In this paper, we analyze the time series of site coordinates of 27 continuously monitoring GPS sites covered by the Crustal Movement Observation Network of China over the whole country. The data are obtained in the p...In this paper, we analyze the time series of site coordinates of 27 continuously monitoring GPS sites covered by the Crustal Movement Observation Network of China over the whole country. The data are obtained in the period from the beginning of the observation to the November of 2005. On the basis of data processing, we analyze the power spectrum density of coordinate component noise at each site and calculate the spectral indexes manifesting the noise property of each component. The spectral indexes indicate that for most sites, the noise of time series of each coordinate component can be addressed by the model of white noise ＋ flicker noise; and for a small amount of sites, it can be described by the model of white noise ＋ flicker noise ＋ random walk noise. We also quantitatively estimate each noise component in the model by using the criterion of maximum likelihood estimation. The result shows that the white noise in the time series of GPS site coordinates does not constitute the main part of noise. Therefore, the error estimation of site movement parameters is usually too small, or too optimistic if we consider the white noise only. Correspondingly, if this factor is not fully considered in explaining these movement parameters, it might mislead the readers.展开更多
BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the...BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus(T2DM).METHODS A total of 591 individuals with T2DM(297 with DF and 294 without DF)were enrolled.Relevant clinical data,complications,comorbidities,hematological parameters,and 72-hour CGM data were collected.Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.RESULTS Individuals with DF exhibited higher mean blood glucose(MBG)levels and increased proportions of time above range(TAR),TAR level 1,and TAR level 2,but lower TIR(all P<0.001).Patients with DF had significantly lower rates of achieving target ranges for TIR,TAR,and TAR level 2 than those without DF(all P<0.05).Logistic regression analysis revealed that GRI,MBG,and TAR level 1 were positively associated with DF risk,while TIR was inversely correlated(all P<0.05).Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels(P<0.05).Additionally,achieving TAR was influenced by fasting plasma glucose,body mass index,diabetes duration,and antidiabetic medication use.CONCLUSION CGM metrics,particularly TIR and GRI,are significantly associated with the risk of DF in T2DM,emphasizing the importance of improved glucose control.展开更多
This paper addresses the problem of access efficiency in multi-robot systems to the monitoring area.A distributed algorithm for multi-robot continuous monitoring,based on the uncertainty of target points,is used to mi...This paper addresses the problem of access efficiency in multi-robot systems to the monitoring area.A distributed algorithm for multi-robot continuous monitoring,based on the uncertainty of target points,is used to minimize the uncertainty and instantaneous idle time of all target points in the task domain,while maintaining a certain access frequency to the entire task domain at regular time intervals.During monitoring,the robot uses shared information to evaluate the cumulative uncertainty and idle time of the target points,and combines the update list collected from adjacent target points with a utility function to determine the target points to be visited online.At the same time,the paper further delves into the impact of stability and scalability on multi-robot continuous monitoring algorithms in different surveillance environments.Finally,through simulation experiments and physical experiments in different environments,it has been demonstrated that the use of the algorithm presented in the paper leads to superior overall monitoring performance for robotic systems,providing assistance for research on large-scale robotic systems.展开更多
Pediatric type 1 diabetes(T1D)is a lifelong condition requiring meticulous glucose management to prevent acute and chronic complications.Conventional management of diabetic patients does not allow for continuous monit...Pediatric type 1 diabetes(T1D)is a lifelong condition requiring meticulous glucose management to prevent acute and chronic complications.Conventional management of diabetic patients does not allow for continuous monitoring of glucose trends,and can place patients at risk for hypo-and hyperglycemia.Continuous glucose monitors(CGMs)have emerged as a mainstay for pediatric diabetic care and are continuing to advance treatment by providing real-time blood glucose(BG)data,with trend analysis aided by machine learning(ML)algorithms.These predictive analytics serve to prevent against dangerous BG variations in the perioperative environment for fasted children undergoing surgical stress.Integration of CGM data into electronic health records(EHR)is essential,as it establishes a foundation for future technologic interfaces with artificial intelligence(AI).Challenges in perioperative CGM implementation include equitable device access,protection of patient privacy and data accuracy,ensuring institution of standardized protocols,and financing the cumbersome healthcare costs associated with staff training and technology platforms.This paper advocates for implementation of CGM data into the EHR utilizing multiple facets of AI/ML algorithms.展开更多
Benefiting from the widespread potential applications in the era of the Internet of Thing and metaverse,triboelectric and piezoelectric nanogenerators(TENG&PENG)have attracted considerably increasing attention.The...Benefiting from the widespread potential applications in the era of the Internet of Thing and metaverse,triboelectric and piezoelectric nanogenerators(TENG&PENG)have attracted considerably increasing attention.Their outstanding characteristics,such as self-powered ability,high output performance,integration compatibility,cost-effectiveness,simple configurations,and versatile operation modes,could effectively expand the lifetime of vastly distributed wearable,implantable,and environmental devices,eventually achieving self-sustainable,maintenance-free,and reliable systems.However,current triboelectric/piezoelectric based active(i.e.self-powered)sensors still encounter serious bottlenecks in continuous monitoring and multimodal applications due to their intrinsic limitations of monomodal kinetic response and discontinuous transient output.This work systematically summarizes and evaluates the recent research endeavors to address the above challenges,with detailed discussions on the challenge origins,designing strategies,device performance,and corresponding diverse applications.Finally,conclusions and outlook regarding the research gap in self-powered continuous multimodal monitoring systems are provided,proposing the necessity of future research development in this field.展开更多
