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LADR CASE NOTES JANUARY 2024 LADR CASE NOTES Breadeaux's Pisa, LLC v. Beckman Bros., 83 F.4th 1113 (8th Cir. 2023) (1) Franchisor filed a lawsuit in court against its franchisee [...]

Russian thinking on Russian aerospace forces' capabilities prior to the invasion of Ukraine reveals the force faced interconnected and unresolved challenges, including a mistaken strategic priority on defensive over offensive operations, a failure to develop sufficient capacity and capability for large-scale operations, and comparatively undeveloped operational concepts. As European NATO partners modernize their forces in the coming years, these critical shortfalls provide lessons related to acquiring specific technologies and platforms, engaging relevant operational concepts, and committing to extensive, ongoing training., Since the start of Russia's invasion of Ukraine in February 2022, one of the enduring questions of the conflict has been why Russian airpower has failed to establish air superiority [...]

Objective. The aim of this systematic review and correlation meta-analysis was to identify factors associated with kinesiophobia in individuals with patellofemoral pain (PFP) and to identify interventions that may reduce kinesiophobia in individuals with PFP. Methods. Seven databases were searched for articles including clinical factors associated with kinesiophobia or interventions that may reduce kinesiophobia in individuals with PFP. Two reviewers screened articles for inclusion, assessed risk of bias and quality, and extracted data from each study. A mixed-effects model was used to calculate correlations of function and pain with kinesiophobia using individual participant data. Meta-analyses were performed on interventional articles; Grading of Recommendations, Assessment, Development, and Evaluation was used to evaluate certainty of evidence. Results were reported narratively when pooling was not possible. Results. Forty-one articles involving 2712 individuals were included. Correlation meta-analyses using individual participant data indicated a moderate association between self-reported function and kinesiophobia (n = 499; r = -0.440) and a weak association between pain and kinesiophobia (n = 644; r = 0.162). Low-certainty evidence from 2 articles indicated that passive treatment techniques were more effective than minimal intervention in reducing kinesiophobia (standardized mean difference = 1.11; 95% CI= 0.72 to 1.49). Very low-certainty evidence from 5 articles indicated that interventions to target kinesiophobia (psychobehavioral interventions, education, and self-managed exercise) were better in reducing kinesiophobia than physical therapist treatment approaches not specifically targeting kinesiophobia (standardized mean difference = 1.64; 95% CI= 0.14 to 3.15). Conclusion. Higher levels of kinesiophobia were moderately associated with poorer function and weakly associated with higher pain in individuals with PFP. Taping and bracing may reduce kinesiophobia immediately after use, and specific kinesiophobia-targeted interventions may reduce kinesiophobia following the full intervention; however, the certainty of evidence is very low. Impact.Assessment of kinesiophobia in clinical practice is recommended, on the basis of the relationships identified between kinesiophobia and other important factors that predict outcomes in individuals with PFP. Keywords: Patellofemoral Pain Syndrome, Runner's Knee, Anterior Knee Pain, Chondromalacia Patella, Fear, Anxiety, Introduction Patellofemoral pain (PFP) is characterized by anterior knee pain in activities that load the patellofemoral joint including ascending and descending stairs, squatting, and running. (1) The burden associated with [...]

The unprovoked Russian attack on Ukraine has recently highlighted the need for engineers to shift focus. Such a shift in focus--from the Global War on Terrorism to large-scale combat operations [...]

Background: Sleep disturbances and their potential association with stroke remains understudied at a population level. We sought to determine the prevalence of sleep disturbances among people who have effects of stroke compared with the general population. Methods: We used data from people aged 18 years or older who responded to the sleep and chronic disease modules of the 2017-2018 cycle of the Canadian Community Health Survey (CCHS). We measured sleep disturbances by self-reports of having trouble staying awake most or all of the time; either short (< 5 h) or long (> 9 h) nightly sleep duration; having trouble going to or staying asleep most or all of the time; and never, rarely or sometimes having refreshing sleep. We used log-binomial and multinomial regression to investigate prevalence of sleep disturbances among respondents who reported effects of stroke compared with others, adjusting for confounding factors. Results: We included 46 404 CCHS respondents, 682 of whom reported effects of stroke. The prevalence of sleep disturbances for those with effects of stroke was higher than among others in the sample with regard to trouble staying awake (13.0% v. 6.1%; adjusted relative risk [RR] 2.16, 95% confidence interval [CI] 1.59-2.94), short or long duration sleep (28.9% v. 10.0%; adjusted RR 1.93, 95% CI 1.57-2.38), trouble going to or staying asleep, (28.1% v. 17.6%; adjusted RR 1.53, 95% CI 1.28-1.83) and lack of refreshing sleep (41.1% v. 37.1%; adjusted RR 1.30, 95% CI 1.14-1.49). The prevalence of at least 1 reported measure of sleep disturbance was 61.6% among those with effects of stroke, compared with 48.2% among others (adjusted RR 1.28, 95% CI 1.18-1.40). Interpretation: Self-report of having effects of stroke was associated with increased prevalence of sleep disturbances compared with the general population. Sleep disturbances were reported by a high proportion of respondents with effects of stroke, indicating the importance of screening for related disorders., Disturbance of normal sleeping patterns is a commonly reported, but understudied, condition among people who have had a stroke. (1) Sleep disturbances represent both a risk factor for and a [...]

This study compared the effects of a conventional approach and a progressive approach to discrete trial teaching when teaching tact relations to 12 children diagnosed with autism spectrum disorder (ASD). The conventional approach was informed by best practice guidelines for teaching receptive and expressive language (Green Focus on Autism and Other Developmental Disabilities, 16(2), 72-85, 2001 (See CR12); Grow & Leblanc Behavior Analysis in Practice, 6(1), 56-75, 2013 (See CR14)) and other relevant research (e.g., Graff & Karsten Behavior Analysis in Practice, 5(2), 37-48, 2012 (See CR11); León & Rosales Journal of Behavioral Education, 27(1), 81-100, 2018 (See CR31); Majdalany et al. Journal of Applied Behavior Analysis, 47(3), 657-662, 2014 (See CR36)). The progressive approach was informed by guidelines outlined by Leaf, Cihon, Leaf, et al. International Electronic Journal of Elementary Education, 9(2), 361-372, (2016a (See CR24)) and Leaf, Leaf, McEachin, et al. Journal of Autism & Developmental Disorders, 46(2), 720-731, (2016c (See CR26)). In this study, highly vocal-verbal participants diagnosed with ASD were randomly assigned to the conventional or progressive condition and received 20 sessions of intervention. Following intervention, statistical analysis was used to evaluate and compare the effects of each condition. Although both were effective in teaching the participants tact relations, there was a statistically significant difference in the number of tact relations learned in the progressive condition when compared to the conventional condition., Author(s): Christine M. Milne [sup.1] [sup.2], Justin B. Leaf [sup.1] [sup.2], Mary Jane Weiss [sup.1], Julia L. Ferguson [sup.2], Joseph H. Cihon [sup.1] [sup.2], Matthew S. Lee [sup.2], Ronald Leaf [...]

