Search

Aim:Acceptability of a new safety-engineered peripherally inserted intravenous catheter (PIVC) with multiple access blood control (MBC) was evaluated in this observational study by experienced volunteer clinicians on healthy volunteers.Methods:Clinicians and healthy volunteers were recruited for this study. Observers documented study procedures, including if there was any blood leakage from the catheter hub at various times during hub connections and disconnections and how many attempts it took a clinician to get a successful stick. Clinicians responded to yes-or-no and Likert-scale questionnaires describing their experiences with PIVC with MBC after each procedure. Questionnaire data were summarized by frequency and percent of responses; analyses were conducted using binomial statistics.Results:Overall, clinicians considered PIVC with MBC to be acceptable (93.6% agreement). Clinicians were able to easily remove the catheter protective cap, insert the catheter, visualize primary and secondary flashbacks, easily remove the needle from the catheter hub and determine if the safety clip was activated after withdrawing the needle. In addition, they were able to connect or disconnect and flush extension sets. Clinicians did not have to change their insertion technique, found the catheter easy to insert, and believed the catheter would protect them from blood exposure during insertion of the catheter and subsequent hub accesses (agreement ranged from 82.3% to 98.9%).Conclusions:No blood leakage was observed from the catheter hub at any time during the procedures. Overall, clinicians found the new PIVC with MBC to be acceptable, easy to use, and functioned properly.HIGHLIGHTSAcceptability, usability, and ease of use of a new safety-engineered PIVC with MBC was evaluated.PIVC with MBC was >93% acceptable: prevented blood exposure after multiple insertions/removals.Most clinicians (96%) achieved first stick success when using their product.PIVC with MBC was easy to use, worked properly and allowed clinicians to keep their PIVC technique.

Objectives: Early in the COVID-19 pandemic, several outbreaks were linked with facilities employing essential workers, such as long-term care facilities and meat and poultry processing facilities. However, timely national data on which workplace settings were experiencing COVID-19 outbreaks were unavailable through routine surveillance systems. We estimated the number of US workplace outbreaks of COVID-19 and identified the types of workplace settings in which they occurred during August–October 2021.Methods: The Centers for Disease Control and Prevention collected data from health departments on workplace COVID-19 outbreaks from August through October 2021: the number of workplace outbreaks, by workplace setting, and the total number of cases among workers linked to these outbreaks. Health departments also reported the number of workplaces they assisted for outbreak response, COVID-19 testing, vaccine distribution, or consultation on mitigation strategies.Results: Twenty-three health departments reported a total of 12 660 workplace COVID-19 outbreaks. Among the 12 470 workplace types that were documented, 35.9% (n = 4474) of outbreaks occurred in health care settings, 33.4% (n = 4170) in educational settings, and 30.7% (n = 3826) in other work settings, including non–food manufacturing, correctional facilities, social services, retail trade, and food and beverage stores. Eleven health departments that reported 3859 workplace outbreaks provided information about workplace assistance: 3090 (80.1%) instances of assistance involved consultation on COVID-19 mitigation strategies, 1912 (49.5%) involved outbreak response, 436 (11.3%) involved COVID-19 testing, and 185 (4.8%) involved COVID-19 vaccine distribution.Conclusions: These findings underscore the continued impact of COVID-19 among workers, the potential for work-related transmission, and the need to apply layered prevention strategies recommended by public health officials.

Objective:This study evaluated the impact of four weeks of treatment with Prontosan Wound Irrigation Solution and Prontosan Wound Gel (B. Braun Medical Inc., US) on adults with hard-to-heal leg wounds. Overall change (weeks 1–5) in the Global Quality of Life scale (GQOL), changes in body, psyche and everyday life (EDL) quality of life (QoL) subscores, and changes in wound appearance and size after treatment were assessed.Method:In this prospective, open-label, single-arm, five-centre study, non-hospitalised patients with no more than two wounds below the knee were recruited into the study; wounds were ≥5cm2and ≤50cm2and present for ≥4 weeks. The investigator or a designee applied the wound solution and gel to the wounds at clinic visits, and patients/caregivers applied the wound solution and gel at home. Wound-QoL questionnaires were completed at the initial screening and at each week of treatment. Wound size and photographs were obtained at pre- and post-treatment during clinic visits.Results:A total of 43 patients were enrolled in the study. Mean GQOL scores decreased by 1.11 (46.1%). Body, psyche and EDL decreased by 1.17 (60.0%), 1.26 (41.8%) and 1.00 (42.2%), respectively. Wounds also showed improvement in odour, appearance and size. Adverse events were mild in intensity and transient in nature.Conclusion:This study demonstrated marked improvement in the QoL of patients with hard-to-heal leg wounds below the knee during four weeks of treatment with the wound solution and gel. Wounds also showed improvement in odour, appearance and size, and the treatment solution and gel were well tolerated.Declaration of interest:B. Braun Medical Inc. funded the research and preparation of this article. AK, DV, CRC and WC are employees of B. Braun Medical Inc. AO and RS declare no conflict of interest.

