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JNMA; Journal of the Nepal Medical... 2019Glucose meters are gaining popularity in monitoring of blood glucose at household levels and in health care set-ups due to their portability, affordability and...
INTRODUCTION
Glucose meters are gaining popularity in monitoring of blood glucose at household levels and in health care set-ups due to their portability, affordability and convenience of use over the laboratory based reference methods. Still they are not free of limitations. Operator's technique, extreme temperatures, humidity, patients' medication, hematocrit values can affect the reliability of glucose meter results. Hence, the accuracy of glucose meter has been the topic of concern since years. Therefore, present study aims to evaluate the analytical and clinical accuracy of glucose meter using International Organization for Standardization 15197 guideline.
METHODS
A community based descriptive cross-sectional study was conducted in Kapan, Kathmandu, Nepal in April 2018. Glucose levels were measured using glucose meter and reference laboratory method simultaneously among 203 adults ≥20 years, after an overnight fasting and two hours of ingestion of 75 grams glucose. Modified Bland-Altman plots were created by incorporating ISO 15197 guidelines to check the analytical accuracy and Park error grid was used to evaluate the clinical accuracy of the device.
RESULTS
Modified Bland-Altman plots showed>95% of the test results were beyond the acceptable analytical criteria of ISO 15197:2003 and 2013. Park Error Grid-Analysis showed 99% of the data within zones A and B of the consensus error grid.
CONCLUSIONS
Glucose meter readings were within clinically acceptable parameters despite discrepancies on analytical merit. Possible sources of interferences must be avoided during the measurement to minimize the disparities and the values should be interpreted with caution.
Topics: Adult; Aged; Aged, 80 and over; Blood Glucose; Blood Glucose Self-Monitoring; Cross-Sectional Studies; Female; Hematocrit; Humans; Humidity; Male; Middle Aged; Nepal; Reproducibility of Results; Temperature; Young Adult
PubMed: 31477942
DOI: 10.31729/jnma.4247 -
Journal of the American Heart... Dec 2021Background Knowledge gaps exist regarding the effect of time elapsed after stroke on the effectiveness of exercise training interventions, offering incomplete guidance...
Background Knowledge gaps exist regarding the effect of time elapsed after stroke on the effectiveness of exercise training interventions, offering incomplete guidance to clinicians. Methods and Results To determine the associations between time after stroke and 6-minute walk distance, 10-meter walk time, cardiorespiratory fitness and balance (Berg Balance Scale score [BBS]) in exercise training interventions, relevant studies in post-stroke populations were identified by systematic review. Time after stroke as continuous or dichotomized (≤3 months versus >3 months, and ≤6 months versus >6 months) variables and weighted mean differences in postintervention outcomes were examined in meta-regression analyses adjusted for study baseline mean values (pre-post comparisons) or baseline mean values and baseline control-intervention differences (controlled comparisons). Secondary models were adjusted additionally for mean age, sex, and aerobic exercise intensity, dose, and modality. We included 148 studies. Earlier exercise training initiation was associated with larger pre-post differences in mobility; studies initiated ≤3 months versus >3 months after stroke were associated with larger differences (weighted mean differences [95% confidence interval]) in 6-minute walk distance (36.3 meters; 95% CI, 14.2-58.5), comfortable 10-meter walk time (0.13 m/s; 95% CI, 0.06-0.19) and fast 10-meter walk time (0.16 m/s; 95% CI, 0.03-0.3), in fully adjusted models. Initiation ≤3 months versus >3 months was not associated with cardiorespiratory fitness but was associated with a higher but not clinically important Berg Balance Scale score difference (2.9 points; 95% CI, 0.41-5.5). In exercise training versus control studies, initiation ≤3 months was associated with a greater difference in only postintervention 6-minute walk distance (baseline-adjusted 27.3 meters; 95% CI, 6.1-48.5; fully adjusted, 24.9 meters; 95% CI, 0.82-49.1; a similar association was seen for ≤6 months versus >6 months after stroke (fully adjusted, 26.6 meters; 95% CI, 2.6-50.6). Conclusions There may be a clinically meaningful benefit to mobility outcomes when exercise is initiated within 3 months and up to 6 months after stroke.
Topics: Exercise Therapy; Humans; Regression Analysis; Stroke; Time-to-Treatment; Treatment Outcome
PubMed: 34913357
DOI: 10.1161/JAHA.121.022588 -
The Journal of Neuroscience : the... Jan 2022Predicting and organizing patterns of events is important for humans to survive in a dynamically changing world. The motor system has been proposed to be actively, and...
