bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of a Laser-Assisted Wound Measurement Device for Measuring Wound Volume
Authors: Davis Kathryn E. , Constantine Fadi C. , MacAslan Elaine C. , Bills Jessica D. , Noble Debby L. , Lavery Lawrence A.
Published: January 2015

Background:

Accurate and precise wound measurement is an essential part of the medical record when monitoring a patient with a chronic wound. This study was designed to determine if a new device, a laser-assisted wound measurement (LAWM) device, provides valid measurements for wound area, depth, and volume.

Methods:

We compared four methods to evaluate the area and volume of 12 wounds of differing size and depth that were created on the dorsum of a sacrificed pig. We evaluated the LAWM device, digital photograph assessment with National Institutes of Health ImageJ software, measurements of depth with a ruler, and weight-to-volume assessment with dental paste. We then sought to cross validate this data with further analyses obtained from these measurements using a Play-Doh®-based wound as a model for constant area with different depths.

Results:

We demonstrate that the LAWM device measures wound area accurately. Depth (and therefore volume) measurements, however, are artificially low. This inaccuracy is the same for shallow and deep wounds.

Conclusions:

The inaccuracy in the depth and volume measurements with the LAWM device results in an artificially low measurement. However, this may not affect percentage difference measurements. Further studies will need to be performed to determine if this device can accurately determine wound changes in the clinical setting.
Corneal Confocal Microscopy to Assess Diabetic Neuropathy: An Eye on the Foot
Authors: Tavakoli Mitra , Petropoulos Ioannis N. , Malik Rayaz A.
Published: January 2015

Accurate detection and quantification of human diabetic peripheral neuropathy are important to define at-risk patients, anticipate deterioration, and assess new therapies. Easily performed clinical techniques such as neurological examination, assessment of vibration perception or insensitivity to the 10 g monofilament only assess advanced neuropathy, i.e., the at-risk foot. Techniques that assess early neuropathy include neurophysiology (which assesses only large fibers) and quantitative sensory testing (which assesses small fibers), but they can be highly subjective while more objective techniques, such as skin biopsy for intra-epidermal nerve fiber density quantification, are invasive and not widely available. The emerging ophthalmic technique of corneal confocal microscopy allows quantification of corneal nerve morphology and enables clinicians to diagnose peripheral neuropathy in diabetes patients, quantify its severity, and potentially assess therapeutic benefit. The present review provides a detailed critique of the rationale, a practical approach to capture images, and a basis for analyzing and interpreting the images. We also critically evaluate the diagnostic ability of this new noninvasive ophthalmic test to diagnose diabetic and other peripheral neuropathies.
Continuous Glucose Monitoring in the Subcutaneous Tissue over a 14-Day Sensor Wear Period
Authors: Hoss Udo , Budiman Erwin S. , Liu Hanqing , Christiansen Mark P.
Published: January 2015

Background:

Glucose monitoring systems using subcutaneously inserted sensors are currently labeled for up to 7 days of wear. In this study, we evaluated the feasibility of a 14-day wear duration using a modified version of the sensor found in the Freestyle Navigator™ continuous glucose monitoring system.

Methods:

Sixty-two subjects with diabetes were enrolled in the study. One sensor per subject was inserted on the arm for a wear time of 14 days. Two different calibration algorithms were applied retrospectively, one that uses periodic sensor recalibrations and one without recalibrations. Sensor in vivo stability was determined by least square regression analysis using capillary blood glucose. Mean absolute relative difference (MARD) and mean relative difference were calculated. Consensus error grid analysis was performed by day and over the 14-day wear period to evaluate accuracy of both systems. The sensor insertion sites were inspected after sensor removal for skin reactions.

Results:

Sensor data from 55 subjects were used for the analysis. The accuracy metrics for the system with recalibration were calculated to MARD = 13.9% and 84.0% in zone A (error grid analysis). The system without recalibration performed significantly better, resulting in MARD of 12.2% and 88.0% in zone A ( p < .0001). The maximum change of in vivo sensor sensitivity over the 14-day wear period was 2% per day. Two subjects reported pain during the first 5 days of sensor wear, and 1 subject reported itching at the sensor site. No further skin reactions were noticed.

Conclusions:

The study shows that a 14-day sensor wear period is achievable. Moreover, sensors using “wired enzyme” technology showed excellent in vivo stability, with no significant sensitivity loss over the 14-day wear period.
Retrospective Outcomes of Glucose Control in Critically Ill Children
Authors: Kandil Sarah B. , Spear Debra , Thomas Neal J. , Weinzimer Stuart A. , Faustino Edward Vincent S.
Published: January 2015

Background:

Hyperglycemia is a significant problem for critically ill children. Treatment for hyperglycemia remains controversial. This study explores the effect of controlling blood glucose (BG) in hyperglycemic critically ill children.

Methods:

A retrospective cohort of nondiabetic critically ill children (defined as requiring mechanical ventilation and/or vasopressors) with BG persistently ≥150 mg/dl and treated with insulin (treatment group) were compared with a historical cohort of similar children who did not receive interventions to control hyperglycemia (baseline group).

Results:

There were 130 children in the treatment group and 137 children in the baseline group. Mean BG in the treatment group was 140 ± 24 mg/dl compared with 179 ± 47 mg/dl in the baseline group ( p < .001). After adjusting for patient characteristics, cointerventions, and glucose metrics, patients in the treatment group had 2.5 fewer intensive care unit (ICU)-free days (i.e., number of days alive and discharged from ICU within 28 days after inclusion) than the baseline group ( p = .023). Glucose control was not independently associated with duration of ICU stay, ventilator-free days, vasopressor-free days, or mortality.

