A Convenient Method for Measuring Blood Ascorbate Concentrations in Patients Receiving High-Dose Intravenous Ascorbate

Objective: A simple method of using fingerstick blood glucose (FSBG) monitors to estimate blood ascorbate values after high-dose intravenous (IV) ascorbate infusion is evaluated as a substitution for high-performance liquid chromatography (HPLC) measurement.

Methods: In 33 participants, readings from FSBG monitors were taken before and after IV ascorbate infusions at various time points, with the postinfusion FSBG readings subtracted from the baseline glucose readings. The results of the subtractions (AA_FSBG) were correlated with ascorbate concentrations detected by HPLC (AA_HPLC).

Results: A linear regression was found between ascorbate concentrations detected by the fingerstick method (AA_FSBG) and by HPLC (AA_HPLC). The linear correlations were identical in healthy subjects, diabetic subjects, and cancer patients. Analysis of variance obtained an AA_FSBG/AA_HPLC ratio of 0.90, with a 90% confidence interval of (0.69, 1.20). The corrections of AA_FSBG improved similarity to AA_HPLC but did not significantly differ from the uncorrected values.

Conclusion: The FSBG method can be used as an approximate estimation of high blood ascorbate concentration after IV ascorbate (>50 mg/dL, or 2.8 mM) without correction. However, this measurement is not accurate in detecting lower or baseline blood ascorbate. It is also important to highlight that in regard to glucose monitoring, FSBG readings will be erroneously elevated following IV ascorbate use and insulin should not be administered to patients based on these readings.     

B／S模式下动态心电系统开单及检查结果的设计与实现

介绍了动态心电系统的设计方案，以MYSQL为后台数据库，前台开发语言C#，电子开单、查询图文报告采用ASP．Net技术，突破了心电设备本身的限制，实现了临床业务的简便化、快捷化。     

基于移动通讯技术的新型院外远程实时心电监测系统的临床研究

目的 评价一种自主研发的基于移动通讯技术的新型院外远程实时心电监测系统数据传输的实时性及对心律失常检测的敏感性.方法 通过测定心电信号传输的延时评估系统的实时性;通过与动态心电图对比评估远程监测对心律失常检测的敏感性.结果 远程监测时心电数据传输的最短延时为9s,最长延时为17s,平均延时为（13.4±4.5）s.在100例受试者中,远程监测和动态心电图分别检测到偶发房性期前收缩62例、57例,频发房性期前收缩22例、25例,心房颤动均为9例,非阵发性室性心动过速16例、12例,差异均无统计学意义（均P ＞0.05）.同时均发现二度Ⅱ型房室传导阻滞5例、三度房室传导阻滞2例.结论 该系统有较好的实时性,对心律失常检出的敏感性与动态心电图相仿.     

Using technology to advance type 1 diabetes care among women during the reproductive years and in pregnancy

The prevalence of diabetes is increasing globally. Technology to improve care among individuals with diabetes is constantly being developed. Women living with Type 1 Diabetes Mellitus (T1DM) have unique challenges affecting their glucose control relating to menstrual cycles, pregnancy, and menopause. The purpose of this review is to examine the literature related to the use of technology to help women with T1DM manage their diabetes during the reproductive years, pregnancy, and beyond. Continuous subcutaneous insulin infusion (CSII) therapy can provider equivalent or better glucose control when compared with multiple daily injections (MDI), with less hypoglycemia, diabetic ketoacidosis, and weight gain. The CSII therapy has features that could help improve glucose control over the menstrual cycle, menopause, and pregnancy, although the most studied of these stages is pregnancy. Continuous glucose monitoring (CGM) can be combined with any insulin delivery system (MDI or CSII) to provide data on glucose values every few minutes and show glucose trends over time. CGM introduction can highlight glucose variability for women with T1DM, may be beneficial during pregnancy, and can reduce hypoglycemia. Sensor-augmented pump therapy and hybrid artificial pancreas (closed-loop) systems are promising tools that improve outcomes among individuals with diabetes. The use of modern technology to improve glucose and metabolic control among menopausal women with diabetes has not been well studied. Internet and phone-based technologies are emerging as important tools that may help with diabetes self-care for women living with diabetes.     