Predicting and organizing patterns of events is important for humans to survive in a dynamically changing world. The motor system has been proposed to be actively, and necessarily, engaged in not only the production but the perception of rhythm by organizing hierarchical timing that influences auditory responses. It is not yet well understood how the motor system interacts with the auditory system to perceive and maintain hierarchical structure in time. This study investigated the dynamic interaction between auditory and motor functional sources during the perception and imagination of musical meters. We pursued this using a novel method combining high-density EEG, EMG, and motion capture with independent component analysis to separate motor and auditory activity during meter imagery while robustly controlling against covert movement. We demonstrated that endogenous brain activity in both auditory and motor functional sources reflects the imagination of binary and ternary meters in the absence of corresponding acoustic cues or overt movement at the meter rate. We found clear evidence for hypothesized motor-to-auditory information flow at the beat rate in all conditions, suggesting a role for top-down influence of the motor system on auditory processing of beat-based rhythms, and reflecting an auditory-motor system with tight reciprocal informational coupling. These findings align with and further extend a set of motor hypotheses from beat perception to hierarchical meter imagination, adding supporting evidence to active engagement of the motor system in auditory processing, which may more broadly speak to the neural mechanisms of temporal processing in other human cognitive functions. Humans live in a world full of hierarchically structured temporal information, the accurate perception of which is essential for understanding speech and music. Music provides a window into the brain mechanisms of time perception, enabling us to examine how the brain groups musical beats into, for example a march or waltz. Using a novel paradigm combining measurement of electrical brain activity with data-driven analysis, this study directly investigates motor-auditory connectivity during meter imagination. Findings highlight the importance of the motor system in the active imagination of meter. This study sheds new light on a fundamental form of perception by demonstrating how auditory-motor interaction may support hierarchical timing processing, which may have clinical implications for speech and motor rehabilitation.
Topics: Acoustic Stimulation; Auditory Perception; Brain; Electroencephalography; Electromyography; Female; Humans; Imagination; Male; Muscle, Skeletal; Music; Periodicity; Time Perception; Young Adult
PubMed: 34848500
DOI: 10.1523/JNEUROSCI.1121-21.2021 -
JMIR Human Factors Jul 2019Despite many new therapies and technologies becoming available in the last decade, people with diabetes continue to struggle to achieve good glycemic control. Innovative...
Health Care Professionals' Clinical Perspectives and Acceptance of a Blood Glucose Meter and Mobile App Featuring a Dynamic Color Range Indicator and Blood Sugar Mentor: Online Evaluation in Seven Countries.
BACKGROUND
Despite many new therapies and technologies becoming available in the last decade, people with diabetes continue to struggle to achieve good glycemic control. Innovative and affordable solutions are needed to support health care professionals (HCPs) to improve patient outcomes.
OBJECTIVE
To gather current self-management perceptions of HCPs in seven countries and investigate HCP satisfaction with a new glucose meter and mobile app featuring a dynamic color range indicator and a blood sugar mentor.
METHODS
A total of 355 HCPs, including 142 endocrinologists (40.0%), 108 primary care physicians (30.4%), and 105 diabetes nurses (29.6%), were recruited from the United Kingdom (n=50), France (n=50), Germany (n=50), India (n=54), Algeria (50), Canada (n=51), and the United States (n=50). HCPs experienced the OneTouch Verio Reflect glucose meter and the OneTouch Reveal mobile app online from their own office computers using interactive demonstrations via webpages and multiple animations. After providing demographic and clinical practice insights, HCPs responded to statements about the utility of the system.
