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Background: Timely reperfusion within 120 min is strongly recommended in patients presenting with non‐ST‐segment myocardial infarction (NSTEMI) with very high‐risk features. Evidence regarding the use of high‐sensitivity cardiac troponin (hs‐cTn) concentration upon admission for the risk‐stratification of patients presenting with NSTEMI to expedite percutaneous coronary intervention (PCI) and thus potentially improve outcomes is limited. Methods: All patients admitted to a tertiary care center ICCU between July 2019 and July 2022 were included. Hs‐cTnI levels on presentaion were recorded, dividing patients into quartiles based on baseline hs‐cTnI. Association between initial hs‐cTnI and all‐cause mortality during up to 3 years of follow‐up was studied. Results: A total of 544 NSTEMI patients with a median age of 67 were included. Hs‐cTnI levels in each quartile were: (a) ≤122, (b) 123–680, (c) 681–2877, and (d) ≥2878 ng/L. There was no difference between the initial hs‐cTnI level groups regarding age and comorbidities. A higher mortality rate was observed in the highest hs‐cTnI quartile as compared with the lowest hs‐cTnI quartile (16.2% vs. 7.35%, p =.03) with hazard ratio (HR) for mortality of 2.6 (95% confidence interval [CI]: 1.23–5.4; p =.012) in the unadjusted model, and HR of 2.06 (95% CI: 1.01–4.79; p =.047) with adjustment for age, gender, serum creatinine, and significant comorbidities. Conclusions: Patients with NSTEMI and higher hs‐cTnI levels upon admission faced elevated mortality risk. This underscores the need for further prospective investigations into early reperfusion strategies' impact on NSTEMI patients' mortality, based on admission troponin elevation. [ABSTRACT FROM AUTHOR]

Various compositions of the series Li1+xM3+xZr2−x(PO4)3 where M3+=Al3+, Sc3+, Y3+ were prepared by solution‐assisted solid‐state reaction, since they could have a higher reduction stability as solid electrolytes in lithium batteries than in germanium‐ or titanium‐containing materials. The influence of substitution on crystallographic parameters, density, and ionic conductivity were investigated. The cation substitution of M3+ (M=Al, Sc, Y) for Zr4+ in LiZr2(PO4)3 stabilizes the rhombohedral NaSICON structure (space group R3‾c ${R\bar{3}c}$) at room temperature and increases the ionic conductivity significantly. Here, at 25 °C and with a consistent relative density of 94 %–96 %, an ionic conductivity of 2.7×10−5 S cm−1, 6.7×10−5 S cm−1, and 3.6×10−6 S cm−1 was achieved with the compositions Li1.2Sc0.2Zr1.8(PO4)3, Li1.2Y0.2Zr1.8(PO4)3, and Li1.2Al0.2Zr1.8(PO4)3, respectively. In comparison with Li1+xScxZr2−x(PO4)3, the Y3+ substitution in LiZr2(PO4)3 enhanced the ionic conductivity slightly and denoted the maximum Li+ ionic conductivity obtained at room temperature. However, substitution with Al3+ decreased the ionic conductivity. For the first time, this work provides a complete overview of three series of solid Li‐ion conductors in the Li2O‐M2O3‐ZrO2‐P2O5 system where M=Al, Sc, Y. Noticeable differences in the chemistry of resulting compounds were observed, which likely depend on the ionic radius of the cations being substituted. The series with Sc showed complete miscibility from x=0 to x=2 with a continuous change of the NaSICON polymorphs. The series with Y showed a solubility limit at about x=0.3 and higher substitution levels led to the increasing formation of YPO4. The series with Al exhibited continuously decreasing ionic conductivity until x=1, whereupon the investigation was terminated due to its very low conductivity of about 10−10 S cm−1. [ABSTRACT FROM AUTHOR]

In the article, the authors present their study on the use of the reflective clinical reasoning tool (RE-CREATE) by medical students to determine potential clinical reasoning (CR) errors in their medical charts to avoid possible diagnostic errors (DE). Also cited are the structure of RE-CREATE including componets like history, assessment, and examination and laboratory, and the effectiveness of the tool in allowing the students to reflect on their CR.