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54. P6208Endothelial damage and its relation to coronary artery stenosis. A correlation between molecular cardiovascular magnetic resonance imaging, and quantitative coronary angiography

Author

Engel, L C, primary, Landmesser, U L, additional, Abdelwahed, Y A, additional, Gigengack, K G, additional, Manes, C M, additional, Wurster, T H W, additional, Skurk, C S, additional, Leistner, D L, additional, Lauten, A L, additional, Schuster, A S, additional, Noutsias, M N, additional, Hamm, B H, additional, Botnar, R B, additional, Makowski, M M, additional, and Bigalke, B B, additional

Published
2018
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55. Filtering and parameter estimation for a class of Hidden Markov Models with application to bubble-counting in microfluidics

Author

Carravetta, F, Manes, C, Palumbo, P, Carravetta F, Manes C, Palumbo P, Carravetta, F, Manes, C, Palumbo, P, Carravetta F, Manes C, and Palumbo P

Abstract

Motivated by a practical problem, in this work we investigate the problem of simultaneous estimation of state and parameters of an Hidden Markov Model with a particular structure. The motivating application is the problem of automatic counting of bubbles or droplets flowing into a microfluidic channel, where the noisy output of a photodiode has to be processed in order to detect the transit of bubbles. The goal is achieved through the recursive computation of a pseudo-max-likelihood estimate.

Published
2014

56. Sampled-data Observer-based Glucose Control for the Artificial Pancreas

Author

Borri, A, Palumbo, P, Manes, C, Panunzi, S, de Gaetano, A, Borri, A, Palumbo, P, Manes, C, Panunzi, S, and de Gaetano, A

Abstract

Artificial Pancreas (AP) is an expression referred to a set of techniques for the closed-loop control of the plasma glucose concentration by means of exogenous insulin administration in diabetic patients. Diabetes comprises a group of metabolic disorders characterized by high blood sugar levels over a prolonged period, due to pancreas failure to produce enough insulin and/or insulin resistance, so that higher amounts of insulin are usually required in order to keep glycemia in a safe range. In this work, we face the problem of glucose control for a class of Type-2 diabetic patients, in the presence of sampled glucose measurements and without any information about the time course of insulinemia. A compact physiological model of the glucose-insulin system is reviewed, then an observer (based on this model) is designed to estimate the insulin trajectory from the glucose samples. Finally, a feedback control law (based on the reconstructed state) is designed to deliver exogenous intra-venous insulin to each individual. Simulations have been performed in-silico on models of virtual patients, whose parameters are tuned according to real data, and aim at validating the method in the presence of parameter variations and quantization errors

Published
2017

57. Luenberger-Like Observers for Nonlinear Time-Delay Systems with Application to the Artificial Pancreas: The Attainment of Good Performance

Author

Borri, A, Cacace, F, De Gaetano, A, Germani, A, Manes, C, Palumbo, P, Panunzi, S, Pepe, P, Borri, A, Cacace, F, De Gaetano, A, Germani, A, Manes, C, Palumbo, P, Panunzi, S, and Pepe, P

Abstract

The analysis and control of time-delay systems has gained increasing interest in the last decades due to the effectiveness of delay differential equations (DDEs) in modeling a wide range of physical and engineering frameworks, such as ecological systems, industrial processes, telerobotic systems, earth-controlled satellite devices, and biomedical engineering. Another significant application area that has recently gained widespread attention is networked and distributed control, which may naturally induce nonnegligible and possibly time-varying delays in the input/output channels. As in the case of systems described by ordinary differential equations (ODEs), a crucial point in most advanced control approaches, such as optimal and robust control, is the possibility to solve the observer problem, that is the design of algorithms that provide full information on the state of the system by real-time processing of few measurements. The reader can refer to the recent edited book on nonlinear delay systems [1] and references therein.