RESULTS
Concerning current practice, 83.1% (295/355) of HCPs agreed that poor numeracy or health literacy was a barrier for their patients. A total of 85.9% (305/355) and 92.1% (327/355) of HCPs responded that type 2 diabetes (T2D) and type 1 diabetes (T1D) patients were aware of what represented a low, in-range, or high blood glucose result. Only 62.0% (220/355) felt current glucose meters made it easy for patients to understand if results were in range. A total of 50.1% (178/355) and 78.0% (277/355) of HCPs were confident that T1D and T2D patients took action for low or high results. A total of 87.0% (309/355) agreed that the ColorSure Dynamic Range Indicator could help them teach patients how to interpret results and 88.7% (315/355) agreed it made them more aware of hyper- and hypoglycemic results so they could take action. A total of 83.7% (297/355) of HCPs agreed that the Blood Sugar Mentor feature gave personalized guidance, insight, and encouragement so patients could take action. A total of 82.8% (294/355) of HCPs also agreed that the Blood Sugar Mentor provided real-time guidance to reinforce the goals HCPs had set so patients could take steps to manage their diabetes between office visits. After experiencing the full system, 85.9% (305/355) of HCPs agreed it was beneficial for patients with lower numeracy or health literacy; 96.1% (341/355) agreed that it helped patients understand when results were low, in range, or high; and 91.0% (323/355) agreed that the way it displayed diabetes information would make patients more inclined to act upon results. A total of 89.0% (316/355) of HCPs agreed that it would be helpful for agreeing upon appropriate in-range goals for their patients for their next clinic visit.
CONCLUSIONS
This multi-country online study provides evidence that HCPs were highly satisfied with the OneTouch Verio Reflect meter and the OneTouch Reveal mobile app. Each of these use color-coded information and the Blood Sugar Mentor feature to assist patients with interpreting, analyzing, and acting upon their blood glucose results, which is particularly beneficial to keep patients on track between scheduled office visits.
PubMed: 31271146
DOI: 10.2196/13847 -
Psychological Research Apr 2023The ability to learn and reproduce sequences is fundamental to every-day life, and deficits in sequential learning are associated with developmental disorders such as...
The ability to learn and reproduce sequences is fundamental to every-day life, and deficits in sequential learning are associated with developmental disorders such as specific language impairment. Individual differences in sequential learning are usually investigated using the serial reaction time task (SRTT), wherein a participant responds to a series of regularly timed, seemingly random visual cues that in fact follow a repeating deterministic structure. Although manipulating inter-cue interval timing has been shown to adversely affect sequential learning, the role of metre (the patterning of salience across time) remains unexplored within the regularly timed, visual SRTT. The current experiment consists of an SRTT adapted to include task-irrelevant auditory rhythms conferring a sense of metre. We predicted that (1) participants' (n = 41) reaction times would reflect the auditory metric structure; (2) that disrupting the correspondence between the learned visual sequence and auditory metre would impede performance; and (3) that individual differences in sensitivity to rhythm would predict the magnitude of these effects. Altering the relationship via a phase shift between the trained visual sequence and auditory metre slowed reaction times. Sensitivity to rhythm was predictive of reaction times over all. In an exploratory analysis, we, moreover, found that approximately half of participants made systematically different responses to visual cues on the basis of the cues' position within the auditory metre. We demonstrate the influence of auditory temporal structures on visuomotor sequential learning in a widely used task where metre and timing are rarely considered. The current results indicate sensitivity to metre as a possible latent factor underpinning individual differences in SRTT performance.
Topics: Humans; Psychomotor Performance; Learning; Reaction Time; Task Performance and Analysis; Cues; Serial Learning
PubMed: 35690927
DOI: 10.1007/s00426-022-01690-y -
Journal of Diabetes Science and... Nov 2017Patients with diabetes rely on blood glucose (BG) monitoring devices to manage their condition. As some self-monitoring devices are becoming more and more accurate, it...
BACKGROUND
Patients with diabetes rely on blood glucose (BG) monitoring devices to manage their condition. As some self-monitoring devices are becoming more and more accurate, it becomes critical to understand the relationship between system accuracy and clinical outcomes, and the potential benefits of analytical accuracy.
METHODS
We conducted a 30-day in-silico study in type 1 diabetes mellitus (T1DM) patients using continuous subcutaneous insulin infusion (CSII) therapy and a variety of BG meters, using the FDA-approved University of Virginia (UVA)/Padova Type 1 Simulator. We used simulated meter models derived from the published characteristics of 43 commercial meters. By controlling random events in each parallel run, we isolated the differences in clinical performance that are directly associated with the meter characteristics.
RESULTS
A meter's systematic bias has a significant and inverse effect on HbA1c ( P < .01), while also affecting the number of severe hypoglycemia events. On the other hand, error, defined as the fraction of measurements beyond 5% of the true value, is a predictor of severe hypoglycemia events ( P < .01), but in the absence of bias has a nonsignificant effect on average glycemia (HbA1c). Both bias and error have significant effects on total daily insulin (TDI) and the number of necessary glucose measurements per day ( P < .01). Furthermore, these relationships can be accurately modeled using linear regression on meter bias and error.
