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  • 1
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    Online Resource
    Model-Based Closed-Loop Glucose Control in Type 1 Diabetes: The DiaCon Experience
    SAGE Publications ; 2013
    In:  Journal of Diabetes Science and Technology Vol. 7, No. 5 ( 2013-09), p. 1255-1264
    Details
    In: Journal of Diabetes Science and Technology, SAGE Publications, Vol. 7, No. 5 ( 2013-09), p. 1255-1264
    Abstract: To improve type 1 diabetes mellitus (T1DM) management, we developed a model predictive control (MPC) algorithm for closed-loop (CL) glucose control based on a linear second-order deterministic-stochastic model. The deterministic part of the model is specified by three patient-specific parameters: Insulin sensitivity factor, insulin action time, and basal insulin infusion rate. The stochastic part is identical for all patients but identified from data from a single patient. Results of the first clinical feasibility test of the algorithm are presented. Methods: We conducted two randomized crossover studies. Study 1 compared CL with open-loop (OL) control. Study 2 compared glucose control after CL initiation in the euglycemic (CL-Eu) and hyperglycemic (CL-Hyper) ranges, respectively. Patients were studied from 22:00–07:00 on two separate nights. Results: Each study included six T1DM patients (hemoglobin A1c 7.2% ± 0.4%). In study 1, hypoglycemic events (plasma glucose 〈 54 mg/dl) occurred on two OL and one CL nights. Average glucose from 22:00–07:00 was 90 mg/dl [74–146 mg/dl; median (interquartile range)] during OL and 108 mg/dl (101–128 mg/dl) during CL (determined by continuous glucose monitoring). However, median time spent in the range 70–144 mg/dl was 67.9% (3.0–73.3%) during OL and 80.8% (70.5–89.7%) during CL. In study 2, there was one episode of hypoglycemia with plasma glucose 〈 54 mg/dl in a CL-Eu night. Mean glucose from 22:00–07:00 and time spent in the range 70–144 mg/dl were 121 mg/dl (117–133 mg/dl) and 69.0% (30.7–77.9%) in CL-Eu and 149 mg/dl (140–193 mg/dl) and 48.2% (34.9–72.5%) in CL-Hyper, respectively. Conclusions: This study suggests that our novel MPC algorithm can safely and effectively control glucose overnight, also when CL control is initiated during hyperglycemia.
    Type of Medium: Online Resource
    ISSN: 1932-2968 , 1932-2968
    URL: Article
    DOI: 10.1177/193229681300700515
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2467312-2
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  • 2
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    Brain Nonoxidative Carbohydrate Consumption is Not Explained by Export of an Unknown Carbon Source: Evaluation of the Arterial and Jugular Venous Metabolome
    SAGE Publications ; 2010
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 30, No. 6 ( 2010-06), p. 1240-1246
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 30, No. 6 ( 2010-06), p. 1240-1246
    Abstract: Brain activation provokes nonoxidative carbohydrate consumption and during exercise it is dominated by the cerebral uptake of lactate resulting in that up to ∼1 mmol/ 100 g of glucose equivalents cannot be accounted for by cerebral oxygen uptake. The fate of this ‘extra’ carbohydrate uptake is unknown, but it may be that brain metabolism is balanced by a yet-unidentified substance(s). This study used a nuclear magnetic resonance-based metabolomics approach to plasma samples obtained from the brachial artery and the right internal jugular vein in 16 healthy young males to identify carbon species going to and from the brain. We observed a carbohydrate accumulation of 255±37 μmol/100 g glucose equivalents at exhaustion not accounted for by the oxygen uptake. Although the cumulated uptake was lower than earlier observed, the results show that glucose and lactate are responsible for the majority of the carbon exchange across the brain. Even during intense exercise associated with the largest nonoxidative carbohydrate consumption, the brain did not show significant release of any other metabolite. We conclude that during exercise, the surplus carbohydrate uptake by the brain cannot be accounted for by changes in the NMR-derived plasma metabolome across the brain.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1038/jcbfm.2010.25
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2039456-1
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  • 3
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    Can visual assessment of blood flow patterns by dynamic contrast-enhanced computed tomography distinguish between malignant and benign lung tumors?
