Search

BACKGROUND: Hyperglycaemia occurs in a substantial portion of critically ill patients in our intensive care units. Near normalization of elevated blood glucose levels with IV insulin may improve outcome. However, currently published IV insulin protocol are not ideal; most are relatively complex and often result in hypoglycaemia. We designed a protocol that would be practical to use while incorporating the necessary complexities required to achieve good glucose control, coupled with a low incidence hypoglycaemia. METHODS: The essential part of the protocol is a matrix specifying the amount by which an insulin flow rate is to be changed. The intersection of the current and the previous blood glucose values on the matrix locates the appropriate cell containing the required change in insulin flow rate. No additional calculations or tables are required. RESULTS: The initial glucose level obtained by blood glucose meter (BGM) averaged 253.5 +/- 95.6 mg/dL and fell below 140 within 9.3 h on the protocol. The average BGM on the protocol was 133.5 +/- 43.9 mg/dL. Only 0.09% of all glucose values were <40 mg/dL and insulin had to be held only 2.2% of the time on the protocol. Physician input was not required and nursing accuracy in applying the protocol was greater than 94%. This protocol has been adopted as the default IV insulin protocol for the NorthShore-LIJ Health System and several other medical centers. CONCLUSION: A practical IV insulin protocol that has been extensively tested is presented. The protocol has been implemented at multiple institutions indicating its ease of use and excellent results. [ABSTRACT FROM AUTHOR]

The mean field solution of the configuration of a polyelectrolyte chain in the limit of unscreened electrostatic interactions is revisited. It is found that the Gaussian statistics behavior is recovered for weak electrostatic interactions at fixed chain size. The end to end distance is shown to crossover smoothly to that of the rod-like configuration for strong electrostatic interactions. The adsorption of a polyelectrolyte on a charged surface is briefly discussed in both limits. [ABSTRACT FROM AUTHOR]

