296 results found
Rodriguez Manzano J, Moser N, Malpartida Cardenas K, et al., Rapid Detection of Mobilized Colistin Resistance using a Nucleic Acid Based Lab-on-a-Chip Diagnostic System, Scientific Reports, ISSN: 2045-2322
Moser N, Leong CL, Hu Y, et al., 2020, CMOS potentiometric FET array platform using sensor learning for multi-ion imaging., Analytical Chemistry, Vol: 92, Pages: 5276-5285, ISSN: 0003-2700
This work describes an array of 1024 Ion-Sensitive Field-Effect Transistors (ISFETs) using sensor learning techniques to perform multi-ion imaging for concurrent detection of potassium, sodium, calcium and hydrogen. Analyte specific ionophore membranes are deposited on the surface of the ISFET array chip, yielding pixels with quasi-Nernstian sensitivity to K+, Na+ or Ca2+. Uncoated pixels display pH sensitivity from the standard Si3N4 passivation layer. The platform is then trained by inducing a change in single ion concentration and measuring the responses of all pixels. Sensor learning relies on k-means clustering and DBSCAN to yield membrane mapping and sensitivity of each pixel to target electrolytes. We demonstrate multi-ion imaging with an average error of 3.7 % (K+), 4.6 % (Na+), and 1.8 % (pH) for each ion respectively, while Ca2+ incurs a larger error 24.2 % and hence is included to demonstrate versatility. We validate the platform with a brain dialysate fluid sample and demonstrate reading by comparing with a gold-standard spectrometry technique.
Rawson TM, Hernandez B, Moore L, et al., 2020, A real-world evaluation of a Case-Based Reasoning algorithm to support antimicrobial prescribing decisions in acute care, Clinical Infectious Diseases, ISSN: 1058-4838
BackgroundA locally developed Case-Based Reasoning (CBR) algorithm, designed to augment antimicrobial prescribing in secondary care was evaluated.MethodsPrescribing recommendations made by a CBR algorithm were compared to decisions made by physicians in clinical practice. Comparisons were examined in two patient populations. Firstly, in patients with confirmed Escherichia coli blood stream infections (‘E.coli patients’), and secondly in ward-based patients presenting with a range of potential infections (‘ward patients’). Prescribing recommendations were compared against the Antimicrobial Spectrum Index (ASI) and the WHO Essential Medicine List Access, Watch, Reserve (AWaRe) classification system. Appropriateness of a prescription was defined as the spectrum of the prescription covering the known, or most-likely organism antimicrobial sensitivity profile.ResultsIn total, 224 patients (145 E.coli patients and 79 ward patients) were included. Mean (SD) age was 66 (18) years with 108/224 (48%) female gender. The CBR recommendations were appropriate in 202/224 (90%) compared to 186/224 (83%) in practice (OR: 1.24 95%CI:0.392-3.936;p=0.71). CBR recommendations had a smaller ASI compared to practice with a median (range) of 6 (0-13) compared to 8 (0-12) (p<0.01). CBR recommendations were more likely to be classified as Access class antimicrobials compared to physicians’ prescriptions at 110/224 (49%) vs. 79/224 (35%) (OR: 1.77 95%CI:1.212-2.588 p<0.01). Results were similar for E.coli and ward patients on subgroup analysis.ConclusionsA CBR-driven decision support system provided appropriate recommendations within a narrower spectrum compared to current clinical practice. Future work must investigate the impact of this intervention on prescribing behaviours more broadly and patient outcomes.
