Monitoring Interval Research Articles

Monitoring Serum Lipid Profile and Liver Transaminase Levels During Isotretinoin Therapy

Objective: Isotretinoin is generally chosen as the first line treatment of nodulocystic acne. Close laboratory monitoring is a general practice for many dermatologists to be on the safe side due to the laboratory side effects of isotretinoin. We aimed to determine the laboratory side effects of oral isotretinoin and optimal frequency interval for laboratory monitoring during isotretinoin treatment. Materials and Methods: One hundred patients who were under oral isotretinoin therapy were included in the study; serum lipid levels along with liver transaminase levels were recorded at the baseline, 1-, 3- and 6- months of the therapy. Results: We found that there might be slight elevations in serum aspartate transaminase and lipid levels during isotretinoin therapy (p<0.05, for all). However, statistically significant elevations were observed within the first month of isotretinoin therapy. Conclusions: Frequent laboratory monitoring might not be necessary for all acne patients undergoing isotretinoin therapy. Patients should be screened at the first month of the therapy and then, the intervals can be extended.

Comparison of Navel Orangeworm Adults Detected with Optical Sensors and Captured with Conventional Sticky Traps

Attractants used with sticky traps for monitoring navel orangeworm include artificial pheromone lures, ovipositional bait (ovibait) bags, and phenyl propionate; however, the sticky traps have the limitations of potentially becoming ineffective because of full or dirty glue surfaces and of having access to data dependent on increasingly expensive labor. A study comparing detection with a commercially available pseudo-acoustic optical sensor (hereafter, sensor) connected to a server through a cellular gateway found similar naval orangeworm activity profiles between the sensor and pheromone traps, and the timestamps of events in the sensors was consistent with the behavior of navel orangeworm males orienting to pheromone. Sensors used with ovibait detected navel orangeworm activity when no navel orangeworm were captured in sticky traps with ovibait, and the timestamps for this activity were inconsistent with oviposition times for navel orangeworm in previous studies. When phenyl propionate was the attractant, sensors and sticky traps were more highly correlated than for pheromone traps on a micro-level (individual replicates and monitoring intervals), but there was high variation and week-to-week profiles differed. These results indicate that these sensors represent a promising alternative to sticky traps for use with pheromone as an attractant, but more research is needed to develop the use of sensors with other attractants. These results will guide developers and industry in transfer of this promising technology.

Applicability of the LSC technique for determining 210Pb in liquid samples for purposes of dose assessment via in vitro bioassay

A new approach for the determination of 210Pb by liquid scintillation counting was developed by the LBIOVT. In order to assess the applicability of the technique for internal monitoring of occupationally exposed workers and members of the public, some probable scenarios for the intake of 210Pb were elaborated and evaluated in this work. The methodology developed provides detection limit values suitable for detecting activities corresponding to committed effective doses below 1 mSv in a variety of scenarios. For members of the public, the time interval between the supposed intake and the collection of the sample could be up to 240 days for daily urine collection or up to 130 days for daily faeces collection. In a monitoring program for occupational exposed workers the methodology developed could be used in a monitoring interval twice an year both for daily urine or faeces collection and the detection limits would still be able to detect activities corresponding to a committed effective doses below the recording level. It is concluded that the methodology developed is suitable to be used for monitoring individual members of the public in case of an accidental exposure or to be used in a monitoring program for occupational exposed workers

Determination of sampling time interval for investigating ecological trends of tintinnids

Abstract Tintinnids are a major group of planktonic ciliates. To determine a desirable sampling interval for analyzing the temporal dynamics of tintinnids, intensive monitoring was conducted on the southern coast of Korea. The mean sampling interval was 1.5 days. The abundance of tintinnids were analyzed by microscopy. The high- frequency temporal pattern showed detailed changes in concentrations and a distinct seasonality in the abundance of tintinnids. An optimal monitoring interval for tintinnid abundance estimations was determined by polynomial interpolation and statistical analysis, involving three steps, namely, interpolation by increasing the number of sampling intervals, graphical analysis with interpolated data and determination of the changepoint depending on the interpolated results. The value of changepoint was 7 days, indicating the optimal monitoring interval. Therefore, data collection at weekly intervals is sufficient and desirable for tracing the temporal signals of tintinnid ecology and its long-term trends.

Bleaching Susceptibility and Resistance of Octocorals and Anemones at the World's Southern-Most Coral Reef.