Background: Oral human papillomavirus (HPV) infections are a leading cause of oropharyngeal cancers. In 2015 and 2016, HPV vaccines became publicly funded for gay, bisexual, and other men who have sex with men (GBM) under 27 years of age in most Canadian provinces., Methods: Between 2017 and 2019, sexually active GBM in Montreal, Toronto, and Vancouver were recruited through respondent-driven sampling. Participants aged 16-30 years were invited to self-collect oral rinse specimens for HPV testing. We estimated HPV prevalence in the oral tract overall and compared these by vaccination status., Results: Among the 838 GBM with a valid oral specimen, 36.9% reported receiving ≥1 dose of HPV vaccine. Overall, oral HPV prevalence was 2.6% (95% confidence interval [CI], 1.5%-3.7%) for at least 1 HPV type and 1.2% (95% CI, .5%-1.9%) for any high-risk type. We detected quadrivalent (HPV 6/11/16/18) vaccine-preventable types in 0.3% (95% CI, .0%-1.0%) of vaccinated individuals and 1.1% (95% CI, .1%-2.0%) of unvaccinated individuals., Conclusions: Oral HPV prevalence was low in a population of young urban GBM in Canada, of whom 37% were vaccinated. Findings serve as a benchmark for monitoring of vaccination impacts on oral HPV infection within this priority population., Competing Interests: Potential conflicts of interest. D. H. S. T.'s institution has received investigator-initiated grants from Abbvie and Gilead; and support for participation in clinical trials sponsored by Glaxo Smith Kline. F. C. reports grants from Réseau FRQS-SIDA during the conduct of the study; and grants to his institution for HPV-related work from Merck Sharp and Dome, Roche Diagnostics, and Becton Dickinson, outside of the submitted work. A. D. P. reports grants from Réseau FRQS-SIDA during the conduct of the study. C. S. is a member of the HPV working group of the National Advisory Committee on Immunization; and is an active member of the Québec Immunization Committee. J. C.’s institution has received funding from ViiV Healthcare and Gilead for research; and J. C. has received remuneration for advisory work from ViiV Healthcare and Gilead. T. A. H. has received funds as Director of the HOPE Centre from Gilead, ViiV, and DECIEM. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Background: Beyond clinical risk factors, little is known about the impact of social determinants on respiratory syncytial virus (RSV) burden. Our study aimed to estimate RSV-related hospitalization rates across sociodemographic and housing characteristics., Methods: We conducted a population-based study of all RSV-related hospitalizations in Ontario, Canada, between September 1, 2016, and August 31, 2019, using validated hospital discharge codes and census data. Crude and age-standardized annualized RSV incidence rates and rate ratios (RRs) were estimated for a range of individual-level demographics and neighborhood-level measures of marginalization and housing characteristics., Results: Overall, the annual RSV-related hospitalization rate was 27 per 100 000, with the highest rates observed in children age <12 months (1049 per 100 000) and 12-23 months (294 per 100 000) and adults age ≥85 years (155 per 100 000). Higher RSV-related hospitalization rates were associated with increasing marginalization quintile (Q) of material resources (RR, 1.4; Q5: 33 per 100 000 vs Q1: 24 per 100 000) and household instability (RR, 1.5; Q5: 31 per 100 000 vs Q1: 22 per 100 000)., Conclusions: The burden of RSV-related hospitalization was greatest in young children and older adults, with variation by sociodemographic and housing factors. Understanding the role of these social factors is crucial for informing equitable preventive program delivery., Competing Interests: Potential conflicts of interest. The authors do not have a commercial or other association that might pose a conflict of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Background: Hyperglycaemia occurs in a substantial portion of critically ill patients in our intensive care units. Near normalization of elevated blood glucose levels with IV insulin may improve outcome. However, currently published IV insulin protocol are not ideal; most are relatively complex and often result in hypoglycaemia. We designed a protocol that would be practical to use while incorporating the necessary complexities required to achieve good glucose control, coupled with a low incidence hypoglycaemia., Methods: The essential part of the protocol is a matrix specifying the amount by which an insulin flow rate is to be changed. The intersection of the current and the previous blood glucose values on the matrix locates the appropriate cell containing the required change in insulin flow rate. No additional calculations or tables are required., Results: The initial glucose level obtained by blood glucose meter (BGM) averaged 253.5 +/- 95.6 mg/dL and fell below 140 within 9.3 h on the protocol. The average BGM on the protocol was 133.5 +/- 43.9 mg/dL. Only 0.09% of all glucose values were <40 mg/dL and insulin had to be held only 2.2% of the time on the protocol. Physician input was not required and nursing accuracy in applying the protocol was greater than 94%. This protocol has been adopted as the default IV insulin protocol for the NorthShore-LIJ Health System and several other medical centers., Conclusion: A practical IV insulin protocol that has been extensively tested is presented. The protocol has been implemented at multiple institutions indicating its ease of use and excellent results.

Objectives: The aim of this study is to evaluate the effect of the different conditions of curing on the residual monomer levels, hardness and impact strength of a microwave-polymerised acrylic resin., Methods: The material was polymerised in a microwave oven in four different conditions of power and curing time. The kinetics of release of residual monomer in water was evaluated by spectrophotometric method up to 24 h. The hardness of the sample was determined by the Rockwell method and the impact strength tested by the Charpy method. The results were subjected to statistical analysis using ANOVA and Tukey's test for comparison., Results: The levels of residual monomer were found dependent upon the curing conditions and they were correlated with the values of impact strength. Significant differences were observed in this property regarding the analysed conditions (p<0.001)., Conclusions: From the appropriate selection of power and time of curing of the resin, it is possible to optimise the level of residual monomer and a low cytotoxicity keeping at the same time the best mechanical properties.

This paper presents a model for pH-dependent adsorption of an ionic homopolypeptide with secondary structure on a flat surface. This model is developed by generalization of a discrete model of semistiff chain with short-range interaction, between homopolypeptide chain and surface. The presence of intramolecular repulsive interaction as well as secondary structure is introduced here by modified Zimm-Bragg stabilization parameters. The model predicts that in the case of low degree of ionization, the adsorption behaviour of an ionic and non-ionic homopolypeptide are qualitatively similar (i.e. both show a second-order phase-transition, characteristic of this phenomenon). We also illustrate the prediction of the model about the critical absorption energy in the case of selective interaction, and show that a discontinuity in the melting-temperature behaviour appears when the pH is tuned to a critical pH value (pHc).