Maternal diabetes significantly increases the risk of adverse maternal and neonatal outcomes.Traditional self-monitoring of blood glucose is often invasive and limited in its ability to capture glycemic variability.Fl...Maternal diabetes significantly increases the risk of adverse maternal and neonatal outcomes.Traditional self-monitoring of blood glucose is often invasive and limited in its ability to capture glycemic variability.Flash continuous glucose monitoring(FCGM)offers a promising alternative;however,its reliability and correlation with biochemical markers such as hemoglobin A1c(HbA1c)and glycated albumin(GA)in pregnant women with gestational diabetes mellitus(GDM)and type 2 diabetes mellitus(T2DM)remain underexplored.AIM To evaluate the performance of the FreeStyle Libre H FCGM against plasma glucose and its correlations with HbA1c and GA.METHODS This prospective observational study involved 152 pregnant women with GDM or T2DM,with intermittent collection of venous plasma glucose,HbA1c,GA,and concurrent FCGM data at regular intervals at a single center.Relationships were evaluated using restricted cubic spline and mixed-effects models.Receiver operating characteristic curve analysis was performed to compare the ability of HbA1c and GA to detect suboptimal glycemic control.RESULTS Analysis of 507 FCGM-plasma glucose pairs revealed an overall mean absolute relative difference of 7.96%.Mean absolute relative differences were 9.22%,7.75%,and 4.15%for low(3.5-4.4 mmol/L),medium(4.5-7.8 mmol/L),and high(7.9-13 mmol/L)glucose levels,respectively.Most values fell within zone A or zone B on the Clarke and Parkes Error Grids.Bland-Altman analysis indicated a slight underestimation by FCGM(-0.121 mmol/L).Restricted cubic spline analysis revealed significant linear or nonlinear associations between HbA1c/GA and mean glucose,time in range,time above range,and coefficient of variation,but not time below range.Both HbA1c and GA were influenced by gestational age and pregestational body mass index.Receiver operating characteristic analysis showed that HbA1c had comparable or superior performance to GA in detecting suboptimal glycemic control based on FCGM-derived thresholds.CONCLUSION The FCGM system served as a validated reference for evaluating glycemic markers in pregnant women with T2DM and GDM.HbA1c reliably assessed average glycemia,while GA provided complementary insight.展开更多
We report the case of a newly diagnosed overweight patient with type 2 diabetes mellitus who achieved diabetes remission using continuous glucose monitoring(CGM),which promotes patient engagement in self‐management.K...We report the case of a newly diagnosed overweight patient with type 2 diabetes mellitus who achieved diabetes remission using continuous glucose monitoring(CGM),which promotes patient engagement in self‐management.Key measures included selection of a patient newly diagnosed with type 2 diabetes mellitus,use of CGM,analysis of glucose trends and contributing factors,and patient guidance in maintaining a health diary and developing personalized self‐management strategies(e.g.,dietary modification and exercise regimens).Following 6‐month CGM‐guided self‐management,the patient's glycated hemoglobin level decreased from 7.3%at baseline to 6.0%and his body weight decreased from 83 to 77 kg,a 7%reduction;thus,the patient met the criteria for diabetes remission.展开更多
This study critically analyzes the findings of Geng et al,which investigated the association between continuous glucose monitoring(CGM)metrics and the risk of diabetic foot(DF)in individuals with type 2 diabetes melli...This study critically analyzes the findings of Geng et al,which investigated the association between continuous glucose monitoring(CGM)metrics and the risk of diabetic foot(DF)in individuals with type 2 diabetes mellitus.The study de-monstrated significant associations between lower time in range,higher glycemic risk index,mean blood glucose,and time above range and an increased risk of DF.While acknowledging the study's strengths,such as its large sample size and robust statistical methods,this analysis also highlights its limitations,including its cross-sectional design and reliance on self-reported data.The findings are dis-cussed within the framework of established theories,including the concepts of metabolic memory,the glucocentric paradigm,and the role of inflammation.This analysis emphasizes that a comprehensive approach to glucose management,extending beyond traditional glycated hemoglobin A1c measurements,is crucial for DF risk mitigation.Recognizing the impact of poor adherence and ongoing inflammation,future research should prioritize exploring causal mechanisms,the effectiveness of interventions aimed at improving CGM metrics,and the specific contributions of glucose variability to DF development.In conclusion,these findings strongly support the clinical application of diverse CGM metrics to enhance patient outcomes and effectively manage the risk of DF.展开更多
With the development of the monitoring technology,it is more and more common that the system is continuously monitored.Therefore,the research on the maintenance optimization of the continuously monitored deterioration...With the development of the monitoring technology,it is more and more common that the system is continuously monitored.Therefore,the research on the maintenance optimization of the continuously monitored deterioration system is important.The deterioration process of the discussed system is described by a Gamma process.The predictive maintenance is considered to be imperfect and formulated.The expected interval of two continuous preventive maintenances is derived.Then,the maintenance optimization model of the continuously monitored deterioration system is presented.In the model,the minimization of the expected operational cost per unit time and the maximization of the system availability are the optimization objectives.The improved ideal point method with the normalized objective functions is employed to solve the proposed model.The validity and sensitivity of the proposed multiobjective maintenance optimization model are analyzed by a numerical example.展开更多
Monitoring and delineating the spatial distribution of shale fracturing is fundamentally important to shale gas production. Standard monitoring methods, such as time-lapse seismic, cross-well seismic and micro-seismic...Monitoring and delineating the spatial distribution of shale fracturing is fundamentally important to shale gas production. Standard monitoring methods, such as time-lapse seismic, cross-well seismic and micro-seismic methods, are expensive, time- consuming, and do not show the changes in the formation with time. The resistivities of hydraulic fracturing fluid and reservoir rocks were measured. The results suggest that the injection fluid and consequently the injected reservoir are characterized by very low resistivity and high chargeability. This allows using of the controlled-source electromagnetic method （CSEM） to monitor shale gas hydraulic fracturing. Based on the geoelectrical model which was proposed according to the well-log and seismic data in the test area the change rule of the reacted electrical field was studied to account for the change of shale resistivity, and then the normalized residual resistivity method for time lapse processing was given. The time-domain electromagnetic method （TDEM） was used to continuously monitor the shale gas fracturing at the Fulin shale gas field in southern China. A high-power transmitter and multi-channel transient electromagnetic receiver array were adopted. 9 h time series of Ex component of 224 sites which were laid out on the surface and over three fracturing stages of a horizontal well at 2800 m depth was recorded. After data processing and calculation of the normalized resistivity residuals, the changes in the Ex signal were determined and a dynamic 3D image of the change in resistivity was constructed. This allows modeling the spatial distribution of the fracturing fluid. The model results suggest that TDEM is promising for monitoring hydraulic fracturing of shale.展开更多
