scholarly journals An in silico method to identify computer-based protocols worthy of clinical study: An insulin infusion protocol use case

2015 ◽  
Vol 23 (2) ◽  
pp. 283-288 ◽  
Author(s):  
Anthony F Wong ◽  
Ulrike Pielmeier ◽  
Peter J Haug ◽  
Steen Andreassen ◽  
Alan H Morris

Abstract Objective Develop an efficient non-clinical method for identifying promising computer-based protocols for clinical study. An in silico comparison can provide information that informs the decision to proceed to a clinical trial. The authors compared two existing computer-based insulin infusion protocols: eProtocol-insulin from Utah, USA, and Glucosafe from Denmark. Materials and Methods The authors used eProtocol-insulin to manage intensive care unit (ICU) hyperglycemia with intravenous (IV) insulin from 2004 to 2010. Recommendations accepted by the bedside clinicians directly link the subsequent blood glucose values to eProtocol-insulin recommendations and provide a unique clinical database. The authors retrospectively compared in silico 18 984 eProtocol-insulin continuous IV insulin infusion rate recommendations from 408 ICU patients with those of Glucosafe, the candidate computer-based protocol. The subsequent blood glucose measurement value (low, on target, high) was used to identify if the insulin recommendation was too high, on target, or too low. Results Glucosafe consistently provided more favorable continuous IV insulin infusion rate recommendations than eProtocol-insulin for on target (64% of comparisons), low (80% of comparisons), or high (70% of comparisons) blood glucose. Aggregated eProtocol-insulin and Glucosafe continuous IV insulin infusion rates were clinically similar though statistically significantly different (Wilcoxon signed rank test P  = .01). In contrast, when stratified by low, on target, or high subsequent blood glucose measurement, insulin infusion rates from eProtocol-insulin and Glucosafe were statistically significantly different (Wilcoxon signed rank test, P  < .001), and clinically different. Discussion This in silico comparison appears to be an efficient nonclinical method for identifying promising computer-based protocols. Conclusion Preclinical in silico comparison analytical framework allows rapid and inexpensive identification of computer-based protocol care strategies that justify expensive and burdensome clinical trials.

2017 ◽  
Vol 11 (4) ◽  
pp. 724-735 ◽  
Author(s):  
Martina Vettoretti ◽  
Andrea Facchinetti ◽  
Giovanni Sparacino ◽  
Claudio Cobelli

Background: A reliable model of the probability density function (PDF) of self-monitoring of blood glucose (SMBG) measurement error would be important for several applications in diabetes, like testing in silico insulin therapies. In the literature, the PDF of SMBG error is usually described by a Gaussian function, whose symmetry and simplicity are unable to properly describe the variability of experimental data. Here, we propose a new methodology to derive more realistic models of SMBG error PDF. Methods: The blood glucose range is divided into zones where error (absolute or relative) presents a constant standard deviation (SD). In each zone, a suitable PDF model is fitted by maximum-likelihood to experimental data. Model validation is performed by goodness-of-fit tests. The method is tested on two databases collected by the One Touch Ultra 2 (OTU2; Lifescan Inc, Milpitas, CA) and the Bayer Contour Next USB (BCN; Bayer HealthCare LLC, Diabetes Care, Whippany, NJ). In both cases, skew-normal and exponential models are used to describe the distribution of errors and outliers, respectively. Results: Two zones were identified: zone 1 with constant SD absolute error; zone 2 with constant SD relative error. Goodness-of-fit tests confirmed that identified PDF models are valid and superior to Gaussian models used so far in the literature. Conclusions: The proposed methodology allows to derive realistic models of SMBG error PDF. These models can be used in several investigations of present interest in the scientific community, for example, to perform in silico clinical trials to compare SMBG-based with nonadjunctive CGM-based insulin treatments.


