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

The 4q25 variant rs13143308T links risk of atrial fibrillation to defective calcium homoeostasis

Aims: Single nucleotide polymorphisms on chromosome 4q25 have been associated with risk of atrial fibrillation (AF) but the exiguous knowledge of the mechanistic links between these risk variants and underlying electrophysiological alterations hampers their clinical utility. Here, we tested the hypothesis that 4q25 risk variants cause alterations in the intracellular calcium homoeostasis that predispose to spontaneous electrical activity. Methods and results: Western blotting, confocal calcium imaging, and patch-clamp techniques were used to identify mechanisms linking the 4q25 risk variants rs2200733T and rs13143308T to defects in the calcium homoeostasis in human atrial myocytes. Our findings revealed that the rs13143308T variant was more frequent in patients with AF and that myocytes from carriers of this variant had a significantly higher density of calcium sparks (14.1¿±¿4.5 vs. 3.1¿±¿1.3 events/min, P¿=¿0.02), frequency of transient inward currents (ITI) (1.33¿±¿0.24 vs. 0.26¿±¿0.09 events/min, P¿<¿0.001) and incidence of spontaneous membrane depolarizations (1.22¿±¿0.26 vs. 0.56¿±¿0.17 events/min, P¿=¿0.001) than myocytes from patients with the normal rs13143308G variant. These alterations were linked to higher sarcoplasmic reticulum calcium loading (10.2¿±¿1.4 vs. 7.3¿±¿0.5¿amol/pF, P¿=¿0.01), SERCA2 expression (1.37¿±¿0.13 fold, P¿=¿0.03), and RyR2 phosphorylation at ser2808 (0.67¿±¿0.08 vs. 0.47¿±¿0.03, P¿=¿0.01) but not at ser2814 (0.28¿±¿0.14 vs. 0.31¿±¿0.14, P¿=¿0.61) in patients carrying the rs13143308T risk variant. Furthermore, the presence of a risk variant or AF independently increased the ITI frequency and the increase in the ITI frequency observed in carriers of the risk variants was exacerbated in those with AF. By contrast, the presence of a risk variant did not affect the amplitude or properties of the L-type calcium current in patients with or without AF. Conclusions: Here, we identify the 4q25 variant rs13143308T as a genetic risk marker for AF, specifically associated with excessive calcium release and spontaneous electrical activity linked to increased SERCA2 expression and RyR2 phosphorylation.Peer ReviewedPostprint (author's final draft

Distribution of lesions in red and fallow deer naturally infected with Mycobacterium bovis

Wild deer have an important role in the epidemiology of bovine tuberculosis (bTB). The aims of this study were (1) to compare the pattern of lesions present in wild red (Cervus elaphus) and fallow (Dama dama) deer that were naturally infected with Mycobacterium bovis, and (2) to use this information to develop a sampling strategy for the isolation of M. bovis from the lymphoid tissues of the head of these animals. Culture of head lymphoid tissues demonstrated that 28 of 95 red deer and 22 of 100 fallow deer sampled were infected with M. bovis. Approx- imately 30% of each deer population had no gross lesions. Fallow deer were significantly more likely to have thoracic lesions than red deer. Lesions were observed in the retropharyngeal lymph nodes of 64% of the culture-positive red deer and 43% of the culture positive fallow deer. One third of the red deer, but none of the fallow deer, had well-encapsulated abscess lesions. There were no microscopical differences in the lesions in the lymph nodes of the red and fallow deer. Bacteriological culture from both the tonsil and retro- pharyngeal lymph nodes increased the rate of isolation of M. bovis by 22% over culture of the retropharyngeal lymph nodes alone in both species. These findings indicate that investigation of wild deer for bTB-compatible lesions should include examination of the medial retropharyngeal, left tracheobronchial, mediastinal, mesen- teric and ileocaecal lymph nodes. Sampling for bacteriological culture from head lymphoid tissues should be from the tonsil and the medial retropharyngeal lymph nodes. These protocols may prove useful in bTB surveil- lance and control in regions where wild deer contribute to the circulation of M. bovis.This study was funded by Consejería de Medio Ambiente, Junta de Andalucía. This is a contribution to CICYT – MEC research grant AGL2008-03875 and FEDER, and to EU grant TB-STEP 212414. Studies on diseases shared between domestic animals and wildlife are also supported by grants and contracts from INIA, Principado de Asturias, Castilla – La Mancha (GC-006), Ministerio de Medio Ambiente y Medio Rural y Marino (OAPN and SDGSPP), and Grupo Santander – Fundacion Marcelino Botin. MPM-H acknowledges a post doctoral contract from the Instituto de Salud Carlos III.Peer reviewe