Diabetes mellitus affects people worldwide,and management of its acute complications or treatment-related adverse events is particularly important in critically ill patients.Previous reports have confirmed that hyperg...Diabetes mellitus affects people worldwide,and management of its acute complications or treatment-related adverse events is particularly important in critically ill patients.Previous reports have confirmed that hyperglycemia can increase the risk of mortality in patients cared in the intensive care unit(ICU).In addition,severe and multiple hypoglycemia increases the risk of mortality when using insulin or intensive antidiabetic therapy.The innovation of continuous glucose monitoring(CGM)may help to alert medical caregivers with regard to the development of hyperglycemia and hypoglycemia,which may decrease the potential complications in patients in the ICU.The major limitation of CGM is the measurement of interstitial glucose levels rather than real-time blood glucose levels;thus,there will be a delay in the treatment of hyperglycemia and hypoglycemia in patients.Recently,the European Union approved a state-of-art artificial intelligence directed loop system coordinated by CGM and a continuous insulin pump for diabetes control,which may provide a practical way to prevent acute adverse glycemic events related to antidiabetic therapy in critically ill patients.In this mini-review paper,we describe the application of CGM to patients in the ICU and summarize the pros and cons of CGM.展开更多
BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the rel...BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the relationship between TIR obtained from continuous glucose monitoring(CGM)and sudomotor function detected by SUDOSCAN in subjects with type 2 diabetes.METHODS The research enrolled 466 inpatients with type 2 diabetes.All subjects underwent 3-d CGM and SUDOSCAN.SUDOSCAN was assessed with electrochemical skin conductance in hands(HESC)and feet(FESC).Average feet ESC<60μS was defined as sudomotor dysfunction(+),otherwise it was sudomotor dysfunction(-).TIR refers to the percentage of time when blood glucose is between 3.9-10 mmol/L during 1 d period.RESULTS Among the enrolled subjects,135(28.97%)presented with sudomotor dysfunction.Patients with sudomotor dysfunction(+)showed a decreased level of TIR(P<0.001).Compared to the lowest tertile of TIR,the middle and the highest tertiles of TIR was associated with an obviously lower prevalence of sudomotor dysfunction(20.51%and 21.94%vs 44.52%)(P<0.001).In addition,with the increase of TIR,HESC and FESC increased(P<0.001).Regression analysis demonstrated that TIR was inversely and independently linked with the prevalence of sudomotor dysfunction after adjusting for confounding values(odds ratio=0.979,95%CI:0.971-0.987,P<0.001).CONCLUSION The tight glycemic control assessed by TIR is of vitally protective value for sudomotor dysfunction in type 2 diabetes mellitus.展开更多
Indoor environmental quality(IEQ)significantly affects human health and wellbeing.Therefore,continuous IEQ monitoring and feedback is of great concern in both the industrial and academic communities.However,most exist...Indoor environmental quality(IEQ)significantly affects human health and wellbeing.Therefore,continuous IEQ monitoring and feedback is of great concern in both the industrial and academic communities.However,most existing studies only focus on developing sensors that cost-effectively promote IEQ measurement while ignoring interactions between the human side and IEQ monitoring.In this study,an intelligent IEQ monitoring and feedback system-the Intelligent Built Enviroment(IBEM)-is developed.Firstly,the IBEM hardware instrument integrates air temperature,relative humidity,CO_(2),particulate matter with an aerodynamic diameter no greater than _(2.5)μm(PM_(2.5)),and illuminance sensors within a small device.The accuracy of this integrated device was tested through a co-location experiment with reference sensors;the device exhibited a strong correlation with the reference sensors,with a slight deviation(R^(2)>0.97 and slopes between 1.01 and 1.05).Secondly,a wireless data transmission module,a cloud storage module,and graphical user interfaces(i.e.,a web platform and mobile interface)were built to establish a pathway for dataflow and interactive feedback with the occupants of the indoor environments.Thus,the IEQ parameters can be continuously monitored with a high spatiotemporal resolution,interactive feedback can be induced,and synchronous data collection on occupant satisfaction and objective environmental parameters can be realized.IBEM has been widely applied in 131 buildings in 18cities/areas in China,with 1188 sample locations.Among these applications,we report on the targeted IEQ diagnoses of two individual buildings and the exploration of relationships between subjective and objective IEQ data in detail here.This work demonstrates the great value of IBEM in both industrial and academic research.展开更多
Diabetic kidney disease(DKD)is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease(ESKD).Wide glycemic var-iations,such as hypoglycemia and hyperglycemia,are broadly fou...Diabetic kidney disease(DKD)is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease(ESKD).Wide glycemic var-iations,such as hypoglycemia and hyperglycemia,are broadly found in diabetic patients with DKD and especially ESKD,as a result of impaired renal metabolism.It is essential to monitor glycemia for effective management of DKD.Hemoglobin A1c(HbA1c)has long been considered as the gold standard for monitoring glycemia for>3 months.However,assessment of HbA1c has some bias as it is susceptible to factors such as anemia and liver or kidney dysfunction.Continuous glucose monitoring(CGM)has provided new insights on glycemic assessment and management.CGM directly measures glucose level in interstitial fluid,reports real-time or retrospective glucose concentration,and provides multiple glycemic metrics.It avoids the pitfalls of HbA1c in some contexts,and may serve as a precise alternative to estimation of mean glucose and glycemic variability.Emerging studies have demonstrated the merits of CGM for precise monitoring,which allows fine-tuning of glycemic management in diabetic patients.Therefore,CGM technology has the potential for better glycemic monitoring in DKD patients.More research is needed to explore its application and management in different stages of DKD,including hemodialysis,peritoneal dialysis and kidney transplantation.展开更多
The aim of this study was to compare the difference of blood glucose(BG) fluctuation in the patients of type-2 diabetes mellitus(DM-2) with and without clinical diagnosed diabetic nephropathy(DN) by the continuous glu...The aim of this study was to compare the difference of blood glucose(BG) fluctuation in the patients of type-2 diabetes mellitus(DM-2) with and without clinical diagnosed diabetic nephropathy(DN) by the continuous glucose monitoring system(CGMS).Thirty DM-2 patients with clinical diagnosed DN and fifteen DM-2 patients without complication underwent continuous glucose monitoring for 3 days(72 h) by CGMS.The difference of daily glucose fluctuation in both groups was compared by the parameter of CGMS.The 24-h mean blood glucose (MBG),minimal BG(MIN-BG),area under curve of BG over 7.8(AUC7.8),percentage of time of BG over 7.8 (PT7.8),area under curve of BG over 11.1(AUC11.1),percentage of time of BG over 11.1(PT11.1),as well as mean of daily difference(MODD) were significantly increased in the group of DN,compared with those in the group of DM-2 without complication(all statistic probability P<0.05).No statistical significance of mean amplitude of glycaemic excursion(MAGE) was found.In the group of DN,MBG,standard deviation of blood glucose(SDBG),large amplitude of glycaemic excursion(LAGE),AUC7.8,PT7.8,AUC11.1,PT11.1,MAGE and MODD were(10.7±1.9) mmol/L,(2.5±1.3) mmol/L,(9.2±3.9) mmol/L,3.2±1.7,(81±18)%,1.2±1.0,(42±24)%, (5.8±2.5) mmol/L and(2.6±1.5) mmol/L,respectively.The study showed that the BG level of the patients with DN fluctuated throughout the day.MBG of the patients with DN was higher than that of the patients of DM-2 without complications,with the characteristics of long-lasting high BG period,dramatic instability during the day and especially high postprandial blood glucose.CGMS is a useful tool for physicians to know the details of the change of BG in the patients with DN.展开更多
