How Continuous Monitoring Changes the Interaction of Patients with a Mobile Telemedicine System

The use of continuous glucose monitor changes the way patients manage their diabetes, as observed in the increased number of daily insulin bolus, the increased number of daily BG measurements, and the differences in the distribution of BG measurements throughout the day. Continuous monitoring also increases the interaction of patients with the information system and modifies their patterns of use

Modelling of composite sandwich structures with honeycomb core subjected to high-velocity impact

7 pages, 9 figuresIn this study the perforation of composite sandwich structures subjected to high-velocity impact was analysed. Sandwich panels with carbon/epoxy skins and an aluminium honeycomb core were modelled by a three-dimensional finite element model implemented in ABAQUS/Explicit. The model was validated with experimental tests by comparing numerical and experimental residual velocity, ballistic limit, and contact time. By this model the influence of the components on the behaviour of the sandwich panel under impact load was evaluated; also, the contribution of the failure mechanisms to the energy-absorption of the projectile kinetic energy was determined.The authors are indebted to the Spanish Comisión Interministerial de Ciencia y Tecnología (Project TRA2004 03960) for the financial support of this work.Publicad

Electronic Report Generation Web Service evaluated within a Telemedicine System

This work presents a generic tool based on a client-server architecture that generates electronic reports helping the evaluation process of any information system. For the specific evaluation of telemedicine systems the defined reports cover four dimensions: auditory of the system; evolution of clinical protocols; results from the questionnaires for user acceptance and quality of life; and surveillance of clinical variables. The use of a Web Service approach allows multiplatform use of the developed electronic report service and the modularity followed in the implementation enables easy system evolution and scalability

Perceived Competence in the Face of Death before and after Nursing Studies: An Intrasubject Longitudinal Study

Perceived competence is a subject’s perception of being able to interact effectively with the environment. Perceived Competence in the face of death in Nursing degree programs in which the presence of the subject of death and bereavement is key becomes more topical and relevant. The objective of this study is to determine whether this competence is improved through Nursing Studies. This study was designed as paired repeated intrasubject measures, initial measurement at the beginning of the first year and second measurement in the fourth year of the Nursing degree. One hundred and seventeen nursing students were assessed. Significant improvement is evidenced in three of the four dimensions of Perceived Competence in the face of death (Accompaniment and Communication: 25.70/29.34; Self-Confidence: 9.64/12.78; Management of Self-Fear: 13.18/14.66). These results show notable differences with their cross-sectional predecessors, suggesting the need for further studies in this field to consolidate a still developing body of knowledge.Enfermerí

Resilience, Stress, and Cortisol Predict Cognitive Performance in Older Adults

Objective: to determine the relationship between stress, resilience, and cognitive perfor- mance in older people without dementia. Method: multiple linear regressions were performed using measures of cognitive performance as dependent variables, and measures of stress and resilience as predictors in a sample of 63 Spanish elderly people. Results: participants reported low levels of stress during their lifetime. In addition to socio-demographic variables, greater stress was related to better delayed recall and worse letter–number sequencing and block design. Higher capillary cortisol was associated with lower flexibility on the Stroop task. Regarding protective factors, we found that greater psychological resilience was related to higher scores on the Addenbrooke’s Cognitive Examination-III, letter–number sequencing, and verbal fluency. Conclusion: in older people with low stress, apart from age, gender, and education, psychological resilience is a significant predictor of global cognitive status, working memory, and fluency. Likewise, stress is related to verbal memory functioning, working memory, and visuoconstructive abilities. Capillary cortisol level predicts cogni- tive flexibility. These findings may help to identify risk and protective factors for cognitive decline in older people. Training-based programs to reduce stress and increase psychological resilience may play an important role in preventing cognitive decline

6th International Conference on Mechanical Models in Structural Engineering

Producción CientíficaThis ebook contains the 37 full papers submitted to the 6th International Conference on Mechanical Models in Structural Engineering (CMMOST 2021) held in Valladolid on December 2021

Using a causal smoothing to improve the performance of an on-line neural network glucose prediction algorithm

This work evaluates a spline-based smoothing method applied to the output of a glucose predictor. Methods:Our on-line prediction algorithm is based on a neural network model (NNM). We trained/validated the NNM with a prediction horizon of 30 minutes using 39/54 profiles of patients monitored with the Guardian® Real-Time continuous glucose monitoring system The NNM output is smoothed by fitting a causal cubic spline. The assessment parameters are the error (RMSE), mean delay (MD) and the high-frequency noise (HFCrms). The HFCrms is the root-mean-square values of the high-frequency components isolated with a zero-delay non-causal filter. HFCrms is 2.90±1.37 (mg/dl) for the original profiles

Parallel workflows to personalize clinical guidelines recommendations: application to gestational diabetes mellitus

The MobiGuide system provides patients with personalized decision support tools, based on computerized clinical guidelines, in a mobile environment. The generic capabilities of the system will be demonstrated applied to the clinical domain of Gestational Diabetes (GD). This paper presents a methodology to identify personalized recommendations, obtained from the analysis of the GD guideline. We added a conceptual parallel part to the formalization of the GD guideline called "parallel workflow" that allows considering patient?s personal context and preferences. As a result of analysing the GD guideline and eliciting medical knowledge, we identified three different types of personalized advices (therapy, measurements and upcoming events) that will be implemented to perform patients? guiding at home, supported by the MobiGuide system. These results will be essential to determine the distribution of functionalities between mobile and server decision support capabilities