serve an institution I deeply respect and cherish. I’m grateful for the opportunity to help shape its future and to build on the momentum already in place. I couldn’t be more excited about what lies ahead and to once again be part of a community that means so much to me.” Morgan holds a bachelor’s degree in psychology and a master’s degree in education from the University of West Georgia. If you want to book time to talk or interview with Vice President for Enrollment Management, Cassie Morgan then let us help - simply contact Georgia Southern's Director of Communications Jennifer Wise at jwise@georgiasouthern.edu to arrange an interview today.
Aston University researcher to help uncover hidden impact of painkiller overuse among older people
The HOPE-AO project led by the University of Plymouth will look at the potential harms of overprescribed pain medication in older people in the UK Aston University’s Professor Ian Maidment will bring his expertise in pharmacy and work with patient groups on medicine optimisation The project has been funded by the National Institute for Health and Care Research (NIHR) A new study led by the University of Plymouth will explore chronic pain prescribing in older adults across the UK, with the aim of understanding whether current treatments and processes meet their needs. The HOPE-AO: Helping to Optimise Pain control in the Elderly experiencing Analgesic Overprescribing project is being supported by the National Institute for Health and Care Research (NIHR) and includes Aston University’s Professor Ian Maidment. It will investigate whether certain groups of the older population are more likely to have analgesic (pain relief) medication overprescribed to them, and any side effects or other harms these medications can pose if taken for long periods. It aims to identify alternative treatment solutions to reduce the use of unnecessary pain medicines, working with patients to develop a list of acceptable strategies that could be tested and implemented across the UK. Around 4m older people across the UK live with varying degrees of chronic pain as a result of conditions including arthritis, diabetes or frailty. While some people benefit from pain relief medicines, many end up receiving long-term repeated prescriptions – for medications ranging from paracetamol and ibuprofen to opioids and antidepressants – for weeks, months or years at a time. The project is being led by researchers from the University of Plymouth, working with colleagues at the University of Exeter, Aston University, University of Aberdeen and the North East London Foundation NHS Trust. It is funded by through a Programme Development Grant from the National Institute for Health and Care Research (NIHR). The project team comprises experts in the care of older people – including healthcare researchers, nurses, consultants, GPs, pharmacists and psychiatrists working across the UK – as well as medical statisticians and health economists. It also involves an advisory group of patients with lived experience of receiving repeat prescriptions for pain medication. During the project, the team will speak to patients aged 65 and over with a history of chronic pain for which they are taking, or have taken, medication and families who cared for and supported relatives with chronic pain. They will also speak to healthcare professionals who are either prescribing or supporting older adults taking medication for chronic pain management. Alongside this work, the team will analyse anonymised healthcare data to understand more about older adults who are prescribed medication for chronic pain. This includes patterns in prescribing, health and demographic factors associated with pain medication use, and potential health outcomes, and will help identify those likely to benefit most from support. Professor Maidment, from Aston Pharmacy School, will bring his expertise in pharmacy, medication use in day-to-day clinical practice and working with diverse groups of patients to support medication optimisation. He said: “From my experience in community pharmacy, the use of pain medicines is very common in older people. We need to work with older people to understand how we can help older people to use other potentially safer approaches.” Patricia Schofield, professor of clinical nursing at the University of Plymouth and one of the study’s chief investigators, said: “Very often, older people are told by a doctor that the most effective means of treating a health condition is through some form of pain relief. But they often don’t get any form of follow-up appointment and, as a generation, are less likely to seek one as they either feel pain is part of the ageing process or they don’t wish to be seen as a burden. The result is that they end up getting repeat prescriptions, potentially for pain medications they no longer need and also at significant cost to the NHS. “This study will give us a clearer understanding of the scale of the issue which we can use to develop ways of benefitting patients and their families, and the healthcare professionals working to treat and support them.” Victoria Abbott-Fleming MBE, founder of the charity Burning Nights CRPS Support, is the chair of the Patient and Public Involvement and Engagement group for the HOPE-AO study. It will be made up of several adults over the age of 65 who live with chronic pain and have received repeat prescriptions for pain medication. Victoria has herself lived for more than 20 years with a chronic pain condition, Complex Regional Pain Syndrome (CRPS), and set up Burning Nights to support those affected by it on a day-to-day basis and their families. She is also chair of the Expert Patient and Carer Committee at the British Pain Society. She said: “I’m excited to support this study that places the voices of older adults and their carers at the heart of pain management. All too often, those living with chronic pain – especially older adults – are prescribed medication without regular review or consideration of alternative approaches. This study is a vital step towards more informed and balanced care, helping ensure that older people living with chronic pain are not just treated, but truly heard and supported.”