Conclusions:

Blood glucose control appears associated with worse outcomes in critically ill children. Our data combined with conflicting results in adults leads us to strongly advocate for the conduct of randomized trials on glucose control in critically ill children.
Association of Self-Monitoring of Blood Glucose Use on Glycated Hemoglobin and Weight in Newly Diagnosed, Insulin-Naïve Adult Patients with Type 2 Diabetes
Authors: Virdi Naunihal S. , Lefebvre Patrick , Parisé Hélène , Duh Mei Sheng , Pilon Dominic , Laliberté François , Sundaresan Devi , Garber Lawrence , Dirani Riad
Published: January 2015

Background:

Clinical trials have shown that self-monitoring of blood glucose (SMBG) combined with patient education and medication titration can lead to improved glycated hemoglobin (HbA1c) and reduced weight in recently diagnosed non-insulin-treated type 2 diabetes mellitus (T2DM) patients. This retrospective matched cohort study assessed the association of SMBG with achieving long-term clinical outcomes in these patients in a real-world clinical setting.

Methods:

Using electronic medical records (2008–2011), we selected a population of adult patients recently diagnosed with T2DM not receiving insulin who were SMBG users and a population of non-SMBG controls with similar demographic and clinical characteristics using propensity score matching. The main study outcomes compared between the two groups were time to achieve (1) HbA1c <7% for patients with baseline HbA1c ≥7% and (2) a ≥5% reduction in weight from baseline.

Results:

Of the 589 patients identified in each group, 113 in each group had a baseline HbA1c ≥7% (mean, 8.2%). The SMBG users were more likely to achieve an HbA1c <7% (12 months: 58.4% versus 38.9%, p = .0037; 36 months: 84.0% versus 70.0%, p = .0013) and to do so faster (median, 6.5 versus 20.5 months; log-rank p = .0016). Self-monitoring of blood glucose was associated with faster weight reduction (median time to achieve a ≥5% reduction, 23.5 versus 35.9 months for SMBG and non-SMBG, respectively; log-rank p = .0005).

Conclusions:

In newly diagnosed T2DM insulin-naïve patients, SMBG users had an improved rate of achieving long-term glycemic control and weight loss in a real-world clinical setting.
Evaluation of Point-of-Care Blood Glucose Measurements in Patients with Diabetic Ketoacidosis or Hyperglycemic Hyperosmolar Syndrome Admitted to a Critical Care Unit
Authors: Corl Dawn E. , Yin Tom S. , Mills Michelle E. , Spencer Tina L. , Greenfield Lucy , Beauchemin Erin , Cochran Jessica , Suhr Louise D. , Thompson Rachel E. , Wisse Brent E.
Published: January 2015

Background:

Point-of-care (POC) blood glucose (BG) measurement is currently not recommended in the treatment of patients presenting with diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS).

Methods:

We prospectively evaluated and compared capillary and venous POC BG values with laboratory venous glucose in patients with DKA or HHS admitted to one critical care unit over 8 months.

Results:

Venous laboratory glucose was strongly correlated with venous ( r = 0.98) and capillary ( r = 0.96) POC glucose values, though POC glucose values were higher than venous laboratory values (venous POC 21 ± 3 mg/dl, capillary POC 30 ± 4 mg/dl; both p < .001). Increased plasma osmolality had no effect on glucose meter error, while acidemia (pH < 7.3) was associated with greater glucose meter error ( p = .04) independent of glucose levels. Comparing hypothetical insulin infusion rates based on laboratory venous glucose to actual infusion rates based on POC glucose values showed that 33/61 insulin infusion rates would have been unchanged, while 28 out of 61 rates were on average 7% ± 2% higher. There were no instances of hypoglycemia in any of the patients.

Conclusions:

Overall, both venous and capillary POC BG values were safe for the purpose of titrating insulin infusions in patients with severe hyperglycemia. Acidemia, but not hyperosmolality, increased POC BG value errors.
Technical Aspects of the Parkes Error Grid
Authors: Pfützner Andreas , Klonoff David C. , Pardo Scott , Parkes Joan L.
Published: January 2015

Background:

The Parkes error grid, which was developed in 1994, presented performance zones for blood glucose (BG) monitors with borders that were not mathematically specified at the time the grid was published.

Methods:

In this article, we (1) review the history of the Parkes error grid, (2) present the never-before-published exact coordinates and specifications of the grid so that others may produce an exact replica of the original grid, and (3) discuss our suggestions how this metric should be applied.

Results:

The new ISO15197:2013 guideline for system accuracy assessment of BG meters for patient self-measurement incorporates use of this metric for defining acceptable accuracy of BG monitors. It is expected that, for regulatory purposes, this document will stipulate that the error grid version for type 1 diabetes should be applied with the caveat that only the A zone represents acceptable accuracy.

