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Detection of petroleum hydrocarbons at low ppb levels using quartz resonator sensors and instrumentation of a smart environmental monitoring system.

Petroleum hydrocarbon vapors at low ppb levels can be detected using a thickness shear mode resonator (TSMR) coated with a chemical-sensing overlayer, prepared by radiofrequency sputtering of porous sintered-polyethylene (PS-PE). The sensing capabilities of PS-PE sensors were profoundly affected by the sputtering methods; they were enhanced by the photo-excitation effect, and were reduced by carbonization and water treatment. The photo-assisted PS-PE sensor was extremely sensitive and could detect linear hydrocarbon (> C12) vapors below the ppb level. The time constant of the sorption curve, however, was large, indicating a slow sensing speed. Toward creating instrumentation for a smart environmental monitoring system, the TSMR sensors were arrayed on a circuit board equipped with a serial interface and signal processing chips of the oscillation drive and frequency counter. Co-sorption with water vapor at a relative humidity of about 10% has almost no effect on the sensing ability of PS-PE sensors for 1,2,4-trimethylbenzene. Conversely, it enhances the sensitivity of the TSMR sensor coated with a D-phenylalanine film. Upward shifts in the baseline are evident with elapsed time. However, a rigorous ten-cycle iteration test for 100 ppm toluene vapor demonstrated good reproducibility of the sensor's signals.

Air Pollution↗

Unintended childbearing: pregnancy risk assessment monitoring system--Oklahoma, 1988-1991.

Unintended pregnancies may be associated with delays in the initiation of prenatal care and behaviors during pregnancy that increase the risk for adverse birth outcomes (1,2). Based on estimates from the 1988 National Survey of Family Growth, 28% of births were mistimed during the 3-4 years before the survey, and 12% were unwanted (3). In Oklahoma, family-planning services are provided as an element of the state's maternal and child health program efforts, and the state has made a priority of identifying mothers at high risk for unintended pregnancy. This report summarizes an analysis of data from the Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) to assess the risk for unintended childbearing in Oklahoma during 1988-1991.

Adolescent↗

The in vitro real-time oscillation monitoring system identifies potential entrainment factors for circadian clocks.

BACKGROUND: Circadian rhythms are endogenous, self-sustained oscillations with approximately 24-hr rhythmicity that are manifested in various physiological and metabolic processes. The circadian organization of these processes in mammals is governed by the master oscillator within the suprachiasmatic nuclei (SCN) of the hypothalamus. Recent findings revealed that circadian oscillators exist in most organs, tissues, and even in immortalized cells, and that the oscillators in peripheral tissues are likely to be coordinated by SCN, the master oscillator. Some candidates for endogenous entrainment factors have sporadically been reported, however, their details remain mainly obscure. RESULTS: We developed the in vitro real-time oscillation monitoring system (IV-ROMS) by measuring the activity of luciferase coupled to the oscillatory gene promoter using photomultiplier tubes and applied this system to screen and identify factors able to influence circadian rhythmicity. Using this IV-ROMS as the primary screening of entrainment factors for circadian clocks, we identified 12 candidates as the potential entrainment factor in a total of 299 peptides and bioactive lipids. Among them, four candidates (endothelin-1, all-trans retinoic acid, 9-cis retinoic acid, and 13-cis retinoic acid) have already been reported as the entrainment factors in vivo and in vitro. We demonstrated that one of the novel candidates, 15-deoxy-Delta12,14-prostaglandin J2 (15d-PGJ2), a natural ligand of the peroxisome proliferator-activated receptor-gamma (PPAR-gamma), triggers the rhythmic expression of endogenous clock genes in NIH3T3 cells. Furthermore, we showed that 15d-PGJ2 transiently induces Cry1, Cry2, and Roralpha mRNA expressions and that 15d-PGJ2-induced entrainment signaling pathway is PPAR-gamma--and MAPKs (ERK, JNK, p38MAPK)-independent. CONCLUSION: Here, we identified 15d-PGJ2 as an entrainment factor in vitro. Using our developed IV-ROMS to screen 299 compounds, we found eight novel and four known molecules to be potential entrainment factors for circadian clocks, indicating that this assay system is a powerful and useful tool in initial screenings.

