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This article describes a new electrochromic device (ECD) designed to achieve improved black color and long-term bistability. We achieved these improvements by fabricating a double-layered nanostructure of two different electrochromic materials stacked in layers on a single electrode. The fabricated ECD maintains 90% of the light transmittance of the colored state even after 1 h if powered off in the colored state. To achieve an improved black, green and blue viologens were successively immobilized in the bottom and top layers of materials on an electrode. The green viologens are initially colored at low voltage, and the purple viologens become colored when the voltage increases. This is because the reduction potential of the green viologens is less than that of purple viologens. Finally, an improved black color is obtained through a mixture of the two colors. [ABSTRACT FROM AUTHOR]

Background: Previous studies have not evaluated the prevalence and specific risk factors for the development of left ventricular (LV) thrombus in patients with severely reduced left ventricular dysfunction due to chemotherapy‐related cardiomyopathy. We sought to evaluate the prevalence and potential markers of LV thrombus in this patient population. Methods: From January 2009 to December 2013, patients with chemotherapy‐related severe LV dysfunction (LV ejection fraction [LVEF] ≤ 30%) identified from MD Anderson Cancer Center database were reviewed. Patient characteristics and echocardiographic parameters were analyzed to determine potential risk factors for LV thrombus. Results: A total of 121 patients met inclusion criteria (age 54.8 ± 15.2 years; female 63.6%; LVEF 26.3 ± 4%). LV thrombus was present in 9 patients (7.4%). Patients with LV thrombus have significantly lower LVEF compared to those without (18.7 ± 3.8% vs 26.9 ± 3.4%, P < .0001). Prevalence of LV thrombus increased as LVEF decreased and was the highest in patients with LVEF < 20%. By univariate analysis, decreased LVEF, particularly LVEF < 20% (OR 36.30, 95% CI 7.35–179.25, P < .0001) and restrictive LV filling pattern (OR 18.13, 95% CI 4.17–78.89, P = .0001) were associated with presence of LV thrombus. Conclusion: In patients with severely reduced LV systolic function due to chemotherapy‐induced cardiomyopathy, LV thrombus was found in 7.4% of subjects. Severely decreased LVEF (<20%) and restrictive LV filling pattern were associated with the presence of LV thrombus. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to evaluate the effectiveness of the American Orthopaedic Association's Own the Bone secondary fracture prevention program in the United States.Methods: The objective of this quality improvement cohort study was dissemination of Own the Bone and implementation of secondary prevention (osteoporosis pharmacologic and bone mineral density [BMD] test recommendations). The main outcome measures were the number of sites implementing Own the Bone and implementation of secondary prevention, i.e., orders for BMD testing and/or pharmacologic treatment. The 177 sites participating in the program were academic and community hospitals, orthopaedic surgery groups, and a health system; data were obtained from the first 125 sites utilizing its registry, between January 1, 2010, and March 31, 2015. It included all patients, aged 50 years or older, presenting with fragility fractures (n = 23,132) who were enrolled in the Own the Bone web-based registry. The interventions were education, development of program elements, dissemination, implementation, and evaluation of the Own the Bone program at participating sites.Results: A growing number of institutions implemented Own the Bone (14 sites in 2005-2006 to 177 sites in 2015). After consultation, 53% of patients had a BMD test ordered and/or pharmacologic therapy for osteoporosis.Conclusions: The Own the Bone intervention has succeeded in improving the behaviors of medical professionals in the areas of osteoporosis treatment and counseling, BMD testing, initiation of pharmacotherapy, and coordination of care for patients who have experienced a fragility fracture. [ABSTRACT FROM AUTHOR]

