43 research outputs found
Insulin requirements and carbohydrate to insulin ratio in normal weight, overweight, and obese women with type 1 diabetes under pump treatment during pregnancy: a lesson from old technologies
No full textAim:The primary aim of this study was to assess insulin requirements and carbohydrateto insulin ratio (CHO/IR) in normal weight, overweight, and obese pregnant women withtype 1 diabetes across early, middle, and late pregnancy.Methods:In this multicenter, retrospective, observational study we evaluated 86 of 101pregnant Caucasian women with type 1 diabetes under pump treatment. The womenwere trained to calculate CHO/IR daily by dividing CHO grams of every single meal byinsulin units injected. Since the purpose of the study was to identify the CHO/IR able toreach the glycemic target, we only selected the CHO/IR obtained when glycemic valueswere at target. Statistics: SPSS 20.Results:We studied 45 normal weight, 31 overweight, and 10 obese women. Insulinrequirements increased throughout pregnancy (p < 0.0001 and <0.001 respectively) inthe normal and overweight women, while it remained unchanged in the obese women.Insulin requirements were different between groups when expressed as an absolute value,but not when adjusted for body weight. Breakfast CHO/IR decreased progressivelythroughout pregnancy in the normal weight women, from 13.3 (9.8–6.7) at thefirst stageof pregnancy to 6.2 (3.8–8.6) (p = 0.01) at the end stage, and in the overweight womenFrontiers in Endocrinology | www.frontiersin.orgFebruary 2021 | Volume 12 | Article 6108771Edited by:Elena Succurro,University of Magna Graecia, ItalyReviewed by:Cristina Bianchi,Azienda Ospedaliero-UniversitariaPisana, ItalyMaria Grazia Dalfra’,University of Padua, Italy*Correspondence:Camilla [email protected] section:This article was submitted toObesity,a section of the journalFrontiers in EndocrinologyReceived:27 September 2020Accepted:14 January 2021Published:25 February 2021Citation:Festa C,Fresa R,Visalli N,Bitterman O,Giuliani C,Suraci C,Bongiovanni M andNapoli A (2021)Insulin Requirements andCarbohydrate to Insulin Ratio inNormal Weight, Overweight, andObese Women With Type 1Diabetes Under Pump TreatmentDuring Pregnancy: A LessonFrom Old Technologies.Front. Endocrinol. 12:610877.doi: 10.3389/fendo.2021.610877ORIGINAL RESEARCHpublished: 25 February 2021doi: 10.3389/fendo.2021.610877
from 8.5 (7.1–12.6) to 5.2 (4.0–8.1) (p = 0.001), while in the obese women it remainedstable, moving from 6.0 (5.0–7.9) to 5.1 (4.1–7.4) (p = 0.7). Likewise, lunch and dinnerCHO/IR decreased in the normal weight and overweight women (p < 0.03) and not in theobese women. The obese women gained less weight than the others, especially in earlypregnancy when they even lost a median of 1.25 (−1−1.1) kg (p = 0.005). In earlypregnancy, we found a correlation between pregestational BMI and insulin requirements(IU/day) or CHO/IR at each meal (p < 0.001 and p = 0.001, respectively). In latepregnancy, a relationship between pre-gestational BMI and CHO/IR change was found(P = 0.004), as well as between weight gain and CHO/IR change (p=0.02). Thesignificance was lost when both variables were included in the multiple regressionanalysis. There was no difference in pregnancy outcomes except for a higher pre-termdelivery rate in the obese women.Conclusion:Pre-gestational BMI and weight gain may play a role in determining CHO/IRduring pregnancy in women with type 1 diabetes under pump treatment
Efficacy of flash glucose monitoring in pregnant women with poorly controlled pregestational diabetes (flashmom): a randomized pilot study
No full textBackground and Aims
Good glycemic control is crucial to reduce the risk of adverse pregnancy outcomes. Our aim was to evaluate the efficacy of Flash Glucose Monitoring (FGM) on glucose control in women with pregestational diabetes.
