Who is coming in? Evaluation of physician performance within multi-physician emergency departments.

Background: This study aimed to examine how physician performance metrics are affected by the speed of other attendings (co-attendings) concurrently staffing the ED.

Methods: A retrospective study was conducted using patient data from two EDs between January-2018 and February-2020. Machine learning was used to predict patient length of stay (LOS) conditional on being assigned a physician of average speed, using patient- and departmental-level variables.

Natural Densitals.

The concept of natural densitals (NDs) and their amplitudes is introduced. These quantities provide the spectral decomposition of the cumulant of the two-electron density that, by definition, quantifies the extent of electron correlation. Consequently, they are ideally suited for a rigorous description of electron correlation effects in Coulombic systems.

Energy-poverty-inequality SDGs: A large-scale household analysis and forecasting in China.

Affordable and clean energy, eliminating poverty, and reducing inequality are important goals of the United Nations Sustainable Development Goals (SDGs). This paper examines the role of access to clean cooking fuels in promoting income growth and reducing income inequality. Using data from Chinese households, we show that a 10% increase in the adoption of clean cooking fuels would result in an increase in total annual household income of US$37 billion nationwide.

Confined cell migration along extracellular matrix space in vivo.

Collective migration of cancer cells is often interpreted using concepts derived from the physics of active matter, but the experimental evidence is mostly restricted to observations made in vitro. Here, we study collective invasion of metastatic cancer cells injected into the mouse deep dermis using intravital multiphoton microscopy combined with a skin window technique and three-dimensional quantitative image analysis. We observe a multicellular but low-cohesive migration mode characterized by rotational patterns which self-organize into antiparallel persistent tracks with orientational nematic order.

Unveiling hidden reaction kinetics of carbon dioxide in supercritical aqueous solutions.

Dissolution of CO in water followed by the subsequent hydrolysis reactions is of great importance to the global carbon cycle, and carbon capture and storage. Despite numerous previous studies, the reactions are still not fully understood at the atomistic scale. Here, we combined ab initio molecular dynamics (AIMD) simulations with Markov state models to elucidate the reaction mechanisms and kinetics of CO in supercritical water both in the bulk and nanoconfined states.

Integrin-activating protein Invasin sustains long-term expansion of primary epithelial cells as 2D organoid sheets.

Matrigel/BME, a basement membrane-like preparation, supports long-term growth of epithelial 3D organoids from adult stem cells [T. Sato , , 262-265 (2009); T. Sato , , 1762-1772 (2011)].

Binding mode-guided development of high-performance antibodies targeting site-specific posttranslational modifications.

Posttranslational modifications (PTMs) of proteins play critical roles in regulating many cellular events. Antibodies targeting site-specific PTMs are essential tools for detecting and enriching PTMs at sites of interest. However, fundamental difficulties in molecular recognition of both PTM and surrounding peptide sequence have hindered the efficient generation of highly sequence-specific anti-PTM antibodies.

Efficacy of GABA aminotransferase inactivator OV329 in models of neuropathic and inflammatory pain without tolerance or addiction.

Dysregulation of GABAergic inhibition is associated with pathological pain. Consequently, enhancement of GABAergic transmission represents a potential analgesic strategy. However, therapeutic potential of current GABA agonists and modulators is limited by unwanted side effects.

Electron transfer in polysaccharide monooxygenase catalysis.

Polysaccharide monooxygenase (PMO) catalysis involves the chemically difficult hydroxylation of unactivated C-H bonds in carbohydrates. The reaction requires reducing equivalents and will utilize either oxygen or hydrogen peroxide as a cosubstrate. Two key mechanistic questions are addressed here: 1) How does the enzyme regulate the timely and tightly controlled electron delivery to the mononuclear copper active site, especially when bound substrate occludes the active site? and 2) How does this electron delivery differ when utilizing oxygen or hydrogen peroxide as a cosubstrate? Using a computational approach, potential paths of electron transfer (ET) to the active site copper ion were identified in a representative AA9 family PMO from (PMO9E).

Oppositional and competitive instigation of hippocampal synaptic plasticity by the VTA and locus coeruleus.