Composite made of short-cut carbon fiber mat and vinyl ester resin was observed to be an effective sensor for tensile strain up to 6 000με. Based on its strain sensitivity, a skin-like sensitive layer which can cont...Composite made of short-cut carbon fiber mat and vinyl ester resin was observed to be an effective sensor for tensile strain up to 6 000με. Based on its strain sensitivity, a skin-like sensitive layer which can continuously cover the structural surface to sense strain in large area was developed. The sensitive layer was applied to continuously monitor the deformation of a simply supported beam. The result indicates that the fractional change in electrical resistance of the sensitive layer reversibly reflects the beam deformation in each section and describes the distribution of the average strain of the beam. The effect of temperature change on the monitoring was studied by monitoring tests conducted at different temperatures ranging from 20 to 80 ℃, which reveals temperature sensitivity in the sensitive layer and the temperature dependence of the piezoresistive behavior when the temperature exceeds 50 ℃. By the application of differential conaection principle, a method for temperature compensation was established and the gauge factor for the monitoring was dramatically increased. This method was verified experimentally.展开更多
BACKGROUND The FreeStyle Libre flash glucose monitoring(FGM)system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose.Due to its increased usage in clinics,the number of studies inve...BACKGROUND The FreeStyle Libre flash glucose monitoring(FGM)system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose.Due to its increased usage in clinics,the number of studies investigating its accuracy has increased.However,its accuracy has not been investigated in highland populations in China.AIM To evaluate measurements recorded using the FreeStyle Libre FGM system compared with capillary blood glucose measured using the enzyme electrode method in patients with type 2 diabetes(T2D)who had migrated within 3 mo from highlands to plains.METHODS Overall,68 patients with T2D,selected from those who had recently migrated from highlands to plains(within 3 mo),were hospitalized at the Department of Endocrinology from August to October 2017 and underwent continuous glucose monitoring(CGM)with the FreeStyle Libre FGM system for 14 d.Throughout the study period,fingertip capillary blood glucose was measured daily using the enzyme electrode method(Super GL,China),and blood glucose levels were read from the scanning probe during fasting and 2 h after all three meals.Moreover,the time interval between reading the data from the scanning probe and collecting fingertip capillary blood was controlled to<5 min.The accuracy of the FGM system was evaluated according to the CGM guidelines.Subsequently,the factors influencing the mean absolute relative difference(MARD)of this system were analyzed by a multiple linear regression method.RESULTS Pearson’s correlation analysis showed that the fingertip and scanned glucose levels were positively correlated(R=0.86,P=0.00).The aggregated MARD of scanned glucose was 14.28±13.40%.Parker's error analysis showed that 99.30%of the data pairs were located in areas A and B.According to the probe wear time of the FreeStyle Libre FGM system,MARD_(1 d) and MARD_(2-14 d) were 16.55%and 14.35%,respectively(t=1.23,P=0.22).Multiple stepwise regression analysis showed that MARD did not correlate with blood glucose when the largest amplitude of glycemic excursion(LAGE)was<5.80 mmol/L but negatively correlated with blood glucose when the LAGE was≥5.80 mmol/L.CONCLUSION The FreeStyle Libre FGM system has good accuracy in patients with T2D who had recently migrated from highlands to plains.This system might be ideal for avoiding the effects of high hematocrit on blood glucose monitoring in populations that recently migrated to plains.MARD is mainly influenced by glucose levels and fluctuations,and the accuracy of the system is higher when the blood glucose fluctuation is small.In case of higher blood glucose level fluctuations,deviation in the scanned glucose levels is the highest at extremely low blood glucose levels.展开更多
Continuous drug monitoring is a promising alternative to current therapeutic drug monitoring strategies and has a strong potential to reshape our understanding of pharmacokinetic variability and to improve individuali...Continuous drug monitoring is a promising alternative to current therapeutic drug monitoring strategies and has a strong potential to reshape our understanding of pharmacokinetic variability and to improve individualised therapy.This review highlights recent advances in biosensing technologies that support continuous drug monitoring in real time.We focus primarily on aptamer-based biosensors,wearable and implantable devices.Emphasis is given to the approaches employed in constructing biosensors.We pay attention to sensors’biocompatibility,calibration performance,long-term characteristics stability and measurement quality.Last,we discuss the current challenges and issues to be addressed in continuous drug monitoring to make it a promising,future tool for individualised therapy.The ongoing efforts are expected to result in fully integrated implantable drug biosensing technology.Thus,we may anticipate an era of advanced healthcare in which wearable and implantable biochips will automatically adjust drug dosing in response to patient health conditions,thus enabling the management of diseases and enhancing individualised therapy.展开更多
Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level mon...Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.展开更多
In this editorial,we comment on the article by Zhang et al.Chronic kidney disease(CKD)presents a significant challenge in managing glycemic control,especially in diabetic patients with diabetic kidney disease undergoi...In this editorial,we comment on the article by Zhang et al.Chronic kidney disease(CKD)presents a significant challenge in managing glycemic control,especially in diabetic patients with diabetic kidney disease undergoing dialysis or kidney transplantation.Conventional markers like glycated haemoglobin(HbA1c)may not accurately reflect glycemic fluctuations in these populations due to factors such as anaemia and kidney dysfunction.This comprehensive review discusses the limitations of HbA1c and explores alternative methods,such as continuous glucose monitoring(CGM)in CKD patients.CGM emerges as a promising technology offering real-time or retrospective glucose concentration measure-ments and overcoming the limitations of HbA1c.Key studies demonstrate the utility of CGM in different CKD settings,including hemodialysis and peritoneal dialysis patients,as well as kidney transplant recipients.Despite challenges like sensor accuracy fluctuation,CGM proves valuable in monitoring glycemic trends and mitigating the risk of hypo-and hyperglycemia,to which CKD patients are prone.The review also addresses the limitations of CGM in CKD patients,emphasizing the need for further research to optimize its utilization in clinical practice.Altogether,this review advocates for integrating CGM into managing glycemia in CKD patients,highlighting its superiority over traditional markers and urging clinicians to consider CGM a valuable tool in their armamentarium.展开更多
基金Special project of China Earthquake Administration"Study on the Integrated Observation of Vertical Crustal Move-ment and Deformation of South-North Seismic Zone on the Chinese Mainland".
