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Context. Recent works use a linear birth metallicity gradient to estimate the evolution of the [Fe/H] profile in the Galactic disk over time, and infer stellar birth radii (Rbirth) from [Fe/H] and age measurements. These estimates rely on the evolution of [Fe/H] at the Galactic center ([Fe/H](0, τ)) and the birth metallicity gradient (∇[Fe/H](τ)) over time – quantities that are unknown and inferred under key assumptions. Aims. In this work, we use the sample of Milky Way and Andromeda analogues from the TNG50 simulation to investigate the ability to recover [Fe/H](R, τ) in a variety of galaxies. Methods. Using stellar disk particles, we tested the assumptions required in estimating Rbirth, [Fe/H](0, τ), and ∇[Fe/H](τ) using recently proposed methods to understand when they are valid. Results. We show that ∇[Fe/H](τ) can be recovered in most galaxies to within 26% from the range in [Fe/H] across age, with better accuracy for more massive and stronger barred galaxies. We also find that the true central metallicity is unrepresentative of the genuine disk [Fe/H] profile; thus we propose to use a projected central metallicity instead. About half of the galaxies in our sample do not have a continuously enriching projected central metallicity, with a dilution in [Fe/H] correlating with mergers. Most importantly, galaxy-specific [Fe/H](R, τ) can be constrained and confirmed by requiring the Rbirth distributions of mono-age, solar neighborhood populations to follow inside-out formation. Conclusions. We conclude that examining trends with Rbirth is valid for the Milky Way disk and similarly structured galaxies, where we expect Rbirth can be recovered to within 20% assuming today's measurement uncertainties in TNG50. [ABSTRACT FROM AUTHOR]

We use numerical simulations to model Gaia  DR3 data with the aim of constraining the Milky Way (MW) bar and spiral structure parameters. We show that both the morphology and the velocity field in MW-like galactic disc models are strong functions of time, changing dramatically over a few tens of Myr. This suggests that by finding a good match to the observed radial velocity field, vR (x, y), we can constrain the bar-spiral orientation. Incorporating uncertainties into our models is necessary to match the data; most importantly, a heliocentric distance uncertainty above 10–15 per cent distorts the bar's shape and vR quadrupole pattern morphology, and decreases its apparent angle with respect to the Sun-Galactocentric line. An excellent match to the Gaia   DR3 vR (x, y) field is found for a simulation with a bar length Rb ≈ 3.6 kpc. We argue that the data are consistent with an MW bar as short as ∼3 kpc, for moderate strength inner disc spiral structure (A 2/ A 0 ≈ 0.25) or, alternatively, with a bar length up to ∼5.2 kpc, provided that spiral arms are quite weak (A 2/ A 0 ≈ 0.1), and is most likely in the process of disconnecting from a spiral arm. We demonstrate that the bar angle and distance uncertainty can similarly affect the match between our models and the data – a smaller bar angle (20° instead of 30°) requires smaller distance uncertainty (20 per cent instead of 30 per cent) to explain the observations. Fourier components of the face-on density distribution of our models suggest that the MW does not have strong m = 1 and/or m  = 3 spirals near the solar radius. [ABSTRACT FROM AUTHOR]

