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.

A minimal vertex model explains how the amnioserosa avoids fluidization during dorsal closure.

Dorsal closure is a process that occurs during embryogenesis of . During dorsal closure, the amnioserosa (AS), a one-cell thick epithelial tissue that fills the dorsal opening, shrinks as the lateral epidermis sheets converge and eventually merge. During this process, both shape index and aspect ratio of amnioserosa cells increase markedly.

In utero progression of cephaloceles: prenatal to postnatal analysis.

Objective: The natural history of cephaloceles is not well understood. The goal of this study was to better understand the natural history of fetal cephaloceles from prenatal diagnosis to the postnatal period.

Methods: Between January 2013 and April 2023, all patients evaluated with a cephalocele at the Center for Fetal Diagnosis and Treatment were identified.

The impact of lower thoracic versus upper lumbar upper instrumented vertebra in minimally invasive correction of adult spinal deformity.

Objective: The goal of this study was to compare the impact of using a lower thoracic (LT) versus upper lumbar (UL) level as the upper instrumented vertebra (UIV) on clinical and radiographic outcomes following minimally invasive surgery for adult spinal deformity.

Methods: A multicenter retrospective study design was used. Inclusion criteria were age ≥ 18 years, and one of the following: coronal Cobb angle > 20°, sagittal vertical axis > 50 mm, pelvic tilt > 20°, pelvic incidence-lumbar lordosis mismatch > 10°.

Enhancing semantical text understanding with fine-tuned large language models: A case study on Quora Question Pair duplicate identification.

Semantical text understanding holds significant importance in natural language processing (NLP). Numerous datasets, such as Quora Question Pairs (QQP), have been devised for this purpose. In our previous study, we developed a Siamese Convolutional Neural Network (S-CNN) that achieved an F1 score of 82.

Internal validation of a convolutional neural network pipeline for assessing meibomian gland structure from meibography.

Significance: Optimal meibography utilization and interpretation are hindered due to poor lid presentation, blurry images, or image artifacts and the challenges of applying clinical grading scales. These results, using the largest image dataset analyzed to date, demonstrate development of algorithms that provide standardized, real-time inference that addresses all of these limitations.

Purpose: This study aimed to develop and validate an algorithmic pipeline to automate and standardize meibomian gland absence assessment and interpretation.

The Impact of Leadership Training on Burnout and Fulfillment Among Direct Reports.

Goal: Burnout, decreased professional fulfillment, and resultant attrition across the medical professions are increasingly recognized as threats to sustainable and cost-effective healthcare delivery. While the skill level of leaders as perceived by their direct reports has been correlated with rates of burnout and fulfillment, no studies, to our knowledge, have directly evaluated whether intervention via leadership training impacts burnout and fulfillment among direct reports. The goal of this study was to evaluate the effectiveness of a leadership training intervention on direct reports' perceptions of the leadership skills of supervising residents and subsequently on the well-being of the direct reports.

Anticoagulation for Minimally Invasive Glaucoma Surgery: An American Glaucoma Society Survey.

Precis: Perspectives and practice patterns regarding perioperative anticoagulation management and minimally invasive glaucoma surgery were queried among surgeons of American Glaucoma Society. Management varied based on surgeon preference and type of procedure performed.

Purpose: The purpose of this study was to characterize anticoagulation and antiplatelet practice patterns for minimally invasive glaucoma surgery (MIGS) in the perioperative period.

Large enhancement of ferroelectric properties of perovskite oxides via nitrogen incorporation.

Perovskite oxides have a wide variety of physical properties that make them promising candidates for versatile technological applications including nonvolatile memory and logic devices. Chemical tuning of those properties has been achieved, to the greatest extent, by cation-site substitution, while anion substitution is much less explored due to the difficulty in synthesizing high-quality, mixed-anion compounds. Here, nitrogen-incorporated BaTiO thin films have been synthesized by reactive pulsed-laser deposition in a nitrogen growth atmosphere.

Beyond Increasing Sample Sizes: Optimizing Effect Sizes in Neuroimaging Research on Individual Differences.

Linking neurobiology to relatively stable individual differences in cognition, emotion, motivation, and behavior can require large sample sizes to yield replicable results. Given the nature of between-person research, sample sizes at least in the hundreds are likely to be necessary in most neuroimaging studies of individual differences, regardless of whether they are investigating the whole brain or more focal hypotheses. However, the appropriate sample size depends on the expected effect size.

Multiomics dissection of human RAG deficiency reveals distinctive patterns of immune dysregulation but a common inflammatory signature.

Human recombination-activating gene (RAG) deficiency can manifest with distinct clinical and immunological phenotypes. By applying a multiomics approach to a large group of -mutated patients, we aimed at characterizing the immunopathology associated with each phenotype. Although defective T and B cell development is common to all phenotypes, patients with hypomorphic variants can generate T and B cells with signatures of immune dysregulation and produce autoantibodies to a broad range of self-antigens, including type I interferons.

sp. nov., a bacterium isolated from the roots of the aquatic plant .

A polyphasic taxonomic study was carried out on strain T5W1, isolated from the roots of the aquatic plant . This isolate is Gram-negative, rod-shaped, motile, aerobic and non-pigmented. Nearly complete 16S rRNA gene sequence homology related the strain to , with 98.

Development and Validation of a Brief Age-Normed Screening Tool for Subthreshold Psychosis Symptoms in Youth.