文摘In this paper, we analyze the time series of site coordinates of 27 continuously monitoring GPS sites covered by the Crustal Movement Observation Network of China over the whole country. The data are obtained in the period from the beginning of the observation to the November of 2005. On the basis of data processing, we analyze the power spectrum density of coordinate component noise at each site and calculate the spectral indexes manifesting the noise property of each component. The spectral indexes indicate that for most sites, the noise of time series of each coordinate component can be addressed by the model of white noise ＋ flicker noise; and for a small amount of sites, it can be described by the model of white noise ＋ flicker noise ＋ random walk noise. We also quantitatively estimate each noise component in the model by using the criterion of maximum likelihood estimation. The result shows that the white noise in the time series of GPS site coordinates does not constitute the main part of noise. Therefore, the error estimation of site movement parameters is usually too small, or too optimistic if we consider the white noise only. Correspondingly, if this factor is not fully considered in explaining these movement parameters, it might mislead the readers.
基金Supported by Yunnan Province Academician(Expert)Workstation Project,No.202305AF150097the Basic Research Program of Yunnan Province(Kunming Medical University Joint Special Project),No.202101AY070001-276+3 种基金the National Natural Science Foundation of China,No.82160159the Key Project Program of Yunnan Province(Kunming Medical University Joint Special Project),No.202301AY070001-013the Major Science and Technology Project of Yunnan Province,No.202202AA100004the Double First-class University Construction Project of Yunnan University,No.CY22624106.
文摘BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus(T2DM).METHODS A total of 591 individuals with T2DM(297 with DF and 294 without DF)were enrolled.Relevant clinical data,complications,comorbidities,hematological parameters,and 72-hour CGM data were collected.Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.RESULTS Individuals with DF exhibited higher mean blood glucose(MBG)levels and increased proportions of time above range(TAR),TAR level 1,and TAR level 2,but lower TIR(all P<0.001).Patients with DF had significantly lower rates of achieving target ranges for TIR,TAR,and TAR level 2 than those without DF(all P<0.05).Logistic regression analysis revealed that GRI,MBG,and TAR level 1 were positively associated with DF risk,while TIR was inversely correlated(all P<0.05).Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels(P<0.05).Additionally,achieving TAR was influenced by fasting plasma glucose,body mass index,diabetes duration,and antidiabetic medication use.CONCLUSION CGM metrics,particularly TIR and GRI,are significantly associated with the risk of DF in T2DM,emphasizing the importance of improved glucose control.
基金The National Nature Science Foundation of China under Grant 62106186.
文摘This paper addresses the problem of access efficiency in multi-robot systems to the monitoring area.A distributed algorithm for multi-robot continuous monitoring,based on the uncertainty of target points,is used to minimize the uncertainty and instantaneous idle time of all target points in the task domain,while maintaining a certain access frequency to the entire task domain at regular time intervals.During monitoring,the robot uses shared information to evaluate the cumulative uncertainty and idle time of the target points,and combines the update list collected from adjacent target points with a utility function to determine the target points to be visited online.At the same time,the paper further delves into the impact of stability and scalability on multi-robot continuous monitoring algorithms in different surveillance environments.Finally,through simulation experiments and physical experiments in different environments,it has been demonstrated that the use of the algorithm presented in the paper leads to superior overall monitoring performance for robotic systems,providing assistance for research on large-scale robotic systems.
文摘Pediatric type 1 diabetes(T1D)is a lifelong condition requiring meticulous glucose management to prevent acute and chronic complications.Conventional management of diabetic patients does not allow for continuous monitoring of glucose trends,and can place patients at risk for hypo-and hyperglycemia.Continuous glucose monitors(CGMs)have emerged as a mainstay for pediatric diabetic care and are continuing to advance treatment by providing real-time blood glucose(BG)data,with trend analysis aided by machine learning(ML)algorithms.These predictive analytics serve to prevent against dangerous BG variations in the perioperative environment for fasted children undergoing surgical stress.Integration of CGM data into electronic health records(EHR)is essential,as it establishes a foundation for future technologic interfaces with artificial intelligence(AI).Challenges in perioperative CGM implementation include equitable device access,protection of patient privacy and data accuracy,ensuring institution of standardized protocols,and financing the cumbersome healthcare costs associated with staff training and technology platforms.This paper advocates for implementation of CGM data into the EHR utilizing multiple facets of AI/ML algorithms.
基金supported by the National Key R&D Program of China(Grant Nos.2022YFB3603403,2021YFB3600502)the National Natural Science Foundation of China(Grant Nos.62075040,62301150)+3 种基金the Southeast University Interdisciplinary Research Program for Young Scholars(2024FGC1007)the Start-up Research Fund of Southeast University(RF1028623164)the Nanjing Science and Technology Innovation Project for Returned Overseas Talent(4206002302)the Fundamental Research Funds for the Central Universities(2242024K40015).
文摘Benefiting from the widespread potential applications in the era of the Internet of Thing and metaverse,triboelectric and piezoelectric nanogenerators(TENG&PENG)have attracted considerably increasing attention.Their outstanding characteristics,such as self-powered ability,high output performance,integration compatibility,cost-effectiveness,simple configurations,and versatile operation modes,could effectively expand the lifetime of vastly distributed wearable,implantable,and environmental devices,eventually achieving self-sustainable,maintenance-free,and reliable systems.However,current triboelectric/piezoelectric based active(i.e.self-powered)sensors still encounter serious bottlenecks in continuous monitoring and multimodal applications due to their intrinsic limitations of monomodal kinetic response and discontinuous transient output.This work systematically summarizes and evaluates the recent research endeavors to address the above challenges,with detailed discussions on the challenge origins,designing strategies,device performance,and corresponding diverse applications.Finally,conclusions and outlook regarding the research gap in self-powered continuous multimodal monitoring systems are provided,proposing the necessity of future research development in this field.
基金Supported by the National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-015the Healthcare Quality and Safety Incubation Program of Peking Union Medical Foundation,No.XHFY2406.
