Compliance with ecological momentary assessment programmes in the elderly: a systematic review and meta-analysis.

OBJECTIVE: Ecological momentary assessment (EMA) refers to the repeated sampling of information about an individual's symptoms and behaviours, enabling the capture of ecologically meaningful real-time information in a timely manner. Compliance with EMA is critical in determining the validity of an assessment. However, there is limited evidence related to how the elderly comply with EMA programmes or the factors that are associated with compliance. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed, Embase, the Cochrane Library and Web of Science were searched up to 17 July 2022. ELIGIBILITY CRITERIA: We included observational studies on EMA in the elderly reported in English. DATA EXTRACTION AND SYNTHESIS: Two investigators independently performed screening and data extraction. Discrepancies were resolved by discussion or a third investigator. A systematic review was carried out to characterise the basic characteristics of the participants and EMA programmes. Random-effects meta-analysis was conducted to assess overall compliance and to explore factors associated with differences in compliance among the elderly. RESULTS: A total of 20 studies with 2047 participants were included in the systematic review and meta-analysis. Meta-analysis showed that the combined compliance rate was 86.41% (95% CI: 77.38% to 92.20%; I2=96.4%; p<0.001). Subgroup analysis revealed high levels of heterogeneity in terms of the methods used to assess population classification, assessment method and assessment frequency, although these may not be the sources of heterogeneity. Meta-regression analysis showed that population classification and assessment period might have a significant impact on heterogeneity (p<0.05). Egger's test indicated significant publication bias (p<0.001). CONCLUSIONS: Compliance with EMA programmes is high in the elderly. It is recommended that scholars design reasonable EMA programmes according to the health status of the elderly in the future.

Assessment of Osteoporosis in Lumbar Spine: In Vivo Quantitative MR Imaging of Collagen Bound Water in Trabecular Bone.

AIM: Bone collagen matrix makes a crucial contribution to the mechanical properties of bone by imparting tensile strength and elasticity. The collagen content of bone is accessible via quantification of collagen bound water (CBW) indirectly. We prospectively study the performance of the CBW proton density (CBWPD) measured by a 3D short repetition time adiabatic inversion recovery prepared ultrashort echo time (STAIR-UTE) magnetic resonance imaging (MRI) sequence in the diagnosis of osteoporosis in human lumbar spine. METHODS: A total of 189 participants with a mean age of 56 (ranged from 50 to 86) years old were underwent MRI, quantitative computed tomography (QCT), and dual-energy X-ray absorptiometry (DXA) in lumbar spine. Major fracture risk was also evaluated for all participants using Fracture Risk Assessment Tool (FRAX). Lumbar CBWPD, bone marrow fat fraction (BMFF), bone mineral density (BMD) and T score values were calculated in three vertebrae (L2-L4) for each subject. Both the CBWPD and BMFF were correlated with BMD, T score, and FRAX score for comparison. The abilities of the CBWPD and BMFF to discriminate between three different cohorts, which included normal subjects, patients with osteopenia, and patients with osteoporosis, were also evaluated and compared using receiver operator characteristic (ROC) analysis. RESULTS: The CBWPD showed strong correlation with standard BMD (R2 = 0.75, P < 0.001) and T score (R2 = 0.59, P < 0.001), as well as a moderate correlation with FRAX score (R2 = 0.48, P < 0.001). High area under the curve (AUC) values (≥ 0.84 using QCT as reference; ≥ 0.76 using DXA as reference) obtained from ROC analysis demonstrated that the CBWPD was capable of well differentiating between the three different subject cohorts. Moreover, the CBWPD had better correlations with BMD, T score, and FRAX score than BMFF, and also performed better in cohort discrimination. CONCLUSION: The STAIR-UTE-measured CBWPD is a promising biomarker in the assessment of bone quality and fracture risk.

[Insulin requirement profiles and related factors of type 2 diabetics with insulin pump therapy].

OBJECTIVE: To explore the insulin requirement profiles and analyze the related factors of type 2 diabetics on insulin pump therapy. METHODS: A total of 296 patients were admitted to hospital for 1-2 weeks of insulin pump therapy and received a diet of 25-30 kcal/kg ideal body weight per day. Insulin infusion was adjusted to achieve normoglycemia. It was defined as fasting capillary blood glucose of no more than 7.0 mmol/L and capillary blood glucose at 2 hours after each of three meals of no more than 10.0 mmol/L. After goal-reaching for 3 days, the insulin requirement profiles and related factors were analyzed. RESULTS: The average time of achieving normoglycemia was (5.1 ± 2.9) days. The total daily insulin dose per kilogram was (0.80 ± 0.27) U/kg and the ratio of total basal insulin dose to total bolus insulin dose 40%: 60%. Patients with central obesity needed a higher ratio of total basal insulin dose to total daily insulin dose (P < 0.05). Associations existed between the ratio of total basal insulin dose to total daily insulin dose and disease duration, waist circumference and ratio of 2 hour-postprandial C-peptide to fasting C-peptide (r = 0.169, 0.143, -0.107, all P < 0.05). Multivariate linear regression analyses showed that waist circumference, disease duration and ratio of 2 hour-postprandial C-peptide to fasting C-peptide were independently related with the ratio of total basal insulin dose to total daily insulin dose. Also waist circumference, fasting plasma glucose and hemoglobin A1c levels were independently associated with total daily insulin dose per kilogram. CONCLUSION: The ratio of total basal insulin dose to total bolus insulin dose is 40%: 60% in Chinese type 2 diabetics with insulin pump therapy. And it is associated with central obesity level and ß-cell function. Parameters indicating glycemic control and central obesity should be taken into consideration for total insulin requirements.