Practice of Glycemic Self-Monitoring in Diabetic Patients Followed at the Endocrinology Department of Donka University Hospital in Guinea

Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.

Self-monitoring Application of Asphalt Concrete Containing Graphite and Carbon Fibers

The self-monitoring application of asphalt concrete containing graphite and carbon fibers using indirect tensile test and wheel rolling test were introduced. The experiment results indicate that this kind of pitch-based composite is effective for strain/stress self-monitoring. In the indirect tensile test, for a completely conductive asphalt concrete specimen, the piezoresistivity was very weak and slightly positive, which meant the resistivity increase with the increment of tensile strain at all stress/strain amplitudes, with the gage factor as high as 6. The strain self-sensing ability was superior in the case of higher graphite content. However, when the conductive concrete was embedded into common asphalt concrete specimen as a partial structure function, the piezoresistivity was positive at all stress/strain amplitudes and with the gage factor of 13, which was much higher than that of completely conductive specimen. Thus, the strain self-sensing ability was superior when conductive asphalt concrete was taken in as a partial structure function. In the wheel-rolling test, the piezoresistivity was highly positive. At any stress amplitude, the piezoresistivity was strong, with the gage factor as high as 100, which was higher for a stress amplitude of 0.7 MPa than that of 0.5 MPa.

Efficacy of blood glucose self-monitoring on glycemic control in patients with non-insulin-treated type 2 diabetes: A meta-analysis

Objective:To evaluate the efficacy of blood glucose self-monitoring on glycemic control in patients with non-insulin-treated type 2 diabetes by performing a meta-analysis.Methods:Randomized controlled trials(RCTs)of the efficacy of blood glucose selfmonitoring were collected from the PubMed,EMBASE,Cochrane Library,CNKI,and VIP databases.Data were analyzed by RevMan 5.1 software.Results:Seven RCTs were included in this meta-analysis.The results indicated that blood glucose self-monitoring significantly reduced the glycated hemoglobin(HbA1c)level by 0.41%.Subgroup analysis showed that while implementation of a diabetes management regimen based on the blood glucose self-monitoring results effectively reduced the HbA1c level by 0.42%,no significant improvement in HbA1c level control was observed with the implementation of blood glucose self-monitoring alone.Conclusion:Blood glucose self-monitoring combined with diabetes management effectively improves glycemic control in patients with non-insulin-treated type 2 diabetes.

A randomized controlled trial of lifestyle self-monitoring for irritable bowel syndrome in female nursing school students

Background: The aim of this study was to verify the efficacy of lifestyle self-monitoring for the improvement of the IBS and reveal what has been changed due to the intervention. Methods: A total of 111 nursing school students were randomized into three groups, two intervention groups (a two-month intervention group, n = 34, and a four-month intervention group, n = 35) and a control group (n = 34). The intervention groups conducted lifestyle self-monitoring in conjunction with a 15-minutes group work for either two or four months. The primary outcome measure was Rome II criteria for IBS. Other outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Gastrointestinal Symptom Rating Scale (GSRS). They were assessed at the baseline and the end of both of the intervention periods. Analysis was conducted as intention-to-treat. Results: The prevalence of IBS did not change significantly after the intervention in any of the groups. The HAD-A score, a subscale of the HADS score for anxiety, decreased 1.4 points in the two-month intervention group (p = 0.02) and 2.3 points in the four-month intervention group of (p = 0.01) after intervention. The average GSRS decreased 0.2 points in the control group (p = 0.05) and 0.3 points in the four-month intervention group (p < 0.01). Conclusions: Lifestyle self-monitoring for two or four months did not reduce the prevalence of the IBS significantly, but it did decrease anxiety and improved the QOL related to gastrointestinal symptoms in female nursing school students.

Self-monitoring of blood glucose in gestational diabetes mellitus patients during the COVID-19 pandemic in low- and middle-income countries

Self-monitoring of blood glucose(SMBG)is critical for gestational diabetes mellitus(GDM)care.However,there are several hurdles to its practice during the coronavirus disease 2019(COVID-19)pandemic in GDM patients in low-and middle-income countries when GDM care recommendations emphasize telemedicine-based care.Based on available knowledge,this letter proposes the following barriers to SMBG in these GDM patients during the ongoing COVID-19 pandemic:Poor internet connectivity,affordability of SMBG and digital applications to connect with healthcare providers,government-imposed social mobility restriction,psychological stress,and mental health conditions.Nevertheless,definitive evidence will only be acquired from rigorous research.

