Physician Experiences With Implementing a Virtual Observation Unit in Emergency Medicine.

Study Objective: Physician experiences with new care models like the virtual observation unit in emergency departments (EDs) can offer important insights. Virtual observation unit leverages telehealth, remote monitoring, and mobile integrated health to enable home-based ED-level care. We explored physicians' experience with delivering care in the virtual observation unit and perceived effect of this new model.

Barriers and facilitators to point-of-care ultrasound use in an academic emergency department by perceived usability.

Background: While use of point-of-care ultrasound (POCUS) has become widespread in emergency medicine, its adoption and usage among emergency clinicians is variable. In this study, we explored the barriers and facilitators to POCUS use among emergency medicine clinicians in a tertiary care emergency department in the United States by clinical role and perceived usability of POCUS.

Methods: We initially administered a quantitative survey via REDCap and used a validated technology usability scale to categorize clinicians into tertiles of low, moderate, and high, based on perceived utility of POCUS.

Thermally Assisted Microfluidics to Produce Chemically Equivalent Microgels with Tunable Network Morphologies.

Although micron-sized microgels have become important building blocks in regenerative materials, offering decisive interactions with living matter, their chemical composition mostly significantly varies when their network morphology is tuned. Since cell behavior is simultaneously affected by the physical, chemical, and structural properties of the gel network, microgels with variable morphology but chemical equivalence are of interest. This work describes a new method to produce thermoresponsive microgels with defined mechanical properties, surface morphologies, and volume phase transition temperatures.

Adsorption of Polycyclic Aromatics on Crystal Surface of Coordination Cages: Photophysical Properties and Förster Resonance Energy Transfer.

Self-assembly reactions of PdX (X = NO, BF, ClO, ReO, PF, and CFSO) with 9,10-bis((isoquinolin-5-yloxy)methyl)anthracene (L) in MeSO give rise to single crystals of coordination cages, [X@PdL]X, irrespective of X anions, in high yields. The intracage PdPd distance is significantly sensitive to the nestled X anion, which can serve as a gauge for recognition of ubiquitous polyatomic anions. One interesting feature is that, via π-π interactions, various polycyclic aromatics (PAs) are characteristically adsorbed on the crystal surface of designed coordination cages with a wall of anthranyl moiety.

Composite polymer/wax coatings as a corrosion barrier of bioresorbable magnesium coronary stents.

Magnesium and its alloys are suitable materials for biodegradable biomedical implants such as cardiovascular stents. Here we introduce an innovative composite polyelectrolyte multilayer/wax coating applied to commercial coronary Mg-based stents serving as a barrier layer effectively retarding corrosion. This hydrophobic coating, build by layer-by-layer technology, appeared very thin, smooth, homogeneous, strongly adherent and completely covering the surface of the Mg-stent.

Selective Formation of Small and Large Coordination Cages and Their Catalytic Differences.

Self-assembly of CuX (X = BF, ClO, and CFSO) with a new tridentate 5,5',5″-(((2,4,6-trimethylbenzene-1,3,5-triyl)tris(methylene))tris(oxy))triisoquinoline (L) gives rise to single-crystal pairs consisting of small and large cages, [X@CuXL]X and [CuXL], respectively, via selection of solvents. In particular, the large cage is transformed into a small cage in acetonitrile above 50 °C. A significant difference in heterogeneous catechol oxidation catalysis between the small and large cages is observed.

Biphasic bone substitutes coated with PLGA incorporating therapeutic ions Sr and Mg: cytotoxicity cascade and response of immune and bone regeneration.

The incorporation of bioactive ions into biomaterials has gained significant attention as a strategy to enhance bone tissue regeneration on the molecular level. However, little knowledge exists about the effects of the addition of these ions on the immune response and especially on the most important cellular regulators, the macrophages. Thus, this study aimed to investigate the cytocompatibility and regulation of bone remodeling and material-related immune responses of a biphasic bone substitute (BBS) coated with metal ions (Sr/Mg) and PLGA, using the pure BBS as control group.

Cytocompatibility Analysis and Comparison of Different Hyaluronic Acid Fillers for Minimally Invasive Esthetics.

Background/aim: To overcome the natural visual consequences of the physiological aging process, the use of biodegradable fillers made of hyaluronic acid or sodium carboxymethyl cellulose is increasingly popular in modern esthetic medicine. Clinicians can choose from a wide range of fillers with variable compositions and rheological properties, and therefore with different application areas and injection depths. The aim of this study was to analyze and compare the most commonly used fillers for facial augmentation regarding their in vitro biocompatibility and to find potential correlations to their rheological properties.

M(II) effect on encapsulation of guests into a series of ML chiral cages: enantio-recognition.

