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Novel artificial pancreas controls blood sugar more than 24 hours

first_imgAn artificial pancreas system that closely mimics the body’s blood sugar control mechanism was able to maintain near-normal glucose levels without causing hypoglycemia in a small group of patients.The system, combining a blood glucose monitor and insulin pump technology with software that directs administration of insulin and the blood-sugar-raising hormone glucagon, was developed at Boston University (BU).The first clinical trial of the system was conducted by Harvard researchers at Massachusetts General Hospital (MGH) and confirmed the feasibility of an approach utilizing doses of both hormones. In their report, appearing in Science Translational Medicine, the researchers also found unexpectedly large differences in insulin absorption rates between study participants, differences they were able to account for by adjustments to the system.“This is the first study to test an artificial pancreas using both insulin and glucagon in people with type 1 diabetes. It showed that, by delivering both hormones in response to frequent blood sugar tests, it is possible to control blood sugar levels without hypoglycemia, even after high-carbohydrate meals,” says Steven Russell, a Harvard Medical School (HMS) instructor in medicine in the MGH Diabetes Unit, who co-led the research team with Edward Damiano of the BU Department of Biomedical Engineering.In type 1 diabetes, the insulin-producing beta cells of the pancreas are destroyed by the immune system, requiring insulin treatment to regulate blood sugar levels. Intensive glucose control involving frequent blood sugar testing and insulin administration can delay or prevent long-term complications – such as retinal damage, kidney failure, or cardiovascular disease – but is extremely demanding and difficult to maintain. Continuous glucose monitors and insulin pumps can help, but patients remain at risk for hypoglycemia, a potentially life-threatening drop in blood sugar caused by too much insulin.Because any administration of insulin, even by an artificial pancreas system, has been associated with the risk of hypoglycemia, BU investigators Damiano and lead author Firas El-Khatib developed a system that both accounts for the rate of insulin absorption and also incorporates glucagon, a hormone naturally released by the pancreas to raise blood sugar levels. While the alpha cells of the pancreas that produce glucagon are not destroyed in people with type 1 diabetes, the cells no longer release glucagon in response to low blood sugar.“Large doses of glucagon are used as a rescue drug for people with severely low blood sugar,” explains Damiano. “Our system is designed to counteract moderate drops in blood sugar with minute doses of glucagon spread out throughout the day, just as the body does in people without diabetes.” In 2007 Damiano’s team tested the system in diabetic pigs, which led to FDA approval of the human trial.The current study enrolled 11 adults with type 1 diabetes and was primarily designed to test the software that controls the system. To get the most accurate glucose levels, the system used a monitor that directly reads blood sugar through a sensor placed into a vein instead of a continuous glucose monitor that takes readings under the skin.Participants’ blood sugar was controlled by the system for 27 hours, during which time they ate three standardized, high-carbohydrate meals and slept through the night at the hospital. While the system kept glucose levels close to the target range for six participants, five others experienced hypoglycemia significant enough that they needed a dose of orange juice to raise their blood sugar.Close analysis of participants’ blood-insulin levels revealed a nearly fourfold difference in the rate at which individuals absorbed and cleared the fast-acting insulin used in the study, with some rates of absorption being much slower than anticipated. Since the controlling software determined dosage based on the expected rate of insulin absorption, participants who absorbed at a slower rate received excessive doses, leading to hypoglycemia.A test of participants’ response to a single insulin injection verified that some had consistently slow and some consistently fast rates of insulin absorption. Rates of absorption also varied too much from experiment to experiment, even on an individual basis, to allow participant-specific dosage calculations.After globally adjusting the software parameters to a slower insulin absorption rate, the researchers conducted repeat experiments in the same participants. This time none of the slow-absorption participants experienced hypoglycemia significant enough to require intervention. Blood-sugar levels were only slightly higher in repeat experiments involving participants with fast insulin absorption, showing that the adjusted software parameters were effective for all study participants and may be adequate for everyone with type 1 diabetes.The elimination of episodes of hypoglycemia in repeat experiments involving the same participants affirmed that the initial mismatch between parameter settings and insulin absorption rate had been the cause of the hypoglycemia. All previous reported studies of artificial pancreas systems have included episodes of hypoglycemia, but this is the first study to confirm and address the cause of that hypoglycemia.Later this spring the researchers will begin a follow-up study with a system using the revised settings and driven by an FDA-approved continuous glucose monitor.  Those experiments will last more than 48 hours and include children as well as adults. The investigators also plan to compare the insulin/glucagon system with a version that uses only insulin. “The device we ultimately envision will be wearable and incorporate a glucose sensor inserted under the skin that communicates wirelessly with a pump about the size of a cell phone,” says Harvard’s Russel. “The pump would administer insulin and probably glucagon, and would contain a microchip that runs the control software.”Damiano, whose 11-year-old son was diagnosed with type 1 diabetes at the age of 1, adds, “a system like this would replace the need for people to constantly check their blood sugar and to make treatment decisions every few hours. It would need to be maintained but could take over the decision-making process, closely emulating a functioning pancreas. It wouldn’t be a cure, but it has the potential to be the ultimate evolution of insulin therapy for type 1 diabetes.” Damiano is an associate professor of Biomedical Engineering at Boston University.The study was supported by grants from the Juvenile Diabetes Research Foundation, the Wallace H. Coulter Foundation, the Charlton Fund for Innovative Research in Diabetes and the National Center for Research Resources. Co-authors of the paper are David M. Nathan, MD, professor of medicine at HMS and director of the MGH Diabetes Center, and Robert Sutherlin, RN, also of the MGH Diabetes Center.last_img read more