I. Introduction As many readers already know, on December 28, 2021, the Treasury Department and the Internal Revenue Service (the "IRS") issued final regulations relating to the allocation and apportionment [...]

A form of asymmetric warfare is waged against the United States and its citizens daily across multiple venues and platforms without reaching the threshold or definition of open conflict. (1) [...]

Complementary X-ray absorption fine structure (XAFS) and Raman spectroscopy studies were conducted on various UCl3concentrations in alkali chloride salt compositions. The samples were 5 mol % UCl3in LiCl (S1), 5 mol % UCl3in KCl (S2), 5 mol % UCl3in LiCl–KCl eutectic (S4), 50 mol % UCl3in KCl (S5), and 20 mol % UCl3in KCl (S6) molar concentrations. Samples were heated to 800 °C and allowed to cool to room temperature with measurements performed at selected temperatures; the highest temperatures showed the most stability and will be primarily referenced for conclusions. The processing and interpretation of the Raman and extended X-ray absorption fine structure (EXAFS) peaks revealed several uranium–oxygen bond lengths and symmetries in the samples before, during, and after heating. Based on published thermodynamic data of similar systems, X-ray absorption fine structure spectroscopy, and identification of Raman peaks, a β variation of α-U3O8, typical at room temperature, is the suspected dominant phase of all samples at high temperatures (800 °C). In the existing literature, this β structure of U3O8was synthesized by slow cooling of uranium oxides from 1350 °C. This paper suggests the rapid formation of the compound due to the decomposition of the uranium chlorides or oxychlorides at increasing temperatures and O2reaction kinetics.

Abstract:Between 1949 and 1964, Canada’s Department of National Defence owned and operated the Fort Churchill Military Hospital in northern Manitoba. As one of only two military hospitals in the country to treat civilian patients, the other being Whitehorse, Fort Churchill played a unique and critical role in the provision of federal health services in the postwar period. This article centres the experiences of military nurses in the Hudson Bay area of northern Canada, using the rise and fall of Fort Churchill’s hospital, to investigate Ottawa’s approach to medical governance. Military medicine is more than a wartime or overseas phenomenon, and it is incumbent upon medical historians to consider domestic military contexts in peacetime as a crucial component of Canada’s twentieth century health history.Résumé:Entre 1949 et 1964, le ministère de la Défense nationale du Canada détenait et exploitait l’hôpital militaire de Fort Churchill au nord du Manitoba. Puisque c’était l’un des deux seuls hôpitaux militaires du pays à soigner des civils, l’autre étant situé à Whitehorse, Fort Churchill a joué un rôle unique et essentiel dans la prestation de services de santé fédéraux pendant la période de l’après-guerre. Le présent article, qui porte sur les expériences des infirmières militaires de la région de la baie d’Hudson dans le Nord canadien, aborde l’ascension et la chute de l’hôpital de Fort Churchill pour explorer l’approche d’Ottawa envers la gouvernance médicale. La médecine militaire ne se limite pas à un phénomène de guerre ou outre-mer, et il incombe aux historiens médicaux de considérer les contextes militaires nationaux en temps de paix comme un volet essentiel de l’histoire de la santé du Canada au vingtième siècle.

Controlling excitons at the nanoscale in semiconductor materials represents a formidable challenge in the quantum photonics and optoelectronics fields. Monolayers of transition metal dichalcogenides (TMDs) offer inherent 2D confinement and possess significant exciton binding energies, making them promising candidates for achieving electric-field-based confinement of excitons without dissociation. Exploiting the valley degree of freedom associated with these confined states further broadens the prospects for exciton engineering. Here, we show electric control of light polarization emitted from one-dimensional (1D) quantum-confined states in MoSe2. Building on previous reports of tunable trapping potentials and linearly polarized emission, we extend this understanding by demonstrating how nonuniform in-plane electric fields enable in situ control of these effects and highlight the role of gate-tunable valley hybridization in these localized states. Their polarization is entirely engineered through either the 1D confinement potential’s geometry or an out-of-plane magnetic field. Controlling nonuniform in-plane electric fields in TMDs enables control of the energy (up to five times its line width), polarization state (from circular to linear), and position of 1D confined excitonic states (5 nm V–1).

The Samsung Odyssey OLED G8 is a 32-inch QD-OLED monitor that stands out for its Smart TV functionality, including built-in apps and a remote control. Priced at $1,299.99 MSRP, it offers 4K resolution, a refresh rate of up to 240Hz, and a QD-OLED panel with Adaptive Sync and HDR support. While the monitor's design is elegant and sturdy, its software features may not appeal to PC enthusiasts who prefer a more traditional monitor experience. Overall, the Samsung Odyssey OLED G8 is recommended for those seeking a versatile display for both entertainment and productivity purposes. [Extracted from the article]

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Background: The talus is more internally rotated within the ankle mortise in progressive collapsing foot deformity (PCFD) patients. However, no studies have investigated the change in talar axial rotation (AR) in PCFD postoperatively. The primary aim was to investigate the change in talar AR following PCFD reconstruction. Secondary aims were to determine whether talar AR changes were associated with other radiographic measurements or specific procedures, and whether postoperative talar AR was associated with 2-year patient-reported outcome scores.Methods: Twenty-seven patients older than 18 years who underwent flexible PCFD reconstruction with preoperative and at least 5-month postoperative weightbearing computed tomographic (WBCT) scans and radiographs and had preoperative and at least 2-year postoperative PROMIS scores were included. Patients with talonavicular fusions were excluded. Talar AR was the angle between the transmalleolar axis and talar axis on WBCT scans, with smaller angles representing more internal rotation as described by Kim et al. Hindfoot moment arm, Meary angle, fibulocalcaneal and talocalcaneal distance, subtalar middle facet uncoverage, and talonavicular angle were measured on radiographs.Results: Postoperative talar AR was 49.7 degrees (IQR, 45.9, 57.3), which was more externally rotated than preoperative AR by a median of 8.3 degrees (IQR, 2.2, 15.7) (P> .001). The change in talar AR was not associated with changes in any radiographic parameter. Increasing external talar AR was associated with an increase in postoperative PROMIS pain intensity (rs= 0.38, 95% CI 0.00, 0.67). Lateral column lengthening and subtalar fusion procedures were not associated with changes in talar AR (P> .10).Conclusion: PCFD reconstruction results in external rotation of the talus within the ankle mortise. Kim et al found that control patients had approximately 40 to 60 degrees of talar AR, which is similar to this study’s corrected position of the talus. However, increasing talar external rotation resulted in worse postoperative PROMIS pain intensity, suggesting the possibility of overcorrecting the internal AR deformity.

