Introduction It is unclear whether inpatient heart failure (HF) performance measures reduce post-discharge adverse events. This exploratory study examined the association between systematic adherence to a set of performance measures and outcomes. Measures included all four Joint Commission (JC) HF core measures and AHA recommended beta blockade prescription on discharge. Methods A retrospective review of a 3-hospital system was performed for all patients discharged with a primary diagnosis of HF in 2008-2009. Patients were included if they met eligibility criteria for one or more measures (n=1270). ‘Perfect care’ was defined as compliance with all eligible measures. Subsequent all-cause 30-day readmission and 1-year mortality was determined via electronic records and social security national database. Results ‘Perfect care’ significantly reduced 30-day readmissions (19.2% vs. 24.9%, p=.045; OR=.72, 95% CI 0.52-0.99). ‘Perfect care’ did not influence 1-year mortality. Conclusions Adherence to this set of composite performance measures positively influenced short-term patient outcomes. Benefit of adherence was found despite the longer LOS and higher severity of illness on index admission for patients receiving ‘perfect care’. The data support the clinical value of a systematic approach towards HF care on patient care quality. ‘Perfect care’ did not influence long term outcomes, which may be because inpatient processes do not extend to long term outpatient medical management.

Embryonic stem cells (ESC) have been explored as tools for studying development, as well as, potential sources for a large number of therapies in regenerative medicine. Traditionally, ESC are cultured on tissue culture plastic, however; it has been recently shown that the stiffness of the environmental substrate can direct the cells towards various cell lineages. Our laboratory is specifically interested in examining the combined roles of biochemical and physical signaling in cardiac and vascular cell fate and patterning these vascular cells into vascular branch-like tress.Using our novel mouse ESC that expresses a GFP reporter under the Tie-2 and an RFP reporter under alpha smooth muscle actin and serum-free inductionmediums, we examined the role of stiffness in the diverging fate of Flk-1 + vascular progenitor cells. The results indicate that both of the Flk-1 + vascular progenitor cells and human umbilical vein endothelial cells (HUVEC) preferentially adhere to 10 kPa compared with the 1 kPa, and 34 kPa compared with the 10 kPa. We also observed both the GFP/Tie-2 + endothelial-like and RFP + smooth muscle-like cells outgrowths from the Flk-1 + cells, with the GFP/Tie-2 + cells dominating the cultures, supporting the role of stiffness in vascular fate. Next, we generated a vascular fractal-like pattern reverse mold and have stamped fibronectin vascular pattern onto non-tissue culture treated plastic. Using these combined technologies, we have been able to genera

NASA's Solar Probe Plus (SPP) mission will make the first in situ measurements of the solar corona and the birthplace of the solar wind. The FIELDS instrument suite on SPP will make direct measurements of electric and magnetic fields, the properties of in situ plasma waves, electron density and temperature profiles, and interplanetary radio emissions, amongst other things. Here, we describe the scientific objectives targeted by the SPP/FIELDS instrument, the instrument design itself, and the instrument concept of operations and planned data products.