364 research outputs found

    Performance and patients’ satisfaction with the A7+TouchCare insulin patch pump system: A randomized controlled non-inferiority study

    No full text
    Background We assessed the performance and patient satisfaction of a new insulin patch pump, the A7+TouchCare (Medtrum), compared with the Omnipod system. Methods This multicenter, randomized, open-label, controlled study enrolled 100 adult patients with type 1 or type 2 diabetes mellitus (A1C ≥ 6.5% and ≤ 9.5%, i.e., 48 to 80 mmol/mol) who were assigned with the Omnipod or with the A7+TouchCare pump for 3 months. The primary study outcome was the glucose management indicator (GMI) calculated with continuous glucose monitoring (CGM). Results Premature withdrawals occurs respectively in 2 and 9 participants in the Omnipod and TouchCare groups. In the Per Protocol analysis, the difference in GMI between groups was 0.002% (95% confidence interval -0.251; 0.255). The non-inferiority was demonstrated since the difference between treatments did not overlap the pre-defined non-inferiority margin (0.4%). There was no significant difference in CGM parameters between groups. On average, patients in both groups were satisfied/very satisfied with the insulin pump system. Patients preferred Omnipod as an insulin management system and especially the patch delivery system but preferred the A7+TouchCare personal diabetes manager to control the system. Conclusions This study showed that the A7+TouchCare insulin pump was as efficient as the Omnipod pump in terms of performance and satisfaction. Clinical trail registration The study was registered in the ClinicalTrials.gov protocol register (NCT04223973)

    Gene expression signature predicts rate of type 1 diabetes progressionResearch in context

    No full text
    Summary: Background: Type 1 diabetes is a complex heterogenous autoimmune disease without therapeutic interventions available to prevent or reverse the disease. This study aimed to identify transcriptional changes associated with the disease progression in patients with recent-onset type 1 diabetes. Methods: Whole-blood samples were collected as part of the INNODIA study at baseline and 12 months after diagnosis of type 1 diabetes. We used linear mixed-effects modelling on RNA-seq data to identify genes associated with age, sex, or disease progression. Cell-type proportions were estimated from the RNA-seq data using computational deconvolution. Associations to clinical variables were estimated using Pearson's or point-biserial correlation for continuous and dichotomous variables, respectively, using only complete pairs of observations. Findings: We found that genes and pathways related to innate immunity were downregulated during the first year after diagnosis. Significant associations of the gene expression changes were found with ZnT8A autoantibody positivity. Rate of change in the expression of 16 genes between baseline and 12 months was found to predict the decline in C-peptide at 24 months. Interestingly and consistent with earlier reports, increased B cell levels and decreased neutrophil levels were associated with the rapid progression. Interpretation: There is considerable individual variation in the rate of progression from appearance of type 1 diabetes-specific autoantibodies to clinical disease. Patient stratification and prediction of disease progression can help in developing more personalised therapeutic strategies for different disease endotypes. Funding: A full list of funding bodies can be found under Acknowledgments

    My future-self has (not) quit smoking: an experimental study into the effect of a future-self intervention on smoking-related self-identity constructs

    Get PDF
    Objectives: Envisioning one's (non)smoking future may make (un)desired future identities more accessible, salient, and personally relevant and facilitate smoking cessation. The current study assessed whether a future-self intervention can weaken smoker self-identity and expected identity loss when quitting smoking, and strengthen quitter-and nonsmoker self-identity, while accounting for personal factors-socioeconomic position, nicotine dependence, consideration of future consequences, and clarity of the envisioned future-self. Additionally, it examined the association between smoking-related identity and quitting intention and behavior. Methods: This longitudinal online experimental study randomized 233 adult smokers to an intervention condition (where they completed mental imagery, visual, and verbal tasks about a future (non)smoking self), or to a passive control condition. Smoker-, quitter-, nonsmoker self-identity and identity loss were measured post-intervention and after one-and three-months. Quit intention and attempts were measured at baseline and after one month. Results: There was a consistent increase in non-smoker self-identity, and decrease in smoker self-identity and identity loss over a period of six months for all participants, but no significant difference in smoking-related identity between the intervention and control group. While personal factors did not moderate the effect of the intervention, we found that smoking-related identity constructs do vary with nicotine dependence, consideration of future consequences, and clarity of the envisioned future-self. Quitting behavior is primarily associated with non-smoker self-identity. Conclusions: Although the future-self intervention did not significantly influence smoking-related identity or behavior, identity-in particular, non-smoker self-identity-is important to consider in smoking cessation in-terventions. More research is needed to find effective operationalizations for identity-based interventions in the context of smoking

