Accuracy of FreeStyle Libre flash glucose monitoring in patients with type 2 diabetes who migrated from highlands to plains

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.

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.

A Fuzzy Trust Management Mechanism with Dynamic Behavior Monitoring for Wireless Sensor Networks

Traditional wireless sensor networks(WSNs)are typically deployed in remote and hostile environments for information collection.The wireless communication methods adopted by sensor nodes may make the network highly vulnerable to various attacks.Traditional encryption and authentication mechanisms cannot prevent attacks launched by internal malicious nodes.The trust-based security mechanism is usually adopted to solve this problem in WSNs.However,the behavioral evidence used for trust estimation presents some uncertainties due to the open wireless medium and the inexpensive sensor nodes.Moreover,how to efficiently collect behavioral evidences are rarely discussed.To address these issues,in this paper,we present a trust management mechanism based on fuzzy logic and a cloud model.First,a type-II fuzzy logic system is used to preprocess the behavioral evidences and alleviate uncertainty.Then,the cloud model is introduced to estimate the trust values for sensor nodes.Finally,a dynamic behavior monitoring protocol is proposed to provide a balance between energy conservation and safety assurance.Simulation results demonstrate that our trust management mechanism can effectively protect the network from internal malicious attacks while enhancing the energy efficiency of behavior monitoring.

Push forward LC-MS-based therapeutic drug monitoring and pharmacometabolomics for anti-tuberculosis precision dosing and comprehensive clinical management

The spread of tuberculosis(TB),especially multidrug-resistant TB and extensively drug-resistant TB,has strongly motivated the research and development of new anti-TB drugs.New strategies to facilitate drug combinations,including pharmacokinetics-guided dose optimization and toxicology studies of first-and second-line anti-TB drugs have also been introduced and recommended.Liquid chromatography-mass spectrometry(LC-MS)has arguably become the gold standard in the analysis of both endo-and exo-genous compounds.This technique has been applied successfully not only for therapeutic drug monitoring(TDM)but also for pharmacometabolomics analysis.TDM improves the effectiveness of treatment,reduces adverse drug reactions,and the likelihood of drug resistance development in TB patients by determining dosage regimens that produce concentrations within the therapeutic target window.Based on TDM,the dose would be optimized individually to achieve favorable outcomes.Pharmacometabolomics is essential in generating and validating hypotheses regarding the metabolism of anti-TB drugs,aiding in the discovery of potential biomarkers for TB diagnostics,treatment monitoring,and outcome evaluation.This article highlighted the current progresses in TDM of anti-TB drugs based on LC-MS bioassay in the last two decades.Besides,we discussed the advantages and disadvantages of this technique in practical use.The pressing need for non-invasive sampling approaches and stability studies of anti-TB drugs was highlighted.Lastly,we provided perspectives on the prospects of combining LC-MS-based TDM and pharmacometabolomics with other advanced strategies(pharmacometrics,drug and vaccine developments,machine learning/artificial intelligence,among others)to encapsulate in an all-inclusive approach to improve treatment outcomes of TB patients.

Clinical/Behavioral Monitoring of Rodents and Rabbits Undergoing Scientific Experiments

Background: We currently have international and national guidelines regarding the assessment and monitoring of clinical signs and humane endpoints in animals used in teaching and research, which make the performance of these activities mandatory for any experiment and professional working in this area. Assigning the severity of a research experiment is the result of an analysis of records of observations of the animal’s behavior, and clinical signs. The aim of this study was to describe the importance of carrying out a severity assessment associated with clinical and behavioral monitoring of rodents and rabbits during experimentation to maintain the welfare of these animals undergoing scientific research. Methods: The literature search was carried out using the following terms: “Monitoring”;“Humane endpoints”;“Animal welfare”, “Rodents”;“Rabbits”, and as connectors “and”;“or”, in the following databases: PubMed;LILACS/BIREME and SciELO. Results: A total of 987 articles were identified in the databases, and 20 of these studies were included in this review. Conclusions: Humane endpoint protocols and procedure severity tables are of the utmost importance, both from an ethical point and to refine the results of research conducted on laboratory animals. They should be drawn up jointly by the teams responsible for the project and the maintenance of the animals during the research period, and the data obtained should be published so that the scientific community can have access to it, helping to disseminate these practices, as well as helping to draw up new procedures. Monitoring and evaluating the welfare and clinical condition of animals undergoing scientific research procedures is the responsibility of the professors, researchers, veterinarians, and animal facility coordinators. The Ethics Committee on the Use of Animals must monitor all the activities conducted with the animals, by inspecting the experimental procedures and the physical environment of the laboratory animal facility where the animals are housed.

