Development and usability testing of a multifaceted intervention to reduce low-value injury care.

Background: Multifaceted interventions that address barriers and facilitators have been shown to be most effective for increasing the adoption of high-value care, but there is a knowledge gap on this type of intervention for the de-implementation of low-value care. Trauma is a high-risk setting for low-value care, such as unnecessary diagnostic imaging and the use of specialized resources. The aim of our study was to develop and assess the usability of a multifaceted intervention to reduce low-value injury care.

Identifying mild traumatic brain injury in the post-acute polytrauma setting: a scoping review of diagnostic approaches and screening tools.

Objective: Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.

Methods: By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults.

Applying statistical modeling strategies to sparse datasets in synthetic chemistry.

The application of statistical modeling in organic chemistry is emerging as a standard practice for probing structure-activity relationships and as a predictive tool for many optimization objectives. This review is aimed as a tutorial for those entering the area of statistical modeling in chemistry. We provide case studies to highlight the considerations and approaches that can be used to successfully analyze datasets in low data regimes, a common situation encountered given the experimental demands of organic chemistry.

Primary care follow-up improves outcomes in older adults following emergency general surgery admission.

Background: While preoperative optimization improves outcomes for older adults undergoing major elective surgery, no such optimization is possible in the emergent setting. Surgeons must identify postoperative interventions to improve outcomes among older emergency general surgery (EGS) patients. The objective of this cohort study was to examine the association between early follow-up with a primary care physician (PCP) and the risk of nursing home acceptance or death in the year following EGS admission among older adults.

Rapid prediction of conformationally-dependent DFT-level descriptors using graph neural networks for carboxylic acids and alkyl amines.

Data-driven reaction discovery and development is a growing field that relies on the use of molecular descriptors to capture key information about substrates, ligands, and targets. Broad adaptation of this strategy is hindered by the associated computational cost of descriptor calculation, especially when considering conformational flexibility. Descriptor libraries can be precomputed agnostic of application to reduce the computational burden of data-driven reaction development.

Improved Three-Dimensional Reconstructions in Electron Ptychography through Defocus Series Measurements.

A detailed analysis of ptychography for three-dimensional (3D) phase reconstructions of thick specimens is performed. We introduce multi-focus ptychography, which incorporates a 4D-STEM defocus series to enhance the quality of 3D reconstructions along the beam direction through a higher overdetermination ratio. This method is compared with established multi-slice ptychography techniques, such as conventional ptychography, regularized ptychography, and multi-mode ptychography.

Gene Expression Shifts in Emperor Penguin Adaptation to the Extreme Antarctic Environment.

Gene expression can accelerate ecological divergence by rapidly tweaking the response of an organism to novel environments, with more divergent environments exerting stronger selection and supposedly, requiring faster adaptive responses. Organisms adapted to extreme environments provide ideal systems to test this hypothesis, particularly when compared to related species with milder ecological niches. The Emperor penguin (Aptenodytes forsteri) is the only endothermic vertebrate breeding in the harsh Antarctic winter, in stark contrast with the less cold-adapted sister species, the King penguin (A.

Costs of Transfer From Nontrauma to Trauma Centers Among Patients With Minor Injuries.

Importance: Nearly half the patients transferred from nontrauma centers to trauma centers have minor injuries, yet trauma center care is not associated with a difference in morality among patients with minor injuries. Consequently, reducing the frequency of such transfers has been postulated as a method to improve resource allocation. Currently, the economic implications of these transfers are not well understood.

Commission on collegiate nursing education standards inspire a new model of shared governance.

Purpose: A school of nursing re-envisioned its faculty organization structure and created a Shared Governance model based on the Commission on Collegiate Nursing Education Standards (CCNE). The model promotes shared decision-making and encourages nursing faculty and staff to exercise greater control over their professional endeavors.

Principal Results: The Shared Governance model launched as a one semester pilot before it was formally adopted by faculty.

Individual gaze shapes diverging neural representations.

Complex visual stimuli evoke diverse patterns of gaze, but previous research suggests that their neural representations are shared across brains. Here, we used hyperalignment to compare visual responses between observers viewing identical stimuli. We find that individual eye movements enhance cortical visual responses but also lead to representational divergence.

Estimating the human bottleneck for contact tracing.

The SARS-CoV-2 pandemic has highlighted the importance of contact tracing for epidemiological mitigation. Contact tracing interviews (CTIs) typically rely on episodic memory, which is prone to decline over time. Here, we provide a quantitative estimate of reporting decline for age- and gender-representative samples from the United Kingdom and Germany, emulating >15,000 CTIs.

Best practices to evaluate the impact of biomedical research software-metric collection beyond citations.

Motivation: Software is vital for the advancement of biology and medicine. Impact evaluations of scientific software have primarily emphasized traditional citation metrics of associated papers, despite these metrics inadequately capturing the dynamic picture of impact and despite challenges with improper citation.

Results: To understand how software developers evaluate their tools, we conducted a survey of participants in the Informatics Technology for Cancer Research (ITCR) program funded by the National Cancer Institute (NCI).

Exercise-induced inflammation alters the perception and visual exploration of emotional interactions.

Introduction: The study aimed to investigate whether an exercise-induced pro-inflammatory response alters the perception as well as visual exploration of emotional body language in social interactions.

Methods: In a within-subject design, 19 male, healthy adults aged between 19 and 33 years performed a downhill run for 45 min at 70% of their VO on a treadmill to induce maximal myokine blood elevations, leading to a pro-inflammatory status. Two control conditions were selected: a control run with no decline and a rest condition without physical exercise.