Context. In June 2022, Gaia DR3 provided the astronomy community with about one million spectra from the Radial Velocity Spectrometer (RVS) covering the CaII triplet region. In the next Gaia data releases, we anticipate the number of RVS spectra to successively increase from several 10 million spectra to eventually more than 200 million spectra. Thus, stellar spectra are projected to be produced on an 'industrial scale', with numbers well above those for current and anticipated ground-based surveys. However, one-third of the published spectra have 15 ≤ S /N ≤ 25 per pixel such that they pose problems for classical spectral analysis pipelines, and therefore, alternative ways to tap into these large datasets need to be devised. Aims. We aim to leverage the versatility and capabilities of machine learning techniques for supercharged stellar parametrisation by combining Gaia-RVS spectra with the full set of Gaia products and high-resolution, high-quality ground-based spectroscopic reference datasets. Methods. We developed a hybrid convolutional neural network (CNN) that combines the Gaia DR3 RVS spectra, photometry (G, G_BP, G_RP), parallaxes, and XP coefficients to derive atmospheric parameters (Teff, log(g) as well as overall [M/H]) and chemical abundances ([Fe/H] and [α/M]). We trained the CNN with a high-quality training sample based on APOGEE DR17 labels. Results. With this CNN, we derived homogeneous atmospheric parameters and abundances for 886 080 RVS stars that show remarkable precision and accuracy compared to external datasets (such as GALAH and asteroseismology). The CNN is robust against noise in the RVS data, and we derive very precise labels down to S/N =15. We managed to characterise the [α/M] - [M/H] bimodality from the inner regions to the outer parts of the Milky Way, which has never been done using RVS spectra or similar datasets. Conclusions. This work is the first to combine machine learning with such diverse datasets and paves the way for large-scale machine learning analysis of Gaia-RVS spectra from future data releases. Large, high-quality datasets can be optimally combined thanks to the CNN, thereby realising the full power of spectroscopy, astrometry, and photometry. [ABSTRACT FROM AUTHOR]

This article discusses the case of a 3.5 kg infant who underwent a transcatheter device closure of a large muscular ventricular septum defect (VSD) at the age of 19 days. The infant had previously undergone aortic arch patch plastic surgery due to critical coarctation of the aorta. The surgical repair of the VSD was considered high-risk, so an interventional closure using a device was chosen as an opt-out strategy. The procedure was successful, with a small residual pressure and no device-related obstruction observed. The infant's condition improved, and they were eventually discharged from the hospital. The article concludes that transcatheter device closure of a large VSD is feasible in neonates and can be a successful alternative in certain cases. [Extracted from the article]

A palladium capsule, made of three cavitands, namely P , P -dichlorido{5,17-bis[5-(diphenylphosphanyl)-4(24),6(10),12(16),18(22)-tetramethylenedioxy-2,8,14,20-tetrapentylresorcin[4]arenyl-17-oxymthyl]-4(24),6(10),12(16),18(22)-tetramethylenedioxy-2,8,14,20-tetrapentylresorcin[4]arene}palladium(II) ( 1 ), was synthetized by coordination of the corresponding diphosphinated ligand and the palladium precursor [PdCl 2 (PhCN) 2 ] in 27% yield. The obtained P , P -chelate complex was fully characterized by elemental analysis, NMR and mass spectrometry. Molecular dynamics simulations carried out on the metallo-capsule showed the structure made by the three cavitands was slightly distorted over the 1 μs of the simulation. The evaluation of the palladium capsule 1 in the reaction between arylacetylenes and Et 3 SiH in undried conditions unequivocally demonstrates a drastic change in chemoselectivity, with the formation of the partially hydrogenation product rather than the hydrosilylation products observed with complexes whose active center is more accessible, for instance [PdCl 2 (PPh 3 ) 2 ].

We investigated the dehydrogenation reaction and the thermal robustness of the liquid organic hydrogen carrier (LOHC) couple benzaldehyde/cyclohexylmethanol on a Pt(111) model catalyst in situ in synchrotron radiation photoelectron spectroscopy- and complementary temperature-programmed desorption experiments. The system stores hydrogen in a cyclohexyl group and a primary alcohol functionality and achieves an attractive hydrogen storage capacity of 7.0 mass%. We observed a stepwise dehydrogenation mechanism, characterized by a low temperature dehydrogenation of the alcohol group at 235 K. However, stability limitations challenge the system's applicability as reversible hydrogen storage solution, as the resultant aldehyde was found to decompose during the dehydrogenation of its cyclohexyl group (between 250 and 350 K). A comparison of cyclohexylmethanol with the structurally related secondary alcohol (1-cyclo-hexylethanol; 6.3 mass% hydrogen) revealed a parallel stepwise dehydrogenation pattern for both compounds, but a technically relevant superior thermal robustness of the latter. This demonstrates the influence of the alcohol group's substitution degree on the dehydrogenation characteristics of alcohol-functionalized LOHC compounds. Density functional theory calculations are in good agreement with the experimentally observed stability trend., (© 2024 Wiley‐VCH GmbH.)

