Continuous glucose monitoring metrics in pregnancy with type 1 diabetes mellitus

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.

Regulatable Orthotropic 3D Hybrid Continuous Carbon Networks for Efficient Bi-Directional Thermal Conduction

Vertically oriented carbon structures constructed from low-dimen-sional carbon materials are ideal frameworks for high-performance thermal inter-face materials(TIMs).However,improving the interfacial heat-transfer efficiency of vertically oriented carbon structures is a challenging task.Herein,an orthotropic three-dimensional(3D)hybrid carbon network(VSCG)is fabricated by depositing vertically aligned carbon nanotubes(VACNTs)on the surface of a horizontally oriented graphene film(HOGF).The interfacial interaction between the VACNTs and HOGF is then optimized through an annealing strategy.After regulating the orientation structure of the VACNTs and filling the VSCG with polydimethylsi-loxane(PDMS),VSCG/PDMS composites with excellent 3D thermal conductive properties are obtained.The highest in-plane and through-plane thermal conduc-tivities of the composites are 113.61 and 24.37 W m^(-1)K^(-1),respectively.The high contact area of HOGF and good compressibility of VACNTs imbue the VSCG/PDMS composite with low thermal resistance.In addition,the interfacial heat-transfer efficiency of VSCG/PDMS composite in the TIM performance was improved by 71.3%compared to that of a state-of-the-art thermal pad.This new structural design can potentially realize high-performance TIMs that meet the need for high thermal conductivity and low contact thermal resistance in interfacial heat-transfer processes.

Application and management of continuous glucose monitoring in diabetic kidney disease

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.

Strengthening effect of prefabrication(10-12)tensile twinning on AZ80+0.4%Ce magnesium alloy and inhibition mechanism of discontinuous precipitation

This paper provided an effective method to further improve the mechanical properties of the AZ80+0.4%Ce magnesium alloy wheel spoke.The effect of high strength and ductility was obtained with a yield strength of 295.36 MPa,an elongation of 10%,by the combination of pre-deformation(7%deformation)and two-stage aging treatment(120℃/9 h+175℃/24 h).The evolution of the microstructure and properties of the alloy was explored under the coupling conditions of different pre-deformation degrees and multi-stage aging.The results show that,pre-deformation introduced a large number of(1012)tensile twinning and dislocations,which greatly promoted the probability of continuous precipitates(CPs)appearing.On the contrary,the discontinuous precipitates(DPs)were limited by the vertical and horizontal twin structure.As a result,the pre-nucleation method of two-stage aging increased the proportion of CPs by 34%-38%.Owing to the DPs was effectively suppressed,the alloy's yield strength has been greatly improved.Besides,under multi-stage aging,the twin boundaries induce protruding nucleation to form static recrystallization by hindering the migration of dislocations,and the matrix swallows the twins,then the texture gradually tilts from the two poles to the basal plane.As an important supplement,the grain refinement and oblique texture promoted the improvement of the yield strength of the component.

Enhanced measurement precision with continuous interrogation during dynamical decoupling

Dynamical decoupling(DD)is normally ineffective when applied to DC measurement.In its straightforward implementation,DD nulls out DC signal as well while suppressing noise.This work proposes a phase relay method that is capable of continuously interrogating the DC signal over many DD cycles.We illustrate its efficacy when applied to the measurement of a weak DC magnetic field with an atomic spinor Bose-Einstein condensate.Sensitivities approaching standard quantum limit or Heisenberg limit are potentially realizable for a coherent spin state or a squeezed spin state of 10000 atoms,respectively,while ambient laboratory level noise is suppressed by DD.Our work offers a practical approach to mitigate the limitations of DD to DC measurement and would find other applications for resorting coherence in quantum sensing and quantum information processing research.