Coral reefs are amongst the most biodiverse ecosystems on earth, and while stony corals create the foundational complexity of these ecosystems, octocorals and anemones contribute significantly to their biodiversity and function. Like stony corals, many octocorals contain Symbiodiniaceae endosymbionts and can bleach when temperatures exceed the species’ upper thermal limit. Here, we report octocoral bleaching susceptibility and resistance within the subtropical Lord Howe Island coral reef ecosystem during and after marine heatwaves in 2019. Octocoral and anemone surveys were conducted at multiple reef locations within the Lord Howe Island lagoon during, immediately after, and 7 months after the heatwaves. One octocoral species, Cladiella sp. 1, experienced bleaching and mortality, with some bleached colonies detaching from the reef structure during the heatwave (presumed dead). Those that remained attached to the benthos survived the event and recovered endosymbionts within 7 months of bleaching. Cladiella sp. 1 Symbiodiniaceae density (in cells per µg protein), chlorophyll a and c 2 per µg protein, and photosynthetic efficiency were significantly lower in bleached colonies compared to unbleached colonies, while chlorophyll a and c 2 per symbiont were higher. Interestingly, no other symbiotic octocoral species of the Lord Howe Island lagoonal reef bleached. Unbleached Xenia cf crassa colonies had higher Symbiodiniaceae and chlorophyll densities during the marine heatwave compared to other monitoring intervals, while Cladiella sp. 2 densities did not change substantially through time. Previous work on octocoral bleaching has focused primarily on gorgonian octocorals, while this study provides insight into bleaching variability in other octocoral groups. The study also provides further evidence that octocorals may be generally more resistant to bleaching than stony corals in many, but not all, reef ecosystems. Responses to marine heating events vary and should be assessed on a species by species basis.

Myeloproliferative neoplasms – a global view

Myeloproliferative neoplasms – a global view

Perioperative use of glucose containing solutions in infants less than 6months of age: A clinical practice survey among US academic centers.

Although there is a wide breadth of literature on glucose homeostasis in infants, standardization of perioperative hypoglycemia diagnosis and management is lacking. Survey of academic pediatric anesthesiology departments across the USA to evaluate institutional policies regarding the perioperative use of glucose containing solutions in infants less than 6months of age. A questionnaire was sent to 20 United States university affiliated academic pediatric anesthesiology departments. The responses suggest that, in the centers surveyed, glucose administration in infants is largely practitioner dependent. Two respondents (10%) claim to have a departmental policy regarding glucose administration in infants less than 6months of age. In premature infants, 75% of respondents administer glucose. When administering glucose, 75% of physicians surveyed replete infants at their maintenance intravenous fluid rate. There was discrepancy among practitioners regarding initiation of hypoglycemia treatment, 35% treat infants at a blood glucose level of 70mg/dl, 30% at BG 60mg/dl, 25% at 50mg/dl, and 10% are unsure. This survey highlights the lack of consensus, at least among pediatric anesthesiologists working in US academic centers, regarding blood glucose management in infants less than 6months of age. There is a need to define the indications for using glucose containing solutions in infants during the perioperative period, their ideal content, the appropriate thresholds for hypo- and hyperglycemia as well as the optimal point-of care glucose monitoring intervals.

N20 Safety of extended blood monitoring for adult Inflammatory Bowel Disease (IBD) patients on oral azathioprine during the COVID-19 pandemic: a single-centre audit

BackgroundAzathioprine (AZA) is a recognised treatment option for maintaining remission in IBD patients. Myelotoxicity and abnormal liver function tests may present at any stage of therapy, therefore ECCO advises practitioners to check full blood count, liver and kidney function tests at 3-monthly intervals for patients established on therapy. During the COVID-19 pandemic, UK guidance suggested reducing blood test monitoring to a minimum safe frequency to facilitate ‘shielding’ of vulnerable patient groups.Patients established on treatment at St Mark’s Hospital for more than 12 months, on stable doses were deemed eligible for extended blood monitoring intervals of 6-monthly. The aim of this audit was to assess the impact of this extension on patient safety, by measuring outcomes against locally agreed standards.MethodsAll patients on AZA were identified using the pharmacy dispensing system and patient information software for blood test results, clinic letters and notes. Outcomes for patients who had extended blood monitoring were collected retrospectively including monitoring calls to the IBD advice line and any hospital admissions associated with therapy. Subsequent blood test results were also captured.ResultsA total of 92 patient records were identified and analysed. Table 1 shows the achieved compliance (%) to the audit standards compared to the target compliance (%). 54% of patients (n=50) received medication that lasted beyond the standard 12-week validity of a blood test, i.e. had extended blood monitoring. Of those 50 patients, 43 were eligible for extended blood monitoring (86%). From 50 patients with extended blood monitoring, one patient had elevated alanine aminotransferase levels which improved after a one-week treatment break. Another patient called the IBD advice line reporting nausea and abdominal cramps due to treatment and was advised to split the dose and monitor for side effects. No patients were admitted to emergency care or hospital due to deranged blood test results or adverse effects from their medication. ConclusionOverall the findings suggest that the temporary relaxation of blood monitoring did not adversely affect patient safety. For more comprehensive results, it would be prudent to repeat the audit using a larger sample size; however the audit has established a baseline at a time of unprecedented changes in the workplace, which will be useful in guiding future practice.