Application of GNSS-PPP on Dynamic Deformation Monitoring of Offshore Platforms

The real-time dynamic deformation monitoring of offshore platforms under environmental excitation is crucial to their safe operation.Although Global Navigation Satellite System-Precise Point Positioning(GNSS-PPP)has been considered for this purpose,its monitoring accuracy is relatively low.Moreover,the influence of background noise on the dynamic monitoring accuracy of GNSS-PPP remains unclear.Hence,it is imperative to further validate the feasibility of GNSS-PPP for deformation monitoring of offshore platforms.To address these concerns,vibration table tests with different amplitudes and frequencies are conducted.The results demonstrate that GNSS-PPP can effectively monitor horizontal vibration displacement as low as±30 mm,which is consistent with GNSS-RTK.Furthermore,the spectral characteristic of background noise in GNSS-PPP is similar to that of GNSS-RTK(Real Time Kinematic).Building on this observation,an improved Complete Ensemble Empirical Mode Decomposition with Adaptive Noise(CEEMDAN)has been proposed to de-noise the data and enhance the dynamic monitoring accuracy of GNSS-PPP.Field monitoring application research is also undertaken,successfully extracting and analyzing the dynamic deformation of an offshore platform structure under environmental excitation using GNSS-PPP monitoring in conjunction with improved CEEMDAN de-noising.By comparing the de-noised dynamic deformation trajectories of the offshore platform during different periods,it is observed that the platform exhibits reversible alternating vibration responses under environmental excitation,with more pronounced displacement deformation in the direction of load action.The research results confirm the feasibility and potential of GNSS-PPP for dynamic deformation monitoring of offshore platforms.

Long-term hydrochemical monitoring and geothermometry:understanding groundwater salinization and thermal fluid contamination in Mila’s basin,Northeastern Algeria

The regular hydrochemical monitoring of groundwater in the Mila basin over an extended period has provided valuable insights into the origin of dissolved salts and the hydrogeochemical processes controlling water salinization.The data reveals that the shallow Karst aquifer shows an increase in TDS of 162 mg L^(-1) while the ther-mal carbonate aquifer that is also used for drinking water supply exhibits an increase of 178 mg L^(-1).Additionally,significant temperature variations are recorded at the sur-face in the shallow aquifers and the waters are carbo-gaseous.Analysis of dissolved major and minor elements has identified several processes influencing the chemical composition namely:dissolution of evaporitic minerals,reduction of sulphates,congruent and incongruent car-bonates’dissolution,dedolomitization and silicates’weathering.The hydrogeochemical and geothermometric results show a mixing of saline thermal water with recharge water of meteoric origin.Two main geothermalfields have been identified,a partially evolved water reservoir and a water reservoir whosefluid interacts with sulphuric acid(H_(2)S)of magmatic origin.These hot waters that are char-acterized by a strong hydrothermal alteration do ascend through faults and fractures and contribute to the contamination of shallower aquifers.Understanding the geothermometry and the hydrogeochemistry of waters is crucial for managing and protecting the quality of groundwater resources in the Mila basin,in order to ensure sustainable water supply for the region.A conceptual model for groundwater circulation and mineralization acquisition has been established to further enhance under-standing in this regard.