Conclusions:

It remains to be seen by how much the new error grid, which is currently being developed by the Food and Drug Administration/Diabetes Technology Society/American Diabetes Association/The Endocrine Society/Association for Advancement of Medical Instrumentation, will deviate from the Parkers error grid.
Analytic Evaluation of a New Glucose Meter System in 15 Different Critical Care Settings
Authors: Mitsios John V. , Ashby Lori A. , Haverstick Doris M. , Bruns David E. , Scott Mitchell G.
Published: January 2015

Background:

Maintaining appropriate glycemic control in critically ill patients reduces morbidity and mortality. The use of point-of-care (POC) glucose devices is necessary to obtain rapid results at the patient's bedside. However, the devices should be thoroughly tested in the intended population before implementation. The use of POC glucose meters in critically ill patients has been questioned both in the literature and by regulatory agencies. The aim of this study was to determine if the ACCU-CHEK® Inform II system (Roche Diagnostics) POC glucose meter demonstrated the desired accuracy and precision, as defined by Clinical and Laboratory Standards Institute guideline POCT12-A3, in a large number of critically ill patients from multiple intensive care settings at two academic medical centers.

Methods:

A total of 1200 whole blood meter results from 600 patients were compared with central laboratory plasma values. Whole blood aliquots from venous samples were used to obtain duplicate meter results with the remaining sample being processed to obtain plasma for central laboratory testing within 5 min of meter testing.

Results:

A total of 1185 (98.8%) of the new meter's glucose values were within ±12.5% (±12 mg/dl for values ≥100 mg/dl) of the comparative laboratory glucose values, and 1198 (99.8%) were within ±20% (±20 mg/dl for values <100 mg/dl).

Conclusions:

Considering the large number of patients from numerous critical care units examined, the new glucose meter system appears to have sufficient analytic accuracy for use in critically ill patients.
Analysis: New Point-of-Care Blood Glucose Monitoring System for the Hospital Demonstrates Satisfactory Analytical Accuracy Using Blood from Critically Ill Patients—An Important Step toward Improved Blood Glucose Control in the Hospital
Authors: Joseph Jeffrey I
Published: January 2015

Patients managed in the intensive care units (ICUs) and general wards of the hospital experience a high incidence of hyperglycemia, hypoglycemia, and glycemic variability, despite significant hospital resources devoted to glucose control. Optimized glucose meters and monitoring systems are required to improve the safety and efficacy of insulin delivery and glucose control in the hospital. Safe insulin dosing requires timely and accurate glucose measurements, especially during dynamic changes in nutrition, insulin sensitivity, and physiological stress. In the current issue of Journal of Diabetes Science and Technology, Mitsios and coauthors describe the analytical accuracy of the new Accu-Check® Inform II blood glucose (BG) monitoring system commercialized by F. Hoffmann-La Roche Ltd. The point-of-care glucose meter achieved the desired degree of accuracy and precision, as defined by Clinical and Laboratory Standards Institute POCT12-A3 guidelines when evaluated using venous blood from 600 critically ill patients from multiple ICUs at two medical centers. Venous whole blood samples were used to obtain glucose meter results in duplicate. The remaining blood sample was centrifuged to obtain plasma for central hospital laboratory testing using the hexokinase method within 5 min of meter testing. A total of 98.8% of the 1200 Accu-Check Inform II meter's glucose values were within ±12.5% (±12 mg/dl) of the mean laboratory glucose value, and 99.8% were within ±20% (±20 mg/dl), thus meeting the Clinical and Laboratory Standards Institute criteria. Future studies are required to evaluate the clinical performance of the new BG monitoring system in the intended-use patient populations and critical care environments, using arterial, peripheral venous, central venous, and capillary blood samples.
Signal Processing Algorithms Implementing the “Smart Sensor” Concept to Improve Continuous Glucose Monitoring in Diabetes
Authors: Facchinetti Andrea , Sparacino Giovanni , Cobelli Claudio
Published: January 2015

Glucose readings provided by current continuous glucose monitoring (CGM) devices still suffer from accuracy and precision issues. In April 2013, we proposed a new conceptual architecture to deal with these problems and render CGM sensors algorithmically smarter, which consists of three modules for denoising, enhancement, and prediction placed in cascade to a commercial CGM sensor. The architecture was assessed on a data set consisting of 24 type 1 diabetes patients collected in four clinical centers of the AP@home Consortium (a European project of 7th Framework Programme funded by the European Committee). This article, as a companion to our prior publication, illustrates the technical details of the algorithms and of the implementation issues.
Multiplicative Surrogate Standard Deviation: A Group Metric for the Glycemic Variability of Individual Hospitalized Patients
Authors: Braithwaite Susan S. , Umpierrez Guillermo E. , Chase J. Geoffrey
Published: January 2015

Objective:

Group metrics are described to quantify blood glucose (BG) variability of hospitalized patients.

Methods:

The “multiplicative surrogate standard deviation” (MSSD) is the reverse-transformed group mean of the standard deviations (SDs) of the logarithmically transformed BG data set of each patient. The “geometric group mean” (GGM) is the reverse-transformed group mean of the means of the logarithmically transformed BG data set of each patient. Before reverse transformation is performed, the mean of means and mean of SDs each has its own SD, which becomes a multiplicative standard deviation (MSD) after reverse transformation. Statistical predictions and comparisons of parametric or nonparametric tests remain valid after reverse transformation. A subset of a previously published BG data set of 20 critically ill patients from the first 72 h of treatment under the SPRING protocol was transformed logarithmically. After rank ordering according to the SD of the logarithmically transformed BG data of each patient, the cohort was divided into two equal groups, those having lower or higher variability.