Biomolecular condensates regulate cellular function by compartmentalizing molecules without a surrounding membrane. Condensate function arises from the specific exclusion or enrichment of molecules. Thus, understanding condensate composition is critical to characterizing condensate function. Whereas principles defining macromolecular composition have been described, understanding of small-molecule composition remains limited. Here we quantified the partitioning of ~1,700 biologically relevant small molecules into condensates composed of different macromolecules. Partitioning varied nearly a million-fold across compounds but was correlated among condensates, indicating that disparate condensates are physically similar. For one system, the enriched compounds did not generally bind macromolecules with high affinity under conditions where condensates do not form, suggesting that partitioning is not governed by site-specific interactions. Correspondingly, a machine learning model accurately predicts partitioning using only computed physicochemical features of the compounds, chiefly those related to solubility and hydrophobicity. These results suggest that a hydrophobic environment emerges upon condensate formation, driving the enrichment and exclusion of small molecules.

Background Underrepresented minority groups (URMs) in surgery are not significantly increasing despite evidence suggesting that diversity in health care providers leads to excellent patient outcomes and care. Efforts to increase URM representation in surgical residency programs are essential for addressing disparities and improving health care delivery.Methods This retrospective study outlines a three-phase strategy implemented at a large academic-affiliated hospital to increase URM representation in its general surgery residency program. The strategy encompassed interview selection with a holistic review and implicit bias training for interviewers, modification of the interview scoring rubric, and post-interview recruitment efforts, including a virtual second look event for URM applicants.Results Following the implementation of these strategies, the URM match rate improved from 0 to 33.3% in the first year and was sustained at 33.3% in the subsequent year. Consequently, the representation of URMs in the residency program rose from 6.7% before our intervention to 13.3% afterwards.Discussion This structured approach successfully increased URM representation in a surgical residency program, affirming the success of targeted recruitment strategies. By promoting a diverse and inclusive environment, the program better reflects the community it serves, with aims at improved patient care and patient satisfaction.

Widely distributed in nature, sulfated glycan epitopes play important roles in diverse pathophysiological processes. However, due to their structural complexity, the preparation of glycan epitopes with structurally defined sulfation patterns is challenging, which significantly hampers the detailed elucidation of their biological functions at the molecular level. Here, we introduce a strategy for site-specific chemical sulfation of glycan epitopes, leveraging enzymatic sialylation and desialylation processes to precisely control the regio-specificity of sulfation of disaccharide or trisaccharide glycan backbones. Using this method, a sulfated glycan library covering the most common sialylated glycan epitopes was prepared in high yield and efficiency. By screening a microarray prepared with this glycan library, we systematically probed their binding specificity with human Siglecs (sialic acid-binding immunoglobulin-type lectins), many of which function as glyco-immune checkpoints to suppress immune system activation. Our investigation revealed that sulfation and sialylation patterns serve as important determinants of Siglec binding affinity and specificity. Thus, these findings offer new insights for the development of research tools and potential therapeutic agents targeting glyco-immune checkpoints by modulating the Siglec signaling pathway.

Sialic acid (Neu5Ac) is installed onto glycoconjugates by sialyltransferases (STs) using cytidine monophosphate-Neu5Ac (CMP-β-d-Neu5Ac) as their donor. The only class of cell-active ST inhibitors are those based on a 3FaxNeu5Ac scaffold, which is metabolically converted into CMP-3FaxNeu5Ac within cells. It is essential for the fluorine to be axial, yet stereoselective installation of fluorine in this specific orientation is challenging. Sialic acid aldolase can convert 3-fluoropyruvate and 2-acetamido-2-deoxy-d-mannopyranose (ManNAc) to 3FNeu5Ac, but stereocontrol of the fluorine in the product has not been possible. We hypothesized that the 3Faxkinetic product of a sialic acid aldolase reaction could be trapped by coupling with CMP-sialic acid synthetase to yield CMP-3FaxNeu5Ac. Here, we report that highly active CMP-sialic acid synthetase and short reaction times produce exclusively CMP-3FaxNeu5Ac. Removal of CMP from CMP-3FaxNeu5Ac under acidic conditions unexpectedly led to 3-fluoro-β-d-Neu5Ac 2-phosphate (3FaxNeu5Ac-2P). Alkaline phosphatase successfully converted 3FaxNeu5Ac-2P to 3FaxNeu5Ac, enabling stereochemically controlled access to 3FaxNeu5Ac, which is effective in lowering the sialoglycan ligands for Siglecs on cells. Moreover, our kinetic trapping approach could be used to access CMP-3FaxNeu5Ac with modifications at the C5, C9, or both positions, which enabled the chemoenzymatic synthesis of a photo-cross-linkable version of CMP-3FaxNeu5Ac that selectively photo-cross-linked to ST6GAL1 over two other STs.

Primary amoebic meningoencephalitis (PAM) is a human brain infection caused by Naegleria fowleriwith a 97% mortality rate. Quinazolinones resulting from a Mannich-coupled domino rearrangement were recently identified as inhibitors of the amoeba. Herein, we resolved the effective concentrations for 25 pilot compounds and then, using the Mannich protocol and a key late-stage, N-demethylation/functionalization, we synthesized 53 additional analogs to improve potency, solubility and microsomal stability. We established an antiamoebic quinazolinone pharmacophore, culminating in (±)-trans-57bwhich featured the best combination of potency, selectivity index, solubility, and microsomal stability. Enantiomeric separation afforded (4aS,13bR)-57b(BDGR-20237) with a 41-fold potency advantage over its enantiomer. ADME and mouse pharmacokinetic profiling for BDGR-20237revealed high brain penetrance but a limited half-life which did not statistically enhance the mouse survival in a pilot efficacy study. The pharmacophoric model, supported by 88 quinazolinones, several of which exhibit subnanomolar potency, will guide further scaffold optimization.