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 monitoring of long-span railway bridges based on SBAS-InSAR technology

The deformation monitoring of long-span railway bridges is significant to ensure the safety of human life and property.The interferometric synthetic aperture radar(In SAR)technology has the advantage of high accuracy in bridge deformation monitoring.This study monitored the deformation of the Ganjiang Super Bridge based on the small baseline subsets(SBAS)In SAR technology and Sentinel-1A data.We analyzed the deformation results combined with bridge structure,temperature,and riverbed sediment scouring.The results are as follows:(1)The Ganjiang Super Bridge area is stable overall,with deformation rates ranging from-15.6 mm/yr to 10.7 mm/yr(2)The settlement of the Ganjiang Super Bridge deck gradually increases from the bridge tower toward the main span,which conforms to the typical deformation pattern of a cable-stayed bridge.(3)The sediment scouring from the riverbed cause the serious settlement on the bridge’s east side compared with that on the west side.(4)The bridge deformation negatively correlates with temperature,with a faster settlement at a higher temperature and a slow rebound trend at a lower temperature.The study findings can provide scientific data support for the health monitoring of long-span railway bridges.

Implantable Electrochemical Microsensors for In Vivo Monitoring of Animal Physiological Information

In vivo monitoring of animal physiological information plays a crucial role in promptly alerting humans to potential diseases in animals and aiding in the exploration of mechanisms underlying human diseases.Currently,implantable electrochemical microsensors have emerged as a prominent area of research.These microsensors not only fulfill the technical requirements for monitoring animal physiological information but also offer an ideal platform for integration.They have been extensively studied for their ability to monitor animal physiological information in a minimally invasive manner,characterized by their bloodless,painless features,and exceptional performance.The development of implantable electrochemical microsensors for in vivo monitoring of animal physiological information has witnessed significant scientific and technological advancements through dedicated efforts.This review commenced with a comprehensive discussion of the construction of microsensors,including the materials utilized and the methods employed for fabrication.Following this,we proceeded to explore the various implantation technologies employed for electrochemical microsensors.In addition,a comprehensive overview was provided of the various applications of implantable electrochemical microsensors,specifically in the monitoring of diseases and the investigation of disease mechanisms.Lastly,a concise conclusion was conducted on the recent advancements and significant obstacles pertaining to the practical implementation of implantable electrochemical microsensors.

Advances in Wireless,Batteryless,Implantable Electronics for Real‑Time,Continuous Physiological Monitoring

This review summarizes recent progress in developing wireless,batteryless,fully implantable biomedical devices for real-time continuous physiological signal monitoring,focusing on advancing human health care.Design considerations,such as biological constraints,energy sourcing,and wireless communication,are discussed in achieving the desired performance of the devices and enhanced interface with human tissues.In addition,we review the recent achievements in materials used for developing implantable systems,emphasizing their importance in achieving multi-functionalities,biocompatibility,and hemocompatibility.The wireless,batteryless devices offer minimally invasive device insertion to the body,enabling portable health monitoring and advanced disease diagnosis.Lastly,we summarize the most recent practical applications of advanced implantable devices for human health care,highlighting their potential for immediate commercialization and clinical uses.

Energy evolution and structural health monitoring of coal under different failure modes:An experimental study

Structural instability in underground engineering,especially in coal-rock structures,poses significant safety risks.Thus,the development of an accurate monitoring method for the health of coal-rock bodies is crucial.The focus of this work is on understanding energy evolution patterns in coal-rock bodies under complex conditions by using shear,splitting,and uniaxial compression tests.We examine the changes in energy parameters during various loading stages and the effects of various failure modes,resulting in an innovative energy dissipation-based health evaluation technique for coal.Key results show that coal bodies go through transitions between strain hardening and softening mechanisms during loading,indicated by fluctuations in elastic energy and dissipation energy density.For tensile failure,the energy profile of coal shows a pattern of “high dissipation and low accumulation” before peak stress.On the other hand,shear failure is described by “high accumulation and low dissipation” in energy trends.Different failure modes correlate with an accelerated increase in the dissipation energy before destabilization,and a significant positive correlation is present between the energy dissipation rate and the stress state of the coal samples.A novel mathematical and statistical approach is developed,establishing a dissipation energy anomaly index,W,which categorizes the structural health of coal into different danger levels.This method provides a quantitative standard for early warning systems and is adaptable for monitoring structural health in complex underground engineering environments,contributing to the development of structural health monitoring technology.

