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https://www.readbyqxmd.com/read/28092515/towards-a-run-to-run-adaptive-artificial-pancreas-in-silico-results
#1
Chiara Toffanin, Roberto Visentin, Mirko Messori, Federico Di Palma, Lalo Magni, Claudio Cobelli
: Contemporary and future outpatient long-term artificial pancreas (AP) studies need to cope with the well-known large intra- and inter-day glucose variability occurring in type 1 diabetic (T1D) subjects. Here we propose an adaptive Model Predictive Control (MPC) strategy to account for it and test it in silico. METHODS: A Run-to-Run (R2R) approach adapts the subcutaneous basal insulin delivery during the night and the carbohydrate-to-insulin ratio (CR) during the day, based on some performance indices calculated from subcutaneous continuous glucose sensor data...
January 11, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28071894/noninvasive-monitoring-of-blood-glucose-with-raman-spectroscopy
#2
Rishikesh Pandey, Santosh Kumar Paidi, Tulio A Valdez, Chi Zhang, Nicolas Spegazzini, Ramachandra Rao Dasari, Ishan Barman
The successful development of a noninvasive blood glucose sensor that can operate reliably over sustained periods of time has been a much sought after but elusive goal in diabetes management. Since diabetes has no well-established cure, control of elevated glucose levels is critical for avoiding severe secondary health complications in multiple organs including the retina, kidney and vasculature. While fingerstick testing continues to be the mainstay of blood glucose detection, advances in electrochemical sensing-based minimally invasive approaches have opened the door for alternate methods that would considerably improve the quality of life for people with diabetes...
January 10, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28071672/metformin-and-the-risk-of-prostate-cancer-across-racial-ethnic-groups-a-population-based-cohort-study
#3
C B Chen, D T Eurich, S R Majumdar, J A Johnson
BACKGROUND: Men with diabetes may have a lower risk of prostate cancer than men without diabetes which may be altered by metformin use or race/ethnicity. METHODS: Using administrative databases, from 1994 to 2012, adult (age⩾50 years) men with diabetes were identified. Metformin exposure was defined as a time-dependent variable, stratified first into any use, and into tertiles of cumulative dose. Surname algorithms identified individuals as Chinese or non-Chinese...
January 10, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28069712/an-evidence-based-medicine-approach-to-antihyperglycemic-therapy-in-diabetes-mellitus-to-overcome-overtreatment
#4
Anil N Makam, Oanh K Nguyen
Overtreatment is pervasive in medicine and leads to potential patient harms and excessive costs in health care. Although evidence-based medicine is often derided as practice by rote algorithmic medicine, the appropriate application of key evidence-based medicine principles in clinical decision making is fundamental to preventing overtreatment and promoting high-value, individualized patient-centered care. Specifically, this article discusses the importance of (1) using absolute rather than relative estimates of benefits to inform treatment decisions; (2) considering the time horizon to benefit of treatments; (3) balancing potential harms and benefits; and (4) using shared decision making by physicians to incorporate the patient's values and preferences into treatment decisions...
January 10, 2017: Circulation
https://www.readbyqxmd.com/read/28068461/a-new-prediction-model-for-evaluating-treatment-resistant-depression
#5
Alexander Kautzky, Pia Baldinger-Melich, Georg S Kranz, Thomas Vanicek, Daniel Souery, Stuart Montgomery, Julien Mendlewicz, Joseph Zohar, Alessandro Serretti, Rupert Lanzenberger, Siegfried Kasper
OBJECTIVE: Despite a broad arsenal of antidepressants, about a third of patients suffering from major depressive disorder (MDD) do not respond sufficiently to adequate treatment. Using the data pool of the Group for the Study of Resistant Depression and machine learning, we intended to draw new insights featuring 48 clinical, sociodemographic, and psychosocial predictors for treatment outcome. METHOD: Patients were enrolled starting from January 2000 and diagnosed according to DSM-IV...
January 3, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28063802/resolving-the-kga1c-paradox-in-the-management-of-type-2-diabetes-mellitus
#6
REVIEW
Jaime Davidson, Sanjay Kalra, Vikram Singh, Mayuresh Fegade, Gursimran Singh, Amey Mane
Excess body weight is a leading cause of metabolic complications such as hypertension and dyslipidemia in T2DM patients. Available antihyperglycemic agents have minimal or no impact on these complications and a majority are known to trigger weight gain, thereby exerting a paradoxical effect on overall metabolic status. This review introduces the concept of 'KgA1c paradox' and underscores the significance of resolving this paradox for comprehensive T2DM management. It provides a therapeutic rationale for inclusion of sodium glucose cotransporter 2 inhibitors in the T2DM treatment algorithm as these agents have demonstrated favorable glycemic effects along with reduction in body weight...