Self-monitoring of blood glucose in type 2 diabetic patients in China：current status and influential factors

Background Self-monitoring of blood glucose （SMBG） by individuals with type 2 diabetes （T2D） is crucial for long-term health,yet numerous cultural,economic and health factors can reduce SMBG.Most studies on SMBG adherence have come out of the US and Europe,and their relevance to Asia is unclear.The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.Methods In this multi-center,cross-sectional study,5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics,education level,occupation,income,lifestyle risk factors,duration of diabetes,chronic complications,and frequency of SMBG.Respondents were also asked whether their glycosylated hemoglobin （HbA1c） had been checked in the past 6 months.The most recent values for fasting plasma glucose,2-hour postprandial blood glucose and HbA1c were recovered from medical records.Results Only 1 130 respondents （18.98％） performed SMBG with the recommended frequency,while 4 823 （81.02％） did not.In fact,nearly 2 105 （35.36％） reported never performing SMBG.In the subset of 3 661 individuals on insulin therapy,only 266 （7.27％） performed SMBG at least once a day,while 1 210 （33.05％） never performed it.In contrast,895 of 2 292 individuals （39.05％） on diet/exercise therapy or oral hypoglycemic therapy never performed it.Multivariate Logistic regression identified several factors associated with SMBG adherence：female gender,higher education level,higher income,longer T2D duration and education about SMBG.Conclusions SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries.Several factors influence SMBG adherence：gender,education level,income,T2D duration,therapy regimen and exposure to education about SMBG.

3ehavioral Analysis of Chinese Adult Patients with Type 1 Diabetes on Self-monitoring of Blood Glucose

Background： The information-motivation-behavioral skills （IMB） model of health behavior is an effective tool to evaluate the behavior of diabetes self-management. The purpose of this study was to explore behavioral factors affecting the practice of self-monitoring of blood glucose （SMBG） within the frame of IMB model of health behavioral among adult patients with type 1 diabetes in a single diabetes clinic in China. Methods： A questionnaire with three subscales on SMBG information, motivation, and behavioral skills based on IMB model was developed. Validity and reliability of the measures were examined and guaranteed. Adult patients with type 1 diabetes visiting our diabetes clinic from January to March 2012 （n = 55） were consecutively interviewed. The self-completion questionnaires were administered and finished at face-to-face interviews among these patients. Both descriptive and correlational analyses were made. Results： Fifty-five patients finished the questionnaires, with the median duration of diabetes 4.5 years and the median of SMBG frequency 2.00. Specific SMBG information deficits, motivation obstacles, and behavioral skill limitations were identified in a substantial proportion of participants. Scores of SMBG motivation （r - 0.299, P = 0.026） and behavioral skills （r = 0.425, P = 0.001） were significantly correlated with SMBG frequency. The multiple correlation of SMBG information, SMBG motivation, and SMBG behavioral skills with SMBG frequency was R - 0.411 （R2 = 0.169, P = 0.023）. Conclusions： Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits, motivation obstacles, and skill limitations. This information provided potential-focused education targets for diabetes health-care providers.

Conductive photo-thermal responsive bifunctional hydrogel system with self-actuating and self-monitoring abilities