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Trials for a global university

first_imgThe Trump administration’s executive order banning refugees and immigrants from seven majority Muslim nations from entering the United States for at least several months has stirred a hornet’s nest of concern internationally, including at Harvard, as a global university.Harvard President Drew Faust, along with deans from across the University’s professional Schools, issued strong statements over the weekend supporting international students and faculty. Echoing a turbulent response to the policy across much of the nation, some Harvard students, faculty, and staff organized demonstrations and campus discussions in protest.Harvard officials have scheduled a town hall session on the travel issue for Wednesday at 4 p.m. in Science Center B. Also, members of the Harvard  Immigration and Refugee Clinic program at the Law School will address a noon town hall at the School, in a location to be determined.At least two Harvard affiliates have been barred from entering the United States.Faust sent a letter to the Harvard community on Sunday afternoon, underscoring the University’s ongoing commitment to internationalism, and the pivotal role that the presence of scholars and students from other nations plays in helping Harvard and other American institutions to thrive.“It fuels the capacities of universities to spur innovation, to advance scholarship and scientific discovery, and to help address society’s hardest challenges,” Faust wrote.“In times of unsettling change, we look toward our deepest values and ideals. Among them is the recognition that drawing people together from across the nation and around the world is a paramount source of our University’s strength.”Her letter also highlighted Harvard’s support of the DREAM Act, an acronym for the Development, Relief, and Education for Alien Minors, and the immigration policy known as the Deferred Action for Childhood Arrivals, as well as the work being done by the Law School’s Immigration and Refugee Clinic program in support of undocumented students.She also unveiled a plan for Harvard to appoint a full-time Muslim chaplain. Under the plan, which was the result of months of internal discussion as well as a longtime goal of Muslim students and alumni, the search for a chaplain will be led by a University-wide committee of students, faculty, and staff chaired by Harvard Divinity School Professor Ousmane Kane.“I think it’s really very important and timely, particularly since the Muslim community and the students feel a great sense of marginalization or persecution with what is happening” nationally, said Kane, Prince Alwaleed Bin Talal Professor of Contemporary Islamic Religion and Society.Kane said the committee would seek someone who can support members of the Muslim community at Harvard and also enlighten the wider community about the Islamic faith. “To have that person as a staff member of the University shows its commitment to enlightening people about Islam,” said Kane, adding, “The fact that the president is establishing this position is a very strong statement.”Halah Ahmad, a Harvard senior and former president of the Harvard Islamic Society, said creating the new position was a welcome step.“We have felt for a long time that there is just a spiritual vacuum and lack of institutional support for Muslims at Harvard,” said Ahmad, adding that the new chaplain will help make the case “not just for the Muslim community but for the value of religious life on campus more broadly.”Jonathan Walton, Plummer Professor of Christian Morals and Pusey Minister in the Memorial Church, and a strong supporter of the new chaplaincy, said Muslim students at Harvard “bear a heavy burden of religious intolerance and ignorance. A full-time Muslim chaplain can serve as a steady and comforting presence, helping students to navigate the challenges of our current political climate at this formative juncture in their lives.”As the federal policy change took hold, the Harvard International Office reached out to all international scholars and students in the University community to help them understand the implications of the executive action as it rolled out, providing guidance and resources as needed. In addition, Harvard Global Support Services contacted all students and scholars in its travel registry to inform them about the policy’s implications.Across campus, as the School week began, Harvard scholars, faculty, students, and staff continued to react to Friday’s executive order. Anne T. and Robert M. Bass Professor of Government Michael Sandel, whose popular course “Justice” asks students to think through complicated moral dilemmas, said the new order undercuts long-held American values and could incite fear and uncertainty.