Results:

For the entire cohort, the GGM was 106 (÷/× 1.07) mg/dl, and MSSD was 1.24 (÷/× 1.07). For the subgroups having lower and higher variability, respectively, the GGM did not differ, 104 (÷/× 1.07) versus 109 (÷/× 1.07) mg/dl, but the MSSD differed, 1.17 (÷/× 1.03) versus 1.31 (÷/× 1.05), p = .00004.

Conclusions:

By using the MSSD with its MSD, groups can be characterized and compared according to glycemic variability of individual patient members. J Diabetes Sci Technol 2013;7(5):1319–1327
Dose Accuracy and Injection Force of Different Insulin Glargine Pens
Authors: Friedrichs Arnd , Bohnet Janine , Korger Volker , Adler Steffen , Schubert-Zsilavecz Manfred , Abdel-Tawab Mona
Published: January 2015

Background:

Dose accuracy and injection force, representing key parameters of insulin pens, were determined for three pens delivering insulin glargine-based copies, Pen Royale (WR) and DispoPen (WD) for Glaritus® (Wockhardt) and GanLee Pen (GL) for Basalin® (Gan & Lee), compared with pens of the originator, ClikSTAR® (CS) and SoloSTAR® (SS) for Lantus® (Sanofi).

Methods:

Using the weighing procedure recommended by DIN EN ISO 11608–1:2000, dose accuracy was evaluated based on nonrandomized delivery of low (5 U), mid (30 U), and high (60 U) dosage levels. Injection force was measured by dispensing the maximum dose of insulin (60 U for the GL, WR, and WD; 80 U for the SS and CS) at dose speeds of 6 and 10 U/s.

Results:

All tested pens delivered comparable average doses within the DIN EN ISO 11608–1:2000 limits at all dosage levels. The GL revealed a higher coefficient of variation (CV) at 5 U, and the WR and WD had higher CVs at all dosage levels compared with the CS and SS. Injection force was higher for the WR, WD, and GL compared with the CS and SS at both dose speeds. In contrast to the CS and SS with an end-of-content feature, doses exceeding the remaining insulin could be dialed with the WR, GL, and WD and, apparently, dispensed with the WD.

Conclusions:

All pens fulfilled the dose accuracy requirements defined by DIN EN ISO 11608–1:2000 standards at all three dosage levels, with the WR, WD, and GL showing higher dosage variability and injection force compared with the SS and CS. Thus, the devices that deliver insulin glargine copies show different performance characteristics compared with the originator.
Average Daily Risk Range as a Measure for Clinical Research and Routine Care
Authors: Patton Susana R. , Clements Mark A.
Published: January 2015

There is emerging evidence suggesting that glycemic variability may relate to risk for diabetes-related complications. This article provides a description of average daily risk range (ADRR), a diabetes-specific measure of risk for hyperglycemia and hypoglycemia, and provides a summary of research using ADRR and clinical applications of ADRR. Average daily risk range is a variability metric that is based on “risk” values obtained from glucose levels that are mathematically transformed to give equal weight to hyperglycemic and hypoglycemic excursions. It can be calculated using self-monitoring of blood glucose or continuous glucose monitoring (CGM) data. The ADRR is scored based on risk categories: Low risk, 0–19; moderate risk, 20–40; and high risk, 40 and above. Research using ADRR has found it to be a reliable predictor of extreme blood glucose values regardless of diabetes type and patients' age. Moreover, in treatment studies, ADRR presents as a very conservative measure of variability. Clinically, ADRR can provide meaningful data related to patients' risk for hyperglycemia and hypoglycemia that is not available from glycated hemoglobin values. Average daily risk range scores may also help clinicians to identify patients who may be overtreating blood glucose levels, leading to very high or low values. To expand the utility of ADRR, future research should examine the validity of existing risk cutoff scores for pediatric patients, determine if ADRR cutoff scores need to be modified for CGM data, and investigate whether patients' ADRR scores also relate to the development of long-term complications, including retinopathy and microalbuminuria.
The New Glucose Standard POCT12-A3 Misses the Mark
Authors: Krouwer Jan S.
Published: January 2015

POCT12-A3 is a Clinical Laboratory Standards Institute standard for hospitals about hospital glucose meter procedures and performance standards. I have reviewed this standard based on the attributes of an ideal performance standard. POCT12-A3 has tighter limits than its predecessor for 95% of results, the limits widen for 98% of results, and there are no limits for 2% of results. It is hard to fathom that 2% of the results are unspecified and could cause life-threatening results, as glucose meters do not perform this poorly. There should be a specification for unreported results since, by definition, point-of-care-testing assays are time sensitive. POCT12-A3 provides useful advice about the glucose testing procedure but provides evaluation guidance only about analytical performance. Moreover, the recommended protocol to assess meter performance is biased and likely to underestimate the observed performance. The guideline would be improved if its specification were based on an error grid and contained evaluation protocols for user errors.
Diabetes Technology, Innovation, and the U.S. Health Insurance System
Authors: Quinn Bruce
Published: January 2015

The flow of funds in the U.S. health care system is crucial both for the provision of services to patients and to encourage innovation that enables long-term improvement of health services. Rising concern about health care costs often includes concerns about inappropriate adoption of costly or unnecessary technology. Many innovations in diabetes technology may involve personal technology, which does not qualify under existing health insurance categories such as “durable medical equipment” or under a currently defined telehealth technology. In such cases, the diabetes technology industry may be developing types of technology that are so innovative they do not have clearly established payment mechanisms in the existing U.S. fee for service health care reimbursement system. This article describes key features of the U.S. health care payment system relevant to developers of new diabetes technologies.
Reconsidering Nerve Decompression: An Overlooked Opportunity to Limit Diabetic Foot Ulcer Recurrence and Amputation
Authors: Nickerson D. Scott
Published: January 2015

