Quality of diabetes treatment in four orthopaedic departments in the Capital Region of Denmark.

INTRODUCTION: Hyperglycaemia during hospitalisation is associated with a longer and more complicated admission and with increased mortality. Therefore, guidelines suggest that blood glucose should be less than 10 mmol/l. In this audit, we aimed to describe the prevalence of diabetes patients at four orthopaedic departments in the Capital Region of Denmark and to measure the quality of in-hospital diabetes management. METHODS: We conducted audits of medical records in the electronic health record system for two months in 2019. All patients admitted were included in the audit. We gathered information on diabetes status, orthopaedic diagnosis, glycosylated haemoglobin and diabetes management. RESULTS: Among 2,463 included patients, 10% had diabetes. The three most frequent diagnosis groups were infection, fracture of lower extremity and hospitalised for alloplastic surgery. The number of blood glucose measurements during 24-hour perioperative care was 6.5. Among patients analysed, 10-20% did not have their blood glucose measured in the days following surgery. Among patients, 64% received insulin 1-50% of the required times. CONCLUSION: We demonstrated that 10% of hospitalised patients suffer from diabetes. The audit also showed that blood glucose is generally measured according to guidelines, whereas the treatment of an elevated blood glucose is far from being given according to guidelines. This may potentially delay recovery and prolong hospitalisation. FUNDING: none. TRIAL REGISTRATION: not relevant.

Do bilingual children lag behind? A study of morphological encoding using ERPs.

The current study investigates how bilingual children encode and produce morphologically complex words. We employed a silent-production-plus-delayed-vocalization paradigm in which event-related brain potentials (ERPs) were recorded during silent encoding of inflected words which were subsequently cued to be overtly produced. The bilingual children's spoken responses and their ERPs were compared to previous datasets from monolingual children on the same task. We found an enhanced negativity for regular relative to irregular forms during silent production in both bilingual children's languages, replicating the ERP effect previously obtained from monolingual children. Nevertheless, the bilingual children produced more morphological errors (viz. over-regularizations) than monolingual children. We conclude that mechanisms of morphological encoding (as measured by ERPs) are parallel for bilingual and monolingual children, and that the increased over-regularization rates are due to their reduced exposure to each of the two languages (relative to monolingual children).

Native and Non-native Speakers' Brain Responses to Filled Indirect Object Gaps.

We examined native and non-native English speakers' processing of indirect object wh-dependencies using a filled-gap paradigm while recording event-related potentials (ERPs). The non-native group was comprised of native German-speaking, proficient non-native speakers of English. Both participant groups showed evidence of linking fronted indirect objects to the subcategorizing verb when this was encountered, reflected in an N400 component. Evidence for continued filler activation beyond the verb was seen only in the non-native group, in the shape of a prolonged left-anterior negativity. Both participant groups showed sensitivity to filled indirect object gaps reflected in a P600 response, which was more pronounced and more globally distributed in our non-native group. Taken together, our results indicate that resolving indirect object dependencies is a two-step process in both native and non-native sentence comprehension, with greater processing cost incurred in non-native compared to native comprehension.

Morphological encoding in German children's language production: evidence from event-related brain potentials.

This study reports developmental changes in morphological encoding across late childhood. We examined event-related brain potentials (ERPs) during the silent production of regularly vs. irregularly inflected verb forms (viz. -t vs. -n participles of German) in groups of eight- to ten-year-olds, eleven- to thirteen-year-olds, and adults. The adult data revealed an enhanced (right-frontal) negativity 300-450 ms after cue onset for the (silent) production of -t relative to -n past participle forms (e.g. geplant vs. gehauen 'planned' vs. 'hit'). For the eleven- to thirteen-year-olds, the same enhanced negativity was found, with a more posterior distribution and a longer duration (=300-550 ms). The eight- to ten-year-olds also showed this negativity, again with a posterior distribution, but with a considerably delayed onset (800-1,000 ms). We suggest that this negativity reflects combinatorial processing required for producing -t participles in both children and adults and that the spatial and temporal modulations of this ERP effect across the three participant groups are due to developmental changes of the brain networks involved in processing morphologically complex words.

Effect of chewing gum containing nicotine and caffeine on energy expenditure and substrate utilization in men.

BACKGROUND: Nicotine replacement therapy limits weight gain after smoking cessation. This finding is partly attributable to the thermogenic effect of nicotine, which may be enhanced by caffeine. OBJECTIVE: We assessed the acute thermogenic effects of chewing gum containing different doses of nicotine and caffeine. DESIGN: This randomized, double-blind, placebo-controlled, crossover study included 12 healthy, normal-weight men (aged 18-45 y). Energy expenditure was measured with indirect calorimetry before and 2.5 h after subjects chewed each of 7 different types of gum containing the following doses of nicotine/caffeine: 0/0, 1/0, 2/0, 1/50, 2/50, 1/100, and 2/100 mg/mg. RESULTS: The thermogenic responses (increases over the response to placebo) were 3.7%, 4.9%, 7.9%, 6.3%, 8.5%, and 9.8%, respectively, for the gums containing 1/0, 2/0, 1/50, 2/50, 1/100, and 2/100 mg nicotine/mg caffeine (P < 0.05 for all). Adding caffeine to 1 and 2 mg nicotine significantly enhanced the thermogenic response, but changing the caffeine dose (from 50 to 100 mg) did not change the thermogenic effect. None of the combinations changed the respiratory quotient compared with placebo, which indicates that glucose and fat oxidation rates were increased to a similar extent. Side effects occurred only with 2 mg nicotine. CONCLUSIONS: One milligram of nicotine has a pronounced thermogenic effect, which can be increased by approximately 100% by adding 100 mg caffeine. Increasing the nicotine dose to 2 mg does not increase the thermogenic effect but produces side effects in most subjects. Caffeine may be useful in preventing weight gain after smoking cessation if its thermogenic effect can be used to enhance nicotine's effect on long-term energy balance.