Differences in discharge letter content: oncologists' vs. home care physicians' needs.

PURPOSE: To compare the details, oncologists include in discharge letters with what home care physicians need. Although discharge letters are important to share patients' information for home palliative care, few studies have compared the details, especially patients' emotions, regarding what oncologists include in discharge letters and home care physicians' needs. METHODS: This cross-sectional study was conducted by sending anonymous, self-administered questionnaires to 500 certified oncologists (OCs) and 500 directors of home care supporting clinics (HCs) in Japan between March and May 2023. The survey considered 20 potential items found in discharge letters, and compared rates of OCs including these items and HCs needs. RESULTS: Of 310 valid responses, 186 were from OCs (average age: 47.7; 29 females) and 124 from HCs (average age: 55.4; 9 females). Major items with lower inclusion rates for OCs included patients' emotions regarding medical conditions (58.4% in OCs vs. 92.6% in HCs, p < 0.001), families' emotions regarding medical conditions (60.0 vs. 92.6%, respectively, p < 0.001), patients' perceptions regarding medical conditions (84.9 vs. 94.3%, respectively, p = 0.011), families' perceptions regarding medical conditions (84.3 vs. 95.1%, respectively, p = 0.004), and potential late-onset treatment-related adverse events (79.3 vs. 92.6%, respectively, p = 0.002). Conversely, OCs included patients' activities of daily living more frequently (96.2 vs. 90.2%, respectively, p = 0.031). CONCLUSION: Transitioning to home-based palliative care may necessitate accurate information and consideration of patients' and families' perceptions and emotions regarding medical conditions in discharge letters for continuous provision of high-quality care.

Peculiar Atomic Bond Nature in Platinum Monatomic Chains.

Metal atomic chains have been reported to change their electronic or magnetic properties by slight mechanical stimulus. However, the mechanical response has been veiled because of lack of information on the bond nature. Here, we clarify the bond nature in platinum (Pt) monatomic chains by our in situ transmission electron microscope method. The stiffness is measured with sub-N/m precision by quartz length-extension resonator. The bond stiffnesses at the middle of the chain and at the connection to the base are estimated to be 25 and 23 N/m, respectively, which are higher than the bulk counterpart. Interestingly, the bond length of 0.25 nm is found to be elastically stretched to 0.31 nm, corresponding to a 24% strain. Such peculiar bond nature could be explained by a novel concept of "string tension". This study is a milestone that will significantly change the way we think about atomic bonds in one-dimension.

Atomic scale mechanics explored by in situ transmission electron microscopy with a quartz length-extension resonator as a force sensor.

An in situ transmission electron microscopy (TEM) holder equipped with a quartz length-extension resonator (LER) as a force sensor was developed to examine the elastic properties of atomic-scale materials. This holder is a useful means of studying the effects of size and crystal orientation on the properties of nanomaterials via measurements of mechanical responses while simultaneously observing atomic structures. The spring constants of nanocontacts (NCs) were determined based on shifts in the resonance frequency of the LER during TEM observations. The LER spring constant and sensitivity (the ratio of the LER induced charge to its oscillation amplitude), both of which are crucial to mechanical evaluation of NCs, were precisely calibrated from an analysis of TEM images along with the output of the electronics attached to the holder. The mechanical stability of the newly developed TEM holder was sufficient to allow chains of Pt atoms in the NC to be maintained for at least several seconds. The minimum measurable NC spring constant was on the order of 1 N m-1, comparable to that associated with a single atomic bond. The spring constant of a NC composed of a single-bonded chain of two Pt atoms was found to be 13.2 N m-1. This holder therefore has significant potential with regard to the characterization of nanoscale mechanical properties.

Intramolecular [2 + 2] and [4 + 2] Cycloaddition Reactions of Cinnamylamides of Ethenetricarboxylate in Sequential Processes.

Intramolecular [2 + 2] and [4 + 2] cycloaddition reactions of cinnamylamides of ethenetricarboxylate in sequential processes have been studied. Reaction of 1,1-diethyl 2-hydrogen ethenetricarboxylate and trans-cinnamylamines in the presence of EDCI/HOBt/Et3N led to pyrrolidine products in one pot, via intramolecular [2 + 2], [4 + 2], and some other cyclizations. The types of the products depend on the substituents on the benzene ring and the reaction conditions. Reaction of cinnamylamines without substituents on the benzene ring and with halogens and OMe on the para position at room temperature gave cyclobutane-fused pyrrolidines as major products via [2 + 2] cycloaddition. The reaction at 80 °C in 1,2-dichloroethane gave δ-lactone fused pyrrolidines as major products, probably via ring-opening of the cyclobutanes. Interestingly, reaction of 1,1-diethyl 2-hydrogen ethenetricarboxylate and cinnamylamines bearing electron-withdrawing groups such as NO2, CN, CO2Me, CO2Et, and CF3 on ortho and para positions in the presence of EDCI/HOBt/Et3N at room temperature or at 60-80 °C gave tetrahydrobenz[f]isoindolines via [4 + 2] cycloaddition as major products. DFT studies have been performed to explained the observed [2 + 2]/[4 + 2] selectivity.