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- Danaei, Goodarz, et al.
(författare)
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Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants
- 2015
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Ingår i: The Lancet Diabetes & Endocrinology. - 2213-8595 .- 2213-8587. ; 3:8, s. 624-637
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Tidskriftsartikel (refereegranskat)abstract
- Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA(1c) (HbA(1c) >= 6 . 5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG >= 7 . 0 mmol/L or 2hOGTT >= 11 . 1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG- or-2hOGTT was correlated with prevalence based on FPG alone (r= 0 . 98), but was higher by 2-6 percentage points at different prevalence levels. Prevalence based on HbA(1c) was lower than prevalence based on FPG in 42 . 8% of age-sex-survey groups and higher in another 41 . 6%; in the other 15 . 6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA(1c)-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA(1c) 6 . 5% or more had a pooled sensitivity of 52 . 8% (95% CI 51 . 3-54 . 3%) and a pooled specificity of 99 . 74% (99 . 71-99 . 78%) compared with FPG 7 . 0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30 . 5% (28 . 7-32 . 3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA(1c) versus FPG. Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA(1c)-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.
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| 2. |
- Zhou, Bin, et al.
(författare)
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Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants
- 2016
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Ingår i: The Lancet. - : Elsevier B.V.. - 0140-6736 .- 1474-547X. ; 387:10027, s. 1513-1530
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Tidskriftsartikel (refereegranskat)abstract
- Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes.Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.Findings: We used data from 751 studies including 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.
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| 3. |
- Sodhro, Ali Hassan, 1986-, et al.
(författare)
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A Joint Transmission Power Control and Duty-Cycle Approach for Smart Healthcare System
- 2019
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Ingår i: IEEE Sensors Journal. - : IEEE. - 1530-437X .- 1558-1748. ; 19:19, s. 8479-8486
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Tidskriftsartikel (refereegranskat)abstract
- Emerging revolution in the healthcare has caught the attention of both the industry and academia due to the rapid proliferation in the wearable devices and innovative techniques. In the mean-time, Body Sensor Networks (BSNs) have become the potential candidate in transforming the entire landscape of the medical world. However, large battery lifetime and less power drain are very vital for these resource-constrained sensor devices while collecting the bio-signals. Hence, minimizing their charge and energy depletions are still very challenging tasks. It is examined through large real-time data sets that due to the dynamic nature of the wireless channel, the traditional predictive transmission power control (PTPC) and a constant transmission power techniques are no more supportive and potential candidates for BSNs. Thus this paper first, proposes a novel joint transmission power control (TPC) and duty-cycle adaptation based framework for pervasive healthcare. Second, adaptive energy-efficient transmission power control (AETPC) algorithm is developed by adapting the temporal variation in the on-body wireless channel amid static (i.e., standing and walking at a constant speed) and dynamic (i.e., running) body postures. Third, a Feedback Control-based duty-cycle algorithm is proposed for adjusting the execution period of tasks (i.e., sensing and transmission). Fourth, system-level battery and energy harvesting models are proposed for body sensor nodes by examining the energy depletion of sensing and transmission tasks. It is validated through Monte Carlo experimental analysis that proposed algorithm saves more energy of 11.5% with reasonable packet loss ratio (PLR) by adjusting both transmission power and duty-cycle unlike the conventional constant TPC and PTPC methods.
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| 4. |
- Sodhro, Ali Hassan, et al.
(författare)
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Artificial Intelligence based QoS optimization for multimedia communication in IoV systems
- 2019
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Ingår i: Future generations computer systems. - : ELSEVIER SCIENCE BV. - 0167-739X .- 1872-7115. ; 95, s. 667-680
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Tidskriftsartikel (refereegranskat)abstract
- Due to the advancements in multimedia communication in internet of vehicles (boy) through emerging technologies i.e., WiFi, Bluetooth, and fifth generation (5G) etc. The critical challenge for boy during multimedia communication in healthcare is the quality of experience (QoE) optimization by managing the mobility of wireless channel between vehicles. Besides, Artificial Intelligence (Al) based approaches have entirely changed the landscape of IoVs, also the portable devices for transmitting multimedia content in IoV system has become very necessary for the end-users in their respective fields. Most of the end users are facing is their annoyed and less satisfactory perspective about the quality they are experiencing i.e., QoE. If the service provisioning is not pleasant then most of the end-users/consumers give-up to continue, and finally market devaluates the overall performance of the devices, company or entire system. So remedy that problem this paper first proposes two novel algorithms named, Power-aware QoE Optimization (PQO) and Buffer-aware QoE Optimization (BQO) and compares their performance with the Baseline. Second proposes multimedia communication mechanism. Third, proposes the QoE optimization framework during multimedia communication in boy system through portable devices. Besides, experimental results reveal that proposed PQO and BQO algorithms optimizes the QoE at (31%, 33.5%) with improved lifetime of portable devices at (25%, 27%) higher level than the Baseline (25%, 17) accordingly by satisfying the end-users. Hence, it is concluded that our proposed algorithms outperforms the Baseline, so can be considered as potential candidates for the boy applications during multimedia communication. (C) 2019 Elsevier B.V. All rights reserved.
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