Introduction:
The general assumption is that blood glucose (BG) and interstitial fluid glucose (IntFG) are practically the same. We aimed to determine whether the typical patient with type 2 diabetes ...can use IntFG to estimate BG.
Description:
The study was conducted on an 83-year-old white male with type 2 diabetes. One hundred pairs of IntFG and BG observations mg/dL (n = 50 simultaneous; n = 50 with 15-minute lag) were made over a 10-day period. We used paired t tests, correlation coefficients, and linear regression to predict relationships between IntFG and BG.
Results:
There were significant (P < .0001) mean differences between IntFG and BG (simultaneous: 53.8 mg/dL; 15-minute time lag: 46.4 mg/dL). There were significant (P < .0001) positive correlations between IntFG and BG (simultaneous: r = 0.641; 15-minute time lag: r = 0.712). Linear regression revealed that increased IntFG was significantly (P < .0001) associated with declines in mean predicted BG.
Conclusion:
The typical type 2 diabetes patient cannot use IntFG level to estimate BG.
Mechanical circulatory support (MCS) leads to favorable changes in the failing heart at the molecular, cellular, and structural levels. However, myocardial recovery leading to device explantation is ...rare. We reasoned that the multicenter United Network for Organ Sharing (UNOS) registry might provide insights into clinical predictors and outcomes of the recovery process.
The MCS device data set of the UNOS registry was queried for patients with long-term continuous-flow left ventricular assist devices (CF-LVADs) that were explanted for heart transplantation or indication of recovery. Analysis was restricted to adult patients (≥18 years old) who were listed for an initial heart transplantation. Patients with CF-LVADs that were explanted because of recovery were compared with patients with CF-LVADs who underwent transplantation.
We identified 594 patients with HeartMate II devices and 92 patients with HeartWare devices. Duration of support was on average 500.4 ± 325.3 days. In 34 (5.0%) patients, devices were explanted secondary to myocardial recovery. Univariate predictors of recovery in patients with long-term LVADs included younger age (40 years vs 53 years), female sex, lower body mass index (25.7 kg/m(2) vs 27.9 kg/m(2)), non-ischemic etiology (91% vs 59%), lack of implantable cardioverter defibrillator at the time of listing (44% vs 79%), and lower serum creatinine (0.97 mg/dl vs 1.28 mg/dl) (all p < 0.05). In the post-explantation period, freedom from death or transplantation was 66% at 1 year.
The incidence of recovery on device support is low in the current MCS era and limited to a select cohort of predominantly young patients with non-ischemic myopathy. Given the high incidence of disease recurrence, patients should be closely followed after device explantation.
Highlights • Used fMRI to examine the long-term effects of prenatal nicotine exposure on verbal working memory in young adults. • Participants were members of the Ottawa Prenatal Prospective Study. • ...12 exposed and 13 non-exposed controls performed a 2-Back working memory task. • Exposed participants demonstrated greater activity in several regions of the brain. • Prenatal nicotine exposure contributes to altered neural functioning.
The measurement of OH reactivity, the inverse of the OH lifetime, provides a powerful tool to investigate atmospheric photochemistry. A new airborne OH reactivity instrument was designed and deployed ...for the first time on the NASA DC-8 aircraft during the second phase of Intercontinental Chemical Transport Experiment-B (INTEX-B) campaign, which was focused on the Asian pollution outflow over Pacific Ocean and was based in Hawaii and Alaska. The OH reactivity was measured by adding OH, generated by photolyzing water vapor with 185 nm UV light in a moveable wand, to the flow of ambient air in a flow tube and measuring the OH signal with laser induced fluorescence. As the wand was pulled back away from the OH detector, the OH signal decay was recorded; the slope of −Δln(signal)/Δ time was the OH reactivity. The overall absolute uncertainty at the 2σ confidence levels is about 1 s−1 at low altitudes (for decay about 6 s−1), and 0.7 s−1 at high altitudes (for decay about 2 s−1). From the median vertical profile obtained in the second phase of INTEX-B, the measured OH reactivity (4.0±1.0 s−1) is higher than the OH reactivity calculated from assuming that OH was in steady state (3.3±0.8 s−1), and even higher than the OH reactivity that was calculated from the total measurements of all OH reactants (1.6±0.4 s−1). Model calculations show that the missing OH reactivity is consistent with the over-predicted OH and under-predicted HCHO in the boundary layer and lower troposphere. The over-predicted OH and under-predicted HCHO suggest that the missing OH sinks are most likely related to some highly reactive VOCs that have HCHO as an oxidation product.
Background
There are limited data evaluating the success of a structured transition plan specifically for pediatric heart transplant (HT) recipients following their transfer of care to an adult ...specialist. We sought to identify risk factors for poor adherence, graft failure, and mortality following the transfer of care to adult HT care teams.
Methods
We retrospectively reviewed all patients who underwent transition from the pediatric to adult HT program at our center between January 2011 and June 2021. Demographic characteristics, comorbid conditions, and psychosocial history were collected at the time of HT, the time of transition, and the most recent follow‐up. Adverse events including mortality, graft rejection, infection, and renal function were also captured before and after the transition.
Results
Seventy‐two patients were identified (54.1% male, 54.2% Caucasian). Mean age at the time of transition was 23 years after a median of 11.6 years in the pediatric program. The use of calcineurin inhibitors was associated with reduced mortality (HR .04, 95% CI .0–.6, p = .015), while prior psychiatric hospitalization (HR 45.3, 95% CI, 6.144–333.9, p = .0001) was associated with increased mortality following transition. Medication nonadherence and young age at the time of transition were markers for high‐risk individuals prior to the transition of care.
Conclusions
Transition of HT recipients from a pediatric program to an adult program occurs during a vulnerable time of emerging adulthood, and we have identified risk factors for mortality following transition. Development of a formalized transition plan with a large multidisciplinary team with focused attention on high‐risk patients, including those with psychiatric comorbidities, may favorably influence outcomes.
The fourth edition of FLAIR, Field Laser Applications in Industry and Research, was held on May 5 until May 9, 2014, in Pratolino, Firenze, Italy, the same venue where the FLAIR series was started in ...2007. The enthusiasm for this edition has been dampened by the sudden passing of Dr. Peter Werle, one of the two co-chairmen, on September 6, 2013, during the organization of the meeting. For an obituary of Dr. Werle see 1. This event obviously affected the organization of the Conference, including its schedule. We wanted to pay Peter Werle a special tribute, but in such a way to transform this remembrance into a positive event. To this end, the conference began with a special session that not only highlighted Peter Werle as a great colleague and friend but also as a visionary who has made numerous significant contributions to quantitative analysis, including noise analysis, employing tunable IR spectroscopy. Dr. Werle was the first to introduce the Allan variance concept 2 to spectrosco ...
The aerosol box was rapidly developed and disseminated to minimize viral exposure during aerosolizing procedures during the COVID-19 pandemic, yet users may not understand how to use and clean the ...device. This could potentially lead to increased viral exposure to subsequent patients and practitioners. We evaluated intraoperative contamination and aerosol box decontamination and the impact of a preoperative educational visual aid.
Using a double-blinded randomized design, forty-four anesthesiology trainees and faculty completed a simulated anesthetic case using an aerosol box contaminated with a fluorescent marker; half of the subjects received a visual aid prior to the simulation. Intraoperative contamination was evaluated at 10 standardized locations using an ultraviolet (UV) light. Next, subjects were instructed to clean the aerosol box for use on the next patient. Following cleaning, the box was evaluated for decontamination using an UV light.
Median total contamination score was significantly reduced in the experimental group (5.0 vs. 10.0, P < 0.001). The aerosol box was completely cleaned by 36.4% of subjects in the experimental group compared to 4.5% in the control group (P = 0.009).
The use of a visual aid significantly decreased intraoperative contamination and improved box cleaning. Despite these findings, a potentially clinically significant amount of viral exposure may exist. Thorough evaluation of the risks and benefits of the aerosol box should be completed prior to use. If an aerosol box is used, a visual aid should be considered to remind practitioners how to best use and clean the box.
We present measurements of organic aerosol (OA) in urban plumes from Houston and Dallas/Fort Worth as well as in industrial plumes in the Houston area during TexAQS‐2006. Consistent with the ...TexAQS‐2000 study, measurements show greater amount of aerosol mass downwind of the industrial centers compared to urban areas. This is likely due to higher emission and processing of volatile organic compounds (VOCs) from the industrial sources along the Houston ship channel. Comparisons of the current measurements with observations from the northeastern (NE) United States indicate that the observed ratios of the enhancement above background in OA, ΔOA, to the enhancement above background in CO, ΔCO, downwind of urban centers of Houston and Dallas/Fort Worth are within a factor of 2 of the same values in plumes from urban areas in the NE United States. In the ship channel plumes, ΔOA/ΔCO exceeds that in the urban areas by factors ranging from 1.5 to 7. We use a chemical box model to simulate secondary organic aerosol (SOA) formation from anthropogenic and biogenic VOCs in different plumes using recently reported dependencies of SOA yields on VOC/NOx ratios. Modeled SOA to CO enhancement ratios are within a factor of 2 of measurements. The increase in SOA from biogenic VOCs (BVOCs) predicted by the chemical box model as well as by a separate analysis using a Lagrangian particle dispersion model (FLEXPART) is <0.7 μg per standard m3 (sm−3). We find no evidence for a substantial influence of BVOCs on OA formation in our measurements in Houston area.
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