December 13, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28063597/living-near-major-roads-and-the-incidence-of-dementia-parkinson-s-disease-and-multiple-sclerosis-a-population-based-cohort-study
#7
Hong Chen, Jeffrey C Kwong, Ray Copes, Karen Tu, Paul J Villeneuve, Aaron van Donkelaar, Perry Hystad, Randall V Martin, Brian J Murray, Barry Jessiman, Andrew S Wilton, Alexander Kopp, Richard T Burnett
BACKGROUND: Emerging evidence suggests that living near major roads might adversely affect cognition. However, little is known about its relationship with the incidence of dementia, Parkinson's disease, and multiple sclerosis. We aimed to investigate the association between residential proximity to major roadways and the incidence of these three neurological diseases in Ontario, Canada. METHODS: In this population-based cohort study, we assembled two population-based cohorts including all adults aged 20-50 years (about 4·4 million; multiple sclerosis cohort) and all adults aged 55-85 years (about 2·2 million; dementia or Parkinson's disease cohort) who resided in Ontario, Canada on April 1, 2001...
January 4, 2017: Lancet
https://www.readbyqxmd.com/read/28062631/rule-in-and-rule-out-of-myocardial-infarction-using-cardiac-troponin-and-glycemic-biomarkers-in-patients-with-symptoms-suggestive-of-acute-coronary-syndrome
#8
Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Richard Whitlock, Guillaume Pare, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter A Kavsak
BACKGROUND: Early rule-in/rule-out of myocardial infarction (MI) in patients presenting to the emergency department (ED) is important for patient care and resource allocation. Given that dysglycemia is a strong risk factor for MI, we sought to explore and compare different combinations of cardiac troponin (cTn) cutoffs with glycemic markers for the early rule-in/rule-out of MI. METHODS: We included ED patients (n = 1137) with symptoms suggestive of acute coronary syndrome (ACS) who had cTnI, high-sensitivity cTnI (hs-cTnI), hs-cTnT, glucose, and hemoglobin A1c (Hb A1c) measurements...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28061760/development-of-an-australian-cardiovascular-disease-mortality-risk-score-using-multiple-imputation-and-recalibration-from-national-statistics
#9
Kathryn Backholer, Yoichiro Hirakawa, Andrew Tonkin, Graham Giles, Dianna J Magliano, Stephen Colagiuri, Mark Harris, Paul Mitchell, Mark Nelson, Jonathan E Shaw, David Simmons, Leon Simons, Anne Taylor, Jessica Harding, Bamini Gopinath, Mark Woodward
OBJECTIVE: To develop and recalibrate an Australian 5-year cardiovascular disease (CVD) mortality risk score to produce contemporary predictions of risk. METHODS: Data were pooled from six Australian cohort studies (n = 54,829), with baseline data collected between 1989 and 2003. Participants included were aged 40-74 years and free of CVD at baseline. Variables were harmonised across studies and missing data were imputed using multiple imputation. Cox proportional hazards models were used to estimate the risk of CVD mortality associated with factors mutually independently predictive (p < 0...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28060528/-learning-can-improve-the-blood-glucose-control-performance-for-type-1-diabetes-mellitus
#10
Youqing Wang, Jinping Zhang, Fanmao Zeng, Na Wang, Xiaoping Chen, Bo Zhang, Dong Zhao, Wenying Yang, Claudio Cobelli
BACKGROUND: A learning-type artificial pancreas has been proposed to exploit the repetitive nature in the blood glucose dynamics. We clinically evaluated the efficacy of the learning-type artificial pancreas. METHODS: We conducted a pilot clinical study in 10 participants of mean age 36.1 years (standard deviation [SD] 12.7; range 16-58) with type 1 diabetes. Each trial was conducted for eight consecutive mornings. The first two mornings were open-loop to obtain the individualized parameters...
