Suchergebnisse

Delivering insulin in type 1 diabetes is a challenging, and potentially risky, activity; hence the importance of including safety measures as part of any insulin dosing or recommender system. This work presents and clinically evaluates a modular safety system that is part of an intelligent insulin dose recommender platform developed within the EU-funded PEPPER project. METHODS: The proposed safety system is composed of four modules which use a novel glucose forecasting algorithm. These modules are predictive glucose alerts and alarms; a predictive low-glucose basal insulin suspension module; an advanced rescue carbohydrate recommender for resolving hypoglycemia; and a personalized safety constraint applied to insulin recommendations. The technical feasibility of the proposed safety system was evaluated in a pilot study including eight adult subjects with type 1 diabetes on multiple daily injections over a duration of six weeks. Glycemic control and safety system functioning were compared between the two-weeks run-in period and the end point at eight weeks. A standard insulin bolus calculator was employed to recommend insulin doses. RESULTS: Overall, glycemic control improved over the evaluated period. In particular, percentage time in the hypoglycemia range (<3.0 mmol/l) significantly decreased from 0.82% (0.05-4.79) at run-in to 0.33% (0.00-0.93) at endpoint ( P = .02). This was associated with a significant increase in percentage time in target range (3.9-10.0 mmol/l) from 52.8% (38.3-61.5) to 61.3% (47.5-71.7) ( P = .03). There was also a reduction in number of carbohydrate recommendations. CONCLUSION: A safety system for an insulin dose recommender has been proven to be a viable solution to reduce the number of adverse events associated to glucose control in type 1 diabetes ; This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement 689810.

Pòster de congrés presentat a: ATTD 2020 - 13th International Conference on Advanced Technologies & Treatments for Diabetes", celebrat a Madrid del 19 al 22 de febrer de 2020 ; PEPPER (Patient Empowerment through Predictive PERsonalised decision support) is an EU-funded H2020 project that provides a personalized decision support system for type 1 diabetes selfmanagement. This work describes the application program interface (API) developed for this purpose ; This project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement 689810

Pòster de congrés presentat a: ATTD 2020 - 13th International Conference on Advanced Technologies & Treatments for Diabetes", celebrat a Madrid del 19 al 22 de febrer de 2020 ; PEPPER (Patient Empowerment through Predictive PERsonalised decision support) is an EU-funded H2020 project that provides personalised insulin bolus advice for people with Type 1 diabetes (T1D). Here, we evaluate the safety, feasibility and usability of the PEPPER system compared to a standard bolus calculator ; This project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement 689810

Background MicroRNAs (miRNAs) have been reported as deregulated in active brain lesions derived from patients with multiple sclerosis (MS). In there, these post-transcriptional regulators may elicit very important effects but proper identification of miRNA candidates as potential biomarkers and/or therapeutic targets is scarcely available. Objective The aim of the study was to detect the presence of a set of candidate miRNAs in cell-free cerebrospinal fluid (CSF) and to determine their association with gadolinium-enhancing (Gd+) lesions in order to assess their value as biomarkers of MS activity. Methods Assessment of 28 miRNA candidates in cell-free CSF collected from 46 patients with MS (26 Gd+ and 20 Gd− patients) was performed by TaqMan assays and qPCR. Variations in their relative abundance were analyzed by the Mann-Whitney U test and further evaluated by receiver operating characteristic (ROC) analysis. Signaling pathways and biological functions of miRNAs were analyzed using bioinformatic tools (miRTarBase, Enrichr, REVIGO, and Cytoscape softwares). Results Seven out of 28 miRNA candidates were detected in at least 75% of CSF samples. Consistent increase of miR-21 and miR-146a/b was found in Gd+ MS patients. This increase was in parallel to the number of Gd+ lesions and neurofilament light chain (NF-L) levels. Gene Ontology enrichment analysis revealed that the target genes of these miRNAs are involved in biological processes of key relevance such as apoptosis, cell migration and proliferation, and in cytokine-mediated signaling pathways. Conclusion Levels of miR-21 and miR-146a/b in cell-free CSF may represent valuable biomarkers to identify patients with active MS lesions ; The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this study was supported by a grant from the Instituto Carlos III–Spanish Government (PI13/ 01782) and by a grant from Fundación Genzyme (2015). M. M.-S.M. was supported by a FI-DGR 2016 from AGAUR. J. ...

Pòster de congrés presentat a: International Conference on Advanced Technologies & Treatments for Diabetes (ATTD) (12th: 20-23 Febrer 2019: Berlin) ; PEPPER (Patient Empowerment through Predictive PERsonalised decision support) is an EU-funded research project which aims to improve the self-management behaviour of adults with type 1 diabetes (T1D). Human factors and ergonomics play a key role in the development of this system ; This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement 689810

Pòster de congrés presentat a: International Conference on Advanced Technologies & Treatments for Diabetes (ATTD) (10th: 15-18 Febrer 2017: Berlin) ; PEPPER (Patient Empowerment through Predictive PERsonalised decision support) is an EU-funded research project to develop a personalised clinical decision support system for Type 1 diabetes self-management. The tool provides insulin bolus dose advice and carbohydrate recommendations, tailored to the needs of individuals. The former is determined by Case-Based Reasoning (CBR), an artificial intelligence technique that adapts to new situations according to past experience. The latter uses a predictive computer model that also promotes safety by providing glucose alarms, low-glucose insulin suspension and fault detection ; This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement 689810

Background Inhibitory control (IC) is critical to keep long-term goals in everyday life. Bidirectional relationships between IC deficits and obesity are behind unhealthy eating and physical exercise habits. Methods We studied gut microbiome composition and functionality, and plasma and faecal metabolomics in association with cognitive tests evaluating inhibitory control (Stroop test) and brain structure in a discovery (n=156), both cross-sectionally and longitudinally, and in an independent replication cohort (n=970). Faecal microbiota transplantation (FMT) in mice evaluated the impact on reversal learning and medial prefrontal cortex (mPFC) transcriptomics. Results An interplay among IC, brain structure (in humans) and mPFC transcriptomics (in mice), plasma/faecal metabolomics and the gut metagenome was found. Obesity-dependent alterations in one-carbon metabolism, tryptophan and histidine pathways were associated with IC in the two independent cohorts. Bacterial functions linked to one-carbon metabolism (thyX,dut, exodeoxyribonuclease V), and the anterior cingulate cortex volume were associated with IC, cross-sectionally and longitudinally. FMT from individuals with obesity led to alterations in mice reversal learning. In an independent FMT experiment, human donor's bacterial functions related to IC deficits were associated with mPFC expression of one-carbon metabolism-related genes of recipient's mice. Conclusion These results highlight the importance of targeting obesity-related impulsive behaviour through the induction of gut microbiota shifts. ; This work was partially supported by research grants FIS (PI15/01934 and PI18/01022) from the Instituto de Salud Carlos III from Spain, SAF2015- 65878-R and #AEI-SAF2017-84060-R-FEDER from Ministry of Economy and Competitiveness, Prometeo/2018/A/133 from Generalitat Valenciana, Spain; and also by Fondo Europeo de Desarrollo Regional (FEDER) funds, European Commission (FP7, NeuroPain #2013-602891), the Catalan Government (AGAUR, #SGR2017-669, ICREA Academia Award ...