Methods and Results
Forty women with inadequately controlled type 1 (T1D, n=34) and type 2 (T2D, n=6) diabetes at conception were randomly assigned to two arms: the Flash Glucose group (FG, n=21) using FGM, and the control group (CG, n=19) using self-monitoring of blood glucose (SMBG). Glycated hemoglobin (HbA1c, %), time in (TIR), below (TBR) and above (TAR) range, glucose variability as well as the occurrence of maternal and neonatal adverse outcomes, were evaluated.
HbA1c decreased significantly (p<0.01) and similarly (-0.65±0.7 vs. -0.67±0.8 for FG and CG, respectively; p=0.89) in both groups during pregnancy. HbA1c reduction was positively associated with the number of daily FGM scans (p<0.01). TBR (12.1±2.0% vs. 19.6±3.9%, p=0.04) and the mean of the daily serum glucose difference (MODD) index (59.1±5.4 vs. 77.7±4.6, p=0.02) were significantly lower in FG at second trimester. The rates of perinatal adverse outcomes were not different in the two studied groups.
Conclusions
In women with pregestational diabetes, FGM and SMBG had similar efficacy on glucose control during pregnancy. FGM showed additional advantages in terms of TBR and glucose variability. Achievement of good metabolic results depended on the adequate use of glucose sensor
A Digital Workflow for Built Heritage: From SCAN-to-BIM Process to the VR-Tour of the Basilica of Sant’Ambrogio in Milan: 7th International Conference, EuroMed 2018, Nicosia, Cyprus, October 29–November 3, 2018, Proceedings, Part I
No full textThe latest information technology developments have enabled the creation of novel virtual experiences favouring an increasingly higher level of information connected to the 3D reconstruction. Building Information Modelling (BIM), 3D cloud services and virtual/augmented reality (AR-VR) projects are the most applied methods to transmit the wealth of built heritage from both the geometrical and informative points of view. In this paper, we present a holistic workflow to integrate the most applied digital techniques with the aim of creating the highest quality-immersive solutions starting from an accurate 3D survey. Thanks to a new SCAN-to-BIM method that transfer the morphological and typological characteristics of the surveyed building to a shared cloud system, it will be possible to support specialists in the documentation and preservation of historical uniqueness of the basilica of Sant’Ambrogio in Milan (Italy) with a new level of information sharing. Finally, a new digital experience based on next-generation technologies has been offered to the cultural tourism. Thanks to the development of a virtual tour that embeds different multimedia data (360° photos, photos, virtual notebook, description, video, audio etc), it has been possible to create a digital history for one of the greatest examples of the historic Italian architecture
Autoimmune hemolytic anemia in chronic lymphocytic leukemia: A comprehensive review
No full textChronic lymphocytic leukemia (CLL) patients have a greater predisposition to develop autoimmune complications. The most common of them is autoimmune hemolytic anemia (AIHA) with a frequency of 7–10% of cases. Pathogenesis is multifactorial involving humoral, cellular, and innate immunity. CLL B-cells have damaged apoptosis, produce less immunoglobulins, and could be responsible for antigen presentation and releasing inflammatory cytokines. CLL B-cells can act similar to antigen-presenting cells activating self-reactive T helper cells and may induce T-cell subsets imbalance, favoring autoreactive B-cells which produce anti-red blood cells autoantibodies. Treatment is individualized and it depends on the presence and severity of clinical symptoms, disease status, and comorbidities. Corticosteroids are the standardized first-line treatment; second-line treatment comprises rituximab. Patients not responding to corticosteroids and rituximab should be treated with CLL-specific drugs as per current guidelines according to age and comorbidities. New targeted drugs (BTK inhibitors and anti BCL2) are recently used after or together with steroids to manage AIHA. In the case of cold agglutinin disease, rituximab is preferred, because steroids are ineffective. Management must combine supportive therapies, including vitamins; antibiotics and heparin prophylaxis are indicated in order to minimize infectious and thrombotic risk