    Feasibility of generating structured motivational messages for tailored physical activity coaching

    No full text
    Tailored motivational messages are helpful to motivate people in eHealth applications for increasing physical activity, but it is not sufficiently clear how such messages can be effectively generated in advance. We, therefore, put forward a theory-driven approach to generating tailored motivational messages for eHealth applications for behavior change, and we examine its feasibility by assessing how motivating the resulting messages are perceived. For this, we designed motivational messages with a specific structure that was based on an adaptation of an existing ontology for tailoring motivational messages in the context of physical activity. To obtain tailored messages, experts in health psychology and coaching successfully wrote messages with this structure for personas in scenarios that differed with regard to the persona’s mood, self-efficacy, and progress. Based on an experiment in which 60 participants each rated the perceived motivational impact of six generic and six tailored messages based on scenarios, we found credible support for our hypothesis that messages tailored to mood, self-efficacy, and progress are perceived as more motivating. A thematic analysis of people’s free-text responses about what they found motivating and demotivating about motivational messages further supports the use of tailored messages, as well as messages that are encouraging and empathetic, give feedback about people’s progress, and mention the benefits of physical activity. To aid future work on motivational messages, we make our motivational messages and corresponding scenarios publicly available.Interactive Intelligenc

    The Oligostilbene Gnetin H Is a Novel Glycolysis Inhibitor That Regulates Thioredoxin Interacting Protein Expression and Synergizes with OXPHOS Inhibitor in Cancer Cells

    No full text
    Since aerobic glycolysis was first observed in tumors almost a century ago by Otto Warburg, the field of cancer cell metabolism has sparked the interest of scientists around the world as it might offer new avenues of treatment for malignant cells. Our current study claims the discovery of gnetin H (GH) as a novel glycolysis inhibitor that can decrease metabolic activity and lactic acid synthesis and displays a strong cytostatic effect in melanoma and glioblastoma cells. Compared to most of the other glycolysis inhibitors used in combination with the complex-1 mitochondrial inhibitor phenformin (Phen), GH more potently inhibited cell growth. RNA-Seq with the T98G glioblastoma cell line treated with GH showed more than an 80-fold reduction in thioredoxin interacting protein (TXNIP) expression, indicating that GH has a direct effect on regulating a key gene involved in the homeostasis of cellular glucose. GH in combination with phenformin also substantially enhances the levels of p-AMPK, a marker of metabolic catastrophe. These findings suggest that the concurrent use of the glycolytic inhibitor GH with a complex-1 mitochondrial inhibitor could be used as a powerful tool for inducing metabolic catastrophe in cancer cells and reducing their growth

    Lessons learnt in developing a virtual coach for smoking cessation and physical activity promotion

