A nonparametric approach for model individualization in an artificial pancreas

The identification of patient-tailored linear time invariant glucose-insulin models is investigated for type 1 diabetic patients, that are characterized by a substantial inter-subject variability. The individualized linear models are identified by considering a novel kernel-based nonparametric approach and are compared with a linear time invariant average model in terms of prediction performance by means of the coefficient of determination, fit, positive and negative max errors, and root mean squared error. Model identification and validation are based on in-silico data collected from the adult virtual population of the UVA/Padova simulator. The data generation involves a protocol designed to produce a sufficient input excitation without compromising patient safety, compatible also with real life scenarios. The identified models are exploited to synthesize an individualized Model Predictive Controller (MPC) for each patient, which is used in an Artificial Pancreas to maintain the blood glucose concentration within an euglycemic range. The MPC used in several clinical studies, synthesized on the basis of a non-individualized average linear time invariant model, is also considered as reference. The closed-loop control performance is evaluated in an in-silico study on the adult virtual population of the UVA/Padova simulator in a perturbed scenario, in which the MPC is blind to random variations of insulin sensitivity in each virtual patient. © 2015, IFAC (International Federation of Automatic Control) Hosting by Elsevier Ltd. All rights reserved

Synthesis, Characterization, and Photochemical Properties of a New Square Mn(I)-Ru(II) Complex Using Pyrazine as Bridge Ligand

The photochemical properties of the complexes cis,fac-[Ru(phen)(2)(pz)(2)-Mn(CO)(3)Br](2)(4+) (I), cis-[Ru(phen)(2)(pz)(2)](2+) (II), and fac-Mn(CO)(3)(pz)(2)Br (III) where phen is phenanthroline and pz is pyrazine in acetonitrile solution are reported. the three complexes were characterized using H-1 NMR, UV-vis and FTIR spectroscopy and electrochemical (cyclic voltammetry and spectroelectrochemical) techniques. the complexes show intense absorption in the visible region assigned to the population of MLCT excited states. the absorption spectrum of I is the sum of the spectra of the mononuclear species II and III, and the two oxidation potentials at +1.10 and +1.56V versus Ag/AGCl observed in I are ascribed to the different coordination environments of metal centers. the photolysis in the acetonitrile solution resulted in the pz dissociation to give the monoacetonitrile complexes for I, II, and III, respectively.Univ Fed Sao Carlos, Dept Quim, BR-13565905 Sao Carlos, SP, BrazilFundacao Univ Fed Grande Dourados, Fac Ciencias Exatas & Tecnol, BR-79804970 Dourados, MS, BrazilUniversidade Federal de São Paulo, Fac Filosofia Ciencias & Letras Ribeirao Preto, Dept Ciencias Farmaceut, BR-14040901 Ribeirao Preto, SP, BrazilUniversidade Federal de São Paulo, Fac Filosofia Ciencias & Letras Ribeirao Preto, Dept Ciencias Farmaceut, BR-14040901 Ribeirao Preto, SP, BrazilWeb of Scienc

Searching through photographic databases with QuickLook

G. Ciocca, C. Cusano, R. Schettini, S. Santini, A. de Polo, F. Tavanti, “Searching through photographic databases with QuickLook”. Proc. Multimedia on Mobile Devices 2012; and Multimedia Content Access: Algorithms and Systems VI. Ed- Reiner Creutzburg; David Akopian; Cees G. M. Snoek; Nicu Sebe; Lyndon Kennedy. 8304. 83040V-1 (2012). Copyright 2012 Society of Photo‑Optical Instrumentation Engineers. One print or electronic copy may be made for personal use only. Systematic reproduction and distribution, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited.We present here the results obtained by including a new image descriptor, that we called prosemantic feature vector, within the framework of QuickLook2 image retrieval system. By coupling the prosemantic features and the relevance feedback mechanism provided by QuickLook2, the user can move in a more rapid and precise way through the feature space toward the intended goal. The prosemantic features are obtained by a two-step feature extraction process. At the first step, low level features related to image structure and color distribution are extracted from the images. At the second step, these features are used as input to a bank of classifiers, each one trained to recognize a given semantic category, to produce score vectors. We evaluated the efficacy of the prosemantic features under search tasks on a dataset provided by Fratelli Alinari Photo Archive.© (2012) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only

A pilot study of the effects of hormone therapy on normal breast tissue of postmenopausal women