2019 ◽  
Vol 7 (3) ◽  
pp. 76
Author(s):  
Idola Perdana Sulistyoning Suharto ◽  
Erik Irham Lutfi ◽  
Mega Diasty Rahayu

The objective of this study was to analysis effect of giving ginger (Zingiber officinale) to the blood glukose in patients of diabetes mellitus. The method was one group pretest – posttest design. There were 16 patients of diabetes mellitus who was given ginger (Zingiber officinale). Ginger (Zingiber officinale) was given twice a day for a week The dose of ginger is 50 mg of ginger boiled with 200 ml of water Blood glucose was measured before and after ginger administration. The data was analyzed by wilcoxon signed rank test. Based on wilcoxon signed rank test, obtained result that there was a significant difference (α


2019 ◽  
Vol 3 (1) ◽  
pp. 25
Author(s):  
Dewi Nurhanifah ◽  
Desy Noor Latifah Sari ◽  
Rahmawati Rahmawati

Salah satu masalah kesehatan yang sering dialami adalah penyakit gastritis. Gejala yang sering dikeluhkan oleh penderita gastritis adalah mual. Salah satu penatalaksanaan keperawatan yang dapat mengurangi rasa mual adalah tirah baring. Penelitian ini bertujuan untuk mengetahui pengaruh tirah baring terhadap penurunan rasa mual pada klien gastritis di Pelayanan Kesehatan. Metode penelitian menggunakan eksperimental dengan bentuk penelitian one group pretest-posttest design. Populasi dan sampel adalah klien yang mengalami mual di Wilayah Kerja Puskesmas  yang berjumlah 15 orang. Sampel diambil dengan teknik purposive sampling. Alat pengumpul data menggunakan observasi. Analisa data melalui uji Wilcoxon Signed Rank Test. Hasil penelitian menujukkan klien gastritis sebelum tirah baring mengalami mual ringan sebanyak 7 orang (46,7%), sesudah tirah baring mengalami tidak mual sebanyak 7 orang (46,7%). Ada pengaruh tirah baring terhadap penurunan rasa mual pada klien gastritis di Pelayanan Kesehatan (ρ value = 0,001).


2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Ferawato Ferawati

ABSTRAKReumatoid Artritis (RA) merupakan penyakit muscoloskelektal yang sering terjadi pada usia lanjut. Gangguan pada system muscoloskelektal yang ditandai dengan munculnya nyeri sendi dan kekakuan yang mengakibatkan penurunan kemampuan fisiologis atau kualitas hidup lansia. Dampak dari Reumatoid Artritis dapat menimbulkan beberapa keluhan dan dapat menyebabkan kelumpuhan. Untuk menganalisis efektifitas kompres jahe merah hangat dan kompres serai hangat terhadap penurunan intensitas nyeri artitris remauthoid pada lanjut usia.Metode Penelitian: Jenis penelitian adalah quasy experimental dengan two group pre – post test design. Subjek adalah sebagian lansia yang penderita Arthritis Remathoid di Desa Sumberagung Kecamatan Dander Kabupaten Bojonegoro. Subjek dibagi menjadi dua kelompok yaitu kelompok I (n=15) diberi perlakuan kompres jahe hangat dan II (n=15) diberi perlakuan kompres serai hangat. Analisis yang digunakan uji Mann Whitney U Test dan Wilcoxon Signed Ranks Test dengan ingkat kemaknaan α = 0,05.Hasil uji Wilcoxon Signed Rank Test, didapat keduanya mempunyai nilai kemaknaan yaitu ρ value = 0,000. Nilai ρ = 0,031 pada kelompok kompres serai hangat dan kelompok kompres jahe merah ρ value = 0,165. Hasil uji Mann Withney U Test pada Post perlakuan kedua terapi diperoleh selisih nilai nyeri pada kompres jahe ρ= 0,003 dan selisih nilai nyeri kompres serai ρ value = 0,001.Penggunaan kompres jahe merah lebih efektif dibandingkan dengan kompres serai terhadap penurunan intensitas nyeri arthritis remathoid. Kata Kunci: usia lanjut, Reumatoid Artritis (RA), jahe merah, serai, perbedaan efektifitas.    ABSTRACTReumatoid Artritis (RA) is a musculoskeletal which frequently occurs in the elderly. The disorders in the musculoskeletal system are noted by the occurrence of pain in the joints and stiffness which reduces the physiological abilities or life quality of the elderly. The disease causes many such complaints and  consequences of the disease rheumatoid arthritis may experience paralysis. The aims of this study is to analyze the effect of warm red ginger compress therapy and warm lemongrass compress therapy against of  Decreased pain intensity in  the elderly  with  artitris remauthoid. The study was Queasy experimental with two group pre – post test design. Subjects were some elderly people with Arthritis Remathoid in Sumberagung Village, Dander Sub District, Bojonegoro District. Subjects were divided into two groups: group I (n-15) with warm ginger compress therapy, and II (n=15) with warm lemongrass compress therapy. The analyses used in this study were the Mann Whitney U Test and Wilcoxon Signed Ranks Test with α of 0.05. Results of Wilcoxon Signed Rank Test obtained Both have meaning p value of  0.000. ρ value = 0,031 in a warm lemongrass compress therapy group and obtained of warm ginger compress therapy group ρ value = 0,165. The results of Mann Withney U Test on Post treatment second therapy, obtained difference of warm ginger compress therapy with ρ value= 0,003 and difference of warm lemongrass compress therapy with ρ value = 0,001.The use of warm ginger compresses therapy are more effective than a warm lemongrass compress therapy against decreased pain intensity in  the elderly  with  artitris remauthoid.  Keywords: elderly, artitris remauthoid, red ginger, lemongrass, differences in effectiveness


Author(s):  
I Ketut Widana

The working practice of the engineering students is part of the learning process that is irreducible and indispensable. The composition of  lecturing between theoretical and practical one is 40% to 60%. With this condition, the students spend more time at the laboratory. Generally, the students perform in the laboratory work by standing position. The design of research is observational cross-sectional. The method applied is observation, interview and measuring. The subjects of research are practicing students amounting to 21 students. Referring to the analysis of statistical test or Wilcoxon signed ranks test, the difference of effect of work position is significant, namely p < 0.05 towards musculoskeletal disorders (MSDs) before and after working. The quantity of the average complaint after working is score 44.62 ± 9.47. The result of Wilcoxon signed rank test shows that there is significant different effects of standing work position, namely p < 0.05 towards fatigue generally before and after working. The degree of the working pulse is on the average of 110.78  ± 17.80 bpm (beats per minutes) which can be categorized into the medium workload. Using paired t-test, the result is p < 0.05.


2010 ◽  
Vol 1 (1) ◽  
Author(s):  
Sri Sumaryani ◽  
Indri Nurasa

PENGARUH PEMBACAAN DZIKIR PADA IBU MELAHIRKAN TERHADAP TINGKAT NYERI INTRA NATAL DI RUMAH BERSALIN FAJAR YOGYAKARTAEffect of Reading Dhikr Women On The Level Of Birth Pain Intra Christmas At Home Delivery Dawn YogyakartaSri Sumaryani1 & Indri Nurasa21, 2)Program Studi Ilmu Keperawatan Fakultas Kedokteran Universitas Muhammadiyah YogyakartaJl. Lingkar Barat Taman Tirto Kasihan Bantul Yogyakarta 55182*)e-mail: [email protected] atau yang biasa disebut dengan proses persalinan merupakan suatu proses membuka dan menipisnya serviks, dan janin turun ke dalam jalan lahir. Gejala awal persalinan akan menimbulkan nyeri yang sangat hebat karena adanya kontraksi uterus dan otot abdomen. Nyeri intra natal adalah suatu nyeri yang dirasakan saat terjadinya proses persalinan (melahirkan). Saat nyeri persalinan muncul, ada baiknya bagi ibu untuk membaca dzikir. Dzikir adalah mengingat Allah SWT dan menghadirkan apa yang tadinya ada di dalam benak untuk kemudian dilafadzkan atau disebut-sebut yang dapat dilakukan secara lisan dengan menggunakan lidah atau bisa juga diucapkan tanpa adanya keterlibatan lidah, yaitu melalui hati. Penelitian ini bertujuan untuk mengetahui pengaruh pembacaan dzikir pada ibu melahirkan terhadap tingkat nyeri intra natal. Teknik pengambilan sampel menggunakan purposive sampling. Desain penelitian pra eksperimen, dengan rancangan pre test-post test tanpa kelompok kontrol. Sampel penelitian berjumlah 30 responden. Pengumpulan data dilakukan dengan observasi langsung kepada responden untuk mengukur tingkat nyeri. Analisa data menggunakan uji statistik wilcoxon signed rank test dan regresi linier dengan menggunakan SPSS 14. Hasil penelitian menunjukkan bahwa hasil uji statistik untuk nilai pre test dan post test tingkat nyeri diperoleh nilai signifikansi 0,02 dengan p < 0,05.Kata kunci: pembacaan dzikir, melahirkan, nyeri intra natal, tingkat nyeriABSTRACTThe delivery or usually called labor process is a process open and thin the cervix, and descent of the fetus into the way of birth. The early symptom of delivery will be appearing very heavy because there are uterus contraction and abdomen muscle. In partum pain is a pain which feel when delivery process happening (labor). When labor pain appears, there is a good for the mother to read dzikir. Dzikir is remembering Allah SWT and make present what before