Chemical and Life Science Engineering Professor Michael “Pete” Peters, Ph.D., is investigating more efficient ways to manufacture biologic pharmaceuticals using a radial flow bioreactor he developed. With applications in vaccines and other personalized therapeutic treatments, biologics are versatile. Their genetic base can be manipulated to create a variety of effects from fighting infections by stimulating an immune response to weight loss by producing a specific hormone in the body. Ozempic, Wegovy and Victoza are some of the brand names for Glucagon-Like Peptide-1 (GLP-1) receptor agonists used to treat diabetes. These drugs mimic the GLP-1 peptide, a hormone naturally produced in the body that regulates appetite, hunger and blood sugar. “I have a lot of experience with helical peptides like GLP-1 from my work with COVID therapeutics,” says Peters. “When it was discovered that these biologic pharmaceuticals can help with weight loss, demand spiked. These drug types were designed for people with type-2 diabetes and those diabetic patients couldn’t get their GLP-1 treatments. We wanted to find a way for manufacturers to scale up production to meet demand, especially now that further study of GLP-1 has revealed other applications for the drug, like smoking cessation.” Continuous Manufacturing of Biologic Pharmaceuticals Pharmaceuticals come in two basic forms: small-molecule and biologic. Small-molecule medicines are synthetically produced via chemical reactions while biologics are produced from microorganisms. Both types of medications are traditionally produced in a batch process, where base materials are fed into a staged system that produces “batches” of the small-molecule or biologic medication. This process is similar to a chef baking a single cake. Once these materials are exhausted, the batch is complete and the entire system needs to be reset before the next batch begins. “ The batch process can be cumbersome,” says Peters. “Shutting the whole process down and starting it up costs time and money. And if you want a second batch, you have to go through the entire process again after sterilization. Scaling the manufacturing process up is another problem because doubling the system size doesn’t equate to doubling the product. In engineering, that’s called nonlinear phenomena.” Continuous manufacturing improves efficiency and scalability by creating a system where production is ongoing over time rather than staged. These manufacturing techniques can lead to “end-to-end” continuous manufacturing, which is ideal for producing high-demand biologic pharmaceuticals like Ozempic, Wegovy and Victoza. Virginia Commonwealth University’s Medicines for All Institute is also focused on these production innovations. Peters’ continuous manufacturing system for biologics is called a radial flow bioreactor. A disk containing the microorganisms used for production sits on a fixture with a tube coming up through the center of the disk. As the transport fluid comes up the tube, the laminar flow created by its exiting the tube spreads it evenly and continuously over the disk. The interaction between the transport medium coming up the tube and the microorganisms on the disk creates the biological pharmaceutical, which is then taken away by the flow of the transport medium for continuous collection. Flowing the transport medium liquid over a disc coated with biologic-producing microorganisms allows the radial flow bioreactor to continuously produce biologic pharmaceuticals. “There are many advantages to a radial flow bioreactor,” says Peters. “It takes minutes to switch out the disk with the biologic-producing microorganisms. While continuously producing your biologic pharmaceutical, a manufacturer could have another disk in an incubator. Once the microorganisms in the incubator have grown to completely cover the disk, flow of the transport medium liquid to the radial flow bioreactor is shut off. The disk is replaced and then the transport medium flow resumes. That’s minutes for a production changeover instead of the many hours it takes to reset a system in the batch flow process.” The Building Blocks of Biologic Pharmaceuticals Biologic pharmaceuticals are natural molecules created by genetically manipulating microorganisms, like bacteria or mammalian cells. The technology involves designing and inserting a DNA plasmid that carries genetic instructions to the cells. This genetic code is a nucleotide sequence used by the cell to create proteins capable of performing a diverse range of functions within the body. Like musical notes, each nucleotide represents specific genetic information. The arrangement of these sequences, like notes in a song, changes what the cell is instructed to do. In the same way notes can be arranged to create different musical compositions, nucleotide sequences can completely alter a cell’s