Background And Hypothesis: Improvements in screening tools for early subthreshold psychosis symptoms are needed to facilitate early identification and intervention efforts, especially given the challenges of rapidly differentiating age-appropriate experiences from potential early signs of emerging psychosis. Tools can be lengthy and time-consuming, impacting their utility and accessibility across clinical settings, and age-normed data are limited. To address this gap, we sought to develop and validate a brief, empirically derived, age-normed, subthreshold psychosis screening tool, for public use.

Medicaid Unwinding Experiences in Dual-Eligible Older Adults.

Importance: Dual-eligible older adults rely on Medicaid to pay for Medicare premiums and cost sharing in addition to supplemental services including dental and long-term care. However, the unique experiences of dual-eligible older adults with Medicaid unwinding remain unknown.

Objective: To assess the awareness and experiences of dual-eligible older adults with Medicaid redetermination.

High-Cost Cancer Drug Use in Medicare Advantage and Traditional Medicare.

Importance: Medicare Advantage (MA) plans are designed to incentivize the use of less expensive drugs through capitated payments, formulary control, and preauthorizations for certain drugs. These conditions may reduce spending on high-cost therapies for conditions such as cancer, a condition that is among the most expensive to treat.

Objective: To determine whether patients insured by MA plans receive less high-cost drugs than those insured by traditional Medicare (TM).

Attributable Risk and Consequences of Bone Mineral Density Deficits in Childhood Cancer Survivors.

Importance: Data characterizing the severity and changing prevalence of bone mineral density (BMD) deficits and associated nonfracture consequences among childhood cancer survivors decades after treatment are lacking.

Objective: To evaluate risk for moderate and severe BMD deficits in survivors and to identify long-term consequences of BMD deficits.

Design, Setting, And Participants: This cohort study used cross-sectional and longitudinal data from the St Jude Lifetime (SJLIFE) cohort, a retrospectively constructed cohort with prospective follow-up.

Radon Exposure and Gestational Diabetes.

Importance: Understanding environmental risk factors for gestational diabetes (GD) is crucial for developing preventive strategies and improving pregnancy outcomes.

Objective: To examine the association of county-level radon exposure with GD risk in pregnant individuals.

Design, Setting, And Participants: This multicenter, population-based cohort study used data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) cohort, which recruited nulliparous pregnant participants from 8 US clinical centers between October 2010 and September 2013.

Repurposing Licensed Drugs with Activity Against Epstein-Barr Virus for Treatment of Multiple Sclerosis: A Systematic Approach.

Background: Epstein-Barr virus (EBV) is implicated as a necessary factor in the development of multiple sclerosis (MS) and may also be a driver of disease activity. Although it is not clear whether ongoing viral replication is the driver for MS pathology, MS researchers have considered the prospect of using drugs with potential efficacy against EBV in the treatment of MS. We have undertaken scientific and lived experience expert panel reviews to shortlist existing licensed therapies that could be used in later-stage clinical trials in MS.

How to Civilize Elites: Controlling "Foreign Scientists" at a Field Station in the Galápagos Islands.

This paper explores the control of visiting "foreign scientists" at the Charles Darwin Research Station (CDRS) after it was established in the Galápagos Islands in 1959. Scholarly accounts of the creation of the Galápagos National Park and of the field station have emphasized their place in an international "land grab," as leading scientists and conservationists sought to control nature in places around the world that seemed less "civilized" to European thinkers. The actual administrative labor in the early years at this scientific field station, however, in practice struggled to control people widely taken to represent "civilization" in its highest form-European and American scientists.

Raman Signature of Stripe Domains in Monolayer WMoS Alloys.

We study the Raman signature of stripe domains in monolayer WMoS alloys, characterized using experimental techniques and density functional theory (DFT) calculations. These stripe domains were found in star-shaped monolayer WS exhibiting a high concentration of molybdenum (Mo) atoms in its central region, and unique Raman peaks that were not previously reported. We attribute these peaks to the splitting of the original doubly degenerate E modes, arising from the lower symmetry of the W-Mo stripe domains.

Student perceptions of repeating a nursing fundamentals course: A qualitative descriptive study.

Purpose: To explore perceptions of student learning in undergraduate nursing students who repeat the fundamentals nursing course and simultaneously take a support course.

Methods: This qualitative descriptive design was conducted at one private liberal arts college. The study included interviews with six undergraduate baccalaureate nursing students repeating the fundamentals course and their perceptions following the repeated course.

Systemic Sodium Iodate Injection as a Model for Expanding Geographic Atrophy.

Purpose: Geographic atrophy (GA), an advanced form of dry age-related macular degeneration (AMD), has limited treatment options. This study introduces a novel mouse model featuring an expanding GA patch that can be used to test mechanisms and therapeutics.

Methods: C57Bl/6J male mice (n = 96) aged 9-10 weeks received an intraperitoneal (IP) injection of 20 mg/kg sodium iodate (NaIO3).

Noncanonical RGS14 structural determinants control hormone-sensitive NPT2A-mediated phosphate transport.

The sodium phosphate cotransporter-2A (NPT2A) mediates basal and parathyroid hormone (PTH)- and fibroblast growth factor-23 (FGF23)-regulated phosphate transport in proximal tubule cells of the kidney. Both basal and hormone-sensitive transport require sodium hydrogen exchanger regulatory factor-1 (NHERF1), a scaffold protein with tandem PDZ domains, PDZ1 and PDZ2. NPT2A binds to PDZ1.

A primer on low-carbon design in architectural acoustics using a case study of residential floorsa).

Designers are increasingly tasked to reduce the carbon footprint of buildings. While core disciplines (e.g.