“The cruelty of the executive order, its betrayal of American ideals, and the chaos and confusion it has sown have the world wondering: Is a great and generous democracy teetering toward tyranny? This, sadly, has become the central political question of our time,” said Sandel.Harvard’s deans stayed in touch with their communities. In a note to the Harvard Business School family, Dean Nitin Nohria, himself an immigrant, said he was distressed by the decision and was working with others “as best we can to understand the implications for our community of this new order.”“Harvard Business School, throughout its history, has welcomed students, faculty, and staff from every part of the world. We have thrived as a result of the international diversity of experiences, perspectives, and beliefs that come together in our classrooms and on our campus.”Harvard Medical School Dean George Q. Daley sent an email to his community that struck a similar tone and emphasized the importance of being able to bring scholars from around the world together to work on “advancing knowledge and improving lives.”“Collaboration among scholars from throughout the world contributes greatly to positive change in medicine, science, society, and humanity,” Daley wrote.“We will do all within our power to care for one another, to protect one another, and to make our values meaningful at this challenging time,” wrote Martha Minow, the Morgan and Helen Chu Dean of the Law School. “The reality and vitality of religious pluralism stands at the center of who we are at HDS,” wrote Dean David N. Hempton of the Divinity School, who is also an immigrant. “We are a strong community,” assured Dean James Ryan of the School of Education.“As you know, treating people differently based on their religion is antithetical to the values of the Kennedy School and the University, so this action worries me greatly,” wrote Dean Douglas Elmendorf of the Kennedy School. “We can and we must ensure that our School and the University continue to fight against bigotry and xenophobia in all their forms,” said Michelle Williams, dean of the Harvard T.H. Chan School of Public Health, and an immigrant.“Harvard’s diversity is our strength,” wrote Rakesh Khurana, the Danoff Dean of Harvard College, in an email to students, “just as the diversity of this nation is its strength.”  Mike Smith, Edgerley Family Dean of the Faculty of Arts and Sciences, said in his email that “In this moment of uncertainty, I write to reinforce a deep commitment to our unique community of scholars that comes to Cambridge from all over the world to pursue this mission with the shared goal of making the world a better place.” Dean Xiao-Li Meng of the Graduate School of Arts and Sciences (GSAS) wrote, “Thanks to the welcoming and nurturing culture I experienced both in America and at Harvard as an international GSAS student from China, I was able to grow from a narrowly trained college graduate to someone who has been honored with the responsibility of leading GSAS, the most international School at Harvard.”For their part, students gathered by the Harvard Square T stop on Friday afternoon in support of fellow members of the Harvard community. Some students also took part in a demonstration in Boston’s Copley Square on Sunday, and members of the Harvard College Iranian Association, the Harvard Islamic Society, the Society of Arab Students, and the Harvard Pakistan Student Association planned an evening of cultural and spoken-word performances for Monday evening to protest the order.Reacting to the ban, Ahmad, whose father is a Palestinian immigrant, said she fears what the order will mean for her family and friends. She added that the outpouring of support she has seen over the past few days is encouraging, but that more needs to be done.“We can’t just protest,” she said. “We need to take strategic action and use our skills and our positions and our writing and our art to communicate to people who think alike, and also to people who think differently.”Labeling the executive order “sweeping in its effects and cruel in its application,” Maggie Morgan, a fellow at the Immigration and Refugee Clinical Program, wrote in an email that it potentially violated “our obligations under the International Refugee Convention, and our domestic-asylum law.” Any refugees arriving on U.S. soil are entitled, she wrote, to “credible fear” interviews to determine whether they should be permitted to remain to apply for asylum.“To return refugees to their home countries where their lives are at risk is in clear violation of our treaty obligations, as well as our statutory law,” said Morgan. “It also places many lives at risk and prolongs suffering.”Members of the clinic have been providing legal assistance to refugees stuck at Logan International Airport and will be hosting information sessions and know-your-rights clinics, in addition to opposing the order on policy and legal grounds.last_img read more