behavior. Microorganisms transcribe the inserted DNA into a much smaller, mRNA coded molecule. Then the mRNA molecule has its nucleotide code translated into a chain of amino acids, forming a polypeptide that eventually folds into a protein that can act within the body. “One of the disadvantages of biologic design is the wide range of molecular conformations biological molecules can adopt,” says Peters. “Small-molecule medications, on the other hand, are typically more rigid, but difficult to design via first-principle engineering methods. A lot of my focus has been on helical peptides, like GLP-1, that are a programmable biologic pharmaceutical designed from first principles and have the stability of a small-molecule.” The stability Peters describes comes from the helical peptide’s structure, an alpha helix where the amino acid chain coils into a spiral that twists clockwise. Hydrogen bonds that occur between the peptide’s backbone creates a repeating pattern that pulls the helix tightly together to resist conformational changes. “It’s why we used it in our COVID therapeutic and makes it an excellent candidate for GLP-1 continuous production because of its relative stability,” says Peters. Programming The Cell Chemical and Life Science Engineering Assistant Professor Leah Spangler, Ph.D., is an expert at instructing cells to make specific things. Her material science background employs proteins to build or manipulate products not found in nature, like purifying rare-earth elements for use in electronics. “My lab’s function is to make proteins every day,” says Spangler. “The kind of proteins we make depends entirely on the project they are for. More specifically I use proteins to make things that don’t occur in nature. The reason proteins don’t build things like solar cells or the quantum dots used in LCD TVs is because nature is not going to evolve a solar cell or a display surface. Nature doesn’t know what either of those things are. However, proteins can be instructed to build these items, if we code them to.” Spangler is collaborating with Peters in the development of his radial flow bioreactor, specifically to engineer a microorganismal bacteria cell capable of continuously producing biologic pharmaceuticals. “We build proteins by leveraging bacteria to make them for us,” says Spangler. “It’s a well known technology. For this project, we’re hypothesizing that Escherichia coli (E. coli) can be modified to make GLP-1. Personally, I like working with E. coli because it’s a simple bacteria that has been thoroughly studied, so there’s lots of tools available for working with it compared to other cell types.” Development of the process and technique to use E. coli with the radial flow bioreactor is ongoing. “Working with Dr. Spangler has been a game changer for me,” says Peters. “She came to the College of Engineering with a background in protein engineering and an expertise with bacteria. Most of my work was in mammalian cells, so it’s been a great collaboration. We’ve been able to work together and develop this bioreactor to produce GLP-1.” Other Radial Flow Bioreactor Applications Similar to how the GLP-1 peptide has found applications beyond diabetes treatment, the radial flow bioreactor can also be used in different roles. Peters is currently exploring the reactor’s viability for harnessing solar energy. “One of the things we’ve done with the internal disc is to use it as a solar panel,” says Peters. “The disk can be a black body that absorbs light and gets warm. If you run water through the system, water also absorbs the radiation’s energy. The radial flow pattern automatically optimizes energy driving forces with fluid residence time. That makes for a very effective solar heating system. This heating system is a simple proof of concept. Our next step is to determine a method that harnesses solar radiation to create electricity in a continuous manner.” The radial flow bioreactor can also be implemented for environmental cleanup. With a disk tailored for water filtration, desalination or bioremediation, untreated water can be pushed through the system until it reaches a satisfactory level of purification. “The continuous bioreactor design is based on first principles of engineering that our students are learning through their undergraduate education,” says Peters. “The nonlinear scaling laws and performance predictions are fundamentally based. In this day of continued emphasis on empirical AI algorithms, the diminishing understanding of fundamental physics, chemistry, biology and mathematics that underlie engineering principles is a challenge. It’s important we not let first-principles and fundamental understanding be degraded from our educational mission, and projects like the radial flow bioreactor help students see these important fundamentals in action.”
The History of Conclave and How Do They Pick a New Pope?