Animals↗

Palm glucose readings compared with fingertip readings under steady and dynamic glycemic conditions, using the OneTouch Ultra Blood Glucose Monitoring System.

OBJECTIVES: Past studies have suggested the absence of lag between palm glucose and fingertip glucose, even when glucose levels are changing rapidly. However, at any given time point, there may be differences between palm and fingertip glucose values because of glycemic instability and/or test methodology. The objectives of this study included assessing the variability in fingertip blood glucose test results between two fingers, and establishing whether the variability in blood glucose test results obtained from the palm was clinically equivalent to that observed in fingertip-to-fingertip comparisons. METHODS: This multicenter trial was conducted on patients under both steady-state glycemic conditions and after meal and exercise challenges (to promote rapidly changing glucose). Sequential capillary glucose testing, performed with the One Touch Ultra Blood Glucose Monitoring System (LifeScan, Inc., Milpitas, CA), was allocated to two of four fingertip sites and one of two palm sites in each subject using a randomized, balanced, incomplete block design. One of the fingertips was designated the reference site. Fingertip-to-fingertip variability and fingertip- to-palm variability were assessed under these steady-state and dynamic testing conditions using error grid analysis and by comparing the proportion of clinically acceptable blood glucose tests at the palm site versus the fingertip site. Clinically acceptable agreement was defined as pairs of values (fingertip to reference, or palm to reference) within 15 mg/dL when reference glucose was < or = 75 mg/dL or within 20% when reference glucose was >75 mg/dL. RESULTS: One hundred eighty-one subjects with type 1 [n = 74 (40.9%)] or type 2 [n = 107 (59.1%)] diabetes at eight clinical sites completed the study. Overall, the proportion of clinically acceptable agreement was high for both palm (95.1%) and fingertip (97.5%) testing. The mean difference between palm and fingertip clinically acceptable agreement when done by healthcare professionals was -1.3% and -4.4%, under steady-state and dynamic glycemic conditions, respectively. Error grid analysis showed >97% of all palm and fingertip measurements fell in Zone A. CONCLUSION: This study demonstrated that variability between fingertip-to-fingertip and palm-to-fingertip measurements was in the clinically acceptable range during steady-state conditions and when glucose was rapidly changing.

Adolescent↗

Chromosome aberrations in plants as a monitoring system.

The potential of higher plants as a first-tier assay system for detecting chemical mutagens is evaluated. The use of plant tissue (primarily root tips and pollen mother cells) for studying the induction of chromosomal aberrations is one of the oldest, simplest, most reliable, and inexpensive methods available. Specific types of abnormalities have been induced by different classes of pesticides. Chromosome clumping, contraction, stickiness, paling, fragmentation, dissolution, chromosome and chromatid bridges, C-mitosis, and endoploidy have been reported in the literature. Examples of cytogenetic studies with pesticides demonstrating the usefulness of higher plants as a monitoring system are reviewed. Pesticides which cause chromosome aberrations in plant cells also produce chromosome aberrations in cultured animal cells. Frequently, the aberrations are identical. For example, studies have shown that compounds which have a C-mitotic effect on plant cells have the same effect on animal cells. It is recommended that plant systems be accepted as a first-tier assay system for the detection of possible genetic damage by environmental chemicals.

Cell Nucleus↗

An ambulatory bile reflux monitoring system: an in vitro appraisal.