Published
2017

58. Glucose control with incomplete information

Author

Borri, A, Panunzi, S, De Gaetano, A, Manes, C, Palumbo, P, Borri, A, Panunzi, S, De Gaetano, A, Manes, C, and Palumbo, P

Abstract

This paper addresses the problem of glucose control in the presence of sampled measurements. This topic is important in the study and development of the Artificial Pancreas (AP), which is a general expression to describe a set of techniques for the control of the glucose behaviour by means of exogenous insulin administration in diabetic individuals. Differently from most of the approaches available in the literature, we not only assume the lack of insulin measurements, but also the availability of the glucose measurements just at sampling times. An observer is designed for the model-based reconstruction of glucose and insulin trajectories from the glucose samples. On top of that, a feedback algorithm (based on the estimated state) is designed to continuously deliver exogenous intra-venous insulin to the patient. Simulations have been performed in-silico on models of virtual patients identified from real data and in the presence of quantization errors. The preliminary results highlight the potential of the proposed approach.

Published
2017

59. Effective Control of Glycemia using a Simple Discrete-delay Model

Author

Gaz, C, De Gaetano, A, Manes, C, Palumbo, P, Borri, A, Panunzi, S, Gaz, C, De Gaetano, A, Manes, C, Palumbo, P, Borri, A, and Panunzi, S

Abstract

Type-2 Diabetes Mellitus (T2DM) is a metabolic syndrome characterized by low insulin sensitivity, so that higher amounts of insulin are required in order to keep glycemia in a safe range (approximately, 60 ~ 110 mg/dl or, equivalently, 3.33 ~ 6.11 mM). Although insulin resistance and T2DM are often treated without exogenous insulin administration, the possibility to early treat pre-diabetic states or T2DM patients with insulin administration could be envisaged if the clinical need exists (e.g. surgical stress, infection). The present work introduces a possible new therapeutic insulin administration dosing approach for T2DM patients. The IVGTT glycemia and insulinemia profiles of a diseased patient are collected and, successively, its metabolic parameters are obtained by fitting a compact delay model to those data. Then a controller is designed exploiting the previous model as a tool. Finally, the tuned controller is applied to the patient as an artificial pancreas supplying external insulin administration. The results are shown on a virtual patient, whose behavior is described by a comprehensive, validated extensive model.

Published
2017

60. A short-term dynamical model for ghrelin

Author

Peaucelle, D, Guerra Pires, J, Borri, A, De Gaetano, A, Manes, C, Palumbo, P, Guerra Pires, Jorge, Borri, Alessandro, De Gaetano, Andrea, Manes, Costanzo, Palumbo, Pasquale, Peaucelle, D, Guerra Pires, J, Borri, A, De Gaetano, A, Manes, C, Palumbo, P, Guerra Pires, Jorge, Borri, Alessandro, De Gaetano, Andrea, Manes, Costanzo, and Palumbo, Pasquale

Abstract

Ghrelin is a peptide hormone playing a crucial role in food intake control. Differently from other hormones contributing to energy homeostasis, usually exerting their regulating action by signaling satiety (e.g. leptin), ghrelin is known to stimulate appetite and, in general, to increase animals' motivation to seek out food and initiate feeding. Medical and experimental literature has shown that approximately 70-80% of ghrelin production occurs in the stomach, whilst the great part of ghrelin control, leading to ghrelin suppression soon after a meal administration, is exerted by signals originated in the small intestine. This note proposes a mathematical model for ghrelin dynamics, focusing the attention on its short-term 24 hours dynamics. The proposed model conforms to the established physiology by introducing a minimal multi-compartmental structure of the gastrointestinal tract. Model parameters are set in order to fit plasma ghrelin concentration data taken from the literature, related to an experiment on humans: simulation-based ghrelin predictions provide promising results if compared to real data. Besides to offer a proper description of the short-term ghrelin dynamics, the model can be thought of as a module of a bigger multi-compartmental structure, aiming to account for the "web of hormones" (including, e.g., leptin and insulin) related to food intake and energy homeostasis.

