Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians’ Recommendations

Aims: To compare insulin dose adjustments made by physicians to those made by an artificial intelligence-based decision support system, the Advisor Pro, in people with type 1 diabetes (T1D) using an insulin pump and self-monitoring blood glucose (SMBG). Methods: This was a multinational, non-interventional study surveying 17 physicians from 11 countries. Each physician was asked to provide insulin dose adjustments for the settings of the pump including basal rate, carbohydrate-to-insulin ratios (CRs), and correction factors (CFs) for 15 data sets of pumps and SMBG of people with T1D (mean age 18.4 ± 4.8 years; eight females; mean glycated hemoglobin 8.2% ± 1.4% [66 ± 11mmol/mol]). The recommendations were compared among the physicians and between the physicians and the Advisor Pro. The study endpoint was the percentage of comparison points for which there was an agreement on the direction of insulin dose adjustments. Results: The percentage (mean ± SD) of agreement among the physicians on the direction of insulin pump dose adjustments was 51.8% ± 9.2%, 54.2% ± 6.4%, and 49.8% ± 11.6% for the basal, CR, and CF, respectively. The automated recommendations of the Advisor Pro on the direction of insulin dose adjustments were comparable)49.5% ± 6.4%, 55.3% ± 8.7%, and 47.6% ± 14.4% for the basal rate, CR, and CF, respectively(and noninferior to those provided by physicians. The mean absolute difference in magnitude of change between physicians was 17.1% ± 13.1%, 14.6% ± 8.4%, and 23.9% ± 18.6% for the basal, CR, and CF, respectively, and comparable to the Advisor Pro 11.7% ± 9.7%, 10.1% ± 4.5%, and 25.5% ± 19.5%, respectively, significant for basal and CR. Conclusions: Considerable differences in the recommendations for changes in insulin dosing were observed among physicians. Since automated recommendations by the Advisor Pro were similar to those given by physicians, it could be considered a useful tool to manage T1D

Novel palladium(II) and platinum(II) complexes with a fluoropiperazinyl based ligand exhibiting high cytotoxicity and anticancer activity in vitro

cis-Dichloro-palladium(II) and cis-dichloro-platinum(II) complexes (2, 4) of the general formula [M(N-N)Cl2] (M=Pd(II) and Pt(II), N-N= 1,2-diamino-4-fluoro-5-(4-methyl-1-piperazinyl) benzene, (DFMPB)) and the dicationic palladium(II) complex [Pd(N-N)(CH3CN)2](BF4)2 (3) have been prepared and characterized by elemental analysis, 1H-NMR-, mass spectroscopy, and IR spectroscopy. The cytotoxic effect of these complexes against MDA-231 and MCF-7 human breast cancer cell lines and K562 human leukemia cell line has been studied. The influence was dose dependent and varies with cell type. The palladium(II) complex (2) showed superior cytotoxic effect compared with the corresponding platinum(II) complex and the standard, cisplatin, when tested against all the above cell lines. 2016 Kayed A. Abu-Safieh et al.Scopu

Post tracheostomy and post intubation tracheal stenosis: Report of 31 cases and review of the literature

<p>Abstract</p> <p>Background</p> <p>Severe post tracheostomy (PT) and post intubation (PI) tracheal stenosis is an uncommon clinical entity that often requires interventional bronchoscopy before surgery is considered. We present our experience with severe PI and PT stenosis in regards to patient characteristics, possible risk factors, and therapy.</p> <p>Methods</p> <p>We conducted a retrospective chart review of 31 patients with PI and PT stenosis treated at Lahey Clinic over the past 8 years. Demographic characteristics, body mass index, co-morbidities, stenosis type and site, procedures performed and local treatments applied were recorded.</p> <p>Results</p> <p>The most common profile of a patient with tracheal stenosis in our series was a female (75%), obese (66%) patient with a history of diabetes mellitus (35.4%), hypertension (51.6%), and cardiovascular disease (45.1%), who was a current smoker (38.7%). Eleven patients (PI group) had only oro-tracheal intubation (5.2 days of intubation) and developed web-like stenosis at the cuff site. Twenty patients (PT group) had undergone tracheostomy (54.5 days of intubation) and in 17 (85%) of them the stenosis appeared around the tracheal stoma. There was an average of 2.4 procedures performed per patient. Rigid bronchoscopy with Nd:YAG laser and dilatation (mechanical or balloon) were the preferred methods used. Only 1(3.2%) patient was sent to surgery for re-stenosis after multiple interventional bronchoscopy treatments.</p> <p>Conclusion</p> <p>We have identified putative risk factors for the development of PI and PT stenosis. Differences in lesions characteristics and stenosis site were noted in our two patient groups. All patients underwent interventional bronchoscopy procedures as the first-line, and frequently the only treatment approach.</p

Glucose-induced posttranslational activation of protein phosphatases PP2A and PP1 in yeast

