Patient-based quality control for glucometers: using the moving sum of positive patient results and moving average

Introduction: The capability of glucometer internal quality control (QC) in detecting varying magnitude of systematic error (bias), and the potential use of moving sum of positive results (MovSum) and moving average (MA) techniques as potential alternatives were evaluated. Materials and methods: The probability of error detection using routine QC and manufacturer’s control limits were investigated using historical data. Moving sum of positive results and MA algorithms were developed and optimized before being evaluated through numerical simulation for false positive rate and probability of error detection. Results: When the manufacturer’s default control limits (that are multiple times higher than the running standard deviation (SD) of the glucometer) was used, they had 0-75% probability of detecting small errors up to 0.8 mmol/L. However, the error detection capability improved to 20-100% when the running SD of the glucometer was used. At a binarization threshold of 6.2 mmol/L and block sizes of 200 to 400, MovSum has a 100% probability of detecting a bias that is greater than 0.5 mmol/L. Compared to MovSum, the MA technique had lower probability of bias detection, especially for smaller bias magnitudes; MA also had higher false positive rates. Conclusions: The MovSum technique is suited for detecting small, but clinically significant biases. Point of care QC should follow conventional practice by setting the control limits according to the running mean and SD to allow proper error detection. The glucometer manufacturers have an active role to play in liberalizing QC settings and also enhancing the middleware to facility patient-based QC practices

Rotational fluid flow experiment: WPI/MITRE advanced space design GASCAN 2

The design and implementation is examined of an electro-mechanical system for studying vortex behavior in a microgravity environment. Most of the existing equipment was revised and redesigned as necessary. Emphasis was placed on the documentation and integration of the mechanical and electrical subsystems. Project results include the reconfiguration and thorough testing of all the hardware subsystems, the implementation of an infrared gas entrainment detector, new signal processing circuitry for the ultrasonic fluid circulation device, improved prototype interface circuits, and software for overall control of experiment design operation

Impact of combining data from multiple instruments on performance of patient-based real-time quality control

It is unclear what is the best strategy for applying patient-based real-time quality control (PBRTQC) algorithm in the presence of multiple instruments. This simulation study compared the error detection capability of applying PBRTQC algorithms for instruments individually and in combination using serum sodium as an example. Four sets of random serum sodium measurements were generated with differing means and standard deviations to represent four simulated instruments. Moving median with winsorization was selected as the PBRTQC algorithm. The PBRTQC parameters (block size and control limits) were optimized and applied to the four simulated laboratory data sets individually and in combination. When the PBRTQC algorithm were individually optimized and applied to the data of the individual simulated instruments, it was able to detect bias several folds faster than when they were combined. Similarly, the individually applied algorithms had perfect error detection rates across different magnitudes of bias, whereas the error detection rates of the algorithm applied on the combined data missed smaller biases. The performance of the individually applied PBRTQC algorithm performed more consistently among the simulated instruments compared to when the data were combined. While combining data from different instruments can increase the data stream and hence, increase the speed of error detection, it may widen the control limits and compromising the probability of error detection. The presence of multiple instruments in the data stream may dilute the effect of the error when it only affects a selected instrument

Transmission Shaft Performance Using Static Simulation for Brushing Simulator

The brushing simulator assists researchers and dentists in conducting investigations on human teeth and plaque removal. In this paper, the development of a brushing simulator is studied. Which focuses on the life expectancy of shaft material used in the development process in the future. The aim of this study is to analyse the stress distribution of the aluminium and brushing simulator’s stainless steel threaded shafts. Besides, to analyse the brushing simulator’s threaded shaft life expectancy. The motor speed of Set 1 can be modified to 450 rpm, 480 rpm, 510 rpm, or 540 rpm. Meanwhile, speeds for set 2 are 550 rpm, 580 rpm, 610 rpm, and 640 rpm. In this study, Solidworks software was used to construct a brushing simulator model and obtain the result of stress distribution in a static simulation. The life expectancy of the aluminium and stainless-steel threaded shafts was determined from the design calculation method by using the simulation data. The threaded shaft life expectancy result showed that stainless steel is more durable than aluminium which is 3522 hours from set 1 compared to 728 hours at 640 rpm for the aluminium threaded shaft. Based on its material properties, the findings indicate that stainless steel is stronger than aluminium. Furthermore, the study shows that life expectancy at speeds below 550 rpm is higher than at speeds above 550 rpm. Hence, the life expectancy of a threaded shaft decreases as the speed increases

Confirmatory factor analysis of the Malay version of the recreational exercise motivation measure

The purpose of the present study was to validate the Malay language version of the Recreational Exercise Motivation Measure (REMM-M) using a confirmatory approach. A total of 506 (females=373, males=133) university students with a mean age of 20 (SD=1.7) years old, participate in this study. Participants completed the REMM-M to measure their motives for doing recreational exercise. The REMM-M consisted of eight subscales, with 73 items measuring motives of respondents related to recreational exercise. The confirmatory factor analysis was tested on the REMM-M using the Mplus 7.3 software. We developed eight hypothesised measurement models of REMM-M based on each subscale. Therefore, there were eight measurement models with eight latent variables and the number of observed variables for each measurement model ranged from seven to 11. All the eight hypothesised measurement models were found not in good fit based on several fit indices. Therefore, several modifications were made iteratively, with theoretical support, to improve the measurement models. These modifications included deleting 22 low-loading items (< 0.50). The final measurement models were combined as one complete measurement model of REMM-M and the CFA results indicated fit based on several fit indices (SRMR=0.064 and RMSEA=0.049 (90% CI: 0.046 to 0.051), Clfit=0.832). The motive constructs' reliability of the final measurement model were acceptable, ranging from 0.683 to 0.867. The final measurement model comprised 51 items and eight subscales. Overall, 70% of the items were retained from the original English version of REMM