Despite enormous efforts in actuators,most researches are only limited to various actuation behaviors and demonstrations of soft materials.It has not yet been reported to capture and monitor its movement status in an invisible environment.Therefore,it is of great significance to develop a self-sensing and self-actuating dual-function hydrogel actuator system to realize real-time monitoring.Here,we report a bifunctional hydrogel system with self-actuating and self-monitoring abilities,which combines the functions of photothermal actuation and electrical resistance sensing into a single material.The bilayer tough conductive hydrogel synthesized by unconventional complementary concentration recombination and cryogenic freezing technique presents a dense conductive network and high-porosity structure,achieving high toughness at 190.3 kPa of tensile strength,high stretchability(164.3%strain),and the toughness dramatically(1,471.4 kJ·m^(−3)).The working mechanism of the monitoring and self-sensing system is accomplished through the integrated monitoring device of surface temperature–bending angle–electron current,to solve the problem of not apperceiving actuator motion state when encountering obstacles in an invisible environment.We demonstrated for the first time a photothermal actuator’s motion of a football player and goalkeeper to finish the penalty and a soft actuator hand,which can achieve the action of sticking to grab and release under photo-thermal actuation.When connected to the control closed circuit,the actuator realized closed-loop monitoring and sensing feedback.The development of bifunctional hydrogel systems may bring new opportunities and ideas in the fields of material science,circuit technology,sensors,and mechanical engineering.

Self-monitoring of blood glucose improved glycaemic control and 10-year coronary heart disease risk profile of type 2 diabetic patients

Background The debate over the overall benefits of self-monitoring of blood glucose in type 2 diabetes patients is still continuing.We aimed to assess the difference in glycaemic control and coronary heart disease （CHD） risk levels of experimental type 2 diabetes patients provided with facilities for self-monitoring blood glucose and their counterparts without such facilities.Methods Sixty-one patients who had no prior experience in using glucometers were studied as intervention （n=30） and control （n=31） groups.The intervention group was trained in self-monitoring of blood glucose and documentation.Baseline blood glucose and fasting blood glucose were measured and the intervention patients were provided with glucometers and advised to self-monitor their fasting and postprandial blood glucose over six months.The 10-year CHD risk levels were determined with the United Kingdom Prospective Diabetes Study-derived risk engine calculator.Results The age and diabetes duration were similar in the two groups （P 〉0.05）.The majority of the patients were unemployed or retired females with only a primary level education.After 3 months,the haemogolbin A1c （HbA1c） levels of the control patients remained unchanged （（7.8±0.3）% vs.（7.9±0.4）%,P 〉0.05） whereas the HbA1c levels of the intervention patients were significantly reduced from the baseline at three （（9.6±0.3）% vs.（7.8±0.3）%,P 〈0.001） and six （（9.2±0.4）% vs.（7.5±0.3）%,P 〈0.001） months.Interestingly,while the 10-year CHD risk level of the control group remained unchanged after three months,that of the intervention group was remarkably reduced at three and six months from the baseline level （（7.4±1.3）% vs.（4.5±0.9）%,P=0.056）.Conclusion Self-monitoring of blood glucose in type 2 diabetes patients significantly improved glycaemic control and the CHD risk profile,suggesting that type 2 diabetes patients will potentially benefit from inclusion of glucose meters and testing strips in their health-care package.

Association of point in range withβ-cell function and insulin sensitivity of type 2 diabetes mellitus in cold areas

Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However,the association between time in range(TIR),as assessed by SMBG,andβ-cell insulin secretion as well as insulin sensitivity remains unexplored.Therefore,this study aims to investigate the connections between TIR,derived from SMBG,and indices representingβ-cell functionality and insulin sensitivity.The primary objective of this study was to elucidate the relationship between short-term glycemic control(measured as points in range[PIR])and bothβ-cell function and insulin sensitivity.Methods:This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus(T2DM).To assessβ-cell secretion capacity,we employed the insulin secretion-sensitivity index-2(ISSI-2)and(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR.Since SMBG offers glucose data at specific point-in-time,we substituted TIR with PIR.According to clinical guidelines,values falling within the range of 3.9-10 mmol were considered"in range,"and the corresponding percentage was calculated as PIR.Results:We observed significant associations between higher PIR quartiles and increased ISSI-2,(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,Matsuda index(increased)and HOMA-IR(decreased)(all P<0.001).PIR exhibited positive correlations with log ISSI-2(r=0.361,P<0.001),log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index(r=0.482,P<0.001),and log Matsuda index(r=0.178,P<0.001)and negative correlations with log HOMA-IR(r=-0.288,P<0.001).Furthermore,PIR emerged as an independent risk factor for log ISSI-2,log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,log Matsuda index,and log HOMA-IR.Conclusion:PIR can serve as a valuable tool for assessingβ-cell function and insulin sensitivity.

