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Retrospective analysis of prospectively collected data.Assess the cost-utility of anterior cervical discectomy and fusion (ACDF) performed in the ambulatory surgery center (ASC) versus inpatient hospital setting for Medicare and privately insured patients at one-year follow-up.Outpatient ACDF has gained popularity due to improved safety and reduced costs. Formal cost-utility studies for ambulatory versus inpatient ACDF are lacking, precluding an accurate assessment of cost-effectiveness.A total of 6504 patients enrolled in the Quality Outcomes Database (QOD) undergoing one-level to two-level ACDF at a single ASC (520) or the inpatient hospital setting (5984) were compared. Propensity matching generated 748 patients for analysis (374 per cohort). Demographic data, resource utilization, patient-reported outcome measures, and quality-adjusted life-years (QALYs) were assessed. Direct costs (1-year resource use×unit costs based on Medicare national allowable payment amounts) and indirect costs (missed workdays×average US daily wage) were recorded. Incremental cost-effectiveness ratios were calculated.Complication rates and improvements in patient-reported outcome measures and QALYs were similar between groups. Ambulatory ACDF was associated with significantly lower total costs at 1 year for Medicare ($5879.46) and privately insured ($12,873.97) patients, respectively. The incremental cost-effectiveness ratios for inpatient ACDF was $3,674,662 and $8,046,231 for Medicare and privately insured patients, respectively, reflecting unacceptably poor cost-utility.Inpatient ACDF is associated with significant increases in total costs compared to the ASC setting without a safety, outcome, or QALY benefit. The ASC setting is a dominant option from a health economy perspective for first-time one-l to two-level ACDF in select patients compared to the inpatient hospital setting.

The mm-Wave Interferometric Survey of Dark Object Masses (WISDOM) is probing supermassive black holes (SMBHs) in galaxies across the Hubble sequence via molecular gas dynamics. We present the first WISDOM study of a luminous infrared galaxy with an active galactic nuclei (AGN): Fairall 49. We use new ALMA observations of the CO(2-1) line with a spatial resolution of about 80 pc together with ancillary HST imaging. We reach the following results: (1) The CO kinematics are well described by a regularly rotating gas disk with a radial inflow motion, suggesting weak feedback on the cold gas from both AGN and starburst activity; (2) The dynamically inferred SMBH mass is 1.6 +/- 0.4 (rnd) +/- 0.8 (sys) x 10^8 Msun, assuming that we have accurately subtracted the AGN and starburst light contributions, which have a luminosity of about 10^9 Lsun; (3) The SMBH mass agrees with the SMBH-stellar mass relation but is about 50 times higher than previous estimates from X-ray variability; (4) The dynamically inferred molecular gas mass is 30 times smaller than that inferred from adopting the Galactic CO-to-H_2 conversion factor (X_CO) for thermalised gas, suggesting low values of X_CO; (5) the molecular gas inflow rate increases steadily with radius and may be as high as 5 Msun/yr. This work highlights the potential of using high-resolution CO data to estimate, in addition to SMBH masses, the X_CO factor and gas inflow rates in nearby galaxies., 19 pages, 13 figures, accepted for publication in MNRAS

Comparison of defect-controlled leaching-kinetics modulation of metal-organic frameworks (MOFs) and porous functionalized silica-based materials was performed on the example of a radionuclide and radionuclide surrogate for the first time, revealing an unprecedented readsorption phenomenon. On a series of zirconium-based MOFs as model systems, we demonstrated the ability to capture and retain99% of the transuranic

A novel series of heterometallic f-block-frameworks including the first examples of transuranic heterometallic 238U/239Pu-metal-organic frameworks (MOFs) and a novel monometallic 239Pu-analog are reported. In combination with theoretical calculations, we probed the kinetics and thermodynamics of heterometallic actinide(An)-MOF formation and reported the first value of a U-to-Th transmetallation rate. We concluded that formation of uranyl species could be a driving force for solid-state metathesis. Density of states near the Fermi edge, enthalpy of formation, band gap, proton affinity, and thermal/chemical stability were probed as a function of metal ratios. Furthermore, we achieved 97% of the theoretical maximum capacity for An-integration. These studies shed light on fundamental aspects of actinide chemistry and also foreshadow avenues for the development of emerging classes of An-containing materials, including radioisotope thermoelectric generators or metalloradiopharmaceuticals.