文摘Maternal diabetes significantly increases the risk of adverse maternal and neonatal outcomes.Traditional self-monitoring of blood glucose is often invasive and limited in its ability to capture glycemic variability.Flash continuous glucose monitoring(FCGM)offers a promising alternative;however,its reliability and correlation with biochemical markers such as hemoglobin A1c(HbA1c)and glycated albumin(GA)in pregnant women with gestational diabetes mellitus(GDM)and type 2 diabetes mellitus(T2DM)remain underexplored.AIM To evaluate the performance of the FreeStyle Libre H FCGM against plasma glucose and its correlations with HbA1c and GA.METHODS This prospective observational study involved 152 pregnant women with GDM or T2DM,with intermittent collection of venous plasma glucose,HbA1c,GA,and concurrent FCGM data at regular intervals at a single center.Relationships were evaluated using restricted cubic spline and mixed-effects models.Receiver operating characteristic curve analysis was performed to compare the ability of HbA1c and GA to detect suboptimal glycemic control.RESULTS Analysis of 507 FCGM-plasma glucose pairs revealed an overall mean absolute relative difference of 7.96%.Mean absolute relative differences were 9.22%,7.75%,and 4.15%for low(3.5-4.4 mmol/L),medium(4.5-7.8 mmol/L),and high(7.9-13 mmol/L)glucose levels,respectively.Most values fell within zone A or zone B on the Clarke and Parkes Error Grids.Bland-Altman analysis indicated a slight underestimation by FCGM(-0.121 mmol/L).Restricted cubic spline analysis revealed significant linear or nonlinear associations between HbA1c/GA and mean glucose,time in range,time above range,and coefficient of variation,but not time below range.Both HbA1c and GA were influenced by gestational age and pregestational body mass index.Receiver operating characteristic analysis showed that HbA1c had comparable or superior performance to GA in detecting suboptimal glycemic control based on FCGM-derived thresholds.CONCLUSION The FCGM system served as a validated reference for evaluating glycemic markers in pregnant women with T2DM and GDM.HbA1c reliably assessed average glycemia,while GA provided complementary insight.
文摘We report the case of a newly diagnosed overweight patient with type 2 diabetes mellitus who achieved diabetes remission using continuous glucose monitoring(CGM),which promotes patient engagement in self‐management.Key measures included selection of a patient newly diagnosed with type 2 diabetes mellitus,use of CGM,analysis of glucose trends and contributing factors,and patient guidance in maintaining a health diary and developing personalized self‐management strategies(e.g.,dietary modification and exercise regimens).Following 6‐month CGM‐guided self‐management,the patient's glycated hemoglobin level decreased from 7.3%at baseline to 6.0%and his body weight decreased from 83 to 77 kg,a 7%reduction;thus,the patient met the criteria for diabetes remission.
基金Supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,No.NRF-RS-2023-00237287。
文摘This study critically analyzes the findings of Geng et al,which investigated the association between continuous glucose monitoring(CGM)metrics and the risk of diabetic foot(DF)in individuals with type 2 diabetes mellitus.The study de-monstrated significant associations between lower time in range,higher glycemic risk index,mean blood glucose,and time above range and an increased risk of DF.While acknowledging the study's strengths,such as its large sample size and robust statistical methods,this analysis also highlights its limitations,including its cross-sectional design and reliance on self-reported data.The findings are dis-cussed within the framework of established theories,including the concepts of metabolic memory,the glucocentric paradigm,and the role of inflammation.This analysis emphasizes that a comprehensive approach to glucose management,extending beyond traditional glycated hemoglobin A1c measurements,is crucial for DF risk mitigation.Recognizing the impact of poor adherence and ongoing inflammation,future research should prioritize exploring causal mechanisms,the effectiveness of interventions aimed at improving CGM metrics,and the specific contributions of glucose variability to DF development.In conclusion,these findings strongly support the clinical application of diverse CGM metrics to enhance patient outcomes and effectively manage the risk of DF.
基金supported by the Fundamental Research Funds for the Central Universities (N090303005)Key National Science and Technology Special Project (2010ZX04014-014)
文摘With the development of the monitoring technology,it is more and more common that the system is continuously monitored.Therefore,the research on the maintenance optimization of the continuously monitored deterioration system is important.The deterioration process of the discussed system is described by a Gamma process.The predictive maintenance is considered to be imperfect and formulated.The expected interval of two continuous preventive maintenances is derived.Then,the maintenance optimization model of the continuously monitored deterioration system is presented.In the model,the minimization of the expected operational cost per unit time and the maximization of the system availability are the optimization objectives.The improved ideal point method with the normalized objective functions is employed to solve the proposed model.The validity and sensitivity of the proposed multiobjective maintenance optimization model are analyzed by a numerical example.
基金supported by NSFC(Grant No.U1562109 and 41774082)the National Major Research Plan(Grant No.2016YFC0601100and 2016ZX05004)the Project of Scientific Research and Technological Development,CNPC(Grant No.2017D-5006-16)
文摘Monitoring and delineating the spatial distribution of shale fracturing is fundamentally important to shale gas production. Standard monitoring methods, such as time-lapse seismic, cross-well seismic and micro-seismic methods, are expensive, time- consuming, and do not show the changes in the formation with time. The resistivities of hydraulic fracturing fluid and reservoir rocks were measured. The results suggest that the injection fluid and consequently the injected reservoir are characterized by very low resistivity and high chargeability. This allows using of the controlled-source electromagnetic method （CSEM） to monitor shale gas hydraulic fracturing. Based on the geoelectrical model which was proposed according to the well-log and seismic data in the test area the change rule of the reacted electrical field was studied to account for the change of shale resistivity, and then the normalized residual resistivity method for time lapse processing was given. The time-domain electromagnetic method （TDEM） was used to continuously monitor the shale gas fracturing at the Fulin shale gas field in southern China. A high-power transmitter and multi-channel transient electromagnetic receiver array were adopted. 9 h time series of Ex component of 224 sites which were laid out on the surface and over three fracturing stages of a horizontal well at 2800 m depth was recorded. After data processing and calculation of the normalized resistivity residuals, the changes in the Ex signal were determined and a dynamic 3D image of the change in resistivity was constructed. This allows modeling the spatial distribution of the fracturing fluid. The model results suggest that TDEM is promising for monitoring hydraulic fracturing of shale.
文摘Diabetes mellitus affects people worldwide,and management of its acute complications or treatment-related adverse events is particularly important in critically ill patients.Previous reports have confirmed that hyperglycemia can increase the risk of mortality in patients cared in the intensive care unit(ICU).In addition,severe and multiple hypoglycemia increases the risk of mortality when using insulin or intensive antidiabetic therapy.The innovation of continuous glucose monitoring(CGM)may help to alert medical caregivers with regard to the development of hyperglycemia and hypoglycemia,which may decrease the potential complications in patients in the ICU.The major limitation of CGM is the measurement of interstitial glucose levels rather than real-time blood glucose levels;thus,there will be a delay in the treatment of hyperglycemia and hypoglycemia in patients.Recently,the European Union approved a state-of-art artificial intelligence directed loop system coordinated by CGM and a continuous insulin pump for diabetes control,which may provide a practical way to prevent acute adverse glycemic events related to antidiabetic therapy in critically ill patients.In this mini-review paper,we describe the application of CGM to patients in the ICU and summarize the pros and cons of CGM.