Appropriateness of Amikacin Dose Prescription, Monitoring and Safety during Hospitalization as an Impact of Clinical Pharmacologist Intervention, in the Israeli Regional Hospital

Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.

Panoptic UAV:Panoptic Segmentation of UAV Images for Marine Environment Monitoring

UAV marine monitoring plays an essential role in marine environmental protection because of its flexibility and convenience,low cost and convenient maintenance.In marine environmental monitoring,the similarity between objects such as oil spill and sea surface,Spartina alterniflora and algae is high,and the effect of the general segmentation algorithm is poor,which brings new challenges to the segmentation of UAV marine images.Panoramic segmentation can do object detection and semantic segmentation at the same time,which can well solve the polymorphism problem of objects in UAV ocean images.Currently,there are few studies on UAV marine image recognition with panoptic segmentation.In addition,there are no publicly available panoptic segmentation datasets for UAV images.In this work,we collect and annotate UAV images to form a panoptic segmentation UAV dataset named UAV-OUC-SEG and propose a panoptic segmentation method named PanopticUAV.First,to deal with the large intraclass variability in scale,deformable convolution and CBAM attention mechanism are employed in the backbone to obtain more accurate features.Second,due to the complexity and diversity of marine images,boundary masks by the Laplacian operator equation from the ground truth are merged into feature maps to improve boundary segmentation precision.Experiments demonstrate the advantages of PanopticUAV beyond the most other advanced approaches on the UAV-OUC-SEG dataset.

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.

Comparative Analysis of ARIMA and LSTM Model-Based Anomaly Detection for Unannotated Structural Health Monitoring Data in an Immersed Tunnel

Structural Health Monitoring(SHM)systems have become a crucial tool for the operational management of long tunnels.For immersed tunnels exposed to both traffic loads and the effects of the marine environment,efficiently identifying abnormal conditions from the extensive unannotated SHM data presents a significant challenge.This study proposed amodel-based approach for anomaly detection and conducted validation and comparative analysis of two distinct temporal predictive models using SHM data from a real immersed tunnel.Firstly,a dynamic predictive model-based anomaly detectionmethod is proposed,which utilizes a rolling time window for modeling to achieve dynamic prediction.Leveraging the assumption of temporal data similarity,an interval prediction value deviation was employed to determine the abnormality of the data.Subsequently,dynamic predictive models were constructed based on the Autoregressive Integrated Moving Average(ARIMA)and Long Short-Term Memory(LSTM)models.The hyperparameters of these models were optimized and selected using monitoring data from the immersed tunnel,yielding viable static and dynamic predictive models.Finally,the models were applied within the same segment of SHM data,to validate the effectiveness of the anomaly detection approach based on dynamic predictive modeling.A detailed comparative analysis discusses the discrepancies in temporal anomaly detection between the ARIMA-and LSTM-based models.The results demonstrated that the dynamic predictive modelbased anomaly detection approach was effective for dealing with unannotated SHM data.In a comparison between ARIMA and LSTM,it was found that ARIMA demonstrated higher modeling efficiency,rendering it suitable for short-term predictions.In contrast,the LSTM model exhibited greater capacity to capture long-term performance trends and enhanced early warning capabilities,thereby resulting in superior overall performance.