A Survey and Analysis on College Students' Use of the Pigai System in Minority Areas —— A Case Study of Honghe University

Writing plays a very important role in college English teaching and learning,and it is considered as one of the main language output methods.This survey aims to analyze college students’use of the pigai system in minority areas based on 515 students from Honghe University,hoping to provide a reference to enhance minority students’efficiency of English writing.Key words:the pigai system;writing motivation;self-monitoring;self-management;

WJD 5^(th) Anniversary Special Issues(2): Type 2 diabetes Structured SMBG in early management of T2DM: Contributions from the St Carlos study

Diabetes mellitus type 2(T2DM)is a global pandemic that will affect 300 million people in the next decade.It has been shown that early and aggressive treatment of T2DM from the onset decreases complications,and the patient’s active role is necessary to achieve better glycemic control.In order to achieve glycemic control targets,an active attitude in patients is needed,and selfmonitoring of blood glucose(SMBG)plays a significant role.Nowadays,SMBG has become an important component of modern therapy for diabetes mellitus,and is even more useful if it is performed in a structured way.SMBG aids physicians and patients to achieve a specific level of glycemic control and to prevent hypoglycemia.In addition,SMBG empowers patients to achieve nutritional and physical activity goals,and helps physicians to optimize the different hypoglycemic therapies as demonstrated in the St Carlos study.This article describes the different ways of using this educational and therapeutic tool from the medical point of view as well as from the patient’s perspective.

Effects of Depression on Aspects of Self-Care in Type 2 Diabetes

Aims and Objectives: Depression is common among patients with chronic medical illnesses. The impact of depressive symptoms in patients with type 2 diabetes on self-care and glycosylated hemoglobin (HbA1c) was explored. Background: Depression is known to decrease compliance with most medical regimens. This study investigated depression’s effects on different aspects of compliance with a diabetic regimen. Design: Cross-sectional, correlational, quantitative study. Methods: A cross-sectional study was conducted using data from 126 patients with type 2 diabetes from a diabetes education class. Participants completed depression and self-care inventories. Regression analyses were performed to determine the impact of depressive symptoms on the dependent variables of compliance to diabetes self-care and HbA1c levels. Results: Levels of depression were significantly and inversely correlated with 1) total self-care scores, accounting for 5.1% of the variance, 2) compliance with glucose self-monitoring accounting for 3.4% of the variance, and 3) compliance with diet accounting for 9.3% of the variance. Levels of depression were not significantly related to HbA1c. Conclusions: Depressive symptoms are associated with poorer total self-care, poorer glucose self-monitoring, and poorer dietary compliance in type 2 diabetes patients. Depression scores help explain variations in patients’ performance with aspects of compliance to diabetes management. Relevance to clinical practice: Administering a personality questionnaire, perhaps on the initial visit could enable the clinical to know which aspects of diabetes self-care are affected by depression, which would enable the clinician to more closely monitor melancholic patients in the effort to improve glycemic control and medical outcomes.

Key Technologies for Decentralized Control Platform with Dynamic Evolution for Railway Transportation System

Key technologies as well as their principles were discussed for a decentralized control platform capable of dynamic evolution. The primary content includes the automatic decision-making mechanism and the algorithm of the control center migration, the principle and technology of system self-monitoring, the principle and technology of the switch-mode of remote control station, the information transmission technology, and the data consistency technology. These key technologies have shown a series of advanced characteristics for decentralized control platform.

Recent developments in non-invasive blood glucose monitoring technology

Diabetes mellitus is a huge and significantly grow ing problem. Continuous and real-time monitoring of blood glucose plays a key role for the people with diabetes,which can help them to control glucose concentration more effectively. However,current blood glucose monitoring methods require blood by needle-pricking,which limit the detection frequency. It is necessary to develop non-invasive blood glucose monitoring methods to achieve the ideal therapeutic and management of diabetes. In this paper,the developments and challenges of non-invasive blood glucose monitoring technologies in recent years are reviewed. And the bottleneck and the developing trends are also analyzed.

