Upper and/or Lower Respiratory Tract Infection Caused by Human Metapneumovirus After Allogeneic Hematopoietic Stem Cell Transplantation.

Background: Human metapneumovirus (hMPV) epidemiology, clinical characteristics and risk factors for poor outcome after allogeneic stem cell transplantation (allo-HCT) remain a poorly investigated area.

Methods: This retrospective multicenter cohort study examined the epidemiology, clinical characteristics, and risk factors for poor outcomes associated with human metapneumovirus (hMPV) infections in recipients of allo-HCT.

Results: We included 428 allo-HCT recipients who developed 438 hMPV infection episodes between January 2012 and January 2019.

Solution and Solid-State Behavior of Amphiphilic ABA Triblock Copolymers of Poly(acrylic acid--styrene)--poly(butyl acrylate)--poly(acrylic acid--styrene).

A combination of statistical and triblock copolymer properties is explored to produce stable aqueous polymer dispersions suitable for the film formation. In order to perform an extensive structural characterization of the products in the dissolved, dispersed, and solid states, a wide range of symmetrical poly(acrylic acid--styrene) --poly(butyl acrylate) --poly(acrylic acid--styrene) , poly(AA--St) --PBA --poly(AA--St) , ( = 56, 108 and 140, = 100-750; the AA:St molar ratio is 42:58) triblock copolymers were synthesized by reversible addition-fragmentation chain transfer (RAFT) solution polymerization using a bifunctional symmetrical RAFT agent. It is demonstrated that the amphiphilic statistical outer blocks can provide sufficient stabilization to largely hydrophobic particles in aqueous dispersions.

Impact of early candidemia on the long-term outcome of allogeneic hematopoietic stem cell transplant in non-leukemic patients: an outcome analysis on behalf of IDWP-EBMT.

We assessed the incidence and outcome of early candidemia after hematopoietic stem cell transplant (HSCT). The analysis included all first HSCTs performed from 2000 to 2015 in adult and pediatric patients with a non-leukemic disease and recorded in the EBMT registry. Overall survival (OS), non-relapse mortality (NRM), and relapse mortality (RM) were evaluated.

Upfront stem cell transplantation for newly diagnosed multiple myeloma with del(17p) and t(4;14): a study from the CMWP-EBMT.

We analyzed newly diagnosed multiple myeloma patients with del(17p) and/or t(4;14) undergoing either upfront single autologous (auto), tandem autologous (auto-auto) or tandem autologous/reduced-intensity allogeneic (auto-allo) stem cell transplantation. 623 patients underwent either auto (n = 446), auto-auto (n = 105), or auto-allo (n = 72) between 2000 and 2015. 46% of patients had t(4;14), 45% had del(17p) while 9% were reported having both abnormalities.

Surfactant modulated interactions of hydrophobically modified ethoxylated urethane (HEUR) polymers with penetrable surfaces.

Hypothesis: Adsorption of hydrophobically modified ethoxylated urethane polymers (HEURs) at the soft colloid interfaces of emulsion droplets will stabilise oil-in-water emulsions (a) via steric stabilisation induced by adsorption of the polymer at the droplet surfaces through the hydrophobic groups, and (b) via continuous phase viscosity enhancement through polymer self-association. Both of these mechanisms will be modulated by the presence of the surfactant, sodium dodecylsulfate (SDS).

Experiments: Dodecane-in-water emulsions stabilised by three HEUR polymers with different structural composition were examined in the absence and presence of SDS by NMR spectroscopy and small-angle neutron scattering (SANS).

Surfactant modulated interaction of hydrophobically modified ethoxylated urethane (HEUR) polymers with impenetrable surfaces.

Hypothesis: The presence of surfactant modulates the surface-chemistry-specific interaction of hard colloidal particles (latex) with HEUR polymers, principally through introducing a preferential solution interaction rather than a competitive surface interaction; addition of surfactant leads to a preponderance of polymer/surfactant solution complexes rather than surface-bound complexes.

Experiments: A range of model formulations comprising a hexyl end-capped urethane polymer (C-L-(EO-L)-C), sodium dodecylsulfate (SDS) and a series of polystyrene-butylacrylate latices (PS-BA-L) have been characterised in terms of rheology, particle surface area (solvent relaxation NMR), polymer conformation (small-angle neutron scattering) and solution composition to build up a detailed picture of the distribution of the HEUR in the presence of both surfactant and latex.

Findings: There is very weak adsorption of C-L-(EO-L)-C to only the most hydrophobic latex surface studied, an adsorption that is further weakened by the addition of low levels of surfactant.

Studying the interaction of hydrophobically modified ethoxylated urethane (HEUR) polymers with sodium dodecylsulfate (SDS) in concentrated polymer solutions.