A Low-Calculation Contactless Continuous Authentication Based on Postural Transition

Currently, available contactless continuous authentication (CA) techniques depend on physiological biometrics to identify individuals at long intervals through complex feature extraction, resulting in poor accuracy, high computation costs, and security vacuums during lengthy intervals. To address these issues, we propose WiPT, a WiFi-based contactless CA system that utilizes contextual features and behavioral biometrics to optimize contactless CA technology. Specifically, we designed a low-computation two-step user state detection (TUSD) mechanism that continuously monitors user states in real-time. It locks the system when the registered user leaves and allows user authentication only when the departing user returns. Therefore, it eliminates pointless periodic re-authentication and results in considerably shorter monitoring intervals while significantly reducing computation. Subsequently, benefiting from contextual features, WiPT can identify individuals using more detectable behavioral biometrics. We built a one-class classification model based on the Convolutional Autoencoder to automatically extract rich representations of WiFi signals associated with postural transition movements, resulting in lower authentication delay, higher accuracy, and anti-interference. WiPT was implemented by the widely available 802.11n devices and has been extensively evaluated with typical sit-to-stand postural transitions. WiPT achieves an average accuracy of 96.63% in authentication and 99.78% in defense across 30 subjects with an authentication delay of 5.59 milliseconds and a monitoring interval of 2 seconds. They are 4.87% and 5.03% more accurate and dozens of times less time-consuming than existing WiFi-based CA solutions.

External validation and recalibration of an incidental meningioma prognostic model – IMPACT: protocol for an international multicentre retrospective cohort study

IntroductionDue to the increased use of CT and MRI, the prevalence of incidental findings on brain scans is increasing. Meningioma, the most common primary brain tumour, is a frequently encountered...

Efeito do national early warning score no monitoramento dos sinais vitais de pacientes no pronto-socorro

ABSTRACT Objective: To verify the effect of using the National Early Warning Score (NEWS) system on the compliance of the vital signs monitoring interval with those recommended for patients in the emergency room. Methods: This is a quasi-experimental, before-and-after study, performed in an emergency room with 280 adult patients selected by convenience. The effect of NEWS on the compliance of the vital signs monitoring interval with those recommended by the system was analyzed by linear regression. Results: In the Pre-NEWS phase, 143 patients were analyzed (mean age ± standard deviation: 54.4 ± 20.5; male: 56.6%) and, in the Post-NEWS phase, 137 patients (mean age ± standard deviation: 55.5 ± 20.8; male: 50.4%). There was compliance of the vital signs monitoring interval with what is recommended by NEWS in 92.6% of vital signs records after adopting this instrument. This compliance was 9% (p < 0.001) higher in the Post-NEWS phase. Conclusion: The use of the NEWS system increased the compliance of the vital signs monitoring intervals with the ones recommended, but this compliance decreased when the NEWS score pointed to a shorter interval in the monitoring of vital signs.

A roadmap for better management for synovitis in haemophilia.

A roadmap for better management for synovitis in haemophilia.

Can we check serum lithium levels less often without compromising patient safety?

