Objective
To explore the effect of continuity of care in reducing domestic symptomatic hypoglycemia of children with type 1 diabetes.
Methods
A total of 50 first diagnosed type 1 diabetic children who were admitted in a classⅢgrade A hospital from May 2014 to December 2015 were selected and divided into observation group and control group randomly with 25 cases in each. The two groups were given the same clinical nursing, while the observation group was given continuity of care after discharge. The observation period last for 12 months from the time of discharge. Observed the average weekly incidence of symptomatic hypoglycemia, admission, HbA1c.
Results
A total of 45 cases completed the research, 21 of which were from the control group, and the last were from the observation group. Compared with the control group, the occurrence of domestic symptomatic hypoglycemia in observation group was significantly reduced (P<0.05) . Meanwhile, the number of readmission in the observation group was significantly lower than that in the control group (P<0.05) .
Conclusions
Continuity of nursing can effectively reduce the symptomatic hypoglycemia occurrence of type 1 diabetic children who were first diagnosed within 12 months. It can also reduce readmission rate, medical expenses and family financial burden.
Key words:
Child; Diabetes mellitus, type 1; Hypoglycemia; Continuity of care
BACKGROUND Hand function assessment heavily relies on specific task scenarios, making it challenging to ensure validity and reliability. In addition, the wide range of assessment tools, limited and expensive data recording, and analysis systems further aggravate the issue. However, smartphones provide a promising opportunity to address these challenges. Thus, the built-in, high-efficiency sensors in smartphones can be used as effective tools for hand function assessment. OBJECTIVE This review aims to evaluate existing studies on hand function evaluation using smartphones. METHODS An information specialist searched 8 databases on June 8, 2023. The search criteria included two major concepts: (1) smartphone or mobile phone or mHealth and (2) hand function or function assessment. Searches were limited to human studies in the English language and excluded conference proceedings and trial register records. Two reviewers independently screened all studies, with a third reviewer involved in resolving discrepancies. The included studies were rated according to the Mixed Methods Appraisal Tool. One reviewer extracted data on publication, demographics, hand function types, sensors used for hand function assessment, and statistical or machine learning (ML) methods. Accuracy was checked by another reviewer. The data were synthesized and tabulated based on each of the research questions. RESULTS In total, 46 studies were included. Overall, 11 types of hand dysfunction–related problems were identified, such as Parkinson disease, wrist injury, stroke, and hand injury, and 6 types of hand dysfunctions were found, namely an abnormal range of motion, tremors, bradykinesia, the decline of fine motor skills, hypokinesia, and nonspecific dysfunction related to hand arthritis. Among all built-in smartphone sensors, the accelerometer was the most used, followed by the smartphone camera. Most studies used statistical methods for data processing, whereas ML algorithms were applied for disease detection, disease severity evaluation, disease prediction, and feature aggregation. CONCLUSIONS This systematic review highlights the potential of smartphone-based hand function assessment. The review suggests that a smartphone is a promising tool for hand function evaluation. ML is a conducive method to classify levels of hand dysfunction. Future research could (1) explore a gold standard for smartphone-based hand function assessment and (2) take advantage of smartphones’ multiple built-in sensors to assess hand function comprehensively, focus on developing ML methods for processing collected smartphone data, and focus on real-time assessment during rehabilitation training. The limitations of the research are 2-fold. First, the nascent nature of smartphone-based hand function assessment led to limited relevant literature, affecting the evidence’s completeness and comprehensiveness. This can hinder supporting viewpoints and drawing conclusions. Second, literature quality varies due to the exploratory nature of the topic, with potential inconsistencies and a lack of high-quality reference studies and meta-analyses.
BACKGROUND. Identifying immune correlates of COVID-19 disease severity is an urgent need for clinical management, vaccine evaluation, and drug development. Here, we present a temporal analysis of key immune mediators, cytokines, and chemokines in blood of hospitalized COVID-19 patients from serial sampling and follow-up over 4 weeks.
The flexible needle is a minimally invasive medical device mainly used for human biopsy. The insertion operation has a small wound, which is conducive to the rehabilitation of patients and has a good application prospect. However, the force of the flexibility on the tissue is not certain, which seriously affects the doctor's judgment of the injury caused by the needle insert to the patient. In this paper, the mechanical properties of the flexible needle are studied by image analysis, the mechanical model between the needle holder and the force sensor is established, and the force of the needle holder is calculated by the force sensor data. Based on the cantilever beam model, the cutting force of the needle tip to the soft tissue and the friction force of the needle body are analyzed by using the force of the needle holder. The mechanical properties of flexible needles and the damage to tissues caused by needle insertion have been studied. Finally, the deflection of the needle body is calculated using the experimental force data, which are compared with the analysis by the image processing system. The results show that the cantilever beam model can predict the force of the needle body more accurately, and then predict the insertion trajectory.
Based on 2006 revised classification criteria of definite antiphospholipid syndrome (APS) and definition of new APS subsets, we investigated clinical features of APS patients, correlation between thrombotic events and related antibodies was assessed as well.165 patients with APS were enrolled and analysed retrospectively.124 female and 41 male patients were included. 116 cases (70.3%), 34 cases (20.6%), 10 cases (6.1%), and 5 cases (3.0%) were classified as definite APS, probable APS, seronegative APS, and microangiopathic APS (MAPS) respectively. Among 124 patients accompanied with other diseases, 113 (91.1%) were autoimmune diseases, mostly systemic lupus erythematosus (79.6%). 121 (73.3%) patients had episodes of thrombosis, with majority of deep vein thrombosis. The patients with positive test of lupus anticoagulant (LA) only were more likely to have episodes of thrombosis than with positive anticardiolipid antibody (ACL) only (86.0% versus 55.7%; P < 0.05). Among 61 patients with prolonged APTT, the presence of LA was detected in 50 (82.0%) patients, and ACL in 34 (55.7%) patients.APS patients could be classified into several subgroups according to their clinical features. Venous thromboses are more common than arterial thromboses, and positive of LA correlates thrombosis more than ACL.
