Search

BackgroundA composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data.MethodsWe assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low-glucose and low-glucose hypoglycemia; very high-glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation.ResultsThe analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals.ConclusionThe GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic effects of prescribed and investigational treatments.

In the present work, manganese cobaltite (MnCo2O4) spinel (MCO) was synthetized by Pechini and hydrothermal method, characterized and photocatalytically evaluated toward H2 production through water splitting under visible-light irradiation. Characterization consisted in Thermogravimetry analysis (TGA), X-ray diffraction (XRD), X-ray photoelectron spectroscopy, scattering transmission electronic microscopy, BET surface area, UV-Vis spectroscopy, cyclic voltammetry, Hall effect, and photoluminescence. The MCO were evaluated as photocatalyst using an artificial visible light lamp and monitored by gas chromatography. XRD analysis found a pure spinel phase MCO. The surface area was ∼5 m2·g−1 for the MCO synthetized by Pechini and increased to 155 m2·g−1 with the hydrothermal method with acetates as precursors. The Pechini MCO showed higher carrier mobility but the fastest recombination. Photocatalytic evaluation of the MCOs showed that the highest photocatalytic activity generated was 12 μmol H2/gcat at 8 h with the MCO obtained by hydrothermal method with the acetates.

Children with autism spectrum disorder are at increased risk for obesity compared to typically developing children. Many obesity intervention programs exclude children with autism spectrum disorder. There is little research on developmentally inclusive approaches to pediatric weight management. We examined the outcomes of children and families with autism spectrum disorder in an inclusive, comprehensive behavioral family-based lifestyle intervention. A secondary analysis of a randomized controlled trial on families enrolled in a comprehensive behavioral family-based lifestyle intervention was conducted. Analyses included chi-square or Fisher's exact tests to examine family and child differences in program completion rates and multivariate regression analysis using generalized estimating equation to further examine differences in weight outcomes between children with autism spectrum disorder versus no autism spectrum disorder accounting for other covariates. There were 158 families; 15 families had children with autism spectrum disorder. There were no significant differences in demographics, program completion, or weight outcomes between the two groups. Children who completed the intervention had a significant decrease in body mass index Z-scores, but no change in their percentage of the 95th percentiles. Families of children with autism spectrum disorder participated in a comprehensive behavioral family-based lifestyle intervention alongside children without autism spectrum disorder with similar outcomes. Comprehensive behavioral family-based lifestyle intervention can meet the weight management needs of children with autism spectrum disorder using an inclusive approach, expanding access to needed obesity interventions.

In response to the water contamination problem, this study presents a novel method to remove methylene blue (MB), a typical water pollutant, using synthesized porous silicon dioxide (SiO2). The SiO2 was synthesized via a cost-effective sol–gel method and characterized for its thermal stability, structural, textural, morphological properties, and elemental composition using techniques such as TGA, FT-IR, XRD, BET-BJH, SEM, TEM, and STEM-EDS. A unique aspect of this study is the evaluation of SiO2 reusability in MB removal through multiple adsorption and thermal regeneration cycles, a critical factor for practical applications. The results demonstrated the successful synthesis of thermally stable, amorphous, porous SiO2 with a surface area of 811 m2g−1 initially, reducing to 600 m2g−1 after the adsorption and regeneration cycles, indicating its stability and durability. The removal efficiency of MB was consistent across cycles, achieving 71.19 ± 0.94%, 75.55 ± 0.69%, and 73.49 ± 0.15% after 20 min, and the adsorption capacity at equilibrium was 3.73 ± 0.025, 4.08 ± 0.045, and 3.48 ± 0.021 mgMB gads−1 during the first, second, and third cycles, respectively. These findings highlight the potential of the synthesized porous SiO2 as a reusable and efficient adsorbent for MB removal in water treatment, contributing to the advancement of sustainable and effective solutions for water pollution. [ABSTRACT FROM AUTHOR]