Guemes Gonzalez A, Etienne Cummings R, Georgiou P, Closed-loop Bioelectronic Medicine for Diabetes Management, Bioelectronic Medicine (BioMed Central Publisher)
Kalofonou M, Malpartida-Cardenas K, Alexandrou G, et al., 2020, A novel hotspot specific isothermal amplification method for detection of thecommon PIK3CA p.H1047R breast cancer mutation, Scientific Reports, Vol: 10, ISSN: 2045-2322
Breast cancer (BC) is a common cancer in women worldwide. Despite advances in treatment, up to 30% of women eventually relapse and die of metastatic breast cancer. Liquid biopsy analysis of circulating cell-free DNA fragments in the patients’ blood can monitor clonality and evolving mutations as a surrogate for tumour biopsy. Next generation sequencing platforms and digital droplet PCR can be used to profile circulating tumour DNA from liquid biopsies; however, they are expensive and time consuming for clinical use. Here, we report a novel strategy with proof-of-concept data that supports the usage of loop-mediated isothermal amplification (LAMP) to detect PIK3CA c.3140 A > G (H1047R), a prevalent BC missense mutation that is attributed to BC tumour growth. Allele-specific primers were designed and optimized to detect the p.H1047R variant following the USS-sbLAMP method. The assay was developed with synthetic DNA templates and validated with DNA from two breast cancer cell-lines and two patient tumour tissue samples through a qPCR instrument and finally piloted on an ISFET enabled microchip. This work sets a foundation for BC mutational profiling on a Lab-on-Chip device, to help the early detection of patient relapse and to monitor efficacy of systemic therapies for personalised cancer patient management.
Moscardó V, Herrero P, Reddy M, et al., 2020, Assessment of Glucose Control Metrics by Discriminant Ratio., Diabetes Technol Ther
OBJECTIVE: Increasing use of continuous glucose monitoring data has created an array of glucose metrics for glucose variability, temporal patterns and times in ranges. However, a gold standard metric has not been defined. We assess the performance of multiple glucose metrics to determine their ability to detect intra- and inter-person variability in order to determine a set of recommended metrics. METHODS: The Juvenile Diabetes Research Foundation (JDRF) dataset, a randomized controlled study of continuous glucose monitoring and self-monitored blood glucose conducted in children and adults with type 1 diabetes was used. To determine the ability of the evaluated glycemic metrics to discriminate between different subjects and attenuate the effect of within-subject variation, the Discriminant Ratio was calculated and compared for each metric. Then, the findings were confirmed using data from two other recent randomized clinical trials. RESULTS: Mean Absolute Glucose (MAG) has the highest discriminant ratio value (2.98 [95% CI 1.64-3.67]). In addition, Low Blood Glucose Index (LBGI) and Index of Glycemic Control (IGC) performed well (1.93 [95% CI 1.15-3.44] and 1.92 [95% CI 1.27-2.93], respectively). For percentage times in glucose target ranges, the optimal discriminator was percentage time in glucose target 70-180 mg/dL. CONCLUSIONS: Mean Absolute Glucose (MAG) is the optimal index to differentiate glucose variability in people with type 1 diabetes, and may be a complementary therapeutic monitoring tool in addition to HbA1c and a measure of hypoglycemia. Percentage time in glucose target 70-180 mg/dL is the optimal percentage time in range to report.
Cacho-Soblechero M, Malpartida-Cardenas K, Cicatiello C, et al., 2020, A dual-sensing thermo-chemical ISFET array for DNA-based diagnostics., IEEE Transactions on Biomedical Circuits and Systems, ISSN: 1932-4545
This paper presents a 32x32 ISFET array with in-pixel dual-sensing and programmability targeted for on-chip DNA amplification detection. The pixel architecture provides thermal and chemical sensing by encoding temperature and ion activity in a single output PWM, modulating its frequency and its duty cycle respectively. Each pixel is composed of an ISFET-based differential linear OTA and a 2-stage sawtooth oscillator. The operating point and characteristic response of the pixel can be programmed, enabling trapped charge compensation and enhancing the versatility and adaptability of the architecture. Fabricated in 0.18 μm standard CMOS process, the system demonstrates a quadratic thermal response and a highly linear pH sensitivity, with a trapped charge compensation scheme able to calibrate 99.5% of the pixels in the target range, achieving a homogeneous response across the array. Furthermore, the sensing scheme is robust against process variations and can operate under various supply conditions. Finally, the architecture suitability for on-chip DNA amplification detection is proven by performing Loop-mediated Isothermal Amplification (LAMP) of phage lambda DNA, obtaining a time-to-positive of 7.71 minutes with results comparable to commercial qPCR instruments. This architecture represents the first in-pixel dual thermo-chemical sensing in ISFET arrays for Lab-on-a-Chip diagnostics.
