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Background: Frailty epitomizes the most complex consequence of an aging population. This study aimed to evaluate the impact of frailty, measured using the Clinical Frailty Scale (CFS), on outcomes of older people in an emergency department (ED). Methods: We conducted a prospective observational study enrolling patients aged 65 years and older in a medical center of Taiwan between March 8, 2021, and November 30, 2021. The primary outcome was 90-day mortality rate. Individuals were categorized into three groups based on the CFS scores. Logistic regression was employed to examine the influence of frailty on clinical outcomes following covariate adjustment. Survival analysis was conducted using Kaplan–Meier curves and Log rank tests. Results: A total of 473 individuals were included in the study, with a mean age of 82.1 years, and 60.5% of them were males. The 90-day mortality rate was 10.6%. Among these groups, the CFS score 7– 9 group had the highest 90-day mortality rate (15.9%), followed by the CFS score 4– 6 group (8.0%) and the CFS score 1– 3 group (7.1%). The multiple logistic regression analyses demonstrated a significant impact of CFS score on prognosis, with adjusted odd ratios of 1.24 (95% CI 1.06– 1.47) for 90-day mortality, 1.18 (95% CI 1.06– 1.31) for hospitalization, and 1.30 (95% CI 1.12– 1.52) for 180-day mortality. The Kaplan–Meier curves revealed a significantly higher 90-day mortality rate for patients with high CFS scores (Log rank tests, p = 0.019). Conclusion: In the older ED population, the severity of frailty assessed by the CFS emerged as a significant and important prognostic factor for hospitalization, 90-day mortality, and 180-day mortality. [ABSTRACT FROM AUTHOR]

Polyimides (PI) are considered as one of the most used materials for flexible printed circuit board substrates because of their excellent thermal stabilities, outstanding mechanical properties, and great dielectric properties. Dielectric constants (Dk) of common commercial PIs, however, are still above 3.0 (at 10 GHz), which is still substandard for high‐frequency applications. In this study, we develop thermally stable PIs with enhanced dielectric properties by structural design and crosslinking. Stiff aromatic 2,2′‐bis(trifluoromethyl)benzidine (TFMB) and soft aliphatic dimer diamines (DDA, priamine), including priamine 1074 (DDA‐1) and priamine 1071 (DDA‐2), are used as the diamines, and cyclobutanetetracarboxylic dianhydride (CBDA) is used as the dianhydride. By adjusting the ratio of the diamines, a series of PIs (PI‐1–PI‐5) with high thermal stabilities and low‐Dk values are synthesized. Among these PIs, PI‐4 synthesized by diamines with the ratio of TFMB:DDA‐1:DDA‐2 = 85:10:5, possesses relatively good performances. Therefore, PI‐4 is further chosen to be thermally crosslinked. By changing the contents of the crosslinker, triallyl isocyanurate (TAIC), crosslinked PIs (CPIs) are synthesized. The resulting CPIs have a significant improvement in thermal properties, dielectric properties, and mechanical strengths. Especially, for the CPI‐4‐30, in which 30% of TAIC is used, the glass transition temperature (Tg) increases by 20°C, the Dk decreases from 2.62 to 2.41, and the ultimate tensile strength boosts from 91.65 to 115.16 MPa. The CPIs with low Dk and high Tg values may have great potential as substrate materials for broad applications, such as microelectronics and integrated circuit packages. [ABSTRACT FROM AUTHOR]

This document is a response to a letter to the editor regarding a study titled "The Association Between Frailty Evaluated by the Clinical Frailty Scale and Mortality of Older Patients in the Emergency Department: A Prospective Cohort Study." The study found that individuals with higher clinical frailty scale scores had worse clinical outcomes. The response addresses the issue of competing risks, the factors considered in the regression analysis, and the limitations of the study. The authors express gratitude for the feedback and declare no conflicts of interest. [Extracted from the article]

Background: Analysis of short-term emergency department (ED) revisits is a common emergency care quality assurance practice. Previous studies have explored various risk factors of ED revisits; however, laboratory data were usually omitted. This study aimed to evaluate the prognostic significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and systemic immune-inflammation index (SII) in predicting outcomes of patients revisiting the ED., Methods: This retrospective observational cohort study investigated short-term ED revisit patients. The primary outcome measure was high-risk ED revisit, a composite of in-hospital mortality or intensive care unit (ICU) admission after 72-hour ED revisit. The NLR, PLR, and SII were investigated as potential prognostic predictors of ED revisit outcomes., Results: A total of 1916 encounters with short-term ED revisit patients were included in the study; among these, 132 (6.9%) encounters, comprising 57 in-hospital mortalities and 95 ICU admissions, were high-risk revisits. High-risk revisit patients had significantly higher NLR, PLR, and SII (11.6 vs 6.6, p < 0.001; 26.2 vs 18.9, p = 0.004; 2209 vs 1486, p = 0.002, respectively). Multiple regression analysis revealed revisit-NLR as an independent factor for predicting poor outcomes post-ED revisits (odds ratio: 1.031, 95% CI: 1.017-1.045, p < 0.001); an optimal cut-off value of 7.9 was proven for predicting high-risk ED revisit., Conclusion: The intensity of the inflammatory response expressed by NLR was an independent predictor for poor outcomes of ED revisits and should be considered when ED revisits occur. Future prediction models for ED revisit outcomes can include revisit-NLR as a potential predictor to reflect the progressive conditions in ED patients., Competing Interests: Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article., (Copyright © 2024, the Chinese Medical Association.)

Competing Interests: Declaration of competing interest The authors declared there is no conflict of interest associated with this study.

In the present paper, the composition of complex Al-CAS-CTMAB was studied with the ratio of double peak values at dual-wavelengths by UV spectrophotometry. First, the composition of complex of Al-CAS was determined in this method, Al:CAS = 1:2. The absorption of ternary complex(Al-CAS-CTMAB) was determined with reference reagent of the complex Al-CAS. The epsilon values of Al-CAS and Al-CAS-CTMAB were determined with water reference. The composition of complex Al (CAS)n1 (CTMAB)n2 was calculated with the formula: [formula: see text] CAS:CTMAB = 1:1; Al:CAS:CTMAB = 1:2:2. The calculated value and that obtained by traditional method are agreeable. The method is reliable for determining composition of ternary complexes.