Distribution of lesions in red and fallow deer naturally infected with Mycobacterium bovis

Wild deer have an important role in the epidemiology of bovine tuberculosis (bTB). The aims of this study were (1) to compare the pattern of lesions present in wild red (Cervus elaphus) and fallow (Dama dama) deer that were naturally infected with Mycobacterium bovis, and (2) to use this information to develop a sampling strategy for the isolation of M. bovis from the lymphoid tissues of the head of these animals. Culture of head lymphoid tissues demonstrated that 28 of 95 red deer and 22 of 100 fallow deer sampled were infected with M. bovis. Approx- imately 30% of each deer population had no gross lesions. Fallow deer were significantly more likely to have thoracic lesions than red deer. Lesions were observed in the retropharyngeal lymph nodes of 64% of the culture-positive red deer and 43% of the culture positive fallow deer. One third of the red deer, but none of the fallow deer, had well-encapsulated abscess lesions. There were no microscopical differences in the lesions in the lymph nodes of the red and fallow deer. Bacteriological culture from both the tonsil and retro- pharyngeal lymph nodes increased the rate of isolation of M. bovis by 22% over culture of the retropharyngeal lymph nodes alone in both species. These findings indicate that investigation of wild deer for bTB-compatible lesions should include examination of the medial retropharyngeal, left tracheobronchial, mediastinal, mesen- teric and ileocaecal lymph nodes. Sampling for bacteriological culture from head lymphoid tissues should be from the tonsil and the medial retropharyngeal lymph nodes. These protocols may prove useful in bTB surveil- lance and control in regions where wild deer contribute to the circulation of M. bovis.This study was funded by Consejería de Medio Ambiente, Junta de Andalucía. This is a contribution to CICYT – MEC research grant AGL2008-03875 and FEDER, and to EU grant TB-STEP 212414. Studies on diseases shared between domestic animals and wildlife are also supported by grants and contracts from INIA, Principado de Asturias, Castilla – La Mancha (GC-006), Ministerio de Medio Ambiente y Medio Rural y Marino (OAPN and SDGSPP), and Grupo Santander – Fundacion Marcelino Botin. MPM-H acknowledges a post doctoral contract from the Instituto de Salud Carlos III.Peer reviewe

Heart rate variability to assess ventilatory thresholds in professional basketball players

AbstractPurposeThe aim of this study was to determine if heart rate variability (HRV) during incremental test could be used to estimate ventilatory threshold (VT) in professional basketball players, with sufficient precision to be used in their training. Furthermore, the second aim was to analyse the association between HRV and three methods of VT determination by gas analysis.MethodsTwenty-four professional basketball players (age: 23.4 ± 4.9 years; height: 195.4 ± 9.8 cm; body mass: 92.2 ± 11.9 kg) performed an incremental running test to exhaustion. First ventilatory threshold (VT1) was determined by ventilatory equivalent (VE) and HRV and second ventilatory threshold (VT2) was determined by three methods of gases analysis (V-slope, VE and gas exchange ratio (R), and HRV). Pearson's coefficient (r) was used to detect differences between data and the strength of each relationship. The mean of absolute differences and Bland–Altman analysis were used to evaluate whether there was agreement.ResultsThe results showed no significant differences in HR and oxygen consumption (VO2) at VT1 between the two methods. Furthermore, no significant differences among the methods of gases analysis and HRV were observed in speed, HR, and VO2 at VT2. Moreover, VTs estimated using HRV and gas methods were significantly correlated. Correlation was higher between R and HRV (r = 0.96) and VE and HRV (r = 0.96) than V-slope and HRV (r = 0.90).ConclusionThese findings provide a practical, inexpensive approach for evaluating specific training loads when determining VT2 in basketball players. Therefore, HRV is an alternative method to determine VT2 without the application of expensive technology that limits its use to laboratories