Zeng J, Kuang L, Miscourides N, et al., 2020, A 128 × 128 current-mode ultra-high frame rate ISFET array with in-pixel calibration for real-time ion imaging., IEEE Transactions on Biomedical Circuits and Systems, Vol: 14, Pages: 359-372, ISSN: 1932-4545
An ultra-high frame rate and high resolution ion-sensing Lab-on-Chip platform using a 128x128 CMOS ISFETarray is presented. Current mode operation is employed to facilitate high-speed operation, with the ISFET sensors biased in the triode region to provide a linear response. Sensing pixels include a reset switch to allow in pixel-calibration for nonidealities such as offset, trapped charge and drift by periodically resetting the floating gate of the ISFET sensor. Current mode row-parallel signal processing is applied throughout the readout pipeline including auto-zeroing circuits for the removal of fixed pattern noise. The 128 readout signals are multiplexed to eight high-sample-rate on-chip current mode ADCs followed by an off-chip PCIe-based digital readout system on a FPGA with a latency of 0.15s. Designed in a 0.35 um CMOS process, the complete system-on-chip occupies an area of 2.6mm x 2.2mm and the whole system achieves a frame rate of 3000fps which is the highest reported in the literature. The platform is demonstrated for real-time ion-imaging through the high-speed visualisation of sodium hydroxide (NaOH) diffusion in water. Furthermore, the proposed platform is able to achieve real-time visualisation of ion dynamics on a screen at 60fps in addition to slow-motion replay in 3000fps.
Herrero P, Alalitei A, Reddy M, et al., 2020, Robust determination of the optimal continuous glucose monitoring length of intervention to evaluate long-term glycaemic control, 13th International Conference on Advanced Technologies & Treatments for Diabetes (ATTD 2020), Publisher: Mary Ann Liebert, Pages: A130-A130, ISSN: 1520-9156
Daniels J, Zhu T, Li K, et al., 2020, Arises: an advanced clinical decision support platform for the management of type 1 diabetes, The conference name (including place and date(s) of the conference): 13th International Conference on Advanced Technologies & Treatments for Diabetes (ATTD 2020), Publisher: Mary Ann Liebert, Pages: A57-A57, ISSN: 1520-9156
Zhu T, Li K, Uduku C, et al., 2020, PERSONALIZED MEAL INSULIN BOLUS FOR TYPE 1 DIABETES USING DEEP REINFORCEMENT LEARNING, Publisher: MARY ANN LIEBERT, INC, Pages: A115-A116, ISSN: 1520-9156
Spence R, Li K, Uduku C, et al., 2020, A NOVEL HAND-HELD INTERFACE SUPPORTING THE SELF-MANAGEMENT OF TYPE 1 DIABETES, Publisher: MARY ANN LIEBERT, INC, Pages: A58-A58, ISSN: 1520-9156
Guemes A, Wang Q, Bi S, et al., 2020, INVESTIGATING THE OPPORTUNITIES OF VAGUS NERVE STIMULATION FOR DIABETES: IMPACT OF STIMULATION FREQUENCY ON GLUCOSE HOMEOSTASIS, Publisher: MARY ANN LIEBERT, INC, Pages: A99-A99, ISSN: 1520-9156
Li K, Daniels J, Liu C, et al., 2020, Convolutional recurrent neural networks for glucose prediction, IEEE Journal of Biomedical and Health Informatics, Vol: 24, Pages: 603-613, ISSN: 2168-2194
Control of blood glucose is essential for diabetes management. Current digital therapeutic approaches for subjects with Type 1 diabetes mellitus (T1DM) such as the artificial pancreas and insulin bolus calculators leverage machine learning techniques for predicting subcutaneous glucose for improved control. Deep learning has recently been applied in healthcare and medical research to achieve state-of-the-art results in a range of tasks including disease diagnosis, and patient state prediction among others. In this work, we present a deep learning model that is capable of forecasting glucose levels with leading accuracy for simulated patient cases (RMSE = 9.38±0.71 [mg/dL] over a 30-minute horizon, RMSE = 18.87±2.25 [mg/dL] over a 60-minute horizon) and real patient cases (RMSE = 21.07±2.35 [mg/dL] for 30-minute, RMSE = 33.27±4.79\% for 60-minute). In addition, the model provides competitive performance in providing effective prediction horizon ( PHeff) with minimal time lag both in a simulated patient dataset ( PHeff = 29.0±0.7 for 30-min and PHeff = 49.8±2.9 for 60-min) and in a real patient dataset ( PHeff = 19.3±3.1 for 30-min and PHeff = 29.3±9.4 for 60-min). This approach is evaluated on a dataset of 10 simulated cases generated from the UVa/Padova simulator and a clinical dataset of 10 real cases each containing glucose readings, insulin bolus, and meal (carbohydrate) data. Performance of the recurrent convolutional neural network is benchmarked against four algorithms. The proposed algorithm is implemented on an Android mobile phone, with an execution time of 6ms on a phone compared to an execution time of 780ms on a laptop.
Liu C, Avari P, Leal Y, et al., 2020, A modular safety system for an insulin dose recommender: a feasibility study., Journal of Diabetes Science and Technology, Vol: 14, Pages: 87-96, ISSN: 1932-2968
BACKGROUND: Delivering insulin in type 1 diabetes is a challenging, and potentially risky, activity; hence the importance of including safety measures as part of any insulin dosing or recommender system. This work presents and clinically evaluates a modular safety system that is part of an intelligent insulin dose recommender platform developed within the EU-funded PEPPER project. METHODS: The proposed safety system is composed of four modules which use a novel glucose forecasting algorithm. These modules are predictive glucose alerts and alarms; a predictive low-glucose basal insulin suspension module; an advanced rescue carbohydrate recommender for resolving hypoglycemia; and a personalized safety constraint applied to insulin recommendations. The technical feasibility of the proposed safety system was evaluated in a pilot study including eight adult subjects with type 1 diabetes on multiple daily injections over a duration of six weeks. Glycemic control and safety system functioning were compared between the two-weeks run-in period and the end point at eight weeks. A standard insulin bolus calculator was employed to recommend insulin doses. RESULTS: Overall, glycemic control improved over the evaluated period. In particular, percentage time in the hypoglycemia range (<3.0 mmol/l) significantly decreased from 0.82% (0.05-4.79) at run-in to 0.33% (0.00-0.93) at endpoint ( P = .02). This was associated with a significant increase in percentage time in target range (3.9-10.0 mmol/l) from 52.8% (38.3-61.5) to 61.3% (47.5-71.7) ( P = .03). There was also a reduction in number of carbohydrate recommendations. CONCLUSION: A safety system for an insulin dose recommender has been proven to be a viable solution to reduce the number of adverse events associated to glucose control in type 1 diabetes.
Li K, Daniels J, Liu C, et al., 2020, Convolutional Recurrent Neural Networks for Glucose Prediction., IEEE J. Biomed. Health Informatics, Vol: 24, Pages: 603-613
Georgiou P, Moniri A, Moser N, et al., 2019, Devices and method for detecting an amplification event, WO2019234451A1
A method is disclosed herein for detecting an amplification reaction in a solution containing a biological sample using an array of ion sensors. The amplification reaction is indicative of the presence of a nucleic acid. The method comprises monitoring a signal from each respective sensor of the array of ion sensors, detecting a change in the signal from a first sensor of the array of ion sensors, and comparing the signal from the first sensor with the signal of at least one neighbouring sensor, the at least one neighbouring sensor being proximate to the first sensor in the array. The method further comprises determining, based on the comparing, that an amplification event has occurred in the solution in the vicinity of the first sensor.
