Artificial neural network algorithm for online glucose prediction from continuous glucose monitoring.

Background and Aims: Continuous glucose monitoring (CGM) devices could be useful for real-time management of diabetes therapy. In particular, CGM information could be used in real time to predict future glucose levels in order to prevent hypo-/hyperglycemic events. This article proposes a new online method for predicting future glucose concentration levels from CGM data. Methods: The predictor is implemented with an artificial neural network model (NNM). The inputs of the NNM are the values provided by the CGM sensor during the preceding 20 min, while the output is the prediction of glucose concentration at the chosen prediction horizon (PH) time. The method performance is assessed using datasets from two different CGM systems (nine subjects using the Medtronic [Northridge, CA] Guardian® and six subjects using the Abbott [Abbott Park, IL] Navigator®). Three different PHs are used: 15, 30, and 45 min. The NNM accuracy has been estimated by using the root mean square error (RMSE) and prediction delay. Results: The RMSE is around 10, 18, and 27 mg/dL for 15, 30, and 45 min of PH, respectively. The prediction delay is around 4, 9, and 14 min for upward trends and 5, 15, and 26 min for downward trends, respectively. A comparison with a previously published technique, based on an autoregressive model (ARM), has been performed. The comparison shows that the proposed NNM is more accurate than the ARM, with no significant deterioration in the prediction delay

Effectiveness of an mHealth intervention combining a smartphone app and smart band on body composition in an overweight and obese population: Randomized controlled trial (EVIDENT 3 study)

Background: Mobile health (mHealth) is currently among the supporting elements that may contribute to an improvement in health markers by helping people adopt healthier lifestyles. mHealth interventions have been widely reported to achieve greater weight loss than other approaches, but their effect on body composition remains unclear. Objective: This study aimed to assess the short-term (3 months) effectiveness of a mobile app and a smart band for losing weight and changing body composition in sedentary Spanish adults who are overweight or obese. Methods: A randomized controlled, multicenter clinical trial was conducted involving the participation of 440 subjects from primary care centers, with 231 subjects in the intervention group (IG; counselling with smartphone app and smart band) and 209 in the control group (CG; counselling only). Both groups were counselled about healthy diet and physical activity. For the 3-month intervention period, the IG was trained to use a smartphone app that involved self-monitoring and tailored feedback, as well as a smart band that recorded daily physical activity (Mi Band 2, Xiaomi). Body composition was measured using the InBody 230 bioimpedance device (InBody Co., Ltd), and physical activity was measured using the International Physical Activity Questionnaire. Results: The mHealth intervention produced a greater loss of body weight (–1.97 kg, 95% CI –2.39 to –1.54) relative to standard counselling at 3 months (–1.13 kg, 95% CI –1.56 to –0.69). Comparing groups, the IG achieved a weight loss of 0.84 kg more than the CG at 3 months. The IG showed a decrease in body fat mass (BFM; –1.84 kg, 95% CI –2.48 to –1.20), percentage of body fat (PBF; –1.22%, 95% CI –1.82% to 0.62%), and BMI (–0.77 kg/m2, 95% CI –0.96 to 0.57). No significant changes were observed in any of these parameters in men; among women, there was a significant decrease in BMI in the IG compared with the CG. When subjects were grouped according to baseline BMI, the overweight group experienced a change in BFM of –1.18 kg (95% CI –2.30 to –0.06) and BMI of –0.47 kg/m2 (95% CI –0.80 to –0.13), whereas the obese group only experienced a change in BMI of –0.53 kg/m2 (95% CI –0.86 to –0.19). When the data were analyzed according to physical activity, the moderate-vigorous physical activity group showed significant changes in BFM of –1.03 kg (95% CI –1.74 to –0.33), PBF of –0.76% (95% CI –1.32% to –0.20%), and BMI of –0.5 kg/m2 (95% CI –0.83 to –0.19). Conclusions: The results from this multicenter, randomized controlled clinical trial study show that compared with standard counselling alone, adding a self-reported app and a smart band obtained beneficial results in terms of weight loss and a reduction in BFM and PBF in female subjects with a BMI less than 30 kg/m2 and a moderate-vigorous physical activity level. Nevertheless, further studies are needed to ensure that this profile benefits more than others from this intervention and to investigate modifications of this intervention to achieve a global effect

