RESUMO
BACKGROUND: In a randomized controlled trial, the efficacy of a digital diabetes diary regarding a reduction of diabetes distress was evaluated. METHODS: A randomized controlled trial with a 12-week follow-up was conducted in 41 study sites across Germany. Key eligibility criteria were a diagnosis of type 1, type 2, or gestational diabetes and regular self-monitoring of blood glucose. Participants were randomly assigned (2:1 ratio) to either use the digital diabetes logbook (mySugr PRO), or to the control group without app use. The primary outcome was the reduction in diabetes distress at the 12-week follow-up. All analyses were based on the intention-to-treat population with all randomized participants. The trial was registered at the German Register for Clinical Studies (DRKS00022923). RESULTS: Between February 11, 2021, and June 24, 2022, 424 participants (50% female, 50% male) were included, with 282 being randomized to the intervention group (66.5%) and 142 to the control group (33.5%). A total of 397 participants completed the trial (drop-out rate: 6.4%). The median reduction in diabetes distress was 2.41 (interquartile range [IQR]: -2.50 to 8.11) in the intervention group and 1.25 (IQR: -5.00 to 7.50) in the control group. The model-based adjusted between-group difference was significant (-2.20, IQR: -4.02 to -0.38, P = .0182) favoring the intervention group. There were 27 adverse events, 17 (6.0%) in the intervention group, and 10 (7.0%) in the control group. CONCLUSIONS: The efficacy of the digital diabetes logbook was demonstrated regarding improvements in mental health in people with type 1, type 2, and gestational diabetes.
RESUMO
BACKGROUND: Diffusion tensor imaging provides information about the location of white matter tracts within the human brain. For neurosurgery, this imaging technique is of major interest in order to minimize the risk of postoperative neurological deficits. In preoperative planning, fiber tracking algorithms based on streamline propagation are used in order to reconstruct major fiber tracts. The resulting streamline bundles approximate the course of the underlying white matter structures and indicate their shape and location in 3 dimensions as well as the spatial relation with respect to surrounding anatomy. However, for intraoperative application in combination with the neuronavigation system, these streamline representations are not adequate. Hulls encompassing the streamline bundles are necessary, since the boundary curves of hulls can be superimposed on the operating room (OR) microscope view for guidance in neurosurgery. METHODS: In this work, we present a novel hull approach which is based on rasterization and isosurface extraction, combined with surface filtering techniques. The advantages of this approach are its robustness and the possibility to control the tightness of wrapping. RESULTS: The approach makes it possible to generate precise hulls for different tract systems, which can be used as a basis for intraoperative visualization in the OR microscope. Distance measurements further confirm the accuracy of the hulls.