Assessment of duodenogastric bile reflux has hitherto been unsatisfactory. An ambulatory system which utilizes the optical properties of bilirubin is examined. Test readings are correlated with the laboratory values for bilirubin in each of a number of physiological solutions. For dilutions of pure bile there was a linear correlation between absorbance and bilirubin concentration (r = 0.93, p < 0.001). In the more acidic environment of gastric juice there was also a linear correlation between absorbance and bilirubin concentration (r = 0.65, p < 0.001), but absorbance values were significantly higher than those of pure bile solutions (F ratio = 130, p < 0.0001). Normal gastric secretions and saliva give low absorbance values (0.02-0.04). Common foodstuffs such as soups, tea and coffee give higher readings and may interfere with bile reflux assessment in a clinical setting. Bilitec 2000 has potential for use as an ambulatory bile reflux monitoring system but consideration should be given to a standard diet or attention must focus on the fasting period.

Ambulatory Care↗

Compliance assessed by the Medication Event Monitoring System.

The accurate assessment of patient compliance is especially crucial in evaluating the efficacy of a new treatment. Because of the problems associated with parenteral desferrioxamine, the development of a safe, effective, and convenient iron chelator is of high priority. The high morbidity and mortality associated with iron overload requires careful evaluation of the ability of any new agent to promote long term effective iron chelation. Patients' compliance with an orally available chelating agent, 1,2,-dimethyl-3-hydroxypyrid-4-one (L1), that has been demonstrated to induce in vivo iron excretion equivalent to that of desferrioxamine during supervised short term administration, was examined. Compliance was assessed in seven patients by patient interview, by daily diaries reviewed monthly with each patient, and with the use of the Medication Event Monitoring System (MEMS) standard pill bottles with microprocessors in the cap that record the timing and frequency of bottle openings. L1 was dispensed in MEMS containers to the patients, who, unaware of their significance, recorded compliance using a daily diary. Overall compliance rate (% of prescribed doses taken) measured by MEMS was 88.7 +/- 6.8%. When 'doubling of doses' was accounted for, significantly poorer compliance with L1 was noted by MEMS (91.7 +/- 7.4%) than by patients' diaries (95.7 +/- 5.2%). There was no significant difference in patient compliance recorded between the first and last 30 day period of drug administration. MEMS can eliminate the confounding variable of erratic patient compliance in the evaluation of a new drug's efficacy. As MEMS cannot distinguish a missed dose from one doubled at the next bottle opening, the use of patient diaries is a useful adjunct to the accurate assessment of compliance and should be combined with the use of MEMS.

Administration, Oral↗

Evaluation of a new real-time blood continuous glucose monitoring system in pregnant women without gestational diabetes. A pilot study.

The incidence of gestational diabetes mellitus (GDM) has reached epidemic proportions in the United States, affecting 200,000 pregnant women annually. Controversies exist regarding whether the glucose levels used to diagnose GDM in pregnancy should be lowered since similar fetal complications are seen in women with GDM as well as in nondiabetic women. Although GDM has been extensively studied, the effects of the earlier stage of glucose intolerance are not well understood. The objectives of this descriptive, comparative, correlational pilot study include assessment of real-time blood glucose concentrations in women (20) with idiopathic macrosomia and/or polyhydramnios but with a normal baseline glucose screening test. This group was compared to pregnant women (20) without idiopathic macrosomia and/or polyhydromnios as confirmed by normal ultrasounds (controls). All subjects had a normal screeing test and/or a 3-hour Glucose Tolerance Test earlier in the pregnancy and wore a continuous glucose monitoring system for 72 hours. No adverse maternal complications were seen. Neonatal complications included macrosomia, shoulder dystocia, and hyperbilirubinemia. There was no significant association between real-time blood glucose levels and adverse maternal or fetal/neonatal complications. There is little evidence available regarding real-time physiologic glycemic levels in pregnant women. The findings of our pilot study provide baseline data for the design of a larger study to compare blood glucose levels and complications in euglycemic women and compare to women with those impaired glucose tolerance.

Adult↗

Neural network of glucose monitoring system.