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Roadwork coming to Brookville

first_imgBROOKVILLE, Ind. — Extensive roadwork is coming to Brookville.INDOT says that construction signs may be put in place this week for the $2,739,500 project that is expected to impact vehicular and pedestrian traffic on US52/Main Street.After signs are put in place, preparation operations are expected to begin.The contract calls for extensive roadbed repairs, pavement milling, and placement of new asphalt surface lifts.The contractor will also construct new sidewalks, curbs, and ADA-compliant curb ramps. Decorative street lighting will also be installed as part of the project.The completion date is currently scheduled for October 13.last_img

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Italian Serie A Returns on DStv, Debuts on GOtv

first_imgSpeaking after the signing of the agreement, Gideon Khobane, SuperSport Chief Executive, said: “We’ve always prided ourselves on offering viewers the best football from around the world and the return of Serie A to our screens fulfils our promise of an unrivalled football offering.”Gaetano Miccichè, President of Serie A, was similarly delighted, saying:: “We are very happy with this agreement as it will allow the SuperSport audience to follow all 380 matches of our league. We are certain that the passionate supporters from Sub-Saharan Africa will appreciate all the stars from Serie A.”Founded in 1898, and contested by 20 teams, the league is regarded as one of the best football leagues in the world and it is often touted as the most tactical national league. “MultiChoice Nigeria is excited to continue to bring customers the best international football. This is part of our ongoing commitment to bring more value to our customers.” says John Ugbe, Managing Director, MultiChoice Nigeria.SuperSport will exclusively broadcast all 380 Serie A matches.The 2017/18 season was exciting and uncertain until the end, thanks to the epic duel between Juventus and Napoli and is a sign of great things to come. The fight for the remaining UEFA Champions League berth was just as enthralling, the challenge between Lazio and Inter Milan settled only in the final minute of the last day of the campaign with Inter Milan ultimately returning to the elite European club competition.Share this:FacebookRedditTwitterPrintPinterestEmailWhatsAppSkypeLinkedInTumblrPocketTelegram One of Europe’s most prestigious football leagues, the Italian Serie A, will have its games return for live broadcast by SuperSport from the upcoming 2018/2019 season, which begins on 19 August.The matches will be broadcast on both DStv and GOtv. It is the first time ever that matches of the Italian league will be broadcast on GOtv.This is sequel to an agreement reached between SuperSport and Serie A.last_img read more

