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iveness. The results support current HCV guidelines that do not distinguish between ribavirin-free EBR/GZR and LDV/SOF.We developed a rapid and simple magnetic chemiluminescence enzyme immunoassay on the Real Express-6 analyzer, which could simultaneously detect immunoglobulin G and immunoglobulin M antibodies against SARS-CoV-2 virus in human blood within 18 min, and which could be used to detect clinical studies to verify its clinical efficacy. We selected blood samples from 185 COVID-19 patients confirmed by polymerase chain reaction and 271 negative patients to determine the clinical detection sensitivity, specificity, stability, and precision of this method. Meanwhile, we also surveyed the dynamic variance of viral antibodies during SARS-CoV-2 infection. This rapid immunoassay test has huge potential benefits for rapid screening of SARS-CoV-2 infection and may help clinical drug and vaccine development.Corn dry milling provides a mature model for lignocellulose biorefinery process. To copy this technical success, a crucial step is to transform lignocellulose into starch-like carbohydrates (SLC), similar to milled corn grain and in a similar fashion to corn dry milling. The transformation process should be zero wastewater generation and sufficient fermentable sugar conservation; the product should be in solid particle form, free of toxic residues, and high enzymatic hydrolysis yield and fermentability. Here we designed and verified a SLC transformation process by (i) biodegradable oxalic acid-catalyzed pretreatment, and (ii) simultaneous biodegradation of inhibitors and oxalic acid catalyst. Ozanimod in vivo The oxalic acid catalyst was effective on disrupting the lignocellulose structure and also biodegradable at low pH value. The biodetoxification fungus Paecilomyces variotii FN89 was capable of degrading the furan/phenolic aldehydes and oxalic acid simultaneously and ultimately, while the fermentable sugars were well preserved. The obtained SLC from wheat straw and corn stover were similar to dry milled corn meal in terms of morphological properties, fermentable sugar contents, enzymatic hydrolysis yield, elemental contents, and free of inhibitors and acid catalyst. The bioconversion of starch-like wheat straw and corn stover produced 78.5 and 75.3 g/L of ethanol (9.9% and 9.5%, v/v) with the yield of 0.47 and 0.45 g ethanol/g cellulose/xylose, respectively, compared with 78.7 g/L (10.0%, v/v) from corn meal and the yield of 0.48 g ethanol/g starch. Mass balances suggest that the ethanol yield, wastewater generation, and elemental recycling of the SLC from lignocellulose were essentially the same as those of corn meal.
Racial and ethnic minority children with cancer disproportionately receive intensive care at the end of life (EOL). It is not known whether these differences are goal-concordant or disparities. The authors sought to explore patterns of pediatric palliative care (PPC) and health care utilization in pediatric oncology patients receiving subspecialty palliative care at the end-of-life (last 6 months) and to examine goal-concordance of location of death in a subset of these patients.
This was a retrospective cohort study of pediatric oncology patients receiving subspecialty palliative care at a single large tertiary care center who died between January 2013 and March 2017.
A total of 115 patients including 71 White, non-Hispanic patients and 44 non-White patients (including 12 Black patients and 21 Hispanic patients) were included in the analytic cohort. There were no significant differences in oncologic diagnosis, cause of death, or health care utilization in the last 6 months of life. White and non-White patients had similar PPC utilization including time from initial consult to death and median number of PPC encounters. Non-White patients were significantly more likely to die in the hospital compared to White patients (68% vs 46%, P = .03). Analysis of a subcohort with documented preferences (n = 45) revealed that 91% of White patients and 93% of non-White patients died in their preferred location of death.
Although non-White children with cancer were more likely to die in the hospital, this difference was goal-concordant in our cohort. Subspecialty PPC access may contribute to the achievement of goal-concordant EOL care.
Although non-White children with cancer were more likely to die in the hospital, this difference was goal-concordant in our cohort. Subspecialty PPC access may contribute to the achievement of goal-concordant EOL care.
Among patients with heart failure and left ventricular (LV) dysfunction despite guideline directed medical therapy, cardiac resynchronization (CRT) is an effective technology to reverse LV remodeling. Given that a large portion of patients are non-responders, alternatives to traditional LV-lead placement have been explored. A promising alternative is image targeted placement of an LV-lead to latest mechanically activated segment without scar.
Electronic database search for randomized controlled trials (RCTs) that evaluated the imaging-guided LV-lead placement on clinical, echocardiographic, and functional outcomes. The primary outcome was a composite of mortality and heart failure hospitalization. The secondary outcomes included CRT responders, New York Heart Association (NYHA), 6-minute walk test, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and ejection fraction (EF) changes.
Analysis included 4 RCTs of 691 patients with an average follow-up of 2 years (age 69.5 ± 10.3years, 76% males, 54% ischemic cardiomyopathy, 81% with NYHA classes III/IV, and EF of 24.4% ± 8). The most common site for LV-lead paced segment was the anterolateral segment (45%) and at mid-LV (49%). Compared with the control, imaging-guided LV-lead placement was associated with a significant reduction of the primary outcome (hazard ratio [HR]=0.60; 95% CI=0.40-0.88; p=.01), higher CRT responders (odd ratio [OR]=2.10; p<.01), more NYHA improvements by ≥1 (OR=1.89; p=.01), increased 6MWT (mean difference [MD]=25.78 feet; p<.01), and lower MLHFQ (MD=-4.04; p=.04), without significant differences in the LVEF (p=.08).
In patients undergoing CRT, imaging-guided LV-lead placement was associated with improved clinical, echocardiographic, and functional status.
In patients undergoing CRT, imaging-guided LV-lead placement was associated with improved clinical, echocardiographic, and functional status.