    SAGE Publications ; 2017
    In:  Acta Radiologica Open Vol. 6, No. 5 ( 2017-05), p. 205846011771005-
    Details
    In: Acta Radiologica Open, SAGE Publications, Vol. 6, No. 5 ( 2017-05), p. 205846011771005-
    Abstract: Dynamic contrast-enhanced computed tomography (DCE-CT) is a tool, which, in theory, can quantify the blood flow and blood volume of tissues. In structured qualitative analysis, parametric color maps yield a visual impression of the blood flow and blood volume within the tissue being studied, allowing for quick identification of the areas with the highest or lowest blood flow and blood volume. Purpose To examine whether DCE-CT could be used to distinguish between malignant and benign lung tumors in patients with suspected lung cancer. Material and Methods Fifty-nine patients with suspected lung cancer and a lung tumor on their chest radiograph were included for DCE-CT. The tumors were categorized using structured qualitative analysis of tumor blood flow patterns. Histopathology was used as reference standard. Results Using structured qualitative analysis of tumor blood flow patterns, it was possible to distinguish between malignant and benign lung tumors (Fisher–Freeman–Halton exact test, P = 0.022). The inter-reader agreement of this method of analysis was slight to moderate (kappa = 0.30; 95% confidence interval [CI] = 0.13–0.46). Conclusion DCE-CT in suspected lung cancer using structured qualitative analysis of tumor blood flow patterns is accurate as well as somewhat reproducible. However, there are significant limitations to DCE-CT.
    Type of Medium: Online Resource
    ISSN: 2058-4601 , 2058-4601
    URL: Article
    DOI: 10.1177/2058460117710053
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2818429-4
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  • 4
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    High Glycogen Levels in the Hippocampus of Patients with Epilepsy
    SAGE Publications ; 2011
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 31, No. 2 ( 2011-02), p. 792-792
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 31, No. 2 ( 2011-02), p. 792-792
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1038/jcbfm.2010.196
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2039456-1
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  • 5
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    Online Resource
    Persistent Resetting of the Cerebral Oxygen/Glucose Uptake Ratio by Brain Activation: Evidence Obtained with the Kety—Schmidt Technique
    SAGE Publications ; 1995
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 15, No. 3 ( 1995-05), p. 485-491
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 15, No. 3 ( 1995-05), p. 485-491
    Abstract: Global cerebral blood flow (CBF), global cerebral metabolic rates for oxygen (CMRO 2 ), and for glucose (CMR glc ), and lactate efflux were measured during rest and during cerebral activation induced by the Wisconsin card sorting test. Measurements were performed in healthy volunteers using the Kety–Schmidt technique. Global CMRO 2 was unchanged during cerebral activation, whereas global CBF and global CMR glc both increased by 12%, reducing the molar ratio of oxygen to glucose consumption from 6.0 during baseline conditions to 5.4 during activation. Data obtained in the period following cerebral activation showed that the activation-induced resetting of the relation between CMR glc and CMRO 2 persisted virtually unaltered for ≥40 min after the mental activation task was terminated. The activation-induced increase in cerebral lactate efflux measured over the same time period accounted for only a small fraction of the activation-induced excess glucose uptake. These data confirm earlier reports that brain activation can induce resetting of the cerebral oxygen/glucose consumption ratio, and indicate that the resetting persists for a long period after cerebral activation has been terminated and physiologic stress indicators returned to baseline values. Activation-induced resetting of the cerebral oxygen/glucose uptake ratio is not necessarily accounted for by increased lactate production from nonoxidative glucose metabolism.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1038/jcbfm.1995.60
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1995
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  • 6
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    Megalin Is Predominantly Observed in Vesicular Structures in First and Third Trimester Cytotrophoblasts of the Human Placenta
    SAGE Publications ; 2016
    In:  Journal of Histochemistry & Cytochemistry Vol. 64, No. 12 ( 2016-12), p. 769-784
    Details
    In: Journal of Histochemistry & Cytochemistry, SAGE Publications, Vol. 64, No. 12 ( 2016-12), p. 769-784
    Abstract: The membrane receptor megalin is crucial for normal fetal development. Besides its expression in the developing fetus, megalin is also expressed in the human placenta. Similar to its established function in the kidney proximal tubules, placental megalin has been proposed to mediate uptake of vital nutrients. However, details of megalin expression, subcellular localization, and function in the human placenta remain to be established. By immunohistochemical analyses of first trimester and term human placenta, we showed that megalin is predominantly expressed in cytotrophoblasts, the highly proliferative cells in placenta. Only limited amounts of megalin could be detected in syncytiotrophoblasts and least in term placenta syncytiotrophoblasts. Immunocytochemical analyses furthermore showed that placental megalin associates with structures of the endolysosomal apparatus. Combined, our results clearly place placental megalin in the context of endocytosis and trafficking of ligands. However, due to the limited expression of megalin in syncytiotrophoblasts, especially in term placenta, it appears that the main role for placental megalin is not to mediate uptake of nutrients from the maternal bloodstream, as previously proposed. In contrast, our results point toward novel and complex functions for megalin in the cytotrophoblasts. Thus, we propose that the perception of placental megalin localization and function should be revised.
