Evaluation of the impact of hematocrit and other interference on the accuracy of hospital-based glucose meters,”

ABSTRACT Background: Most glucose meter comparisons to date have focused on performance specifications likely to impact subcutaneous dosing of insulin. We evaluated four hospital-based glucose meter technologies for accuracy, precision, and analytical interferences likely to be encountered in critically ill patients, with the goal of identifying and discriminating glucose meter performance specifications likely to impact intensive intravenous insulin dosing. Methods: Precision, both within-run and day-to-day, was evaluated on all four glucose meters. Accuracy (bias) of the meters and analytical interference were evaluated by comparing results obtained on whole blood specimens to plasma samples obtained from these whole blood specimens run on a hexokinase reference method. Results: Precision was acceptable and differed little between meters. There were significant differences in the degree to which the meters correlated with the reference hexokinase method. Ascorbic acid showed significant interference with three of the four meters. Hematocrit also affected the correlation between whole blood and plasma hexokinase glucose on three of the four glucose meters tested, with the magnitude of this interference also varying by glucose meter technology. Conclusions: Correlation to plasma hexokinase values and hematocrit interference are the main variables that differentiate glucose meters. Meters that correlate with plasma glucose measured by a reference method over a wide range of glucose concentrations and minimize the effects of hematocrit will allow better glycemic control for critically ill patients

Idle hands are the devil’s tools: The geopolitics and geoeconomics of hunger

In current geopolitical and geoeconomic discourses, hunger is understood as both a threat to be contained, resulting in an often severe social and spatial localization of food insecurity, and a humanitarian problem to be solved through diffuse global flows of food and other aid. The resulting scalar tensions demonstrate the potentially contradictory alignment of geopolitics and geoeconomics within processes of globalization and neoliberalization. This article examines the geopolitical and geoeconomic place of hunger and the hungry through a critical analysis of the food-for-work (FFW) approach to combating hunger. FFW programs distribute food aid in exchange for labor, and have long been used to plan and deliver food aid. While debate continues as to whether and under what conditions FFW programs are socially and economically just, governments, international institutions, and NGOs tout them as a flexible and efficient way to deliver targeted aid, promote community development, and improve long-term prospects for economic development and food security. In the post-9/11 period, FFW programs are also cited as effective deterrents to terrorist recruitment strategies, while development and food security more broadly have been incorporated into national security strategies, especially but not only in the United States. The food-for-work approach attempts to resolve the scalar contradictions of hunger through the imposition of a labor requirement that disciplines the threat of the hungry while enforcing global connection. Case studies of FFW programs in Bangladesh, Ethiopia, and Indonesia illustrate this contradiction, and highlight the development and possible future of approaches to hunger under neoliberal geopolitics

HIV incidence estimate combining HIV/AIDS surveillance, testing history information and HIV test to identify recent infections in Lazio, Italy

<p>Abstract</p> <p>Background</p> <p>The application of serological methods in HIV/AIDS routine surveillance systems to identify persons with recently acquired HIV infection has been proposed as a tool which may provide an accurate description of the current transmission patterns of HIV. Using the information about recent infection it is possible to estimate HIV incidence, according to the model proposed by Karon et al. in 2008, that accounts for the effect of testing practices on the number of persons detected as recently infected.</p> <p>Methods</p> <p>We used data from HIV/AIDS surveillance in the period 2004-2008 to identify newly diagnosed persons. These were classified with recent/non-recent infection on the basis of an avidity index result, or laboratory evidence of recently acquired infection (i.e., previous documented negative HIV test within 6 months; or presence of HIV RNA or p24 antigen with simultaneous negative/indeterminate HIV antibody test). Multiple imputation was used to impute missing information. The incidence estimate was obtained as the number of persons detected as recently infected divided by the estimated probability of detection. Estimates were stratified by calendar year, transmission category, gender and nationality.</p> <p>Results</p> <p>During the period considered 3,633 new HIV diagnoses were reported to the regional surveillance system. Applying the model, we estimated that in 2004-2008 there were 5,465 new infections (95%CI: 4,538-6,461); stratifying by transmission category, the estimated number of infections was 2,599 among heterosexual contacts, 2,208 among men-who-have-sex-with-men, and 763 among injecting-drug-users. In 2008 there were 952 (625-1,229) new HIV infections (incidence of 19.9 per 100,000 person-years). In 2008, for men-who-have-sex-with-men (691 per 100,000 person-years) and injecting drug users (577 per 100,000 person-years) the incidence remained comparatively high with respect to the general population, although a decreasing pattern during 2004-2008 was observed for injecting-drug-users.</p> <p>Conclusions</p> <p>These estimates suggest that the transmission of HIV infection in Lazio remains frequent and men-who-have-sex-with men and injecting-drug-users are still greatly affected although the majority of new infections occurs among heterosexual individuals.</p

Effect of variable transmission rate on the dynamics of HIV in sub-Saharan Africa

