Acute Bioprosthetic Mitral Valve Failure Diagnosed Using Point-of-Care Ultrasound Leading to Prompt Treatment and Good Outcome.

• Acute bioprosthetic mitral valve failure is a medical emergency. • POCUS can confirm the diagnosis along with a good history and physical exam. • Early diagnosis and prompt multidisciplinary treatment will deliver the best outcome.

The association between urinary sodium concentration (UNa) and outcomes of acute heart failure: a systematic review and meta-analysis.

Aims: Urinary sodium concentration (UNa) is a simple test advocated to assess diuretics efficacy and predict outcomes in acute heart failure (AHF). We performed a systematic review and meta-analysis to examine the association of UNa with outcomes of AHF.

Methods And Results: We searched Embase and Medline for eligible studies that reported the association between UNa and outcomes of urinary output, weight loss, worsening renal function, length of hospital stay, re-hospitalization, worsening heart failure, and all-cause mortality in AHF.

Cardio-geriatric model of care in acute heart failure: initial experience of a multidisciplinary approach in complex elderly patients.

A 'cardio-geriatric' heart failure model of care was implemented to address the high rates of readmission in elderly acute decompensated heart failure patients. Despite demonstrably intensified management in both the cardiology and geriatric domains, this study did not demonstrate a positive effect on the primary outcome of all cause readmissions at 30 days.

Handheld ultrasound to reduce requests for inappropriate echocardiogram (HURRIE).

Background: Handheld ultrasound could provide sufficient information to satisfy the clinical questions underlying 'rarely appropriate' echo requests, but there are limited data about its use as a gatekeeper to standard echocardiography. We sought to determine whether the use of handheld ultrasound could improve the appropriate use of echocardiography.

Method: A prospective study comparing handheld ultrasound strategy to standard echocardiography for studies deemed rarely appropriate, using a questionnaire based on appropriate use criteria was conducted across two hospitals, from October 2017 to April 2018.

The increase in healthcare costs associated with frailty in older people discharged to a post-acute transition care program.

Background: older people are high users of healthcare resources. The frailty index can predict negative health outcomes; however, the amount of extra resources required has not been quantified.

Objective: to quantify the impact of frailty on healthcare expenditure and resource utilisation in a patient cohort who entered a community-based post-acute program and compare this to a cohort entering residential care.

Lifting the mirror symmetry of metal surfaces: decoupling the electronic and physical manifestations of surface chirality.

Naturally occurring metal surfaces possess planes of mirror symmetry on the nanometer-length scale. This mirror symmetry can be lifted and chirality "physically" conveyed onto a surface by adsorbing a chiral molecule. Until now, it has not been known whether the conveying of chirality is limited to just the physical structure or whether it goes deeper and permeates the electronic structure of the underlying surface.

A high-resolution photoemission study of nanoscale aluminum oxide films on NiAl(110).

Using high-resolution soft X-ray photoemission, Al 2p, we have been able to quantify the relative populations of tetrahedrally (Al(tet)) and octahedrally (Al(oct)) coordinated Al(3+) in three distinct phases of nanoscale aluminum oxide films on NiAl(110). We have hence determined the bulk alumina phases that the nanoscale films most resemble. Adsorption of oxygen at room temperature produces a layer which predominately (90%) contains Al(tet) and is analogous to the amorphous bulk phase of alumina.

Chiral discrimination within disordered adlayers on metal surfaces.

Using a novel non-linear optical technique enantiomeric excess within a translationally disordered overlayer on a metal surface has been monitored for the first time.