BackgroundPreoperative anxiety is a common occurrence among children and is associated with a host of maladaptive postoperative behaviors. Consequently, increased attention has been placed on interventions to reduce preoperative anxiety and its associated outcomes. Child Life preparation prior to surgery includes evidence-based practices such as age-appropriate distraction and therapeutic play. Virtual reality (VR) is a promising addition to the Child Life toolbox to address anxiety prior to surgery. The current study evaluates the implementation and feasibility of a VR experience, “Doc McStuffins: Doctor for a Day Virtual Reality Experience” (DocVR), developed by Disney Junior in collaboration with Children’s Hospital Los Angeles, to target pediatric preoperative anxiety. ObjectiveThe primary aim of this study was to examine the feasibility and efficacy of DocVR for preoperative anxiety. A secondary aim was to improve patient, caregiver, and health care provider satisfaction with the preoperative experience. MethodsIn this study, 51 patients (age 6-14 years) scheduled for surgery in the ambulatory surgery center and the main operating room at Children’s Hospital Los Angeles were approached to participate in Disney’s DocVR experience. The patients played the DocVR experience for an average of 18 minutes (3-55 minutes). Irrespective of surgical procedure, patients and their families were eligible, as long as they had no known marked cognitive or visual impairments that would interfere with completing the survey and engaging in the DocVR experience. ResultsPatients who tried the DocVR experience (n=51) responded overwhelmingly positively to both the VR technology and to the game itself. Patients experienced a statistically significant decrease in anxiety following DocVR game play (Z=–3.26, P=.001). On the Facial Affective Scale, the percentage of patients who chose the face with the most positive facial expression to represent their affect increased from 23% (12/51) pre-VR to 49% (25/47) post-VR. Furthermore, 97% (38/39) of patients reported feeling more comfortable at the hospital, and 74% (28/38) reported feeling less scared at the hospital after playing the game. The game was enjoyed by 94% (46/49) of patients, and 88% (30/34) of patients reported feeling both “Interested” and “Involved” in the game. ConclusionsDocVR is a feasible and beneficial VR experience to relieve pediatric preoperative anxiety and improve satisfaction in the preoperative area. The VR experience resulted in a decrease in overall anxiety and an increase in overall positive affect during the preoperative time. Patients also responded positively to the game, confirming their interest in the content and affirming the quality of the DocVR experience. The positive response to the game indicates that DocVR has the potential to make the overall preoperative experience less anxiety-producing and more comfortable, which leads to improved patient satisfaction. Naturally, improved patient outcomes lead to improved caregiver and health care provider satisfaction.

The objectives of this study were twofold: firstly, to study the thermal decomposition of Cu2ZnSnS4 (CZTS) in the air or inert atmosphere, and secondly, to study the impact on the structural and optical properties of pure CZTS nanoparticles annealing in an air atmosphere at temperatures of 300 and, 400 °C. CZTS nanoparticles were synthesized at 200 °C through a hydrothermal-microwave technique. CZTS nanoparticles were characterized by TGA, XRD, Raman, SEM, HR-TEM, and UV–Vis techniques to analyze decomposition temperature, crystalline structure, vibrational transitions, morphology, d-spaces, and optical properties, respectively. The as-synthesized particles at 200 °C showed 6 nm size and were annealed at 300, 400, and 500 °C in an air atmosphere. TGA analysis shows CZTS nanoparticles remain stable inside the air atmosphere until 400 °C. However, this material is stable in the inert atmosphere until 600 °C. XRD pattern confirmed the decomposition of CZTS in an air atmosphere at 500 °C to Cu2S, SnO2, Zn(SO4), Cu(SO4), and Cu2(SO4)O. CZTS nanoparticles were stable up to 400 °C, showing a better optical property in the crystal size and structure. The band gap value of CZTS nanoparticles decreases with the heat treatment, which gives a better advantage to light absorption in the visible range for better optoelectronic applications. [ABSTRACT FROM AUTHOR]