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Efficient and robust electrocatalysts composed of earth-abundant elements to replace noble metals is highly essential for cost-effective production of hydrogen from water splitting. Herein, we demonstrate the fabrication of SO4 2-anions bridged MOF-derived Cu3N+ Cu3P heterostructure coated by ultrathin N, P, S-tri-doped carbon (NPSC) on nickel foam (Cu3N-Cu3P/NPSCNWs@NF) via an interface reconstruction strategy. The first-principle simulation demonstrates that both Cu3N, Cu3P and NPSC own good electrical conductivity, suggesting these species can lead to efficient electrocatalytic performance. The remarkable features of high intrinsic conductivity and interfacial heterostructures at Cu3N-Cu3P/NPSCNWs@NF have ensured excellent water splitting electrocatalytic activity with a low potential of 1.54 V at 10 mAcm-2 in 1 M KOH over 24 h, and additionally the resultant electrode exhibits impressive response for HER with an ultralow potential of 109 mV at 10 mAcm+2 in neutral-pH media over 30 h. [ABSTRACT FROM AUTHOR]

The association between common breast cancer therapies and recurrences and second primary breast cancers in older women is unclear, although older women are less likely to receive common therapies.Women aged ≥65 years who were diagnosed with stage I or II breast cancer and who underwent mastectomy or breast‐conserving surgery (BCS) from 1990 to 1994 were identified from automated data from 6 healthcare systems and then were followed for 10 years or until breast cancer recurrence, disenrollment, or death. Trained abstractors reviewed medical records to obtain recurrence, tumor, treatment and demographic data. The authors used proportional hazards models to examine predictors of recurrent and second primary breast cancers adjusted for demographic and tumor factors.Of 1837 eligible women, 34% were ages 65 to 69 years, 46% were ages 70 to 79 years, and 20% were aged ≥80 years. In multivariable models that used mastectomy as the reference group, BCS without radiation therapy was associated with an increased risk of any recurrent and second primary breast cancer (hazard ratio [HR], 1.6; 95% confidence interval [CI], 1.1–2.3), particularly with the subgroup of women with local and regional recurrence (HR, 3.5; 95% CI, 2.0–6.0). Tamoxifen use for <1 year versus ≥5 years exhibited a borderline association with any recurrent or second primary breast cancer (HR, 1.9; 95% CI, 0.9–4.2).Radiation therapy after BCS and 5 years of tamoxifen use were beneficial in reducing recurrences and second primary breast cancers in older women, regardless of their age or comorbidity burden. Cancer 2007. © 2007 American Cancer Society. [ABSTRACT FROM AUTHOR]

To determine whether depression is treated differently in older and younger patients in primary care clinics. Administrative data were used to identify patients with a depression diagnosis code. The sources of data were baseline and 3-month follow-up surveys, the health plan electronic database, and chart audits. Nine primary care clinics owned by a health maintenance organization in the Midwest. The study sample (N=1,023) consisted of adult patients, aged 19 to 93, and was divided into six age groups, from young adult, under age 35, to old old, 75 or older. Independent variables were a series of dummy variables: age groups, baseline depression severity, sex, and incident depression. Outcomes were defined as care processes (assessment, resources) and improvement in depression symptoms (Center for Epidemiologic Studies—Depression scale short form). Univariate and multivariate logistic regression analyses were used to analyze patient characteristics, depression symptoms, and care process variables. Significance level was reported based on the chi-square test of probability, P≤.05. The adjusted response rates to the baseline and follow-up surveys were 69% and 82%. Elderly depressed patients were more likely than younger depressed patients to be widowed, have low levels of education, have fair or poor health, and have three or more comorbid health problems. There were no differences, by age, in number of depressive symptoms, antidepressant treatment, or recommendation for a follow-up appointment. Younger patients were more likely than older patients to have a new diagnosis of depression and to report being depressed most of the past year. Providers were only 6% as likely to ask old-old depressed patients about suicide risk, about one-fourth as likely to referral them to a mental health therapist, about one-fifth as likely to ask if they felt depressed, and one-twentieth as likely to ask about a problem with alcohol as they were with young-adult depressed patients. The old-old were about one-third as likely to report improvement in depression symptoms after 3 months as the young-adult patients. This study suggests a possible pattern of underattention to the oldest depressed patients. Failure to ask about suicide risk is especially of concern because of the high suicide rate of depressed geriatric patients. The finding that physicians are less likely to focus on depression with old-old patients may be explained, in part, by the concept of invisibility of the ordinary. [ABSTRACT FROM AUTHOR]

Evaluates whether patient outcomes may be affected by possible errors in care at discharge as assessed by Peer Review Organizations (PRO). Analysis of the relationship between generic screens of the patient's condition at discharge and adverse outcome.