Glucose-sensitive neural elements exist in the hypothalamus, the nucleus of the solitary tract (NTS) and autonomic afferents from visceral organs such as liver and gastrointestinal tract. Glucose affects neural activity through these central and peripheral chemosensors. Glucose is generally suppressive in the liver, the NTS and the lateral hypothalamic area (LHA), and generally excitatory in the small intestine and ventromedial hypothalamic nucleus (VMH). The hypothalamus is involved in the control of pancreatic hormone secretion through autonomic efferent nerves. Stimulation or lesion of the hypothalamus induces various changes in pancreatic autonomic nerve activity. The VMH, the dorsomedial hypothalamic nucleus and the paraventricular nucleus have inhibitory effects on vagal nerve activity and excitatory effects on splanchnic nerve activity. The LHA is excitatory to the vagal nerve, and both excitatory and inhibitory to the splanchnic nerve. These findings suggest that the neural network of the glucose monitoring system, which also analyzes and integrates information concerning other metabolites and peptides in the blood and cerebrospinal fluid, contributes to regulation of peripheral metabolism and endocrine activity as well as feeding behavior. The physiological function and input-output organization of this network are discussed.

Animals↗

A practical system for monitoring the outcomes of substance use disorder patients.

Outcomes monitoring and management are receiving mounting attention because of increased emphasis on health care accountability and cost containment. Efficient, practical outcomes monitoring systems (OMSs) are crucial if health care system performance is to be determined and effective/cost-effective treatments are to be identified, but such practical monitoring systems generally are lacking. This article describes the features of such a system for monitoring the care received by, and the substance use and psychosocial outcomes of, patients treated for substance use disorders (SUDs) in the Department of Veterans Affairs (VA). In contrast to a 15-21% follow-up rate achieved by VA SUD program staff under a previously mandated system-wide monitoring system, the monitoring system used in this project achieved a 67% follow-up rate without paying patients for their participation. We provide data on patient characteristics and treatment outcomes, estimate the cost of implementing this type of monitoring system on a broad scale, and provide recommendations for OMSs in other large health care organizations.

Adolescent↗

Assessment of left ventricular volume by an ambulatory radionuclide monitoring system during head-up tilt in patients with unexplained syncope: relation to autonomic activity assessed by heart rate variability.

BACKGROUND: Decreased left ventricular volume during head-up tilt plays an important role in triggering syncope in patients with neurally mediated syncope. However, precise changes in left ventricular volume during head-up tilt have not been well investigated. This study was conducted to test the hypothesis that the decline in left ventricular volume during tilt could trigger ventricular mechanoreceptor activation. METHODS AND RESULTS: To investigate the mechanisms of tilt-induced syncope, we measured the temporal changes in left ventricular volume, ejection fraction, cardiac output, and heart rate variability indices during head-up tilt in 25 patients with syncope of undetermined etiology. Eleven patients had a cardioinhibitory response (CI group), 7 patients showed a vasodepressor response (VD group), and 7 patients demonstrated a negative response (NG group). Before syncope, ejection fraction increased most in the CI group, the left ventricular end-diastolic volume declined most in the VD group (VD group, -11.0% +/- 3.3%; CI group, -2.8% +/- 4.8%; NG group, -3.4% +/- 2.2%; P <.005), and the high-frequency spectra increased most in the CI group (CI group, 25.0% +/- 21.0%; VD group, -4.1% +/- 11.7%; NG group, -5.3% +/- 12.7%; P <.01). The vasodepressor response was dependent on left ventricular volume, whereas the cardioinhibitory response was related to the vagal activity reflected by high-frequency spectra. CONCLUSIONS: The precise evaluation of left ventricular volume by an ambulatory radionuclide monitoring system combined with a heart rate variability analysis is considered useful for clarifying the pathophysiology of neurally mediated syncope.

Adult↗

Long-term stability of a TLD-based individual monitoring system.

