Novel patient-centered approach to facilitate same-day discharge in patients undergoing elective percutaneous coronary intervention

Background Same‐day discharge ( SDD ) after elective percutaneous coronary intervention is safe, less costly, and preferred by patients, but it is usually performed in low‐risk patients, if at all. To increase the appropriate use of SDD in more complex patients, we implemented a “patient‐centered” protocol based on risk of complications at Barnes‐Jewish Hospital. Methods and Results Our objectives were as follows: (1) to evaluate time trends in SDD ; (2) to compare (a) mortality, bleeding, and acute kidney injury, (b) patient satisfaction, and (c) hospital costs by SDD versus no SDD ( NSDD ); and (3) to compare SDD eligibility by our patient‐centered approach versus Society for Cardiovascular Angiography and Interventions guidelines. Our patient‐centered approach was based on prospectively identifying personalized bleeding, mortality, and acute kidney injury risks, with a personalized safe contrast limit and mitigating those risks. We analyzed Barnes‐Jewish Hospital's National Cardiovascular Data Registry Cath PCI Registry data from July 1, 2009 to September 30, 2015 (N=1752). SDD increased rapidly from 0% to 77% ( P &lt;0.001), independent of radial access. Although SDD patients were comparable to NSDD patients, SDD was not associated with adverse outcomes (0% mortality, 0% bleeds, and 0.4% acute kidney injury). Patient satisfaction was high with SDD . Propensity score–adjusted costs were 7331 lower/ SDD patient ( P <0.001), saving an estimated 1.8 million annually. Only 16 patients (6.95%) met the eligibility for SDD by Society for Cardiovascular Angiography and Interventions guidelines, implying our patient‐centered approach markedly increased SDD eligibility. Conclusions With a patient‐centered approach, SDD rapidly increased and was safe in 75% of patients undergoing elective percutaneous coronary intervention, despite patient complexity. Patient satisfaction was high, and hospital costs were lower. Patient‐centered decision making to facilitate SDD is an important opportunity to improve the value of percutaneous coronary intervention. </jats:sec

CHANGING MOBILITY OF FILIPINO PROFESSIONALS IN RESPONSE TO K TO 12 IMPLEMENTATION IN THE PHILIPPINES

Professional Mobility is considered an intrinsic trait or character of a worker that pushes to make a decision to career change (Kumlai, 2007). This study analyzes the changing professional mobility of working professionals, who take 18 units in Professional Education, to qualify the Licensure Examinations for Teachers (LET) as a requirement in teaching for basic education (RA, 7836). It seeks to answer the following objectives: (1) describe the profile of the respondents in terms of age, sex, personal and alma-mater status, professional degrees earned and professional satisfaction, (2) analyze the factors that affected their decision to take the Diploma in Professional Education (DPE), (3) ascertain their propensity to teach and (4) generate respondents’ expectations to the teaching profession. This study employed a descriptive survey method using a purposive sampling of 133 professionals. A survey questionnaire was used as a primary tool. Young Filipino professionals change their career to teaching due to dissatisfaction attributed by unemployment, underemployment, low salaries, boredom, work suffocation and unfulfilled expectations. The competent salary package of the public school teacher is the number one attraction that led to the changing professional mobility. Working professionals have the potentiality to shine in the teaching profession and become passionate, altruistic, and stable with life-changing outlook for both personal and professional growth. Their propensity to teach provides a modest tolerance, a passion for integrity, a culture of excellence and a resolute stewardship for learning, which are vital indicators for a prospective self-efficacy in teaching