Nerve decompression for relief of subjective diabetic sensorimotor polyneuropathy pain and numbness has been labeled of “unknown’ benefit. Objective outcomes in treatment and prevention of diabetic foot complications are reviewed. There is growing evidence that plantar foot ulceration and recurrence in high-risk feet are minimized with this operation. Avoiding neuropathic and neuroischemic ulcer wounds should theoretically reduce amputations and perhaps mortality risk. Protective effects are hypothesized to act via relief of neurovascular entrapment, thereby improving neurally modulated tissue homeostasis factors. Nerve decompression deserves considerable research attention to understand its role in limiting foot complications. Its apparent benefits challenge the paradigm that diabetic neuropathy is a purely length-dependent axonopathy and may necessitate appreciation of superimposed nerve entrapment as an significant operant factor.
Advantages and Pitfalls of Fructosamine and Glycated Albumin in the Diagnosis and Treatment of Diabetes
Authors: Danese Elisa , Montagnana Martina , Nouvenne Antonio , Lippi Giuseppe
Published: January 2015

The efficient diagnosis and accurate monitoring of diabetic patients are cornerstones for reducing the risk of diabetic complications. The current diagnostic and prognostic strategies in diabetes are mainly based on two tests, plasma (or capillary) glucose and glycated hemoglobin (HbA1c). Nevertheless, these measures are not foolproof, and their clinical usefulness is biased by a number of clinical and analytical factors. The introduction of other indices of glucose homeostasis in clinical practice such as fructosamine and glycated albumin (GA) may be regarded as an attractive alternative, especially in patients in whom the measurement of HbA1c may be biased or even unreliable. These include patients with rapid changes of glucose homeostasis and larger glycemic excursions, and patients with red blood cell disorders and renal disease. According to available evidence, the overall diagnostic efficiency of GA seems superior to that of fructosamine throughout a broad range of clinical settings. The current method for measuring GA is also better standardized and less vulnerable to preanalytical variables than those used for assessing fructosamine. Additional advantages of GA over HbA1c are represented by lower reagent cost and being able to automate the GA analysis on many conventional laboratory instruments. Although further studies are needed to definitely establish that GA can complement or even replace conventional measures of glycemic control such as HbA1c, GA may help the clinical management of patients with diabetes in whom HbA1c values might be unreliable.
A Comparison of Glide Force Characteristics Between 2 Prefilled Insulin Lispro Pens
Authors: Rees Tina M. , Lennartz Amanda H. , Ignaut Debra A.
Published: January 2015

Background:

Glide force, average glide force, and glide force variability of the insulin lispro 200 units/mL pen (Eli Lilly and Company, Indianapolis, IN, USA) were compared to the Humalog® KwikPen® 100 units/mL pen (hereafter, KwikPen; Eli Lilly and Company, Indianapolis, IN, USA).

Methods:

Data were collected on 2 doses, 2 injection speeds, and 2 needle types.

Results:

Insulin lispro 200 units/mL pen showed significantly lower maximum glide force, average glide force, and glide force variability than the KwikPen across all combinations of dose size, dose speed, and needle type.

Conclusions:

The lower glide force observed with the insulin lispro 200 units/mL pen offers another treatment option for patients with type 1 or type 2 diabetes who require greater than 20 units of mealtime insulin daily.
High Reported Treatment Satisfaction in People With Type 1 Diabetes Switching to Latest Generation Insulin Pump Regardless of Previous Therapy
Authors: Barnard Katharine D , Bromba Michael , de Lange Mirja , Halbron Marine , Levy Brian L. , Lévy Marc , Lippmann-Grob Bernhard , Walshe Kieran , Ziegler Ralph
Published: January 2015

Background:

The effects of transition by individuals with type 1 diabetes (T1D) to more recently available continuous glucose monitoring (CGM)-enabled insulin pumps from either multiple daily insulin injections (MDI) or older insulin pumps on treatment satisfaction have not been well studied. We conducted a survey to assess treatment satisfaction among users of the Animas® Vibe™ insulin pump, a latest generation insulin pump (LGIP) system (CGM-enabled), after switching from MDI or earlier generation insulin pumps.

Methods:

Individuals with T1D from 141 centers in 5 countries and 4 language areas participated in the survey. Treatment satisfaction was assessed by the Insulin Treatment Satisfaction Questionnaire (ITSQ), which was included in a 50-item online questionnaire that also assessed preference for using the LGIP compared with previous treatment and satisfaction with key LGIP features.

Results:

A total of 356 individuals, ages 12-79 years, responded to the survey: mean (SD) age 38.4 (16.1) years; diabetes duration 19.1 (13.3) years; female 59%; previously treated with MDI 58%. Overall mean (SD) ITSQ scores were high among all respondents regardless of prior treatment: 95.1 (23.2) (scale: 0-132). No differences between previous-treatment groups were seen. Most (83%) of respondents rated the LGIP to be better than their previous insulin delivery system: “much better” (65%), “a bit better” (18%) regardless of age, and 95% would recommend using the LGIP to others.

