Use of diabetes registry data for comparing indices of diabetes management: A comparison of 2 urban sites in Canada and Colombia

Q3Q2Objectives: To demonstrate the use of a multinational diabetes registry for comparing indices of diabetes management among countries with differing levels of income, healthcare systems and ethnic backgrounds. Methods: A cross-sectional study was conducted among 1742 people with type 2 diabetes attending diabetes clinics in London, Ontario, Canada, and Bogota, Colombia. The data were extracted from the Global Registry and Surveillance System for Diabetes (GRAND). Results: Canadian patients were diagnosed with diabetes at significantly younger ages than Colombian patients (49 years and 53 years, respectively) and were heavier (body mass indices of 33 and 28, respectively). The Colombian patient population had significantly higher mean glycated hemoglobin (A1C) levels (9.4% vs. 8.6%) and fewer patients (22% vs. 26%) at the glycemic target (A1C <7.0%) than Canadian patients. In Colombia, 1 or more diabetes-related complications were present in 51% of the study population compared with 37% in Canada. Newly diagnosed Colombians had higher mean A1C levels (9.1% vs. 8.7%) and low-density lipoprotein-C levels (3.3 mmol/L vs. 2.5 mmol/L) than did newly diagnosed Canadians. Conclusions: A multination diabetes registry collecting standardized data facilitates transnational comparison of diabetes clinical parameters for the purpose of identifying potential gaps in care

CCC–Pincer–NHC Osmium Complexes: New Types of Blue-Green Emissive Neutral Compounds for Organic Light-Emitting Devices (OLEDs)

Novel homoleptic and heteroleptic NHC carbene containing bis­(tridentate) osmium­(II) complexes have been designed, synthesized, and characterized, and their photophysical properties have been studied. The complex OsH₆(PⁱPr₃)₂ (<b>1</b>) reacts with the tetrafluoroborate salts of 1,3-bis­(3-methylbenzimidazolium-1-yl)­benzene and 1,3-bis­(3-methylimidazolium-1-yl)­benzene, in dimethylformamide, under reflux to afford the hydride–carbonyl derivatives [OsH­(C_NHCC_arylC_{benzimidazolium})­(CO)­(PⁱPr₃)₂]­BF₄ (<b>2</b>) and [OsH­(C_NHCC_arylC_imidazolium)­(CO)­(PⁱPr₃)₂]­BF₄ (<b>3</b>), as a result of the direct metalation of one of the NHC units of the salts, the activation of the C–H bond at the 6-position of the bridged aryl group, and metal carbonylation by solvent decarbonylation. In contrast to the BF₄ salts, under the same conditions, the iodide salts of 1,3-bis­(3-methylbenzimidazolium-1-yl)­benzene, 1,3-bis­(3-methylimidazolium-1-yl)­benzene, and 1,3-bis­(3-methylbenzimidazolium-1-yl)-5-trifluoromethylbenzene undergo direct metalation of both NHC units and C–H bond activation of the bridged aryl group at the 2-position to give the respective osmium­(IV) dihydrides [OsH₂(C_NHCC_arylC_NHC)­(PⁱPr₃)₂]I (<b>4a</b>–<b>6a</b>), which by deprotonation with K^<i>t</i>BuO yield the osmium­(II) monohydrides OsH­(C_NHCC_arylC_NHC)­(PⁱPr₃)₂ (<b>7</b>–<b>9</b>). The reactions of <b>7</b> with 1,3-bis­(3-methylbenzimidazolium-1-yl)­benzene tetrafluoroborate and of <b>9</b> with 1,3-bis­(3-methylbenzimidazolium-1-yl)-5-trifluoromethylbenzene tetrafluoroborate lead to the homoleptic derivatives Os­(C_NHCC_arylC_NHC)₂ (<b>10</b>, <b>11</b>), whereas the reactions of <b>9</b> with the tetrafluoroborate salts of 1,3-bis­(3-methylbenzimidazolium-1-yl)­benzene and 1,3-bis­(3-methylimidazolium-1-yl)­benzene generate heteroleptic Os­(C_NHCC_arylC_NHC)­(C_NHCC_aryl′C_NHC) (<b>12</b>) and Os­(C_NHCC_aryl′C_NHC)­(C_NHC′C_arylC_NHC′) (<b>13</b>). Treatment of <b>7</b> with 3,5-bis­(3-methylbenzimidazolium-1-yl)-2,6-dimethylpyridine tetrafluoroborate affords the salt [Os­(C_NHCC_arylC_NHC)­(C_NHCC_aryl′C_NHC)]­BF₄ (<b>14</b>), with C_aryl′ being a pyridinium group. Its deprotonation generates the neutral heteroleptic derivative Os­(C_NHCC_arylC_NHC)­(C_NHCC_aryl′C_NHC) (<b>15</b>). Complexes <b>10</b>–<b>13</b> and <b>15</b> are emissive in the blue-green spectral region with high quantum yields in the solid state, which reach 0.62 for <b>11</b>. OLEDs using this compound as an emitting material show blue emission (CIE coordinates: (0.14, 0.26)). The brightness of the device reaches 10000 cd/m² at 9.5 V. The maximum external quantum efficiency (EQE) was 19.2% at 1000 cd/m²

