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.

Dynamic treeline and cryosphere response to pronounced mid-Holocene climatic variability in the US Rocky Mountains.

Climate-driven changes in high-elevation forest distribution and reductions in snow and ice cover have major implications for ecosystems and global water security. In the Greater Yellowstone Ecosystem of the Rocky Mountains (United States), recent melting of a high-elevation (3,091 m asl) ice patch exposed a mature stand of whitebark pine () trees, located ~180 m in elevation above modern treeline, that date to the mid-Holocene (c. 5,950 to 5,440 cal y BP).

Modular DNA origami-based electrochemical detection of DNA and proteins.

The diversity and heterogeneity of biomarkers has made the development of general methods for single-step quantification of analytes difficult. For individual biomarkers, electrochemical methods that detect a conformational change in an affinity binder upon analyte binding have shown promise. However, because the conformational change must operate within a nanometer-scale working distance, an entirely new sensor, with a unique conformational change, must be developed for each analyte.

Hydroxychloroquine prevents resistance and potentiates the antitumor effect of SHP2 inhibition in NF1-associated malignant peripheral nerve sheath tumors.

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive sarcomas and the primary cause of mortality in patients with neurofibromatosis type 1 (NF1). These malignancies develop within preexisting benign lesions called plexiform neurofibromas (PNs). PNs are solely driven by biallelic loss eliciting RAS pathway activation, and they respond favorably to MEK inhibitor therapy.

The Relationship Between Longest-Held Occupation and Hand Function in Older Adults.

Objective: Hand function, an important component of daily functioning, declines with age, yet the degree to which occupation modifies such declines is largely unknown.Methods: Older adults (≥65) completed an online cross-sectional survey containing a standardized hand function questionnaire, occupation-related questions, and demographic information. Participants were then categorized by their longest-held occupation as Blue Collar or White Collar.

Sexual assault predicts gender-specific sleep problems in varsity student athletes.

Objective: To determine the direct and indirect effects of sexual assault on sleep health in varsity athletes.

Participants: Varsity athletes ( = 2,910) who completed the Fall 2019 or 2020 administrations of the American College Health Association's National College Health Assessment III.

Methods: We combined exploratory factor analysis and structural equation modeling to evaluate relationships between four predictor variables: and and two response variables: and

Results: Overall, 9.

The Impact of Health Insurance on Mortality.

A 2008 review in the considered the question of whether health insurance improves health. The answer was a cautious yes because few studies provided convincing causal evidence. We revisit this question by focusing on a single outcome: mortality.

Pöschl Reformations Created from High-Resolution Noncontrast Enhanced CT Head Exams Can Be Used to Detect and Classify Superior Semicircular Canal Abnormalities.

Objective: To compare the diagnostic capability of Pöschl reformations created from temporal bone CT (TBCT) and high-resolution noncontrast CT head exams (HR-NECTH) to detect and classify superior semicircular canal (SSC) abnormalities.

Study Design: Retrospective case review.

Setting: Tertiary referral center.

Using "pop-up" clinics and live-attenuated influenza vaccine to reduce barriers to flu vaccination among college students.

College students have cited inconvenience, ease of forgetting, and lack of time as barriers to influenza (flu) vaccine receipt. We hypothesized that "pop-up" clinics and live-attenuated influenza vaccine (LAIV) would facilitate delivery and align with preferences of college students. During the 2023-2024 flu season, undergraduate participants were recruited to receive LAIV at 5 "pop-up" clinics across a large midwestern campus.

Ethanol release patterns and captures of Xylosandrus spp. (Coleoptera: Curculionidae) in ornamental nursery.

Xylosandrus crassiusculus Motschulsky and Xylosandrus germanus Blandford are serious ambrosia beetle pests in ornamental nurseries. Three ethanol baits, AgBio low release (LR), AgBio high release (HR), and Trécé are commercially available for use in bottle traps to determine flight activity of adult Xylosandrus spp. However, release patterns of ethanol from these baits under varying temperatures and captures of Xylosandrus spp.

The Effectiveness and Safety of Beta Antagonists in Patients With Burns: An Updated Meta-Analysis.

Aims: The purpose of this systematic review was to assess the safety and effectiveness of beta antagonists for improving clinical care in burn patients, compared to placebo.

Methods: Articles from randomized-controlled trials were identified by a literature search on PubMed and Cochrane. We included relevant trials involving patients with burn.

Ultrasound pupillometry for the detection of a relative afferent pupillary defect (RAPD): Systematic evaluation in patients with optic neuritis and comparison with infrared video pupillometry.

Purpose: A relative afferent pupillary defect (RAPD) is a characteristic clinical sign of optic neuritis (ON). Here, we systematically evaluated ultrasound pupillometry (UP) for the detection of an RAPD in patients with ON, including a comparison with infrared video pupillometry (IVP), the gold standard for objective pupillometry.

Materials And Methods: We enrolled 40 patients with acute (n = 9) or past (n = 31) ON (ON+), 31 patients with multiple sclerosis (MS) without prior ON, and 50 healthy controls (HC) in a cross-sectional observational study.

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.

Highly Self-Adhesive and Biodegradable Silk Bioelectronics for All-In-One Imperceptible Long-Term Electrophysiological Biosignals Monitoring.