CHANGING MOBILITY OF FILIPINO PROFESSIONALS IN RESPONSE TO K TO 12 IMPLEMENTATION IN THE PHILIPPINES

Professional Mobility is considered an intrinsic trait or character of a worker that pushes to make a decision to career change (Kumlai, 2007). This study analyzes the changing professional mobility of working professionals, who take 18 units in Professional Education, to qualify the Licensure Examinations for Teachers (LET) as a requirement in teaching for basic education (RA, 7836). It seeks to answer the following objectives: (1) describe the profile of the respondents in terms of age, sex, personal and alma-mater status, professional degrees earned and professional satisfaction, (2) analyze the factors that affected their decision to take the Diploma in Professional Education (DPE), (3) ascertain their propensity to teach and (4) generate respondents’ expectations to the teaching profession. This study employed a descriptive survey method using a purposive sampling of 133 professionals. A survey questionnaire was used as a primary tool. Young Filipino professionals change their career to teaching due to dissatisfaction attributed by unemployment, underemployment, low salaries, boredom, work suffocation and unfulfilled expectations. The competent salary package of the public school teacher is the number one attraction that led to the changing professional mobility. Working professionals have the potentiality to shine in the teaching profession and become passionate, altruistic, and stable with life-changing outlook for both personal and professional growth. Their propensity to teach provides a modest tolerance, a passion for integrity, a culture of excellence and a resolute stewardship for learning, which are vital indicators for a prospective self-efficacy in teaching

Both 3,3′,5-triiodothyronine and 3,5-diodo-L-thyronine are able to repair mitochondrial DNA damage but by different mechanisms

This study evaluated the effect of 3,5-diiodo-L-thyronine (T2) and 3,5,3′-triiodo-L-thyronine (T3) on rat liver mitochondrial DNA (mtDNA) oxidative damage and repair and to investigate their ability to induce protective effects against oxidative stress. Control rats, rats receiving a daily injection of T2 (N+T2) for 1 week and rats receiving a daily injection of T3 (N+T3) for 1 week, were used throughout the study. In the liver, mtDNA oxidative damage [by measuring mtDNA lesion frequency and expression of DNA polymerase γ (POLG)], mtDNA copy number, mitochondrial biogenesis [by measuring amplification of mtDNA/nDNA and expression of peroxisome proliferator-activated receptor gamma co-activator 1-alpha (PGC-1α)], and oxidative stress [by measuring serum levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG)] were detected. T2 reduces mtDNA lesion frequency and increases the expression of POLG, and it does not change the mtDNA copy number, the expression of PGC-1α, or the serum levels of 8-OHdG. Therefore, T2, by stimulating the major mtDNA repair enzyme, maintains genomic integrity. Similar to T2, T3 decreases mtDNA lesion frequency but increases the serum levels of 8-OHdG, and it decreases the expression of POLG. Moreover, as expected, T3 increases the mtDNA copy number and the expression of PGC-1α. Thus, in T3-treated rats, the increase of 8-OHdG and the decrease of POLG indicate that there is increased oxidative damage and that the decreased mtDNA lesion frequency might be a consequence of increased mitochondrial biogenesis. These data demonstrate that both T2 and T3 are able to decrease in the liver mtDNA oxidative damage, but they act via different mechanisms

Compact IR laser for calibration of space based sensors

An Er:YAG laser, operating at 2.94 microns, has been developed for in-theater calibration of space based infrared sensors. The laser is used to illuminate a spaceborne sensor focal plane from a surveyed ground reference point. The known reference point is compared to the laser position reported by the sensor, and boresight corrections are made. The Er:YAG laser is side pumped by a InGaAs diode array and is tuned to an atmospheric microwindow with and intracavity etalon. This technology is being directly applied to meet Army requirements for enhanced deep strike targeting information supplied to theater weapons systems

Generar conciencia sobre minibasurales, contaminación por plásticos y otros R.S.U. una tarea de (responsabilidad) de todos