Background: Healthcare professionals in hospitals are exposed to a high level of professional stress, time pressure, workload, and often times poor organizational support. This makes them especially susceptible to burnout. In this pragmatic randomized controlled trial, we test the hypothesis that participation in a 9-week program (LAGOM) that was designed in close collaboration with healthcare professionals, incorporating both individual and organizational aspects reduces emotional exhaustion in healthcare professionals (primary outcome)., Methods: Eighty four nurses and physicians working at the Charité - Universitätsmedizin Berlin and the Immanuel Hospital Berlin are automatically randomized to the LAGOM program (n = 42) or to usual care (n = 42) in a one-to-one allocation rate. The primary outcome emotional exhaustion is measured by the Maslach Burnout Inventory-Human Services Survey at baseline, post-intervention, and 1-month follow-up via an online survey. Secondary outcomes include depersonalization, personal accomplishment, subjective stress, mental well-being, self-care, self-efficacy, working conditions, mindfulness, and adverse events. Electrophysiological measures for heart rate variation analysis are captured. The PRECIS-2 tool is used to characterize the degree of pragmatism in our trial. Data analysis and primary intention-to-treat analysis using repeated measures analysis of variance are performed blind to intervention allocation. Per-protocol, subgroup, and secondary outcome analyses are conducted exploratively. An advisory board consisting of various stakeholders accompanies the study process., Discussion: If LAGOM proves to be effective in reducing symptoms of burnout, the program could make an important contribution to tackling the problem of the very high burnout rates among healthcare professionals and become an integral part of preventive services offered by hospitals., Trial Registration: German Clinical Trials Register, DRKS00034060. Registered 31 May 2024., (© 2024. The Author(s).)

