Shepardrafferty7189

BACKGROUND Understanding the preferences for end-of-life (EOL) care is imperative in providing quality care to patients with life-threatening illness. However, it is difficult for patients, families, and health-care providers to initiate EOL conversations in China. An easy-to-use tool that could help health-care providers initiate EOL discussions is the Heart to Heart Card Game (HHCG), originally designed for Chinese Americans. OBJECTIVE To evaluate the EOL preferences among Chinese patients with cancer using the HHCG. METHODS We conducted a descriptive study to assess EOL preferences using HHCG among patients at the oncology chemoradiotherapy department of a Chinese tertiary hospital. RESULTS We recruited 58 patients in total of which 40 (69%) patients completed HHCG. The most frequently selected card was "I want my family to get along," followed by "I don't want to be a burden to my family," and "I want to maintain my dignity." Among the 3 cards selected, social needs were rated as the most important (36.7%), followed by spiritual needs (35.8%), physical needs (20.0%), and financial needs (7.5%). The evaluation of the HHCG revealed that more than 70% of the participants highly valued HHCG. CONCLUSION The HHCG can be used as a communication tool to encourage EOL discussions between cancer patients and health-care providers in China. Moreover, Chinese patients with cancer attach significant importance to their family and maintaining dignity at the EOL.BACKGROUND Heart failure (HF) impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recommend the inclusion of PC in HF therapy, but referrals are often delayed. OBJECTIVE Introduce PC to patients with HF and examine the impact on PC consults, readmission, mortality, and intensive care unit (ICU) transfers. METHODS Patients (n = 60) admitted with HF to an academic hospital were asked to view a PC educational module. A number of PC consults, re-admissions, mortality, and transfers to the ICU were compared among participants and those who declined. RESULTS Nine patients in the intervention group (n = 30) requested a PC consult (P = .042) versus 2 in the usual care group (n = 30; P = .302). There was no statistically significant difference in readmissions, mortality, or ICU transfers between groups. CONCLUSIONS Palliative care education increases the likelihood of PC utilization but in this short-term project was not found to statistically impact mortality, re-admissions, or transfers to higher levels of care.The oxidative coupling of carboxylic acids with liquid ketones and cyclic ethers has been accomplished in minutes using t-butyl hydroperoxide in the presence of tetrabutylammonium iodide under microwave irradiation in the absence of a solvent. In addition to drastically shortening the reaction times, the use of microwaves resulted, in general, in yields equal to or higher than those obtained by conventional heating.Increased throughput as well as increased multiplexing of liquid chromatography coupled to selected reaction monitoring mass spectrometry (LC-SRM-MS) assays for protein quantification challenges routine data analysis. Despite measurement of multiple transitions from multiple peptides, for clinical applications a single (quantifier) transition from one (quantifier) signature peptide is used to represent the protein quantity with most data used solely to validate the quantifier result. To support the generation of reliable protein results from multiplexed LC-SRM-MS assays with large sample numbers, we developed a data analysis process for quality control and outlier detection using data from an 11-protein multiplex LC-SRM-MS method for dried blood samples (195,492 chromatographic peaks from 1481 samples * 11 proteins * 2 peptides * 3 transitions * 2 isotopologues). The 2-tiered data analysis process detects outliers for ion ratio, peptide ratio, and % difference between duplicates, applying less stringent criteria to samples with a small % difference between duplicates (Tier 1) and more stringent criteria to samples with unassessed or a large % difference between duplicates (Tier 2). After manual peak review, 1127 samples (76%) were selected based on sample quality. The data analysis process thereafter automatically selected quantifier transitions/peptides, removed quality control failures and outliers (8%), averaged duplicates, and generated a comprehensive report listing 6,085 quality controlled protein-level results. The proposed data analysis process serves as a starting-point towards standardized data analysis of multiplexed LC-SRM-MS protein assays.As organic semiconductors attract increasing attention to application in the fields of bioelectronics and artificial photosynthesis, understanding the factors that determine their robust operation in direct contact with aqueous electrolytes becomes a critical task. Herein we uncover critical factors that influence the operational stability of donoracceptor bulk heterojunction photocathodes for solar hydrogen production and significantly advance their performance under operational conditions. First, using the direct photoelectrochemical reduction of aqueous Eu3+ and impedance spectroscopy, we determine that replacing the commonly used fullerene-based electron acceptor with a perylene diimide-based polymer drastically increases operational stability and identify that limiting the photogenerated electron accumulation at the organic/water interface to values of ca. 100 nC cm-2 is required for stable operation (>12 h). These insights are extended to solar-driven hydrogen production using MoS3, MoP, or RuO2 water reduction catalyst overlayers where it is found that the catalyst morphology strongly affects performance due to differences in charge extraction. Optimized performance of bulk heterojunction photocathodes coated with a MoS3MoP composite gave 1 Sun photocurrent density up to 8.7 mA cm-2 at 0 V vs RHE (pH 1). FKBP inhibitor However, increased stability was gained with RuO2 where initial photocurrent density (>8 mA cm-2) deceased only 15% or 33% during continuous operation for 8 or 20 h, respectively, thus demonstrating unprecedented robustness without a protection layer. This performance represents a new benchmark for organic semiconductor photocathodes for solar fuel production and advances the understanding of stability criteria for organic semiconductor/water-junction-based devices.