Developing and Evaluating Large Language Model-Generated Emergency Medicine Handoff Notes.

Importance: An emergency medicine (EM) handoff note generated by a large language model (LLM) has the potential to reduce physician documentation burden without compromising the safety of EM-to-inpatient (IP) handoffs.

Objective: To develop LLM-generated EM-to-IP handoff notes and evaluate their accuracy and safety compared with physician-written notes.

Design, Setting, And Participants: This cohort study used EM patient medical records with acute hospital admissions that occurred in 2023 at NewYork-Presbyterian/Weill Cornell Medical Center.

Understanding Why People Experiencing a Mental Health Crisis Leave the Emergency Department Before Care: A Qualitative Interpretive Study.

A number of people experiencing a mental health crisis who present to a hospital emergency department (ED) do not wait (DNW) for assessment or care and leave. This phenomenon is poorly understood and offers an opportunity to enhance quality of care. We sought to understand the characteristics and reasons of those who DNW for assessment or care, and what happens after leaving the ED.

Aspiring to clinical significance: Insights from developing and evaluating a machine learning model to predict emergency department return visit admissions.

Return visit admissions (RVA), which are instances where patients discharged from the emergency department (ED) rapidly return and require hospital admission, have been associated with quality issues and adverse outcomes. We developed and validated a machine learning model to predict 72-hour RVA using electronic health records (EHR) data. Study data were extracted from EHR data in 2019 from three urban EDs.

A longitudinal meta-analysis of range restriction estimates and general mental ability validity coefficients: Better addressing overcorrection amid decline effects.

Psychometric corrections can be crucial for obtaining valid operational results, but concerns are rising about potential overcorrections for general mental ability (GMA) validity coefficients. Our two-part study identifies a source of overprediction: using national norms rather than recent local applicant pool variance for range restriction corrections. Study 1 demonstrates increasing homogeneity in Wonderlic occupational applicant pool variance across four data time waves, suggesting they are no longer interchangeable with the general working population, a divergence attributable to a rise in education.

Applications of Transition Metal-Catalyzed -Fluorine-Directed C-H Functionalization of (Poly)fluoroarenes in Organic Synthesis.

The synthesis of organic compounds efficiently via fewer steps but in higher yields is desirable as this reduces energy and reagent use, waste production, and thus environmental impact as well as cost. The reactivity of C-H bonds to fluorine substituents in (poly)fluoroarenes with metal centers is enhanced relative to and positions. Thus, direct C-H functionalization of (poly)fluoroarenes without prefunctionalization is becoming a significant area of research in organic chemistry.

Dehydrated human amnion/chorion membrane to treat venous leg ulcers: a cost-effectiveness analysis.

Objective: To evaluate the cost-effectiveness of dehydrated human amnion/chorion membrane (DHACM) in Medicare enrolees who developed a venous leg ulcer (VLU).

Method: This economic evaluation used a four-state Markov model to simulate the disease progression of VLUs for patients receiving advanced treatment (AT) with DHACM or no advanced treatment (NAT) over a three-year time horizon from a US Medicare perspective. DHACM treatments were assessed when following parameters for use (FPFU), whereby applications were initiated 30-45 days after the initial VLU diagnosis claim, and reapplications occurred on a weekly to biweekly basis until completion of the treatment episode.

Clemastine/tamoxifen hybrids as easily accessible antileishmanial drug leads.

A library of hybrid molecules is developed based on the common chemical features shared by clemastine and tamoxifen both of which are well known for their antileishmanial activities. In the initial screening against major and promastigotes, as well as cytotoxicity assays using HepG2 cells, several hybrids showed submicromolar activity against the parasite and no toxicity against human cells. The compounds with an EC < 2 μM against promastigotes of both species and a selectivity index >10 were further characterized against intracellular amastigotes as well as promastigotes of species that cause both visceral and cutaneous leishmaniasis, such as and , respectively.

Spanish validation of the pure procrastination scale: dimensional structure, internal consistency, temporal stability, gender invariance, and relationships with personality and satisfaction with life.

The objective of the current study was to adapt and validate the pure procrastination scale (PPS) for the Spanish adult population. Procrastination can have numerous consequences in daily life, making it essential to have reliable and valid instruments for measuring procrastination. Thus, this study was conducted to address this need.

Systematic review using a spiral approach with machine learning.

With the accelerating growth of the academic corpus, doubling every 9 years, machine learning is a promising avenue to make systematic review manageable. Though several notable advancements have already been made, the incorporation of machine learning is less than optimal, still relying on a sequential, staged process designed to accommodate a purely human approach, exemplified by PRISMA. Here, we test a spiral, alternating or oscillating approach, where full-text screening is done intermittently with title/abstract screening, which we examine in three datasets by simulation under 360 conditions comprised of different algorithmic classifiers, feature extractions, prioritization rules, data types, and information provided (e.

Synthesis and vectorial functionalisation of pyrazolo[3,4-]pyridines.