The novelty, saliency, and valency of ongoing experiences potently influence the firing rate of the ventral tegmental area (VTA) and the locus coeruleus (LC). Associative experience, in turn, is recorded into memory by means of hippocampal synaptic plasticity that is regulated by noradrenaline sourced from the LC, and dopamine, sourced from both the VTA and LC. Two persistent forms of synaptic plasticity, long-term potentiation (LTP), and long-term depression (LTD) support the encoding of different kinds of spatial experience.

ANAC044 orchestrates mitochondrial stress signaling to trigger iron-induced stem cell death in root meristems.

While iron (Fe) is essential for life and plays important roles for almost all growth related processes, it can trigger cell death in both animals and plants. However, the underlying mechanisms for Fe-induced cell death in plants remain largely unknown. S-nitrosoglutathione reductase (GSNOR) has previously been reported to regulate nitric oxide homeostasis to prevent Fe-induced cell death within root meristems.

Dual-Anion-Rich Polymer Electrolytes for High-Voltage Solid-State Lithium Metal Batteries.

Solid polymer electrolytes (SPEs) are promising candidates for lithium metal batteries (LMBs) owing to their safety features and compatibility with lithium metal anodes. However, the inferior ionic conductivity and electrochemical stability of SPEs hinder their application in high-voltage solid-state LMBs (HVSSLMBs). Here, a strategy is proposed to develop a dual-anion-rich solvation structure by implementing ferroelectric barium titanate (BTO) nanoparticles (NPs) and dual lithium salts into poly(vinylidene fluoride) (PVDF)-based SPEs for HVSSLMBs.

Pleural metastases from differentiated thyroid cancer: clinical features and long-term outcomes.

Objective: Pleural metastasis (PM) is rare in patients with differentiated thyroid cancer (DTC). Radioiodine (131I) therapy has been the main treatment for postoperative metastasis and recurrence of DTC. However, clinical data on PM from DTC are limited.

Short communication: Upregulation of hypoxia/reoxygenation-induced Shc3 by downregulated miR-455-5p, suppresses trophoblast invasion and is associated with placental inflammation and angiogenesis in preeclampsia.

Preeclampsia is characterized by insufficient invasion of extravillous trophoblasts and is a consequence of failed adaption of extravillous trophoblasts to changes in the intrauterine environment developing embryo. Specific miRNAs are implicated in the development of preeclampsia (PE). miR-455-5p is present at low levels in PE but its role is not known.

Voices of Nanomedicine: Blueprint Guidelines for Collaboration in Addressing Global Unmet Medical Needs.

The "" under this Perspective underline the importance of interdisciplinary collaboration and partnerships across several disciplines, such as medical science and technology, medicine, bioengineering, and computational approaches, in bridging the gap between research, manufacturing, and clinical applications. Effective communication is key to bridging team gaps, enhancing trust, and resolving conflicts, thereby fostering teamwork and individual growth toward shared goals. Drawing from the success of the COVID-19 vaccine development, we advocate the application of similar collaborative models in other complex health areas such as nanomedicine and biomedical engineering.

Mechanistic Investigations of Cobalt-Catalyzed, Aminoquinoline-Directed C(sp)-H Bond Functionalization.

Monoanionic, bidentate-auxiliary-directed, cobalt-catalyzed C-H bond functionalization has become a very useful tool in organic synthesis. A comprehensive investigation into isolated organometallic intermediates and their reactivity within the catalytic cycle is lacking. We report here mechanistic studies of cobalt-catalyzed, aminoquinoline-directed C(sp)-H bond functionalization.

A Helicobacter pylori flagellar motor accessory is needed to maintain the barrier function of the outer membrane during flagellar rotation.

The Helicobacter pylori flagellar motor contains several accessory structures that are not found in the archetypal Escherichia coli and Salmonella enterica motors. H. pylori hp0838 encodes a previously uncharacterized lipoprotein and is in an operon with flgP, which encodes a motor accessory protein.

Associations of resuscitation fluid load, colloid-to-crystalloid infusion ratio and clinical outcomes in children with dengue shock syndrome.

Background: Severe respiratory distress and acute kidney injury (AKI) are key factors leading to poor outcomes in patients with dengue shock syndrome (DSS). There is still limited data on how much resuscitated fluid and the specific ratios of intravenous fluid types contribute to the development of severe respiratory distress necessitating mechanical ventilation (MV) and AKI in children with DSS.

Methodology/principal Findings: This retrospective study was conducted at a tertiary pediatric hospital in Vietnam between 2013 and 2022.