Lithium is viewed as the first-line long-term treatment for prevention of relapse in people with bipolar disorder. This study examined factors associated with the likelihood of maintaining serum lithium levels within the recommended range and explored whether the monitoring interval could be extended in some cases. We included 46 555 lithium rest requests in 3371 individuals over 7 years from three UK centres. Using lithium results in four categories (<0.4 mmol/L; 0.40-0.79 mmol/L; 0.80-0.99 mmol/L; ≥1.0 mmol/L), we determined the proportion of instances where lithium results remained stable or switched category on subsequent testing, considering the effects of age, duration of lithium therapy and testing history. For tests within the recommended range (0.40-0.99 mmol/L categories), 84.5% of subsequent tests remained within this range. Overall, 3 monthly testing was associated with 90% of lithium results remaining within range, compared with 85% at 6 monthly intervals. In cases where the lithium level in the previous 12 months was on target (0.40-0.79 mmol/L; British National Formulary/National Institute for Health and Care Excellence criteria), 90% remained within the target range at 6 months. Neither age nor duration of lithium therapy had any significant effect on lithium level stability. Levels within the 0.80-0.99 mmol/L category were linked to a higher probability of moving to the ≥1.0 mmol/L category (10%) compared with those in the 0.4-0.79 mmol/L group (2%), irrespective of testing frequency. We propose that for those who achieve 12 months of lithium tests within the 0.40-0.79 mmol/L range, the interval between tests could increase to 6 months, irrespective of age. Where lithium levels are 0.80-0.99 mmol/L, the test interval should remain at 3 months. This could reduce lithium test numbers by 15% and costs by ~$0.4 m p.a.

Survival and Growth Performance of Planted Kandelia candel (L.) Druce Stand in the Philippines

The mangrove species Kandelia candel (L.) Druce is distributed in tropical Southeast and East Asia but limited to one locality in the Philippines. Hence, conservation attempt was carried out through plantation in Gimaloto, Sorsogon, the Philippines. We planted 300 K. candel seedlings on riverbanks 1 m apart along the tidal distance – or the planting distance from seaward to landward direction from the river’s mouth. We monitored seedlings monthly during the first year and then quarterly for 2 yr more for a total of 3 yr. We were interested in determining the survival probability and growth performance of K. candel seedlings along the tidal distance (1–300 m distance) and during different monitoring intervals (i.e. monthly, quarterly, bi-annual, and annual). Thirty-four (34) seedlings survived by the end of the three-year experiment, where most of the seedlings died during the first year after outplanting. Survival probability and growth increased with tidal distance, indicating that planted K. candel seedlings prefer the inland zone of at least 200 m from the sea line in the experimental area. Changes in growth parameters were observed between succeeding monitoring periods conducted during quarterly, bi-annual, and annual monitoring intervals but not during short-term monthly monitoring intervals, indicating growth responses due to seasonal and interannual variability. Our result suggests a possible introduction of K. candel outside its native population with consideration of tidal distance. We suggest mangrove rehabilitation and reforestation programs need to first conduct a zonation experiment similar to the method used in this study to identify the ecological distance where a certain mangrove species can grow better before extensive restoration and rehabilitation programs are implemented

Growth prediction model for abdominal aortic aneurysms.

The most relevant determinant in scheduling monitoring intervals for abdominal aortic aneurysms (AAAs) is maximum diameter. The aim of the study was to develop a statistical model that takes into account specific characteristics of AAA growth distributions such as between-patient variability as well as within-patient variability across time, and allows probabilistic statements to be made regarding expected AAA growth. CT angiography (CTA) data from patients monitored at 6-month intervals with maximum AAA diameters at baseline between 30 and 66 mm were used to develop the model. By extending the model of geometric Brownian motion with a log-normal random effect, a stochastic growth model was developed. An additional set of ultrasound-based growth data was used for external validation. The study data included 363 CTAs from 87 patients, and the external validation set comprised 390 patients. Internal and external cross-validation showed that the stochastic growth model allowed accurate description of the distribution of aneurysm growth. Median relative growth within 1 year was 4.1 (5-95 per cent quantile 0.5-13.3) per cent. Model calculations further resulted in relative 1-year growth of 7.0 (1.0-16.4) per cent for patients with previously observed rapid 1-year growth of 10 per cent, and 2.6 (0.3-8.3) per cent for those with previously observed slow growth of 1 per cent. The probability of exceeding a threshold of 55 mm was calculated to be 1.78 per cent at most when adhering to the current RESCAN guidelines for rescreening intervals. An online calculator based on the fitted model was made available. The stochastic growth model was found to provide a reliable tool for predicting AAA growth.

No more glowing in the dark: how deep learning improves exposure date estimation in thermoluminescence dosimetry

The time- or temperature-resolved detector signal from a thermoluminescence dosimeter can reveal additional information about circumstances of an exposure to ionising irradiation. We present studies using deep neural networks to estimate the date of a single irradiation with 12 mSv within a monitoring interval of 42 days from glow curves of novel TL-DOS personal dosimeters developed by the Materialprüfungsamt NRW in cooperation with TU Dortmund University. Using a deep convolutional network, the irradiation date can be predicted from raw time-resolved glow curve data with an uncertainty of roughly 1–2 days on a 68% confidence level without the need for a prior transformation into temperature space and a subsequent glow curve deconvolution (GCD). This corresponds to a significant improvement in prediction accuracy compared to a prior publication, which yielded a prediction uncertainty of 2–4 days using features obtained from a GCD as input to a neural network.

