169,996 research outputs found
Artificial Pancreas: In Silico Study Shows No Need of Meal Announcement and Improved Time in Range of Glucose with Intraperitoneal vs. Subcutaneous Insulin Delivery
No full textContemporary Artificial Pancreas (AP) consists of a subcutaneous (SC) glucose sensor, a SC insulin pump and a control algorithm. Even the most advanced systems are far from optimal, in particular due to the non-physiologic nature of SC route. While SC insulin delivery is convenient and minimally
invasive, it introduces delays to insulin action that make tight control difficult, particularly during meals. In addition frequent
patient interventions are needed, e.g., at mealtime. The intraperitoneal (IP) insulin delivery could address this major challenge since it exhibits a faster pharmacokinetics/pharmacodynamics, hence making easier to quickly respond to glycemic disturbances. A 1-day hospital closed-loop study has shown significant improvements of IP glucose control vs SC AP, and that meal announcement is not necessary. However, the IP AP has not been tested in more realistic everyday life conditions. In this work we have performed an in silico study of 14 days of an IP AP by using the UVA/Padova simulator which includes intra- and inter-day variability of insulin sensitivity and several real life scenarios. We show superiority of IP AP vs SC AP in terms of quality of glucose control (time in range 87% IP vs 80% SC) without the need of a meal announcement
Personalized LSTM-based alarm systems for hypoglycemia and hyperglycemia prevention
No full textHypoglycemia and hyperglycemia prevention is the main challenge of an efficient Type 1 Diabetes (T1D) control. Alarm systems that alert the patients when their Blood Glucose (BG) levels are going to be critical can be useful instruments in order to react and avoid upcoming hypoglycemia and hyperglycemia events. These alarm systems can be used with both the conventional basal-bolus therapy or in conjunction with the advanced closed-loop control system, the so-called artificial pancreas. Model-based alarms use patient models to predict future BG levels and then activate alarms, so these models have to be reliable and to ensure good performances. In recent studies, neural network techniques for glucose forecasting obtained promising results, for both population and personalized models. These recent works showed that personalized Long Short-Term Memory (LSTM) models for BG predictions obtained good results on the 100 in silico patients of the most recent version of the UVA/Padova simulator. In this work personalized alarm systems for hypoglycemia and hyperglycemia prediction based on personalized LSTM models are proposed. Promising results have been obtained, detecting correctly the 77% of the hypoglycemia and the 89% of the hyperglycemia events
INCORPORATION OF INTRAPERITONEAL INSULIN DELIVERY IN THE UVA/PADOVA TYPE 1 DIABETES SIMULATOR: MODEL PREDICTIVE CONTROL IN SILICO TRIALS VS THE SUBCUTANEOUS ROUTE
No full textIn Silico Trials of an Open-Source Android-Based Artificial Pancreas: A New Paradigm to Test Safety and Efficacy of Do-It-Yourself Systems
No full textObjective: Safety data on Do-It-Yourself Artificial Pancreas Systems are missing. The most widespread in Europe is the AndroidAPS implementation of the OpenAPS algorithm. We used the UVA/Padova Type 1 Diabetes Simulator to in silico test safety and efficacy of this algorithm in different scenarios. Methods: We tested five configurations of the AndroidAPS algorithm differing in aggressiveness and patient's interaction with the system. All configurations were tested with insulin sensitivity variation of ±30%. The most promising configurations were tested in real-life scenarios: over- and underestimated bolus by 50%, bolus delivered 15 min before meal, and late bolus delivered 15 min after meal. Continuous Glucose Monitoring (CGM) time in ranges (TIRs) metrics were used to assess the glycemic control. Results: In silico testing showed that open-source closed-loop system AndroidAPS works effectively and safely. The best results were reached if AndroidAPS algorithm worked with microboluses and when half of calculated bolus was issued (mean glycemia 131 mg/dL, SD 27 mg/dL, TIR 91%, time between 54 and 70 mg/dL <1%, and low blood glucose index even <1). The meal bolus over- and underestimation as well as late bolus did not affect the TIR and, importantly, the time between 54 and 70 mg/dL. Conclusion: In silico testing proved that AndroidAPS implementation of the OpenAPS algorithm is safe and effective, and it showed a great potential to be tested in prospective home setting study