PURPOSE: to analyze breast tissue of postmenopausal women before and after six months of continuous combined estrogen-progestin replacement therapy (0.625 mg conjugated equine estrogens associated with 2.5 mg medroxyprogesterone acetate). METHODS: all patients were evaluated before treatment and considered eligible to receive the drug. The material was obtained from the upper outer left quadrant, through a percutaneous large-core breast biopsy. Epithelial density and nuclear volume on hematoxylin-eosin-stained plates were evaluated for the morphological study. Morphometry was graphically analyzed by optical microscopy (400X) after acquisition of image by a digital image-capturing system (Vidcap 32) and image analysis system (Imagelab 2000 Software®). RESULTS: after six months of estrogen-progestin replacement therapy, there was a significant increase in nuclear volume in late postmenopausal women (103.6 to 138.1 µm³). There was no difference in epithelial density with the treatment (before 0.08 and later 0.10). CONCLUSIONS: estrogen-progestin combined replacement therapy for six months induced an enhacement in nuclear volume of breast epithelial cells, suggesting an increase in their metabolic activity. However, it is important to emphasize that this finding was observed only in late postmenopausal women. The increased nuclear volume could precede other events that confirm the stimulation of cellular proliferation by these hormones.OBJETIVOS: avaliou-se o tecido mamário de mulheres antes e depois de seis meses de terapia estroprogestativa combinada contínua (0,625 mg de estrogênios conjugados eqüinos associados a 2,5 mg de acetato de medroxiprogesterona). MÉTODOS: todas as pacientes foram avaliadas antes de se instituir o tratamento e consideradas aptas para este. Foram obtidos fragmentos de tecido mamário por meio de biópsia percutânea com agulha grossa (acoplada a um propulsor automático - core-biópsia). O material foi fixado e os cortes corados por hematoxilina-eosina. Avaliou-se a densidade epitelial e o volume nuclear do epitélio mamário antes e após a terapia hormonal. Esses parâmetros morfométricos foram analisados graficamente com auxílio do programa Imagelab 2000 ®, após captura da imagem microscópica pelo sistema Vidcap 32. Esse programa permite que sejam selecionadas as áreas de interesse, possibilitando o cálculo de área, volume ou a relação da área ocupada entre diferentes estruturas. RESULTADOS: depois do uso da terapia, o volume nuclear nas mulheres em que o tratamento foi instituído em período mais tardio após a menopausa mostrou um aumento de cerca de 33% (de 103,6 para 138,1 µm³). A densidade epitelial não se modificou de forma significativa: o valor médio antes da terapia hormonal foi de 0,08 e após de 0,10. CONCLUSÕES: a terapia estroprogestativa combinada contínua empregada por seis meses induziu à alteração no volume nuclear das células epiteliais das mamas, sugerindo aumento de sua atividade metabólica. Provavelmente, esse evento precede outros que confirmariam o estímulo da proliferação celular por esses hormônios.Universidade Federal de São Paulo (UNIFESP) Departamento de GinecologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Anatomia PatológicaUNIFESP, Depto. de GinecologiaUNIFESP, Depto. de Anatomia PatológicaSciEL

Variance component estimation with longitudinal data: a simulation study with alternative methods

A pedigree structure distributed in three different places was generated. For each offspring, phenotypicinformation was generated for five different ages (12, 30, 48, 66 and 84 months). The data file was simulated allowing someinformation to be lost (10, 20, 30 and 40%) by a random process and by selecting the ones with lower phenotypic values,representing the selection effect. Three alternative analysis were used, the repeatability model, random regression model andmultiple-trait model. Random regression showed to be more adequate to continually describe the covariance structure ofgrowth over time than single-trait and repeatability models, when the assumption of a correlation between successivemeasurements in the same individual was different from one another. Without selection, random regression and multiple-traitmodels were very similar

the unregulated probiotic market

Background & Aims This narrative review provides an overview of the current regulation of probiotics, with a focus on those used for the dietary management of medical conditions (Medical Foods). Findings The probiotic market has grown rapidly, both for foods and supplements intended to enhance wellness in healthy individuals, and for preparations for the dietary management of disease. Regulation of probiotics varies between regions. Unless they make specific disease-related health claims, probiotics are regulated as food supplements and regulation is focused on the legitimacy of any claims, rather than efficacy, safety and quality. Many properties of probiotics are strain-specific, and safety and efficacy findings associated to specific formulations should not be generalized to other probiotic products. Manufacturing processes, conditions and ingredients are important determinants of product characteristics and changes to manufacturing are likely to give rise to a product not identical to the "original" in efficacy and safety if proper measures and controls are not taken. Current trademark law and the lack of stringent regulation of probiotic manufacturing mean that the trademark owner can commercialize any formulation under the same brand, even if significantly different from the original. These regulatory deficits may have serious consequences for patients where probiotics are used as part of clinical guideline-recommended management of serious conditions such as inflammatory bowel diseases, and may make doctors liable for prescribing a formulation not previously tested for safety and efficacy. Conclusions Current regulation of probiotics is inadequate to protect consumers and doctors, especially when probiotics are aimed at the dietary management of serious conditions