Path-Dependent Progressive Failure Analysis for 3D-Printed Continuous Carbon Fibre Reinforced Composites

In order to predict the damage behaviours of 3D-printed continuous carbon fibre(CCF)reinforced composites,when additional short carbon fibre(SCF)composite components are employed for continuous printing or special functionality,a novel path-dependent progressive failure(PDPF)numerical approach is developed.First,a progressive failure model using Hashin failure criteria with continuum damage mechanics to account for the damage initiation and evaluation of 3D-printed CCF reinforced polyamide(PA)composites is developed,based on actual fibre placement trajectories with physical measurements of 3D-printed CCF/PA constituents.Meanwhile,an elastic-plastic model is employed to predict the plastic damage behaviours of SCF/PA parts.Then,the accuracy of the PDPF model was validated so as to study 3D-printed CCF/PA composites with either negative Poisson's ratio or high stiffness.The results demonstrate that the proposed PDPF model can achieve higher prediction accuracies in mechanical properties of these 3D-printed CCF/PA composites.Mechanism analyses show that the stress distribution is generally aggregated in the CCF areas along the fibre placement paths,and the shear damage and matrix tensile/compressive damage are the key damage modes.This study provides a new approach with valuable information for characterising complex 3D-printed continuous fibre-matrix composites with variable mechanical properties and multiple constituents.

Irregular initial solidification by mold thermal monitoring in the continuous casting of steels:A review

Occasional irregular initial solidification phenomena,including stickers,deep oscillation marks,depressions,and surface cracks of strand shells in continuous casting molds,are important limitations for developing the high-efficiency continuous casting of steels.The application of mold thermal monitoring(MTM) systems,which use thermocouples to detect and respond to temperature variations in molds,has become an effective method to address irregular initial solidification phenomena.Such systems are widely applied in numerous steel companies for sticker breakout prediction.However,monitoring the surface defects of strands remains immature.Hence,indepth research is necessary to utilize the potential advantages and comprehensive monitoring of MTM systems.This paper summarizes what is included in the irregular initial solidification phenomena and systematically reviews the current state of research on these phenomena by the MTM systems.Furthermore,the influences of mold slag behavior on monitoring these phenomena are analyzed.Finally,the remaining problems of the formation mechanisms and investigations of irregular initial solidification phenomena are discussed,and future research directions are proposed.

Deformation mechanisms and microstructural characteristics of AZ61 magnesium alloys processed by a continuous expansion extrusion approach

The unique continuous extrusion-based severe plastic deformation approaches were proposed recently to process high-performance magnesium(Mg)alloys,while the in-depth deformation mechanisms under such complicated thermomechanical conditions were not well understood.In the present work,the fundamental deformation behaviors of AZ61 Mg alloy from 25 to 400°C were firstly examined under uniaxial compression deformation.Then the deformation mechanisms and microstructural characteristics of AZ61 Mg alloy during continuous expansion extrusion forming(CEEF)were systematically investigated by microstructural observations,finite element and cellular automata simulations.The results showed that the continuous evolutions of temperature,larger strain level and complex stress state with strain rate range of 0∼5.98 s−1 during CEEF brought the distinctive dynamic recrystallization behaviors and texture development in AZ61 Mg alloy,which were different to that of uniaxial compression deformation.In details,a remarkable grain refinement was achieved via CEEF processing due to the simultaneous actions of continuous dynamic recrystallization(CDRX)and discontinuous dynamic recrystallization(DDRX).Gradually enhanced CDRX were observed from center to edge region,which had significant effects on the texture distribution and texture strength.The c-axis of most grains rotated under distinctive shear strain following parabolic metal flow,resulting in stable fiber texture.In addition,the evolution of the internal texture of the alloy led to an obvious increase in the Schmid factor for the activation of basalc+aslip system.©2022 Chongqing University.Publishing services provided by Elsevier B.V.on behalf of KeAi Communications Co.Ltd.

Auto-parametric resonance of a continuous-beam-bridge model under two-point periodic excitation:an experimental investigation and stability analysis

The auto-parametric resonance of a continuous-beam bridge model subjected to a two-point periodic excitation is experimentally and numerically investigated in this study.An auto-parametric resonance experiment of the test model is conducted to observe and measure the auto-parametric resonance of a continuous beam under a two-point excitation on columns.The parametric vibration equation is established for the test model using the finite-element method.The auto-parametric resonance stability of the structure is analyzed by using Newmark's method and the energy-growth exponent method.The effects of the phase difference of the two-point excitation on the stability boundaries of auto-parametric resonance are studied for the test model.Compared with the experiment,the numerical instability predictions of auto-parametric resonance are consistent with the test phenomena,and the numerical stability boundaries of auto-parametric resonance agree with the experimental ones.For a continuous beam bridge,when the ratio of multipoint excitation frequency(applied to the columns)to natural frequency of the continuous girder is approximately equal to 2,the continuous beam may undergo a strong auto-parametric resonance.Combined with the present experiment and analysis,a hypothesis of Volgograd Bridge's serpentine vibration is discussed.