The NOMAD Experiment at the CERN SPS

The NOMAD experiment is a short base-line search for ν<sub>μ</sub> − ν<sub>τ</sub> oscillations in the CERN neutrino beam. The ν<sub>τ</sub>'s are searched for through their charged current interactions followed by the observation of the resulting τ− through its electronic, muonic or hadronic decays. These decays are recognized using kinematical criteria necessitating the use of a light target which enables the reconstruction of individual particles produced in the neutrino interactions. This paper describes the various components of the NOMAD detector: the target and muon drift chambers, the electromagnetic and hadronic calorimeters, the preshower and transition radiation detectors and the veto and trigger scintillation counters. The beam and data acquisition system are also described. The quality of the reconstruction and individual particles is demonstrated through the ability of NOMAD to observe K<sub>s</sub><sup>0</sup>'s, Λ<sup>0</sup>'s and π<sup>0</sup>'s. Finally, the observation of τ− through its electronic decay being one of the most promising channels in the search, the identification of electrons in NOMAD is discussed

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

The CARMENES search for exoplanets around M dwarfs. First visual-channel radial-velocity measurements and orbital parameter updates of seven M-dwarf planetary systems

Stars and planetary system

A proposed semantic framework for diabetes education content management, customisation and delivery within the M2DM project

M2DM (multi access services for telematic management of diabetes mellitus, http://www. labmedinfo.org/research/m2dm/m2dm.htm) is an EU-funded telemedicine project that aims at increasing the quality of diabetes care by improving communication between patients and caregivers. As part of this project, we have undertaken the initial work of describing the necessary requirements (framework) of an advanced educational component for M2DM in accordance with the latest Semantic Web concepts. This paper describes our proposed semantic framework for educational content management, customisation and delivery. A big internet challenge today is to find and push situation and user-specific quality knowledge to users based on their actual individual needs, circumstances and profiles at any given time. We believe that the semantic framework presented in this paper could be a good step towards meeting this challenge. Benefits for users, both developers and end users, of adopting such framework are also discussed. The ideas discussed in this paper could be easily adapted to other similar services besides M2DM and to different health topics besides diabetes mellitus

Management of patients with diabetes through information technology: tools for monitoring and control of the patients' metabolic behavior

The junction of telemedicine home monitoring with multifaceted disease management programs seems nowadays a promising direction to combine the need for an intensive approach to deal with diabetes and the pressure to contain the costs of the interventions. Several projects in the European Union and the United States are implementing information technology-based services for diabetes management using a comprehensive approach. Within these systems, the role of tools for data analysis and automatic reminder generation seems crucial to deal with the information overload that may result from large home monitoring programs. The objective of this study was to describe the automatic reminder generation system and the summary indicators used in a clinical center within the telemedicine project M2DM, funded by the European Commission, and to show their usage during a 7-month on-field testing period. METHODS: M2DM is a multi-access service for management of patients with diabetes. The basic functionality of the technical service includes a Web-based electronic medical record and messaging system, a computer telephony integration service, a smart-modem located at home, and a set of specialized software modules for automated data analysis. The information flow is regulated by a software scheduler, called the Organizer, that, on the basis of the knowledge on the health care organization, is able to automatically send e-mails and alerts notifications as well as to commit activities to software agents, such as data analysis. Thanks to this system, it was possible to define an automatic reminder system, which relies on a data analysis tool and on a number of technologies for communication. Within the M2DM system, we have also defined and implemented a number of indexes able to summarize the patients' day-by-day metabolic control. In particular, we have defined the global risk index (GRI) of developing microangiopathic complications. RESULTS: The system for generating automatic alarms and reminders coupled with the indexes for evaluating the patients' metabolic control has been used for 7 months at the Fondazione Salvatore Maugeri (FSM) in Pavia, Italy. Twenty-two patients (43 +/- 16 years old, 12 men and 10 women) have been involved; six dropped out from the study. The average number of monthly automatic messages was 29.44 +/- 9.83, i.e., about 1.8 messages per patient per month. The number of monthly alarm reminders generated by the system was 16.44 +/- 4.39, so that the number of alarms per patient was about 1. The number of messages sent by patients and physicians during the project was about 13 per month. The GRI analysis shows, during the last trimester, a slight improvement of the performance of the FSM clinic, with a decrease in the percentage of badly controlled values from 33% to 27%. Finally, we found the presence of a linear increasing correlation between the mean GRI values and the number of alarms generated by the system. CONCLUSIONS: A telemedicine system may incorporate features that make it a suitable technological backbone for implementing a disease management program. The availability of data analysis tools, automated messaging system, and summary indicators of the effectiveness of the health care program may help in defining efficient clinical interventions

