A Simulation Study of an Inverse Controller for Closed and Semiclosed-Loop Control in Type 1 Diabetes

Background: Closed-loop control algorithms in diabetes aim to calculate the optimum insulin delivery to maintain the patient in a normoglycemic state, taking the blood glucose level as the algorithm's main input. The major difficulties facing these algorithms when applied subcutaneously are insulin absorption time and delays in measurement of subcutaneous glucose with respect to the blood concentration. Methods: This article presents an inverse controller (IC) obtained by inversion of an existing mathematical model and validated with synthetic patients simulated with a different model and is compared with a proportional-integral-derivative controller. Results: Simulated results are presented for a mean patient and for a population of six simulated patients. The IC performance is analyzed for both full closed-loop and semiclosed-loop control. The IC is tested when initialized with the heuristic optimal gain, and it is compared with the performance when the initial gain is deviated from the optimal one (±10%). Conclusions: The simulation results show the viability of using an IC for closed-loop diabetes control. The IC is able to achieve normoglycemia over long periods of time when the optimal gain is used (63% for the full closed-loop control, and it is increased to 96% for the semiclosed-loop control

Biodiversity of Arbuscular Mycorrhizal Fungi in South America: A Review

Identification of species is crucial in understanding how diversity changes affect ecosystemic processes. Particularly, soil microbial are key factors of ecosystemic functioning .Among soil microbes, arbuscular mycorrhizal fungi (AMF, phylum Glomeromycota) are worldwide distributed and form symbiotic associations with almost 80% of the vascular plants of the earth, except for one species, Geosiphon pyriformis, which associates with the cyanobacteria Nostoc. AMF comprise around 300 morphologically defined or 350–1000 molecularly defined taxa. Since AMF associate with aboveground community, their occurrence and composition can influence ecosystemic processes either through affecting plant community composition and thus its processes rates, or soil microbial communities, which are directly involved in nutrient cycling. Soil microorganisms are considered a potentially suitable target for studying regional and local effects on diversity. The symbiosis with AMF not only increases nutrient uptake by the plant of mainly phosphorus (P) and nitrogen (N) in exchange for plant-assimilated carbon (C), but also improves the tolerance of plants to various biotic and abiotic stresses such as pathogens, salinity, and drought

Molecular Structure, Biosynthesis, and Distribution of Coenzyme Q

Coenzyme Q is a very old molecule in evolutionary terms that has accumulated numerous functions in the cellular metabolism beyond its primordial function, the electron transport. In all organisms, coenzyme Q maintains a highly conserved structure allowing a localization inside cell membranes in a hydrophobic environment thanks to having an isoprenoid tail, and at the same time allows the polar ring benzene to interact with acceptors and electron donors. Coenzyme Q deficiency constitutes a group of mitochondrial diseases. Affected patients suffer mainly a decrease in energy production that induces dysfunctions in most organs and body systems. Current therapeutic alternatives are based on increasing coenzyme Q levels either through induction of endogenous mechanisms or exogenous supplementation. This chapter includes both aspects, the mechanisms associated with the coenzyme Q supplementation and the regulatory mechanisms of coenzyme Q biosynthesis. In terms of synthesis, the structure of coenzyme Q is complicated since it requires the participation of two well-differentiated pathways that must be carefully regulated. The synthesis is carried out through the participation of a multienzyme complex located in the inner mitochondrial membrane and controlled by different levels of regulation that at this time are not well-known

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease