Bio-Impedance Sensor for Real-Time Artery Diameter Waveform Assessment

The real-time artery diameter waveform assessment during cardio cycle can allow the measurement of beat-to-beat pressure change and the long-term blood pressure monitoring. The aim of this study is to develop a self-calibrated bio-impedance-based sensor, which can provide regular measurement of the blood-pressure-dependence time variable parameters such as the artery diameter waveform and the elasticity. This paper proposes an algorithm based on analytical models which need prior geometrical and physiological patient parameters for more appropriate electrode system selection and hence location to provide accurate blood pressure measurement. As a result of this study, the red cell orientation effect contribution was estimated and removed from the bio-impedance signal obtained from the artery to keep monitoring the diameter waveform correspondence to the change of blood pressure.

Studying the Accuracy and Function of Different Thermometry Techniques for Measuring Body Temperature

The purpose of this study was to determine which thermometry technique is the most accurate for regular measurement of body temperature. We compared seven different commercially available thermometers with a gold standard medical-grade thermometer (Welch-Allyn): four digital infrared thermometers (Wellworks, Braun, Withings, MOBI), one digital sublingual thermometer (Braun), one zero heat flux thermometer (3M), and one infrared thermal imaging camera (FLIR One). Thirty young healthy adults participated in an experiment that altered core body temperature. After baseline measurements, participants placed their feet in a cold-water bath while consuming cold water for 30 min. Subsequently, feet were removed and covered with a blanket for 30 min. Throughout the session, temperature was recorded every 10 min with all devices. The Braun tympanic thermometer (left ear) had the best agreement with the gold standard (mean error: 0.044 °C). The FLIR One thermal imaging camera was the least accurate device (mean error: −0.522 °C). A sign test demonstrated that all thermometry devices were significantly different than the gold standard except for the Braun tympanic thermometer (left ear). Our study showed that not all temperature monitoring techniques are equal, and suggested that tympanic thermometers are the most accurate commercially available system for the regular measurement of body temperature.

Sustainable Development Model of EU Cities Compliant with UN Settings

Nowadays, the globally accepted UN concept of sustainable development (SD) is gradu®ally transferred to the city level, including small and medium-sized cities. The implementation of SD settings requires regular measurement of developmental progress to monitor the level achieved in statics and dynamics, and to make strategic decisions for the next period. The existing urban SD indicator systems and indices are not well-suited for the monitoring of specific cities. Benchmarking algorithms and mathematical modelling procedures were applied to create a methodology and mathematical model for measuring the achieved urban SD level and to ensure the most objective selection and proportions of key performance indicators (KPIs) to be included in the model. The model (1) complies with the UN concept, (2) is usable for any EU city, (3) reflects the level of quality of life achieved, and (4) includes a limited number of KPIs related to municipal functionality. Mathematical computation of the (1) causality between the KPIs, (2) selection and proportions of KPIs, and (3) the general level of urban SD, as well as the reasonable combination of universality, accuracy, stability, and simplicity are strong advantages of the model. Using the published mathematical expressions of the model, calculation of the SD level does not require specific skills; the performed stability test also confirms that annual calibration of the model is not necessary. The index will help municipalities in planning and managing SD, and in the rational use of their usually limited resources. As a pilot project, SD level values are calculated for several cities.

A glikációs index lehetséges magyarázata a hemoglobinglikáció biokinetikus modellje alapján

Összefoglaló. Bevezetés: A HbA1c integrált retrospektív mutatója az elmúlt időszak vércukrának, rendszeres vizsgálata a cukorbetegek anyagcserekontrolljának megítélésében elengedhetetlen. Helyes értékelése azonban nem egyszerű, mert a HbA1c és a vércukor közötti összefüggés nem lineáris. A mérést közvetlenül megelőző hyperglykaemiás epizódok hatása a HbA1c szintjére nagyobb, mint azoké, amelyek régebben történtek. A jelenségre a glikáció biokinetikus modellje ad magyarázatot. Célkitűzés: A mért és a biokinetikus modell alapján számított HbA1c közötti egyezés, illetve diszkordancia vizsgálata. Módszer: A vizsgálatokat 157, 1-es és 2-es típusú cukorbeteg 1793, laboratóriumban mért éhomi vércukor- és 511 HbA1c-adatából végeztük. A különbséget a glikációs index segítségével számítottuk, amely a mért és a számított HbA1c-érték aránya. Eredmények: Egyezést mindössze a vizsgált betegek kevesebb mint egyötödödében találtunk, 60%-ban az index értéke alacsony (<0,95) és 21%-ban magas (>1,05) volt. Az adatok részletes analízise szerint jó anyagcserekontroll esetében gyakoribb a vártnál magasabb, mért HbA1c-érték, mint a biokinetikus egyenlet által számítotté, és rosszabb kontroll (magasabb átlagos vércukor) esetében ez fordítva van. Egyezés esetén a regressziós egyenlet együtthatói gyakorlatilag azonosak a modell alapján számított értékekkel. Következtetés: Vizsgálataink felvetik azt a lehetőséget, hogy a biokinetikus modell magyarázatot adhat a vércukor és a HbA1c közötti diszkordanciára. Orv Hetil. 2021; 162(41): 1652–1657. Summary. Introduction: HbA1c is an integrated retrospective marker of previous blood glucose concentrations and its regular measurement is indispensable in the assessment of glycaemic compensation of diabetic patients. However, its proper interpretation is not simple becasuse the relationship between HbA1c and average glycemia is not a linear one. Hyperglycemic episodes occuring immediately before the measurement have greater impact on the HbA1c level as compared with those taking place earlier. Objective: Assessment of concordance and discordance between measured and according to the biokinetic model calculated values of HbA1c. Method: The calculations were made from averages of 1793 fasting blood glucose and 511 HbA1c of 157, type 1 and 2 diabetic patients. The glycation index is the quotient between measured and calculated HbA1c. Results: Agreement was found in less than one fifth of the 157 patients; in 60% the value of glycation was low (<0.95) and in 21% high (>1.05). Analysis of the glycation index according to the level of glycemic compensation revealed that in patients with good compensation, the measured HbA1c value was more often higher than the expected and in patients with unsatisfactory compensation the opposite was true. Conclusion: These results raise the possibility that the discordance between average glycemia and measured HbA1c can be explained by the biokinetic model. Orv Hetil. 2021; 162(41): 1652–1657.

Red Cell Distribution Width as a Prognostic Factor and Its Comparison with Lactate in Patients with Sepsis

Sepsis remains the leading cause of death in critically ill patients. Thus, regular measurement of lactate levels has been proposed in sepsis guidelines. Elevated red cell distribution width (RDW) is associated with mortality risk in patients with sepsis. This study aimed to investigate the association between RDW and the risk of other adverse outcomes in patients with sepsis and to compare the mortality discriminative ability between lactate and RDW levels. This is a single-centered, retrospective, case-control study that included 504 adult patients with sepsis in the emergency department between 1 January 2020 and 31 December 2020. Eligible patients were divided into normal (RDW ≤ 14.5%) and high (RDW > 14.5%) groups. The baseline characteristics and adverse outcomes were recorded and compared. Compared with the normal RDW group, the patients in the high RDW group had a significantly higher rate of ICU admission (48.8% vs. 32.4%, p = 0.03), septic shock (39.2% vs. 23.5%, p < 0.01), and 30-day in-hospital mortality (32.0% vs. 20.7%, p < 0.01). Furthermore, the RDW (area under curve (AUC) = 0.71) had superior mortality discriminative ability compared to lactate (AUC = 0.63) levels (p = 0.02). Clinicians could rely on this simple and rapid parameter for risk stratification to initiate prompt treatment for patients with sepsis.

Continuous in-home walking speed monitoring in older people with a low-cost ambient sensor: Results of a feasibility study

BACKGROUND: Walking speed predicts important clinical outcomes in older adults and is one of the most significant indicators of frailty. OBJECTIVE: To test whether it is feasible to measure walking speed frequently and unobtrusively in the home. METHODS: A longitudinal feasibility study was conducted comprising the installation and monitoring of continuous measurement walking speed sensors in twenty frail older adults’ homes for a period of twelve weeks (eighteen participants completed the study). Manual walking speed, frailty level and health status were measured at four-weekly intervals. Qualitative interviews were conducted at the end of the study to assess participants’ attitudes to the sensors and to the concept of continuous in-home walking speed measurement. RESULTS: There was a high degree of variance to the number of walking speed measurements recorded by each participant’s sensor (median 1942.39, range 2-3617). Participants indicated acceptability of both the sensor within the home and the concept of in-home walking speed measurement. CONCLUSIONS: Where regular measurement was achieved, the results indicate that walking speed might be better viewed as a distribution rather than a single figure, taking into account the natural variation to walking speed in daily life. This study demonstrates the feasibility of continuous ambient in-home walking speed monitoring of older adults with a low-cost, easily deployed device.

