Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.

Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.

Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.

Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.

Enhanced sampling of robust molecular datasets with uncertainty-based collective variables.

Generating a dataset that is representative of the accessible configuration space of a molecular system is crucial for the robustness of machine-learned interatomic potentials. However, the complexity of molecular systems, characterized by intricate potential energy surfaces, with numerous local minima and energy barriers, presents a significant challenge. Traditional methods of data generation, such as random sampling or exhaustive exploration, are either intractable or may not capture rare, but highly informative configurations.

Global Perspectives on Returning Genetic Research Results in Parkinson Disease.

Background And Objectives: In the era of precision medicine, genetic test results have become increasingly relevant in the care of patients with Parkinson disease (PD). While large research consortia are performing widespread research genetic testing to accelerate discoveries, debate continues about whether, and to what extent, the results should be returned to patients. Ethically, it is imperative to keep participants informed, especially when findings are potentially actionable.

Optimal Planning Target Volume Margins to Account for Intra-Fractional Prostate Motion Relative to Treatment Duration: A Study Using Real-Time Transperineal Ultrasound Guidance.

Introduction: Prostate motion during external beam radiotherapy (EBRT) is common and typically managed using fiducial markers and cone beam CT (CBCT) scans for inter-fractional motion correction. However, real-time intra-fractional motion management is less commonly implemented. This study evaluated the extent of intra-fractional prostate motion using transperineal ultrasound (TPUS) and examined the impact of treatment time on prostate motion.

Electric Vehicle Charging Route Planning for Shortest Travel Time Based on Improved Ant Colony Optimization.

Electric vehicles (EVs) are gaining significant attention as an environmentally friendly transportation solution. However, limitations in battery technology continue to restrict EV range and charging speed, resulting in range anxiety, which hampers widespread adoption. While there has been increasing research on EV route optimization, personalized path planning that caters to individual user needs remains underexplored.