Objectives Using the Council of State and Territorial Epidemiologists (CSTE) classification guidelines, we characterized coronavirus disease 2019 (COVID-19)–associated confirmed and probable deaths in Puerto Rico during March–July 2020. We also estimated the total number of possible deaths due to COVID-19 in Puerto Rico during the same period.Methods We described data on COVID-19–associated mortality, in which the lower bound was the sum of confirmed and probable COVID-19 deaths and the upper bound was excess mortality, estimated as the difference between observed deaths and average expected deaths. We obtained data from the Puerto Rico Department of Health COVID-19 Mortality Surveillance System, the Centers for Disease Control and Prevention’s National Electronic Disease Surveillance System Base System, and the National Center for Health Statistics.Results During March–July 2020, 225 COVID-19–associated deaths were identified in Puerto Rico (119 confirmed deaths and 106 probable deaths). The median age of decedents was 73 (interquartile range, 59-83); 60 (26.7%) deaths occurred in the Metropolitana region, and 140 (62.2%) deaths occurred among men. Of the 225 decedents, 180 (83.6%) had been hospitalized and 93 (41.3%) had required mechanical ventilation. Influenza and pneumonia (48.0%), sepsis (28.9%), and respiratory failure (27.1%) were the most common conditions contributing to COVID-19 deaths based on death certificates. Based on excess mortality calculations, as many as 638 COVID-19–associated deaths could have occurred during the study period, up to 413 more COVID-19–associated deaths than originally reported.Conclusions Including probable deaths per the CSTE guidelines and monitoring all-cause excess mortality can lead to a better estimation of COVID-19–associated deaths and serve as a model to enhance mortality surveillance in other US jurisdictions.

Objectives: The risk for mpox virus (MPXV) transmission in most workplaces has not been thoroughly assessed in the context of the 2022 global mpox outbreak. Our objectives were to describe mpox case patients who worked while infectious and the subsequent workplace contact tracing efforts, risk assessments, and outcomes.Methods: The Centers for Disease Control and Prevention requested information from health departments in the United States in September 2022 to identify people with confirmed or probable mpox who worked outside the home while infectious, either before or after diagnosis, from June 1 through August 31, 2022. We collected and summarized data on demographic, clinical, and workplace characteristics of case patients and workplace contact investigations. We stratified data by industry and occupation categories.Results: In total, 102 case patients were reported by 6 jurisdictions. The most common industries were accommodation and food services (19.8%) and professional business, management, and technical services (17.0%). Contact investigations identified 178 total contacts; 54 cases (52.9%) had no contacts identified. Of 178 contacts, 54 (30.3%) were recommended to receive postexposure prophylaxis (PEP) and 18 (10.1%) received PEP. None of the contacts developed a rash or were tested for orthopox or mpox, and none were reported to have confirmed or probable mpox.Conclusion: Data from 6 jurisdictions suggest that the risk of MPXV transmission from workers to others in workplace settings in many industries is low. These findings might support future updates to exposure risk classifications and work activity recommendations for patients. These findings also demonstrate the importance of collecting and analyzing occupation and industry data in case reports to better understand risks in workplaces.

A computer-aided methodology for the approximate prediction of axially textured polycrystals’ properties is presented. The input data for the developed application consist of: (a) the two-dimensional diffraction pattern of the material under investigation and (b) the tensors of the elasto-piezo-dielectric properties of the single crystal case. Program ANAELU 2.0allows the determination of the fiber axis inverse pole figure by means of a Rietveld-type procedure. The Material Properties Open Database(MPOD, http://mpod.cimav.edu.mx) provides free access to the experimentally determined values of the tensor properties for several crystal species. Practical estimates of polycrystals’ properties may be obtained by averaging single crystals’ properties tensors, with the orientation distribution function (the symmetry-axis inverse pole figure, in fiber textures) as a weight factor. This treatment, with the application of the Voigt, Reuss and Hill approaches, requires special precautions when it comes to the coupling properties(e.g. piezoelectricity, magnetostriction, magnetoelectricity). Some key physical, mathematical and computational aspects related to the considered topic are discussed. Program GISELLEsystematizes the calculation of polycrystal properties under the considered treatments. The application of the proposed methodology to real-world events is illustrated by means of a case study.