The papal conclave—the centuries-old process by which the Roman Catholic Church selects a new pope—is one of the most secretive and spiritually symbolic events in the world. Rooted in rich ritual and guided by strict protocols, the conclave represents a moment of global significance, not only for the 1.3 billion Catholics worldwide but for all who follow the influence of religion on world affairs. This topic matters to the public as it blends ancient tradition with contemporary global leadership questions, shedding light on how faith, power, and governance intersect. The election of a pope impacts international diplomacy, interfaith relations, and moral discourse on modern issues. Key story angles that may interest a broad audience include: Origins of the papal conclave: Tracing its development from medieval times to its formalization by Pope Gregory X in 1274. The voting process: Exploring the steps from the Sistine Chapel seclusion to the smoke signals that announce a new pontiff. The role of the College of Cardinals: Examining who the electors are, how they are chosen, and the geopolitical makeup of the voting body. Influence of modern issues on papal selection: Understanding how social, environmental, and political concerns may shape cardinal deliberations. Global reaction to papal succession: Looking at how nations, religious groups, and the public respond to the announcement of a new pope. Symbolism and tradition: Analyzing the vestments, rituals, and centuries-old customs that surround the conclave and papal inauguration. Connect with an expert about the Papal Conclave: To search our full list of experts visit www.expertfile.com
Taking ACT-ion for Quality Improvement
“Learning is a journey. It is continuous,” said nurse Hellen Okoth, MSN, CCRN, RN-BC, of the Transitional Surgical Unit. She was one of the learners on that journey through ChristianaCare’s professional development program Achieving Competency Today (ACT). ACT, a 12-week graduate-level program dedicated to health care improvement, will celebrate its 40th session in 2025. Some 1,000 caregivers have graduated from ACT and have tested some 140 innovative project ideas since the program’s launch in 2003. On April 9, three ACT teams presented their quality improvement projects at the John H. Ammon Medical Education Center on ChristianaCare’s Newark campus. Interdisciplinary, experiential learning programs like ACT create a rich and dynamic learning environment,” said Tabassum Salam, M.D., MBA, FACP, chief learning officer for ChristianaCare. “The emphasis on continuous improvement and real-world applications of the educational content sets our ACT graduates up for lifelong learning and repeated application of these new skills.” The ACT course is a collaborative experience that brings together learners from diverse disciplines to tackle real-world health care challenges. Participants learn from health system leaders and gain a broad perspective on health care through coursework. They work in teams to complete problem-solving projects from start to finish using the Plan-Do-Check-Act (PCDA) model of continuous improvement. Facilitators, who are experts in improvement science and team effectiveness, guide the teams through the process, ensuring that each project is meticulously planned and executed. ChristianaCare offers many professional development opportunities. Click here for careers and benefits. “The hands-on projects in ACT enable learners to innovate and test out solutions in settings that directly benefit patients, leading to better outcomes and a higher quality of care,” Salam said. The three most recent teams presented improvement research that has the potential to expand beyond their pilot stage to other areas of the health system. ‘Hush! For the Love of Health’ In “Hush! For the Love of Health,” an interdisciplinary team worked to reduce noise levels on the Cardiovascular Critical Care Unit (CVCCC) at Christiana Hospital. Their goal was to decrease ambient noise levels by 10 decibels during the study period. Intensive care units often experience noise levels that can exceed 80 decibels. A quiet environment is 30 to 40 decibels. Members of the “Hush” project found creative ways to reduce noise on an intensive care unit. Ambient noise refers to all sounds present in the background, which research shows can interfere with communication, concentration and comfort. In a hospital setting, these sounds may include alarms, conversations, announcement and pages and carts moving by. The team looked for opportunities to safely reduce the number of alarms sounding. By collaborating with Philips technology company to lower alarm volumes and eliminate redundant alarms, they reduced the number of alarms sounding from 10,000 to 3,000 daily and successfully decreased noise levels by 13 decibels, exceeding their goal. “It’s good for patients to have a quiet environment and it fights alarm fatigue for caregivers,” said Dylan Norris, a pre-medical student from the University of Delaware and participant in the ACT course. ‘Show Up and Show Out’ Reducing the no-show rate among patients in primary care practices improves health outcomes and conserves resources. In “Show Up and Show Out: Boosting Patient Attendance in Primary Care,” the project team aimed to reduce the incidence of no-show appointments at the Wilmington Adult Medicine (WAM) practice by 10%. The “Show Up and Show Out” project team used personalized communication outreach to patients to encourage keeping their primary care appointments. “Our literature review showed that personal relationships with providers are one thing that can encourage people to attend appointments,” said team member Christi Karawan, MS, BSN, CCRN-CSC. The key to their problem-solving strategy was using a secure messaging platform for automatic