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Under a fixed 4:00 p.m. Eastern Time (ET) timing rule aligned with U.S. spot Bitcoin exchange-traded fund (ETF) valuation practice, we test whether broader public information improves next-day Bitcoin forecasts and costed implementation outcomes relative to Bitcoin-only benchmarks. A Full Logit-Lasso direction model does not beat Bitcoin (BTC)-only Logit on unconditional probability loss (Brier, log loss), but conditional on the model’s activation threshold (τ = 0.55) it identifies a 26% subset of dates with mean next-day BTC return 72 basis points above non-activated dates (heteroskedasticity- and autocorrelation-consistent (HAC) p = 0.0001). Volatility model rankings are loss-dependent (Ridge on point errors; heterogeneous autoregressive ordinary least squares (HAR-OLS) on quasi-likelihood loss (QLIKE)). Carrying the direction and volatility forecasts into a dual decision rule that combines direction-based gating with volatility-targeted sizing produces a point-estimate net-Sharpe cluster of approximately 1.55 to 1.61 and compresses maximum drawdown from –0.67 for buy-and-hold to approximately –0.10 across the three Full Logit-Lasso dual variants on the 1,450-date realized-return panel. Family-wise inference on these two performance dimensions, conducted as parallel stationary-block-bootstrap stepdown maxT procedures over the paper’s fixed nine contrast reduced family, yields materially different conclusions. Sharpedifference inference does not separate any active rule from buy-and-hold or from direction gating; the closest contrasts sit at padj ≈ 0.063 to 0.066, and the incremental Sharpe contribution of adding volatility sizing on top of direction gating is approximately zero (padj ≈ 0.92). Maximum-drawdown-difference inference, by contrast, separates all nine reduced-family contrasts at padj ≤ 0.003: direction gating, volatility sizing alone, sizing over gating, and the full dual policy all reduce drawdown under the same multiplicity discipline. A conservative T−1 observability audit attenuates richer-model magnitudes but does not overturn the benchmark-first forecast conclusions or the qualitative pattern of family-wise drawdown separation. The paper’s contribution is therefore methodological as well as substantive: once timing, implementation costs, and multiplicity are treated as binding constraints, the economic value of the dual policy in this sample is concentrated in path-risk compression rather than in family-wise Sharpe separation.

Social innovations are at risk at a time when surprise is employed as a unilateral government strategy in order to shrink and refocus government operations. Social innovations involve collective efforts, frequently spanning public and private stakeholders. The needed trust and reciprocal understandings are undercut when government employs the logic of reengineering combined with surprise as a strategy— what we term “Surprise by Design.” This contrasts with past federal restructuring initiatives that employed a mix of administrative expertise (top down) and frontline continuous improvement (bottom up) as strategies for negotiated changes. Surprise is a particular type of top- down imposed change, which disrupts patterned roles and routines in order to impose a reconceptualization of how government will function in society. This article documents surprise as a change strategy and identifies needed adjustments to two relevant lateral models for negotiated change. By taking this into account, social innovation initiatives can be more resilient in the face of Surprise by Design.

Background
While the importance of physician-scientists' training is widely accepted, the unique components of their professional identity and its underlying ethical values have not been sufficiently studied. Methodology Senior physician scientists in Israel participated in a Delphi assessment aimed to develop a consensus opinion regarding the various components of identity, training and motivation of those engaged in this vocation. Results Fourteen panel members participated in 2 rounds of grading a questionnaire specifically constructed for this project. Twenty seven out of sixty-five items on the original questionnaire achieved a consensus (set as agreement of 75% and above among panel members). The panelists have agreed on the importance of possessing a moral character (with a special emphasis on truthfulness and commitment) as an ethical basis for physician-scientists' identity, on the significance of a unique professional competence (requiring a "scientific" approach to solving clinical problems) and on the central role of thirst for knowledge and curiosity in creating the motivation to become a physician-scientist. The panelists did not endorse the role of benevolence, compassion and humility as central components in the physician-scientists' identity (as compared to the identity of clinicians), and were not supportive of the need to demonstrate a differential approach to dealing with ambiguity and uncertainty in the clinic and in the lab. They have also rejected a claim that there may exist an inherent conflict between the demands of research and of clinical care. The panelists remained divided as to the impact of simultaneously engaging in research and in clinical care on the personal wellbeing of physician-scientists.

Conclusions
It was seen that senior physician-scientists on our panel sought for ways to define physician-scientists as being both ethical and competent – and as possessing unique identity components, which do not harm but rather advance the care of patients. As far as we know, this is a first attempt to present a collective opinion of senior physician-scientists regarding their professional identity. It should be viewed as an initial step in a long journey, calling for further research that will broaden and deepen our conclusions.

This study examined whether vicarious trauma, the emotional and psychological effects of repeated exposure to others’ traumatic experiences, may affect hospital workers’ physical health. Focusing on nurses and patient care associates at two large hospitals, researchers linked workers’ vicarious trauma symptoms to subsequent health insurance claims for stress-sensitive gastrointestinal conditions. The research suggests that the effects of caring for traumatized patients may extend beyond emotional distress to become a broader occupational health risk.

This study examined whether a hospital safe patient-handling intervention worked equally well for nurses and patient care associates, two groups with different roles, job demands and exposures. The intervention itself went beyond equipment installation to include training, coaching, and organizational supports to help workers actually use the installed equipment. Although the intervention successfully reduced injuries overall, those reductions were concentrated among nurses rather than shared equally across worker groups. The study shows why workplace safety interventions should be judged not only by their overall impact, but also by whether they protect the workers facing the greatest risks.