The kinetics of many chemical reactions can be readily explained with a statistical approach, for example, using a form of transition state theory and comparing calculated Gibbs energies along the reaction coordinate(s). However, there are cases where this approach fails, notably when the vibrational relaxation of the molecule to its statistical equilibrium occurs on the same time scale as the reaction dynamics, whether it is caused by slow relaxation, a fast reaction, or both. These nonstatistical phenomena are then often explored computationally using (quasi)classical ab initio molecular dynamics by calculating a large number of trajectories while being prone to issues such as zero-point energy leakage. On the other side of the field, we see resource-intensive quantum dynamics simulations, which significantly limit the size of explorable systems. We find that using a Fermi’s golden rule type of model for vibrational relaxation, based on anharmonic coupling constants, we can extract the same qualitative information while giving insights into how to enhance (or destroy) the bottlenecks causing the phenomena. We present this model as a middle ground for exploring complex nonstatistical behavior, capable of treating medium-sized organic molecules or biologically relevant fragments. We also cover the challenges involved, in particular quantifying the excess energy in terms of vibrational modes. Relying on readily available electronic structure methods and providing results in a simple master equation form, this model shows promise as a screening tool for opportunities in mode-selective chemistry without external control.

Molecular (dye) aggregates are a materials platform that feature collective excitations, known as excitons, with applications in light harvesting, organic optoelectronics, and nanoscale computing. Several recent works have explored the possibility of using exciton–exciton superpositions as a basic unit in quantum information science (QIS). For their successful use in QIS, it is necessary to maximize both the beating frequency, νh, and the decoherence time, τd, of the superposition. Although direct measurements of these parameters are challenging, it has been shown that excitonic τdis similar to the decoherence time of the associated optical transitions, that is, optical τd. Further, optical τdis related to line broadening, which can readily be measured via absorption spectroscopy. In this work, we characterize line broadening in Cy5 and Cy5.5 monomers and homo- and heterotetramers, tethered to and assembled with Deoxyribonucleic acid (DNA), using steady-state absorption spectroscopy and two-dimensional electronic spectroscopy (2D ES). We also characterize the line broadening of Cy5 free in solution. We find that the width of the primary feature in the tetramer steady-state absorption spectra decreases with increasing Cy5 content. Additionally, the line width of the Cy5 tetramer is smaller than the Cy5 monomer, suggesting that collective excitonic effects may act to reduce the line width. Using 2D ES, we find that homogeneous broadening of all monomers is similar up to time scales of 10 ps; however, after 10 ps DNA appears to cause additional homogeneous broadening, possibly due to large-scale DNA fluctuations. We find using 2D ES that the relative homogeneous and inhomogeneous contributions to spectral broadening in the tetramers are influenced by their composition and excitonic coupling strength. In addition to revealing how aggregate composition influences spectral broadening, this work highlights structural features of dyes that may serve to reduce spectral broadening, which, in turn, may increase optical and excitonic τd.

The MSI MPG 341CQPX is a QD-OLED ultrawide monitor that stands out from its competitors with a 240Hz refresh rate and a USB-C port with 98 watts of Power Delivery. It has a 34-inch panel with a resolution of 3440x1440, Adaptive Sync, and a variety of ports. The design of the monitor is decent, but not as premium as some alternatives, and it lacks RGB lighting. The connectivity options are excellent, and the menu system is easy to use. The image quality is similar to other QD-OLED monitors, with exceptional contrast and color performance, but slightly lower brightness in SDR and potential sharpness issues. The monitor performs well in HDR, with a peak brightness of 1,012 nits in a 10 percent window. Motion performance is also great, thanks to the 240Hz refresh rate and OLED's quick pixel response times. The monitor supports Adaptive Sync, but lacks certification for FreeSync and G-Sync. Overall, the MSI MPG 341CQPX is a solid choice for gaming, movies, and content creation. [Extracted from the article]

Eu-doped CsBr films (CsBr:Eu) exhibit excellent sensitivity for X-rays and are superior storage phosphors for high energy (MeV) photon radiography applications when coupled with thick copper or tungsten substrates. We report on the growth of micro-columnar CsBr:Eu films on copper substrates for megavolt (MV) X-ray imaging applications. Our films exhibit dense uniformly distributed micro-columns with an average diameter of $\sim 10~\mu $ m and a sharp, needle-like top. The advantage of this micro-columnar structured film is that the light can be channeled through the narrow columns to improve both light transmission and spatial resolution. We also determined the optimal Eu concentration in CsBr for the best storage phosphor performance. Growth of uniformly thick, micro-columnar structured films up to 2 mm was achieved on $2^{\prime \prime } \times 2^{\prime \prime }$ metallic substrates, which were then characterized by optically-stimulated luminescence (OSL) coupled with X-ray excitation. Furthermore, 5 mm thick film growth demonstrates the potential to scale up to even thicker films.

IMPORTANCE: The X chromosome has remained enigmatic in Alzheimer disease (AD), yet it makes up 5% of the genome and carries a high proportion of genes expressed in the brain, making it particularly appealing as a potential source of unexplored genetic variation in AD. OBJECTIVES: To perform the first large-scale X chromosome–wide association study (XWAS) of AD. DESIGN, SETTING, AND PARTICIPANTS: This was a meta-analysis of genetic association studies in case-control, family-based, population-based, and longitudinal AD-related cohorts from the US Alzheimer’s Disease Genetics Consortium, the Alzheimer’s Disease Sequencing Project, the UK Biobank, the Finnish health registry, and the US Million Veterans Program. Risk of AD was evaluated through case-control logistic regression analyses. Data were analyzed between January 2023 and March 2024. Genetic data available from high-density single-nucleotide variant microarrays and whole-genome sequencing and summary statistics for multitissue expression and protein quantitative trait loci available from published studies were included, enabling follow-up genetic colocalization analyses. A total of 1 629 863 eligible participants were selected from referred and volunteer samples, 477 596 of whom were excluded for analysis exclusion criteria. The number of participants who declined to participate in original studies was not available. MAIN OUTCOME AND MEASURES: Risk of AD, reported as odds ratios (ORs) with 95% CIs. Associations were considered at X chromosome–wide (P &lt; 1 × 10−5) and genome-wide (P &lt; 5 × 10−8) significance. Primary analyses are nonstratified, while secondary analyses evaluate sex-stratified effects. RESULTS: Analyses included 1 152 284 participants of non-Hispanic White, European ancestry (664 403 [57.7%] female and 487 881 [42.3%] male), including 138 558 individuals with AD. Six independent genetic loci passed X chromosome–wide significance, with 4 showing support for links between the genetic signal for AD and expression of nearby genes in brain and nonbrain tissues. One of these 4 loci passed conservative genome-wide significance, with its lead variant centered on an intron of SLC9A7 (OR, 1.03; 95% CI, 1.02-1.04) and colocalization analyses prioritizing both the SLC9A7 and nearby CHST7 genes. Of these 6 loci, 4 displayed evidence for escape from X chromosome inactivation with regard to AD risk. CONCLUSION AND RELEVANCE: This large-scale XWAS of AD identified the novel SLC9A7 locus. SLC9A7 regulates pH homeostasis in Golgi secretory compartments and is anticipated to have downstream effects on amyloid β accumulation. Overall, this study advances our knowledge of AD genetics and may provide novel biological drug targets. The results further provide initial insights into elucidating the role of the X chromosome in sex-based differences in AD.