可持续液态金属诱导的导电贝壳

Nacre has inspired research to fabricate tough bulk composites for practical applications using inorganic nanomaterials as building blocks.However,with the considerable pressure to reduce global carbon emissions,preparing nacre-inspired composites remains a significant challenge using more economical and environmentally friendly building blocks.Here we demonstrate tough and conductive nacre by assembling aragonite platelets exfoliated from natural nacre,with liquid metal and sodium alginate used as the “mortar”.The formation of Ga-O-C coordination bonding between the gallium ions and sodium alginate molecules reduces the voids and improves compactness.The resultant conductive nacre exhibits much higher mechanical properties than natural nacre.It also shows excellent impact resistance attributed to the synergistic strengthening and toughening fracture mechanisms induced by liquid metal and sodium alginate.Furthermore,our conductive nacre exhibits exceptional self-monitoring sensitivity for maintaining structural integrity.The proposed strategy provides a novel avenue for turning natural nacre into a valuable green composite.

On the Trail of Self-Directed Online Learners

Purpose We describe a series of more than a dozen studies on self-directed online learning spanning over a decade.Design/Approach/Methods We incorporated surveys,interviews,focus groups,and content analyses into these research studies,which initially targeted the goals,motivations,and challenges of learners using open educational resources and OpenCourseWare and then focused on learning from massive open online courses(MOOCs).This research accelerated after creating a database of over 3,000 MOOC instructors,through which we explored cultural sensitivity and personalization practices in MOOCs as well as instructional design considerations and challenges,MOOC instructor professional development and career development,instructor motivation and engagement,and student and instructor perceptions of self-directed learning.Findings This study reveals that self-directed online learners(SDOLs)seek learning environments offering freedom,choice,control,and a sense of autonomy and that both learners and instructors have intrinsic motivation for engaging in open online learning environments.Originality/Value Based on this research with both MOOC instructors and MOOC learners,we offer instructional design guidelines to address SDOLs’needs and assist in efforts to foster a new generation of SDOLs.

A disk failure prediction model for multiple issues

Disk failure prediction methods have been useful in handing a single issue,e.g.,heterogeneous disks,model aging,and minority samples.However,because these issues often exist simultaneously,prediction models that can handle only one will result in prediction bias in reality.Existing disk failure prediction methods simply fuse various models,lacking discussion of training data preparation and learning patterns when facing multiple issues,although the solutions to different issues often conflict with each other.As a result,we first explore the training data preparation for multiple issues via a data partitioning pattern,i.e.,our proposed multi-property data partitioning(MDP).Then,we consider learning with the partitioned data for multiple issues as learning multiple tasks,and introduce the model-agnostic meta-learning(MAML)framework to achieve the learning.Based on these improvements,we propose a novel disk failure prediction model named MDP-MAML.MDP addresses the challenges of uneven partitioning and difficulty in partitioning by time,and MAML addresses the challenge of learning with multiple domains and minor samples for multiple issues.In addition,MDP-MAML can assimilate emerging issues for learning and prediction.On the datasets reported by two real-world data centers,compared to state-of-the-art methods,MDP-MAML can improve the area under the curve(AUC)and false detection rate(FDR)from 0.85 to0.89 and from 0.85 to 0.91,respectively,while reducing false alarm rate(FAR)from 4.88%to 2.85%.

3D/4D Printed Functional Continuous Fiber-reinforced Polymer Composites:Progress and Perspectives

In recent years,innovations in 3D/4D printing techniques for continuous fiber-reinforced polymer composites(CFRPCs)have opened new perspectives for the integrated design and manufacture of composites with customized functions.This paper reviews the current state of 3D/4D printed functional composites,including the materi-als,shape memory/changing effects,self-monitoring/healing behaviors,and challenges surrounding additive-manufactured functional composites.Specifically,continuous fibers and matrices that provide functional roles are classified and discussed in detail.4D printed shape memory and changing CFRPCs can retain their original shapes from a designed shape upon exposure to different external stimuli,including heat,electricity,humidity,and multi-stimuli activation.Furthermore,self-monitoring of structural health is achieved through the piezore-sistive features of reinforced fibers in 3D printed CFRPCs.Finally,this review concludes with an outlook on the future research opportunities for 3D/4D printed functional CFRPCs.