Lipid profile of childhood cancer survivors and the effects of vitamin D supplementation: a prospective study

Background Childhood cancer survivors (CCS) have high prevalence of obesity vitamin D (VD) deficiency together with dyslipidemia. We aimed to evaluate lipid profile and the effect of VD supplementation in CCS. Results VD deficiency was more frequent among obese CCS and their lipid profiles, TC, and LDL-C levels were significantly higher compared to non-obese patients. After VD supplementation trials, VD levels increased among obese and non-obese children albeit it was significantly higher in non-obese subjects while the lipid profile of obese patients significantly decreased. Also, parathyroid hormone levels were persistently elevated among VD-deficient obese patients. Yet, the weight of obese patients remained unchanged. Conclusion VD deficiency was more prevalent among obese CCS. VD supplementation helped in normalization of the lipid profile of obese CCS. Regular measurement of PTH and 25OH-VD is recommended for CCS especially obese ones who may need VD supplementation.

Length-weight relationship of bigeye scad, Selar crumenophthalmus (Bloch, 1793): Regular vs hierarchical bayesian methods

Fisheries management or conservation requires information on length-weight relationship (LWR) for the fishing regulation and biomass estimation. This study aims to assess LWR estimation using two methods, regular and Bayesian hierarchical approached for big-eye Scad (Selar crumenophthalmus). Samples of big eye Scad were collected at several fish landings around Ambon Island from March to August 2020. Length-weight relationship measurement to obtain the parameters of W = a*Lb was tested using generalized linear model and t-test. The parameter b for monthly sampling was not significantly different (F = 0.77, df = 70, P = 0.89) and showed isometric growth b=3 (t = -1.13, df = 4, P = 0.32). Regular measurement resulted parameter log10(a) = -1.99 (±SD = 1.06) dan b = 3.06 (±SD = 0.084). Bayesian method produced parameter log10(a) = -2.07 (±SD = 0.2365) dan parameter b = 3.21 (±SD = 0.1497). Weight measurement from HB approach was significantly higher than the regular method (t = 1.65; df = 405; P <0.0001), and might produce over-estimated of weight from length data. Discrepancy of these methods was overcome by combining all information of LWR to obtain the best estimation on LWR parameters.

Anaemia in chronic kidney disease pregnancy

Aim To review the incidence and management of anaemia and outcomes in pregnancies in a cohort of Australian women with chronic kidney disease. Methods A retrospective audit of 63 pregnancies in 52 women with chronic kidney disease. Results Sixty-eight percent of chronic kidney disease pregnancies were complicated by haemoglobin less than 100 g/L. Iron stores were measured in only 62% of all pregnancies. Serum ferritin was less than 100 ng/ml in 95% of those tested. Erythropoietin-stimulating agents were used in 24 pregnancies (38%). Intravenous iron was used in only nine non-dialysis pregnancies. Conclusion Greater awareness of the importance of regular measurement of iron stores and appropriate levels for repletion in chronic kidney disease pregnancies amongst health professionals involved in obstetric care may result in earlier detection and treatment of iron deficiency, and potentially improve maternal and fetal outcomes.

PRODUCTIVITY IN CONSTRUCTION INDUSTRY

Since the late 1990s, the construction industry in the Kingdom of Saudi Arabia (KSA) has lagged behind the rest of the world in actual levels of productivity and productivity growth. This is despite the KSA Government’s tremendous support for the construction industry and the expectation that, in the coming decades, the KSA construction industry will continue to develop and grow to achieve the targets of Saudi Vision 2030. This paper explores in depth the concept of productivity to gain insights through answering two questions contextualized within the KSA construction industry: 1) How do managers perceive productivity? and 2) How is productivity measured? Semi-structured interviews were conducted with 13 senior managers with 10-27 years’ experience in project management in the KSA construction industry. Qualitative analysis of interview results found that around 40% of interviewees had little or an incorrect understanding of the concept of productivity and its relevance to production processes. This poor understanding of productivity and its measures extends to the lack of clear specific procedures for regular measurement of productivity.