    Type of Medium: Online Resource
    ISSN: 0022-1554 , 1551-5044
    URL: Article
    DOI: 10.1369/0022155416672210
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 1421306-0
    SSG: 12
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  • 7
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    Increased Expression of the Collagen Internalization Receptor uPARAP/Endo180 in the Stroma of Head and Neck Cancer
    SAGE Publications ; 2007
    In:  Journal of Histochemistry & Cytochemistry Vol. 55, No. 4 ( 2007-04), p. 347-353
    Details
    In: Journal of Histochemistry & Cytochemistry, SAGE Publications, Vol. 55, No. 4 ( 2007-04), p. 347-353
    Abstract: Local growth, invasion, and metastasis of malignancies of the head and neck involve extensive degradation and remodeling of the underlying, collagen-rich connective tissue. Urokinase plasminogen activator receptor-associated protein (uPARAP)/Endo180 is an endocytic receptor recently shown to play a critical role in the uptake and intracellular degradation of collagen by mesenchymal cells. As a step toward determining the putative function of uPARAP/Endo180 in head and neck cancer progression, we used immunohistochemistry to determine the expression of this collagen internalization receptor in 112 human squamous cell carcinomas and 19 normal or tumor-adjacent head and neck tissue samples from the tongue, gingiva, cheek, tonsils, palate, floor of mouth, larynx, maxillary sinus, upper jaw, nasopharynx/nasal cavity, and lymph nodes. Specificity of detection was verified by staining of serial sections with two different monoclonal antibodies against two non-overlapping epitopes on uPARAP/Endo180 and by the use of isotype-matched non-immune antibodies. uPARAP/Endo180 expression was observed in stromal fibroblast-like, vimentin-positive cells. Furthermore, expression of the collagen internalization receptor was increased in tumor stroma compared with tumor-adjacent connective tissue or normal submucosal connective tissue and was most prominent in poorly differentiated tumors. These data suggest that uPARAP/Endo180 participates in the connective tissue destruction during head and neck squamous cell carcinoma progression by mediating cellular uptake and lysosomal degradation of collagen.
    Type of Medium: Online Resource
    ISSN: 0022-1554 , 1551-5044
    URL: Article
    DOI: 10.1369/jhc.6A7133.2006
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 1421306-0
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  • 8
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    Development of an individualized asynchronous sensor-based telerehabilitation program for patients undergoing total knee replacement: Participatory design
    SAGE Publications ; 2020
    In:  Health Informatics Journal Vol. 26, No. 4 ( 2020-12), p. 2492-2511
    Details
    In: Health Informatics Journal, SAGE Publications, Vol. 26, No. 4 ( 2020-12), p. 2492-2511
    Abstract: Telerehabilitation programs can be employed to establish communication between patients and healthcare professionals and empower patients performing their training remotely. This study aimed to identify patients’ requirements after a total knee replacement following a self-training rehabilitation program, leading to the design and development of a telerehabilitation program that can meet the stakeholders’ actual needs. System design, development, and testing were conducted in five iterations based on a participatory design approach. Data collection was performed using interviews, observations, prototyping, and questionnaires. It was found that the main barriers facing the existing rehabilitation program were a lack of clear communication, lack of relevant information, and healthcare professional’s feedback. The participants emphasized the main themes of communication, information, training, and motivation in the process of design and development. In using the telerehabilitation program, the patients reported a high level of user-friendliness, flexibility, and a sense of security. This study has identified obstacles in the current rehabilitation program and revealed the potential effectiveness of using asynchronous communication and sensor-based technologies by employing participatory design and development. A higher level of portability and flexibility were observed. However, future studies and development are required to investigate the overall usability and reliability of the telerehabilitation program.
