The OmniPod Insulin Management System: the latest innovation in insulin pump therapy

This review of insulin pump therapy focuses on the OmniPod® Insulin Management System (Insulet Corp., Bedford, MA, USA). The OmniPod System is the first commercially available “patch pump.” It is a fully integrated wearable pump, controlled wirelessly through a handheld device containing a built-in blood glucose meter. This is an evaluation of the OmniPod System, with the aim of providing an educational tool for physicians who are considering recommending this product to their patients. The review includes a discussion of the traditional insulin pump configuration and its limitations, a detailed overview of the OmniPod System, references to clinical study data, planned product enhancements, its use as an insulin delivery system in the Juvenile Diabetes Research Foundation’s Artificial Pancreas Project, and its use to deliver additional compounds

Parental evaluation of a telemonitoring service for children with Type 1 Diabetes

Introduction In the past years, we developed a telemonitoring service for young patients affected by Type 1 Diabetes. That service provides data to the clinical staff and offers an important tool to the parents, that are able to oversee in real time their children. The aim of this work was to analyze the parents' perceived usefulness of the service. Methods The service was tested by the parents of 31 children enrolled in a seven-day clinical trial during a summer camp. To study the parents' perception we proposed and analyzed two questionnaires. A baseline questionnaire focused on the daily management and implications of their children's diabetes, while a post-study one measured the perceived benefits of telemonitoring. Questionnaires also included free text comment spaces. Results Analysis of the baseline questionnaires underlined the parents' suffering and fatigue: 51% of total responses showed a negative tendency and the mean value of the perceived quality of life was 64.13 in a 0-100 scale. In the post-study questionnaires about half of the parents believed in a possible improvement adopting telemonitoring. Moreover, the foreseen improvement in quality of life was significant, increasing from 64.13 to 78.39 ( p-value\u2009=\u20090.0001). The analysis of free text comments highlighted an improvement in mood, and parents' commitment was also proved by their willingness to pay for the service (median\u2009=\u2009200\u2009euro/year). Discussion A high number of parents appreciated the telemonitoring service and were confident that it could improve communication with physicians as well as the family's own peace of mind

Quantifier-Free Interpolation of a Theory of Arrays

The use of interpolants in model checking is becoming an enabling technology to allow fast and robust verification of hardware and software. The application of encodings based on the theory of arrays, however, is limited by the impossibility of deriving quantifier- free interpolants in general. In this paper, we show that it is possible to obtain quantifier-free interpolants for a Skolemized version of the extensional theory of arrays. We prove this in two ways: (1) non-constructively, by using the model theoretic notion of amalgamation, which is known to be equivalent to admit quantifier-free interpolation for universal theories; and (2) constructively, by designing an interpolating procedure, based on solving equations between array updates. (Interestingly, rewriting techniques are used in the key steps of the solver and its proof of correctness.) To the best of our knowledge, this is the first successful attempt of computing quantifier- free interpolants for a variant of the theory of arrays with extensionality

Kadun eri ratkaisujen vaikutukset ylläpitokustannuksiin

Tässä opinnäytetyössä tarkastellaan katujen ylläpitokustannuksia Helsingin kaupungissa. Työn toimeksiantajana on Helsingin kaupunki. Ohjaajina toimivat Helsingin kaupungin ylläpitoinsinööri Tuomas Lautaniemi ja Hämeen ammattikorkeakoulun liikennealan lehtori Rami Tervo. Työn tavoitteena oli kehittää Helsingin kaupungille apuväline ylläpitokustannusten arviointiin katusuunnittelun yhteydessä. Apuvälineeksi on toteutettu Excel-taulukko, joka laskee kadun eri ratkaisujen ja ominaisuuksien perusteella arvion vuosittaisista ylläpitokustannuksista. Tämän taulukon on tarkoitus antaa tarkempaa arviota katusuunnitelman yhteydessä ilmoitettaviin ylläpitokustannuksiin kuin ennen. Suurimmat katujen ylläpitoa hankaloittavat ratkaisut ovat kadunvarsipysäköinti, kolmitasoratkaisut (jalankulun, pyöräilyn ja ajoradan erottaminen eri tasoihin) ja ahtaat katutilat. Kadun ylläpitokustannuksiin vaikuttavat myös monet sellaiset asiat, joihin ei suunnittelulla voida vaikuttaa. Kadun eri rakenteellisten ominaisuuksien vaikutuksetkin ovat hyvin moninaisia ja usein vaikutukset vaihtelevat kohteittain. Näiden takia taulukon antama ylläpitokustannusarvio on vain karkea arvio kadun vuosittaisista ylläpitokustannuksista.In this thesis project maintenance costs of streets were examined by the perspective of the city of Helsinki. The commissioner of this thesis was the city of Helsinki. The supervisors included maintenance engineer Tuomas Lautaniemi from the city of Helsinki and traffic and transport management lecturer Rami Tervo from Häme University of Applied Sciences. The goal of this project was to develop an assistive device to the city of Helsinki which would help estimate the maintenance costs of streets. The assistive device was implemented using an Excel-table which calculates estimated annual maintenance costs for a specific street based on solutions and features of the street. The function of this Excel-table is to provide more exact maintenance costs shown in the street plan than before. The biggest challenges in the maintenance of streets are street parking, three-level solutions (walking, cycling and roadway are separated into different levels) and the narrow street space. The maintenance costs of streets are influenced by many factors which cannot be affected by planning. The effects of structural solutions on streets are multifold and often they change by location. This is why the estimated annual maintenance costs of a street are only a very rough estimates

