Impact of cardiology referral: clinical outcomes and factors associated with physicians' adherence to recommendations

OBJECTIVES: Cardiology referral is common for patients admitted for non-cardiac diseases. Recommendations from cardiologists may involve complex and aggressive treatments that could be ignored or denied by other physicians. The purpose of this study was to compare the outcomes of patients who were given recommendations during cardiology referrals and to examine the clinical outcomes of patients who did not follow the recommendations. METHODS: We enrolled 589 consecutive patients who received in-hospital cardiology consultations. Data on recommendations, implementation of suggestions and outcomes were collected. RESULTS: Regarding adherence of the referring service to the recommendations, 77% of patients were classified in the adherence group and 23% were classified in the non-adherence group. Membership in the non-adherence group (

Electrical Conductivity of Electrospun Polyaniline and Polyaniline-Blend Fibers and Mats

Submicrometer fibers of polyaniline (PAni) doped with (+)-camphor-10-sulfonic acid (HCSA) and blended with poly(methyl methacrylate) (PMMA) or poly(ethylene oxide) were electrospun over a range of compositions. Continuous, pure PAni fibers doped with HCSA were also produced by coaxial electrospinning and subsequent removal of the PMMA shell polymer. The electrical conductivities of both the fibers and the mats were characterized. The electrical conductivities of the fibers were found to increase exponentially with the weight percent of doped PAni in the fibers, with values as high as 50 ± 30 S/cm for as-electrospun fibers of 100% doped PAni and as high as 130 ± 40 S/cm upon further solid state drawing. These high electrical conductivities are attributed to the enhanced molecular orientation arising from extensional deformation in the electrospinning process and afterward during solid state drawing. A model is proposed that permits the calculation of mat conductivity as a function of fiber conductivity, mat porosity, and fiber orientation distribution; the results agree quantitatively with the independently measured mat conductivities.United States. Army Research Office (Institute for Soldier Nanotechnologies, Contract ARO W911NF-07-D- 0004

Homologous recombination suppresses transgenerational DNA end resection and chromosomal instability in fission yeast

Chromosomal instability (CIN) drives cell-to-cell heterogeneity, and the development of genetic diseases, including cancer. Impaired homologous recombination (HR) has been implicated as a major driver of CIN, however, the underlying mechanism remains unclear. Using a fission yeast model system, we establish a common role for HR genes in suppressing DNA double-strand break (DSB)-induced CIN. Further, we show that an unrepaired single-ended DSB arising from failed HR repair or telomere loss is a potent driver of widespread CIN. Inherited chromosomes carrying a single-ended DSB are subject to cycles of DNA replication and extensive end-processing across successive cell divisions. These cycles are enabled by Cullin 3-mediated Chk1 loss and checkpoint adaptation. Subsequent propagation of unstable chromosomes carrying a single-ended DSB continues until transgenerational end-resection leads to fold-back inversion of single-stranded centromeric repeats and to stable chromosomal rearrangements, typically isochromosomes, or to chromosomal loss. These findings reveal a mechanism by which HR genes suppress CIN and how DNA breaks that persist through mitotic divisions propagate cell-to-cell heterogeneity in the resultant progeny

Homologous recombination repair intermediates promote efficient de novo telomere addition at DNA double-strand breaks

The healing of broken chromosomes by de novo telomere addition, while a normal developmental process in some organisms, has the potential to cause extensive loss of heterozygosity, genetic disease, or cell death. However, it is unclear how de novo telomere addition (dnTA) is regulated at DNA double-strand breaks (DSBs). Here, using a non-essential minichromosome in fission yeast, we identify roles for the HR factors Rqh1 helicase, in concert with Rad55, in suppressing dnTA at or near a DSB. We find the frequency of dnTA in rqh1Δ rad55Δ cells is reduced following loss of Exo1, Swi5 or Rad51. Strikingly, in the absence of the distal homologous chromosome arm dnTA is further increased, with nearly half of the breaks being healed in rqh1Δ rad55Δ or rqh1Δ exo1Δ cells. These findings provide new insights into the genetic context of highly efficient dnTA within HR intermediates, and how such events are normally suppressed to maintain genome stabilit

Tuning the Magnetic Anisotropy at a Molecule-Metal Interface

International audienceWe demonstrate that a C 60 overlayer enhances the perpendicular magnetic anisotropy of a Co thin film, inducing an inverse spin reorientation transition from in plane to out of plane. The driving force is the C 60 =Co interfacial magnetic anisotropy that we have measured quantitatively in situ as a function of the C 60 coverage. Comparison with state-of-the-art ab initio calculations show that this interfacial anisotropy mainly arises from the local hybridization between C 60 p z and Co d z 2 orbitals. By generalizing these arguments, we also demonstrate that the hybridization of C 60 with a Fe(110) surface decreases the perpendicular magnetic anisotropy. These results open the way to tailor the interfacial magnetic anisotropy in organic-material–ferromagnet systems

Spatial symmetry constraint of charge-ordered kagome superconductor CsV3_3Sb5_5

Elucidating the symmetry of intertwined orders in exotic superconductors is at the quantum frontier. Recent surface sensitive studies of the topological kagome superconductor CsV$_3$Sb$_5$ discovered a cascade 4a$_0$ superlattice below the charge density wave (CDW) ordering temperature, which can be related to the pair density modulations in the superconducting state. If the 4a$_0$ phase is a bulk and intrinsic property of the kagome lattice, this would form a striking analogy to the stripe order and pair density wave discovered in the cuprate high-temperature superconductors, and the cascade ordering found in twisted bilayer graphene. High-resolution X-ray diffraction has recently been established as an ultra-sensitive probe for bulk translational symmetry-breaking orders, even for short-range orders at the diffusive limit. Here, combining high-resolution X-ray diffraction, scanning tunneling microscopy and scanning transmission electron microscopy, we demonstrate that the 4a$_0$ superstructure emerges uniquely on the surface and hence exclude the 4a$_0$ phase as the origin of any bulk transport or spectroscopic anomaly. Crucially, we show that our detected 2$\times$2$\times$2 CDW order breaks the bulk rotational symmetry to C2, which can be the driver for the bulk nematic orders and nematic surface superlattices including the 4a$_0$ phase. Our high-resolution data impose decisive spatial symmetry constraints on emergent electronic orders in the kagome superconductor CsV$_3$Sb$_5$

The need for nursing instruction in patients receiving steroid pulse therapy for the treatment of autoimmune diseases and the effect of instruction on patient knowledge

<p>Abstract</p> <p>Background</p> <p>Many patients who receive steroid pulse therapy go home the same day or the day after steroid administration. Nursing instructions are important for improving patient knowledge related to their diseases and treatments, but the short hospital stay often prevents complete education and guidance regarding the given therapy. The purpose of this study was to investigate the need for nursing instruction in patients receiving steroid pulse therapy for the treatment of autoimmune diseases and the effect of instruction on patient knowledge of their disease and treatment.</p> <p>Methods</p> <p>Patients with systemic lupus erythematosus (SLE) and systemic sclerosis receiving steroid pulse therapy (N = 63) were recruited from a medical center in Taipei. A structured questionnaire was used for data collection before and after nursing instruction, and 1 week as well as 2 weeks after therapy. The need for nursing instruction and knowledge levels were validated using Cronbach's α reliability test.</p> <p>Results</p> <p>There was a significant difference (<it>P </it>< 0.001) in the need for nursing instruction among the 4 time points. There was a positive correlation between the need for nursing instruction and body weight change, frequency of treatment, and distress, but there was a negative correlation with knowledge level (β = -0.012, <it>P </it>= 0.003) regarding symptoms. The knowledge level of subjects after nursing instruction was significantly higher than before nursing instruction (80 ± 14.31 vs. 70.06 ± 17.23, <it>P </it>< 0.001).</p> <p>Conclusions</p> <p>This study indicates that nursing instruction is needed by patients receiving steroid pulse therapy, and that by designing and administering nursing instructions according to the priority of patient symptoms, nurses can improve patient knowledge related to their diseases and treatments. In addition, the need for nursing instruction can be affected by patient characteristics.</p