appointment reminders specifically for WAM that were personalized with the provider’s name and thanking the patients for letting WAM be a part of their healthcare team. Other steps on the road to success were signage around the practice encouraging patients to update their contact information and calls from office assistants and medical assistants to unconfirmed patients the day prior to their appointments. The team achieved a 9.5% reduction in no-shows, just shy of their goal, over a two-week period. An office assistant who participated in the pilot said, “Outreach has been helpful not only in getting people in but in getting people to reschedule or cancel. We can catch it before it becomes a no-show.” ‘Magnetic Efficiency’ To address delays in patient transport from MRI testing at Newark campus, an ACT team created a new communication workflow to directly connect patient escort dispatch to the MRI charge technician. The ACT team aimed to decrease patient wait times following MRI completion for stretcher transport back to patients rooms by 25% — and “a bold goal,” said one colleague — during the study period. The “Magnetic Efficiency” team identified a new workflow to get patients back to their hospital rooms faster after MRI testing. Using Vocera wearable communications tools, the team created a thread for direct communication between Escort Dispatch caregivers and MRI charge technicians. Also, when an Escort transporter dropped off a patient for an MRI, the transporter asked MRI staff if any patients were ready to go back to their rooms. These changes in communication and empowerment consolidated transports and led to a 17% reduction in wait time during the two-week pilot. “We don’t want people to work harder,” said team member Tim Kane, BSN, RN. “We wanted to avoid preventable delays.” Both teams expressed satisfaction and improved communication with the new process and they expressed interest in continuing the process after the pilot ended. Future forward The ACT course has a rich history, originating from a specific initiative piloted by the Robert Wood Johnson Foundation with ChristianaCare among the early adopters along with Harvard University, the University of Pennsylvania, Johns Hopkins University and Beth Israel Deaconess Medical Center. Through the years, ChristianaCare ACT team members have seen their projects live on both as permanent changes throughout the health system and, more personally, in their professional growth. “I was able to enhance my creativity, organizational and problem-solving skills,” said Starr Lumpkin, a staff assistant who was on the “Hush” team. “This was a pivotal journey for me.” ChristianaCare is growing its program to develop a pipeline for the next generation of health professionals, said Safety and Quality Education Specialist Claire Rudolph, MSM, CPHQ. “We have a varied group of learners and facilitators who are making an impact on health care quality, cost and safety.” Dylan Norris was the first participant from a new partnership with the University of Delaware for pre-med students to get quality improvement experience. “I have learned so much about what goes into a quality improvement project. Buy-in from the stakeholders is key in implementing any new project successfully,” she said. “I have also learned about the importance of the initial research that goes into creating a new project and how much pre-planning goes into it.” Closing the event, Clinical Effectiveness Officer Christian Coletti, M.D., MHCDS, FACEP, FACP, called on the ACT graduates to use their newfound “superpowers” — “vision, seeing the future, catching something before it breaks. “It’s not a glitch in the matrix,” he said. “You are the most important people at the bedside – hearing the alarms going off or the stretchers piling up. Work to identify problems and move toward solutions in your own microenvironments. Pass on your powers with reckless abandon.”
Researchers laying the groundwork to eventually detect cerebral palsy via blood test
At the University of Delaware, molecular biologist Mona Batish in collaboration with Dr. Robert Akins at Nemours Children Hospital, is studying tiny loops in our cells called circular RNAs — once thought to be useless leftovers, but now believed to play an important role in diseases like cancer and cerebral palsy (CP). This is detailed in a new article in the Journal of Biological Chemistry. What are circular RNAs? They’re a special type of RNA that doesn’t make proteins but instead helps control how genes are turned on and off. Because they’re stable and can be found in blood, they may help doctors detect diseases more easily. So what’s the connection to cerebral palsy? CP is the most common physical disability in children, but right now it’s diagnosed only after symptoms appear — there’s no clear-cut test for it. Batish and her team are trying to change that. Working with researchers at Nemours Children’s Health, Batish discovered that in children with CP, a certain circular RNA — circNFIX — is found at much lower levels in muscle cells. This RNA normally helps the body make an important muscle-building protein called MEF2C. When circNFIX is missing or low, MEF2C isn’t made properly, which may lead to the weakened, shorter muscles seen in CP. This is the first time researchers have shown a link between circular RNAs and human muscle development in cerebral palsy. Why does this matter? If scientists can confirm this link, it could lead to: Earlier and more accurate diagnosis of CP using a simple blood test New treatments that help improve muscle development in affected children Batish’s ultimate goal? To create a test that can spot CP at birth — or even before — giving kids a better shot at early treatment and a higher quality of life. To speak to Batish, contact mediarelations@udel.edu.
