Improving the clinical value and utility of CGM systems: issues and recommendations: a joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group

The first systems for continuous glucose monitoring (CGM) became available over 15 years ago. Many then believed CGM would revolutionize the use of intensive insulin therapy in diabetes; however, progress toward that vision has been gradual. Although increasing, the proportion of individuals using CGM rather than conventional systems for self-monitoring of blood glucose on a daily basis is still low in most parts of the world. Barriers to uptake include cost, measurement reliability (particularly with earlier-generation systems), human factors issues, lack of a standardized format for displaying results, and uncertainty on how best to use CGM data to make therapeutic decisions. This Scientific Statement makes recommendations for systemic improvements in clinical use and regulatory (pre- and postmarketing) handling of CGM devices. The aim is to improve safety and efficacy in order to support the advancement of the technology in achieving its potential to improve quality of life and health outcomes for more people with diabetes

Improving the clinical value and utility of CGM systems: issues and recommendations : a joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group

The first systems for continuous glucose monitoring (CGM) became available over 15 years ago. Many then believed CGM would revolutionise the use of intensive insulin therapy in diabetes; however, progress towards that vision has been gradual. Although increasing, the proportion of individuals using CGM rather than conventional systems for self-monitoring of blood glucose on a daily basis is still low in most parts of the world. Barriers to uptake include cost, measurement reliability (particularly with earlier-generation systems), human factors issues, lack of a standardised format for displaying results and uncertainty on how best to use CGM data to make therapeutic decisions. This scientific statement makes recommendations for systemic improvements in clinical use and regulatory (pre- and postmarketing) handling of CGM devices. The aim is to improve safety and efficacy in order to support the advancement of the technology in achieving its potential to improve quality of life and health outcomes for more people with diabetes

Diabetes Digital App Technology: Benefits, Challenges, and Recommendations. A Consensus Report by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group

Digital health technology, especially digital and health applications ("apps"), have been developing rapidly to help people manage their diabetes. Numerous health-related apps provided on smartphones and other wireless devices are available to support people with diabetes who need to adopt either lifestyle interventions or medication adjustments in response to glucose-monitoring data. However, regulations and guidelines have not caught up with the burgeoning field to standardize how mobile health apps are reviewed and monitored for patient safety and clinical validity. The available evidence on the safety and effectiveness of mobile health apps, especially for diabetes, remains limited. The European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) have therefore conducted a joint review of the current landscape of available diabetes digital health technology (only stand-alone diabetes apps, as opposed to those that are integral to a regulated medical device, such as insulin pumps, continuous glucose monitoring systems, and automated insulin delivery systems) and practices of regulatory authorities and organizations. We found that, across the U.S. and Europe, mobile apps intended to manage health and wellness are largely unregulated unless they meet the definition of medical devices for therapeutic and/or diagnostic purposes. International organizations, including the International Medical Device Regulators Forum and the World Health Organization, have made strides in classifying different types of digital health technology and integrating digital health technology into the field of medical devices. As the diabetes digital health field continues to develop and become more fully integrated into everyday life, we wish to ensure that it is based on the best evidence for safety and efficacy. As a result, we bring to light several issues that the diabetes community, including regulatory authorities, policy makers, professional organizations, researchers, people with diabetes, and health care professionals, needs to address to ensure that diabetes health technology can meet its full potential. These issues range from inadequate evidence on app accuracy and clinical validity to lack of training provision, poor interoperability and standardization, and insufficient data security. We conclude with a series of recommended actions to resolve some of these shortcomings

Fecal microbiota transplant rescues mice from human pathogen mediated sepsis by restoring systemic immunity.

Death due to sepsis remains a persistent threat to critically ill patients confined to the intensive care unit and is characterized by colonization with multi-drug-resistant healthcare-associated pathogens. Here we report that sepsis in mice caused by a defined four-member pathogen community isolated from a patient with lethal sepsis is associated with the systemic suppression of key elements of the host transcriptome required for pathogen clearance and decreased butyrate expression. More specifically, these pathogens directly suppress interferon regulatory factor 3. Fecal microbiota transplant (FMT) reverses the course of otherwise lethal sepsis by enhancing pathogen clearance via the restoration of host immunity in an interferon regulatory factor 3-dependent manner. This protective effect is linked to the expansion of butyrate-producing Bacteroidetes. Taken together these results suggest that fecal microbiota transplantation may be a treatment option in sepsis associated with immunosuppression