Self-assembly of M(ClO) (M = Ni, Cu, and Zn) with (1,1',1'',2,2',2'')-(benzenetricarbonyltris(azanediyl))tris(2,3-dihydro-1-indene-2,1-diyl) trinicotinate (,-L) and the corresponding enantiomer (,-L) as a pair of chiral tridentate donors gives rise to the chiral cage pairs [M(,- and ,-L)](ClO). For the two pairs of [(MeCO)(HO)@M(,- and ,-L)](ClO) (M = Ni and Zn), the inner cavity is occupied by both an acetone and a single water molecule, whereas for the copper(II) pair of [MeCO@Cu(,- and ,-L)](ClO) under the same conditions, the cavity is filled by only one acetone molecule. Thus, the encapsulation of guest molecules into the cages during self-assembly shows significant metal(II) ion effects.

Coordinating nature of ML double-stranded macrocycles: co-ligand competition of perchlorate, water, and acetonitrile depending on metal(II) ions.

Self-assembly of M(ClO) (M(II) = Mn(II), Co(II), Ni(II), Cu(II), and Zn(II)) with dicyclopentyldi(pyridine-3-yl)silane (L) as a donor in a mixture of acetonitrile and toluene produces crystals consisting of ML double-stranded macrocycles. The geometry around the M(II) cations is a typical octahedral arrangement, but the metallamacrocycles' outer axial coordination environment is sensitive to the M(II) cations. The conformation of the unique metallamacrocycles is informatively dependent on the nature of the coordination around the M(II) cations subtle co-ligand competition among perchlorate anions, water, and acetonitrile.

Self-assembly of Ni(II) with a chiral ligand pair . mixture of the chiral ligand pair: structural features and recognition ability of NiL cages.

The self-assembly of NiCl with a chiral bidentate ligand pair, (1,2)-(+)- and (1,2)-(-)-1-(nicotinamido)-2,3-dihydro-1-inden-2-yl nicotinate (,-L and ,-L) in a mixture of ethanol and dioxane, gives rise to stable crystals consisting of [2Cl@NiCl(,-L)(HO)]·4CHO·EtOH and [2Cl@NiCl(,-L)(HO)]·4CHO·EtOH chiral cages, respectively, with two encapsulated chloride anions in the cavities. The most interesting feature is that the self-assembly of NiCl with the mixture of ,-L and ,-L (1 : 1-1 : 4) produces crystals of thermodynamically stable achiral cages, [2Cl·2HO@NiCl(,-L)(,-L)(HO)]·7CHO, in the molar ratio range. Furthermore, the [2Cl@NiCl(,-L)(HO)]·4CHO·EtOH and [2Cl@NiCl(,-L)(HO)]·4CHO·EtOH chiral crystals can recognize the pairs of L-,D-tryptophan and L-,D-cysteine cyclic voltammetry (CV) signals, in contrast to the [2Cl·2HO@NiCl(,-L)(,-L)(HO)]·7CHO achiral crystal.

Patient Perceptions of Emergency Department Observation Care at Home.

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Nuclear phosphoinositide signaling promotes YAP/TAZ-TEAD transcriptional activity in breast cancer.

The Hippo pathway effectors Yes-associated protein 1 (YAP) and its homolog TAZ are transcriptional coactivators that control gene expression by binding to TEA domain (TEAD) family transcription factors. The YAP/TAZ-TEAD complex is a key regulator of cancer-specific transcriptional programs, which promote tumor progression in diverse types of cancer, including breast cancer. Despite intensive efforts, the YAP/TAZ-TEAD complex in cancer has remained largely undruggable due to an incomplete mechanistic understanding.

Patient-Centered Innovation: Involving Patients in Open Social Innovation.

Background: Involving patients in the health-care delivery innovation has many benefits. Open social innovation (OSI) presents a fitting lens to examine and advance patient engagement in innovation. OSI offers a participatory approach to innovation, in which diverse groups of participants collaboratively generate ideas and scale solutions on complex social challenges.

Engaging Interdisciplinary Innovation Teams in Federally Qualified Health Centers.

To foster bottom-up innovations, health care organizations are leveraging interdisciplinary frontline innovation teams. These teams include workers across hierarchical levels and professional backgrounds, pooling diverse knowledge sources to develop innovations that improve patient and worker experiences and care quality, equity, and costs. Yet, these frontline innovation teams experience barriers, such as time constraints, being new to innovation, and team-based role hierarchies.

Modulating Lipid Nanoparticles with Histidinamide-Conjugated Cholesterol for Improved Intracellular Delivery of mRNA.

Recently, mRNA-based therapeutics, including vaccines, have gained significant attention in the field of gene therapy for treating various diseases. Among the various mRNA delivery vehicles, lipid nanoparticles (LNPs) have emerged as promising vehicles for packaging and delivering mRNA with low immunogenicity. However, while mRNA delivery has several advantages, the delivery efficiency and stability of LNPs remain challenging for mRNA therapy.

Efficacy of Internet-based rumination-focused cognitive behavioral therapy and mindfulness-based intervention with guided support in reducing risks of depression and anxiety: A randomized controlled trial.

Rumination and worry are common risk factors of depression and anxiety. Internet-based transdiagnostic interventions targeting individuals with these specific risks may be an effective way to prevent depression and anxiety. This three-arm randomized controlled trial compared the efficacy of Internet-based rumination-focused cognitive behavioral therapy (RFCBT), mindfulness-based intervention (MBI), and psychoeducation (EDU) control among 256 at-risk individuals.