Published
2017

61. Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME (R) trial

Author

Fitchett, David, Zinman, Bernard, Wanner, Christoph, Lachin, John M., Hantel, Stefan, Salsali, Afshin, Johansen, Odd Erik, Woerle, Hans J., Broedl, Uli C., Inzucchi, Silvio E., Aizenberg, D., Ulla, M., Waitman, J., De Loredo, L., Farias, J., Fideleff, H., Lagrutta, M., Maldonado, N., Colombo, H., Ferre Pacora, F., Wasserman, A., Maffei, L., Lehman, R., Selvanayagam, J., d'Emden, M., Fasching, P., Paulweber, B., Toplak, H., Luger, A., Drexel, H., Prager, R., Schnack, C., Schernthaner, G., Fliesser-Goerzer, E., Kaser, S., Scheen, A., Van Gaal, L., Hollanders, G., Kockaerts, Y., Capiau, L., Chachati, A., Persu, A., Hermans, M., Vantroyen, D., Vercammen, C., Van de Borne, P., Mathieu, C., Benhalima, K., Lienart, F., Mortelmans, J., Strivay, M., Vereecken, G., Keymeulen, B., Lamkanfi, F., Chacra, A., Eliaschewitz, F., Zanella, M., Faludi, A., Bertolami, M., Hayashida, C., Nunes Salles, J., Monte, O., Dinato, M., Manenti, E., Rassi, N., Halpern, A., Lima Filho, M., Ayoub, J., Felicio, J., Borges, J., Gross, J., Sgarbi, J., Betti, R., Tiburcio, A., Purisch, S., Schmid, H., Takahashi, M., Castro, M., Rea, R., Hissa, M., Geloneze Neto, B., Saraiva, J., Henein, S., Lochnan, H., Imran, S. A., Clayton, D., Bayly, K., Berlingieri, J., Boucher, P., Chan, Y., Gupta, M., Chehayeb, R., Ouellett, A., Ur, E., Woo, V., Zinman, B., St Amour, E., Terront Lozano, M., Yupanqui Lozno, H., Urina, M., Lopez Jaramillo, P., Jaramillo, N., Sanchez, G., Perez, G., Tusek, S., Mirosevic, G., Goldoni, V., Jurisic-Erzen, D., Balasko, A., Balic, S., Drvodelic-Sunic, E., Varzic, S. Canecki, Machkova, M., Weiner, P., Lastuvka, J., Olsovsky, J., Krarup, T., Ridderstrale, M., Tarnow, L., Boesgaard, T. Wellov, Lihn, A. Saetre, Christensen, P., Juhl, H., Urhammer, S., Lund, P., Adojaan, B., Jakovlev, U., Lanno, R., Lubi, M., Marandi, T., Gouet, D., Courreges, J., Zaoui, P., Choukroun, G., Petit, C., Formagne, L., Estour, B., Mabire, P., Daugenet, C., Lemarie, B., Clavel, S., Aure, P., Remaud, P., Halimi, J., Hadjadj, S., Couffinhal, T., Glonti, S., Metreveli, D., Lominadze, Z., Giorgadze, E., Burtchuladze, T., Javashvili, L., Kurashvili, G., Kurashvili, R., Virsaladze, D., Nadareishvili, L., Khomasuridze, A., Cahill, T., Green, F., MacRury, S., Waldron, M., Middleton, A., McKnight, J., Pearson, E., Butler, M., Choksi, M., Caldwell, I., Farmer, I., Wyatt, N., Patrick, J., O'Brien, I., Devers, M., Bousboulas, S., Pappas, S., Piaditis, G., Vryonidou, A., Tentolouris, N., Karamitsos, K., Manes, C., Benroubi, M., Avramidis, I., Ozaki, R., Tan, K., Siu, S., Tsang, C., Dudas, M., Nagy, K., Salamon, C., Ip, T., Geroo, L., Patkay, J., Tabak, A., Juhasz, F., Szentpeteri, I., Tamas, G., Ghaisas, N., Bantwal, G., Mohan, V., Gupta, J., Sadhu, N., Kulkarni, A., Garg, N., Reddy, S., Deshpande, N., Gutlapalli, K., Pillai, M., Premchand, R., Badgandi, M., Jain, S., Aravind, S., Shamanna, P., Pandey, A., Gupta, S., Pramono, B., Saksono, H. Dante, Agung, P., Wahono, S. Djoko, Suastika, K., Tanggo, Y., Juwana, Y., Siswanto, B., Adawi, F., Efrati, S., Mazen, E