Microarrow sensor array with enhanced skin adhesion for transdermal continuous monitoring of glucose and reactive oxygen species

Conventional blood sampling for glucose detection is prone to cause pain and fails to continuously record glucose fluctuations in vivo.Continuous glucose monitoring based on implantable electrodes could induce pain and potential tissue inflammation,and the presence of reactive oxygen species(ROS)due to inflammationmay affect glucose detection.Microneedle technology is less invasive,yet microneedle adhesion with skin tissue is limited.In this work,we developed a microarrow sensor array(MASA),which provided enhanced skin surface adhesion and enabled simultaneous detection of glucose and H_(2)O_(2)(representative of ROS)in interstitial fluid in vivo.The microarrows fabricated via laser micromachining were modified with functional coating and integrated into a patch of a three-dimensional(3D)microneedle array.Due to the arrow tip mechanically interlocking with the tissue,the microarrow array could better adhere to the skin surface after penetration into skin.The MASA was demonstrated to provide continuous in vivo monitoring of glucose and H_(2)O_(2) concentrations,with the detection of H_(2)O_(2) providing a valuable reference for assessing the inflammation state.Finally,the MASA was integrated into a monitoring system using custom circuitry.This work provides a promising tool for the stable and reliable monitoring of blood glucose in diabetic patients.

Development of high-power microwave mechanical integrated continuous mining device

This article introduces a high-power microwave mechanical integrated continuous mining device,which can achieve synchronous cutting of hard rocks by microwave and machinery.The device includes a cutting system,a rotary translation system,a loading system,a high-power microwave system,and a control and monitoring system.The technology of“master-slave follow-up”disc cutter alternating side cutting of rock was proposed,which could improve the effectiveness of rock breaking.The integrated structure of a microwave-cut system was then proposed,and synchronous motion of the microwave-cut system and adjustment of the loading system could be realized.The automatic adjustment technology of the microwave working distance was developed to dynamically control the optimal microwave working distance.The basic functions of the equipment were verified by tests.By comparing the two types of disk cutters,it is found that the master-slave follow-up disk cutter can improve significantly the dust removal effect and rock breaking efficiency in rock breaking process versus the conventional large disc cutter.Cutting tests of slate with or without microwave were conducted using a master-slave follow-up disk cutter.The results show that the cutting patterns of slates change from intermittent chunks(without microwave irradiation)to persistent debris(with microwave irradiation),and the cutting speed is significantly improved(170%).The development of the device provides a scientific basis for changing the conventional mining technology of metal mines and realizing the mechanical continuous mining in hard metal mines.

NCCMF:Non-Collaborative Continuous Monitoring Framework for Container-Based Cloud Runtime Status

The security performance of cloud services is a key factor influencing users’selection of Cloud Service Providers(CSPs).Continuous monitoring of the security status of cloud services is critical.However,existing research lacks a practical framework for such ongoing monitoring.To address this gap,this paper proposes the first NonCollaborative Container-Based Cloud Service Operation State Continuous Monitoring Framework(NCCMF),based on relevant standards.NCCMF operates without the CSP’s collaboration by:1)establishing a scalable supervisory index system through the identification of security responsibilities for each role,and 2)designing a Continuous Metrics Supervision Protocol(CMA)to automate the negotiation of supervisory metrics.The framework also outlines the supervision process for cloud services across different deployment models.Experimental results demonstrate that NCCMF effectively monitors the operational state of two real-world IoT(Internet of Things)cloud services,with an average supervision error of less than 15%.

Improvement and security analysis of multi-ring discrete modulation continuous variable quantum secret sharing scheme

In order to avoid the complexity of Gaussian modulation and the problem that the traditional point-to-point communication DM-CVQKD protocol cannot meet the demand for multi-user key sharing at the same time, we propose a multi-ring discrete modulation continuous variable quantum key sharing scheme(MR-DM-CVQSS). In this paper, we primarily compare single-ring and multi-ring M-symbol amplitude and phase-shift keying modulations. We analyze their asymptotic key rates against collective attacks and consider the security key rates under finite-size effects. Leveraging the characteristics of discrete modulation, we improve the quantum secret sharing scheme. Non-dealer participants only require simple phase shifters to complete quantum secret sharing. We also provide the general design of the MR-DM-CVQSS protocol.We conduct a comprehensive analysis of the improved protocol's performance, confirming that the enhancement through multi-ring M-PSK allows for longer-distance quantum key distribution. Additionally, it reduces the deployment complexity of the system, thereby increasing the practical value.