Postoperative endometrial cancer treatments with electronic brachytherapy source

Purpose This study is a dosimetric and acute toxicity comparison of endometrial cancer patients treated with either Axxent (Xoft, Inc., San José, CA, USA) electronic and interstitial brachytherapy versus interstitial high dose rate brachytherapy (HDRBT). Materials and Methods Between 2015 and 2017, 94 patients with postoperative endometrial cancer were treated in our centre with the Axxent electronic brachytherapy (eBT) system. The V 150 and V 200 are evaluated prospectively for each plan. The mean age of patients was 65.9 years (age range 33-84 years), with different tumour staging. Of the 94 patients, 37 received exclusive adjuvant brachytherapy (25 Gy in five sessions); the remaining patients received external beam radiotherapy (EBRT) with a regimen of 23 sessions of 2 Gy each to the entire pelvis, followed by eBT (15 Gy in three sessions). Additionally, the absorbed doses received by the organs at risk (OAR), urinary bladder, rectum and sigmoid colon were compared with HDRBT plans, evaluating D 2cc, V 50% and V 35%. Median follow-up was done for each of the 94 patients to assess the toxicity of the treatment: vaginal mucosa toxicity, rectal and urinary toxicity; and results are presented for acute toxicity, toxicity at 1 month after the end of treatment and follow-up after 12 months for a portion of patients according to the Radiation Therapy Oncology Group (RTOG) toxicity criteria. Results The doses in OAR for eBT plans were lower than that for HDRBT plans, both Ir-192 and Co-60 plans, whose doses were similar. The dose in bladder with eBT was 63.8% of the prescribed dose for D 2cc versus 70.1% for HDRBT Ir-192, for V 50% was 7.2% versus 12.7% and for V 35% was 15.2% versus 28.2%. In rectum the D 2cc was 61.2% versus 68.4%, for V 50% was 7.9% versus 14.3% and for V 35% was 16.7% versus 32%. Results demonstrated lower doses to OAR in all eBT plans. Acute toxicity in eBT was very low in cases of mucositis, with only one case of toxicity greater than grade 1, rectal toxicity and urinary toxicity; results at 1 month are equally good, toxicity symptoms disappeared and no relapses have occurred to date. Conclusions The results of treatment with the Axxent eBT unit for 94 patients are very good, as no recurrence has been observed and the toxicity of the treatment is very low. The increase in V 150 and V 200 has not produced an increase in vaginal mucosa toxicity, and the doses in the OAR are lower than in the plans implemented for HDRBT with Ir-192 or Co-60. eBT is a good alternative to treat endometrial cancer in centres without conventional HDR availability. To date, there are limited published studies reporting on outcomes from patients treated with eBT

The Parkinson's disease-associated GPR37 receptor interacts with striatal adenosine A2A receptor controlling its cell surface expression and function in vivo

G protein-coupled receptor 37 (GPR37) is an orphan receptor associated to Parkinson's disease (PD) neuropathology. Here, we identified GPR37 as an inhibitor of adenosine A2A receptor (A2AR) cell surface expression and function in vivo. In addition, we showed that GPR37 and A2AR do oligomerize in the striatum. Thus, a close proximity of GPR37 and A2AR at the postsynaptic level of striatal synapses was observed by double-labelling post-embedding immunogold detection. Indeed, the direct receptor-receptor interaction was further substantiated by proximity ligation in situ assay. Interestingly, GPR37 deletion promoted striatal A2AR cell surface expression that correlated well with an increased A2AR agonist-mediated cAMP accumulation, both in primary striatal neurons and nerve terminals. Furthermore, GPR37−/− mice showed enhanced A2AR agonist-induced catalepsy and an increased response to A2AR antagonist-mediated locomotor activity. Overall, these results revealed a key role for GPR37 controlling A2AR biology in the striatum, which may be relevant for PD management