Confinement-imposed photophysics was probed for novel stimuli-responsive hydrazone-based compounds demonstrating a conceptual difference in their behavior within 2D versus 3D porous matrices for the first time. The challenges associated with photoswitch isomerization arising from host interactions with photochromic compounds in 2D scaffolds could be overcome in 3D materials. Solution-like photoisomerization rate constants were realized for sterically demanding hydrazone derivatives in the solid state through their coordinative immobilization in 3D scaffolds. According to steady-state and time-resolved photophysical measurements and theoretical modeling, this approach provides access to hydrazone-based materials with fast photoisomerization kinetics in the solid state. Fast isomerization of integrated hydrazone derivatives allows for probing and tailoring resonance energy transfer (ET) processes as a function of excitation wavelength, providing a novel pathway for ET modulation.

In this work, we report the reactivity of the carboranyl diphosphine, 1-P

Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach to surgical care that aims to improve outcomes and reduce costs. Its application to spine surgery has been increasing in recent years, with a notable focus on lumbar fusion. This study describes the development, implementation, and outcomes of the first ERAS pathway for ambulatory spine surgery and the largest ambulatory minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) series to date.A comprehensive protocol for ambulatory lumbar fusion is described, including patient selection criteria, a multimodal analgesia regimen, and discharge assessment. Consecutive patients undergoing 1- or 2-level MIS TLIF using the described protocol at a single ambulatory surgery center (ASC) over a five-year period were queried.A total of 215 patients underwent ambulatory MIS TLIF over the study period. There were no intraoperative or immediate postoperative complications. All but one patient (99.5%) were discharged home from the ASC. Almost three-quarters (71.2%) were discharged on the day of surgery. Thirty- and 90-day readmission rates were 1.4% and 2.8%, respectively. Only one readmission (0.5%) was for intractable back pain. There were no reoperations or mortalities within 90 days of surgery.MIS TLIF can be performed safely in a freestanding ambulatory surgery center with minimal perioperative and short-term morbidity. The addition of comprehensive ERAS protocols to the ambulatory setting can promote the transition of fusion procedures to this lower cost environment in an effort to provide higher value care.

Participation in hunting has been declining and organizations have increased efforts to recruit non-traditional path hunters (NTPHs) such as adults who did not hunt as children, urban residents, an...

Herein, we report structural, computational, and conductivity studies on urea-directed self-assembled iodinated triphenylamine (TPA) derivatives. Despite numerous reports of conductive TPAs, the challenges of correlating their solid-state assembly with charge transport properties hinder the efficient design of new materials. In this work, we compare the assembled structures of a methylene urea bridged dimer of di-iodo TPA (1) and the corresponding methylene urea di-iodo TPA monomer (2) with a di-iodo mono aldehyde (3) control. These modifications lead to needle shaped crystals for 1 and 2 that are organized by urea hydrogen bonding, π⋯π stacking, I⋯I, and I⋯π interactions as determined by SC-XRD, Hirshfeld surface analysis, and X-ray photoelectron spectroscopy (XPS). The long needle shaped crystals were robust enough to measure the conductivity by two contact probe methods with 2 exhibiting higher conductivity values (∼6 × 10

New zwitterionic dirhenium carbonyl complexes containing ammonioethenyl and phosphonioethenyl ligands have been synthesized and studied. The reaction of Re

A series of alkali metal rare-earth borates were prepared via high-temperature flux crystal growth, and their structures were characterized by single crystal X-ray diffraction (SXRD). Na

Unprecedented one-step C 00000000 00000000 00000000 00000000 11111111 00000000 11111111 00000000 00000000 00000000 C bond cleavage leading to opening of the buckybowl (π-bowl), that could provide access to carbon-rich structures with previously inaccessible topologies, is reported; highlighting the possibility to implement drastically different synthetic routes to π-bowls in contrast to conventional ones applied for polycyclic aromatic hydrocarbons. Through theoretical modeling, we evaluated the mechanistic pathways feasible for π-bowl planarization and factors that could affect such a transformation including strain and released energies. Through employment of Marcus theory, optical spectroscopy, and crystallographic analysis, we estimated the possibility of charge transfer and electron coupling between “open” corannulene and a strong electron acceptor such as 7,7,8,8-tetracyanoquinodimethane. Alternative to a one-pot solid-state corannulene “unzipping” route, we reported a nine-step solution-based approach for preparation of novel planar “open” corannulene-based derivatives in which electronic structures and photophysical profiles were estimated through the energies and isosurfaces of the frontier natural transition orbitals., An electron shuttle contributed to breaking corannulene's heart through a unique one-step reductive CC bond cleavage in the traditionally robust π-bowl. The heartbreak did not stop there as “broken analogs” were developed through a solution-phase route.