    Type of Medium: Online Resource
    ISSN: 1460-4582 , 1741-2811
    URL: Article
    DOI: 10.1177/1460458220909779
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2070802-6
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  • 9
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    Online Resource
    Activation-Induced Resetting of Cerebral Oxygen and Glucose Uptake in the Rat
    SAGE Publications ; 1998
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 18, No. 7 ( 1998-07), p. 742-748
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 18, No. 7 ( 1998-07), p. 742-748
    Abstract: In the clinical setting it has been shown that activation will increase cerebral glucose uptake in excess of cerebral oxygen uptake. To study this phenomenon further, this study presents an experimental setup that enables precise determination of the ratio between cerebral uptake of glucose and oxygen in the awake rat. Global CBF was measured by the Kety-Schmidt technique, and the ratio between cerebral uptake rates for oxygen, glucose, and lactate was calculated from cerebral arterial—venous differences. During baseline conditions, rats were kept in a closed box designed to minimize interference. During baseline conditions CBF was 1.08 ± 0.25 mL·g −1 ·minute −1 , and the cerebral oxygen to glucose uptake ratio was 5.5. Activation was induced by opening the sheltering box for 6 minutes. Activation increased CBF to 1.81 mL·g −1 ·minute −1 . During activation cerebral glucose uptake increased disproportionately to cerebral oxygen uptake, and the cerebral oxygen to glucose uptake ratio was 4.2. The accumulated excess glucose uptake during 6 minutes of activation amounted to 2.4 μmol/g. Activation was terminated by closure of the sheltering box. In the postactivation period, the cerebral oxygen to glucose uptake ratio rose to a maximum of 6.4. This response is exactly opposite to the excess cerebral glucose uptake observed during activation.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1097/00004647-199807000-00005
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1998
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  • 10
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    Incorporation of a Poly-ε-Caprolactone Scaffold in a ;Circular Stapled End-To-End Small Intestine Anastomosis Does Not Have Any Adverse Effects Within 30 days: A Study in Piglets
    SAGE Publications ; 2021
    In:  Surgical Innovation Vol. 28, No. 6 ( 2021-12), p. 679-687
    Details
    In: Surgical Innovation, SAGE Publications, Vol. 28, No. 6 ( 2021-12), p. 679-687
    Abstract: Background . Incorporation of a poly-ε-caprolactone (PCL) scaffold in circular stapled anastomoses has been shown to increase the anastomotic tensile strength on postoperative day (POD) 5 in a pig model. The aim of this study was to investigate the effects of incorporation of a PCL scaffold in a circular stapled end-to-end small intestine anastomosis, with stricture formation and anastomotic histology as primary outcomes in a 30-day observation period. Methods . A total of 15 piglets were included. In each piglet, three circular stapled end-to-end anastomoses were made in the small intestines. Two were interventional and one was a control. On POD 10, 20, or 30, the anastomoses were subjected to in vivo intraluminal contrast study, and the index for anastomotic lumen was calculated. The anastomotic segment was resected and subjected to a tensile strength test and histological examination. Results . At POD 10, the mean ± SD value for anastomotic index was .749 ± .065 in control anastomoses and .637 ± .051 in interventional anastomosis ( P = .0046), at POD 20, .541 ± .150 and .724 ± .07 ( P = .051), and at POD 30, .645 ± .103 and .686 ± .057 ( P = .341), respectively. No significant difference was observed in maximum tensile strength and histology at POD 30. Conclusions . The incorporation of a PCL scaffold in a circular stapled end-to-end small intestine anastomosis does not increase the risk of stricture or impair wound healing after 30 days.
    Type of Medium: Online Resource
    ISSN: 1553-3506 , 1553-3514
    URL: Article
    DOI: 10.1177/1553350621999294
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2233576-6
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