Emerging technologies for the management of Type 1 diabetes in pregnancy

Purpose of Review: The purpose of the study is to discuss emerging technologies available in the management of type 1 diabetes in pregnancy. Recent Findings: The latest evidence suggests that continuous glucose monitoring (CGM) should be offered to all women on intensive insulin therapy in early pregnancy. Studies have additionally demonstrated the ability of CGM to help gain insight into specific glucose profiles as they relate to glycaemic targets and pregnancy outcomes. Despite new studies comparing insulin pump therapy to multiple daily injections, its effectiveness in improving glucose and pregnancy outcomes remains unclear. Sensor-integrated insulin delivery (also called artificial pancreas or closed-loop insulin delivery) in pregnancy has been demonstrated to improve time in target and performs well despite the changing insulin demands of pregnancy. Summary: Emerging technologies show promise in the management of type 1 diabetes in pregnancy; however, research must continue to keep up as technology advances. Further research is needed to clarify the role technology can play in optimising glucose control before and during pregnancy as well as to understand which women are candidates for sensor-integrated insulin delivery

A filled duration illusion in music: Effects of metrical subdivision on the perception and production of beat tempo.

This study replicates and extends previous findings suggesting that metrical subdivision slows the perceived beat tempo (Repp, 2008). Here, musically trained participants produced the subdivisions themselves and were found to speed up, thus compensating for the perceived slowing. This was shown in a synchronization-continuation paradigm (Experiment 1) and in a reproduction task (Experiment 2a). Participants also judged the tempo of a subdivided sequence as being slower than that of a preceding simple beat sequence (Experiment 2b). Experiment 2 also included nonmusician participants, with similar results. Tempo measurements of famous pianists’ recordings of two variation movements from Beethoven sonatas revealed a strong tendency to play the first variation (subdivided beats) faster than the theme (mostly simple beats). A similar tendency was found in musicians’ laboratory performances of a simple theme and variations, despite instruc-tions to keep the tempo constant (Experiment 3a). When playing melodic sequences in which only one of three beats per measure was subdivided, musicians tended to play these beats faster and to perceive them as longer than adjacent beats, and they played the whole sequence faster than a sequence without any subdivisions (Experiments 3b and 3c). The results amply demonstrate a filled duration illusion in rhythm perception and music performance: Intervals containing events seem longer than empty intervals and thus must be shortened to be perceived as equal in duration

Day and night closed-loop control in adults with type 1 diabetes: a comparison of two closed-loop algorithms driving continuous subcutaneous insulin infusion versus patient self-management.

OBJECTIVE: To compare two validated closed-loop (CL) algorithms versus patient self-control with CSII in terms of glycemic control. RESEARCH DESIGN AND METHODS: This study was a multicenter, randomized, three-way crossover, open-label trial in 48 patients with type 1 diabetes mellitus for at least 6 months, treated with continuous subcutaneous insulin infusion. Blood glucose was controlled for 23 h by the algorithm of the Universities of Pavia and Padova with a Safety Supervision Module developed at the Universities of Virginia and California at Santa Barbara (international artificial pancreas [iAP]), by the algorithm of University of Cambridge (CAM), or by patients themselves in open loop (OL) during three hospital admissions including meals and exercise. The main analysis was on an intention-to-treat basis. Main outcome measures included time spent in target (glucose levels between 3.9 and 8.0 mmol/L or between 3.9 and 10.0 mmol/L after meals). RESULTS: Time spent in the target range was similar in CL and OL: 62.6% for OL, 59.2% for iAP, and 58.3% for CAM. While mean glucose level was significantly lower in OL (7.19, 8.15, and 8.26 mmol/L, respectively) (overall P = 0.001), percentage of time spent in hypoglycemia (<3.9 mmol/L) was almost threefold reduced during CL (6.4%, 2.1%, and 2.0%) (overall P = 0.001) with less time ≤2.8 mmol/L (overall P = 0.038). There were no significant differences in outcomes between algorithms. CONCLUSIONS: Both CAM and iAP algorithms provide safe glycemic control