Diabetes knowledge, attitudes, self-management, and quality of life among people with type 2 diabetes mellitus – a comparison between Australia- and Malaysia-based samples

The present study aimed to examine the levels of diabetes knowledge, attitudes, self-management and quality of life (QoL) between two countries with different cultural and language backgrounds. Data collection was conducted in two hospitals in Melbourne, Australia, and a hospital in Kelantan, Malaysia. Participants with type 2 diabetes mellitus (T2DM) were asked to complete four questionnaires, measuring diabetes knowledge, attitudes, self-management, and QoL. The differences between the samples were examined using chi-square and independent samples t-tests. The variables of gender and type of treatment (using insulin or not using insulin for treatment) based on groups were analysed using one-way ANOVA. All analyses were conducted using SPSS 22.0. The results highlighted some similarities and differences between the Australia-based sample and the Malaysia-based sample. In general, the Australia-based participants scored significantly higher in diabetes knowledge and reported more regular self-management of T2DM in exercise, blood glucose testing and foot care. The Australia-based sample also scored higher on attitudes compared to the Malaysia-based participants. On the other hand, Malaysia-based participants reported a lower level of impacts of T2DM on QoL. There was no significant difference between self-management of T2DM in terms of diet and satisfaction as an aspect of QoL related to living with diabetes between the two samples. The present study highlighted the levels of diabetes knowledge, attitudes, self-management, and QoL among Australia-based and Malaysia-based people with T2DM

Co-Curricular Activities and Motives for Participating in Physical Activity among Health Sciences Students at Universiti Sains Malaysia, Malaysia

Background: The purpose of the study was to compare the motives for participating in physical activity (PA) through the different types of co-curricular activities chosen by health sciences undergraduate students at Universiti Sains Malaysia (USM), Malaysia. Methods: The participants were university students at USM’s Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS). Results: A total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation (P < 0.001), appearance (P = 0.008) and physical condition (P = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities. Conclusion: The study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines.Universiti Sains Malaysia Short Term Grant (Grant Scheme No. 304/PPSP/61313041

Retrospective cohort study to investigate the 10-year trajectories of disease patterns in patients with hypertension and/or diabetes mellitus on subsequent cardiovascular outcomes and health service utilisation: a study protocol.

INTRODUCTION: Hypertension (HT) and diabetes mellitus (DM) and are major disease burdens in all healthcare systems. Given their high impact on morbidity, premature death and direct medical costs, we need to optimise effectiveness and cost-effectiveness of primary care for patients with HT/DM. This study aims to find out the association of trajectories in disease patterns and treatment of patients with HT/DM including multimorbidity and continuity of care with disease outcomes and service utilisation over 10 years in order to identify better approaches to delivering primary care services. METHODS AND ANALYSIS: A 10-year retrospective cohort study on a population-based primary care cohort of Chinese patients with documented doctor-diagnosed HT and/or DM, managed in the Hong Kong Hospital Authority (HA) public primary care clinics from 1 January 2006 to 31 December 2019. Data will be extracted from the HA Clinical Management System to identify trajectory patterns of patients with HT/DM. Complications defined by ICPC-2/International Classification of Diseases-Ninth Revision, Clinical Modification diagnosis codes, all-cause mortality rates and public service utilisation rates are included as independent variables. Changes in clinical parameters will be investigated using a growth mixture modelling analysis with standard quadratic trajectories. Dependent variables including effects of multimorbidity, measured by (1) disease count and (2) Charlson's Comorbidity Index, and continuity of care, measured by the Usual Provide Continuity Index, on patient outcomes and health service utilisation will be investigated. Multivariable Cox proportional hazards regression will be conducted to estimate the effect of multimorbidity and continuity of care after stratification of patients into groups according to respective definitions. ETHICS AND DISSEMINATION: This study was approved by the institutional review board of the University of Hong Kong-the HA Hong Kong West Cluster, reference no: UW 19-329. The study findings will be disseminated through peer-reviewed publications and international conferences. TRIAL REGISTRATION NUMBER: NCT04302974

Large-scale interaction profiling of PDZ domains through proteomic peptide-phage display using human and viral phage peptidomes

The human proteome contains a plethora of short linear motifs (SLiMs) that serve as binding interfaces for modular protein domains. Such interactions are crucial for signaling and other cellular processes, but are difficult to detect because of their low to moderate affinities. Here we developed a dedicated approach, proteomic peptide-phage display (ProP-PD), to identify domain-SLiM interactions. Specifically, we generated phage libraries containing all human and viral C-terminal peptides using custom oligonucleotide microarrays. With these libraries we screened the nine PSD-95/ Dlg/ZO-1 (PDZ) domains of human Densin-180, Erbin, Scribble, and Disks large homolog 1 for peptide ligands. We identified several known and putative interactions potentially relevant to cellular signaling pathways and confirmed interactions between fulllength Scribble and the target proteins β-PIX, plakophilin-4, and guanylate cyclase soluble subunit a-2 using colocalization and coimmunoprecipitation experiments. The affinities of recombinant Scribble PDZ domains and the synthetic peptides representing the C termini of these proteins were in the 1- to 40-μM range. Furthermore, we identified several well-established host-virus protein- protein interactions, and confirmed that PDZ domains of Scribble interact with the C terminus of Tax-1 of human T-cell leukemia virus with micromolar affinity. Previously unknown putative viral protein ligands for the PDZ domains of Scribble and Erbin were also identified. Thus, we demonstrate that our ProP-PD libraries are useful tools for probing PDZ domain interactions. The method can be extended to interrogate all potential eukaryotic, bacterial, and viral SLiMs and we suggest it will be a highly valuable approach for studying cellular and pathogen-host protein-protein interactions