AI-powered model predicts post-concussion injury risk in college athletes
Athletes who suffer a concussion have a serious risk of reinjury after returning to play, but identifying which athletes are most vulnerable has always been a bit of a mystery, until now. Using artificial intelligence (AI), University of Delaware researchers have developed a novel machine learning model that predicts an athlete’s risk of lower-extremity musculoskeletal (MKS) injury after concussion with 95% accuracy. A recent study published in Sports Medicine details the development of the AI model, which builds on previously published research showing that the risk of post-concussion injury doubles, regardless of the sport. The most common post-concussive injuries include sprains, strains, or even broken bones or torn ACLs. “This is due to brain changes we see post-concussion,” said Thomas Buckley, professor of kinesiology and applied physiology at the College of Health Sciences. These brain changes affect athletes’ balance, cognition, and reaction times and can be difficult to detect in standard clinical testing. “Even a minuscule difference in balance, reaction time, or cognitive processing of what’s happening around you can make the difference between getting hurt and not,” Buckley said. How AI is changing injury risk assessment Recognizing the need for enhanced injury reduction risk tools, Buckley collaborated with colleagues in UD’s College of Engineering, Austin Brockmeier, assistant professor of electrical and computer engineering, and César Claros, a fourth-year doctoral student; Wei Qian, associate professor of statistics in the College of Agriculture and Natural Resources; and former KAAP postdoctoral fellow Melissa Anderson, who’s now an assistant professor at Ohio University. To assess injury risk, Brockmeier and Claros developed a comprehensive AI model that analyzes more than 100 variables, including sports and medical histories, concussion type, and pre- and post-concussion cognitive data. “Every athlete is unique, especially across various sports,” said Brockmeier. “Tracking an athlete’s performance over time, rather than relying on absolute values, helps identify disturbances, deviations, or deficits that, when compared to their baseline, may signal an increased risk of injury.” While some sports, such as football, carry higher injury risk, the model revealed that individual factors are just as important as the sport played. “We tested a version of the model that doesn’t have access to the athlete’s sport, and it still accurately predicted injury risk,” Brockmeier said. “This highlights how unique characteristics—not just the inherent risks of a sport—play a critical role in determining the likelihood of future injury,” said Brockmeier. The research, which tracked athletes over two years, also found that the risk of MSK injury post-concussion extends well into the athlete’s return to play. “Common sense would suggest that injuries would occur early in an athlete’s return to play, but that’s simply not true,” said Buckley. “Our research shows that the risk of future injury increases over time as athletes compensate and adapt to small deficits they may not even be aware of.” The next step for Buckey’s Concussion Research Lab is to further collaborate with UD Athletics’ strength and conditioning staff to design real-time interventions that could reduce injury risk. Beyond sports: AI’s potential in aging research The implications of the UD-developed machine-learning model extend far beyond sports. Brockmeier believes the algorithm could be used to predict fall risk in patients with Parkinson’s disease. Claros is also exploring how the injury risk reduction model can be applied to aging research with the Delaware Center for Cognitive Aging. “We want to use brain measurements to investigate whether baseline lifestyle measurements such as weight, BMI, and smoking history are predictive of future mild cognitive impairment or Alzheimer’s disease,” said Claros. To arrange an interview with Buckley, email UD's media relations team at MediaRelations@udel.edu
A final disbursement of $8.8 million completes the $17.8 million grant awarded by the Department of Defense (DoD) to Virginia Commonwealth University’s (VCU) Convergence Lab Initiative (CLI). The funding allows CLI to continue advancing research in the areas of quantum and photonic devices, microelectronics, artificial intelligence, neuromorphic computing, arts and biomedical science. “The Convergence Lab Initiative represents a unique opportunity to drive innovation at the intersection of advanced technologies, preparing our students to tackle the critical challenges of tomorrow,” said Nibir Dhar, Ph.D., electrical and computer engineering professor and CLI director. “By combining cutting-edge research in electro-optics, infrared, radio frequency and edge computing, we are equipping the next generation of engineers with the skills to shape the future of both defense and commercial industries.” Working with Industry Partnership is at the heart of CLI and what makes the initiative unique. CivilianCyber, Sivananthan Laboratories and the University of Connecticut are among several collaborators focusing on cutting-edge, multidisciplinary research and workforce development. The lightweight, low-power components CLI helps develop are capable of transforming military operations and also have commercial applications. The Convergence Lab Initiative has 25 collaborative projects in this area focused on: Electro-optic and Infrared Technologies: Enhancing thermal imaging for medical diagnostics, search-and-rescue operations and environmental monitoring. This improves military