Supermassive black hole (SMBH) masses can be measured by resolving the dynamical influences of the SMBHs on tracers of the central potentials. Modern long-baseline interferometers have enabled the use of molecular gas as such a tracer. We present here Atacama Large Millimeter/submillimeter Array observations of the elliptical galaxy NGC 7052 at 0${^{\prime\prime}_{.}}$11 ($37\,$pc) resolution in the 12CO(2-1) line and $1.3\,$ mm continuum emission. This resolution is sufficient to resolve the region in which the potential is dominated by the SMBH. We forward model these observations, using a multi-Gaussian expansion of a Hubble Space Telescope F814W image and a spatially constant mass-to-light ratio to model the stellar mass distribution. We infer an SMBH mass of $2.5\pm 0.3\times 10^{9}\, \mathrm{M_\odot }$ and a stellar I-band mass-to-light ratio of $4.6\pm 0.2\, \mathrm{M_\odot /L_{\odot ,I}}$ (3σ confidence intervals). This SMBH mass is significantly larger than that derived using ionized gas kinematics, which however appears significantly more kinematically disturbed than the molecular gas. We also show that a central molecular gas deficit is likely to be the result of tidal disruption of molecular gas clouds due to the strong gradient in the central gravitational potential.

Acquiring fundamental knowledge of properties of actinide-based materials is a necessary step to create new possibilities for addressing the current challenges in the nuclear energy and nuclear waste sectors. In this report, we established a photophysics-electronics correlation for actinide-containing metal-organic frameworks (An-MOFs) as a function of excitation wavelength, for the first time. A stepwise approach for dynamically modulating electronic properties was applied for the first time towards actinide-based heterometallic MOFs through integration of photochromic linkers. Optical cycling, modeling of density of states near the Fermi edge, conductivity measurements, and photoisomerization kinetics were employed to shed light on the process of tailoring optoelectronic properties of An-MOFs. Furthermore, the first photochromic MOF-based field-effect transistor, in which the field-effect response could be changed through light exposure, was constructed. As a demonstration, the change in current upon light exposure was sufficient to operate a two-LED fail-safe indicator circuit.

Reactions of the pentaruthenium cluster complexes Ru5(μ5-C)(CO)15 (5), Ru5(μ5-C)(CO)14[μ-η2-O═C(NMe2)](μ-H) (6), and Ru5(μ5-C)(CO)15Cl(μ-H) (7) with ethyne (C2H2) in the presence of Me3NO yielded t...

Single crystals of new rubidium rare earth thiophosphates with the formulas Rb3Ln(PS4)2 (Ln = La, Ce, Pr), Rb3−xNaxLn(PS4)2 (Ln = Ce, Pr; x = 0.50, 0.55), and RbEuPS4 were crystallized out of a molten RbCl flux. The compounds Rb3Ln(PS4)2 (Ln = La, Ce, Pr) and Rb3−xNaxLn(PS4)2 (Ln = Ce, Pr; x = 0.50, 0.55) both crystallize in the monoclinic crystal system adopting the space groups P21 and P21/c, respectively, while RbEuPS4 crystallizes in the orthorhombic crystal system adopting the space group Pnma. A survey of all known rubidium rare earth thiophosphates grown using an alkali halide flux revealed trends suggesting that the Rb3Ln(PS4)2 and Rb3−xNaxLn(PS4)2 families of compounds can be actively targeted over a wide range of temperatures by employing RbCl as at least a component of the flux. Fluorescence measurements were performed on all compounds obtained, revealing resolved f–f transitions in Rb3Pr(PS4)2 and Rb2.45(2)Na0.55(2)Pr(PS4)2 and only single broad emission peaks for Rb3Ce(PS4)2 and Rb2.50(6)Na0.50(6)Ce(PS4)2, behavior characteristic for cerium(III) compounds.