基金National Natural Science Foundation of China,No.81774134 and No.81873174Natural Science Foundation of Jiangsu Province of China,No.BK20150558 and No.BK20171331+2 种基金Postdoctoral Foundation of Jiangsu Province of China,No.1501120CJiangsu Province 333 Talent Funding Project,No.BRA2017595Young Medical Key Talents Project of Jiangsu Province,No.QNRC2016902.
文摘BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the relationship between TIR obtained from continuous glucose monitoring(CGM)and sudomotor function detected by SUDOSCAN in subjects with type 2 diabetes.METHODS The research enrolled 466 inpatients with type 2 diabetes.All subjects underwent 3-d CGM and SUDOSCAN.SUDOSCAN was assessed with electrochemical skin conductance in hands(HESC)and feet(FESC).Average feet ESC<60μS was defined as sudomotor dysfunction(+),otherwise it was sudomotor dysfunction(-).TIR refers to the percentage of time when blood glucose is between 3.9-10 mmol/L during 1 d period.RESULTS Among the enrolled subjects,135(28.97%)presented with sudomotor dysfunction.Patients with sudomotor dysfunction(+)showed a decreased level of TIR(P<0.001).Compared to the lowest tertile of TIR,the middle and the highest tertiles of TIR was associated with an obviously lower prevalence of sudomotor dysfunction(20.51%and 21.94%vs 44.52%)(P<0.001).In addition,with the increase of TIR,HESC and FESC increased(P<0.001).Regression analysis demonstrated that TIR was inversely and independently linked with the prevalence of sudomotor dysfunction after adjusting for confounding values(odds ratio=0.979,95%CI:0.971-0.987,P<0.001).CONCLUSION The tight glycemic control assessed by TIR is of vitally protective value for sudomotor dysfunction in type 2 diabetes mellitus.
基金supported by the China National Key Research and Development(R&D)Program(2018YFE0106100)the National Science Foundation for Distinguished Young Scholars of China(51825802)+3 种基金the Innovative Research Groups of the National Natural Science Foundation of China(51521005)the Strategic Research and Consulting Project of Chinese Academy of Engineering(2021XY-3)the China Postdoctoral Science Foundation(2021M691789)Shuimu Tsinghua Scholar Program(2020SM001)。
文摘Indoor environmental quality(IEQ)significantly affects human health and wellbeing.Therefore,continuous IEQ monitoring and feedback is of great concern in both the industrial and academic communities.However,most existing studies only focus on developing sensors that cost-effectively promote IEQ measurement while ignoring interactions between the human side and IEQ monitoring.In this study,an intelligent IEQ monitoring and feedback system-the Intelligent Built Enviroment(IBEM)-is developed.Firstly,the IBEM hardware instrument integrates air temperature,relative humidity,CO_(2),particulate matter with an aerodynamic diameter no greater than _(2.5)μm(PM_(2.5)),and illuminance sensors within a small device.The accuracy of this integrated device was tested through a co-location experiment with reference sensors;the device exhibited a strong correlation with the reference sensors,with a slight deviation(R^(2)>0.97 and slopes between 1.01 and 1.05).Secondly,a wireless data transmission module,a cloud storage module,and graphical user interfaces(i.e.,a web platform and mobile interface)were built to establish a pathway for dataflow and interactive feedback with the occupants of the indoor environments.Thus,the IEQ parameters can be continuously monitored with a high spatiotemporal resolution,interactive feedback can be induced,and synchronous data collection on occupant satisfaction and objective environmental parameters can be realized.IBEM has been widely applied in 131 buildings in 18cities/areas in China,with 1188 sample locations.Among these applications,we report on the targeted IEQ diagnoses of two individual buildings and the exploration of relationships between subjective and objective IEQ data in detail here.This work demonstrates the great value of IBEM in both industrial and academic research.
基金Supported by Natural Science Foundation of Zhejiang Province,No.LY23H050005and Zhejiang Medical Technology Project,No.2022RC009.
文摘Diabetic kidney disease(DKD)is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease(ESKD).Wide glycemic var-iations,such as hypoglycemia and hyperglycemia,are broadly found in diabetic patients with DKD and especially ESKD,as a result of impaired renal metabolism.It is essential to monitor glycemia for effective management of DKD.Hemoglobin A1c(HbA1c)has long been considered as the gold standard for monitoring glycemia for>3 months.However,assessment of HbA1c has some bias as it is susceptible to factors such as anemia and liver or kidney dysfunction.Continuous glucose monitoring(CGM)has provided new insights on glycemic assessment and management.CGM directly measures glucose level in interstitial fluid,reports real-time or retrospective glucose concentration,and provides multiple glycemic metrics.It avoids the pitfalls of HbA1c in some contexts,and may serve as a precise alternative to estimation of mean glucose and glycemic variability.Emerging studies have demonstrated the merits of CGM for precise monitoring,which allows fine-tuning of glycemic management in diabetic patients.Therefore,CGM technology has the potential for better glycemic monitoring in DKD patients.More research is needed to explore its application and management in different stages of DKD,including hemodialysis,peritoneal dialysis and kidney transplantation.
基金the Shanghai United Developing Technology Project of Municipal Hospitals (No.SHDC12006101)
文摘The aim of this study was to compare the difference of blood glucose(BG) fluctuation in the patients of type-2 diabetes mellitus(DM-2) with and without clinical diagnosed diabetic nephropathy(DN) by the continuous glucose monitoring system(CGMS).Thirty DM-2 patients with clinical diagnosed DN and fifteen DM-2 patients without complication underwent continuous glucose monitoring for 3 days(72 h) by CGMS.The difference of daily glucose fluctuation in both groups was compared by the parameter of CGMS.The 24-h mean blood glucose (MBG),minimal BG(MIN-BG),area under curve of BG over 7.8(AUC7.8),percentage of time of BG over 7.8 (PT7.8),area under curve of BG over 11.1(AUC11.1),percentage of time of BG over 11.1(PT11.1),as well as mean of daily difference(MODD) were significantly increased in the group of DN,compared with those in the group of DM-2 without complication(all statistic probability P<0.05).No statistical significance of mean amplitude of glycaemic excursion(MAGE) was found.In the group of DN,MBG,standard deviation of blood glucose(SDBG),large amplitude of glycaemic excursion(LAGE),AUC7.8,PT7.8,AUC11.1,PT11.1,MAGE and MODD were(10.7±1.9) mmol/L,(2.5±1.3) mmol/L,(9.2±3.9) mmol/L,3.2±1.7,(81±18)%,1.2±1.0,(42±24)%, (5.8±2.5) mmol/L and(2.6±1.5) mmol/L,respectively.The study showed that the BG level of the patients with DN fluctuated throughout the day.MBG of the patients with DN was higher than that of the patients of DM-2 without complications,with the characteristics of long-lasting high BG period,dramatic instability during the day and especially high postprandial blood glucose.CGMS is a useful tool for physicians to know the details of the change of BG in the patients with DN.
