Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study.

BACKGROUND: Remote patient monitoring (RPM) for automated peritoneal dialysis (APD) may improve clinical outcomes. Paediatric data, however, remain extremely scarce. METHODS: We conducted a prospective observational study of children (0-18 years) receiving APD with cloud-based RPM over two 24-week periods (pre- and post-RPM). Primary outcomes were unplanned hospitalizations and fluid management. Children receiving APD without RPM (non-RPM) were included as control. RESULTS: Seven patients (6 females) receiving APD were enrolled in the RPM programme at 11.3 years (IQR 2.6-17.1). Main indications for RPM included history of fluid overload (n = 3) and non-adherence (n = 2). Ten children were included in the non-RPM group (6 females; 16.9 years, IQR 12.8-17.6). Four patients (57.1%, 95% CI 22.5-100%) experienced fewer unplanned hospitalizations and 5 patients (71.4%, 95% CI 34.1-100%) had shorter hospital stays during the post-RPM period. The hospitalization rates and length of stay were reduced by 45% and 42%, respectively. The higher hospitalization rates among the RPM group, compared to the non-RPM group, were no longer observed following implementation of RPM. There was a significant increase in ultrafiltration (565.6 ± 248.7 vs. 501.7 ± 286.6 ml/day, p = 0.03) and reduction in systolic blood pressure (114.1 ± 12.6 vs. 119.9 ± 11.19 mmHg, p = 0.02) during the post-RPM period. All patients demonstrated satisfactory adherence. Although quality of life (PedsQL 3.0 ESRD module) was not different pre- and post-RPM, all patients agreed in the questionnaires that the use of RPM improved their quality of life and sense of security. CONCLUSIONS: In conclusion, RPM in children receiving APD is associated with fewer and shorter unplanned hospitalizations, improved fluid management and favourable adherence to PD. A higher resolution version of the Graphical abstract is available as Supplementary information.

[Evaluation of the research features and methodology of acupuncture literatures of headache published in foreign journals in SCI in the recent 5 years].

Retrieving literatures in SCI source journals in the recent 5 years through Web of Science and PubMed databases, articles regarding to the treatment of headache with acupuncture are arranged and analyzed. It turns out that (1) the acupoint selection and treatment is not under the guidence of syndrome differentiation in the clinical research literatures published in foreign journals. (2) The clinical research trials published in foreign journals shows that regarding to curative effect, there is no difference between acupuncture group and sham acupuncture group which indicats that the westerners do not grasp the westerners do not grasp the essene of acupuncture techniques owing to the great difference of medical theory and thinking mode between eastern and western, and the western's shallow cognition of TCM and acupuncture. The sham acupuncture trials published in foreign journals with respect to acupuncture for headache cannot highlight the advantage o acupuncture therapy, what's more, the sham acupuncture trial designation is unfit for acupuncture therapy.