Hypothesis: Hydrophobically modified ethoxylated urethane polymers (HEURs) are widely used to control the rheological profile of formulated particulate dispersions through associative network formation, the properties of which are perturbed by the presence of surfactants. At high polymer concentrations and in the presence of surfactants, it is hypothesised that the dominant factors in determining the rheological profile are the number and composition of the mixed hydrophobic aggregates, these being defined by the number and distribution of the hydrophobic linkers along the polymer backbone, rather than the end-group hydrophobe characteristics per se that dominate the low polymer concentration behaviour.

Experiments: Three different HEUR polymers with formulae (C-L-(EO-L)-C, C-L-(EO-L)-C and C-L-(EO-L)-C (where L = urethane linker, C = hydrophobic end-group chain length, and EO = ethylene oxide block) have been studied in the absence and presence of SDS employing techniques that quantify (a) the bulk characteristics of the polymer surfactant blend, (b) the structure and composition of the hydrophobic domains, (c) the dynamics of the polymer and surfactant, and (d) the polymer conformation.

Cyclophosphamide versus etoposide in combination with total body irradiation as conditioning regimen for adult patients with Ph-negative acute lymphoblastic leukemia undergoing allogeneic stem cell transplant: On behalf of the ALWP of the European Society for Blood and Marrow Transplantation.

Allogeneic hematopoietic cell transplantation (alloHCT) with myeloablative conditioning based on total body irradiation (TBI) is widely used for the treatment of adults with acute lymphoblastic leukemia (ALL). TBI is most frequently administered in combination with either cyclophosphamide (Cy/TBI) or etoposide (Vp/TBI). The goal of this study was to retrospectively compare these two regimens.

Effect of Monomer Solubility on the Evolution of Copolymer Morphology during Polymerization-Induced Self-Assembly in Aqueous Solution.

Polymerization-induced self-assembly (PISA) has become a widely used technique for the rational design of diblock copolymer nano-objects in concentrated aqueous solution. Depending on the specific PISA formulation, reversible addition-fragmentation chain transfer (RAFT) aqueous dispersion polymerization typically provides straightforward access to either spheres, worms, or vesicles. In contrast, RAFT aqueous emulsion polymerization formulations often lead to just kinetically-trapped spheres.

Competition between polymers for adsorption on silica: a solvent relaxation NMR and small-angle neutron scattering study.

The competition between poly(vinylpyrrolidone) and poly(ethylene oxide) for adsorption at the silica surface was studied by solvent relaxation nuclear magnetic resonance and small-angle neutron scattering. The additive nature of the NMR relaxation rate enhancement was used to observe changes in the train layer when the two polymers were in direct competition for an increasing weight percentage of silica. PVP is shown to displace preadsorbed PEO from the particle surface, and this was observed for a range of PVP molecular weights.

Colloidal particles in competition for stabilizer: a solvent relaxation NMR study of polymer adsorption and desorption.

The competitive adsorption of poly(vinylpyrrolidone) onto silica and alumina-modified silica particles was studied using solvent relaxation nuclear magnetic resonance. The additive nature of the measured relaxation rate enabled predictions to be made of the relaxation rate in different polymer adsorption scenarios. Preferential adsorption of the poly(vinylpyrrolidone) onto the unmodified silica particles occurred when there was insufficient polymer in the system to coat the entire available surface area.

Resolving the film-formation dilemma with infrared radiation-assisted sintering.

The film formation of an acrylate latex with a glass-transition temperature of 38 °C has been achieved through the use of near-infrared (NIR) radiative heating. A hard, crack-free coating was obtained without the addition of plasticizers. Sintering of acrylate particles was confirmed through measurements using atomic force microscopy.

Time-resolved small-angle X-ray scattering studies of polymer-silica nanocomposite particles: initial formation and subsequent silica redistribution.

Small angle X-ray scattering (SAXS) is a powerful characterization technique for the analysis of polymer-silica nanocomposite particles due to their relatively narrow particle size distributions and high electron density contrast between the polymer core and the silica shell. Time-resolved SAXS is used to follow the kinetics of both nanocomposite particle formation (via silica nanoparticle adsorption onto sterically stabilized poly(2-vinylpyridine) (P2VP) latex in dilute aqueous solution) and also the spontaneous redistribution of silica that occurs when such P2VP-silica nanocomposite particles are challenged by the addition of sterically stabilized P2VP latex. Silica adsorption is complete within a few seconds at 20 °C and the rate of adsorption strongly dependent on the extent of silica surface coverage.

When does silica exchange occur between vinyl polymer-silica nanocomposite particles and sterically stabilized latexes?