Individual differences in face salience and rapid face saccades.

Humans saccade to faces in their periphery faster than to other types of objects. Previous research has highlighted the potential importance of the upper face region in this phenomenon, but it remains unclear whether this is driven by the eye region. Similarly, it remains unclear whether such rapid saccades are exclusive to faces or generalize to other semantically salient stimuli.

Structure and transcription of integrated HPV DNA in vulvar carcinomas.

HPV infections are associated with a fraction of vulvar cancers. Through hybridization capture and DNA sequencing, HPV DNA was detected in five of thirteen vulvar cancers. HPV16 DNA was integrated into human DNA in three of the five.

Determining recommended acceptable intake limits for N-nitrosamine impurities in pharmaceuticals: Development and application of the Carcinogenic Potency Categorization Approach (CPCA).

N-Nitrosamine impurities, including nitrosamine drug substance-related impurities (NDSRIs), have challenged pharmaceutical industry and regulators alike and affected the global drug supply over the past 5 years. Nitrosamines are a class of known carcinogens, but NDSRIs have posed additional challenges as many lack empirical data to establish acceptable intake (AI) limits. Read-across analysis from surrogates has been used to identify AI limits in some cases; however, this approach is limited by the availability of robustly-tested surrogates matching the structural features of NDSRIs, which usually contain a diverse array of functional groups.

Sulfonylureas exert antidiabetic action on adipocytes by inhibition of PPARγ serine 273 phosphorylation.

Objective: Sulfonylureas (SUs) are still among the mostly prescribed antidiabetic drugs with an established mode of action: release of insulin from pancreatic β-cells. In addition, effects of SUs on adipocytes by activation of the nuclear receptor peroxisome proliferator-activated receptor γ (PPARγ) have been described, which might explain their insulin-sensitizing potential observed in patients. However, there is a discrepancy between the impact of SUs on antidiabetic action and their rather moderate in vitro effect on PPARγ transcriptional activity.

Greater mesophyll conductance and leaf photosynthesis in the field through modified cell wall porosity and thickness via AtCGR3 expression in tobacco.

Mesophyll conductance (g) describes the ease with which CO passes from the sub-stomatal cavities of the leaf to the primary carboxylase of photosynthesis, Rubisco. Increasing g is suggested as a means to engineer increases in photosynthesis by increasing [CO] at Rubisco, inhibiting oxygenation and accelerating carboxylation. Here, tobacco was transgenically up-regulated with Arabidopsis Cotton Golgi-related 3 (CGR3), a gene controlling methylesterification of pectin, as a strategy to increase CO diffusion across the cell wall and thereby increase g.

Taking High-Fidelity Simulation to the Next Level: Nursing in Nontraditional Environments.

Nurse educators must prepare nursing students to be competent first responders and providers in nontraditional situations. We developed a course that provides in-depth experiential instruction in disaster nursing, remote/austere nursing, and global health. The Nursing in Nontraditional Environments course provides nursing students with the knowledge and skills to provide quality care to patients in environments outside traditional hospitals and clinics.

More than just changeability: Specific factors are used to explain the changeability of personality traits.

Implicit theories and psychological essentialism are valuable frameworks used to model how changeable many traits are perceived to be. These frameworks, however, characterise changeability as a broad and generalised construct and do not fully capture the nuance and specificity involved in personality changeability. We therefore sought to deconstruct implicit theories about changeability into underlying more specific aspects of changeability.

De novo detection of somatic variants in high-quality long-read single-cell RNA sequencing data.

In cancer, genetic and transcriptomic variations generate clonal heterogeneity, leading to treatment resistance. Long-read single-cell RNA sequencing (LR scRNA-seq) has the potential to detect genetic and transcriptomic variations simultaneously. Here, we present LongSom, a computational workflow leveraging high-quality LR scRNA-seq data to call somatic single-nucleotide variants (SNVs), including in mitochondria (mtSNVs), copy-number alterations (CNAs), and gene fusions, to reconstruct the tumor clonal heterogeneity.

A multidimensional approach to identifying high-performing trauma centers across the United States.

Introduction: The differentiators of centers performing at the highest level of quality and patient safety are likely both structural and cultural. We aimed to combine five indicators representing established domains of trauma quality and to identify and describe the structural characteristics of consistently performing centers.

Methods: Using American College of Surgeons Trauma Quality Improvement Program data from 2017 to 2020, we evaluated five quality measures across several care domains for adult patients in levels I and II trauma centers: (1) time to operating room for patients with abdominal gunshot wounds and shock, (2) proportion of patients receiving timely venous thromboembolism prophylaxis, (3) failure to rescue (death following a complication), (4) major hospital complications, and (5) mortality.

Enantioselective Sulfonimidamide Acylation via a Cinchona Alkaloid-Catalyzed Desymmetrization: Scope, Data Science, and Mechanistic Investigation.

Methods to access chiral sulfur(VI) pharmacophores are of interest in medicinal and synthetic chemistry. We report the desymmetrization of unprotected sulfonimidamides via asymmetric acylation with a cinchona-phosphinate catalyst. The desired products are formed in excellent yield and enantioselectivity with no observed bis-acylation.

Individual differences in human gaze behavior generalize from faces to objects.

Individuals differ in where they fixate on a face, with some looking closer to the eyes while others prefer the mouth region. These individual biases are highly robust, generalize from the lab to the outside world, and have been associated with social cognition and associated disorders. However, it is unclear, whether these biases are specific to faces or influenced by domain-general mechanisms of vision.