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Implementation Strategies for Inpatient Continuous Glucose Monitoring-based Diabetes Management: A Systematic Review
Get PDFIntroductionContinuous glucose monitoring (CGM) provides real-time glucose data that has revolutionised outpatient diabetes care; however, its impact on inpatient care remains limited, likely due to the lack of standardised CGM-based insulin titration protocols, implementation strategies, and proper familiarity with the technology among others.MethodsA systematic literature search was conducted on October 15, 2024, using PubMed and Embase, without a restriction on publication date. The search focused on CGM-based insulin titration protocols and related implementation strategies in non-intensive care unit (non-ICU) settings. This systematic review was registered with PROSPERO (RD42024596819).ResultsA total of 7,625 references were screened. Nine protocols for inpatient CGM-based insulin titration and related implementation strategies were identified. Six protocols recommended a weight-based basal-bolus insulin regimen. Insulin titration on basal and bolus insulin was mostly done daily based on either clinical discretion or clearly defined insulin titration protocols. All protocols employed a hybrid approach, utilising both CGM and finger prick glucose testing to guide glucose management. Diabetes-trained staff oversaw CGM-based insulin titration and glucose management in five protocols. CGM-alarm settings varied widely, with hyperglycaemic alarm thresholds between >13.9 and >22.2 mmol/l, and hypoglycaemia alarm thresholds between <3.9 and <5.0 mmol/l.ConclusionWe observed considerable variation in the detail and clarity provided by the reviewed protocols. This highlights the need for standardised operational protocols for CGM-based insulin titration and related implementation strategies to implement CGM effectively in non-ICU settings
Navigating ‘the bumpy road’ from research to practice: improving the impact of research on spatial reasoning practice with young children
Get PDFEnsuring that knowledge generated through research has an impact on early childhood education practice is a familiar and complex challenge. This article reports on an attempt to bridge the research-practice divide in one area of mathematics, early spatial reasoning, through the development of a practitioner toolkit to aid professional learning. The approach was to research practitioner perspectives on what is needed to support practice in this important and often under-recognised area of mathematics. We conducted two questionnaires and three rounds of focus groups across three design cycles where the toolkit was expanded and adapted based on their feedback. Analysis of the data indicates that practitioners in England desire support in all areas of spatial reasoning, having received little or no training previously, and that multiple professional learning resources are required for a diverse sector. We argue that research dissemination, which is inclusive of the breadth of the early education sector, should provide age-range specific, accessible, practice-focussed, multi-modal resources
An extensive analysis of the utilisation of phase change materials in food storage process
Get PDFWith improving living standards, the demand for high-quality food is escalating. Conventional food storage methods often entail issues such as limitations in sustaining food quality and related energy wastage. The utilisation of PCMs in the food storage sector offers a means to achieve energy conservation whilst preserving food quality due to the inherent benefits of PCMs. This article presents a literature review on the application of PCMs in food storage, primarily focusing on drying and refrigeration techniques. The first part of this study summarises the utilisation of PCMs in food storage industry, conducting data analysis to uncover their developmental trends. The utilisation of PCMs in the domains of drying and cooling holds the capability to effectively diminish temperature fluctuations by (7.5/8 °C), enhance storage efficiency by (43.42/11.5 %), curtail energy consumption by (33/39 %), and uphold the physical, chemical, and nutritional content of food. Paraffin wax stands out as the prevalent PCM, and the phase change temperature predominantly falls within the range of 40–60 °C (46.57 %). Furthermore, there exists a research gap in the combined utilisation of different PCMs and the deployment of single/multi-function PCM refrigeration systems. This article offers insights into future research directions concerning PCM applications in the realm of food storage
Congruency between viewers’ movements and the region of the display being sampled speeds up search through an aperture
Get PDFSearching for a target amongst distractors is faster when moving an aperture over the search display than when moving the search display beneath an aperture. Is this because when moving the aperture, each item is sampled at a different position, while when moving the search display, all items are sampled at the same position? When moving the aperture, it might therefore be easier to keep track of where one has already searched. Experiment 1 showed that, when the extent of the search display is visible to provide an additional reference frame, participants still found targets faster when moving the aperture. Experiment 2 showed that, even when the aperture and search display constantly moved around the screen together so that remembering where on the screen one had already searched is less useful, participants still found targets faster when moving the aperture. Experiment 3 showed that inverting the mapping between movements of the mouse and the item they were toggled to reversed the outcome: for the inverted mapping, search was faster when moving the search display than when moving the aperture. We conclude that the congruency between the user's movements and the spatial region of the search display that they are sampling from is critical for speeding up search
Enhancing radiative sky cooling performance by employing crossed compound parabolic concentrating configurations