基金Funded by the National Natural Science Foundation of China(No.50878169)the Project of State Key Laboratory of Refractories and Metallurgy(Wuhan University of Science and Technology)(No.G201407)
文摘Composite made of short-cut carbon fiber mat and vinyl ester resin was observed to be an effective sensor for tensile strain up to 6 000με. Based on its strain sensitivity, a skin-like sensitive layer which can continuously cover the structural surface to sense strain in large area was developed. The sensitive layer was applied to continuously monitor the deformation of a simply supported beam. The result indicates that the fractional change in electrical resistance of the sensitive layer reversibly reflects the beam deformation in each section and describes the distribution of the average strain of the beam. The effect of temperature change on the monitoring was studied by monitoring tests conducted at different temperatures ranging from 20 to 80 ℃, which reveals temperature sensitivity in the sensitive layer and the temperature dependence of the piezoresistive behavior when the temperature exceeds 50 ℃. By the application of differential conaection principle, a method for temperature compensation was established and the gauge factor for the monitoring was dramatically increased. This method was verified experimentally.
基金Supported by Health and Family Planning Project of Sichuan Province,No.17PJ069Tibet Autonomous Region Science and Technology Program,No.XZ202303ZY0011G.
文摘BACKGROUND The FreeStyle Libre flash glucose monitoring(FGM)system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose.Due to its increased usage in clinics,the number of studies investigating its accuracy has increased.However,its accuracy has not been investigated in highland populations in China.AIM To evaluate measurements recorded using the FreeStyle Libre FGM system compared with capillary blood glucose measured using the enzyme electrode method in patients with type 2 diabetes(T2D)who had migrated within 3 mo from highlands to plains.METHODS Overall,68 patients with T2D,selected from those who had recently migrated from highlands to plains(within 3 mo),were hospitalized at the Department of Endocrinology from August to October 2017 and underwent continuous glucose monitoring(CGM)with the FreeStyle Libre FGM system for 14 d.Throughout the study period,fingertip capillary blood glucose was measured daily using the enzyme electrode method(Super GL,China),and blood glucose levels were read from the scanning probe during fasting and 2 h after all three meals.Moreover,the time interval between reading the data from the scanning probe and collecting fingertip capillary blood was controlled to<5 min.The accuracy of the FGM system was evaluated according to the CGM guidelines.Subsequently,the factors influencing the mean absolute relative difference(MARD)of this system were analyzed by a multiple linear regression method.RESULTS Pearson’s correlation analysis showed that the fingertip and scanned glucose levels were positively correlated(R=0.86,P=0.00).The aggregated MARD of scanned glucose was 14.28±13.40%.Parker's error analysis showed that 99.30%of the data pairs were located in areas A and B.According to the probe wear time of the FreeStyle Libre FGM system,MARD_(1 d) and MARD_(2-14 d) were 16.55%and 14.35%,respectively(t=1.23,P=0.22).Multiple stepwise regression analysis showed that MARD did not correlate with blood glucose when the largest amplitude of glycemic excursion(LAGE)was<5.80 mmol/L but negatively correlated with blood glucose when the LAGE was≥5.80 mmol/L.CONCLUSION The FreeStyle Libre FGM system has good accuracy in patients with T2D who had recently migrated from highlands to plains.This system might be ideal for avoiding the effects of high hematocrit on blood glucose monitoring in populations that recently migrated to plains.MARD is mainly influenced by glucose levels and fluctuations,and the accuracy of the system is higher when the blood glucose fluctuation is small.In case of higher blood glucose level fluctuations,deviation in the scanned glucose levels is the highest at extremely low blood glucose levels.
基金supported by the start-up funds from Westlake University to CenBRAIN lab and Bright Dream Joint Institute for Intelligent Robotics.
文摘Continuous drug monitoring is a promising alternative to current therapeutic drug monitoring strategies and has a strong potential to reshape our understanding of pharmacokinetic variability and to improve individualised therapy.This review highlights recent advances in biosensing technologies that support continuous drug monitoring in real time.We focus primarily on aptamer-based biosensors,wearable and implantable devices.Emphasis is given to the approaches employed in constructing biosensors.We pay attention to sensors’biocompatibility,calibration performance,long-term characteristics stability and measurement quality.Last,we discuss the current challenges and issues to be addressed in continuous drug monitoring to make it a promising,future tool for individualised therapy.The ongoing efforts are expected to result in fully integrated implantable drug biosensing technology.Thus,we may anticipate an era of advanced healthcare in which wearable and implantable biochips will automatically adjust drug dosing in response to patient health conditions,thus enabling the management of diseases and enhancing individualised therapy.
文摘Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.
文摘In this editorial,we comment on the article by Zhang et al.Chronic kidney disease(CKD)presents a significant challenge in managing glycemic control,especially in diabetic patients with diabetic kidney disease undergoing dialysis or kidney transplantation.Conventional markers like glycated haemoglobin(HbA1c)may not accurately reflect glycemic fluctuations in these populations due to factors such as anaemia and kidney dysfunction.This comprehensive review discusses the limitations of HbA1c and explores alternative methods,such as continuous glucose monitoring(CGM)in CKD patients.CGM emerges as a promising technology offering real-time or retrospective glucose concentration measure-ments and overcoming the limitations of HbA1c.Key studies demonstrate the utility of CGM in different CKD settings,including hemodialysis and peritoneal dialysis patients,as well as kidney transplant recipients.Despite challenges like sensor accuracy fluctuation,CGM proves valuable in monitoring glycemic trends and mitigating the risk of hypo-and hyperglycemia,to which CKD patients are prone.The review also addresses the limitations of CGM in CKD patients,emphasizing the need for further research to optimize its utilization in clinical practice.Altogether,this review advocates for integrating CGM into managing glycemia in CKD patients,highlighting its superiority over traditional markers and urging clinicians to consider CGM a valuable tool in their armamentarium.
