Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study

Abstract Background Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine trends in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. Methods A population-based school survey was conducted biennially among 14–16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for any and frequent cannabis use over time according to socioeconomic adversities were calculated using crosstabs and chi-square test. Associations between any and frequent cannabis use, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals. Results At the overall level, the prevalences of lifetime and frequent cannabis use varied only slightly between 2000 and 2015. Cannabis use was associated with socioeconomic adversities (parental unemployment in the past year, low parental education, and not living with both parents). The differences in any and frequent cannabis use between socioeconomic groups increased significantly over the study period. Conclusions Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.

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In- and out-of-hospital mortality for myocardial infarction during the first wave of the COVID-19 pandemic in Emilia-Romagna, Italy: A population-based observational study

The Lancet Regional Health - Europe ◽

10.1016/j.lanepe.2021.100055 ◽

2021 ◽

pp. 100055

Author(s):

Gianluca Campo ◽

Daniela Fortuna ◽

Elena Berti ◽

Rossana De Palma ◽

Giuseppe Di Pasquale ◽

...

Keyword(s):

Myocardial Infarction ◽

Observational Study ◽

Hospital Mortality ◽

Population Based

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A “Smart” Biosensor-Enabled Intravascular Catheter and Platform for Dynamic Delivery of Propofol to “Close the Loop” for Total Intravenous Anesthesia

Military Medicine ◽

10.1093/milmed/usaa470 ◽

2021 ◽

Vol 186 (Supplement_1) ◽

pp. 370-377

Author(s):

Edward Chaum ◽

Ernő Lindner

Keyword(s):

Real Time ◽

Drug Distribution ◽

Population Based ◽

Pharmacokinetic Data ◽

Drug Infusion ◽

Blood Concentrations ◽

The Usa ◽

The Difference ◽

Automated Delivery

ABSTRACT Background Target-controlled infusion anesthesia is used worldwide to provide user-defined, stable, blood concentrations of propofol for sedation and anesthesia. The drug infusion is controlled by a microprocessor that uses population-based pharmacokinetic data and patient biometrics to estimate the required infusion rate to replace losses from the blood compartment due to drug distribution and metabolism. The objective of the research was to develop and validate a method to detect and quantify propofol levels in the blood, to improve the safety of propofol use, and to demonstrate a pathway for regulatory approval for its use in the USA. Methods We conceptualized and prototyped a novel “smart” biosensor-enabled intravenous catheter capable of quantifying propofol at physiologic levels in the blood, in real time. The clinical embodiment of the platform is comprised of a “smart” biosensor-enabled catheter prototype, a signal generation/detection readout display, and a driving electronics software. The biosensor was validated in vitro using a variety of electrochemical methods in both static and flow systems with biofluids, including blood. Results We present data demonstrating the experimental detection and quantification of propofol at sub-micromolar concentrations using this biosensor and method. Detection of the drug is rapid and stable with negligible biofouling due to the sensor coating. It shows a linear correlation with mass spectroscopy methods. An intuitive graphical user interface was developed to: (1) detect and quantify the propofol sensor signal, (2) determine the difference between targeted and actual propofol concentration, (3) communicate the variance in real time, and (4) use the output of the controller to drive drug delivery from an in-line syringe pump. The automated delivery and maintenance of propofol levels was demonstrated in a modeled benchtop “patient” applying the known pharmacokinetics of the drug using published algorithms. Conclusions We present a proof-of-concept and in vitro validation of accurate electrochemical quantification of propofol directly from the blood and the design and prototyping of a “smart,” indwelling, biosensor-enabled catheter and demonstrate feedback hardware and software architecture permitting accurate measurement of propofol in blood in real time. The controller platform is shown to permit autonomous, “closed-loop” delivery of the drug and maintenance of user-defined propofol levels in a dynamic flow model.

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