The protein phosphatases PP2A and PP1 are major regulators of a variety of cellular processes in yeast and other eukaryotes. Here, we reveal that both enzymes are direct targets of glucose sensing. Addition of glucose to glucose-deprived yeast cells triggered rapid posttranslational activation of both PP2A and PP1. Glucose activation of PP2A is controlled by regulatory subunits Rts1, Cdc55, Rrd1 and Rrd2. It is associated with rapid carboxymethylation of the catalytic subunits, which is necessary but not sufficient for activation. Glucose activation of PP1 was fully dependent on regulatory subunits Reg1 and Shp1. Absence of Gac1, Glc8, Reg2 or Red1 partially reduced activation while Pig1 and Pig2 inhibited activation. Full activation of PP2A and PP1 was also dependent on subunits classically considered to belong to the other phosphatase. PP2A activation was dependent on PP1 subunits Reg1 and Shp1 while PP1 activation was dependent on PP2A subunit Rts1. Rts1 interacted with both Pph21 and Glc7 under different conditions and these interactions were Reg1 dependent. Reg1-Glc7 interaction is responsible for PP1 involvement in the main glucose repression pathway and we show that deletion of Shp1 also causes strong derepression of the invertase gene SUC2. Deletion of the PP2A subunits Pph21 and Pph22, Rrd1 and Rrd2, specifically enhanced the derepression level of SUC2, indicating that PP2A counteracts SUC2 derepression. Interestingly, the effect of the regulatory subunit Rts1 was consistent with its role as a subunit of both PP2A and PP1, affecting derepression and repression of SUC2, respectively. We also show that abolished phosphatase activation, except by reg1Δ, does not completely block Snf1 dephosphorylation after addition of glucose. Finally, we show that glucose activation of the cAMP-PKA (protein kinase A) pathway is required for glucose activation of both PP2A and PP1. Our results provide novel insight into the complex regulatory role of these two major protein phosphatases in glucose regulation

Pengaruh Pemupukan dan Pemangkasan Tanaman terhadap Produktivitas Daun Murbei di Kota Tomohon, Sulawesi Utara

Mulberry is an important feed for increasing the productivity in cocoons on silkworm cultivation. Mulberry having a high nutrition is very important. This is because the nutritional value is the most important factor influencing the quality and quantity of cocoons and silk. Therefore, the development of improved mulberry accompanied with an appropriate cultivation technique is necessary. This study aims to determine the effect of fertilization and trimming on the leaves productivity of three species of mulberry planted in a demonstration plot in Rurukan, Tomohon, North Sulawesi. The three species of mulberry used in this study are mulberry of SULI 01, Morus cathayana and M. canva which were tested under three types of fertilizer: Taikam, Petroganik and manure. The trimming test was only practiced for the two species of M. cathayana dan M. canva with three trimming height of 30 cm, 45 cm and 60 cm above the ground. All the tests were arranged under a completely randomized factorial design. The genetic materials of mulberry were supplied from Forest Productivity Research and Development Center in Bogor. The measured parameters were diameter and height of plant, and leaves production. The results showed that in general the fertilization had no effect on leaves productivity for all of the tested species of mulberry. The application of Taikam and manure only affected the growth of diameter and height of mulberry plant. The trimming treatment provided a difference of leaves productivity between the two species of mulberry. The highest leaf production for M. canva (639.61 gr) was found at trimming of 45 cm, while for M. cathayana was found at trimming of 60 cm (482.40 gr)

تحضير ودراسات طيفية لمشتقات عقار الاتينولول ذات ذائبية متميزة في الليبيدات باعتبارها صيغ دوائية محتملة

Atenolol, a selective pi-adrenoceptor blocking agent is characterized by its low bioavailability. A number of atenolol prodrugs were synthesized to improve its lipid solubility and hence bioavailability. These compounds included an oxazolidine-2-thione derivative (II), a l,4-oxazine-2,3-dione derivative (III), and a series of oxazolidine derivatives (IVa-m). The structure of each compound was characterized by elemental analysis, infrared (IR), protonnuclear magnetic resonance ( H-NMR), and mass spectra (MS). The Spectroscopic results for these compounds are discussed.الأتينولول المستخدم انتقائيا لإيقاف مستقبلات الأدرينالين معروف بانخفاض معدل استيعابه المتاح بيولوجيا. وقد جرى في هذا البحث تحضير عدد من المشتقات والصيغ الى الدوائية لهذا العقار لغرض تحسين ذائبيته في الليبيدات وبالتالي يرتفع معدل إتاحته بيولوجيا تتضمن هذه المشتقات مركبات تحتوي أوكسازوليدين -2 ثيون ، ومركبات 1.4- أوكسازين – 2.3- دايون ، ومركبات من مشتقات ا لأوكسازوليدين . وقد تم التعرف على هذه المركبات من خلال تحليل العناصر وطيف الأشعة تحت الحمراء والرنين النووي المغناطيسي وطيف الكتلة، كذلك جرت مناقشة نتائج هذه التحاليل الطيفية من خلال هنا البحث