Background: Advances in treatment of sarcoma patients has prolonged survival but has led to increased disease- or treatment-related complications resulting in greater number of admissions to the intensive care unit (ICU). Survival and long-term outcome information about such critically ill patients with sarcoma is unknown. Methods: The primary objective of the study was to determine the ICU and post-ICU survival rates of critically ill sarcoma patients. Secondary objectives included determining the modifiable and non-modifiable predictors of poor survival. We performed a retrospective chart review of sarcoma patients admitted to the ICU at The University of Texas MD Anderson Cancer Center between January 1, 2005, and December 31, 2012. Main outcome measures were ICU mortality, in-hospital mortality and 1, 2, and 6-month survival rates. Covariates such as histological diagnosis, disease characteristics, chemotherapy use, Charlson comorbidity index, Sequential Organ Failure Assessment (SOFA) scores, and clinical findings leading to ICU admission were analyzed for their effects on survival. Results: We identified 172 admissions over the 8-year study period hat met our inclusion criteria. The study population was 45.9% males with a median age of 52 years. The most common sarcoma subgroups were high-grade unclassified sarcoma (25%) and bone tumors (17.4%). The ICU mortality rate was 23.3% (95% confidence interval [CI], 16.9-29.6%), and an additional 6.4% of patients died before hospital discharge (95% CI, 22.9-37.1%). 6-month OS rates were 41%. The median SOFA scores on admission were 6 (inter quartile range (IQR), 3.5-9) in ICU survivors and 10 (IQR, 6.5-14) in ICU non-survivors. Increase in SOFA scores ≥6 led to poor outcomes (ICU survival 13.3%, OS 6.7%). Charlson comorbidity index (HR 1.139, 95% CI 1.023-1.268, p = 0.02) and discharge SOFA scores (HR 1.210, 95% CI 1.141-1.283, p < 0.0001) correlated with overall survival. Conclusions: Our results suggest that patients that are admitted to the ICU for respiratory failure, cardiac arrest, septic shock, acute renal failure or acidosis and also have a high SOFA score with subsequent worsening in the ICU have poor prognosis. Based on the retrospective data which needs further validation we can recommend that judicious approach should be taken in patients with predictors of poor survival before subjecting them to aggressive treatment. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the results of total thyroidectomy (TT) for hyperthyroidism secondary to Graves' disease (GD) with TT for other benign thyroid diseases to determine if TT should be considered more often as first-line therapy for GD. Seven hundred eighty patients underwent TT for benign disease: 203 for GD, 56 for other hyperthyroidisms, and 521 for other benign diseases from March 1, 2003, to December 31, 2009. The perioperative results of these three groups were compared for demographics, blood loss, operative time, complications, and hospitalization. There were no significant differences among the three groups except the patients with GD were more likely to be younger (42 vs 56 vs 57 years; P < 0.001), have more blood loss (154 vs 99 vs 110 mL; P = 0.05), and were more likely to develop permanent hypoparathyroidism (1.0 vs 1.8 vs 0%; P = 0.03) when compared with other causes of hyperthyroidism and other benign thyroid diseases. Permanent recurrent laryngeal nerve injury did not occur in the GD group (0 vs 0 vs 0.4% nerves at risk; P = 0.69) with transient recurrent laryngeal nerve injury occurring in 1.7 versus 2.7 versus 3.1 per cent nerves at risk (P = 0.35). The lack of a euthyroid state preoperatively had no influence on surgical outcomes or complications. Eighty percent of the TTs for GD were done as same-day outpatient procedures. TT offers a safe, low-risk, and rapid cure for GD to justifiably be considered as a reasonable first-line therapy in selected patients with Graves' hyperthyroidism. [ABSTRACT FROM AUTHOR]

The article discusses updated estimates of the adjusted effectiveness of the seasonal influenza vaccine in the U.S. as of February 2013. Data is based on children and adults enrolled in the U.S. Influenza Vaccine Effectiveness (Flu VE) Network during December 3, 2012 to January 19, 2013. The overall vaccine effectiveness (VE) rate against influenza A and B virus infections linked to medically attended acute respiratory illness is mentioned.

The article presents a retrospective radiographic and clinical review of patients in a trauma database. The study aims to detect occipitocervical complex injuries initially missed at a level 1 trauma center. It shows five patients having evidence of atlantooccipital dissociation and two with atlantoaxial dissociation.