Georgiou P, Moniri A, Rodriguez Manzano J, 2019, A method for analysis of real-time amplification data, WO2019234247A1
This disclosure relates to methods, systems, computer programs and computer- readable media for the multidimensional analysis of real-time amplification data. A framework is presented that shows that the benefits of standard curves extend beyond absolute quantification when observed in a multidimensional environment. Relating to the field of Machine Learning, the disclosed method combines multiple extracted features (e.g. linear features) in order to analyse real-time amplification data using a multidimensional view. The method involves two new concepts: the multidimensional standard curve and its 'home', the feature space. Together they expand the capabilities of standard curves, allowing for simultaneous absolute quantification, outlier detection and providing insights into amplification kinetics. The new methodology thus enables enhanced quantification of nucleic acids, single-channel multiplexing, outlier detection, characteristic patterns in the multidimensional space related to amplification kinetics and increased robustness for sample identification and quantification.
Georgiou P, Malpartida Cardenas K, Yu L-S, et al., 2019, Method for detecting a single nucleotide polymorphism (snp) using lamp and blocking primers, WO2019234251A1
The present application relates to methods for detecting a first allele of a single nucleotide polymorphism (SNP) in a nucleic acid sequence under isothermal conditions using primers specific for said first allele, in particular using Loop mediated isothermal amplification (LAMP), wherein the amplification of a second allele is prevented by using blocking primers.
Georgiou P, Yu L-S, Malpartida-Cardenas K, et al., 2019, Method for detecting a tandem repeat, WO2019234252A1
The present application relates to methods for detecting a tandem repeat in a nucleic acid sequence under isothermal conditions using primers.
Malpartida-Cardenas K, Miscourides N, Rodriguez-Manzano J, et al., 2019, Quantitative and rapid Plasmodium falciparum malaria diagnosis and artemisinin-resistance detection using a CMOS Lab-on-Chip platform, Biosensors and Bioelectronics, Vol: 145, ISSN: 0956-5663
Early and accurate diagnosis of malaria and drug-resistance is essential to effective disease management. Available rapid malaria diagnostic tests present limitations in analytical sensitivity, drug-resistance testing and/or quantification. Conversely, diagnostic methods based on nucleic acid amplification stepped forwards owing to their high sensitivity, specificity and robustness. Nevertheless, these methods commonly rely on optical measurements and complex instrumentation which limit their applicability in resource-poor, point-of-care settings. This paper reports the specific, quantitative and fully-electronic detection of Plasmodium falciparum, the predominant malaria-causing parasite worldwide, using a Lab-on-Chip platform developed in-house. Furthermore, we demonstrate on-chip detection of C580Y, the most prevalent single-nucleotide polymorphism associated to artemisinin-resistant malaria. Real-time non-optical DNA sensing is facilitated using Ion-Sensitive Field-Effect Transistors, fabricated in unmodified complementary metal-oxide-semiconductor (CMOS) technology, coupled with loop-mediated isothermal amplification. This work holds significant potential for the development of a fully portable and quantitative malaria diagnostic that can be used as a rapid point-of-care test.