intelligence, surveillance and reconnaissance capabilities. Radio Frequency and Beyond 5G Communication: Developing ultra-fast, low-latency communication systems for autonomous vehicles, smart cities and telemedicine. Accelerating advancements in this area also address electronic warfare challenges and security vulnerabilities. Optical Communication in the Infrared Wavelength: Increasing data transmission rates to create more efficient networks that support cloud computing, data centers, AI research and covert military communications. Edge Technologies: Creating low size, weight and low power-consuming (SWaP) computing solutions for deployment in constrained environments, such as wearables, medical devices, internet of things devices and autonomous systems. These technologies enhance real-time decision-making capabilities for agriculture, healthcare, industrial automation and defense. Benefits for Students College of Engineering students at VCU have an opportunity to engage with cutting-edge research as part of the DoD grant. Specialized workforce development programs, like the Undergraduate CLI Scholars Program, provide hands-on experience in advanced technologies. The STEM training also includes students from a diverse range of educational backgrounds to encourage a cross-disciplinary environment. Students can also receive industry-specific training through CLI’s Skill-Bridge Program, which facilitates direct connections between business needs and academic education. Unlike the DoD program for transitioning military personnel, the CLI Skill-Bridge is open to students from VCU and other local universities, creating direct connections between industry needs and academic training. This two-way relationship between academia and industry is unlike traditional academic research centers. With the College of Engineering’s focus on public-private partnerships, VCU becomes a registered partner with the participating businesses, collaborating to design individualized training programs focused on the CLI’s core research areas. This approach ensures students receive relevant, up-to-date training while companies gain access to a pipeline of skilled talent familiar with the latest industry trends and innovations. “The significance of this grant extends beyond immediate research outcomes. It addresses critical capability gaps for both the DoD and commercial sectors,” says Dhar. “This dual-use approach maximizes DoD investment impacts and accelerates innovation in areas that affect everyday life — from healthcare and environmental monitoring to communication networks and smart infrastructure. Breakthroughs emerging from these collaborations will strengthen national security while creating commercial spinoffs that drive economic growth and improve quality of life for communities both locally and globally. Advances in infrared technology, in particular, will position the VCU College of Engineering as a center for defense technologies and new ideas.”
Executive Order - Energy and Power Perspective
The tariffs imposed by the Executive Order (EO) are expected to significantly impact the energy and infrastructure sectors. New build energy projects in the United States heavily depend on importing components such as inverters, transformers, cabling, solar panels, mounting racks, and batteries from regions such as Southeast Asia, China, and the European Union. These tariffs are likely to affect all energy and infrastructure projects. We are seeing large capital projects across the United States impose caveats within their EPC contracts; allowing for steep and continual price adjustments upward. This is impacting billions of dollars of critical material and contractual obligated componentry. This also includes all materials with high volatility (steel, copper, aluminum). Not only are projects costs on the rise but so are supply chain disruptions, potentially causing delays in project timelines and/or project cancellations. The United States continues to grow in energy demand requirements, provided the vast deployment of data centers. Because of this grid reliability, modernization and new build implementation is critical in the coming decade. The tariffs are likely to have a large impact on these projects as well, given their requirement for componentry from all the regions impacted. As this situation continues to develop, the full implications and responses for the energy and infrastructure industry will become more apparent. Jeremy Erndt is a seasoned power development, engineering, and operations professional, with experience in power generation, infrastructure, and the sector with J.S. Held. He has led utility-scale power, transmission, port, and water projects from early development and conceptual design through NTP and eventual operation. He is an international development expert and supports a variety of programs for capital project development. Jeremy is a subject matter expert in project due diligence, engineering, and constructability for large-scale projects. Jeremy has been involved in various project-related and company mergers and acquisitions, thus providing a comprehensive track record and perspective of financial transactions at all stages. He has nearly two decades of experience in the development, engineering, construction, and operations of energy and infrastructure projects, spanning more than 30 GW within energy projects and over $60B of capital expenditures within infrastructure. Looking to know more or connect with Jeremy Erndt? Simply click on the expert's icon now to arrange an interview today. For any other media inquiries - contact : Kristi L. Stathis, J.S. Held +1 786 833 4864 Kristi.Stathis@JSHeld.com