., Bashkin, A., Herskovits, T., Jaffe, A., Schiff, E., Wainstein, J., Taddei, S., Aiello, A., Arca, M., Calabro, P., Cignarelli, M., Fioretto, P., Reggiani, G. Marchesini, Gnasso, A., Marchionni, N., Marsilii, A., Bucci, M., Mezzetti, A., Pozzilli, P., Colivicchi, F., Santini, M., Moro, E., Toscano, V., Fucili, A., Semplicini, A., Monno, S., Furui, K., Higashiue, S., Hiramatsu, N., Kawamitsu, K., Takenaka, T., Takahashi, H., Hojo, F., Onishi, Y., Izumino, K., Okubo, M., Wakida, Y., Kondo, Y., Hieshima, K., Jinnouchi, H., Suzuki, A., Ito, M., Park, S., Kim, Y., Hong, T., Park, H., Gwon, H., Kim, H., Kang, K., Jeong, M., Seung, K., Lim, D., Rha, S., Tahk, S., Yang, J., Yoon, J., Shin, M., Kim, D., Jeong, J., Ahmad, N. Nik, Mustafa, N., Mohamed, W. Wan, Fung, Y., Ghani, R. Abdul, Chandramouli, A., Chee, K., Kadir, K. Abdul, Ling, K., Abu Hassan, M., Foo, S., Lee, S., Garcia Hernandez, P., Aguilar-Salinas, C., Vidrio Velazquez, M., Flores, F., Alpizar Salazar, M., Micher Escalante, D., Garcia Soria, M., Cardona Munoz, E., Storms, G., Schaper, N., Kooy, A., Krekels, M., van Bemmel, T., Verhoeven, R., Mulder, H., Oldenburg-Ligtenberg, P., Gonkel, F., de Jong, A., van Soest, J., Viergever, P., Mevissen, H., Lochorn, G., Zwiers, G., Hoogslag, P., Ronner, E., Nierop, P., Al-Windy, N., Kragten, J., Dekelver, P., Benatar, J., Krebs, J., Scott, R., Heggen, E., Berz, A., Fossum, C., Hurtig, U., Langslet, G., Baranowski, M., Sparby, J., Karlsson, T., Karlsson, Thomas, Delgado Torres, C., Rodriguez Escudero, A., Lisson, R., Allemant Maldonado, A., Gallardo Rojas, W., Gonzales Bravo, L., Lema Osores, J., Farfan, J., Zapata, L., Godoy Junchaya, J., Roldan Concha, Y., Urquiaga Calderon, J., Sy, R., Tan, G., Aquitania, G., De Los Santos, G., Panelo, A., Roderos, O., Rosales, R., Toledo, R., Liwag, A., Ramoncito, H., Skokowska, E., Krzyzagorska, E., Ogorek, M., Wojnowski, L., Spyra, J., Konieczny, M., Piesiewicz, W., Kus, W., Ocicka-Kozakiewicz, A., Orlowska-Kunikowska, E., Zmuda, W., Duarte, S., Leitao, A., Monteiro, P., Rita, H., Salgado, V., Pinto, L., Queiros, J., Teixeira, J., Rogado, C., Duarte, R., Sobral do Rosario, F., Silva, A., Andrade, L., Velez, M., Brazao, M., Istratoaie, O., Lichiardopol, R., Catrinoiu, D., Militaru, C., Zetu, C., Barbonta, D., Cosma, D., Crisan, C., Pop, L., Esip, V., Khetagurova, F., Petrov, A., Arutyunov, G., Boyarkin, M., Agafyina, A., Vorokhobina, N., Petunina, N., Libov, I., Zalevskaya, A., Nikolaev, K., Barbarash, O., Potemkin, V., Bystrova, A., Krasilnikova, E., Barbarich, V., Chumakova, G., Tarasov, N., Meleshkevich, T., Zateyshchikov, D., Lantseva, O., Belenkiy, D., Obrezan, A., Rossolko, L., Fillipova, E., Yakhontova, P., Khokhlov, A., Tan, R., Sum, C., Chang, H., Distiller, L., Pretorius, M., Nortje, H., Mitha, E., Burgess, L., Blignaut, S., Venter, T., Moodley, R., Lombaard, J., Govind, U., Naidoo, V., Mookadam, M., Engelbrecht, J., Omar, M., Jurgens, J., Podgorski, G., Vawda, H., Naidoo, D., Emanuel, S., Roodt, A., Amod, A., Van Zyl, L., Segura, J., Brito, M., Fernandez-Cruz, A., Artola, S., Iglesias, R., Toural, E., Garcia-Ortiz, L., Saban, J., Mesa, J., Vidal, J., Linares, J., del