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BtoBet and Spinomenal become iGaming partners

first_imgShare BtoBet grows Nigerian presence with Booster99 deal August 26, 2020 Submit Share Related Articles BtoBet refines African SMS payment options with Tola Mobile  August 20, 2020 StumbleUpon BtoBet grows LatAm portfolio with GlobalBet deal August 12, 2020 Spinomenal, the cross platform games supplier, has become a partner of iGaming and sportsbook platform BtoBet, winners of Rising Star in Sports Betting Innovation at the SBC Awards 2017.Commenting on the partnership, Lior Shvartz, Spinomenal CEO, stated: “We constantly strive to reach the perfect balance of amazing graphics, fun game flow and easy access for worldwide clients. “Since its foundation, Spinomenal has created more than 85 original cross-platform games and we are just getting warmed up. “We are very excited about the integration with BtoBet and are always happy to work with such a responsive and professional team of experts who are able to make the process easy and fast”.Kostandina Zafirovska, BtoBet CEO, added: “Spinomenal has an interesting set of games and we’re enthusiastic about integrating their content onto BtoBet’s platform, ready for any regulated market. “I firmly believe the combination of Spinomenal’s games proposal and BtoBet’s platform will definitely provide operators with the possibility to elaborate unique offers, tailored for every single market, offering more than 3,000 exciting games. “Additionally, with our sophisticated recommendation engine, operators can suggest to players their preferred games, at the ideal time and on their preferred device.”This follows news that Editec has chosen BtoBet as the technological partner to drive its online brands towards sustained growth within Africa.The London headquartered firm, which already boasts a strong presence across several of the continents regions, operates under the Premier Bet, SBA, Guinee Games, and R&S Betting brands.last_img read more

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Shenhua face tough Asian Champions League

first_imgBut they have a fight on their hands in the group stage of Asia’s premier club competition against Antlers, finalists in the 2016 FIFA Club World Cup and Sydney.Two-time winners and Chinese Super League champions Guangzhou Evergrande will face South Korea’s Jeju United, Thailand’s Buriram United and the winner of Japan’s Emperor’s Cup, following the draw in the Malaysian capital Kuala Lumpur.2017 AFC Champions League winners Urawa Red Diamonds of Japan are not competing after failing to qualify.Runners-up Al-Hilal of Saudi Arabia face Iran’s Esteghlal and Qatar’s Al-Rayyan, as they make a fresh bid to end years of dominance by East Asian clubs.Meanwhile 2016 champions Jeonbuk Hyundai Motors of South Korea are set to return to the tournament after being barred last year due to a bribery scandal.The group stage runs from February to April with the West and East Asian teams kept apart until the final in November.Group A: Al Jazira (UAE), Al Ahli (KSA), Tractorsazi Tabriz (IRI), Winner of Playoff 3Group B: Al Duhail SC (QAT), Al Wahda (UAE), PFC Lokomotiv (UZB), Winner of Playoff 2Group C: Persepolis FC (IRI), Al Sadd SC (QAT), Al Wasl (UAE), Winner of Playoff 4Group D: Al Hilal SFC (KSA), Esteghlal FC (IRI), Al Rayyan SC (QAT), Winner of Playoff 1Group E: Jeonbuk Hyundai Motors FC (KOR), Kitchee SC (HKG), Winner of Play-off 4, Winner of Play-off 2Group F: Kawasaki Frontale (JPN), Ulsan Hyundai FC (KOR), Melbourne Victory (AUS), Winner of Playoff 3Group G: Guangzhou Evergrande FC (CHN), Japan 2nd Club, Jeju United FC (KOR), Buriram United (THA)Group H: Sydney FC (AUS), Shanghai Shenhua FC (CHN), Kashima Antlers (JPN), Winner of Playoff 10Shares0000(Visited 1 times, 1 visits today) 0Shares0000AFC National Team Competitions Director Shin Man Gil announcing the 2018 AFC Champions League draw © AFP / Manan VATSYAYANAKUALA LUMPUR, Malaysia, Dec 6 – Chinese FA Cup winners Shanghai Shenhua face a tough test in the 2018 Asian Champions League after being drawn Wednesday against top Japanese club Kashima Antlers and Australian A-League leaders Sydney FC.The Chinese side unexpectedly beat expensively assembled rivals Shanghai SIPG in last month’s FA Cup final, without Argentine forward Carlos Tevez whose future in China is in doubt after a poor run of form.last_img read more

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