IMPORTANCE: Nonrestorable teeth are recommended to be extracted prior to radiation therapy (RT). Occasionally, preradiation extractions introduce unacceptable delays in treatment initiation. Planned dental extractions immediately postradiation presents an alternative strategy, though outcomes are uncertain. OBJECTIVE: To evaluate the feasibility and safety of dental extractions immediately postradiation. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study including patients planned for curative-intent RT but unable or unwilling to proceed with 1 or more extractions recommended pretreatment was carried out. From January 2020 to September 2022, 58 patients were screened and 50 enrolled. The dental care was performed at a single academic department and the cancer care at regional centers. Analysis took place between September 22, 2023, and June 10, 2024. EXPOSURE: On completion of RT, patients were recommended to complete extractions as soon as feasible, and ideally within 4 months. MAIN OUTCOMES AND MEASURES: The primary end point was the actuarial cumulative incidence of exposed alveolar bone noted by any practitioner at any time after extraction, calculated using Gray method with death as a competing risk. As a pilot study, no formal power calculation was performed; resources allowed for 50 evaluable patients. RESULTS: Among the 50 participants enrolled, RT was nonoperative for 32 patients (64%) and postoperative for 18 patients (36%). Intensity-modulated RT (IMRT) was delivered in all patients. Of the 50 patients, 20 (40%) declined dental extractions immediately postradiation and the remaining 30 (60%) underwent a median (range) of 8.5 (1-28) extractions at a median (range) of 64.5 (13-152) days after RT. The median (IQR) follow-up for survivors without exposed bone was 26 (17-35) months from the end of RT. The 2-year cumulative incidence of any exposed bone was 27% (95% CI, 14%-40%). The 2-year incidence of exposed bone for those who underwent dental extractions immediately postradiation was 40% (95% CI, 22%-58%) and 7% (95% CI, 0%-22%) for those who did not. Of the 13 who developed exposed bone: 4 resolved, 1 was lost to follow-up, and 8 were confirmed as osteoradionecrosis. CONCLUSIONS AND RELEVANCE: This cohort study found that postradiation dental extractions incur considerable risk, even if performed within a 4-month window.

IMPORTANCE: Liberal oxygen (hyperoxia) is commonly administered to patients during surgery, and oxygenation is known to impact mechanisms of perioperative organ injury. OBJECTIVE: To evaluate the effect of intraoperative hyperoxia compared to maintaining normoxia on oxidative stress, kidney injury, and other organ dysfunctions after cardiac surgery. DESIGN, SETTING, AND PARTICIPANTS: This was a participant- and assessor-blinded, randomized clinical trial conducted from April 2016 to October 2020 with 1 year of follow-up at a single tertiary care medical center. Adult patients (>18 years) presenting for elective open cardiac surgery without preoperative oxygen requirement, acute coronary syndrome, carotid stenosis, or dialysis were included. Of 3919 patients assessed, 2501 were considered eligible and 213 provided consent. Of these, 12 were excluded prior to randomization and 1 following randomization whose surgery was cancelled, leaving 100 participants in each group. INTERVENTIONS: Participants were randomly assigned to hyperoxia (1.00 fraction of inspired oxygen [FiO2]) or normoxia (minimum FiO2 to maintain oxygen saturation 95%-97%) throughout surgery. MAIN OUTCOMES AND MEASURES: Participants were assessed for oxidative stress by measuring F2-isoprostanes and isofurans, for acute kidney injury (AKI), and for delirium, myocardial injury, atrial fibrillation, and additional secondary outcomes. Participants were monitored for 1 year following surgery. RESULTS: Two hundred participants were studied (median [IQR] age, 66 [59-72] years; 140 male and 60 female; 82 [41.0%] with diabetes). F2-isoprostanes and isofurans (primary mechanistic end point) increased on average throughout surgery, from a median (IQR) of 73.3 (53.1-101.1) pg/mL at baseline to a peak of 85.5 (64.0-109.8) pg/mL at admission to the intensive care unit and were 9.2 pg/mL (95% CI, 1.0-17.4; P = .03) higher during surgery in patients assigned to hyperoxia. Median (IQR) change in serum creatinine (primary clinical end point) from baseline to postoperative day 2 was 0.01 mg/dL (−0.12 to 0.19) in participants assigned hyperoxia and −0.01 mg/dL (−0.16 to 0.19) in those assigned normoxia (median difference, 0.03; 95% CI, −0.04 to 0.10; P = .45). AKI occurred in 21 participants (21%) in each group. Intraoperative oxygen treatment did not affect additional acute organ injuries, safety events, or kidney, neuropsychological, and functional outcomes at 1 year. CONCLUSIONS: Among adults receiving cardiac surgery, intraoperative hyperoxia increased intraoperative oxidative stress compared to normoxia but did not affect kidney injury or additional measurements of organ injury including delirium, myocardial injury, and atrial fibrillation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02361944

Recombinant adeno-associated virus (rAAV) vector gene delivery systems have demonstrated great promise in clinical trials but continue to face durability and dose-related challenges. Unlike rAAV gene therapy, integrating gene addition approaches can provide curative expression in mitotically active cells and pediatric populations. We explored a novel in vivodelivery approach based on an engineered transposase, Sleeping Beauty(SB100X), delivered as an mRNA within a lipid nanoparticle (LNP), in combination with an rAAV-delivered transposable transgene. This combinatorial approach achieved correction of ornithine transcarbamylase deficiency in the neonatal Spfashmouse model following a single delivery to dividing hepatocytes in the newborn liver. Correction remained stable into adulthood, while a conventional rAAV approach resulted in a return to the disease state. In non-human primates, integration by transposition, mediated by this technology, improved gene expression 10-fold over conventional rAAV-mediated gene transfer while requiring 5-fold less vector. Additionally, integration site analysis confirmed a random profile while specifically targeting TA dinucleotides across the genome. Together, these findings demonstrate that transposable elements can improve rAAV-delivered therapies by lowering the vector dose requirement and associated toxicity while expanding target cell types.

