Background
The purpose of this study was to assess the effectiveness and safety of a model predictive control (MPC) algorithm for an artificial pancreas system in outpatients with type 1 diabetes.
Methods
We searched PubMed, EMBASE, Cochrane Central, and the Web of Science to December 2021. The eligibility criteria for study selection were randomized controlled trials comparing artificial pancreas systems (MPC, PID, and fuzzy algorithms) with conventional insulin therapy in type 1 diabetes patients. The heterogeneity of the overall results was identified by subgroup analysis of two factors including the intervention duration (overnight and 24 h) and the follow-up periods (< 1 week, 1 week to 1 month, and > 1 month).
Results
The meta-analysis included a total of 41 studies. Considering the effect on the percentage of time maintained in the target range between the MPC-based artificial pancreas and conventional insulin therapy, the results showed a statistically significantly higher percentage of time maintained in the target range in overnight use (10.03%, 95% CI [7.50, 12.56] p < 0.00001). When the follow-up period was considered, in overnight use, the MPC-based algorithm showed a statistically significantly lower percentage of time maintained in the hypoglycemic range (−1.34%, 95% CI [−1.87, −0.81] p < 0.00001) over a long period of use (> 1 month).
Conclusions
Overnight use of the MPC-based artificial pancreas system statistically significantly improved glucose control while increasing time maintained in the target range for outpatients with type 1 diabetes. Results of subgroup analysis revealed that MPC algorithm-based artificial pancreas system was safe while reducing the time maintained in the hypoglycemic range after an overnight intervention with a long follow-up period (more than 1 month).
Objectives: This study investigated the relationship between maternal autonomy support and social withdrawal, executive function, and behavioral inhibition in young children. Specifically, it examined how behavioral inhibition moderates the mediating effect of executive function on the relationship between maternal autonomy support and social withdrawal in young children.Methods: Participants were 273 3-to 4-year-old children and their mothers. The data obtained were analyzed using descriptive statistics, frequency analysis, Cronbach’s α, and Pearson correlation analysis with SPSS 20.0. Meanwhile, the PROCESS Macro 3.5 software was used for analyzing the moderating effect, mediating effect, and moderated mediation effect.Results: Our findings indicated that, first, maternal autonomy support and executive function, social withdrawal, and behavioral inhibition in young children were significantly correlated. Second, executive function had a partial mediating effect on the relationship between maternal autonomy support and social withdrawal in young children. Third, the behavioral inhibition had a moderating effect on the relationship between maternal autonomy support and executive function. Last, the findings verified that the mediating effect of executive function on the relationship between maternal autonomy support and social withdrawal was moderated by behavioral inhibition.Conclusion: These results indicate that improving executive function and reducing social withdrawal through maternal autonomy support can promote positive development in young children, even when behavioral inhibition is high. Thus, they can be used to highlight the importance of parenting behaviors in shaping young children’s temperament. Furthermore, the results could provide a framework for parental education programs and early intervention programs for reducing social withdrawal in children.
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