1,720,956 research outputs found
Freestyle Libre trend arrows for the management of adults with insulin-treated diabetes: A practical approach
No full textFreestyle Libre (FSL) system is a new method to detect glucose enabling a new paradigm in glucose monitoring and self-management. The sensor, reading the interstitial fluid glucose concentration, provides a numerical data of glucose level and a trend arrow that add context to static measurement of glucose level. Therefore, patients could easily follow the progression of their glucose levels over the time, allowing early detection and timely treatment of deviations from targeted glucose level range, thus preventing extreme fluctuations. In order to take full advantage of the system both the caregiver and the person with diabetes must appreciate the need of careful interpretation of the data generated by the FSL. To this purpose we have generated recommendations that are based on methods suggested for CGM, our clinical experience and discussion with experienced patients using FSL, to provide a pragmatic approach to use FSL trend arrow data for managing diabetes in adults
Type 1 diabetes and COVID-19: the "Lockdown effect"
No full textAims: The aim of this study was to evaluate the effect the lockdown imposed during COVID-19 outbreak on the glycemic control of people with Type 1 diabetes (T1D) using Con- tinuous (CGM) or Flash Glucose Monitoring (FGM).
Materials and methods: We retrospectively analyzed glucose reading obtained by FGM or CGM in T1D subjects. Sensor data from 2 weeks before the lockdown (Period 0, P0), 2 weeks immediately after the lockdown (period 1, P1), in mid-lockdown (Period 2, P2) and immedi- ately after end of lockdown (Period 3, P3) were analyzed.
Results: The study included 63 T1D patients, (FGM: 52, 82%; CGM:11, 18%). Sensor use (91%) were slightly reduced. Despite this reduction, Time in Range increased in P1 (62%), P2 (61%) and P3 (62%) as compared to P0 (58%, all p < 0.05 or less) with concomitant reduction in the Time Above Range (P0: 38%; P1: 34%, P2: 34%, P3: 32%, all p < 0.05 or less vs. P0). Average glu- cose and GMI improved achieving statistical difference in P3 (165 vs. 158 mg/dl, p = 0.040 and 7.2% (55 mmol/mol) vs. 7.0% (53 mmol/mol), p = 0.016) compared to P0. Time Below Range (TBR) and overall glucose variability remained unchanged. Bi-hourly analysis of glu- cose profile showed an improvement particularly in the early morning hours.
Conclusions: In T1D subjects with good glycemic control on CGM or FGM, the lockdown had no negative impact. Rather a modest but significant improvement in glycemic control has been recorded, most likely reflecting more regular daily life activities and reduces work- related distress
Efficacia e sicurezza a lungo termine del sistema di monitoraggio continuo del glucosio interstiziale a rilevazione intermittente: esperienza in real-life
No full textIl recente sviluppo di dispositivi tecnologici innovativi per la gestione del diabete offre nuove possibilità ai pazienti e al team di cura per migliorare sia il controllo glicemico che la qualità della vita. Il monitoraggio continuo del glucosio interstiziale a rilevazione intermittente (o Flash Glucose Monitoring – FGM) offre un’opportunità di monitoraggio glicemico meno invasiva rispetto al glucometro tradizionale (SMBG). Recenti studi controllati evidenziano come, l’impiego di questi strumenti, possa avere benefici sul controllo glicemico e sulla frequenza di ipoglicemie. Modeste sono però le esperienze sull’impatto di questa metodologia e dei nuovi parametri metabolici ad essa associata nel setting clinico.
Il ricorso a questo tipo di monitoraggio è in costante aumento nel nostro paese e nei paesi industrializzati. Scopo di questa tesi è stato quello di valutare il grado di diffusione e gradimento dell’FGM, la sicurezza del sistema, i benefici metabolici di tale forma di monitoraggio, eventuali ripercussioni sull’evoluzione delle complicanze d’organo nei pazienti diabetici sia di tipo 1 (DMT1) che di tipo 2 (DMT2) insulino-trattati. In questo studio retrospettivo longitudinale sono stati esaminati i dati glico-metabolici di 656 pazienti affetti da DMT1 (85%) o DMT2 insulino-trattati (15%) (rapporto M/F:1/1, età media 47±15 anni, durata del diabete 20,5 ± 13,0 anni, MDI 83%, CSII 17%, BMI 26.1±5.1 Kg/m2, dosaggio insulinico giornaliero 46±22 UI/die) seguiti presso gli ambulatori dell’U.O. Malattie Metaboliche e Diabetologia dell’Azienda Ospedaliero-Universitaria Pisana, e avviati al sistema FGM nell’arco di 30 mesi, dal Gennaio 2017 al Luglio 2019. Il 42% era affetto da vari gradi di retinopatia diabetica, il 22% da neuropatia diabetica, il 23% da vari gradi di nefropatia diabetica, il 17% da malattie cardiovascolari.
I risultati del nostro studio mostrano una larga diffusione di questo tipo di monitoraggio ed un’alta percentuale di gradimento (tasso di ri-prescrizione >97%). Solo il 3.6% dei pazienti infatti ha smesso di utilizzare il sistema e solo ¼ di questi perché non ritenevano il sistema affidabile. I dati raccolti mostrano che l’FGM è in grado di migliorare precocemente il controllo glicemico dei pazienti (da 7.9±1.3% a 7.6±1.0% con una riduzione media di 0.3±1.1% nei primi 6 mesi di follow up; p<0.0001) ed in maniera duratura (fino a 24 mesi). È stato inoltre registrato un aumento significativo dei pazienti con valori di HbA1c a target (≤7%). Tale aumento è risultato in costante crescita durante tutto il periodo di follow up passando da 27.3% al basale a 41.8% a 24 mesi (p=0.005). Abbiamo inoltre registrato una minore incidenza di ipoglicemie severe e chetoacidosi per tutto il periodo di follow up (p<0.0001). Non abbiamo invece riscontrato differenze per quanto concerne il BMI o il dosaggio insulinico giornaliero. L’analisi del profilo glicemico ambulatoriale (AGP) ha permesso di individuare una tendenza, seppur non significativa, all’aumento del tempo trascorso in target e una riduzione del tempo trascorso sotto il target. Inoltre è stata osservata a 6 mesi una relazione inversa tra numero di scansioni ed HbA1c (R=0.243; p=0.0032); eHbA1c (R=0.166; p=0.03), media glicemica giornaliera (R=0.161; p=0.04); tempo medio trascorso in ipoglicemia (R=0.190; p=0.01) e variabilità glicemia (R=0.308; p<0.0001). Una correlazione diretta con il numero di scansioni giornaliere si riscontrava per il TIR (R=0.181; p=0.02). Sulla base dei nostri dati , possiamo affermare che il monitoraggio continuo del glucosio interstiziale a rilevazione intermittente è sicuro (non aumenta il rischio di ipoglicemie severe né di chetoacidosi), efficace (riduzione precoce e duratura dell’HbA1c) e rappresenta una valida alternativa al monitoraggio glicemico su sangue capillare mediante sticks. Come per tutti gli altri dispositivi a tecnologia sofisticata, è fondamentale una adeguata formazione del paziente alla corretta interpretazione e utilizzazione del dato ottenuto dal sistema di monitoraggio al fine di ottimizzare il controllo glico-metabolico
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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