This study explored the effect of a moderate (90 g/d) low-carbohydrate diet (LCD) in type 2 diabetes patients over 18 months. Methods Ninety-two poorly controlled type 2 diabetes patients aged 20-80 years with HbA1c �7.5% (58 mmol/mol) in the previous three months were randomly assigned to a 90 g/d LCD r traditional diabetic diet (TDD). The primary outcomes were glycaemic control status and change in medication effect score (MES). The secondary outcomes were lipid profiles, small, dense low-density lipoprotein (sdLDL), serum creatinine, microalbuminuria and carotid intimamedia thickness (IMT). Results A total of 85 (92.4%) patients completed 18 months of the trial. At the end of the study, the LCD and TDD group consumed 88.0±29.9 g and 151.1±29.8 g of carbohydrates, respectively (p < 0.05). The 18-month mean change from baseline was statistically significant for the HbA1c (-1.6±0.3 vs.-1.0±0.3%), 2-h glucose (-94.4±20.8 vs.-18.7±25.7 mg/dl), MES (-0.42±0.32 vs.-0.05±0.24), weight (-2.8±1.8 vs.-0.7±0.7 kg), waist circumference (-5.7 ±2.7 vs.-1.9±1.4 cm), hip circumference (-6.1±1.8 vs.-2.9±1.7 cm) and blood pressure (-8.3±4.6/-5.0±3 vs. 1.6±0.5/2.5±1.6 mmHg) between the LCD and TDD groups (p<0.05). The 18-month mean change from baseline was not significantly different in lipid profiles,
The Tutotest is one of the few structured instruments developed for the assessment of students' learning skills in a problem-based learning (PBL) curriculum. This study was designed to validate the Tutotest in a hybrid PBL curriculum. Forty-four tutors completed 370 evaluations on second to fourth year medical students at the end of the first semester in 2004 using the Chinese version of the Tutotest. There was significant correlation between global rating and Tutotest-C (r = 0.44, P < 0.001). The Cronbach's alpha coefficient was 0.97. Two-week test-retest correlation coefficient was 0.85. Factor analysis revealed four factors, where three were similar to the factors of "effectiveness in group", "communication and leadership skills", and "respect for others" identified in the original Tutotest. "Hypothesis forming and testing" instead of "scientific curiosity" became the fourth factor in our data. Our study validated the Tutotest-C in a hybrid PBL curriculum and students from the Chinese educational system. The test-retest reliability measure with a 2-week interval at the end of the PBL tutorial confirmed the stability of the Tutotest, which has not been previously reported. Since most Asian medical schools adopted a hybrid PBL curriculum, a valid student evaluation instrument for this type of curriculum is valuable.
Gait velocity has been considered the sixth vital sign. It can be used not only to estimate the survival rate of the elderly, but also to predict the tendency of falling. Unfortunately, gait velocity is usually measured on a specially designed walk path, which has to be done at clinics or health institutes. Wearable tracking services using an accelerometer or an inertial measurement unit can measure the velocity for a certain time interval, but not all the time, due to the lack of a sustainable energy source. To tackle the shortcomings of wearable sensors, this work develops a framework to measure gait velocity using distributed tracking services deployed indoors. Two major challenges are tackled in this paper. The first is to minimize the sensing errors caused by thermal noise and overlapping sensing regions. The second is to minimize the data volume to be stored or transmitted. Given numerous errors caused by remote sensing, the framework takes into account the temporal and spatial relationship among tracking services to calibrate the services systematically. Consequently, gait velocity can be measured without wearable sensors and with higher accuracy. The developed method is built on top of WuKong, which is an intelligent IoT middleware, to enable location and temporal-aware data collection. In this work, we present an iterative method to reduce the data volume collected by thermal sensors. The evaluation results show that the file size is up to 25% of that of the JPEG format when the RMSE is limited to 0.5◦.
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