Skin-like bioelectronics offer a transformative technological frontier, catering to continuous and real-time yet highly imperceptible and socially discreet digital healthcare. The key technological breakthrough enabling these innovations stems from advancements in novel material synthesis, with unparalleled possibilities such as conformability, miniature footprint, and elasticity. However, existing solutions still lack desirable properties like self-adhesivity, breathability, biodegradability, transparency, and fail to offer a streamlined and scalable fabrication process.

gneSeqCOO: a novel method for classifying diffuse large B-cell lymphoma cell of origin based on bulk tumor RNA sequencing profiles.

The cell of origin (COO) classification is an expression-based tumor algorithm identifying molecular subtypes of diffuse large B-cell lymphoma (DLBCL) with distinct prognostic characteristics. Traditional immunohistochemical methods for classifying COO subtypes have poor concordance and limited prognostic value in frontline DLBCL. In contrast, RNA-based metrics like the NanoString Lymphoma Subtyping Test (LST) define more robust subtypes with validated prognostic associations.

Sonogenetics is a novel antiarrhythmic mechanism.

Arrhythmia of the heart is a dangerous and potentially fatal condition. The current widely used treatment is the implantable cardioverter defibrillator (ICD), but it is invasive and affects the patient's quality of life. The sonogenetic mechanism proposed here focuses ultrasound on a cardiac tissue, controls endogenous stretch-activated Piezo1 ion channels on the focal region's cardiomyocyte sarcolemma, and restores normal heart rhythm.

Evaluation of Larger Side-Group Functionalities and the Side/End-Group Interplay in Ritonavir-Like Inhibitors of CYP3A4.

A new series of 13 ritonavir-like inhibitors of human drug-metabolizing CYP3A4 was rationally designed to study the R side-group and R end-group interplay when the R side-group is represented by phenyl. Spectral, functional, and structural characterization showed no improvement in the binding affinity and inhibitory potency of R/R-phenyl inhibitors upon elongation and/or fluorination of R-Boc (tert-butyloxycarbonyl) or its replacement with benzenesulfonyl. When R is pyridine, the impact of R-phenyl-to-indole/naphthalene substitution was multidirectional and highly dependent on side-group stereo configuration.

Screening the human miRNA interactome reveals coordinated up-regulation in melanoma, adding bidirectional regulation to miRNA networks.

Cellular protein expression is coordinated posttranscriptionally by an intricate regulatory network. The current presumption is that microRNAs (miRNAs) work by repression of functionally related targets within a system. In recent work, up-regulation of protein expression via direct interactions of messenger RNA with miRNA has been found in dividing cells, providing an additional mechanism of regulation.

Laws about bodily damage originate from shared intuitions about the value of body parts.

From the biblical to the medieval wergild system and modern workers' compensation laws, laws about bodily damage may originate from cognitive mechanisms that capitalize on an enduring regularity: Different body parts vary in their incremental contributions to human functionality. To evaluate this hypothesis, we conducted a preregistered study with materials based on five legal codes from highly diverse cultures and historical eras: the Law of Æthelberht (Kent, approximately 600 CE), the Guta lag (Gotland, approximately 1220 CE), and workers' compensation laws from the United States, the Republic of Korea, and the United Arab Emirates; and 614 laypeople from the United States and India. The data indicate ordinal agreement in the values attached to body parts by ancient and modern lawmakers, as well as by laypeople in the United States and India.

Groundwater releases CO to diverse global coastal ecosystems.

Coastal ecosystems play a major role in marine carbon budgets, but substantial uncertainties remain in the sources and fluxes of coastal carbon dioxide (CO). Here, we assess when, where, and how submarine groundwater discharge (SGD) releases CO to shallow coastal ecosystems. Time-series observations of dissolved CO and radon (Rn, a natural groundwater tracer) across 40 coastal systems from 14 countries revealed large SGD-derived CO fluxes.

High-throughput design of a light and strong refractory eutectic medium entropy alloy with outstanding He-ion irradiation resistance.

Light, strong, and radiation-tolerant materials are essential for advanced nuclear systems and aerospace applications. However, the comprehensive properties of current radiation-tolerant materials are far from being satisfactory in harsh operating environments. In this study, a high-throughput-designed NbVTaSi refractory eutectic medium entropy alloy realizes the controllable formation of the β-NbSi phase with a high content and has outstanding comprehensive properties, i.

Cropland expansion links climate extremes and diets in Nigeria.

Climate change threatens smallholder agriculture and food security in the Global South. While cropland expansion is often used to counter adverse climate effects despite ecological trade-offs, the benefits for diets and nutrition remain unclear. This study quantitatively examines relationships between climate anomalies, forest loss from cropland expansion, and dietary outcomes in Nigeria, Africa's most populous country.

The punctuated evolution of the Venusian atmosphere from a transition in mantle convective style and volcanic outgassing.

A key question in the planetary sciences centers on the divergence between the sibling planets, Venus and Earth. Venus currently does not operate with plate tectonics, and its thick atmosphere has led to extreme greenhouse conditions. It is unknown if this state was set primordially or if Venus was once more Earth-like.

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.