Canizo, F., Rigla, M., Suarez, C., Llorente, I., Moreno, B., Antoli, A., Gomez Peralta, F., Iglesias, M., Pereg, V., de Teresa, L., Camafort, M., Trescoli, C., Satarasinghe, R., Somasundaram, N., Siyambalapitiya, S., Antonypillai, C., Bulugahapitiya, D., Medagama, U., Huang, C., Lu, Y., Hwang, J., Chiang, C., Wen, M., Chen, J., Lai, W., Chang, K., Wang, J., Yeh, H., Kriangsak, P., Deerochanawong, C., Suwanwalaikorn, S., Mangklabruks, A., Kaewsuwanna, P., Piyayotai, D., Iabluchanskyi, M., Samoylov, O., Godlevska, O., Kovalyova, O., Voloshyna, O., Tseluyko, V., Zotov, S., Vykhovanyuk, I., Dulgeroff, A., Mayfield, R., Zaniewski-Singh, M., Ullal, J., Aloi, J., De La Rosa, R., Mosely, J., Wittmer, B., Aronoff, S., Rosenfeld, J., Seidner, M., Warren, M., Fishman, N., Weiss, R., Arif, A., Sandberg, M., Lewis, D., Ball, E., Graf, R., Breton, C., Tamayo, R., Richards, R., Cefalu, W., Uwaifo, G., Zayour, D., Hoffman, J., Fitz-Patrick, D., Khan, B., Blaze, K., Bressler, P., Halpern, S., Chappell, D., Bergenstal, R., Cuddihy, R., Matfin, G., Freedman, Z., Gonzalez-Campoy, J., Lerman, S., Rendell, M., Sitar, S., Reeves, M., Howard, T., Soufer, J., Miranda-Palma, B., Laliotis, A., Shomali, M., Teltser, M., Hurley, D., Morawski, E., Cherlin, R., Houchin, V., Welch, M., Goytia-Leos, D., Syed, M., Kowaloff, E., Weinrauch, L., Peniston, J., Brockmyre, A., First, B., Feld, L., Huffman, D., Nassim, O., Gottschlich, G., Patel, A., Knopke, C., Hernandez, M., Diaz, J., Giugliano, G., Nicasio, J., Eagerton, D., Huntley, R., Reed, J., III, Magee, M., Hippert, R., Sofley, C., Jr., Alzohaili, O., Levins, P., Anspach, R., Shah, S., Brusco, O., Naidu, J., Lindenbaum, J., Jacks, R., Hammond, G., Arena, C., Saxman, K., Mach, M., Kerstein, H., Kereiakes, D., Wahlen, J., Wehmeier, K., Chaykin, L., Rothman, J., Fogelfeld, L., Stroger, John H., Jr., Bittar, N., Rosenstock, J., Kayne, D., Navarro, J., Colfer, H., Mokshagundam, S., Shandilya, L., Connery, L., Wysham, C., Dela Llana, A., Jardula, M., MacAdams, M., Flippo, G., Heurich, E., Curtis, C., Sanders, D., Rawls, R., Velazquez, F., Osea, E., Mahood, K., Feldman, G., Eder, F., Riley, E., Fowler, W., Jain, M., Shepard, M., Schear, M., Barker, B., Strout, C., Obiekwe, O., Shanik, M., Green, C., Blakney, E., Roberson, K., Bretton, E., Pish, R., Kaveh, K., Maynard, B., Barager, W., Soldyshev, R., Austin, B., Parmar, P., Simpson, R., Chauhan, A., Kasper, J., Burr, R., Patel, N., Mariano, H., Pluto, T., Bratcher, C., Juarez, M., Levinson, L., Awad, A., Longshaw, K., Hoffman, K., Richwine, R., Molter, D., Boscia, J., III, Kowalyk, S., Lemis, P., Liss, J., Orr, R., Riser, J., Wood, J., Ubani, A., Paine, W., Hassani, F., Miranda, F., Hansen, V., Hansen, Val R., Farris, N., Bowden, R., Ajani, D., Maw, K., Andersen, J., Bergman, B., Dunmyer, S., Brandon, D., Anderson, M., Bononi, P., Prawer, J., Seidman, B., Cruz, H., Wilks, K., DiSanto, L., Buynak, R., Christensen, T., Denker, P., Koppel, W., Stedman, M., Lewy-Alterbaum, L., Karim, S., Shapiro, J., Gardner, T., Oskin, T., Gabra, N., Malano, J., EMPA-REG OUTCOME Trial, and EMPA-REG OUTCOME(R) trial investigators