Liu Y, Constandinou TG, Georgiou P, 2019, Ultrafast large-scale chemical sensing with CMOS ISFETs: a level-crossing time-domain approach, IEEE Transactions on Biomedical Circuits and Systems, Vol: 13, Pages: 1201-1213, ISSN: 1932-4545
The introduction of large-scale chemical sensing systems in CMOS which integrate millions of ISFET sensors have allowed applications such as DNA sequencing and fine-pixel chemical imaging systems to be realised. Using CMOS ISFETs provides advantages of digitisation directly at the sensor as well as correcting for non-linearity in its response. However, for this to be beneficial and scale, the readout circuits need to have the minimum possible footprint and power consumption. Within this context, this paper analyses an ISFET based pH-to-time readout using an inverter in the time-domain as a level-crossing detector and presents a 32×32 array with in-pixel digitisation for pH sensing. The inverter-based sensing pixel, controlled by a triangular waveform, converts the pH response into a time-domain signal whilst also compensating for sensor offset and thus resulting in an increase in dynamic range. The sensor pixels interface to a 15-bit asynchronous column-wise time-to-digital converter (TDC), enabling fast asynchronous conversion whilst using minimal silicon area. Parallel outputs of 32 TDC interfaces are serialised to achieve fast data throughput. This system is implemented in a standard 0.18um CMOS technology, with a pixel size of 26μm×26μm and a TDC area of 26μm×180μm. Measured results demonstrate the system is able to sense reliably with an average pH sensitivity of 30mVpH, whilst being able to compensate for sensor offset by up to ±7V. A resolution of 0.013pH is achieved and noise measurements show an integrated noise of 0.08pH within 2-500Hz and SFDR of 42.6dB. Total power consumption is 11.286mW.
© 2019 IEEE. This paper reviews the field of ISFET arrays for Lab-on-Chip applications from the early age of ISFET instrumentation to the current state-of-the-art. We provide an overview of the last decades of research by describing three eras which range from early steps in instrumentation to integration with autonomous Lab-on-Chip platforms for biochemical applications. We expect the future of ISFET arrays to be dictated by the new wave of detectable molecular targets, which will provide new specification to designers. Future papers are also likely to include more insights into integration of the sensing array with an end-to-end LoC platform.
Rawson TM, Gowers SAN, Freeman DME, et al., 2019, Microneedle biosensors for real-time, minimally invasive drug monitoring of phenoxymethylpenicillin: a first-in-human evaluation in healthy volunteers, The Lancet Digital Health, Vol: 1, Pages: e335-e343, ISSN: 2589-7500
BackgroundEnhanced methods of drug monitoring are required to support the individualisation of antibiotic dosing. We report the first-in-human evaluation of real-time phenoxymethylpenicillin monitoring using a minimally invasive microneedle-based β-lactam biosensor in healthy volunteers.MethodsThis first-in-human, proof-of-concept study was done at the National Institute of Health Research/Wellcome Trust Imperial Clinical Research Facility (Imperial College London, London, UK). The study was approved by London-Harrow Regional Ethics Committee. Volunteers were identified through emails sent to a healthy volunteer database from the Imperial College Clinical Research Facility. Volunteers, who had to be older than 18 years, were excluded if they had evidence of active infection, allergies to penicillin, were at high risk of skin infection, or presented with anaemia during screening. Participants wore a solid microneedle β-lactam biosensor for up to 6 h while being dosed at steady state with oral phenoxymethylpenicillin (five 500 mg doses every 6 h). On arrival at the study centre, two microneedle sensors were applied to the participant's forearm. Blood samples (via cannula, at −30, 0, 10, 20, 30, 45, 60, 90, 120, 150, 180, 210, 240 min) and extracellular fluid (ECF; via microdialysis, every 15 min) pharmacokinetic (PK) samples were taken during one dosing interval. Phenoxymethylpenicillin concentration data obtained from the microneedles were calibrated using locally estimated scatter plot smoothing and compared with free-blood and microdialysis (gold standard) data. Phenoxymethylpenicillin PK for each method was evaluated using non-compartmental analysis. Area under the concentration–time curve (AUC), maximum concentration, and time to maximum concentration were compared. Bias and limits of agreement were investigated with Bland–Altman plots. Microneedle biosensor limits of detection were estimated. The study was registered with ClinicalTria
Herrero P, El-Sharkawy M, Daniels J, et al., 2019, The bio-inspired artificial pancreas for type 1 diabetes control in the home: System architecture and preliminary results, Journal of Diabetes Science and Technology, Vol: 13, Pages: 1017-1025, ISSN: 1932-2968
BACKGROUND: Artificial pancreas (AP) technology has been proven to improve glucose and patient-centered outcomes for people with type 1 diabetes (T1D). Several approaches to implement the AP have been described, clinically evaluated, and in one case, commercialized. However, none of these approaches has shown a clear superiority with respect to others. In addition, several challenges still need to be solved before achieving a fully automated AP that fulfills the users' expectations. We have introduced the Bio-inspired Artificial Pancreas (BiAP), a hybrid adaptive closed-loop control system based on beta-cell physiology and implemented directly in hardware to provide an embedded low-power solution in a dedicated handheld device. In coordination with the closed-loop controller, the BiAP system incorporates a novel adaptive bolus calculator which aims at improving postprandial glycemic control. This paper focuses on the latest developments of the BiAP system for its utilization in the home environment. METHODS: The hardware and software architectures of the BiAP system designed to be used in the home environment are described. Then, the clinical trial design proposed to evaluate the BiAP system in an ambulatory setting is introduced. Finally, preliminary results corresponding to two participants enrolled in the trial are presented. RESULTS: Apart from minor technical issues, mainly due to wireless communications between devices, the BiAP system performed well (~88% of the time in closed-loop) during the clinical trials conducted so far. Preliminary results show that the BiAP system might achieve comparable glycemic outcomes to the existing AP systems (~73% time in target range 70-180 mg/dL). CONCLUSION: The BiAP system is a viable platform to conduct ambulatory clinical trials and a potential solution for people with T1D to control their glucose control in a home environment.
Liu C, Vehí J, Avari P, et al., 2019, Long-term glucose forecasting using a physiological model and deconvolution of the continuous glucose monitoring signal, Sensors, Vol: 19, Pages: 1-19, ISSN: 1424-8220
(1) Objective: Blood glucose forecasting in type 1 diabetes (T1D) management is a maturing field with numerous algorithms being published and a few of them having reached the commercialisation stage. However, accurate long-term glucose predictions (e.g., >60 min), which are usually needed in applications such as precision insulin dosing (e.g., an artificial pancreas), still remain a challenge. In this paper, we present a novel glucose forecasting algorithm that is well-suited for long-term prediction horizons. The proposed algorithm is currently being used as the core component of a modular safety system for an insulin dose recommender developed within the EU-funded PEPPER (Patient Empowerment through Predictive PERsonalised decision support) project. (2) Methods: The proposed blood glucose forecasting algorithm is based on a compartmental composite model of glucose–insulin dynamics, which uses a deconvolution technique applied to the continuous glucose monitoring (CGM) signal for state estimation. In addition to commonly employed inputs by glucose forecasting methods (i.e., CGM data, insulin, carbohydrates), the proposed algorithm allows the optional input of meal absorption information to enhance prediction accuracy. Clinical data corresponding to 10 adult subjects with T1D were used for evaluation purposes. In addition, in silico data obtained with a modified version of the UVa-Padova simulator was used to further evaluate the impact of accounting for meal absorption information on prediction accuracy. Finally, a comparison with two well-established glucose forecasting algorithms, the autoregressive exogenous (ARX) model and the latent variable-based statistical (LVX) model, was carried out. (3) Results: For prediction horizons beyond 60 min, the performance of the proposed physiological model-based (PM) algorithm is superior to that of the LVX and ARX algorithms. When comparing the performance of PM against the secondly ranked method (ARX) on a 120 min
Cacho-Soblechero M, Malpartida-Cardenas K, Moser N, et al., 2019, Programmable Ion-Sensing Using Oscillator-Based ISFET Architectures, IEEE SENSORS JOURNAL, Vol: 19, Pages: 8563-8575, ISSN: 1530-437X
Guemes A, Cappon G, Hernandez B, et al., 2019, Predicting quality of overnight glycaemic control in type 1 diabetes using binary classifiers, IEEE Journal of Biomedical and Health Informatics, ISSN: 2168-2194
In type 1 diabetes management, maintaining nocturnal blood glucose within target range can be challenging. Although semi-automatic systems to modulate insulin pump delivery, such as low-glucose insulin suspension and the artificial pancreas, are starting to become a reality, their elevated cost and performance below user expectations is hindering their adoption. Hence, a decision support system that helps people with type 1 diabetes, on multiple daily injections or insulin pump therapy, to avoid undesirable overnight blood glucose fluctuations (hyper- or hypoglycaemic) is an attractive alternative. In this paper, we introduce a novel data-driven approach to predict the quality of overnight glycaemic control in people with type 1 diabetes by analyzing commonly gathered data during the day-time period (continuous glucose monitoring data, meal intake and insulin boluses). The proposed approach is able to predict whether overnight blood glucose concentrations are going to remain within or outside the target range, and therefore allows the user to take the appropriate preventive action (snack or change in basal insulin). For this purpose, a number of popular established machine learning algorithms for classification were evaluated and compared on a publicly available clinical dataset (i.e. OhioT1DM). Although there is no clearly superior classification algorithm, this study indicates that, by using commonly gathered data in type 1 diabetes management, it is possible to predict the quality of overnight glycaemic control with reasonable accuracy (AUC-ROC= 0.7).
Peiffer-Smadja N, Rawson TM, Ahmad R, et al., Machine learning for clinical decision support in infectious diseases: A narrative review of current applications, Clinical Microbiology and Infection, ISSN: 1198-743X
BACKGROUNDMachine learning (ML) is a growing field in medicine. This narrative review describes the current body of literature on ML for clinical decision support in infectious diseases (ID). OBJECTIVESWe aim to inform clinicians about the use of ML for diagnosis, classification, outcome prediction and antimicrobial management in ID.SOURCESReferences for this review were identified through searches of MEDLINE/PubMed, EMBASE, Google Scholar, biorXiv, ACM Digital Library, arXiV and IEEE Xplore Digital Library up to July 2019.CONTENTWe found 60 unique ML-CDSS aiming to assist ID clinicians. Overall, 37 (62%) focused on bacterial infections, 10 (17%) on viral infections, nine (15%) on tuberculosis and four (7%) on any kind of infection. Among them, 20 (33%) addressed the diagnosis of infection, 18 (30%) the prediction, early detection or stratification of sepsis, 13 (22%) the prediction of treatment response, four (7%) the prediction of antibiotic resistance, three (5%) the choice of antibiotic regimen and two (3%) the choice of a combination antiretroviral therapy. The ML-CDSS were developed for intensive care units (n=24, 40%), ID consultation (n=15, 25%), medical or surgical wards (n=13, 20%), emergency department (n=4, 7%), primary care (n=3, 5%) and antimicrobial stewardship (n=1, 2%). Fifty-three ML-CDSS (88%) were developed using data from high-income countries and seven (12%) with data from low- and middle-income countries (LMIC). The evaluation of ML-CDSS was limited to measures of performance (e.g. sensitivity, specificity) for 57 ML-CDSS (95%) and included data in clinical practice for three (5%). IMPLICATIONSConsidering comprehensive patient data from socioeconomically diverse health care settings, including primary care and LMICs, may improve the ability of ML-CDSS to suggest decisions adapted to various clinical contexts. Currents gaps identified in the evaluation of ML-CDSS must also be addressed in order to know the potential impact of such tools for cli
Moscardo V, Herrero P, Diez J-L, et al., 2019, Coordinated dual-hormone artificial pancreas with parallel control structure, COMPUTERS & CHEMICAL ENGINEERING, Vol: 128, Pages: 322-328, ISSN: 0098-1354
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