January 6, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28059209/enhanced-visualization-of-peripheral-retinal-vasculature-with-wavefront-sensorless-adaptive-optics-optical-coherence-tomography-angiography-in-diabetic-patients
#11
James Polans, David Cunefare, Eli Cole, Brenton Keller, Priyatham S Mettu, Scott W Cousins, Michael J Allingham, Joseph A Izatt, Sina Farsiu
Optical coherence tomography angiography (OCTA) is a promising technique for non-invasive visualization of vessel networks in the human eye. We debut a system capable of acquiring wide field-of-view (>70°) OCT angiograms without mosaicking. Additionally, we report on enhancing the visualization of peripheral microvasculature using wavefront sensorless adaptive optics (WSAO). We employed a fast WSAO algorithm that enabled wavefront correction in <2  s by iterating the mirror shape at the speed of OCT B-scans rather than volumes...
January 1, 2017: Optics Letters
https://www.readbyqxmd.com/read/28058805/biomarker-signatures-of-aging
#12
Paola Sebastiani, Bharat Thyagarajan, Fangui Sun, Nicole Schupf, Anne B Newman, Monty Montano, Thomas T Perls
Because people age differently, age is not a sufficient marker of susceptibility to disabilities, morbidities, and mortality. We measured nineteen blood biomarkers that include constituents of standard hematological measures, lipid biomarkers, and markers of inflammation and frailty in 4704 participants of the Long Life Family Study (LLFS), age range 30-110 years, and used an agglomerative algorithm to group LLFS participants into clusters thus yielding 26 different biomarker signatures. To test whether these signatures were associated with differences in biological aging, we correlated them with longitudinal changes in physiological functions and incident risk of cancer, cardiovascular disease, type 2 diabetes, and mortality using longitudinal data collected in the LLFS...
January 6, 2017: Aging Cell
https://www.readbyqxmd.com/read/28048761/mo-fg-campus-iep3-05-a-novel-model-for-evaluating-exercise-induced-skeletal-muscle-metabolism-with-phosphorus-mrs
#13
E Ripley, G Clarke, F Settles
PURPOSE: The phosphocreatine (PCr) recovery rate after exercise is used an index of mitochondrial function in muscle 31P-MRS. We tested the hypothesis that the initial rate of PCr recovery after exercise reflects the equilibrium mitochondrial ATP production rate required to balance ATP requirements during exercise. METHODS: Exercise data is often analyzed by fitting the PCr recovery curve to the Levenberg-Marquardt algorithm to determine the rate constant, k. In this study, the initial rates of change for PCr and inorganic phosphate (Pi) were examined at the beginning and after the end of exercise in the vastus lateralis...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048716/su-f-j-04-automated-detection-of-diabetic-retinopathy-using-deep-convolutional-neural-networks
#14
Kele Xu, Li Zhu, Ruixing Wang, Chang Liu, Yi Zhao
PURPOSE: In this work, we explore to use very deep convolutional neural network (CNN) for the automatic classification of diabetic retinopathy using color fundus image. METHODS: We apply translation, stretching, rotation and flipping to the labeled dataset. The original number of labeled-frames is 3000, while after augmentations, 6000 frames with labels are used for the CNN training task. Several different CNN architectures have been proposed and tested. The architecture of our network contains 18 layers with parameters, consists of 12 convolutional layers, some of which followed by max-pooling layers, and two fully connected layers...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045725/utilization-of-stand-by-extracorporeal-membrane-oxygenation-in-a-high-risk-parturient-with-methamphetamine-associated-cardiomyopathy-undergoing-dilation-and-evacuation-a-case-report
#15
Cesar Padilla, Antonio Hernandez Conte, Danny Ramzy, Lorraine Lubin, Troy LaBounty, Judith H Chung, Ying Zeng
Parturients may present with evidence of acute heart failure or respiratory distress during the peripartum period. This case report documents utilization of "stand-by" extracorporeal membrane oxygenation (ECMO) for a 40-year-old woman with a history of severe left ventricular dysfunction who presented for elective dilation and evacuation of triplets at 20 weeks' gestation. The patient's medical history was significant for hypertension, diabetes mellitus, methamphetamine use (acute/chronic), and cardiac-respiratory arrest before her previous emergent cesarean delivery...
December 30, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/28045591/clinical-practice-guideline-update
#16
Seth R Schwartz, Anthony E Magit, Richard M Rosenfeld, Bopanna B Ballachanda, Jesse M Hackell, Helene J Krouse, Claire M Lawlor, Kenneth Lin, Kourosh Parham, David R Stutz, Sandy Walsh, Erika A Woodson, Ken Yanagisawa, Eugene R Cunningham
Objective This update of the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation cerumen impaction clinical practice guideline provides evidence-based recommendations on managing cerumen impaction. Cerumen impaction is defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. Changes from the prior guideline include a consumer added to the development group; new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials); enhanced information on patient education and counseling; a new algorithm to clarify action statement relationships; expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; an enhanced external review process to include public comment and journal peer review; and 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care...