in the mind and then pronounced or make cal can do spoken by tongue or pronounced without there are involving tongue, by heart. The purpose of this research is to know about the influence of reading dzikir to the delivery mother toward in partum level of pain. Technique sampling used purpose sampling. The research of design pre experiment, with pre test-post test without control group design. The sample in this research’s total is 30 respondents. The manner of data was did by direct observation to the respondents to measure pain level. Data analysis used statistic test wilcoxon signed rank test and regression linier in SPSS 14. The results of research showed that results of the statistic pretest and posttest of pain level show significance value 0,02 with p < 0,05.Keywords: reading dzikir, delivery, in partum pain, pain level


2021 ◽  
Vol 10 (9) ◽  
pp. 1905
Author(s):  
Cristina Peris-Martínez ◽  
María Amparo Díez-Ajenjo ◽  
María Carmen García-Domene ◽  
María Dolores Pinazo-Durán ◽  
María José Luque-Cobija ◽  
...  

(1) Purpose: To assess the main corneal response differences between normal and subclinical keratoconus (SCKC) with a Corvis® ST device. (2) Material and Methods: We selected 183 eyes of normal patients, of a mean age of 33 ± 9 years and 16 eyes of patients with SCKC of a similar mean age. We measured best corrected visual acuity (BCVA) and corneal topography with a Pentacam HD device to select the SCKC group. Biomechanical measurements were performed using the Corvis® ST device. We carried out a non-parametric analysis of the data with SPSS software (Wilcoxon signed rank-test). (3) Results: We found statistically significant differences between the control and SCKC groups in some corneal biomechanical parameters: first and second applanation time (p = 0.05 and p = 0.02), maximum deformation amplitude (p = 0.016), highest concavity radius (p = 0.007), and second applanation length and corneal velocity ((p = 0.039 and p = 0.016). (4) Conclusions: Our results show that the use of normalised biomechanical parameters provided by noncontact tonometry, combined with a discriminant function theory, is a useful tool for detecting subclinical keratoconus.


Author(s):  
Elke Knisel ◽  
Helge Rupprich ◽  
Annika Wunram ◽  
Markus Bremer ◽  
Christiane Desaive

Health literacy is an important outcome of the discussion of school-related health education and health promotion in the 21st century. Although the improvement of health literacy at an early age is increasingly recognized and few interventions show the development of children´s health literacy, still there is little research in this area. The purpose of the study was to examine the enhancement of health literacy among children in a physical activity-based program at elementary school. In total, 137 students aged 6–12 years participated in the program, which included health knowledge transfer in child-appropriate games and exercises. Participants´ health literacy was assessed using the HLS-Child-Q15-DE at the beginning and the end of the program. The instrument measures the access, understanding, appraisal and application of health-related information on a four-point Likert-type scale. As expected, the Wilcoxon signed-rank test revealed significant increases in self-reported health literacy over time. The results show that the degree of change in health literacy was not associated with gender or age. The results suggest that the physical activity-based program has the potential to improve elementary school children´s health literacy, even though in a single group pilot study.


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