Get PDFAchieving superior radiative sky cooling (RC) performance in practical applications is challenging due to its cooling power is easily compromised by unwanted thermal energy influxes, including solar heat gain and thermal radiation from nearby warm objects. To address this issue, the present work introduces the integration of affiliated crossed compound parabolic concentrators (CPC) as a means to effectively mitigate this thermal burden. Through the development of a comprehensive mathematical framework that characterizes the heat exchange between the RC emitter and different environmental heat sources, the cooling performance of the novel crossed CPC-RC module is evaluated and compared with other RC configurations. The results show that due to its excellent capability to shield unfavourable heat inflows from large zenith angles, the crossed CPC-RC module shows the potential to reach a cooling power density of 99.50 W/m2 at noon, outperforming the flat-RC and 2D CPC-RC modules by 5.1% and 41.7%, respectively. Furthermore, key parameters optimization and the cooling performance assessment throughout a typical summer day is carried out to demonstrate the superiority of the crossed CPC structure in boosting cooling capacity, particularly the cooling benefits throughout the day, thereby offering a promising solution to better align with the cooling demands of buildings
Novel Use of Manganese Gluconate as a Marker for Visualization of Tablet Dissolution in the Fed Human Stomach Using Magnetic Resonance Imaging
Get PDFMagnetic resonance imaging (MRI) of dry or solid materials in the gastrointestinal (GI) tract requires the use of contrast agents to enhance visualisation of the dosage forms. In this study, we explore the novel use of manganese gluconate added to tablets. Manganese was released during tablet dissolution, generating a bright ‘halo’ effect around the tablets, consistent with shortening of the longitudinal relaxation time of the bulk water surrounding the tablet. This is the first study to use MRI to directly image tablet dissolution in the fed stomach using a manganese gluconate contrast agent as dissolution marker
Oral Hyoscine butylbromide exerts spasmolytic effects both in gastrointestinal and urogenital tissues in rats
Get PDFBackground and Purpose: Hyoscine butylbromide (HBB) has a low oral (PO) bioavailability. Further, limited data on its activity on non-gastrointestinal (GI) smooth muscle spasms after oral dosing are available, meaning its effect outside the GI tract has been questioned. This pharmacokinetic/pharmacodynamic (PK/PD) study, conducted using female rats, aims to cover this gap. Experimental Approach: PK study: HBB and atropine (comparator) were administered PO and IV to rats, and concentrations in plasma, and colon, uterus and urinary bladder (CUB) were measured. PD study-1: Concentration–response (C-R) curves of HBB and atropine (10−9–10−4 M) were obtained for carbachol (CCH)-induced (10−5 M) pre-contracted CUB; PD study-2: CUB were pre-incubated with HBB and atropine at maximum concentrations (Cmax) from PK study, and CCH C-R curves (10−9–10−4 M) were obtained; PD study-3: HBB and atropine were administered PO and IV to rats as for PK study, CUB were collected at 0.5 h (IV) and 4 h (PO), and CCH C-R curves (10−9–10−4 M) were obtained.Key Results: PO HBB showed higher Cmax in CUB (192.5, 3.70 and 1.85 ng∙g−1, respectively) than plasma (0.008 ng∙mL−1). HBB and atropine reduced (concentration dependently) CCH-induced contractions in CUB. PO HBB showed highest spasmolytic activity in colon (40%), followed by uterus (30%) and urinary bladder (10%).Conclusion and Implications: This is the first comparative study investigating PO and IV HBB and atropine in GI and non-GI tissues. Despite low bioavailability, PO HBB accumulates and exerts spasmolytic effects outside the GI tract
Recent Advances in Non-Isolated DC/DC Converter Topologies: A Review and Future Perspectives
Get PDFContinuous advancements in power conversion techniques address the growing need for efficiency and adaptability in contemporary energy applications, including e-mobility, renewable energy, and energy storage systems. This work presents a review grounded in the fundamental topologies of power converters and subsequently analyzes their modern modifications and technological advances. Traditional structures such as Buck, Boost, Ćuk, and flyback converters remain effective solutions for voltage and current regulation; however, they exhibit limitations when extremely high voltage conversion ratios are required. These constraints have motivated the emergence of more sophisticated architectures capable of overcoming such challenges. In this context, the paper provides a novel characterization and comparative analysis of quadratic and bidirectional converter topologies, emphasizing their capability to efficiently achieve both high and low conversion ratios while minimizing component stress and avoiding extreme load cycles. Quadratic converters demonstrate high performance in nonlinear systems with significant energy demands, whereas bidirectional converters enhance energy management in applications requiring bidirectional power flow, such as electric vehicles and energy storage systems
Algorithmic processing and AI bias; using overfitting to reveal rather than perpetuate existing bias
No full textIn this paper we analyse AI overfitting in algorithmic processing to show how it relates to cases of unfairness or AI bias and how it combines with complex social phenomena such as looping effects to maintain and exacerbate existing bias. We discuss existing and proposed AI regulation attempting to address this bias to pick up dominant trends and priorities. Finally, we suggest that, although the focus of the literature currently falls on the negative consequences of overfitting, it can be used as a diagnostic tool for detecting underlying social inequalities and, as such, lead to alternative uses of AI analytics to expose social injustice rather than exacerbate it. This paper provides further theoretical support to recent views in the literature suggesting that algorithmic processing can be used to diagnose and monitor bias; by highlighting the interaction with looping effects, it also provides additional motivation to use overfitting as a first step towards mitigation of historical prejudice
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