Objective: Efficacy and tolerability of nifedipine gastrointestinal therapeutic system (GITS) 60 mg once daily (QD) in uncontrolled blood pressure (BP) is not completely explored in China. Therefore, we studied the efficacy and tolerability of nifedipine GITS 60 mg in Chinese hypertensive patients inadequately controlled with prior monotherapy. Design and method: This single-arm phase-4 study (NCT02413515) enrolled 278 hypertensive adults from 13 centers in China, in whom BP was uncontrolled after 4-weeks of antihypertensive monotherapy. The patients received oral nifedipine GITS 60 mg QD for 8-consecutive weeks. Primary endpoint was mean sitting systolic BP control rate (MSSBP; <130 mmHg for subjects with diabetes (DM) and <140 mmHg for others) at 8-weeks. Secondary endpoints included change in MSSBP and mean sitting diastolic BP (MSDBP), 24-h SBP and DBP reduction measured by 24 hour ABPM, and safety of nifedipine GITS 60 mg. Results: A total of 269 patients (mean age 55 ± 8.21 years, 62.8% males, 28.3% with DM) were included for efficacy and 278 for safety analysis. At week 8, overall MSSBP control rate was 64.7%. From baseline to 8-weeks, decrease in MSSBP and MSDBP was −15.2 ± 11.37 mmHg (147.9 ± 6.87 mmHg to 132.7 ± 11.82 mmHg) and −6.4 ± 7.87 mmHg (89.1 ± 7.13 mmHg to 82.7 ± 8.04), respectively (Table 1). The control rate was lower in patients with DM From baseline to 8-weeks, mean 24-h SBP was decreased from 138.5 ± 12.78 mmHg to 131.6 ± 12.29 mmHg (diff. −6.9 ± 11.30 mmHg, 95% CI −8.29, −5.56) and mean 24-h DBP was decreased from 86.4 ± 9.32 mmHg to 82.5 ± 9.12 mmHg (diff. −3.9 ± 7.63 mmHg, 95% CI −9.47, −6.42). Fifty (18%) cases of adverse events (AEs) and 25 (9%) cases of peripheral edema were reported. No drug related serious AEs and deaths occurred during the study.Conclusions: Nifedipine GITS 60 mg QD further improved control rate of MSSBP and MSDBP and was well tolerated in Chinese patients previously treated with standard dosage of antihypertensive monotherapy.
Objective: Post-marketing surveillance data has confirmed the efficacy and tolerability of 30 and 60 mg Nifedipine GITS in the management of hypertension. However, role of high dose Nifedipine GITS in controlling blood pressure (BP) in patients with uncontrolled BP levels with prior antihypertensive therapy is not studied. This 2nd analysis of ADEPT study aimed to evaluate the effect of Nifedipine GITS 60 mg treatment on 24 hours BP control in uncontrolled hypertensive patients using Ambulatory Blood Pressure Monitoring (ABPM). Design and method: Men and women (18–65 years) whose BP was uncontrolled with prior antihypertensive monotherapy were included in a prospective, open-label, multicenter, single-arm study. Patients received oral Nifedipine GITS 60 mg for 8 weeks, OD. BP data was obtained at baseline, week 2, 4, and 8. Mean 24-h systolic (SBP) and diastolic blood pressure (DBP) data was obtained through 24-h ABPM at baseline and after Week 8. BP reduction at each hour and throughout 8-week study period was analyzed along with heart rate (HR). Results: Patients who started both baseline and week 8 ABPM between 8:00 and 11:59AM were included in the analyses (n = 138, age = 55.6 ± 8.1 years, 58% men, 42% women). Hourly variation in SBP and DBP at baseline and week 8 is represented in Fig.1. Mean 24-h SBP decreased from 129.1 ± 16.1 mmHg to 121.6 ± 12.7 mmHg and DBP decreased from 79.1 ± 10.1 mmHg to 76.0 ± 9.2 mmHg. T/P ratio for SBP was 0.71 and 0.63 for DBP. Mean change in SBP and DBP for last 4-h at baseline and week 8 was 133.4 ± 15.0 mmHg and 126.3 ± 12.6 mmHg, 82.9 ± 9.1 mmHg and 80.0 ± 8.8 mmHg respectively. Mean change in SBP and DBP for last 6-h at baseline and week 8 was 131.9 ± 14.9 mmHg and 124.6 ± 11.9 mmHg, 81.6 ± 9.0 mmHg and 78.4 ± 8.8 mmHg respectively. 24-h variation in HR was 1.5 bpm.Conclusions: Nifedipine GITS showed good efficacy in the last dosing time along with good BP control for 24-h in patients with uncontrolled BP with prior antihypertensive monotherapy.
Hand function assessment heavily relies on specific task scenarios, making it challenging to ensure validity and reliability. In addition, the wide range of assessment tools, limited and expensive data recording, and analysis systems further aggravate the issue. However, smartphones provide a promising opportunity to address these challenges. Thus, the built-in, high-efficiency sensors in smartphones can be used as effective tools for hand function assessment.
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