January 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28041707/little-contribution-of-conventional-factors-in-an-algorithm-to-predicting-death-risk-in-turkish-adults
#17
Altan Onat, Günay Can, Evin Ademoğlu, Adnan Kaya, Eyyup Tusun, Dilek Ural
OBJECTIVE: Determinants of risk of death are highly relevant for the management strategy of individuals. We aimed to determine an algorithm for predicting risk of death in Turkish adults who have a high prevalence of metabolic syndrome (MetS). METHODS: Nine-year risk of death was estimated in 3348 middle-aged adults, followed over 8.81±4.2years. Cox proportional hazard regression was used to predict risk of death. Discrimination was assessed using C-statistics...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28041652/abnormal-spontaneous-brain-activity-in-type-2-diabetic-retinopathy-revealed-by-amplitude-of-low-frequency-fluctuations-a-resting-state-fmri-study
#18
Z-L Wang, L Zou, Z-W Lu, X-Q Xie, Z-Z Jia, C-J Pan, G-X Zhang, X-M Ge
AIM: To explore the altered spontaneous cerebral activity patterns and impaired functional regions in patients with diabetic retinopathy (DR) using resting-state functional magnetic resonance imaging (rs-fMRI) based on the amplitude of low-frequency fluctuations (ALFF) algorithm. MATERIALS AND METHODS: Twenty-one patients with DR (mean age, 54.9±9.9 years; 11 females) and 17 healthy control subjects (54.8±5.7 years; 9 females) were prospectively studied. The DR patients underwent laboratory tests...
December 29, 2016: Clinical Radiology
https://www.readbyqxmd.com/read/28036406/winner-s-curse-correction-and-variable-thresholding-improve-performance-of-polygenic-risk-modeling-based-on-genome-wide-association-study-summary-level-data
#19
Jianxin Shi, Ju-Hyun Park, Jubao Duan, Sonja T Berndt, Winton Moy, Kai Yu, Lei Song, William Wheeler, Xing Hua, Debra Silverman, Montserrat Garcia-Closas, Chao Agnes Hsiung, Jonine D Figueroa, Victoria K Cortessis, Núria Malats, Margaret R Karagas, Paolo Vineis, I-Shou Chang, Dongxin Lin, Baosen Zhou, Adeline Seow, Keitaro Matsuo, Yun-Chul Hong, Neil E Caporaso, Brian Wolpin, Eric Jacobs, Gloria M Petersen, Alison P Klein, Donghui Li, Harvey Risch, Alan R Sanders, Li Hsu, Robert E Schoen, Hermann Brenner, Rachael Stolzenberg-Solomon, Pablo Gejman, Qing Lan, Nathaniel Rothman, Laufey T Amundadottir, Maria Teresa Landi, Douglas F Levinson, Stephen J Chanock, Nilanjan Chatterjee
Recent heritability analyses have indicated that genome-wide association studies (GWAS) have the potential to improve genetic risk prediction for complex diseases based on polygenic risk score (PRS), a simple modelling technique that can be implemented using summary-level data from the discovery samples. We herein propose modifications to improve the performance of PRS. We introduce threshold-dependent winner's-curse adjustments for marginal association coefficients that are used to weight the single-nucleotide polymorphisms (SNPs) in PRS...
December 2016: PLoS Genetics
https://www.readbyqxmd.com/read/28027460/sm-ruleminer-spider-monkey-based-rule-miner-using-novel-fitness-function-for-diabetes-classification
#20
Ramalingaswamy Cheruku, Damodar Reddy Edla, Venkatanareshbabu Kuppili
Diabetes is a major health challenge around the world. Existing rule-based classification systems have been widely used for diabetes diagnosis, even though they must overcome the challenge of producing a comprehensive optimal ruleset while balancing accuracy, sensitivity and specificity values. To resolve this drawback, in this paper, a Spider Monkey Optimization-based rule miner (SM-RuleMiner) has been proposed for diabetes classification. A novel fitness function has also been incorporated into SM-RuleMiner to generate a comprehensive optimal ruleset while balancing accuracy, sensitivity and specificity...
December 19, 2016: Computers in Biology and Medicine
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