Validity,potential clinical utility and comparison of a consumer activity tracker and a research‐grade activity tracker in insomnia disorder II: Outside the laboratory

Accurate assessment of sleep can be fundamental for monitoring, managing and evaluating treatment outcomes within diseases. A proliferation of consumer activity trackers gives easy access to objective sleep. We evaluated the performance of a commercial device (Fitbit Alta HR) relative to a research‐grade actigraph (Actiwatch Spectrum Pro) in measuring sleep before and after a cognitive behavioural intervention in insomnia disorder. Twenty‐five individuals with DSM‐5 insomnia disorder (M = 50.6 ± 15.9 years) wore Fitbit and Actiwatch and completed a sleep diary during an in‐laboratory polysomnogram, and for 1 week preceding and following seven weekly sessions of cognitive‐behavioural intervention for insomnia. Device performance was compared for sleep outcomes (total sleep time, sleep latency, sleep efficiency and wake after sleep onset). The analyses assessed (a) agreement between devices across days and pre‐ to post‐treatment, and (b) whether pre‐ to post‐treatment changes in sleep assessed by devices correlated with clinical measures of change. Devices generally did not significantly differ from each other on sleep variable estimates, either night to night, in response to sleep manipulation (pre‐ to post‐treatment) or in response to changes in environment (in the laboratory versus at home). Change in sleep measures across time from each device showed some correlation with common clinical measures of change in insomnia, but not insomnia diagnosis as a categorical variable. Overall, the Fitbit provides similar estimates of sleep outside the laboratory to a research grade actigraph. Despite the similarity between Fitbit and Actiwatch performance, the use of consumer technology is still in its infancy and caution should be taken in its interpretation.     

Totally Implantable Wireless Ultrasonic Doppler Blood Flowmeters: Toward Accurate Miniaturized Chronic Monitors

Totally implantable wireless ultrasonic blood flowmeters provide direct-access chronic vessel monitoring in hard-to-reach places without using wired bedside monitors or imaging equipment. Although wireless implantable Doppler devices are accurate for most applications, device size and implant lifetime remain vastly underdeveloped. We review past and current approaches to miniaturization and implant lifetime extension for wireless implantable Doppler devices and propose approaches to reduce device size and maximize implant lifetime for the next generation of devices. Additionally, we review current and past approaches to accurate blood flow measurements. This review points toward relying on increased levels of monolithic customization and integration to reduce size. Meanwhile, recommendations to maximize implant lifetime should include alternative sources of power, such as transcutaneous wireless power, that stand to extend lifetime indefinitely. Coupling together the results will pave the way for ultra-miniaturized totally implantable wireless blood flow monitors for truly chronic implantation.     

压力波形联合回流液相双指征监测法定位硬膜外麻醉的临床应用

背景 硬膜外穿刺技术临床上广泛用于颈部、胸腹部、下肢手术的麻醉与疼痛治疗.现行传统硬膜外麻醉操作为一种盲探性穿刺置管技术,单独依靠操作者的感觉和经验及简单的试验方法评判麻醉成功与否,难以做到精确可控,而麻醉状态无客观指征监测,麻醉失败原因常无法得知.目的 为改进现行盲探方法,探求硬膜外麻醉的可视化指征的可行性.内容 自2006年以来,经不断深入研究,以“压力波形联合回流液相双指征法”用于辅助硬膜外麻醉,达到了可视化指征,辅助硬膜外麻醉定位与监测,效果理想.至今已在临床成功应用万例以上(内蒙古医学院附属医院完成硬膜外麻醉1万余例/年,约占麻醉总例数的50％).趋向 目前此项技术已常规应用于临床并加以推广,现予以介绍,以期建立新型硬膜外麻醉操作流程,从而使麻醉全程达到严谨、规范、安全、可靠,进一步提高硬膜外麻醉的安全有效性.     

StepWatch accuracy during walking,running, and intermittent activities

IntroductionThe purpose of this study was two-fold: 1) to investigate effects of cadence and sensitivity settings for the StepWatch (SW3) on step count accuracy over a wide range of ambulatory speeds, and 2) to compare the preprogrammed “quick start” settings to modified settings during intermittent lifestyle activities.MethodsPart 1: Fifteen participants (18–57 years of age) performed two trials of treadmill walking and running at ten speeds ranging from 26.8 to 268 m min⁻¹ while wearing four SW3 devices. During the first trial, the cadence setting was maintained while sensitivity was varied; in the second trial sensitivity was maintained while the cadence setting was varied. Part 2: Fifteen participants performed four intermittent activities and drove an automobile while wearing two SW3 devices, one with preprogrammed settings and the other with the modified settings determined in Part 1.ResultsPart 1: The modified settings (cadence setting of 70% of default and sensitivity of 16) provided the greatest step counting accuracy across a wide range of speeds reporting 96.0–104% of actual steps between 53.6 and 268 m min⁻¹. Part 2: The preprogrammed settings tended to have higher accuracy for light household tasks (recording 88% to 94% of actual steps) than the modified settings (recording 82% to 86% of actual steps) which showed a trend towards higher accuracy for tennis (recording 93% vs. 89% of actual steps) (p < 0.05).ConclusionThe preprogrammed “quick start” StepWatch settings should be used with individuals who do not engage in running and vigorous sports. However, for individuals who engage in running and tennis, use of modified settings may result in improved step counting accuracy.