Open-label randomized trial of titrated disease management for patients with hypertension: Study design and baseline sample characteristics

Despite the availability of efficacious treatments, only half of patients with hypertension achieve adequate blood pressure (BP) control. This paper describes the protocol and baseline subject characteristics of a 2-arm, 18-month randomized clinical trial of titrated disease management (TDM) for patients with pharmaceutically-treated hypertension for whom systolic blood pressure (SBP) is not controlled (≥140mmHg for non-diabetic or ≥130mmHg for diabetic patients). The trial is being conducted among patients of four clinic locations associated with a Veterans Affairs Medical Center. An intervention arm has a TDM strategy in which patients' hypertension control at baseline, 6, and 12 months determines the resource intensity of disease management. Intensity levels include: a low-intensity strategy utilizing a licensed practical nurse to provide bi-monthly, non-tailored behavioral support calls to patients whose SBP comes under control; medium-intensity strategy utilizing a registered nurse to provide monthly tailored behavioral support telephone calls plus home BP monitoring; and high-intensity strategy utilizing a pharmacist to provide monthly tailored behavioral support telephone calls, home BP monitoring, and pharmacist-directed medication management. Control arm patients receive the low-intensity strategy regardless of BP control. The primary outcome is SBP. There are 385 randomized (192 intervention; 193 control) veterans that are predominately older (mean age 63.5 years) men (92.5%). 61.8% are African American, and the mean baseline SBP for all subjects is 143.6mmHg. This trial will determine if a disease management program that is titrated by matching the intensity of resources to patients' BP control leads to superior outcomes compared to a low-intensity management strategy

Development of a certified reference material for the analysis of vitamins in multivitamin tablets

Abstract Multivitamin tablet certified reference material (CRM, 108-10-019) was developed for the analysis of seven water-soluble vitamins, including thiamine, riboflavin, nicotinamide, pantothenic acid, pyridoxine, biotin, and folic acid. The CRM was prepared in powder form by grinding multivitamin tablets and then mixing, sieving, and bottling the powder. For the certification of each water-soluble vitamin, the isotope dilution mass spectrometry based on the liquid chromatography was applied. The methods for each analyte were validated by confirming the repeatability and reproducibility and by comparing with other CRMs. The property values and uncertainties for the vitamins were determined with 10 units from sample stored at − 20 °C. The homogeneity of each certified component was also examined in the range of 0.48–2.2%. All certified values for the seven water-soluble vitamins were stable for 3 or 6 years after the initial certification under storage conditions at − 20 °C. For fat-soluble vitamins, including retinol, α-tocopherol, cholecalciferol, and phylloquinone, two expert laboratories participated in analyses based on official methods, and the mean values of the reported results were assigned as reference values. The multivitamin tablet CRM (108-10-019) will be useful for validating analytical methods and for ensuring the quality of results for vitamin analysis in multivitamin tablets or similar products

High-performance and self-calibrating multi-gas sensor interface to trace multiple gas species with sub-ppm level

Developing a better understanding of gas-metal oxide interactions as well as improving the output performance with the aging of the gas sensing array represents a critical challenge. In this work, we have designed a surface-functionalized metal-oxide sensors array containing six units for detecting NO2, SO2, H2S, and CO hazardous gases. The responses of the sensor array to four target gases are enhanced by various catalytic effects on the surface, and they show distinctive responses to each gas. For improved selectivity, a pattern recognition algorithm is implemented under an edge computing-based environment to relieve the overload of a monitoring server. Moreover, a self-calibration method for long-term stability is designed to indirectly calibrate gas responses with aging. With its edge-computing device prototype, which includes a sensor array and its readout integrated circuit, four target gases are distinguished by an artificial neural network algorithm with 97% accuracy. The present work describes the effective platforms for emerging next-generation gas sensors with improved communication and monitoring systems

Open-label randomized trial of titrated disease management for patients with hypertension: Study design and baseline sample characteristics

Despite the availability of efficacious treatments, only half of patients with hypertension achieve adequate blood pressure (BP) control. This paper describes the protocol and baseline subject characteristics of a 2-arm, 18-month randomized clinical trial of titrated disease management (TDM) for patients with pharmaceutically-treated hypertension for whom systolic blood pressure (SBP) is not controlled (≥140mmHg for non-diabetic or ≥130mmHg for diabetic patients). The trial is being conducted among patients of four clinic locations associated with a Veterans Affairs Medical Center. An intervention arm has a TDM strategy in which patients' hypertension control at baseline, 6, and 12 months determines the resource intensity of disease management. Intensity levels include: a low-intensity strategy utilizing a licensed practical nurse to provide bi-monthly, non-tailored behavioral support calls to patients whose SBP comes under control; medium-intensity strategy utilizing a registered nurse to provide monthly tailored behavioral support telephone calls plus home BP monitoring; and high-intensity strategy utilizing a pharmacist to provide monthly tailored behavioral support telephone calls, home BP monitoring, and pharmacist-directed medication management. Control arm patients receive the low-intensity strategy regardless of BP control. The primary outcome is SBP. There are 385 randomized (192 intervention; 193 control) veterans that are predominately older (mean age 63.5 years) men (92.5%). 61.8% are African American, and the mean baseline SBP for all subjects is 143.6mmHg. This trial will determine if a disease management program that is titrated by matching the intensity of resources to patients' BP control leads to superior outcomes compared to a low-intensity management strategy