Deployment of modular MPC for type 1 diabetes control: The Italian experience 2008-2016
No full textIn the last decade, Artificial Pancreas (AP) prototypes, using subcutaneous glucose sensing and subcutaneous insulin delivery, have proved their effectiveness in increasingly complex and realistic clinical trails. At first, they have been extensively tested in experiments involving hospitalized patients (in-patient testing). To ensure the highest level of safety and to limit possible confounding factors, in-patient protocols strictly limited patients’ behavior. Then AP prototypes were tested outside the hospital environment and free of strict protocol prescriptions (out-patient testing) although still under close supervision of the study team. Finally, in the last four years a number of groups showed safety and efficacy of their AP system in real-life conditions. In this chapter, we offer a review of some technological and algorithmic challenges posed by the in-to out-patient transition and report our experience in making this transition possible
Metodo per la biofertilizzazione e bioprotezione di plantule, in particolare per applicazioni di propagazione in vitro, colture protette, semenzai, e formulato batterico per attuare tale metodo
No full textIl brevetto prevede i campi di applicazione e la formulazione batterica a base di Azospirillum brasilense SP 245 da impiegare nelle diverse attività vivaistiche. L'applicazione del metodo permette di incrementare la capacità di accrescimento delle plantule, aumentando la vigoria, lo sviluppo e la resistenza ad attacchi parassitari, notoriamente molto dannosi su tessuti erbacei come quelli che caratterizzano le piantine nelle prime fasi di accrescimento
Psychosis in Patients in COVID-19-Related Quarantine: A Case Series
No full textWhile the long-term mental health effects of previous pandemics and related quarantines have been reported in the literature, research is scarce with regard to the first stages of this type of emergency situation. Sudden social isolation, societal restrictions, and virus-related fears may serve as precipitating factors in vulnerable individuals for many types of psychiatric conditions. The literature reports that individuals who are mentally vulnerable to environmental stressors can be deeply affected by quarantines,2 but no data are yet available regarding the collateral effects of the coronavirus disease 2019 (COVID-19) infection on the onset of acute psychosis.
We describe 3 clinical cases of patients admitted to the psychiatric ward of the Padua University Hospital, Padua, Italy, following the enactment of quarantine measures in the Veneto region of northeastern Italy. All 3 admissions occurred in a period of less than a week (March 20-25, 2020), starting 10 days after initiation of strict societal restrictions in the country
Agronomic management strategies to increase soil organic carbon in the short-term: evidence from on-farm experimentation in the Veneto region
No full textBackground and aims: Organic fertilizers and cover crops (CC) are considered crucial strategies to pursue the objective of increasing soil organic carbon (SOC). The present research focuses on an ‘on farm experimentation’ to assess the combined effects of organic fertilization with different biomasses, CC and irrigation on SOC stock. Methods: A 4-year on-farm experimentation was co-developed with local farmers and a land reclamation authority in north-eastern Italy on a biennial maize-soybean rotation. We examined the effects of two organic fertilizers (compost or digestate), three CC treatments (a fixed cover crop species – x triticosecale; a succession of cover crop species – Sinapis alba and Lolium multiflorum; no CC) under rainfed and irrigated conditions on the SOC content and stock, and crops yields. Results: All these integrated practices – except when digestate was applied in the field in the absence of a CC under rainfed conditions – determined a significant increase of the SOC stock after 4 years, matching the goals set by the ‘4 per mille’ initiative. The highest SOC increase was observed under irrigated management and compost fertilization, regardless of the presence or absence of a CC (range: 9.3–10.3 Mg ha−1 in the first 0–40 cm of soil). Soybean grain yields were comparable with those obtained in farms of the same rural district under business as usual, but maize grain yields were lower. Conclusion: SOC accumulation is achievable in the short term with abundant applications of organic biomass, but the strategy might lead to economic loss such as lower maize productivity
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