Relationship between erythemal UV and broadband solar irradiation at high altitude in Northwestern Argentina

An analysis of the broadband solar irradiation, IT, and the erythemal UV irradiation, IUVER, has been performed using the measurements made from 2013 to 2015 at three sites located at altitudes over 1000 m a.s.l. In Northwestern Argentina (Salta, El Rosal, and Tolar Grande). The main objective of this paper is to determine a relationship between IT and IUVER, which would allow to estimate IUVER from IT in places with few IUVER measurements available, and especially in those where is important to establish adequate photoprotection measures given their dense population and location at high altitude. The relationship between the daily values of IUVER and IT has been fitted to a linear regression (IUVER = m IT + n), showing good correlation in the three measurement sites (R2 ≥ 0.77). Besides, the IUVER/IT ratio shows an increase with altitude of 0.32 ± 0.03 units per km, indicating a more significant influence of altitude on IUVER than on IT. Total ozone column also attenuates more IUVER than IT. In order to reduce the local nature of the relationship between IUVER and IT, the clearness indices kT and kTUVER have been used to obtain a multivariable linear regression of kTUVER as a function of the solar zenith angle, θz, and kT, which shows good correlation (R2 ≥ 0.89) for the three measurement sites

Preferential oxidation of CO (CO-PROX) over CuOx/CeO2 coated microchannel reactor

The general aspects of the synthesis and characterization results of a CuOx/CeO2 catalyst were presented. In addition the principal steps for manufacturing a microchannel reactor and for the coating of the CuOx/CeO2 catalyst onto the microchannels walls, were also summarized. The catalytic activity of this microchannel reactor during the preferential oxidation of CO (CO-PROX) was evaluated employing a feed-stream that simulates a reformate off-gas after the WGS unit. Two activation atmospheres were studied (H2/N2 and O2/N 2). The reducing pretreatment improved the resistance to deactivation by formation of carbonaceous species over the catalyst surface at high temperatures. The presence of H2O and CO2 in the feed-stream was also analyzed indicating that the adsorption of CO2 inhibited the conversion of CO at lower temperatures because these compounds modified the active sites through the formation of carbonaceous species on the catalyst surface. Finally, the experimental results of the microreactor performance were compared with CFD simulations that were carried out using a kinetic for the CuOx/CeO2 powder catalyst. The experimental results were reasonably well described by the model, thus confirming its validity.Peer Reviewe

Tumores óseos de la pelvis

Se presenta la experiencia del Servicio de Ortopedia del Adulto del Hospital «Ramón y Cajal», en neoplasias de la pelvis, desde su creación hasta la actualidad, siendo 61 los pacientes recogidos y no se hace un trabajo estadístico, sino más bien se muestran las peculiaridades recogidas con la experiencia, que abarca desde la abstención en algunos casos de tumores secundarios, y el simple curetage hasta las grandes sustituciones con homoinjertos de banco, relacionándolo a su vez con publicaciones de aparición más o menos moderna sobre este tema, para concluir que se trata de una cirugía no exenta de complicaciones y problemas, pero necesaria a la hora de proporcionar a los enfermos curaciones, que le ofrezcan una salida a este difícil problema.The experience of Adult Orthopaedics Unit at the Hospital «Ramón y Cajal», Madrid, treating patients with malignant tumors of the pelvic bons is presented. In this paper, the results after surgery are not reported in terms of statistical analysis. The aún of this work is to comment the surgical experience covering from simple curettage to great bone replacement using bank allografts. The message is that surgical treatment of pelvic tumors is not exent of complications, but it seems to be worth in order to offer a better quality of Ufe for patients