Despite the prevalence of N-heteroarenes in small-molecule pharmaceuticals, Pd-catalyzed C–N cross-coupling reactions of aryl halides and amines containing these rings remain challenging due to their ability to displace the supporting ligand via coordination to the metal center. To address this limitation, we report the development of a highly robust Pd catalyst supported by a new dialkylbiarylphosphine ligand, FPhos. The FPhos-supported catalyst effectively resists N-heteroarene-mediated catalyst deactivation to readily promote C–N coupling between a wide variety of Lewis-basic aryl halides and secondary amines, including densely functionalized pharmaceuticals. Mechanistic and structural investigations, as well as principal component analysis and density functional theory, elucidated two key design features that enable FPhos to overcome the limitations of previous ligands. First, the ligated Pd complex is stabilized through its conformational preference for the O-bound isomer, which likely resists coordination by N-heteroarenes. Second, 3′,5′-disubstitution on the non-phosphorus-containing ring of FPhos creates the ideal steric environment around the Pd center, which facilitates binding by larger secondary amines while mitigating the formation of off-cycle palladacycle species.

We present VoxAR, a method to facilitate an effective visualization of volume-rendered objects in optical see-through head-mounted displays (OST-HMDs). The potential of augmented reality (AR) to integrate digital information into the physical world provides new opportunities for visualizing and interpreting scientific data. However, a limitation of OST-HMD technology is that rendered pixels of a virtual object can interfere with the colors of the real-world, making it challenging to perceive the augmented virtual information accurately. We address this challenge in a two-step approach. First, VoxAR determines an appropriate placement of the volume-rendered object in the real-world scene by evaluating a set of spatial and environmental objectives, managed as user-selected preferences and pre-defined constraints. We achieve a real-time solution by implementing the objectives using a GPU shader language. Next, VoxAR adjusts the colors of the input transfer function (TF) based on the real-world placement region. Specifically, we introduce a novel optimization method that adjusts the TF colors such that the resulting volume-rendered pixels are discernible against the background and the TF maintains the perceptual mapping between the colors and data intensity values. Finally, we present an assessment of our approach through objective evaluations and subjective user studies.

•Intracranial aneurysms are more prevalent than previously described, affecting 1 in 6 participants in our cohort.•Tissue-based cerebral blood flow may serve as a neuroimaging biomarker of hemodynamic stress underlying aneurysmal formation.

About 90% of active pharmaceutical ingredients (APIs) in the oral drug delivery system pipeline have poor aqueous solubility and low bioavailability. To address this problem, amorphous solid dispersions (ASDs) embed hydrophobic APIs within polymer excipients to prevent drug crystallization, improve solubility, and increase bioavailability. There are a limited number of commercial polymer excipients, and the structure–function relationships which lead to successful ASD formulations are not well-documented. There are, however, certain solid-state ASD characteristics that inform ASD performance. One characteristic shared by successful ASDs is a high glass transition temperature (Tg), which correlates with higher shelf stability and decreased drug crystallization. We aim to identify how polymer features such as side chain geometry, backbone methylation, and hydrophilic–lipophilic balance impact Tgto design copolymers capable of forming high-TgASDs. We tested a library of 50 ASD formulations (18 previously studied and 32 newly synthesized) of the model drug probucol with copolymers synthesized through automated photoinduced electron/energy transfer-reversible addition–fragmentation chain-transfer (PET-RAFT) polymerization. A machine learning (ML) algorithm was trained on the Tgdata to identify the major factors influencing Tg, including backbone methylation and nonlinear side chain geometry. In both polymer alone and probucol-loaded ASDs, a Random Forest Regressor captured structure–function trends in the data set and accurately predicted Tgwith an average R2> 0.83 across a 10-fold cross validation. This ML model will be used to predict novel copolymers to design ASDs with high Tg, a crucial factor in predicting ASD success.

Interlayer excitons in transition-metal dichalcogenide heterobilayers combine high binding energy and valley-contrasting physics with a long optical lifetime and strong dipolar character. Their permanent electric dipole enables electric-field control of the emission energy, lifetime, and location. Device material and geometry impact the nature of the interlayer excitons via their real- and momentum-space configurations. Here, we show that interlayer excitons in MoS2/MoSe2heterobilayers are formed by charge carriers residing at the Brillouin zone edges, with negligible interlayer hybridization. We find that the moiré superlattice leads to the reversal of the valley-dependent optical selection rules, yielding a positively valued g-factor and cross-polarized photoluminescence. Time-resolved photoluminescence measurements reveal that the interlayer exciton population retains the optically induced valley polarization throughout its microsecond-long lifetime. The combination of a long optical lifetime and valley polarization retention makes MoS2/MoSe2heterobilayers a promising platform for studying fundamental bosonic interactions and developing excitonic circuits for optical information processing.

The garnet aluminates RE3Al5O12(RE= Gd – Lu, Y) are an important class of optical materials with a range of applications. Typically, they do not tolerate large deviations from ideal stoichiometry, and their luminescence properties are controlled by dopant selection rather than modification of the host structure. Here, we use glass crystallization as a nonequilibrium synthesis route to a new family of highly nonstoichiometric gadolinium aluminate garnets, of formula Gd3+xAl5-xO12with x≤ 0.60. Remarkably, this range is much broader than the previously reported Y3+xAl5-xO12series (x≤ 0.4), despite the vast size contrast between Al3+and Gd3+, which are forced to share a crystallographic site in the nonstoichiometric materials: the endmember Gd3.6Al4.4O12lies halfway between ideal garnet and perovskite stoichiometries, with 30% of its octahedral Al3+sites substituted by Gd3+. In principle, this crystal chemistry should allow the synthesis of phosphor systems with rare-earth activators distributed over two different cation sublattices. To probe the response of luminescence properties to extreme nonstoichiometry in Gd3+xAl5-xO12, we synthesized three model phosphor systems by doping with Ce3+, Tb3+, or Tm3+/Yb3+and found that upconversion (Tm3+/Yb3+) phosphors have the most potential to be tuned by this approach. These results demonstrate that highly nonstoichiometric garnet aluminates are not limited to small rare-earth hosts such as YAG, opening new opportunities for development of different garnet-based optical and magnetic materials.