<p>Abstract</p> <p>Background</p> <p>The cause of the high HIV prevalence in sub-Saharan Africa is incompletely understood, with heterosexual penile-vaginal transmission proposed as the main mechanism. Heterosexual HIV transmission has been estimated to have a very low probability; but effects of cofactors that vary in space and time may substantially alter this pattern.</p> <p>Methods</p> <p>To test the effect of individual variation in the HIV infectiousness generated by co-infection, we developed and analyzed a mathematical sexual network model that simulates the behavioral components of a population from Malawi, as well as the dynamics of HIV and the co-infection effect caused by other infectious diseases, including herpes simplex virus type-2, gonorrhea, syphilis and malaria.</p> <p>Results</p> <p>The analysis shows that without the amplification effect caused by co-infection, no epidemic is generated, and HIV prevalence decreases to extinction. But the model indicates that an epidemic can be generated by the amplification effect on HIV transmission caused by co-infection.</p> <p>Conclusion</p> <p>The simulated sexual network demonstrated that a single value for HIV infectivity fails to describe the dynamics of the epidemic. Regardless of the low probability of heterosexual transmission per sexual contact, the inclusion of individual variation generated by transient but repeated increases in HIV viral load associated with co-infections may provide a biological basis for the accelerated spread of HIV in sub-Saharan Africa. Moreover, our work raises the possibility that the natural history of HIV in sub-Saharan Africa cannot be fully understood if individual variation in infectiousness is neglected.</p

Multi-Destination Trips: A Survey on Incoming Zourism in Sicily

Many pleasure trips are often characterized by the visit of more than a single destination. Despite the topic is well documented in literature, the empirical studies are limited to a few pioneering studies. This lack may be attributable to the failure of tourism organizations to collect data on multi-destination trip behaviors, as it results, for example, from the system of European statistics on tourism (according to the Council Directive 95/57 EC), where no information on the average number of destinations visited within a single trip are provided. This paper aims to analyze the main implications of multi-destination trips both on tourism statistics and in tourism planning, and to describe the research design and the solutions adopted for the analysis of incoming tourism in Sicily. Some results related to the number of destinations visited and on the main travel itineraries undertaken by tourists in Sicily derived from the survey are presented

Wartosc nawozowa kompostu z osadu sciekowego

The fertilization value of composted sewage sludge was estimated on the basis of pot experiments during three following vegetation periods with buckwheat sown twice (1998), oat and maize (1999) and oat again (2000). The availability of nitrogen, phosphorus, magnesium and zinc for tested plants was determined. Tested manure was obtained after 8 months of composting of the mixture of sewage sludge with 20% of sawdust and 3% of CaO. The compost moisture was 69%. The following contents of nutrients was found (g·kg⁻¹): N - 21.0, P - 5.47, K - 1.11, Mg - 3.22 and Zn - 1 204 mg·kg⁻¹. The C : N ratio was 17.4. Compost was applied in the first year of experiment in two doses 150 or 300 g per 6 kg of poor sandy loam acid soil. The application of compost to the soil resulted with a noticeable increase of the yield of dry matter of tested plants due to the privation of nutrients under the tested conditions. The uptake of nutrients noticeably increased, predominantly of phosphorus and magnesium. Total uptake of nitrogen, phosphorus and magnesium was at the level of 16.4%, 32.5% and 45% respectively, during 3 years of experiment with the incorporated lower dose of compost. The incorporation of a high dose of zinc with compost at both doses did not result with a significant increase of its uptake by plants due to the decrease of acidity. Fertilization of the tested soil with composted sewage sludge positively affects the physico-chemical properties of soil. The cation exchange capacity and the amount of available phosphorus and zinc were found to be improved and as the soil acidity was noticeable lower.W doświadczeniu wazonowym oceniano dostępność azotu, fosforu, magnezu i cynku zawartych w kompoście z osadu ściekowego. W trzech kolejnych sezonach wegetacyjnych uprawiano dwukrotnie grykę (1998), owies i kukurydzę (1999) oraz owies (2000). Nawóz uzyskano kompostując przez 8 miesięcy osad ściekowy z 20% dodatkiem trocin oraz 3% CaO. Kompost zawierał 69% wody, a w suchej masie (g·kg⁻¹): 21,0 N, 5,47 P, 1,11 Ki 3,22 Mg oraz 1204 mg·kg⁻¹ Zn. Stosunek C : N wynosił 17,4. Nawóz ten zastosowano w pierwszym roku doświadczenia w dawkach: 150 i 300 g świeżej masy na wazon zawierający 6 kg gleby ubogiej w składniki pokarmowe. W warunkach niedostatku badanych pierwiastków, po zastosowaniu kompostu obserwowano znaczne przyrosty plonów oraz pobrania przede wszystkim fosforu i magnezu. Z niższej dawki kompostu, w okresie trzech lat, wykorzystanie azotu wyniosło zaledwie 16,4%, natomiast fosforu 32,5% a magnezu 45%. Duża ilość cynku wnoszonego w nawozie organicznym, w wyniku wzrostu pH gleby, nie powodowała znaczących przyrostów jego pobrania przez rośliny, zwłaszcza po zastosowaniu wyższej dawki kompostu. Nawożenie kompostem korzystnie wpłynęło na odczyn gleby, zwiększyło jej pojemność sorpcyjną oraz zawartość przyswajalnego fosforu i cynku