A Pilot Study of Youth With Type 1 Diabetes Initiating Use of a Hybrid Closed-Loop System While Receiving a Behavioral Economics Intervention

ObjectiveMany youth do not use the hybrid closed-loop system for type 1 diabetes effectively. This study evaluated the impact of financial incentives for diabetes-related tasks on use of the 670G hybrid closed-loop system and on glycemia.MethodsAt auto mode initiation and for 16 weeks thereafter, participants received a flat rate for wearing and calibrating the sensor ($1/day), administering at least 3 mealtime insulin boluses per day ($1/day), and uploading ($5/week). Weekly bonuses were given for maintaining at least 70% of the time in auto mode, which were increased for persistent auto mode use from $3/week to a maximum of $13/week. If a participant failed to maintain auto mode for a week, the rewards were reset to baseline. Data from 17 participants aged 15.9 years ± 2.5 years (baseline hemoglobin A1c [HbA1c] 8.6% ± 1.1%) were collected at 6, 12, and 16 weeks. The reinforcers were withdrawn at 16 weeks, with a follow-up assessment at 24 weeks.ResultsWith reinforcers, the participants administered an average of at least 3 mealtime insulin boluses per day and wore the sensor over 70% of the time. However, auto mode use waned. HbA1c levels decreased by 0.5% after 6 weeks, and this improvement was maintained at 12 and 16 weeks (P < .05). Upon withdrawal of reinforcers, HbA1c levels increased back to baseline at 24 weeks.ConclusionCompensation for diabetes-related tasks was associated with lower HbA1c levels, consistent administration of mealtime insulin boluses, and sustained sensor use. These results support the potential of financial rewards for improving outcomes in youth with type 1 diabetes.     

Association Between a Low-Carbohydrate Diet,Glycemic Control,and Quality of Life in Australian Adults Living With Type 1 Diabetes: A Pilot Study

ObjectiveTo examine if there is an association between a low-carbohydrate diet (LCD), glycemic control, and quality of life (QoL) in Australian adults with type 1 diabetes.MethodsThis single-group, pre-post, mixed methods (quantitative and qualitative) study was conducted in an outpatient tertiary hospital. Eligible participants were those aged ≥18 years, with type 1 diabetes for ≥1 year, and using multiple daily insulin injections. Participants followed a 12-week individualized LCD (<100 g/d). Daily glucose levels were monitored using a continuous glucose monitor. Glycated hemoglobin (HbA1c) and QoL were measured preintervention and postintervention. A post-hoc exploratory regression analysis determined whether changes in carbohydrate intake was associated with changes in HbA1c and QoL. Qualitative data collected postintervention explored participants’ perceptions relating to a LCD, glycemic control, and QoL.ResultsParticipants (n = 22) completed the 12-week LCD intervention. An LCD provided a statistically, significant improvement in HbA1c 0.83% (95% CI 0.32%-1.33%), P = .003 but did not impact QoL: estimated change 1.14 units (95% CI: ?5.34 to 7.61); P = .72. The post-hoc exploratory regression analysis showed that participants with poorer baseline glycemic control were more likely to respond to an LCD resulting in significant reductions in HbA1c. Participant perceptions relating to the study variables were mixed.ConclusionsAn LCD (<100 g/d) is a potentially effective and safe strategy to improve glycemic control without negatively effecting QoL in Australian adults with type 1 diabetes.     

Comparative ecology of Varanus in the Great Victoria Desert

Abstract The ecologies of seven desert species of monitor lizards (Varanus), which are very variable in size, are described and compared. Data are reported on abundance, anatomy, behaviour, body temperature relationships, daily activity patterns, diet, growth, habitat and microhabitat, prey size, reproduction, seasonal patterns of activity, sexual dimorphisms, and tracks. As many as six of the seven species occur together in sympatry at one study site. New results reported here are merged with extensive data collected over the past quarter of a century to provide a comprehensive and detailed overview of numerous aspects of the natural history and ecology of the seven species in the Great Victoria Desert. One species of pygmy monitor has evolved large clutch size for unknown reasons. A food web for 40 species of desert lizards is presented. Hutchinsonian ratios of head lengths (larger/smaller) are significantly greater in two observed assemblages of sympatric varanids than in a null model consisting of all possible pairs of species of all Australian varanids. Evolution of body size and the two adaptive radiations of Varanus in Australia are discussed.     

S-ICD oversensing detected by remote monitoring using a new atrial fibrillation diagnostic algorithm

A 64-year-old male with a high body mass index, and subcutaneous implantable cardioverter defibrillator, (S-ICD) presented with a remote transmission of inappropriately diagnosed AF episodes, due to oversensing of P and T waves. The AF monitor can be an early warning for inappropriate sensing. Oversensing, due to small amplitude signals, can be caused by the lead position not being adequately opposed to the sternum.     

Multi-strip silicon sensors for beam array monitoring in micro-beam radiation therapy

We present here the latest results from tests performed at the ESRF ID17 and ID21 beamlines for the characterization of novel beam monitors for Microbeam Radiation Therapy (MRT), which is currently being implemented at ID17. MRT aims at treating solid tumors by exploiting an array of evenly spaced microbeams, having an energy spectrum distributed between 27 and 600 keV and peaking at 100 keV. Given the high instantaneous dose delivered (up to 20 kGy/s), the position and the intensity of the microbeams has to be precisely and instantly monitored. For this purpose, we developed dedicated silicon microstrip beam monitors. We have successfully characterized them, both with a microbeam array at ID17, and a submicron scanning beam at ID21. We present here the latest results obtained in recent tests along with an outlook on future developments.     