The Asus ROG Swift PG32UCDP is a 32-inch 4K OLED monitor that offers exceptional image quality and versatility. It has a maximum refresh rate of 480Hz at 1080p, making it ideal for both immersive gaming and competitive multiplayer titles. The monitor also boasts superb HDR performance and a wide range of connectivity options, including USB-C. While the color performance may not be as strong as some competitors, the overall image quality, motion clarity, and HDR capabilities make the Asus ROG Swift PG32UCDP an outstanding choice for those seeking a top-of-the-line OLED monitor. [Extracted from the article]

Accurate image reconstruction is at the heart of diagnostics in medical imaging. Supervised deep learning-based approaches have been investigated for solving inverse problems including image reconstruction. However, these trained models encounter unseen data distributions that are widely shifted from training data during deployment. Therefore, it is essential to assess whether a given input falls within the training data distribution. Current uncertainty estimation approaches focus on providing an uncertainty map to radiologists, rather than assessing the training distribution fit. In this work, we propose a method based on the local Lipschitz metric to distinguish out-of-distribution images from in-distribution with an area under the curve of 99.94% for True Positive Rate versus False Positive Rate. We demonstrate a very strong relationship between the local Lipschitz value and mean absolute error (MAE), supported by a Spearman's rank correlation coefficient of 0.8475, to determine an uncertainty estimation threshold for optimal performance. Through the identification of false positives, we demonstrate the local Lipschitz and MAE relationship can guide data augmentation and reduce uncertainty. Our study was validated using the AUTOMAP architecture for sensor-to-image Magnetic Resonance Imaging (MRI) reconstruction. We demonstrate our approach outperforms baseline techniques of Monte-Carlo dropout and deep ensembles as well as the state-of-the-art Mean Variance Estimation network approach. We expand our application scope to MRI denoising and Computed Tomography sparse-to-full view reconstructions using UNET architectures. We show our approach is applicable to various architectures and applications, especially in medical imaging, where preserving diagnostic accuracy of reconstructed images remains paramount.

Graphical Abstract:

Introduction: As the volume of technology-assisted total hip arthroplasty (THA) increases, there is a need to characterise the outcomes of robotic-assisted (RA) and computer-navigated (CN) THA. The goal of this study was to assess outcomes and opioid consumption following CN-THA and RA-THA compared to conventionally-instrumented (CON) THA.Methods: The Premier Database was queried for all patients who underwent primary, elective THA from 2015-2020. Patients were divided into 3 groups: CN, RA, or CON-THA. Yearly usage trends were assessed. Univariate and multivariate analyses were performed to assess the 90-day risk of postoperative complications. Opioid consumption was reported in morphine milligram equivalents (MME) for postoperative days (POD) 0 and 1.Results: Overall, 474,707 elective THAs were identified (95.7% CON, 2.1% CN, 2.2% RA. After accounting for confounders, CN-THA patients were at decreased risk for periprosthetic joint infection (PJI) (aOR: 0.55, p< 0.001) and dislocation (aOR 0.45, p< 0.001), but increased risk for blood transfusion (aOR 1.97, <0.001) compared to CON-THA. RA-THA patients were at decreased risk of dislocation (aOR:0.66, p< 0.001) but increased risk for transfusion (aOR 1.20, p< 0.001), prosthesis breakage (aOR 3.88, p< 0.001), and periprosthetic fracture (aOR 1.72, p< 0.001). Opioid consumption for CN-THA patients was lower on POD1 and lower for RA-THA patients POD0 and 2 compared to CON-THA.Discussion: CN-THA was associated with reduced rates of PJI and dislocation, but increased rates of blood transfusion while RA-THA was associated with decreased rates of dislocation, but increased rates of blood transfusion, prosthesis complications, and periprosthetic fracture compared to CON-THA. Technology-assisted THA was associated with lower postoperative opioid consumption.

Empirical decisions to select therapies for psoriasis (PSO) and atopic dermatitis (AD) can lead to delays in disease control and increased health care costs. However, routine molecular testing for AD and PSO are lacking.

Background Orbital involvement of invasive fungal sinusitis (IFS) is an ominous prognostic marker that should prompt rapid intervention. Transcutaneous retrobulbar administration of amphotericin B (TRAMB) is an off-label adjunctive treatment that can increase drug penetrance into diseased orbital tissue. To date, there is a lack of consensus regarding the use of TRAMB for treatment of IFS with orbital involvement.Objective This systematic review aims to synthesize the indications, efficacy, and potential complications of TRAMB.Methods PubMed, EMBASE, and Web of Science databases were probed for systematic review. Article search was conducted through June 2023 using the keywords “invasive fungal sinusitis,” “invasive fungal rhinosinusitis,” “rhino-orbital mucormycosis,” “rhinosinusitis,” “orbital,” “retrobulbar,” and “amphotericin.”Results In suitable cases as determined by radiologic and clinical evaluation, TRAMB administration has the potential to improve orbital salvage rates and improve versus stabilize visual acuity. Treatment complications are more likely with deoxycholate than with liposomal amphotericin formulations. The existing literature describing use of TRAMB is limited due to its retrospective nature, but the increase in IFS cases since 2020 due to the COVID pandemic has broadened the literature.Conclusions TRAMB is an effective adjunctive treatment in IFS with mild-to-moderate orbital involvement when used in combination with standard of care debridement, systemic antifungal therapy, and immunosuppression reversal. Prospective longitudinal studies and multi-institutional randomized trials are necessary to determine the definitive utility of TRAMB.

Open vascular reconstructions (OVR), including bypass grafts and dialysis access, are standard treatments for cardiovascular and renal diseases. Unfortunately, OVR often fail largely due to intimal hyperplasia (IH), and there are no clinical methods to prevent this complication. Perivascular drug administration during OVR presents a promising strategy for IH suppression. However, durations of drug release from carriers are generally short whereas sustained efficacy is essential for clinical success. This raises a critical question in clinical translation: can IH suppression be realistically maintained long-term (e.g., over 6 months) with short-term perivascular interventions? To address this question, we modified a rat vein-graft model to prolong IH progression. We then applied Pericelle, a nanoparticle/hydrogel hybrid system that we developed for perivascular delivery of rapamycin, an established IH-inhibitory drug. Surprisingly, despite short (∼3-month) drug release, Pericelle demonstrated IH suppression throughout 3, 6, and 9 months with IH reduced from 115.58 ± 27.89 to 40.34 ± 5.18 at 9 months (P < 0.05, n = 6 rats), as indicated by morphometric analysis. Live animal ultrasonography showed the same trend. Consistently, histone-3 lysine-27 trimethylation, an epigenetic mark associated with IH progression, was decreased at 6 months after Pericelle treatment. Moreover, Pericelle exhibited promising efficacy in mitigating IH in a porcine model of arteriovenous fistula that mimics dialysis access. These results suggest that Pericelle-mediated suppression of IH in rat vein-grafts extends much beyond drug release, offering potential solutions to longstanding translational challenges in reducing OVR failure.