Use of insulin detemir in pregnancy: a report on 10 type 1 diabetic women
No full textSomalia has suffered a massive internal population displacement and exodus that began in 1988 and is still ongoing during the prolonged and intermittent civil war. This review looks at the burden of HIV infection in Somali and the impact of civil war on its epidemiology. Serosurveys have indicated that HIV was not present in Somalia before the civil war and to date Somalia has had an HIV prevalence markedly below that of its neighbours. However, due to the ongoing war HIV sentinel surveillance cannot reach most of the affected areas in Somalia and the current HIV infection problem may be greater than the figures indicate
Experiences of continuous subcutaneous insulin infusion in pregnant women with type 1 diabetes during delivery from four Italian centers: A retrospective observational study
No full textObjectives: An optimized metabolic control during delivery is mandatory to prevent maternal-neonatal complications. The primary aim of this study was to evaluate the efficacy and safety of continuous subcutaneous insulin infusion (CSII) during delivery in pregnant women with type 1 diabetes. The secondary aim was to assess the impact of real-time continuous glucose monitoring (RT-CGM) added to CSII versus CSII alone. Research Design and Methods: This was a multicenter observational retrospective study. A standardized protocol, to use CSII throughout pregnancy and delivery, foresaw three different insulin basal rates according to blood glucose level: profile A, the last basal rate in use; profile B, preventive 50% reduction of the last basal rate in use; and profile C, 0.1-0.2 U/h for blood glucose level <70 mg/dL, activated just before anesthesia or at the beginning of active labor. An alternative intravenous protocol (IVP) was given in case of complications and relevant metabolic deterioration. Blood glucose in the target range (70-140 mg/dL) throughout delivery and percentage of activation of the IVP were primary outcomes. Results: Sixty-five pregnant women with diabetes included in the study (56-86% cesarean section; 9-14% spontaneous/stimulated vaginal delivery). Mean blood glucose level was 102±31 mg/dL at 0 min, 109±42 mg/dL at 30 min, 120±48 mg/dL at 60 min, and 99±34 mg/dL at 24 h. Mean basal rate during delivery was 0.6±0.4 U/h (profile B). Mean capillary blood glucose (CBG) level was lower in the RT-CGM group relative to the CSII-alone group: 80±14 mg/dL versus 111±32 mg/dL at 0 min (P<0.01), 79±11 mg/dL versus 109±42 mg/dL at 30 min (P<0.02), and 98±20 mg/dL versus 125±51 mg/dL at 60 min (difference not significant). Eleven newborns experienced transient neonatal hypoglycemia. None of the women switched to IVP. No major differences were observed according to delivery procedure. Conclusions: CSII is possible and safe in different types of delivery in selected and educated women. RT-CGM helps to obtain better outcomes in terms of maternal peripartum CBG level. © Mary Ann Liebert, Inc
Detective fiction in Cuban society and culture.
No full textPhDThe object of this thesis is to reach towards an understanding of Cuban society through a
study of its detective fiction and more particularly contemporary Cuban society through
the novels of the author and critic, Leonardo Padura Fuentes.
The method has been to trace the development of Cuban detective writing and to
read Padura Fuentes in the light of the work of twentieth century Western European
literary critics and philosophers including Raymond Williams, Antonio Gramsci, Terry
Eagleton, Roland Barthes, Jean Paul Sartre, Michel Foucault, Jean François Lyotard and
Jean Baudrillard in order to gain a better understanding of the social and historical
context from which this genre emerged.
By concentrating on the literary texts, I have explored readings which lead out into
an analysis of the broader philosophical, political and historical issues raised by the
Cuban revolution. Since it deals primarily with modes of deviance and notions of legality
and justice within the context of the modern state, detective fiction is particularly well
suited to this type of investigation. The intention is to show how this is as valid in the
Cuban context as it is in advanced capitalist societies where such research has already
been carried out with some success.