Magnetic field measurements near RF induction heaters

We discuss initial magnetic field strength measurements made around radiofrequency (RF) induction heaters. These measurements were made with a monitor developed for the National Institute for Occupational Safety and Health (NIOSH) by the National Bureau of Standards (NBS). The monitor has a dynamic range of .01 to 10,000 A2/m2, a frequency range of 300 kHz to 100 MHz, an isotropic response (+/- .3 dB) with three mutally orthogonal loop antennas that have the ability to measure and display each of three orthogonal magnetic field components, a high probe burnout protection level of 20,000 A2/m2, and an accuracy of +/- 1.0 dB at 13 calibration frequencies. The portable survey monitor was used to measure the magnetic field strengths in the vicinity of 16 RF induction heaters. Typically these induction heaters are operated continuously for several hours. The maximum field strengths (without duty factor correction) ranged from 15 to 4,500 A2/m2 and were measured 5 to 51 cm from the loop applicators of the induction heaters. At locations commonly occupied by workers (ie, approximately 30 to 76 cm from heaters), the fields ranged from .01 to 300 A2/m2 (without duty factor correction).     

Response of hatchling Komodo Dragons (Varanus komodoensis) at Denver Zoo to visual and chemical cues arising from prey

Five hatchling Komodo Dragons (Varanus komodoensis) at Denver Zoo were observed in two experiments that studied the effects of visual and chemical cues arising from prey. Rate of tongue flicking was recorded in Experiment 1, and amount of time the lizards spent interacting with stimuli was recorded in Experiment 2. Our hypothesis was that young V. komodoensis would be more dependent upon vision than chemoreception, especially when dealing with live, moving, prey. Although visual cues, including prey motion, had a significant effect, chemical cues had a far stronger effect. Implications of this falsification of our initial hypothesis are discussed. Zoo Biol 28:29–34, 2009. © 2008 Wiley-Liss, Inc.     

In-house spread sheet based monitor unit verification program for volumetric modulated arc therapy

Independent monitor unit verification calculation (MUVC) has been recommended by several authors for intensity modulated radiotherapy (IMRT) as a patient specific quality assurance tool. Aim of the present work is to develop an in-house excel spread sheet based MUVC program for volumetric modulated arc therapy (VMAT) using Clarkson's integration technique. Total scatter factor (S_c,p) and tissue maximum ratio (TMR) for circular fields obtained from Treatment planning system (TPS) were used for the calculation. Multileaf collimator (MLC) interleaf leakage, MLC round edge transmission and tongue and groove effect were accounted. MUVC calculation was performed for 58 patients both for patient anatomy and for homogenous cylindrical phantom. Radiological path lengths were used as water equivalent depths (WED) for calculations using patient anatomy. Monitor unit (MU) discrepancies between −2.60% and 0.28% with mean deviation of −0.92% ± 0.75% were obtained for homogenous cylindrical phantom calculations. MUVC for patient anatomy resulted in large variations between −19.02% and 0.67% for 14 plans where isocenter was at a region below −350 HU. But For 44 plans where the isocenter was at a region above −350 HU, variations between −3.44% and 0.48% were obtained with mean deviation of −1.73% ± 1.12%. For VMAT patient specific quality assurance, the independent MUVC algorithm can be used as an easy and quick auxiliary to measurement based verification for plans with isocenter at a region above −350 HU.     

An in-house real-time polymerase chain reaction: standardisation and comparison with the Cobas Amplicor HBV monitor and Cobas AmpliPrep/Cobas TaqMan HBV tests for the quantification of hepatitis B virus DNA

This study aimed to standardise an in-house real-time polymerase chain reaction (rtPCR) to allow quantification of hepatitis B virus (HBV) DNA in serum or plasma samples, and to compare this method with two commercial assays, the Cobas Amplicor HBV monitor and the Cobas AmpliPrep/Cobas TaqMan HBV test. Samples from 397 patients from the state of São Paulo were analysed by all three methods. Fifty-two samples were from patients who were human immunodeficiency virus and hepatitis C virus positive, but HBV negative. Genotypes were characterised, and the viral load was measure in each sample. The in-house rtPCR showed an excellent success rate compared with commercial tests; inter-assay and intra-assay coefficients correlated with commercial tests (r = 0.96 and r = 0.913, p < 0.001) and the in-house test showed no genotype-dependent differences in detection and quantification rates. The in-house assay tested in this study could be used for screening and quantifying HBV DNA in order to monitor patients during therapy.     

Ultrasound monitoring of temperature and coagulation change during tumor treatment with microwave ablation

Microwave ablation therapy has become an important method for tumor treatment in recent years. The temperature and the coagulation region need real-time noninvasive monitoring to ensure the safety and effective-ness during the treatment. The authors reviewed the ultrasonic monitoring methods for tumor microwave ablation therapy both at home and abroad. In addition, the authors also prospected this technique in the future.