Voice is not enough: A multilevel model of how frontline voice can reach implementation.

Issue: When frontline employees' voice is not heard and their ideas are not implemented, patient care is negatively impacted, and frontline employees are more likely to experience burnout and less likely to engage in subsequent change efforts.

Critical Theoretical Analysis: Theory about what happens to voiced ideas during the critical stage after employees voice and before performance outcomes are measured is nascent. We draw on research from organizational behavior, human resource management, and health care management to develop a multilevel model encompassing practices and processes at the individual, team, managerial, and organizational levels that, together, provide a nuanced picture of how voiced ideas reach implementation.

Access challenges to opioid use disorder treatment among individuals experiencing homelessness: Voices from the streets.

Background: Achieving equitable access to medications for opioid use disorder (MOUD) such as buprenorphine is a pressing issue. Evidence suggests disparities in MOUD access based on race and socioeconomic status, further exacerbated by the COVID-19 pandemic. However, the drivers behind this access gap remain poorly understood.

Formation Process of SiF@CuL Chiral Cage Pairs in a Glass Vessel: Catechol Oxidation Catalysis and Chiral Recognition.

Self-assembly of CuX (X = BF, PF, and SbF) with a pair of chiral bidentate ligands, (12)-(+)- and (12)-(-)-1-(nicotinamido)-2,3-dihydro-1-inden-2-yl-nicotinate (-L or -L), in a mixture solvent including ethanol in a glass vessel gives rise to SiF-encapsulated CuL chiral cage products. The SiF anion from the reaction of X with SiO of the glass-vessel surface acts as a cage template or cage bridge. One of the products, [SiF@Cu(SiF)(-L)]·3CHCl·4EtOH, is one of the most effective heterogeneous catalysts for the oxidation of 3,5-di--butylcatechol.

Mission possible: open innovation in nursing and patient care services at Massachusetts General Hospital.

Objectives: Although front-line nurses and staff are uniquely positioned to identify the inefficiencies and gaps in care delivery, formal processes are not always in place to hear from those very employees.

Design: We established a scalable process that embodies open innovation principles, to broaden and distribute the innovation locus.

Setting: Massachusetts General Hospital, Boston, MA.

Crystals of NiL Ellipsoidal Tubes as Single-Crystal-to-Single-Crystal Adsorption Matrix: Penetrative Study of Self-Assembled Crystals vs Guest-Exchanged Crystals.

Informative similarities/differences between self-assembled and single-crystal-to-single-crystal (SCSC) guest-exchanged crystals based on both the molecular structure and adsorption nature are observed. The self-assembly of Ni(ClO) with a dicyclopentyldi(pyridine-3-yl)silane bidentate ligand (L) in a mixture of toluene and acetonitrile gives rise to purple crystals consisting of double-stranded ellipsoidal tubes, [Ni(ClO)(CHCN)L]·8ClO·4CHCN·5CH. The coordinated acetonitriles as well as the solvates are removed at 170 °C to transform the purple crystals into blue crystals of [Ni(ClO)L] that return to the original crystals in the mixture of toluene and acetonitrile.

Ideas from the Frontline: Improvement Opportunities in Federally Qualified Health Centers.

Background: Engaging frontline clinicians and staff in quality improvement is a promising bottom-up approach to transforming primary care practices. This may be especially true in federally qualified health centers (FQHCs) and similar safety-net settings where large-scale, top-down transformation efforts are often associated with declining worker morale and increasing burnout. Innovation contests, which decentralize problem-solving, can be used to involve frontline workers in idea generation and selection.

Pair of (Hg)L Chiral Cages and Successive Transformation into (Hg)L Chiral Cages: Chiral DOPA Recognition via Chiral Cages.

Self-assembly of Hg(ClO) with a pair of -symmetric chiral ligands, (1,1',1″,2,2',2″)-(benzenetricarbonyltris(azanediyl))tris(2,3-dihydro-1H-indene-2,1-diyl)trinicotinate (,-L) and (1,1',1″,2,2',2″)-(benzenetricarbonyltris(azanediyl))tris(2,3-dihydro-1H-indene-2,1-diyl)trinicotinate (,-L), produces a pair of chiral cages CHO@[(Hg)(ClO)(,-L)(HO)](CHO) and CHO@[(Hg)(ClO)(,-L)(HO)](CHO), respectively, via straightforward formation of the reduced Hg species with an inner cavity in which a single dioxane molecule is nestled. The pair of chiral cages are transformed into their downsized pair of cages, [Hg(ClO)(,-L)] and [Hg(ClO)(,-L)], respectively, in the presence of hydrochloric acid. The original chiral cages are more effective than the corresponding downsized cages for enantiorecognition of chiral 3,4-dihydroxyphenylalanine (DOPA) via the shifts of electrochemical oxidation potentials observed by linear sweep voltammetry (LSV) technique.