El presente artículo se refiere a los talleres teórico-prácticos desarrollados, en el marco del Proyecto Voluntariado “Las 3R” financiado por la SPU del Ministerio de Educación de la Nación, con el objeto de difundir y educar sobre contaminación por plásticos, residuos sólidos urbanos y el impacto ambiental negativo que se produce debido a la presencia de minibasurales en los distintos barrios de nuestra ciudad. Mediante el trabajo en conjunto entre docentes y estudiantes de los diferentes niveles educativos, instituciones, y personas interesadas en la problemática planteada se puede disminuir la contaminación debido a los mini basurales a cielo abierto, residuos plásticos (PET, HDPE, PP y otros) y en el proceso lograr que los participantes a los talleres adquieran un aprendizaje significativo sobre tipos de plásticos, usos, y la importancia que presentan los procesos de recolección, separación y reutilización de residuos plásticos. Los talleres son realizados por miembros del grupo GIESMA de la FaCENA con la participación de instituciones educativas del nivel primario y secundario y organizaciones religiosas como CARITAS Corrientes

High surface area mesoporous silica nanoparticles with tunable size in the sub-micrometer regime: Insights on the size and porosity control mechanisms

Mesoporous silica nanostructures (MSNs) attract high interest due to their unique and tunable physical chemical features, including high specific surface area and large pore volume, that hold a great potential in a variety of fields, i.e., adsorption, catalysis, and biomedicine. An essential feature for biomedical application of MSNs is limiting MSN size in the sub-micrometer regime to control uptake and cell viability. However, careful size tuning in such a regime remains still chal-lenging. We aim to tackling this issue by developing two synthetic procedures for MSN size mod-ulation, performed in homogenous aqueous/ethanol solution or two-phase aqueous/ethyl acetate system. Both approaches make use of tetraethyl orthosilicate as precursor, in the presence of cetyltri-methylammonium bromide, as structure-directing agent, and NaOH, as base-catalyst. NaOH catalyzed syntheses usually require high temperature (&gt;80 °C) and large reaction medium volume to trigger MSN formation and limit aggregation. Here, a successful modulation of MSNs size from 40 up to 150 nm is demonstrated to be achieved by purposely balancing synthesis conditions, being able, in addition, to keep reaction temperature not higher than 50 °C (30 °C and 50 °C, respectively) and reaction mixture volume low. Through a comprehensive and in-depth systematic morphologi-cal and structural investigation, the mechanism and kinetics that sustain the control of MSNs size in such low dimensional regime are defined, highlighting that modulation of size and pores of the structures are mainly mediated by base concentration, reaction time and temperature and ageing, for the homogenous phase approach, and by temperature for the two-phase synthesis. Finally, an in vitro study is performed on bEnd.3 cells to investigate on the cytotoxicity of the MNSs

The doubling of the superorbital period of Cyg X-1

We study properties of the superorbital modulation of the X-ray emission of Cyg X-1. We find that it has had a stable period of about 300 d in soft and hard X-rays and in radio since 2005 until at least 2010, which is about double the previously seen period. This new period, seen in the hard spectral state only, is detected not only in the light curves but also in soft X-ray hardness ratios and in the amplitude of the orbital modulation. On the other hand, the spectral slope in hard X-rays, >20 keV, averaged over superorbital bins is constant, and the soft and hard X-rays and the radio emission change in phase. This shows that the superorbital variability consists of changing the normalization of an intrinsic spectrum of a constant shape and of changes of the absorbing column density with the phase. The maximum column density is achieved at the superorbital minimum. The amplitude changes are likely to be caused by a changing viewing angle of an anisotropic emitter, most likely a precessing accretion disc. The constant shape of the intrinsic spectrum shows that this modulation is not caused by a changing accretion rate. The modulated absorbing column density shows the presence of a bulge around the disc centre, as proposed previously. We also find the change of the superorbital period from about 150 d to about 300 d to be associated with almost unchanged average X-ray fluxes, making the period change difficult to explain in the framework of disc-irradiation models. Finally, we find no correlation of the X-ray and radio properties with the reported detections in the GeV and TeV gamma-ray range.Comment: MNRAS, in press, 8 page