CONCLUSIONS
Two components of meter accuracy, bias and error, clearly affect clinical outcomes. While error has little effect on HbA1c, it tends to increase episodes of severe hypoglycemia. Meter bias has significant effects on all considered metrics: a positive systemic bias will reduce HbA1c, but increase the number of severe hypoglycemia attacks, TDI use, and number of fingersticks per day.
Topics: Biomarkers; Blood Glucose; Blood Glucose Self-Monitoring; Computer Simulation; Diabetes Mellitus, Type 1; Equipment Design; Glycated Hemoglobin; Humans; Hypoglycemia; Hypoglycemic Agents; Infusions, Subcutaneous; Insulin; Insulin Infusion Systems; Linear Models; Models, Biological; Predictive Value of Tests; Reproducibility of Results; Signal Processing, Computer-Assisted; Transducers; Treatment Outcome
PubMed: 28569076
DOI: 10.1177/1932296817710474 -
Journal of Diabetes Science and... Mar 2015Hypoglycemia in infants is common, is difficult to recognize, and may lead to permanent neurologic impairment. Low glucose concentrations and high hematocrits in...
Hypoglycemia in infants is common, is difficult to recognize, and may lead to permanent neurologic impairment. Low glucose concentrations and high hematocrits in newborns pose significant analytic challenges for whole blood glucose meters. Three Bayer glucose monitoring systems were evaluated using 211 blood samples from 162 neonates (age range 5 hours to 29 days, median age 3 days). Hematocrit and whole blood glucose were determined in heparinized whole blood, and plasma glucose was determined using the Roche Cobas 6000. Accuracy was evaluated against plasma concentrations using ISO 15197:2013 and CLSI POCT 12-A3 criteria. Glucose imprecision on the Cobas system was 1.8-2.6% (CV) from 26-610 mg/dL. Imprecision across all meter systems was 2.8% (CV) at 130 mg/dL. Glucose concentrations, hematocrit, and total bilirubin ranged from 20-150 mg/dL, 18 -75%, and 0.5-19.6 mg/dL, respectively. Linear regression analysis of whole blood versus plasma for the 3 combined systems yielded an average slope of 1.06 and correlation coefficient greater than 0.980. Bias between the Contour and Cobas was not significantly correlated with hematocrit. Greater than 99% of meter results were within 15 mg/dL and 20% of plasma results at glucose concentrations ≤ 75 and > 75 mg/dL, respectively. Of meter results, 97% were within 12.5 mg/dL of plasma results at concentrations ≤ 100 mg/dL, while 96% of meter results were within 12.5% of plasma at concentrations > 100 mg/dL. The Bayer CONTOUR Blood Glucose Monitoring Systems exceed ISO 15197:2013 and CLSI criteria in neonatal blood samples.
Topics: Blood Glucose; Female; Humans; Infant, Newborn; Male; Monitoring, Physiologic; Point-of-Care Systems
PubMed: 25377056
DOI: 10.1177/1932296814557669 -
Journal of Sports Science & Medicine Jun 2018To validate the new PowerTap P1 pedals power meter (PP1), thirty-three cyclists performed 12 randomized and counterbalanced graded exercise tests (100-500 W), at 70, 85...
To validate the new PowerTap P1 pedals power meter (PP1), thirty-three cyclists performed 12 randomized and counterbalanced graded exercise tests (100-500 W), at 70, 85 and 100 rev·min cadences, in seated and standing positions. A scientific SRM system and a pair of PP1 pedals continuously recorded cadence and power output data. Significantly lower power output values were detected for the PP1 compared to the SRM for all workloads, cadences, and pedalling conditions (2-10 W, p < 0.05), except for the workloads ranged between 150 W to 350 W at 70 rev·min in seated position (p > 0.05). Strong Spearman's correlation coefficients were found between the power output values recorded by both power meters in a seated position, independently from the cadence condition (rho ≥ 0.987), although slightly lower concordance was found for the standing position (rho = 0.927). The mean error for power output values were 1.2%, 2.7%, 3.5% for 70, 85 and 100 rev·min, respectively. Bland-Altman analysis revealed that PP1 pedals underestimate the power output data obtained by the SRM device in a directly proportional manner to the cyclist's cadence (from -2.4 W to -7.3 W, rho = 0.999). High absolute reliability values were detected in the PP1 pedals (150-500 W; CV = 2.3%; SEM < 1.0 W). This new portable power meter is a valid and reliable device to measure power output in cyclists and triathletes for the assessment, training and competition using their own bicycle, although caution should be exercised in the interpretation of the results due to the slight power output underestimation of the PP1 pedals when compared to the SRM system and its dependence on both pedalling cadence and cyclist's position (standing vs. seated).