Artificial intelligence-driven analysis of embryo morphokinetics in singleton, twin, and triplet pregnancies.

In recent years, the transfer of more than one embryo has become less frequent to diminish multiple pregnancies. Even so, there is still a risk of one embryo splitting into two or even three. This report presents the case of a triamniotic monochorionic gestation in a 35-year-old woman, obtained after the transfer of a single day 5 embryo that had been previously hatched with a laser and subsequently transferred in a fresh IVF cycle.

Human fallopian tube organoids provide a favourable environment for sperm motility.

Study Question: Does a human fallopian tube (HFT) organoid model offer a favourable apical environment for human sperm survival and motility?

Summary Answer: After differentiation, the apical compartment of a new HFT organoid model provides a favourable environment for sperm motility, which is better than commercial media.

What Is Known Already: HFTs are the site of major events that are crucial for achieving an ongoing pregnancy, such as gamete survival and competence, fertilization steps, and preimplantation embryo development. In order to better understand the tubal physiology and tubal factors involved in these reproductive functions, and to improve still suboptimal in vitro conditions for gamete preparation and embryo culture during IVF, we sought to develop an HFT organoid model from isolated adult stem cells to allow spermatozoa co-culture in the apical compartment.

Bacillus coagulans alleviates hepatic injury caused by Klebsiella pneumoniae in rabbits.

Background: As an opportunistic bacterial pathogen, Klebsiella pneumoniae (KP) is prone to causing a spectrum of diseases in rabbits when their immune system is compromised, which poses a threat to rabbit breeding industry. Bacillus coagulans (BC), recognized as an effective probiotic, confers a variety of benefits including anti-inflammatory and antioxidant properties.

Aim: The purpose of this study was to investigate whether dietary BC can effectively alleviate hepatic injury caused by KP.

2D Chiral Ag(I) Complexes with A-π-- and D-π--Type Dicarboxylic Acid Ligands: Presenting Significant Differences in Nonlinear Optical Responses.

Three two-dimensional (2D) chiral Ag(I) complexes with formulas [Ag(L)(5-nipa)] (), [Ag(L)(5-nipa)] (), and {[Ag(L)(5-hipa)]·2HO} () were prepared through the reactions of AgO with enantiopure -monodentate N-donors (L/L) and different dicarboxylic acids bearing A (acceptor)-π-- and D (donor)-π--type structural features, where / = (-)/(+)-2-(4'-pyridyl)-4,5-pinene-pyridine, 5-Hnipa = 5-nitroisophthalic acid, and 5-Hhipa = 5-hydroxyisophthalic acid. A study of their nonlinear optical responses reveals that chiral and enantiomeric pairs with the A-π--type dicarboxylic acid ligand simultaneously display second- and third-harmonic generation (SHG and THG) responses, while chiral containing the D-π--type dicarboxylic acid ligand only exhibits a very strong THG response. The THG intensity of is 451 × α-SiO, being about 27 and 24 times larger than those of and , respectively.

Median Craniofacial Hypoplasia.

Median craniofacial hypoplasia is characterized by tissue deficiency of the midline facial structures and/or brain. Patients can present with a wide variety of facial differences that may or may not require operative intervention. Common reconstructive procedures include cleft lip and/or palate repair, rhinoplasty, and orthognathic surgery, among others.

Use of Financial Hardship as a Metric for Assessing Financial Toxicity in Surgical Trauma Patients.

Background: Financial toxicity is the detrimental impact of health care costs that must be mitigated to achieve universal health coverage. Catastrophic health expenditure (CHE) is widely used to measure financial toxicity but does not capture patient perspectives of unaffordable health care costs. Financial hardship (FH), a patient-reported outcome measure, is currently underutilized but may be an important adjunct metric.

Measuring social, economic, policy, and health system determinants of maternal health and survival: An urgent global priority.

In 2015, the World Health Organization (WHO) released global targets and strategies for reducing maternal mortality in the Sustainable Development Goal (SDG) period developed through broad stakeholder consultations. The targets and strategies identified in the "Strategies toward Ending Preventable Maternal Mortality (EPMM)" report are grounded in a systemic and human rights approach to maternal health and aim to address the broad spectrum of key social, political, economic, and health system determinants of maternal health and survival, as exemplified by 11 Key Themes. These upstream determinants of maternal survival are not well represented in maternal health measurement efforts, which tend to focus on service delivery.