Process and performance of DAAF microspheres prepared by continuous integration from synthesis to spherical coating based on microfluidic system

In order to improve the energy output consistency of 3, 3’-diamino-4, 4’-azoxyfurazan(DAAF) in the new insensitive booster and the safety and efficiency in the preparation process, a continuous preparation system of DAAF from synthesis to spherical coating was designed and established in this paper, which combined ultrasonic micromixing reaction with microdroplet globular template. In the rapid micromixing stage, the microfluidic mixing technology with ultrasonic was used to synergistically strengthen the uniform and rapid mass transfer mixing reaction between raw materials to ensure the uniformity of DAAF particle nucleation-growth, and to prepare high-quality DAAF crystals with uniform structure and morphology and concentrated particle size distribution. In the microdroplet globular template stage, the microfluidic droplet technology was used to form a droplet globular template with uniform size under the shear action of the continuous phase of the dispersed phase solution containing DAAF particles and binder. The size of the droplet template was controlled by adjusting the flow rate ratio between the continuous phase and the dispersed phase. In the droplet globular template, with the diffusion of the solvent in the dispersed phase droplets, the binder precipitates to coat the DAAF into a ball, forming a DAAF microsphere with high sphericity, narrow particle size distribution and good monodispersity. The problem of discontinuity and DAAF particle suspension in the process was solved, and the coating theory under this process was studied. DAAF was coated with different binder formulations of fluororubber(F2604), nitrocellulose(NC) and NC/glycidyl azide polymer(GAP), and the process verification and evaluation of the system were carried out. The balling effects of large, medium and small droplet templates under different binder formulations were studied. The scanning electron microscope(SEM) results show that the three droplet templates under the three binder formulations exhibit good balling effect and narrow particle size distribution. The DAAF microspheres were characterized by powder X-ray diffraction(XRD), differential scanning calorimetry(DSC), thermo-gravimetric(TG) and sensitivity analyzer. The results showed that the crystal structure of DAAF did not change during the process, and the prepared DAAF microspheres had lower decomposition temperature and lower mechanical sensitivity than raw DAAF. The results of detonation parameters show that the coating of DAAF by using the above three binder formulations will not greatly reduce the energy output of DAAF, and has comparable detonation performance to raw DAAF. This study proves an efficient and safe continuous system from synthesis to spherical coating modification of explosives, which provides a new way for the continuous, safe and efficient preparation of spherical explosives.

THE ABSENCE OF SINGULAR CONTINUOUS SPECTRUM FOR PERTURBED JACOBI OPERATORS

This paper is mainly about the spectral properties of a class of Jacobi operators(H_(c,b)u)(n)=c_(n)u(n+1)+c_(n-1)u(n-1)+b_(n)u(n),.where∣c_(n)−1∣=O(n^(−α))and b_(n)=O(n^(−1)).We will show that,forα≥1,the singular continuous spectrum of the operator is empty.

Semi-implantable device based on multiplexed microfilament electrode cluster for continuous monitoring of physiological ions

Modern medicine is increasingly interested in advanced sensors to detect and analyze biochemical indicators.Ion sensors based on potentiometric methods are a promising platform for monitoring physiological ions in biological subjects.Current semi-implantable devices are mainly based on single-parameter detection.Miniaturized semi-implantable electrodes for multiparameter sensing have more restrictions on the electrode size due to biocompatibility considerations,but reducing the electrode surface area could potentially limit electrode sensitivity.This study developed a semi-implantable device system comprising a multiplexed microfilament electrode cluster(MMEC)and a printed circuit board for real-time monitoring of intra-tissue K^(+),Ca^(2+),and Na^(+)concentrations.The electrode surface area was less important for the potentiometric sensing mechanism,suggesting the feasibility of using a tiny fiber-like electrode for potentiometric sensing.The MMEC device exhibited a broad linear response(K^(+):2–32 mmol/L;Ca^(2+):0.5–4 mmol/L;Na^(+):10–160 mmol/L),high sensitivity(about 20–45 mV/decade),temporal stability(>2weeks),and good selectivity(>80%)for the above ions.In vitro detection and in vivo subcutaneous and brain experiment results showed that the MMEC system exhibits good multi-ion monitoring performance in several complex environments.This work provides a platform for the continuous real-time monitoring of ion fluctuations in different situations and has implications for developing smart sensors to monitor human health.