Heterocycles are a cornerstone of fragment-based drug discovery (FBDD) due to their prevalence in biologically active compounds. However, novel heterocyclic fragments are only valuable if they can be suitably elaborated to compliment a chosen target protein. Here we describe the synthesis of 5-halo-1-pyrazolo[3,4-]pyridine scaffolds and demonstrate how these compounds can be selectively elaborated along multiple growth-vectors.

Improved Utilization of Serial Testing Without Increased Admissions after Implementation of High-Sensitivity Troponin I: a Controlled Retrospective Cohort Study.

Background: Guidelines recommend high-sensitivity cardiac troponin (hs-cTn) for diagnosis of myocardial infarction. Use of hs-cTn is increasing across the U.S.

Inhibition of HSP90 distinctively modulates the global phosphoproteome of developmental stages.

In the unicellular parasites spp., the etiological agents of leishmaniasis, a complex infectious disease that affects 98 countries in 5 continents, chemical inhibition of HSP90 protein leads to differentiation from promastigote to amastigote stage. Recent studies indicate potential role for protein phosphorylation in the life cycle control of .

Assessing Dose-Exposure-Response Relationships of Miltefosine in Adults and Children using Physiologically-Based Pharmacokinetic Modeling Approach.

Objectives: Miltefosine is the first and only oral medication to be successfully utilized as an antileishmanial agent. However, the drug is associated with differences in exposure patterns and cure rates among different population groups e.g.

Disruption of the inositol phosphorylceramide synthase gene affects Trypanosoma cruzi differentiation and infection capacity.

Sphingolipids (SLs) are essential components of all eukaryotic cellular membranes. In fungi, plants and many protozoa, the primary SL is inositol-phosphorylceramide (IPC). Trypanosoma cruzi is a protozoan parasite that causes Chagas disease (CD), a chronic illness for which no vaccines or effective treatments are available.

Activity-based protein profiling: A graphical review.

Activity-based protein profiling (ABPP) is a chemoproteomic technology that employs small chemical probes to directly interrogate protein function within complex proteomes. Since its initial application almost 25 years ago, ABPP has proven to be a powerful and versatile tool for addressing numerous challenges in drug discovery, including the development of highly selective small-molecule inhibitors, the discovery of new therapeutic targets, and the illumination of target proteins in tissues and organisms. This graphical review provides an overview of the rapid evolution of ABPP strategies, highlighting the versatility of the approach with selected examples of its successful application.

Navigating drug repurposing for Chagas disease: advances, challenges, and opportunities.

Chagas disease is a vector-borne illness caused by the protozoan parasite (). It poses a significant public health burden, particularly in the poorest regions of Latin America. Currently, there is no available vaccine, and chemotherapy has been the traditional treatment for Chagas disease.

Motivational Congruence Theory: Beyond the Dualistic Approach to Human Motivation.

Dualism has long been part of human sciences, including psychology and its sub-discipline of motivation. In psychology, such dualism is reflected in the rationalism-empiricism dichotomy. This dichotomy has resulted in two seemingly contradictory perspectives, including empiricism and rationalism.

A Collaborative Emergency Medicine and Radiology Pulmonary Nodule Program: Identification of Associated Efficacy and Outcomes.

Purpose: Incidental radiologic findings are commonplace, but the episodic nature of emergency department (ED) care makes it challenging to ensure that patients obtain appropriate follow-up. Rates of follow-up range from 30% to 77%, with some studies demonstrating that more than 30% have no follow-up at all. The aim of this study is to describe and analyze the outcomes of a collaborative emergency medicine and radiology initiative to establish a formal workflow for the follow-up of pulmonary nodules identified during ED care.

Social Determinants of Health Screening and Management: Lessons at a Large, Urban Academic Health System.

Background: In October 2022 a multisite social determinants of health screening initiative was expanded across seven emergency departments of a large, urban hospital system. The aim of the initiative was to identify and address those underlying social needs that frequently interfere with a patient's health and well-being, often resulting in increased preventable system utilization.

Methods: Building on an established Patient Navigator Program, an existing screening process, and long-standing community-based partnerships, an interdisciplinary workgroup was formed to develop and implement the initiative.

Integral Role of Water in the Solid-State Behavior of the Antileishmanial Drug Miltefosine.

Miltefosine is a repurposed anticancer drug and currently the only orally administered drug approved to treat the neglected tropical disease leishmaniasis. Miltefosine is hygroscopic and must be stored at subzero temperatures. In this work, we report the X-ray structures of miltefosine monohydrate and methanol solvate, along with 12- and 14-carbon chain analogue hydrates and a solvate.

Discovery of Druggable Serine Proteases by Activity-Based Protein Profiling.

Leishmaniasis are a group of diseases caused by parasitic protozoa of the genus . Current treatments are limited by difficult administration, high cost, poor efficacy, toxicity, and growing resistance. New agents, with new mechanisms of action, are urgently needed to treat the disease.