The thesis comprises an introduction, ten chapters and a conclusion. The chapters
are divided into three sections. Chapters 1 to 3 attempt a broad theoretical, historical and
socio-political analysis of the cultural reality within which the Cuban revolutionary
detective genre emerged. Chapters 4 to 6 analyse the Cuban detective narrative from its
inception in the early part of the twentieth century until the emergence of Leonardo
Padura Fuentes as the foremost exponent of the genre in Cuba after 1991. Chapters 7-
10 concentrate upon the work of Leonardo Padura Fuentes, offering a reading of his
detective tetralogy informed by the preceding discussion.
The contribution made by the thesis to knowledge of the subject is to build upon the
work of Seymour Menton and Amelia S. Simpson on the development of the Cuban
detective novel and to provide analyses of the pre-Revolutionary Cuban detective
narrative and the work of Leonardo Padura Fuentes for the first time in the English
language. The thesis concludes that the study of this popular genre in Cuba is of crucial
importance to the scholar who wishes to reach as full an understanding of the social
dynamics within that society as possible. In particular, it proves that Cuban detective
fiction provides a useful barometer of social change which records the shifts in the Cuban
Zeitgeist that have taken place over the past century
Quality principles for cultural Web sites: a Handbook
No full textprinted and on-line versions, co-author with Eelco Bruinsma, Christophe Dessaux, Ciaran Clissman, Jean-Pierre Dalbéra, David Dawson, Isabelle Dujacquier, Axel Ermert, Pierluigi Feliciati, Fedora Filippi, Muriel Foulonneau,
Antonella Fresa, Monika Hagedorn-Saupe, Annette Kelly, Brian Kelly, Daniel Malbert, Andrea Mulrenin, Stefan Rhode-Enslin, Marius Snyders, Gert Van Tittelboom, Frank von Hage
The Museum as Information Space: Metadata and Documentation
No full textAlthough museums vary in nature and may have been founded for all sorts of reasons, central to all museum institutions are the collected objects. These objects are information carriers organized in a catalogue system. In this chapter, the museum will be conceived as an information space, consisting of an information system related to different methods of reasoning. We will highlight the new possibilities offered by digital technology and the changes brought by the way in which visitors come into contact with objects. Our central claim is that the visitor moved from being onsite within the museum’s information space to being outside the museum in the online information space of the Internet. This has fundamental implications for the institutional role of museums, our understanding of metadata and the methods of documentation. The onsite museum institution will, eventually, not be able to function as an institutional entity on the Internet, for in this new information space, objects, collections and museums, all function as independent components in a vast universe of data, side by side at everyone’s disposal at anytime. Potentially, users can access cultural heritage anytime, anywhere and anyhow. © The Author(s) 2016
Interdisciplinary Collaborations in the Creation of Digital Dance and Performance: A Critical Examination
No full textThis chapter explores the convergence between performance-based cultural heritage and new technologies, with a focus on interdisciplinary collaborations in creation and making processes. These interdisciplinary work spaces present a tremendous potential for innovative art making, as they bring together deep knowledge of the arts and artistic sensibility with a sound understanding of technology languages and possibilities. At the same time, being situated at the confluence of different fields of practice and research dwelling on diverse epistemologies and approaches, interdisciplinary collaborations do more than configuring new ways of making art: they contribute to synergies between arts and technology fields, marking places of cross-fertilisation, blurring boundaries and influencing their evolution. Through a close analysis of interdisciplinary undertakings in making digital performance, we show how creative work in mixed teams of performance artists, researchers and practitioners on the one hand, and researchers from technology and design-focused disciplines on the other, is instrumental to the development of interdisciplinary artscapes and interdisciplinary knowledgescapes: spaces that offer a fertile ground for creative initiatives and knowledge advancement drawing on integrated perspectives, theories, methodologies and approaches from arts and technology fields. Together, interdisciplinary artscapes and interdisciplinary knowledgescapes contribute to opening up and pushing the boundaries of thinking and art making, reconsidering taken for granted assumptions and coming up with radically new artforms. Publisher statement: This book is distributed under the terms of the Creative Commons Attribution-Non-commercial 2.5 License (https://creativecommons.org/licenses/by-nc/2.5/) which permits any non-commercial use, distribution and reproduction in any medium, provided the original author(s) and source are credite