Background and Objectives: Neurosurgeons and hospitals devote tremendous resources to improving recovery from lumbar spine surgery. Current efforts to predict surgical recovery rely on one-time patient report and health record information. However, longitudinal mobile health (mHealth) assessments integrating symptom dynamics from ecological momentary assessment (EMA) and wearable biometric data may capture important influences on recovery. Our objective was to evaluate whether a preoperative mHealth assessment integrating EMA with Fitbit monitoring improved predictions of spine surgery recovery., Methods: Patients age 21-85 years undergoing lumbar surgery for degenerative disease between 2021 and 2023 were recruited. For up to 3 weeks preoperatively, participants completed EMAs up to 5 times daily asking about momentary pain, disability, depression, and catastrophizing. At the same time, they were passively monitored using Fitbit trackers. Study outcomes were good/excellent recovery on the Quality of Recovery-15 (QOR-15) and a clinically important change in Patient-Reported Outcomes Measurement Information System Pain Interference 1 month postoperatively. After feature engineering, several machine learning prediction models were tested. Prediction performance was measured using the c-statistic., Results: A total of 133 participants were included, with a median (IQR) age of 62 (53, 68) years, and 56% were female. The median (IQR) number of preoperative EMAs completed was 78 (61, 95), and the median (IQR) number of days with usable Fitbit data was 17 (12, 21). 63 patients (48%) achieved a clinically meaningful improvement in Patient-Reported Outcomes Measurement Information System pain interference. Compared with traditional evaluations alone, mHealth evaluations led to a 34% improvement in predictions for pain interference (c = 0.82 vs c = 0.61). 49 patients (40%) had a good or excellent recovery based on the QOR-15. Including preoperative mHealth data led to a 30% improvement in predictions of QOR-15 (c = 0.70 vs c = 0.54)., Conclusion: Multimodal mHealth evaluations improve predictions of lumbar surgery outcomes. These methods may be useful for informing patient selection and perioperative recovery strategies., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Background Context: Lateral approaches for lumbar interbody fusion (LIF) allow for access to the lumbar spine and disc space by passing through a retroperitoneal corridor either pre- or trans-psoas. A contraindication for this approach is the presence of retroperitoneal scarring that may occur from prior surgical intervention in the retroperitoneal space or from inflammatory conditions with fibrotic changes and pose challenges for the mobilization and visualization needed in this approach. However, there is a paucity of evidence on the prevalence of surgical complications following lateral fusion surgery in patients with a history of abdominal surgery., Purpose: The primary aim of this study is to describe the association between surgical complications following lateral interbody fusion surgery and prior abdominal surgical., Study Design: Retrospective study., Patient Sample: Patients over the age of 18 who underwent lateral lumbar interbody fusion at a large, tertiary care center between 2011 and 2019 were included in the study., Outcome Measures: The primary outcome included medical, surgical, and thigh-related complications either in the intraoperative or 90-day postoperative periods. Additional outcome metrics included readmission rates, length of stay, and operative duration., Methods: The electronic health records of 250 patients were reviewed for demographic information, surgical data, complications, and readmission following surgery. The association of patient and surgical factors to complication rate was analyzed using multivariable logistic regression. Statistical analysis was performed using R statistical software (R, Vienna, Austria)., Results: Of 250 lateral interbody fusion patients, 62.8% had a prior abdominal surgery and 13.8% had a history of colonic disease. The most common perioperative complication was transient thigh or groin pain/sensory changes (n=62, 24.8%). A multivariable logistic regression considering prior abdominal surgery, age, BMI, history of colonic disease, multilevel surgery, and the approach relative to psoas found no significant association between surgical complication rates and colonic disease (OR 0.40, 95% CI 0.02-2.22) or a history of prior abdominal surgeries (OR 0.56, 95% CI 0.20-1.55). Further, the invasiveness of prior abdominal surgeries showed no association with overall spine complication rate, lateral-specific complications, or readmission rates (p>.05)., Conclusion: Though retroperitoneal scarring is an important consideration for lateral approaches to the lumbar spine, this study found no association between lateral lumbar approach complication rates and prior abdominal surgery. Further study is needed to determine the impact of inflammatory colonic disease on lateral approach spine surgery., Competing Interests: Declaration of competing interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Study Design: Observational study., Objectives: To evaluate the prevalence of erectile dysfunction and evaluate the effects of decompressive surgery on erectile dysfunction in cervical spinal stenosis and lumbar canal stenosis patients., Methods: This observational, prospective analysis enrolled patients aged 18-80 with cervical spinal stenosis and/or lumbar canal stenosis that underwent respective decompressive surgery. The IIEF-5 questionnaire was administered preoperatively, and at 6- and 12-months postoperatively to assess erectile dysfunction severity. The EPIC database was queried to determine any postoperative complications and document prominent erectile dysfunction risk factors., Results: Of 79 patients included in the analysis, 42 (53.2%) completed the IIEF-5 at 6 months, and 62 (78.5%) completed it at 12 months. Eighteen had cervical stenosis only, 54 had lumbar stenosis only, and 7 had both. 72% (18/25) of cervical stenosis patients and 83.6% (51/61) of lumbar stenosis patients had erectile dysfunction preoperatively according to IIEF-5 responses. The average preoperative IIEF-5 score indicated significant presence of erectile dysfunction for both the cervical and lumbar stenosis groups. No significant differences were identified in IIEF-5 score deltas from pre- to both postoperative periods. The presence of erectile dysfunction in both the cervical and lumbar stenosis groups was not significantly associated with the presence of any documented risk factors., Conclusions: Our results suggest no significant improvement in overall erectile function postoperatively for patients with preoperative erectile dysfunction. This is important to address during patient counseling for decompression surgery candidates with cervical spinal stenosis and/or lumbar canal stenosis to manage expectations., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