The thermoluminescence dosemeter (TLD) system at the Individual Monitoring Service (IMS) of the Nuclear Technology Institute (ITN) at the Radiological Protection and Nuclear Safety Department (DPRSN) comprises two 6600 Harshaw readers and the Harshaw 8814 TL card and the holder containing two LiF:Mg,Ti (TLD-100) dosemeters for the evaluation of H(p)(10) and H(p)(0.07). The readers are calibrated on a monthly basis and as part of the quality assurance programme implemented at the IMS a set of dosemeters is issued monthly to the DPRSN's Standard Dosimetry Laboratory for linearity measurements. The results obtained since November 2001 are presented. Fading and sensitivity change experiments are carried out every month covering 8 week periods so that enough time is given to simulate issuing, integrating and receiving times and respective delays. A set of 96 dosemeters organised in eight subsets of 12 are used. In each subset, four dosemeters are irradiated and stored at room temperature (RT), four are not irradiated at all and the last four are irradiated after storage. The 12 dosemeters of each subset are readout at the same time, one per week, covering the 8 week period. The results from the sets irradiated and stored at different periods allowed for the evaluation of fading and sensitivity changes experienced over the whole monitoring period and respective preparation time and readout delays. Time evolution charts of the reader calibration factors, of the linearity parameters and of the evolution of the integrated area in the region of dosimetric interest with storage at RT were obtained. This paper aims to quantify the long-term stability of the TLD system in use at the IMS.

Equipment Design↗

An in vitro monitoring system for simulated thermal process in cryosurgery.

This paper describes a new in vitro experimental model that records temperature changes over a culture plate, which then can be used to assess the biological effects of cryosurgery. A cryoprobe and 16 thermocouples set up by a computer control system were used to monitor the temperature changes during freezing and thawing in a culture plate, and the data were used to create a temperature profile of the entire plate. Location of the thermocouples was confirmed by a digital camera viewing from under the plate, and temperature changes at any point in the interpolated areas were estimated using a curve fitting method. The estimated temperature was checked by sampling with four additional randomly placed thermocouples. Linear regression analysis showed that the estimated temperature and measured temperature were very close (correlation coefficients 0.98-0.99). MBT-2 tumor cells were cultured and then subjected to simulated cryosurgery. The surviving cells were stained with crystal violet and the cell death boundary was detected by image processing. Temperature history at the cell death boundary was retrieved and analyzed. With this system it is possible to recreate the temperature changes that result in a certain biological effect (such as cell death) during the process of simulated cryosurgery.

Animals↗

The use and cost of HIV service provision in England in 1996. National Prospective Monitoring System (NPMS) Steering Group and NPMS Working Party on Costs.

OBJECTIVE: The aim of the study was to measure the use and estimate the cost of HIV service provision in England. DESIGN AND SETTING: Standardised activity and case-severity data were collected prospectively in 10 English HIV clinics (5 London and 5 non-London sites) for the periods 1 January 1996 to 30 June 1996 and 1 July 1996 to 31 December 1996 and linked to unit cost data. In total, 5440 patients with HIV infection attended during the first 6 months and 5708 during the second 6 months in 1996. MAIN OUTCOME MEASURES AND RESULTS: The mean number of inpatient days per patient-year for patients with AIDS was 19.7 [95% confidence interval (CI): 13.7 to 25.7] for January to June and 20.8 (95% CI: 15.3 to 26.4) for July to December 1996. The mean number of outpatient visits for asymptomatic patients with HIV infection was 14.8 (95% CI: 11.9 to 17.6) and 13.3 (95% CI: 10.8 to 15.7) for the respective periods and 16.1 (95% CI: 13.21 to 18.97) and 15.7 (95% CI: 11.2 to 20.2), respectively, for patients with symptomatic non-AIDS (i.e. symptomatic patients with HIV infection but without AIDS-defining conditions). Substantial centre-to-centre variation was observed, suggesting that many clinics can continue the shift from an inpatient- to an outpatient-based service. Cost estimates per patient-year for HIV service provision for 1996 varied from 4695 Pounds (95% CI: 3769 Pounds to 5648 Pounds) for asymptomatic patients, to 7605 Pounds (95% CI: 6273 Pounds to 8909 Pounds) for symptomatic non-AIDS patients to 20,358 Pounds (95% CI: 17,681 Pounds to 23,206 Pounds) for patients with AIDS. CONCLUSIONS: Different combinations of antiretroviral therapy affect the cost estimates of HIV service provision differently. Anticipated reduction in inpatient-related activity through the increased use of combination antiretroviral therapy will further shift service provision from an inpatient- to outpatient-based service and reduce costs per patient-year. The extent and duration of such effects are currently unknown. The long term effects of combination treatment on the morbidity and mortality patterns of individuals infected with HIV are also currently unknown, as are their implications on the use and cost of HIV service provision. Multicentre databases like the National Prospective Monitoring System (NPMS) will provide healthcare professionals with information to improve existing services and anticipate the impact of new developments.

