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Zhang X, Li M, Gao Q, Kang X, Sun J, Huang Y, Xu H, Xu J, Shu S, Zhuang J, Huang Y. Cutting-edge microneedle innovations: Transforming the landscape of cardiovascular and metabolic disease management. iScience 2024; 27:110615. [PMID: 39224520 PMCID: PMC11366906 DOI: 10.1016/j.isci.2024.110615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Cardiovascular diseases (CVDs) and metabolic disorders (MDs) have surfaced as formidable challenges to global health, significantly imperiling human well-being. Recently, microneedles (MNs) have garnered substantial interest within the realms of CVD and MD research. Offering a departure from conventional diagnostic and therapeutic methodologies, MNs present a non-invasive, safe, and user-friendly modality for both monitoring and treatment, thereby marking substantial strides and attaining pivotal achievements in this avant-garde domain, while also unfurling promising avenues for future inquiry. This thorough review encapsulates the latest developments in employing MNs for both the surveillance and management of CVDs and MDs. Initially, it succinctly outlines the foundational principles and approaches of MNs in disease surveillance and therapy. Subsequently, it delves into the pioneering utilizations of MNs in the surveillance and management of CVDs and MDs. Ultimately, this discourse synthesizes and concludes the primary findings of this investigation, additionally prognosticating on the trajectory of MN technology.
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Affiliation(s)
- Xiaoning Zhang
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Ming Li
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Qiang Gao
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Xiaoya Kang
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jingyao Sun
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Yao Huang
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Hong Xu
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jing Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Songren Shu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Jian Zhuang
- School of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Yuan Huang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
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Sanders SF, Shen MS, Alaiev D, Knoll B, Cho HJ, Tsega S, Krouss M, Fagan I, Klinger A. Don't hold the metformin: Enhancing inpatient diabetes education to encourage best practices in a public hospital. J Hosp Med 2024; 19:551-556. [PMID: 38695331 DOI: 10.1002/jhm.13269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 06/04/2024]
Affiliation(s)
- Samantha F Sanders
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, New York, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA
| | - Michael S Shen
- Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA
- Department of Medicine, NYC Health + Hospitals/Woodhull, Brooklyn, New York, USA
| | - Daniel Alaiev
- Department of Quality and Safety, NYC Health + Hospitals, New York, New York, USA
| | - Brianna Knoll
- Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA
- Department of Medicine, NYU Langone Health, New York, New York, USA
| | - Hyung J Cho
- Department of Quality and Safety, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Surafel Tsega
- Department of Quality and Safety, NYC Health + Hospitals, New York, New York, USA
- Department of Medicine, NYC Health + Hospitals/Kings, Brooklyn, New York, USA
| | - Mona Krouss
- Department of Quality and Safety, NYC Health + Hospitals, New York, New York, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ian Fagan
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, New York, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA
| | - Amanda Klinger
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, New York, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA
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Klein P, Bonhomme J, Bourne C, Hellot-Guersing M, Marcucci C, Rodier S, Charpiat B. [Inability of hospital computerised physician order entry systems to secure the use of concentrated potassium intravenous solutions]. ANNALES PHARMACEUTIQUES FRANÇAISES 2024; 82:359-368. [PMID: 37879563 DOI: 10.1016/j.pharma.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 05/29/2023] [Accepted: 06/12/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued by French healthcare agencies. METHODS We sent a questionnaire to the members of the Association pour le Digital et l'Information en Pharmacie. RESULTS More than three quarters of the 84 responses received involving 23 CPOE systems indicate that it is possible to: prescribe an ampoule of concentrated potassium chloride 10% 10mL intravenously without any diluents (80%); prescribe 4g of KCl in a bag of 500mL of NaCl 0,9% (98%); prescribe a solution that contains 6 grams of KCl per liter (94%); prescribe the administration of an injectable ampoule orally by means of a free text comment (83%). Nearly half of the responses indicate that it is possible to prescribe: concentrated KCl ampoules as administration solvent (50%); an injectable vial to be administered by oral route (52%). CONCLUSION At least 23 hospital CPOE systems are unable to secure the prescriptions of injectable KCl. This finding lifts the veil on an unthought, namely the role of CPOE systems in securing high-risk medications. In order to solve this problem, it should be mandatory that health information technology vendors pay particular attention to these drugs. With regard to injectable KCl, the utilisation of a dilution vehicle, maximum concentration and maximum infusion flow rate are the first four constraints to be satisfied.
