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Background Reusable laryngoscopes have been reported to be superior to disposable laryngoscopes with plastic blades during emergent intubations. Surprisingly, at our institution a quality reporting system revealed a high number of equipment failures with reusable laryngoscopes in an emergency out-of-OR (operating room) setting. As recent studies indicated an improved quality of disposable laryngoscopes, we hypothesized that a thoroughly evaluated disposable laryngoscope would result in less equipment failure in an emergency out-of-OR setting. Methods To perform a more standardized and time efficient analysis, four distinct disposable laryngoscope blade/handle configurations were trialed during standard intubations ( n  = 4 × 30) in the OR by experienced anesthesia providers who completed a 6-question, Likert-scale/open-ended survey for product evaluation. The ‘best’ disposable blade was implemented in an emergency out-of-OR setting and equipment failure rates were monitored over a 3-year period. Results Different disposable laryngoscopes were equal regarding sturdiness, illumination and airway visualization. The laryngoscope with the highest overall score was significantly higher scored than the laryngoscope with the lowest overall score. All disposable laryngoscopes were more cost effective than the reusable ones, and the top scored laryngoscope demonstrated the highest 5-year cost-saving ($210 K). Implementation of the top scored disposable laryngoscope into an emergency out-of-OR setting reduced the equipment failure incidence from high 20s to 0. Conclusion Disposable laryngoscopes are cost effective and superior to reusable laryngoscopes in an emergency out-of-OR setting. We demonstrate that the implementation of a disposable laryngoscope in the emergency out-of-OR setting resulted in a near elimination of equipment related quality submissions which ultimately enhances patient safety.

A randomized trial comparing a 5-day course of intravenous remdesivir with a 10-day course in patients with Covid-19 pneumonia and hypoxemia who were not yet receiving mechanical ventilation showed no significant differences in outcome related to the duration of treatment.

Background. Interferon-based hepatitis C virus (HCV) therapy is safe and effective among people receiving opioid substitution therapy (OST), but treatment uptake remains low. Our aim was to evaluate the impact of OST and drug use during therapy on completion, adherence, sustained virologic response (SVR12), and safety of ledipasvir/sofosbuvir ± ribavirin. Methods. The phase 3 ION studies evaluated a fixed-dose combination of ledipasvir/sofosbuvir ± ribavirin administered for 8, 12, or 24 weeks in patients with chronic HCV genotype 1. People with clinically significant drug use (prior 12 months) or noncannabinoids detected at screening by urine drug tests (not explained by prescriptions) were ineligible. Stored samples were available from ION-1 for retrospective testing for illicit drugs by enzyme-linked immunosorbent assay. Results. Among 1952 patients enrolled in the ION studies, 4% (n = 70) were receiving OST. Among those receiving (n = 70) and not receiving OST (n = 1882), there was no difference in treatment completion (97% vs 98%; P = .40), ≥80% adherence (93% vs 92%; P = 1.00), SVR12 (94% vs 97%; P = .28), and serious adverse events (4% vs 3%; P = .43), respectively. Among participants in the ION-1 trial, 23% (n = 196) used illicit drugs during therapy (15% cannabinoids alone; 8% other illicity drugs ± cannabinoids). There was no difference in treatment completion, ≥80% adherence, SVR12, or serious AEs in those with no drug use during treatment compared with those who used cannabinoids and/or other illicit drugs. No cases of HCV reinfection were observed in the 24 weeks following treatment. Conclusions. OST and drug use during HCV therapy did not impact treatment completion, adherence, SVR12, or safety. Clinical Trials Registration. ION-1 (NCT01701401); ION-2 (NCT01768286); and ION-3 (NCT01851330).

This study reports a genetic map created using a progeny family descended from the interspecific hazelnut cross Corylus avellana x Corylus americana. This research represents a critical step in the development of genomic tools that enable the deployment of next-generation sequencing methods in the breeding of hazelnut, specifically the improvement of well-adapted Midwestern hazelnut varieties. To produce this map, we first developed high-density molecular markers using short-read Illumina sequencing of genotype-by-sequencing libraries. By aligning reads to a newly assembled reference genome for C. americana, we were able to identify over 75,000 high-quality indel-based polymorphisms across an F1 experimental population. These markers exhibited both high allele depth coverage, and low linkage disequilibrium, making them well-suited to genetic map development. We constructed such a map using 95 individuals from a single F1 family, demonstrating the utility of next-generation sequencing to efficiently and accurately generate high-density genetic maps. This research will improve the efficiency of breeding efforts, both through the validation of specific molecular markers that are associated with agronomically-relevant traits in breeding populations of interest.Competing Interest StatementThe authors have declared no competing interest.Footnotes* https://doi.org/10.6084/m9.figshare.21902193