The redistribution of silica nanoparticles between "core-shell" polymer-silica nanocomposites and sterically stabilized latexes is investigated using a combination of electron microscopy, disk centrifuge photosedimentometry (DCP), and X-ray photoelectron spectroscopy (XPS). Facile exchange of silica nanoparticles occurs on addition of sterically-stabilized polystyrene (or poly(2-vinylpyridine)) latex to polystyrene-silica (or poly(2-vinylpyridine)-silica) nanocomposite particles previously prepared by heteroflocculation. In contrast, no silica exchange occurs after such a latex "challenge" if similar polymer/silica nanocomposite particles are prepared via in situ polymerization.

Enhancing lives together: reviewing the process of an organizational amalgamation.

The amalgamation between two hospitals creates a transition period of significant change, uncertainty and complexity. It is a challenging time within an organization that needs to be managed effectively. This article outlines the integration process and eight-step framework used during an amalgamation of an acute hospital organization and a post-acute hospital.

Cracking of drying latex films: an ESEM experiment.

In this study environmental scanning electron microscopy was used to observe the cracking of drying latex films below their glass-transition temperature. By controlling the relative humidity so that it decreases linearly with time, a critical level of humidity at which cracking occurs can be determined and this is measured as a function of film thickness. It was found that the cracking humidity decreases with increases in film thickness for thicknesses in the range of 30 to 100 mum and then remains almost unchanged.

Unexpected facile redistribution of adsorbed silica nanoparticles between latexes.

Addition of excess sterically stabilized P2VP latex to a colloidal dispersion of P2VP-silica nanocomposite particles (with silica shells at full monolayer coverage) leads to the facile redistribution of the silica nanoparticles such that partial coverage of all the P2VP latex particles is achieved. This silica exchange, which is complete within 1 h at 20 degrees C as judged by small-angle x-ray scattering, is observed for nanocomposite particles prepared by heteroflocculation, but not for nanocomposite particles prepared by in situ copolymerization. These observations are expected to have important implications for the optimization of nanocomposite formulations in the coatings industry.

Leveraging our collective investment in Canada's Healthcare System.

The pursuit of tangible mechanisms and measures to quantify the value-for-money proposition within Canada's healthcare system has become healthcare's own Holy Grail. A critical assessment and analysis of this age-old conundrum, as explored in the lead paper of this issue, forms the basis of this commentary which goes on to challenge readers to consider how healthcare providers can collectively act on the information and research available and begin to leverage investments already made with the goal of affecting real change across the system.

The times they are a-changing: what worked and what we learned in deploying Ontario's Wait Time Information System.

How many days would you be comfortable waiting if you needed cancer surgery? What would you do if someone, not as medically urgent, was able to receive an MRI or CT scan before you? Would you want to know if you could wait less time for treatment at another location or with another clinician? These are some of the dilemmas facing patients and our health system when dealing with the issue of wait times. To address these pressing concerns, in the fall of 2004, Ontario launched its Wait Time Strategy. Two years later, Collins-Nakai et al.

Probing the mechanism of the PCl5-initiated living cationic polymerization of the phosphoranimine Cl3P=NSiMe3 using model compound chemistry.

New insight into the mechanism of the ambient temperature PCl5-initiated living cationic chain growth polycondensation of the N-silylphosphoranimine Cl3P=NSiMe3 (1) to give poly(dichlorophosphazene), [N=PCl2]n, has been provided by studies of model compound chemistry. Investigations of the reactivity of Cl- salts of the proposed cationic intermediates [Cl3P=N=PCl3]+ ([2]+) and [Cl3P=N-PCl2=N=PCl3]+ ([6]+) toward Ph3P=NSiMe3 (3a) provided evidence that under the usual polymerization conditions that involve a high monomer to initiator ratio, propagation occurs at both chain ends. However, analogous studies of near stoichiometric processes suggested that propagation is faster at one chain end, particularly when the chains are short.

A visit down under: our journey to improve Canada's healthcare system.

Good health is a journey. It cannot be achieved overnight, in a month or even a year. Good health is perhaps best viewed as a quest - an evolution that takes ongoing commitment and often requires compromise, sacrifice and a lot of simple hard work.

Powering the future: how Hamilton Health Sciences put cogeneration to work for healthcare.

The absolute necessity of a stable and uninterrupted power supply within hospitals makes many of these facilities uniquely suited to cogeneration plants. Hamilton Health Sciences recently completed the largest hospital cogeneration project ever undertaken in the country. Spanning three acute care hospitals and generating a combined total of 22.

The surprising and stereoselective formation of P2C10 cages by the reduction of Cp*PCl2.

Reactions of Cp*PCl2 with Group 13 reducing agents result in a cascade of P-C, P-P and C-C bond forming reactions and the stereoselective formation of P2C10 cages.