COVID-19 is a heterogenous infection-asymptomatic to fatal. While the course of pediatric COVID-19 infections is usually mild or even asymptomatic, individuals after adult heart transplantation are at high risk of a severe infection. We conducted a retrospective, multicenter survey of 16 pediatric heart transplant centers in Germany, Austria and Switzerland to evaluate the risk of a severe COVID-19 infection after pediatric heart transplantation between 02/2020 and 06/2021. Twenty-six subjects (11 male) with a median age of 9.77 years at time of transplantation and a median of 4.65 years after transplantation suffered from COVID-19 infection. The median age at time of COVID-10 infection was 17.20 years. Fourteen subjects had an asymptomatic COVID-19 infection. The most frequent symptoms were myalgia/fatigue (n = 6), cough (n = 5), rhinitis (n = 5), and loss of taste (n = 5). Only one subject showed dyspnea. Eleven individuals needed therapy in an outpatient setting, four subjects were hospitalized. One person needed oxygen supply, none of the subjects needed non-invasive or invasive mechanical ventilation. No specific signs for graft dysfunction were found by non-invasive testing. In pediatric heart transplant subjects, COVID-19 infection was mostly asymptomatic or mild. There were no SARS-CoV-2 associated myocardial dysfunction in heart transplant individuals., (© 2024 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd.)

Background: Smoking cessation is challenging, despite making use of established smoking cessation therapies. Preclinical studies and one clinical pilot study suggest the antidiabetic drug glucagon-like peptide-1 (GLP-1) analogue to modulate addictive behaviours and nicotine craving. Previously, we reported the short-term results of a randomised, double-blind, placebo-controlled trial. Herein we report long-term abstinence rates and weight developments after 24 and 52 weeks., Methods: This single-centre, randomised, double-blind, placebo-controlled, parallel group trial was done at the University Hospital Basel in Switzerland. We randomly assigned (1:1) individuals with at least a moderate nicotine dependence willing to quit smoking to either a 12-week treatment with dulaglutide 1.5 mg or placebo subcutaneously once weekly in addition to standard of care smoking cessation therapy (varenicline 2 mg/day and behavioural counselling). After 12 weeks, dulaglutide or placebo injections were discontinued and the participants were followed up at week 24 and 52. The primary outcome of self-reported and biochemically confirmed point prevalence abstinence rate, and secondary outcome of secondary outcome of weight change were assessed at weeks 24 and 52. All participants who received one dose of the study drug were included in the intention to treat set and participants who received at least 10/12 doses of the study drug formed the per protocol set. The trial was registered at ClinicalTrials.gov, NCT03204396., Findings: Of the 255 participants who were randomly assigned between June 22, 2017 and December 3, 2020, 63% (80/127) (dulaglutide group) and 65% (83/128) (placebo group) were abstinent after 12 weeks. These abstinence rates declined to 43% (54/127) and 41% (52/128), respectively, after 24 weeks and to 32% (41/127) and 32% (41/128), respectively, after 52 weeks. Post-cessation weight gain was prevented in the dulaglutide group (-1.0 kg, standard deviation [SD] 2.7) as opposed to the placebo group (+1.9 kg, SD 2.4) after 12 weeks. However, at week 24, increases in weight from baseline were observed in both groups (median, interquartile range [IQR]: dulaglutide: +1.5 kg, [-0.4, 4.1], placebo: +3.0 kg, [0.6, 4.6], baseline-adjusted difference in weight change -1.0 kg (97.5% CI [-2.16, 0.16])), and at week 52 the groups showed similar weight gain (median, IQR: dulaglutide: +2.8 kg [-0.4, 4.7], placebo: +3.1 kg [-0.4, 6.0], baseline-adjusted difference in weight change: -0.35 kg (95% CI [-1.72, 1.01])). In the follow-up period (week 12 to week 52) 51 (51%) and 48 (48%) treatment-unrelated adverse events were recorded in the dulaglutide and the placebo group, respectively. No treatment-related serious adverse events or deaths occurred., Interpretation: Dulaglutide does not improve long-term smoking abstinence, but has potential to counteract weight gain after quitting. However, 3 months of treatment did not have a sustained beneficial effect on weight at 1 year. As post-cessation weight gain is highest in the first year after quitting smoking, future studies should consider a longer treatment duration with a GLP-1 analogue in abstinent individuals., Funding: Swiss National Science Foundation, the Gottfried and Julia Bangerter-Rhyner Foundation, the Goldschmidt-Jacobson Foundation, the Hemmi-Foundation, the University of Basel, the Swiss Academy of Medical Sciences., Competing Interests: All authors declare no competing interests., (© 2024 The Author(s).)