    No full text
    Background: Smoking and physical inactivity are two key preventable risk factors of cardiovascular disease. Yet, as with most health behaviors, they are difficult to change. In the interdisciplinary Perfect Fit project, scientists from different fields join forces to develop an evidence-based virtual coach that supports smokers in quitting smoking and increasing their physical activity. Intervention content, design and implementation as well as lessons learnt are presented in the hopes of guiding other research groups working on similar projects.Methods: Numerous approaches were used and combined to support the development of the Perfect Fit virtual coach. Approaches include literature reviews, empirical studies, collaboration with end-users, content and technical development sprints, interdisciplinary collaboration and iterative proof-of-concept implementation. Findings: The Perfect Fit intervention integrates evidence-based behavioral change techniques as well as new techniques focused on identity change, big data science, sensor technology and personalized real-time coaching. Intervention content of the virtual coaching matches communication preferences and individual needs of end users. Lessons learnt include ways to optimally implement and tailor interactions from the virtual coach (e.g., ‘explain why user is asked for input’, ‘tailor timing and frequency of intervention components’). With regards to the development process, lessons learnt include strategies for effective interdisciplinary collaboration and technical development (e.g., ‘Find a good balance between wishes of end-users and legal possibilities’).Discussion: The Perfect Fit development process was interactive, iterative and challenging at times. We hopethat our experiences and lessons learnt can inspire and benefit others.Interactive Intelligenc

    Analyse d’ouvrage :

    No full text

    Performance and patients' satisfaction with the A7+TouchCare insulin patch pump system: A randomized controlled non-inferiority study.

    No full text
    BackgroundWe assessed the performance and patient satisfaction of a new insulin patch pump, the A7+TouchCare (Medtrum), compared with the Omnipod system.MethodsThis multicenter, randomized, open-label, controlled study enrolled 100 adult patients with type 1 or type 2 diabetes mellitus (A1C ≥ 6.5% and ≤ 9.5%, i.e., 48 to 80 mmol/mol) who were assigned with the Omnipod or with the A7+TouchCare pump for 3 months. The primary study outcome was the glucose management indicator (GMI) calculated with continuous glucose monitoring (CGM).ResultsPremature withdrawals occurs respectively in 2 and 9 participants in the Omnipod and TouchCare groups. In the Per Protocol analysis, the difference in GMI between groups was 0.002% (95% confidence interval -0.251; 0.255). The non-inferiority was demonstrated since the difference between treatments did not overlap the pre-defined non-inferiority margin (0.4%). There was no significant difference in CGM parameters between groups. On average, patients in both groups were satisfied/very satisfied with the insulin pump system. Patients preferred Omnipod as an insulin management system and especially the patch delivery system but preferred the A7+TouchCare personal diabetes manager to control the system.ConclusionsThis study showed that the A7+TouchCare insulin pump was as efficient as the Omnipod pump in terms of performance and satisfaction.Clinical trail registrationThe study was registered in the ClinicalTrials.gov protocol register (NCT04223973)

    Prévention des risques liés à un usage inapproprié/consommation inutile des médicaments

    No full text
    Le mésusage est défini dans le Code de santé publique comme une utilisation intentionnelle et inappropriée d’un médicament ou d’un produit, non conforme à l’autorisation de mise sur le marché ou à l’enregistrement ainsi qu’aux recommandations de bonnes pratiques. On retrouve un acteur ou plus souvent l’interaction de plusieurs acteurs parmi lesquels le patient, ses aidants, le ou les prescripteurs et le ou les dispensateurs. Le mésusage est fréquent, il est source d’effets indésirables médicamenteux dont une partie importante est évitable. Des médicaments initialement prescrits ou dispensés dans le cadre de leur autorisation de mise sur le marché (AMM) peuvent également faire l’objet de dépendance primaire et de détournement. Les entreprises qui exploitent un médicament sur le territoire national déclarent auprès de l’ANSM et mettent en place des mesures pour limiter l’usage non conforme de leurs produits. Récemment, le contexte de la pandémie coronavirus-19 (COVID-19) a mis en lumière l’influence et l’impact sociétal du mésusage médicamenteux. Le constat de l’existence d’un mésusage systémique, de l’impossibilité de proposer des solutions simplistes nous amène à proposer deux principaux axes d’amélioration de l’information et de la formation des usagers et des professionnels de santé sur les médicaments dans le cadre d’interventions multi-facettes : la prévention du mésusage, d’une part, son identification et sa prise en charge, d’autre part
    • …
    corecore