Effect of continuous nursing on rehabilitation of older patients with joint replacement after discharge

BACKGROUND Joint replacement is a common treatment for older patients with high incidences of hip joint diseases.However,postoperative recovery is slow and complications are common,which reduces surgical effectiveness.Therefore,patients require long-term,high-quality,and effective nursing interventions to promote rehabilitation.Continuity of care has been used successfully in other diseases;however,little research has been conducted on older patients who have undergone hip replacement.AIM To explore the clinical effect of continuous nursing on rehabilitation after discharge of older individuals who have undergone joint replacement.METHODS A retrospective analysis was performed on the clinical data of 113 elderly patients.Patients receiving routine nursing were included in the convention group(n=60),and those receiving continuous nursing,according to various methods,were included in the continuation group(n=53).Harris score,short form 36(SF-36)score,complication rate,and readmission rate were compared between the convention and continuation groups.RESULTS After discharge,Harris and SF-36 scores of the continuation group were higher than those of the convention group.The Harris and SF-36 scores of the two groups showed an increasing trend with time,and there was an interaction effect between group and time(Harris score:F_(intergroup effect)=376.500,F_(time effect)=20.090,Finteraction effect=4.824;SF-36 score:F_(intergroup effect)=236.200,Ftime effect=16.710,Finteraction effect=5.584;all P<0.05).Furthermore,the total complication and readmission rates in the continuation group were lower(P<0.05).CONCLUSION Continuous nursing could significantly improve hip function and quality of life in older patients after joint replacement and reduce the incidence of complications and readmission rates.

Large-scale particle trapping by acoustic vortices with a continuously variable topological charge

Strengthened directivity with higher-order side lobes can be generated by the transducer with a larger radius at a higher frequency. The multi-annular pressure distributions are displayed in the cross-section of the acoustic vortices(AVs)which are formed by side lobes. In the near field, particles can be trapped in the valley region between the two annuli of the pressure peak, and cannot be moved to the vortex center. In this paper, a trapping method based on a sector transducer array is proposed, which is characterized by the continuously variable topological charge(CVTC). This acoustic field can not only enlarge the range of particle trapping but also improve the aggregation degree of the trapped particles. In the experiments, polyethylene particles with a diameter of 0.2 mm are trapped into the multi-annular valleys by the AV with a fixed topological charge. Nevertheless, by applying the CVTC, particles outside the radius of the AV can cross the pressure peak successfully and move to the vortex center. Theoretical studies are also verified by the experimental particles trapping using the AV with the continuous variation of three topological charges, and suggest the potential application of large-scale particle trapping in biomedical engineering.

Utilising continuous glucose monitoring for glycemic control in diabetic kidney disease

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.

A low-frequency pure metal metamaterial absorber with continuously tunable stiffness

To address the incompatibility between high environmental adaptability and deep subwavelength characteristics in conventional local resonance metamaterials,and overcome the deficiencies in the stability of existing active control techniques for band gaps,this paper proposes a design method of pure metal vibration damping metamaterial with continuously tunable stiffness for wideband elastic wave absorption.We design a dual-helix narrow-slit pure metal metamaterial unit,which possesses the triple advantage of high spatial compactness,low stiffness characteristics,and high structural stability,enabling the opening of elastic flexural band gaps in the low-frequency range.Similar to the principle of a sliding rheostat,the introduction of continuously sliding plug-ins into the helical slits enables the continuous variation of the stiffness of the metamaterial unit,achieving a continuously tunable band gap effect.This successfully extends the effective band gap by more than ten times.The experimental results indicate that this metamaterial unit can be used as an additional vibration absorber to absorb the low-frequency vibration energy effectively.Furthermore,it advances the metamaterial absorbers from a purely passive narrowband design to a wideband tunable one.The pure metal double-helix metamaterials retain the subwavelength properties of metamaterials and are suitable for deployment in harsh environments.Simultaneously,by adjusting its stiffness,it substantially broadens the effective band gap range,presenting promising potential applications in various mechanical equipment operating under adverse conditions.