Conclusions:

Use of the Animas Vibe was associated with high treatment satisfaction and perceived as a better method of insulin delivery regardless of previous insulin therapy or age.
Analytical Evaluation of the Diazyme Glycated Serum Protein Assay on the Siemens ADVIA 1800
Authors: Rodriguez-Capote Karina , Tovell Kayla , Holmes Deborah , Dayton Janice , Higgins Trefor N.
Published: January 2015

Background:

Hemoglobin A1c (HbA1c) is considered the gold standard for assessment of glycemic control in diabetic patients. HbA1c is inadequate in individuals homozygous or compound heterozygous for hemoglobin variants or in conditions with an altered red blood cell turnover. In these cases glycated albumin (GA) is proposed as an alternative assay. We aimed to evaluate the analytical performance of the Diazyme glycated serum protein (GSP) assay on an automated analyzer, to establish a reference interval (RI), and to compare from a clinical perspective, GSP/GA with glycated Hb (glyHb) results.

Methods:

Validation studies followed the CLSI guidelines and included precision, linearity, interferences, concordance of results with glyHb, and RI calculation. GSP was analyzed on representative samples with previously ordered HbA1c and albumin from the Dyna LIFEDX laboratory. Samples from patients with bisalbuminemia, hemoglobinopathies, and multiple myeloma were also included.

Results:

Within-run and total imprecision was <3.0% at both levels of control, analytical sensitivity was 5.31 μmol/L, and linearity was verified from 10 to 1150 μmol/L (total allowable error of 5%). Clinical concordance between %GA and glyHb was substantial (n = 175, R2 = .91, kappa = .78, P = .167). GSP RI was 160 to 340 μmol/L or if expressed as %GA 10.5 to 17.5%.

Conclusion:

Analytical performance of the Diazyme GSP assay on the Siemens ADVIA 1800 is acceptable for clinical use. The RI obtained was higher than that suggested by the manufacturer.
Mobile value-added services and the economic empowerment of women: The case of Usaha Wanita in Indonesia
Authors: Cai Tian , Chew Han Ei , Levy Mark R.
Published: January 2015

Mobile value-added services (MVAS) represent a growing collaboration between the private sector and the development community. In this paper, we examine one such MVAS, the Nokia Usaha Wanita service running on the Nokia Life+ platform in Indonesia, and we assess its impact as an innovative means for the economic empowerment of businesswomen. Data were gathered through 282 telephone interviews with a nationwide random sample of women who subscribed to Usaha Wanita. Our research found evidence that subscribers derived economic benefit from using the service. Subscribers reported that their business profits were greater, because of what they had learned from reading Usaha Wanita content. Women who were subscribers also had higher “good month’s” profits as well. Increased profits were positively correlated with frequent reading of the tips and information provided by Usaha Wanita and subscriber perception that the service was useful for business. Women who exhibited entrepreneurial optimism also had greater business profits. Findings suggest that entrepreneurial optimism amplified the effect of mobile phone use on profits.
The amplification effect of mobile phones on female-owned microenterprises
Authors: Chew Han Ei , Ilavarasan P. Vigneswara , Levy Mark R.
Published: January 2015

Based on a survey of urban female-owned microentrepreneurs in Chennai, India, we contend that access to mobile phones is a necessary but not sufficient condition for achieving certain development goals. Through the analysis of a survey completed by 335 female microentrepreneurs who owned mobile phones, we explicate an innovative concept, entrepreneurial expectations, and explore its linkage with mobile phones and microenterprise growth. We found that among microentrepreneurs with high entrepreneurial expectations (14% of the sample), business use of mobile phones amplified the impact of entrepreneurial expectations and was associated with greater microenterprise growth.
Predicting actual weight loss: A review of the determinants according to the theory of planned behaviour
Authors: Chung Louisa Ming Yan , Fong Shirley Siu Ming
Published: January 2015

Weight reduction that corresponds with lifestyle modification is difficult to foster. The theory of planned behaviour has been actively cited in explaining health-related behaviour. This review evaluated the application of the theory of planned behaviour to weight-loss behaviour. Among the three reviewed papers, cross-sectional survey designs and subjective outcome measurements were commonly applied. All of the studies recruited obese female adults as participants, limiting the generalisability of the studies’ findings. The theory of planned behaviour can be effectively applied in weight-reduction programmes targeting female obese patients. This review confirmed critiques citing the limitations of experimental studies, the subjective measurement of behaviour and short follow-up periods.
Effects of weld metal strength and transformation temperature on welding residual stress
Authors: Xu M. , Chen J. , Jin Y. , Li Y. , Lu H.
Published: January 2015

In this study, we assess the effects of weld metal strength and transformation temperature on the residual stress in 2·25Cr–1·6W steel welded joints. We find that the stress levels in the weld and the peak residual stress position in the base metal can be controlled by the appropriate selection of filler metal. Low transformation temperature weld metals are capable of inducing compressive residual stresses in the weld bead. Meanwhile, for stresses and bending moment equilibrium, the high strength weld metal pushes the peak tensile stress outward to reside at the base metal, keeping off the weak region. A reasonable agreement is obtained between the numerical modelling considering phase transformation and the accurate local stresses measurement associated to weld microstructure regions.
Effect of post-weld heat treatment on microstructures and properties of friction stir welded joint of 32Mn–7Cr–1Mo–0·3N steel
Authors: Li Y. J. , Fu R. D. , Du D. X. , Jing L. J. , Sang D. L. , Wang Y. P.
Published: January 2015