Cost estimate of mammographic screening in climacteric women

PURPOSE: to evaluate the cost of preventive mammographic screening in climacteric women, as compared to the cost of breast cancer treatment in more advanced stages. METHODS: one thousand and fourteen patients attended at the Climacteric outpatient service of the Gynecology Department, Federal University of São Paulo Paulista School of Medicine, were included in the study and submitted to mammographic test. All mammographic test's were analyzed by the same two physicians and classified according to the BI-RADS (Breast Imaging Reporting and Data System American College of Radiology) categories. The detected lesions were submitted to cytological and histological examination. RESULTS: the final diagnostic impression of the 1014 examinations, according to the classification of BI-RADS categories was: 1=261, 2=671, 3=59, 4=22 and 5=1. The invasive procedures were performed through a needle guided by ultrasound or stereotactic examinations: 33 fine-needle aspiration biopsies, 6 core biopsies guided by ultrasound and 20 core biopsies guided by stereotactic examination. Five cancer diagnoses were established. The total cost of this screening based on Brazilian procedure values was R$76,593.79 (25,534 dollars). Therefore, the cost of the diagnosis of the five cases of cancer in this screening was R$ 15,318.75 (5,106 dollars) each. However, the average cost per patient screened was R$75.53 (25 dollars). CONCLUSIONS: considering that the total treatment cost of only one case of breast cancer in advanced stage including hospital costs, surgery, chemotherapy, radiotherapy and hormonal treatment is similar to the cost of 1,000 mammographic screenings in climacteric women, it may be concluded that the cost of the early cancer diagnosis program is worth it and should be included in the public health program, as a way of lowering the public health expense.OBJETIVOS: analisar os custos de um ciclo de rastreamento mamográfico do câncer de mama em população de 1014 mulheres no climatério e comparar com os custos do tratamento do câncer da mama em estádios mais avançados. MÉTODOS: realizou-se rastreamento em 1014 mulheres atendidas em ambulatório de Climatério. Todas as mamografias foram classificadas de acordo com as categorias do BI-RADSä (Breast Imaging Reporting and Data System American College of Radiology) e as lesões detectadas foram submetidas a estudo citológico ou histológico. A estimativa dos custos dos exames e procedimentos realizados foram obtidos da Tabela AMB 92. RESULTADOS: a impressão diagnóstica final dos 1014 exames, de acordo com a classificação em categorias do BI-RADSä, foi: 1=261; 2=671; 3=59; 4=22; 5=1. Os procedimentos invasivos realizados totalizaram 33 punções com agulha fina dirigida por USG, 6 biópsias com agulha grossa orientada por USG e 20 biópsias orientadas por mamografia (estereotaxia). Com base nos valores da tabela AMB 92, foram necessários para rastrear e diagnosticar essa população cerca de R$ 76.000,00. Detectaram-se 5 cânceres de mama, ao custo aproximado de R$15.318,75 por diagnóstico e média de custo por paciente de R$ 75,53. CONCLUSÕES: considerando que o custo total do tratamento de um único caso de câncer de mama em estádio II ou mais pode atingir R$ 75.000,00, concluímos que os programas de rastreamento mamográfico podem ser incluídos entre as políticas de saúde.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de GinecologiaUNIFESP, EPM, Depto. de GinecologiaSciEL

An Anomalous Extra Z Prime from Intersecting Branes with Drell-Yan and Direct Photons at the LHC

We quantify the impact of gauge anomalies at the Large Hadron Collider by studying the invariant mass distributions in Drell-Yan and in double prompt photon, using an extension of the Standard Model characterized by an additional anomalous U(1) derived from intersecting branes. The approach is rather general and applies to any anomalous abelian gauge current. Anomalies are cancelled using either the Wess-Zumino mechanism with suitable Peccei-Quinn-like interactions and a Stueckelberg axion, or by the Green-Schwarz mechanism. We compare predictions for the corresponding extra Z-prime to anomaly-free realizations such as those involving U(1)_{B-L}. We identify the leading anomalous corrections to both channels, which contribute at higher orders, and compare them against the next-to-next-to-leading order (NNLO) QCD background. Anomalous effects in these inclusive observables are found to be very small, far below the percent level and below the size of the typical QCD corrections quantified by NNLO K-factors.Comment: 46 pages, 36 figures, comments and citations adde

Immunoregulatory biological response modifiers: effect of cytokines on septic shock

Whole bacteria or bacterial components or their extracts were employed to restore or augment the immune system. Beneficial effects were attained with these agents in treating various diseases. These agents were named biological response modifiers (BRMs) because they regulated certain cellular components of the immune system. The cellular regulation induced by these BRMs was found to be due to cytokines. The cytokines were shown to act directly on the various cellular components and to provide therapeutic benefit in various autoimmune and immune deficiency diseases. Overproduction of specific cytokines however leads to a deleterious effect on the host. Overproduction of tumour necrosis factor (endotoxin, lipopolysaccharide) leads to septic shock. Bacteraemia is the leading cause of overproduction of tumour necrosis factor (TNF). Septic shock in many cases leads to death. Several monoclonal antibodies to lipopolysaccharide (LPS) and anticytokines have demonstrated protection against septic shock

Morte súbita e angina vasoespástica

Variant angina is defined by chest pain occurring at rest associated with transitory ST segment elevation on ECG, and is caused by a spasm of a coronary artery. Frequently, variant angina is associated with atherosclerotic coronary obstruction and patients with normal coronary arteries are rare. Patients with variant angina and normal coronary arteries have good prognosis, and the development of ventricular arrhythmias or sudden death is rare. The authors present two cases of sudden cardiac death in patients with variant angina and normal coronary arteries