Topics: Adult; Bicycling; Cross-Sectional Studies; Exercise Test; Humans; Male; Muscle Strength; Reproducibility of Results; Sitting Position; Standing Position; Workload; Young Adult
PubMed: 29769832
DOI: No ID Found -
Frontiers in Plant Science 2022To solve multiple problems, such as the poor seeding process stability in the conventional finger-clip precision corn seed metering device and the inability to monitor...
To solve multiple problems, such as the poor seeding process stability in the conventional finger-clip precision corn seed metering device and the inability to monitor the seeding effect, a long-belt finger-clip precision seed metering device was optimized and designed. The overall structure and working principle were described, and the mechanism of smooth transport and delivery was analyzed. A diffuse reflection photoelectric sensor and rectangular optical fiber sensor were used to monitor the number of corn seeds in the seeding process, and the states of multiple and miss seeding were calculated. A corn seeding quality monitoring system was designed. In this study, the seed metering performance of the long-belt finger-clip precision seed metering device was compared to that of the conventional finger-clip precision corn seed metering device. It was shown that the reseeding index, the miss-seeding index and the coefficient of variation can be effectively reduced with increasing seed metering tray speed. At the maximum speed of 65r/min, the qualified index increased from 75.75 to 84.70%, the reseeding index decreased from 13.66 to 8.49%, the miss-seeding index decreased from 10.59 to 6.81%, and the coefficient of variation decreased from 20.69 to 6.83%. The variations of these four evaluation parameters with the seed metering tray rotating speed were analyzed. Furthermore, the effects of the seeding frequency and seeding speed on the four evaluation parameters were studied through single factor and variance analyses. The results showed that the relative errors of the qualified index, the reseeding index, the miss-seeding index and the seeding amount increased gradually with the increase in the seed metering tray rotating speed, and the monitoring accuracy of the sensor decreased gradually. The accuracy of sensor monitoring decreased with increasing seeding frequency and seeding speed. This study provides an optimized scheme for the smooth delivery and movement of conventional seed metering devices and provides a technical reference for the development and design of monitoring systems with multiple index and the miss-seeding index of seed metering devices.
PubMed: 35154226
DOI: 10.3389/fpls.2022.814747 -
Sensors (Basel, Switzerland) May 2024Dissolved Oxygen (DO) in water enables marine life. Measuring the prevalence of DO in a body of water is an important part of sustainability efforts because low oxygen...
Dissolved Oxygen (DO) in water enables marine life. Measuring the prevalence of DO in a body of water is an important part of sustainability efforts because low oxygen levels are a primary indicator of contamination and distress in bodies of water. Therefore, aquariums and aquaculture of all types are in need of near real-time dissolved oxygen monitoring and spend a lot of money on purchasing and maintaining DO meters that are either expensive, inefficient, or manually operated-in which case they also need to ensure that manual readings are taken frequently which is time consuming. Hence a cost-effective and sustainable automated Internet of Things (IoT) system for this task is necessary and long overdue. DOxy, is such an IoT system under research and development at Santa Clara University's Ethical, Pragmatic, and Intelligent Computing (EPIC) Laboratory which utilizes cost-effective, accessible, and sustainable Sensing Units (SUs) for measuring the dissolved oxygen levels present in bodies of water which send their readings to a web based cloud infrastructure for storage, analysis, and visualization. DOxy's SUs are equipped with a High-sensitivity Pulse Oximeter meant for measuring dissolved oxygen levels in human blood, not water. Hence a number of parallel readings of water samples were gathered by both the High-sensitivity Pulse Oximeter and a standard dissolved oxygen meter. Then, two approaches for relating the readings were investigated. In the first, various machine learning models were trained and tested to produce a dynamic mapping of sensor readings to actual DO values. In the second, curve-fitting models were used to produce a successful conversion formula usable in the DOxy SUs offline. Both proved successful in producing accurate results.
PubMed: 38794107
DOI: 10.3390/s24103253