In this study, the microstructures and mechanical properties of friction stir welded and post-weld heat treated joints of 32Mn–7Cr–1Mo–0·3N steel were investigated. Significant microstructural and mechanical property gradients were found along the transverse directions of the as welded joint. These gradients led to overmatching characteristic with higher strength but lower ductile than base material. The post-weld heat treatment effectively reduced the gradient characteristics in the as welded joint. Consequently, the mechanical property of the joint was nearly restored to the level of base metals. However, the abnormal grain growth was observed in the heat affected zone of the post-weld heat treated joint. The possible mechanism was discussed in term of the evolution of atom segregation at grain boundaries.
Memory switching characteristics in amorphous ZnIn2Se4 thin films
Authors: Dhruv D. K. , Nowicki A. , Patel B. H. , Dhamecha V. D.
Published: January 2015

ZnIn2Se4 thin films were deposited by flash evaporation of bulk material onto glass and pyrographite substrates under vacuum. The surface aspects of films have been studied by scanning electron microscopy. The dynamic and static current ( I) versus voltage ( V) characteristics of brass/pyrographite/ZnIn2Se4 thin film/platinum sandwiched devices for different film thicknesses (350–650 nm) and temperatures (313–353 K) were measured. The OFF state I–V characteristics of fabricated thin film devices indicated that the conduction mechanism is of the Poole–Frenkel type. In addition, a threshold memory switching mechanism from a high resistance OFF state to a low resistance ON state was observed in these thin film structures. The I–V characteristics of the memory device were studied at different annealed and ambient temperatures. The threshold voltage was found to increase linearly with film thickness and decrease exponentially with ambient temperature. The results obtained were discussed, and a thermal model for initiating the switching process in this device system could be indicated.
Magnetic model of oxidation process of Y containing Cr–Al–C films
Authors: Boucher R. , Berger O.
Published: January 2015

Layers containing a mixture of a solid solution and Cr2AlC-MAX phase were magnetically characterised for the first time for various oxidation times. It was found that with increasing oxidation time at 700 and 900°C, there was an initial decrease in the magnetic signal, followed by an increase for longer exposure times. This initial drop was interpreted as being due to the transformation process of the Cr–Al–C layer from solid solution to MAX phase and the subsequent increase due to the breakdown of the MAX phase.

For the layers with Y a saturation in the magnetisation with oxidation time was observed which implies that the surface α-Al2O3 had protected the MAX phase from further oxidation and stopped the breakdown of the MAX phase, and for the layers without Y, no saturation was observed, which implies a continuous breakdown due to the ongoing growth of the various alumina phases. These results support the interpretation of previous studies and derived schematic model of the oxidation process on such layers.
Determination of strength properties for yttria stabilised zirconia coatings
Authors: Gong M. F. , Mei F. , Qiao S. R. , Wu S. H. , Lyashenko B. A.
Published: January 2015

The mechanical properties of coatings are significantly influenced by their interfacial bonded status and interfacial stresses, which are quite difficult to measure by traditional testing techniques. In this study, a series of theoretical analyses regarding Young's modulus, interface shear stress and tension stress for coatings are successfully deduced based on an assumption of interfacial constraints and homogeneous strain. Three equations are derived to determine the Young's modulus, interface shear strength and cohesion strength for coatings. A tension method is used to test the mechanical properties of coatings and presented in detail. It concludes that this method is relatively simple to perform, and allows for a reliable determination of interface shear strength and cohesion strength for coatings. A corresponding theoretical analysis is logical and reasonable. The magnitude of the Young's modulus, interface shear strength and cohesion strength for yttria stabilised zirconia coatings was about 171–189, 6–24 and 175–238 MPa respectively.
Maintenance of mouse hematopoietic stem cells ex vivo by reprogramming cellular metabolism
Authors: Liu Xia , Zheng Hong , Yu Wen-Mei , Cooper Todd M. , Bunting Kevin D. , Qu Cheng-Kui
Published: January 2015

Key Points

Treatment with alexidine dihydrochloride, a Ptpmt1 inhibitor, reprograms cellular metabolism and preserves long-term stem cells ex vivo. Inhibition of mitochondrial metabolism by metformin also decreases differentiation and helps maintain stem cells in culture.
Defective PDI release from platelets and endothelial cells impairs thrombus formation in Hermansky-Pudlak syndrome
Authors: Sharda Anish , Kim Sarah H. , Jasuja Reema , Gopal Srila , Flaumenhaft Robert , Furie Barbara C. , Furie Bruce
Published: January 2015

Key Points

Hermansky-Pudlak syndrome exhibits impaired granule exocytosis and PDI secretion that contribute to its associated bleeding disorder. Endothelial cells deficient in HPS6 show defective secretion of granules, including Weibel-Palade bodies.
Composite end point of graft-versus-host disease-free, relapse-free survival after allogeneic hematopoietic cell transplantation
Authors: Holtan Shernan G. , DeFor Todd E. , Lazaryan Aleksandr , Bejanyan Nelli , Arora Mukta , Brunstein Claudio G. , Blazar Bruce R. , MacMillan Margaret L. , Weisdorf Daniel J.
Published: January 2015