Hepatic xenobiotic metabolism and transport decline with age, while intact xenobiotic metabolism is associated with longevity. However, few studies have examined the genome-wide impact of epigenetic aging on these processes. We used reduced representation bisulfite sequencing (RRBS) to map DNA methylation changes in liver DNA from mice ages 4 and 24 months. We identified several thousand age-associated differentially methylated sites (a-DMS), many of which overlapped genes encoding Phase I and Phase II drug metabolizing enzymes, in addition to ABC and SLC classes of transporters. Notable genes harboring a-DMS were Cyp1a2, Cyp2d9, and Abcc2that encode orthologs of the human drug metabolizing enzymes CYP1A2 and CYP2D6, and the multidrug resistance protein 2 (MRP2) transporter. Cyp2d9hypermethylation with age was significantly associated with reduced gene expression, while Abcc2expression was unchanged with age. Cyp1a2lost methylation with age while, counterintuitively, its expression also reduced with age. We hypothesized that age-related dysregulation of the hepatic transcriptional machinery caused down-regulation of genes despite age-related hypomethylation. Bioinformatic analysis of hypomethylated a-DMS in our sample found them to be highly enriched for hepatic nuclear factor 4 alpha (HNF4α) binding sites. HNF4α promotes Cyp1a2expression and is downregulated with age, which could explain the reduction in Cyp1a2expression. Overall, our study supports the broad impact of epigenetic aging on xenobiotic metabolism and transport. Future work should evaluate the interplay between hepatic nuclear receptor function and epigenetic aging. These results may have implications for studies of longevity and healthy aging.

Background: Surgery for urological cancers is associated with high complication rates and survivors commonly experience fatigue, reduced physical ability and quality of life. High-intensity interval training (HIIT) as surgical prehabilitation has been proven effective for improving the cardiorespiratory fitness (CRF) of urological cancer patients, however the mechanistic basis of this favourable adaptation is undefined. Thus, we aimed to assess the mechanisms of physiological responses to HIIT as surgical prehabilitation for urological cancer. Methods: Nineteen male patients scheduled for major urological surgery were randomised to complete 4-weeks HIIT prehabilitation (71.6 ± 0.75 years, BMI: 27.7 ± 0.9 kg·m2) or a no-intervention control (71.8 ± 1.1 years, BMI: 26.9 ± 1.3 kg·m2). Before and after the intervention period, patients underwent m. vastus lateralisbiopsies to quantify the impact of HIIT on mitochondrial oxidative phosphorylation (OXPHOS) capacity, cumulative myofibrillar muscle protein synthesis (MPS) and anabolic, catabolic and insulin-related signalling. Results: OXPHOS capacity increased with HIIT, with increased expression of electron transport chain protein complexes (C)-II (p= 0.010) and III (p= 0.045); and a significant correlation between changes in C-I (r= 0.80, p= 0.003), C-IV (r= 0.75, p= 0.008) and C-V (r= 0.61, p= 0.046) and changes in CRF. Neither MPS (1.81 ± 0.12 to 2.04 ± 0.14%·day−1, p= 0.39) nor anabolic or catabolic proteins were upregulated by HIIT (p> 0.05). There was, however, an increase in phosphorylation of AS160Thr642(p= 0.046) post-HIIT. Conclusions: A HIIT surgical prehabilitation regime, which improved the CRF of urological cancer patients, enhanced capacity for skeletal muscle OXPHOS; offering potential mechanistic explanation for this favourable adaptation. HIIT did not stimulate MPS, synonymous with the observed lack of hypertrophy. Larger trials pairing patient-centred and clinical endpoints with mechanistic investigations are required to determine the broader impacts of HIIT prehabilitation in this cohort, and to inform on future optimisation (i.e., to increase muscle mass).

Objective. The objective of this study was to examine primary factors that may predict patients&apos; failure to show at initial physical therapist evaluation in an orthopedic and sports outpatient setting. Methods. A retrospective analysis of patients&apos; demographic data for physical therapist evaluations between January 2013 and April 2015 was performed. A binary logistic regression model was used to evaluate the odds of a no-show at evaluation. Demographic variables of age, employment status, days waited for the appointment, payer source, and distance traveled to the clinic were analyzed. Independent variables were considered significant if the 95% CIs of the odds ratios (ORs) did not include 1.0. Results. A total of 6971 patients were included in the final analysis, with 10% (n = 698) of the scheduled patients having a no-show event for their initial evaluation. The following factors increased the odds of patients having a no-show event: days to appointment (OR = 1.058; 95% CI = 1.042-1.074), unemployment status (OR = 1.96; 95% CI = 1.41 -2.73), unknown employment status (OR = 3.22; 95% CI = 1.12-8.69), Medicaid insurance (OR = 4.87; 95% CI = 3.43-6.93), Medicare insurance (OR = 2.22; 95% CI = 1.10-4.49), unknown payer source (OR = 262.84; 95% CI = 188.72-366.08), and distance traveled 8 or more kilometers (OR = 1.31; 95% CI = 1.01 -1.70). Female sex (OR = 0.73; 95% CI = 0.57-0.95) and age 40 years or older (OR = 0.44; 95% CI = 0.33-0.60) decreased the odds of a no-show event. Conclusions. Results from this study indicate there may be some demographic factors that are predictive of patients failing to attend their first physical therapist visit. Impact. Understanding the predictive factors and identifying potential opportunities for improvements in scheduling processes might help decrease the number of patients failing to show for their initial physical therapy appointment, with the ultimate goal of positively influencing patient outcomes. Keywords: Attendance, Employment, Health Insurance, Medicaid, Medicare, No-Show, Patient Characteristics, Time to Appointment, Workers&apos; Compensation, Introduction Within the US health care system, timely access to medical care can be a challenge both for patients and providers. (1) Overall, wait times for new patient appointments with [...]

Keywords: Education: Postprofessional, Education: Professional, Education: Competency-Based, Education: Accreditation, A pandemic has disrupted every facet of life. Educators have scrambled to adapt what existed "pre-COVID," attempting to salvage plans while considering how to meet requirements that previously seemed important [...]

Most Combat Training Center (CTC) struggles tie back to 'time' and 'stuff.' The military decision-making process (MDMP) typically takes too much time, and the brigade combat team (BCT) has more [...]

Introduction. Persons with disabilities around the world struggle to make the kinds of decisions about their lives that many other people take for granted. These include decisions about whom to [...]

AbstractThe diagnosis of plasma-facing components in a fusion environment is challenging due to the limited number of measurement techniques that have been developed for in situ surface analysis. In this work, we assess the feasibility of using neutron reflectometry (NR) for the in situ diagnosis of deuterium accumulation in tungsten and dispersion-strengthened tungsten alloys. TRIM is used to simulate deuterium implantation at different energies to approximate the deuterium depth profiles in these materials in order to calculate the expected measurements from NR for various fluences. Our results suggest that NR should be an effective technique for testing hypotheses about the surface composition of materials under fusion-relevant fluences of deuterium irradiation.