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Affiliation(s)
- Pauline Klein
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier Nord, hospices civils de Lyon, 103, grande rue de la Croix Rousse, 69317 Lyon cedex 04, France.
| | - Jeremy Bonhomme
- OMEDIT Océan Indien - ARS La Réunion, 2bis, avenue Georges-Brassens CS 61002, 97743 Saint-Denis cedex 9, Réunion
| | - Cindy Bourne
- Service pharmaceutique, centre hospitalier de Crest, rue Paul-Goy, 26400 Crest, France
| | - Magali Hellot-Guersing
- Service pharmaceutique, centre hospitalier Lucien-Hussel, montée du Dr-Chapuis, 38200 Vienne, France
| | - Charles Marcucci
- Service pharmaceutique, centre hospitalier de Clermont de l'Oise, rue Frédéric-Raboisson, BP 40024, 60607 Clermont Cedex, France
| | - Simon Rodier
- Service pharmaceutique, centre hospitalier intercommunal Alençon-Mamers, 25, rue de Fresnay, 61000 Alençon, France
| | - Bruno Charpiat
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier Nord, hospices civils de Lyon, 103, grande rue de la Croix Rousse, 69317 Lyon cedex 04, France
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Nimri R, Phillip M, Clements MA, Kovatchev B. Closed-Loop Control, Artificial Intelligence-Based Decision-Support Systems, and Data Science. Diabetes Technol Ther 2024; 26:S68-S89. [PMID: 38441444 DOI: 10.1089/dia.2024.2505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Affiliation(s)
- Revital Nimri
- Diabetes Technology Center, Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Phillip
- Diabetes Technology Center, Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mark A Clements
- Division of Pediatric Endocrinology, Children's Mercy Hospitals and Clinics, Kansas City, MO, USA
| | - Boris Kovatchev
- Center for Diabetes Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
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Qvist A, Mullan L, Nguyen L, Wynter K, Rasmussen B, Goh M, Feely K. Investigating allied health professionals' attitudes, perceptions and acceptance of an electronic medical record using the Unified Theory of Acceptance and Use of Technology. AUST HEALTH REV 2024; 48:16-27. [PMID: 38281312 DOI: 10.1071/ah23092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
Objective This study aimed to investigate allied health professionals' (AHPs') perspectives pre- and post-implementation of an electronic medical record (EMR) in a tertiary health service in Australia and examine factors influencing user acceptance. Methods Data were collected pre- and post-EMR implementation via cross-sectional online surveys based on the Unified Theory of Acceptance and Usage of Technology (UTAUT). All AHPs at a large tertiary hospital were invited to complete the surveys. Data analysis included descriptive analysis, Mann-Whitney U tests for pre-post item- and construct-level comparison and content analysis of free-text responses. The theoretical model was empirically tested using partial least squares structural equation modelling. Results AHPs had positive attitudes toward EMR use both pre- and post-implementation. Compared to pre-implementation, AHPs felt more positive post-implementation about system ease of use and demonstrated decreased anxiety and apprehension regarding EMR use. AHPs felt they had adequate resources and knowledge to use EMR and reported real-time data accessibility as a main advantage. Disadvantages of EMR included an unfriendly user interface, system outages and decreased efficiency. Conclusions As AHPs increase EMR system familiarity, their positivity towards its use increases. An understanding of what influences AHPs when implementing new compulsory technology can inform change management strategies to improve adoption.