Key Points

GRFS is a new composite end point useful for comparing HCT techniques and represents ideal post-HCT recovery. In our cohort of 907 allogeneic HCT recipients, 1-year GRFS was 31%, with best outcomes in recipients of marrow from matched sibling donors.
A receptor like kinase gene with expressional responsiveness on Xanthomonas oryzae pv. oryzae is essential for Xa21-mediated disease resistance
Authors: Hu Haitao , Wang Jing , Shi Chan , Yuan Can , Peng Chunfang , Yin Junjie , Li Weitao , He Min , Wang Jichun , Ma Bintian , Wang Yuping , Li Shigui , Chen Xuewei
Published: January 2015

Background

Leucine-rich repeat receptor-like kinases (LRR-RLKs) represent a large class of proteins in regulating plant development and immunity. The LRR-RLK XA21 confers resistance to the bacterial disease caused by the pathogen ofXanthomonas oryzae pv. oryzae(Xoo). Several XA21 binding proteins have been characterized, however the early events governing XA21 signaling have not been fully elucidated.

Results

Here we report the identification of one LRR-RLK gene (XIK1) whose expression is induced rapidly upon the infection with the pathogen ofXoo. Expression pattern analysis reveals thatXIK1is preferentially expressed in reproductive leaves and panicles, and that expression is associated with plant development. By using RNA interference (RNAi), we silenced the expression ofXIK1in rice withXa21and found that reduced expression ofXIK1compromised disease resistance mediated by XA21. In addition, we found that the expression of the downstream marker genes of pathogen associated molecular pattern (PAMP) triggered immunity (PTI) in rice was compromised inXa21plants silenced forXIK1.

Conclusion

Our study reveals that the LRR-RLK geneXIK1isXoo-responsive and positively regulatesXa21-mediated disease resistance.
Coronary stent as a tubular flow heater in magnetic resonance imaging
Authors: Vrtnik Stanislav , Wencka Magdalena , Jelen Andreja , Kim Hae Jin , Dolinšek Janez
Published: January 2015

Background

A coronary stent is an artificial metallic tube, inserted into a blocked coronary artery to keep it open. In magnetic resonance imaging (MRI), a stented person is irradiated by the radio-frequency electromagnetic pulses, which induce eddy currents in the stent that produce Joule (resistive) heating. The stent in the vessel is acting like a tubular flow heater that increases the temperature of the vessel wall and the blood that flows through it, representing a potential hazard for the stented patient.

Methods

Heating of a metallic coronary stent in MRI was studied theoretically and experimentally. An analytical theoretical model of the stent as a tubular flow heater, based on the thermodynamic law of heat conduction, was developed. The model enables to calculate the time-dependent stent’s temperature during the MRI examination, the increase of the blood temperature passing through the stent and the distribution of the temperature in the vessel wall surrounding the stent. The model was tested experimentally by performing laboratory magnetic resonance heating experiments on a non-inserted stainless-steel coronary stent in the absence of blood flow through it. The model was then used to predict the temperature increase of the stainless-steel coronary stent embedded in a coronary artery in the presence of blood flow under realistic MRI conditions.

Results

The increase of the stent’s temperature and the blood temperature were found minute, of the order of several tenths of a degree, because the blood flow efficiently cools the stent due to a much larger heat capacity of the blood as compared to the heat capacity of the stent. However, should the stent in the vessel become partially re-occluded due to the restenosis problem, where the blood flow through the stent is reduced, the stent’s temperature may become dangerously high.

Conclusions

In the normal situation of a fully open (unoccluded) stent, the increase of the stent temperature and the blood temperature exiting the stent were found minute, of less than 1°C, so that the blood flow efficiently cools the stent. However, should the problem of restenosis occur, where the blood flow through the stent is reduced, there is a risk of hazardous heating.
Evaluation of sampling strategies to estimate crown biomass
Authors: Poudel Krishna P , Temesgen Hailemariam , Gray Andrew N
Published: January 2015

Background

Depending on tree and site characteristics crown biomass accounts for a significant portion of the total aboveground biomass in the tree. Crown biomass estimation is useful for different purposes including evaluating the economic feasibility of crown utilization for energy production or forest products, fuel load assessments and fire management strategies, and wildfire modeling. However, crown biomass is difficult to predict because of the variability within and among species and sites. Thus the allometric equations used for predicting crown biomass should be based on data collected with precise and unbiased sampling strategies. In this study, we evaluate the performance different sampling strategies to estimate crown biomass and to evaluate the effect of sample size in estimating crown biomass.

Methods

Using data collected from 20 destructively sampled trees, we evaluated 11 different sampling strategies using six evaluation statistics: bias, relative bias, root mean square error (RMSE), relative RMSE, amount of biomass sampled, and relative biomass sampled. We also evaluated the performance of the selected sampling strategies when different numbers of branches (3, 6, 9, and 12) are selected from each tree. Tree specific log linear model with branch diameter and branch length as covariates was used to obtain individual branch biomass.

Results

Compared to all other methods stratified sampling with probability proportional to size estimation technique produced better results when three or six branches per tree were sampled. However, the systematic sampling with ratio estimation technique was the best when at least nine branches per tree were sampled. Under the stratified sampling strategy, selecting unequal number of branches per stratum produced approximately similar results to simple random sampling, but it further decreased RMSE when information on branch diameter is used in the design and estimation phases.

Conclusions

Use of auxiliary information in design or estimation phase reduces the RMSE produced by a sampling strategy. However, this is attained by having to sample larger amount of biomass. Based on our finding we would recommend sampling nine branches per tree to be reasonably efficient and limit the amount of fieldwork.