Some Drawings by Some Albertans

Presenting works by 51 Alberta artists, Mabie examines various definitions of drawing. Statements by 29 artists

Mechanisms underpinning sympathetic nervous activity and its modulation using transcutaneous vagus nerve stimulation

New Findings •What is the topic of this review? This review briefly considers what modulates sympathetic nerve activity and how it may change as we age or in pathological conditions. It then focuses on transcutaneous vagus nerve stimulation, a method of neuromodulation in autonomic cardiovascular control. •What advances does it highlight? The review considers the pathways involved in eliciting the changes in autonomic balance seen with transcutaneous vagus nerve stimulation in relationship to other neuromodulatory techniques. The autonomic nervous system, consisting of the sympathetic and parasympathetic branches, is a major contributor to the maintenance of cardiovascular variables within homeostatic limits. As we age or in certain pathological conditions, the balance between the two branches changes such that sympathetic activity is more dominant, and this change in dominance is negatively correlated with prognosis in conditions such as heart failure. We have shown that non-invasive stimulation of the tragus of the ear increases parasympathetic activity and reduces sympathetic activity and that the extent of this effect is correlated with the baseline cardiovascular parameters of different subjects. The effects could be attributable to activation of the afferent branch of the vagus and, potentially, other sensory nerves in that region. This indicates that tragus stimulation may be a viable treatment in disorders where autonomic activity to the heart is compromised

National survey of indigenous primary healthcare capacity and delivery models in Canada: the TransFORmation of IndiGEnous PrimAry HEAlthcare delivery (FORGE AHEAD) community profile survey

Background: There is a significant deficiency of national health information for Indigenous peoples in Canada. This manuscript describes the Community Profile Survey (CPS), a community-based, national-level survey designed to identify and describe existing healthcare delivery, funding models, and diabetes specific infrastructure and programs in Indigenous communities. Methods: The CPS was developed collaboratively through FORGE AHEAD and the First Nations and Inuit Health Branch of Health Canada. Regional and federal engagement and partnerships were built with Indigenous organizations to establish regionally-tailored distribution of the 8-page CPS to 440 First Nations communities. Results were collected (one survey per community) and reported in strata by region, with descriptive analyses performed on all variables. Results were shared with participating communities and regional/federal partners through tailored reports. Results: A total of 84 communities completed the survey (19% response rate). The majority of communities had a health centre/office to provide service to their patients with diabetes, with limited on-reserve hospitals for ambulatory or case-sensitive conditions. Few healthcare specialists were located on-site, with patients frequently travelling off-site (> 40 km) for diabetes-related complications. The majority of healthcare professionals on-site were Health Directors, Community Health Nurses, and Home Care Nurses. Many communities had a diabetes registry but few reported a diabetes surveillance system. Regional variation in healthcare services, diabetes programs, and funding models were noted, with most communities engaging in some type of innovative strategy to improve care for patients with diabetes. Conclusions: The CPS is the first community-based, national-level survey of its kind in Canada. Although the response rate was low, the CPS was distributed and successfully administered across a broad range of First Nations communities, and future considerations would benefit from a governance structure and leadership that strengthens community engagement, and a longitudinal research approach to increase the representativeness of the data. This type of information is important for communities and regions to inform decision making (maintain successes, and identify areas for improvement), strengthen health service delivery and infrastructure, increase accessibility to healthcare personnel, and allocate funding and/or resources to build capacity and foster a proactive chronic disease prevention and management approach for Indigenous communities across Canada. Trial registration: Current ClinicalTrial.gov protocol ID NCT02234973. Registered: September 9, 2014