VR-based digital twin for remote monitoring of mining equipment:Architecture and a case study

Background Traditional methods for monitoring mining equipment rely primarily on visual inspections,which are time-consuming,inefficient,and hazardous.This article introduces a novel approach to monitoring mission-critical systems and services in the mining industry by integrating virtual reality(VR)and digital twin(DT)technologies.VR-based DTs enable remote equipment monitoring,advanced analysis of machine health,enhanced visualization,and improved decision making.Methods This article presents an architecture for VR-based DT development,including the developmental stages,activities,and stakeholders involved.A case study on the condition monitoring of a conveyor belt using real-time synthetic vibration sensor data was conducted using the proposed methodology.The study demonstrated the application of the methodology in remote monitoring and identified the need for further development for implementation in active mining operations.The article also discusses interdisciplinarity,choice of tools,computational resources,time and cost,human involvement,user acceptance,frequency of inspection,multiuser environment,potential risks,and applications beyond the mining industry.Results The findings of this study provide a foundation for future research in the domain of VR-based DTs for remote equipment monitoring and a novel application area for VR in mining.

Is tumor necrosis factor-α monoclonal therapy with proactive therapeutic drug monitoring optimized for inflammatory bowel disease? Network meta-analysis

BACKGROUND The efficacy and safety of anti-tumor necrosis factor-α(TNF-α)monoclonal antibody therapy[adalimumab(ADA)and infliximab(IFX)]with therapeutic drug monitoring(TDM),which has been proposed for inflammatory bowel disease(IBD)patients,are still controversial.AIM To determine the efficacy and safety of anti-TNF-αmonoclonal antibody therapy with proactive TDM in patients with IBD and to determine which subtype of IBD patients is most suitable for proactive TDM interventions.METHODS As of July 2023,we searched for randomized controlled trials(RCTs)and observa-tional studies in PubMed,Embase,and the Cochrane Library to compare anti-TNF-αmonoclonal antibody therapy with proactive TDM with therapy with reactive TDM or empiric therapy.Pairwise and network meta-analyses were used to determine the IBD patient subtype that achieved clinical remission and to determine the need for surgery.RESULTS This systematic review and meta-analysis yielded 13 studies after exclusion,and the baseline indicators were balanced.We found a significant increase in the number of patients who achieved clinical remission in the ADA[odds ratio(OR)=1.416,95%confidence interval(CI):1.196-1.676]and RCT(OR=1.393,95%CI:1.182-1.641)subgroups and a significant decrease in the number of patients who needed surgery in the proactive vs reactive(OR=0.237,95%CI:0.101-0.558)and IFX+ADA(OR=0.137,95%CI:0.032-0.588)subgroups,and the overall risk of adverse events was reduced(OR=0.579,95%CI:0.391-0.858)according to the pairwise meta-analysis.Moreover,the network meta-analysis results suggested that patients with IBD treated with ADA(OR=1.39,95%CI:1.19-1.63)were more likely to undergo TDM,especially in comparison with patients with reactive TDM(OR=1.38,95%CI:1.07-1.77).CONCLUSION Proactive TDM is more suitable for IBD patients treated with ADA and has obvious advantages over reactive TDM.We recommend proactive TDM in IBD patients who are treated with ADA.

Monitoring seismicity in the southern Sichuan Basin using a machine learning workflow

Monitoring seismicity in real time provides significant benefits for timely earthquake warning and analyses.In this study,we propose an automatic workflow based on machine learning(ML)to monitor seismicity in the southern Sichuan Basin of China.This workflow includes coherent event detection,phase picking,and earthquake location using three-component data from a seismic network.By combining Phase Net,we develop an ML-based earthquake location model called Phase Loc,to conduct real-time monitoring of the local seismicity.The approach allows us to use synthetic samples covering the entire study area to train Phase Loc,addressing the problems of insufficient data samples,imbalanced data distribution,and unreliable labels when training with observed data.We apply the trained model to observed data recorded in the southern Sichuan Basin,China,between September 2018 and March 2019.The results show that the average differences in latitude,longitude,and depth are 5.7 km,6.1 km,and 2 km,respectively,compared to the reference catalog.Phase Loc combines all available phase information to make fast and reliable predictions,even if only a few phases are detected and picked.The proposed workflow may help real-time seismic monitoring in other regions as well.

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.