Should Estimated Glomerular Filtration Rate Be Adjusted for Race?

Should Estimated Glomerular Filtration Rate Be Adjusted for Race?

Radiographic pattern of inactive occlusal enamel lesions and its relationship with caries progression over 4–5 years

ObjectiveTo assess the radiographic pattern of inactive enamel caries lesions (IECL) in the occlusal surfaces of permanent molars and to investigate whether the presence of radiolucency at baseline could predict lesion progression over 4–5 years. MethodsA prospective cohort study followed 193 schoolchildren from southern Brazil. At baseline, clinical and radiographic examinations were performed. After 4–5 years, clinical examination was repeated following the same protocol. Logistic regression models were used to investigate the relationship between the presence of radiolucency at baseline and caries progression. ResultsThis study included 916 permanent molars, classified as sound occlusal surfaces (n = 434), non-cavitated IECL (n = 438), or cavitated IECL (n = 44) at baseline. The proportion of lesions with radiolucency increased as lesion severity increased (p<0.001, chi-square test). The proportion of cases that progressed was significantly higher among teeth showing radiolucency at baseline than among teeth without radiolucency (p<0.001, chi-square test). The presence of radiolucency at baseline was found to be a predictor of caries progression (activity criteria, adjusted OR=3.37, 95%CI=1.66–6.82, p<0.001; severity criteria, adjusted OR=4.01, 95%CI=1.85–8.72, p<0.001). ConclusionOcclusal surfaces (either sound or with IECL) presenting radiolucency at baseline were more likely to progress over 4–5 years of monitoring and should be monitored more closely. Clinical relevanceBitewing radiographs, when available, may be used to identify which surfaces/lesions are more likely to progress and thus, to define proper recall intervals for patient monitoring.

다기준 결정모형을 이용한 최적 점검주기 분석연구

Purpose: We developed a multicriteria decision model to assist decision-makers in determining the optimal inspection intervals based on a set of competing criteria, such as cost, downtime, and availability.<BR>Methods: A procedure based on multiattribute utility theory is proposed for developing the model. The proposed approach can simultaneously determine the optimal inspection intervals for monitoring the failure behavior of systems trails to be inspected, maintainability features, and decision-maker preferences for cost, downtime, and availability.<BR>Results: We determined the optimal inspection intervals for periodic condition monitoring based on delay time analysis and a multicriteria framework.<BR>Conclusion: We developed a multicriteria decision model that includes cost, downtime, and availability for consequences that have multiple dimensions to be considered.

Salazosulfapyridine-induced agranulocytosis in a patient on chronic hemodialysis with seronegative spondyloarthropathy: a case report

BackgroundSalazosulfapyridine is a generally safe drug often used to treat rheumatoid arthritis and ulcerative colitis. However, agranulocytosis is a rare but serious adverse effect of this drug. To date, there have been no reports describing the clinical course of salazosulfapyridine-induced agranulocytosis in a chronic hemodialysis patient.Case presentationThe patient was a 64-year-old man with IgA nephropathy who had been on chronic hemodialysis for about 3 years. For 1 month, he had general fatigue, mild fever, and pain in multiple joints of the upper extremities. He was hospitalized and underwent detailed examinations in our department. Laboratory investigations revealed an erythrocyte sedimentation rate of 67 mm/h and a C-reactive protein level of 7.73 mg/dL. Rheumatoid factor and anti-cyclic citrullinated peptide antibody were negative. Musculoskeletal ultrasonography showed inflammation of the tendon sheath in both wrists and the right shoulder joint. Computed tomography scans revealed osteosclerosis and narrowing of the sacroiliac joint. The diagnosis was seronegative spondyloarthropathy. He was started on salazosulfapyridine. Four weeks later, he had a high fever and low granulocyte count. Treatment with granulocyte colony-stimulating factor was started. The agranulocytosis could not be ascribed to any other cause and was considered an adverse effect of salazosulfapyridine, which was then stopped. Nine days later, the granulocyte count had recovered and the fever had resolved.ConclusionsCurrently, there are no guidelines on the use of salazosulfapyridine in chronic hemodialysis patients. The starting dosage should be smaller for these patients than for patients without renal impairment. Also, the laboratory monitoring interval for complete blood count should be shorter than usual.