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Affiliation(s)
- Alison Qvist
- Western Health, Digital Health, Footscray, Vic. 3011, Australia
| | - Leanne Mullan
- School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia; and School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 1100 Nudgee Road, Banyo, Qld 4014, Australia
| | - Lemai Nguyen
- Department of Information Systems and Business Analytics, Deakin Business School, Deakin University, Burwood, Vic., Australia
| | - Karen Wynter
- School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia; and Department of Psychiatry, Monash University, Clayton, Vic. 3168, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia; and The Centre for Quality and Patient Safety Research in the Institute of Health Transformation, Deakin University - Western Health Partnership, St Albans, Vic., Australia; and Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Copenhagen, Denmark; and Faculty of Health and Medical Sciences, University of Copenhagen, Odense, Denmark
| | - Min Goh
- Western Health, Digital Health, Footscray, Vic. 3011, Australia
| | - Kath Feely
- Western Health, Digital Health, Footscray, Vic. 3011, Australia; and Royal Melbourne Hospital, EMR team, Parkville, Vic. 3052, Australia
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ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Ekhlaspour L, Galindo RJ, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S295-S306. [PMID: 38078585 PMCID: PMC10725815 DOI: 10.2337/dc24-s016] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Huang S, Liang Y, Li J, Li X. Applications of Clinical Decision Support Systems in Diabetes Care: Scoping Review. J Med Internet Res 2023; 25:e51024. [PMID: 38064249 PMCID: PMC10746969 DOI: 10.2196/51024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Providing comprehensive and individualized diabetes care remains a significant challenge in the face of the increasing complexity of diabetes management and a lack of specialized endocrinologists to support diabetes care. Clinical decision support systems (CDSSs) are progressively being used to improve diabetes care, while many health care providers lack awareness and knowledge about CDSSs in diabetes care. A comprehensive analysis of the applications of CDSSs in diabetes care is still lacking. OBJECTIVE This review aimed to summarize the research landscape, clinical applications, and impact on both patients and physicians of CDSSs in diabetes care. METHODS We conducted a scoping review following the Arksey and O'Malley framework. A search was conducted in 7 electronic databases to identify the clinical applications of CDSSs in diabetes care up to June 30, 2022. Additional searches were conducted for conference abstracts from the period of 2021-2022. Two researchers independently performed the screening and data charting processes. RESULTS Of 11,569 retrieved studies, 85 (0.7%) were included for analysis. Research interest is growing in this field, with 45 (53%) of the 85 studies published in the past 5 years. Among the 58 (68%) out of 85 studies disclosing the underlying decision-making mechanism, most CDSSs (44/58, 76%) were knowledge based, while the number of non-knowledge-based systems has been increasing in recent years. Among the 81 (95%) out of 85 studies disclosing application scenarios, the majority of CDSSs were used for treatment recommendation (63/81, 78%). Among the 39 (46%) out of 85 studies disclosing physician user types, primary care physicians (20/39, 51%) were the most common, followed by endocrinologists (15/39, 39%) and nonendocrinology specialists (8/39, 21%). CDSSs significantly improved patients' blood glucose, blood pressure, and lipid profiles in 71% (45/63), 67% (12/18), and 38% (8/21) of the studies, respectively, with no increase in the risk of hypoglycemia. CONCLUSIONS CDSSs are both effective and safe in improving diabetes care, implying that they could be a potentially reliable assistant in diabetes care, especially for physicians with limited experience and patients with limited access to medical resources. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.37766/inplasy2022.9.0061.
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Affiliation(s)
- Shan Huang
- Endocrinology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuzhen Liang
- Department of Endocrinology, The Second Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Jiarui Li
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, China
| | - Xuejun Li
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Xiamen Diabetes Institute, Xiamen, China
- Fujian Provincial Key Laboratory of Translational Medicine for Diabetes, Xiamen, China
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ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Gabbay RA, on behalf of the American Diabetes Association. 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S267-S278. [PMID: 36507644 PMCID: PMC9810470 DOI: 10.2337/dc23-s016] [Citation(s) in RCA: 85] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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