Age and prolificacy at first lambing of rasa aragonesa ewe lambs carrying or not the FecXr alelle

Desde el descubrimiento en 2007 en la raza Rasa Aragonesa del polimorfismo prolífico Fecx" en el gen BMP15 (Jurado y Calvo, 2007; Martinez-Royo et al., 2008) el número de animales de este genotipo se ha incrementado de manera continua en las ganaderías. Actualmente el 58% (164/283) de los rebaños que forman parte del programa de selección por prolificidad de Unión de Productores de Rasa Aragonesa (UPRA-Grupo Pastores) tienen hembras portadoras heterocigotas (R+), contabilizándose en total 13.024 hembras de este genotipo. De estos, el 38% (63/164) tienen más de un 10% de ovejas R+ (Jurado y Jiménez, 2016). Esto se debe a los efectos demostrados de este polimorfismo sobre la prolificidad de las ovejas heterocigotas y su consecuente impacto positivo en la rentabilidad de las ganaderfas. Las ovejas heterocigotas presentan cambios importantes a nivel de sus follculos ováricos. En concreto, se ve afectada su sensibilidad a las gonadotropinas de manera que son capaces de ovular un mayor número de foliculos con un menor diámetro, y en algunas razas viene acompañado de alteraciones endocrinas relevantes (Fabre et al., 2006). Estos cambios podrfan afectar la entrada en pubertad de los animales. El objetivo del presente trabajo consiste en evaluar la edad al primer parto y la prolificidad de las corderas R+ y ++ en las ganaderlas a lo largo de los últimos 12 años.Since the discovery in 2007 of !he prolific Fecx" polymorphism in !he Rasa Aragonesa sheep breed, !he number of carrier ewes (R+) in farms has significantly increased. These ewes present changes in their ovarían follicles which could lead to endocrine alterations and might affect !he onset of puberty. The objective of !he present work was to evaluate !he age al first lambing (AFL) and !he prolificacy in farm conditions of R+ ewe lambs over !he las! 12 years. AFL was similar in R+ and non-carrier (++) ewes (601 vs_ 600 days), with similar effects of year and month of birth. As expected, prolificacy was higher in R+ comparad to++ ewe lambs (1.47 vs. 1-19; P<0.0001). Over !he studied period AFL significantly decreased and prolificacy significantly increased among years, which demonstrated !he improvements made by sorne farms which perform Al and work with prolific genotypes_ Prolificacy and AFL were related, so that a delay of 365 days in AFL give rise to an increase of 0.21 lambs/lambing ewe lamb, with no interaction with genotype. lt should be taken into account to reach equilibrium between desired age and prolificacy al first lambing.Financiado con fondos FEDER a través de POCTEFA (Proyecto PIRINNOVI EFA103/15) y CDTI (Proyecto IDl-20160426).Publishe