Acquired Immunodeficiency Syndrome↗

A comparison of amplitude-modulated and frequency-modulated ambulatory monitoring systems.

To compare the results of monitoring for ischemia with amplitude-modulated (AM) and frequency-modulated (FM) ambulatory recorders, 22 patients with coronary artery disease were monitored during exercise and during 24 to 48 hours of daily activities. Simultaneous recordings were obtained with Oxford Medilog 4000-II and Medilog MR-35 systems from the same 2 bipolar leads. Each potential ischemic episode was interpreted blindly by 2 investigators. Significant ST depression was strictly defined as greater than or equal to 1 mm of horizontal or down-sloping ST depression persisting for 0.06 second beyond the J point and lasting greater than or equal to 1 minute. Of 82 episodes reviewed, 63 (77%) were either positive (37) or negative (26) for ischemia by both systems. However, 17 episodes were interpreted as positive on AM tracings but negative on FM tracings; the converse was true for only 2 episodes (p less than 0.01). For episodes read as positive with both systems, there were close correlations between recorders for duration (r = 0.80) and magnitude (r = 0.90) of ST depression. Because of the greater number of positive AM events, however, the mean total duration of ST depression for patients with ischemia during daily activities was greater on AM than on FM recordings (74 +/- 77 vs 39 +/- 42 minutes, p less than 0.10). Discrepancies between AM and FM tracings were invariably due to small differences in ST-segment morphology or in the magnitude of ST-segment depression. In summary, AM monitors generate complexes similar in appearance to those produced by FM devices in most instances.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

A universal precautions monitoring system adaptable to any health care department.

The Occupational Safety and Health Administration has proposed monitoring employee compliance with universal precautions, as recommended by the Centers for Disease Control. Our respiratory care department, following a four-step system development plan, has developed and implemented a universal precautions monitoring system that is easy to adapt to any health care department. The results from monitoring can be used for educational planning, quality assurance purposes, and employee performance reviews.

Cooperative Behavior↗

Chlorinated hydrocarbon insecticides in Colorado beef cattle serum--a pilot environmental monitoring system.

A pilot project was initiated to test an existing animal disease surveillance system for use in monitoring environmental pollutants. Eleven chlorinated hydrocarbon insecticides were assayed to provide an indication of environmental contamination. A total of 241 bovine serum samples from 53 Colorado beef ranches was tested; 123 samples (51%) were found to contain detectable concentrations of 1 or more of 11 chlorinated hydrocarbons. There were a total of 203 occurrences of a compound being found at a level exceeding the detection limit. Heptachlor, heptachlor epoxide, lindane, and oxychlordane were the insecticides detected most frequently in bovine sera. This pilot study supports the use of domestic food-producing animals as sentinels of environmental contamination with insecticides.

Animals↗