XMM-Newton survey of two Upper Scorpius regions

We study X-ray emission from young stars by analyzing deep XMM-Newton observations of two regions of the Upper Scorpius association, having an age of 5 Myr. Based on near infrared and optical photometry we identify 22 Upper Scorpius photometric members among the 224 detected X-ray sources. We derive coronal properties of Upper Scorpius stars by performing X-ray spectral and timing analysis. The study of four strong and isolated stellar flares allows us to derive the length of the flaring loops. Among the 22 Upper Scorpius stars, 13 are identified as Upper Scorpius photometric members for the first time. The sample includes 7 weak-line T Tauri stars and 1 classical T Tauri star, while the nature of the remaining sources is unknown. Except for the intermediate mass star HD 142578, all the detected USco sources are low mass stars of spectral type ranging from G to late M. The X-ray emission spectrum of the most intense Upper Scorpius sources indicates metal depleted plasma with temperature of ~10 MK, resembling the typical coronal emission of active main sequence stars. At least 59% of the detected members of the association have variable X-ray emission, and the flaring coronal structures appear shorter than or comparable to the stellar radii already at the Upper Scorpius age. We also find indication of increasing plasma metallicity (up to a factor 20) during strong flares. We identify a new galaxy cluster among the 224 X-ray source detected: the X-ray spectrum of its intra cluster medium indicates a redshift of 0.41+/-0.02.Comment: 27 pages, 15 postscript figures, accepted for publication in Astronomy and Astrophysics. A complete version of the paper, containing better qaulity figures and Appendices B & C, is available at http://www.astropa.unipa.it/Library/preprint.htm

Two-Loop Soft Corrections and Resummation of the Thrust Distribution in the Dijet Region

The thrust distribution in electron-positron annihilation is a classical precision QCD observable. Using renormalization group (RG) evolution in Laplace space, we perform the resummation of logarithmically enhanced corrections in the dijet limit, $T\to 1$ to next-to-next-to-leading logarithmic (NNLL) accuracy. We independently derive the two-loop soft function for the thrust distribution and extract an analytical expression for the NNLL resummation coefficient $g_3$. To combine the resummed expressions with the fixed-order results, we derive the $\log(R)$-matching and $R$-matching of the NNLL approximation to the fixed-order NNLO distribution.Comment: 50 pages, 12 figures, 1 table. Few minor changes. Version accepted for publication in JHE

D-wave charmonium production in B decays

The calculation of D-wave charmonium prodution rates in B meson deacys under the NRQCD factorization formalism is presented. We find that inclusion of the color-octet contributions permits us to detect the D-wave charmonium states in B decays at present experimental facilities. The same amount signals of 2^{--} D-wave state as that of \psi' could be observed at LEP and CESR. We also predict the relative production rates for four D-wave states are \delta^c:\delta^c_1: \delta^c_2:\delta^c_3=2.5:3:5:7, where \delta^c, \delta^c_1, \delta^c_2, \delta^c_3 represent respectively the 2^{-+}, 1^{--}, 2^{--}, 3^{--} states.Comment: 11 pages in LaTe

Towards subdiffraction imaging with wire array metamaterial hyperlenses at MIR frequencies

We describe the fabrication of metamaterial magnifying hyperlenses with subwavelength wire array structures for operation in the mid-infrared (around 3 µm). The metadevices are composed of approximately 500 tin wires embedded in soda-lime glass, where the metallic wires vary in diameter from 500 nm to 1.2 µm along the tapered structure. The modeling of the hyperlenses indicates that the expected overall losses for the high spatial frequency modes in such metadevices are between 20 dB to 45 dB, depending on the structural parameters selected, being promising candidates for far-field subdiffraction imaging in the mid-infrared. Initial far-field subdiffraction imaging attempts are described, and the problems encountered discussed

Photoswitchable diacylglycerols enable optical control of protein kinase C.

Increased levels of the second messenger lipid diacylglycerol (DAG) induce downstream signaling events including the translocation of C1-domain-containing proteins toward the plasma membrane. Here, we introduce three light-sensitive DAGs, termed PhoDAGs, which feature a photoswitchable acyl chain. The PhoDAGs are inactive in the dark and promote the translocation of proteins that feature C1 domains toward the plasma membrane upon a flash of UV-A light. This effect is quickly reversed after the termination of photostimulation or by irradiation with blue light, permitting the generation of oscillation patterns. Both protein kinase C and Munc13 can thus be put under optical control. PhoDAGs control vesicle release in excitable cells, such as mouse pancreatic islets and hippocampal neurons, and modulate synaptic transmission in Caenorhabditis elegans. As such, the PhoDAGs afford an unprecedented degree of spatiotemporal control and are broadly applicable tools to study DAG signaling