Habitable planets are commonly imagined to be temperate planets like Earth, with areas of open ocean and warm land. In contrast, planets in snowball states, where oceans are entirely ice covered, are believed to be inhospitable. However, we show using a general circulation model that terrestrial planets in the inner habitable zone are able to support large unfrozen areas of land while in a snowball state. Due to their lower albedo, these unfrozen regions reach summer temperatures in excess of 10 °C. Such conditions permit CO2weathering, suggesting that continental weathering can provide a mechanism for trapping planets in stable snowball states. The presence of land areas with warm temperatures and liquid surface water motivates a more‐nuanced understanding of habitability during these snowball events. Studies examining the ability of Earth‐like planets to host life have often used conditions leading to “snowball” events, where sea ice extends all the way to the equator, as a limit to the range of habitable climates. This has been based on the assumption that snowball planets are always below freezing everywhere on their surfaces. As the chemical process by which CO2is removed from the atmosphere and bound in surface rocks relies on warm temperatures and liquid water and therefore would not happen in globally cold conditions, this has also led to the conclusion that snowball events should be temporary, coming to an end when volcanoes release enough accumulated CO2to warm the planet enough to melt the ice. We ran several thousand three‐dimensional computer simulations of Earth‐like climates and found that if there are inland areas of dark, bare ground under enough sunlight, those regions can be warm enough for liquid water and life without causing the sea ice to retreat. This suggests that snowball planets should not be excluded as inhospitable to life and that on some planets the burial of CO2in surface rocks in these areas could balance volcanic emissions, resulting in permanent snowball conditions. Direct sunlight can warm bare land areas above freezing even if the rest of the planet is frozenWarm temperatures and elevated CO2lead to continental weathering during snowball eventsSnowball planets with low outgassing rates may both be stable and have habitable land surfaces

Insulin resistance (IR) is a condition favored by metabolic and endocrine changes experienced by adipose tissue in the context of obesity. The prevalence and the presentation of both IR and obesity vary among the populations, and may be affected by ancestral genetic composition among other factors. The aim of this study was to compare the presence of IR and obesity in Amerindians of the Embera-Chamí ethnicity and Colombian mestizo population.

Insulin resistance (IR) is a condition favored by metabolic and endocrine changes experienced by adipose tissue in the context of obesity. The prevalence and the presentation of both IR and obesity vary among the populations, and may be affected by ancestral genetic composition among other factors. The aim of this study was to compare the presence of IR and obesity in Amerindians of the Embera-Chamí ethnicity and Colombian mestizo population.

The field of extrasolar planets has rapidly expanded to include the detection of planets with masses smaller than that of Uranus. Many of these are expected to have little or no hydrogen and helium gas, and we might find Earth analogs among them. In this paper we describe our detailed interior models for a rich variety of such massive terrestrial and ocean planets in the 1-10 M[?] range (super-Earths). The grid presented here allows the characterization of the bulk composition of super-Earths detected in transit and with a measured mass. We show that, on average, planet radius measurements to better than 5%, combined with mass measurements to better than 10%, would permit us to distinguish between an icy or rocky composition. This is due to the fact that there is a maximum radius a rocky terrestrial planet may achieve for a given mass. Any value of the radius above this maximum terrestrial radius implies that the planet contains a large (>10%) amount of water (ocean planet).

With improving methods and surveys, the young field of extrasolar planet studies has recently expanded into a qualitatively new domain--terrestrial (mostly rocky) planets. The first such planets were discovered during the past year and a half, judging by their measured masses of less than 10 M[?] ("super-Earths"). They are introducing a novel physical regime that has not been explored before, as such planets do not exist in our solar system. Their compositions can be completely terrestrial, or they may harbor an extensive ocean (water and ices) above a rocky core. We model the structure and properties of the first super-Earth (mass ~7.5 M[?]), discovered in 2005, illustrating the possible compositions and providing radius evaluations in view of future detection of similar planets by transits. We find that there exists a threshold in radius above which a super-Earth most certainly has an extensive water content. In the case of GJ 876d, this threshold is at about 12,000 km. Our results show that unique characterization of the bulk composition of super-Earths will be possible with future transit studies.

Purpose: Hemoglobin Hotel Dieu (HbHD) is a high-oxygen affinity variant of HbA never before reported in a Hispanic patient. This Hb variant was first reported in 1981 by Blouquit et al. in a white person with erythrocytosis with a substitution in the [399 aspartic acid residue by glycine.