Subjects
medicine.medical_specialty, Cardiac & Cardiovascular Systems, Aha Fasttrack, BLOOD-PRESSURE, 030209 endocrinology & metabolism, Cardiovascular disease, Hospitalization, Mortality, Type 2 diabetes, 030204 cardiovascular system & hematology, COLLABORATION, GUIDELINES, DOUBLE-BLIND, MELLITUS, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Empagliflozin, Medicine, ddc:610, Adverse effect, Science & Technology, COTRANSPORTER 2 INHIBITION, business.industry, MORTALITY, Hazard ratio, Heart Failure/Cardiomyopathy, medicine.disease, INSULIN, Editor's Choice, Endocrinology, Blood pressure, DISEASES, SAFETY, Heart failure, Cardiovascular System & Cardiology, Number needed to treat, Cardiology, Fast Track, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine
Abstract

Aims We previously reported that in the EMPA-REG OUTCOME(R) trial, empagliflozin added to standard of care reduced the risk of 3-point major adverse cardiovascular events, cardiovascular and all-cause death, and hospitalization for heart failure in patients with type 2 diabetes and high cardiovascular risk. We have now further investigated heart failure outcomes in all patients and in subgroups, including patients with or without baseline heart failure. Methods and results Patients were randomized to receive empagliflozin 10 mg, empagliflozin 25 mg, or placebo. Seven thousand and twenty patients were treated; 706 (10.1%) had heart failure at baseline. Heart failure hospitalization or cardiovascular death occurred in a significantly lower percentage of patients treated with empagliflozin [265/4687 patients (5.7%)] than with placebo [198/2333 patients (8.5%)] [hazard ratio, HR: 0.66 (95% confidence interval: 0.55-0.79); P < 0.001], corresponding to a number needed to treat to prevent one heart failure hospitalization or cardiovascular death of 35 over 3 years. Consistent effects of empagliflozin were observed across subgroups defined by baseline characteristics, including patients with vs. without heart failure, and across categories of medications to treat diabetes and/or heart failure. Empagliflozin improved other heart failure outcomes, including hospitalization for or death from heart failure [2.8 vs. 4.5%; HR: 0.61 (0.47-0.79); P < 0.001] and was associated with a reduction in all-cause hospitalization [36.8 vs. 39.6%; HR: 0.89 (0.82-0.96); P = 0.003]. Serious adverse events and adverse events leading to discontinuation were reported by a higher proportion of patients with vs. without heart failure at baseline in both treatment groups, but were no more common with empagliflozin than with placebo. Conclusion In patients with type 2 diabetes and high cardiovascular risk, empagliflozin reduced heart failure hospitalization and cardiovascular death, with a consistent benefit in patients with and without baseline heart failure., This work was supported by Boehringer Ingelheim and Eli Lilly and Company. Boehringer Ingelheim was involved in the design and conduct of the study; collection, analysis, and interpretation of data; and preparation of this manuscript. Eli Lilly's involvement was limited to co-funding of the study. Funding to pay the Open Access publication charges for this article was provided by Boehringer Ingelheim.

Published
2016

65. Protein intake and urinary albumin excretion rates in the EURODIAB IDDM Complications Study

Author

Toeller, M, Buyken, A, Heitkamp, G, Brämswig, S, Mann, J, Milne, R, Gries, F. A, Keen, H, Karamanos, B, Tountas, C, Kofinis, A, Petrou, K, Katsilambros, N, Roussipenessi, D, Cignarelli, M, Giorgino, R, Degeco, Ml, Ramunni, I, Ionescutirgoviste, C, Strachinariu, R, Nicolau, A, Tamas, G, Kerenyi, Z, Ahmed, Am, Toth, J, Kempler, P, Muntoni, S, Songini, M, Stabilini, M, Fossarello, M, Pintus, S, Ferriss, B, Cronin, Cc, Humphreys, M, Klischan, A, Forst, T, Schumacher, W, Rottiers, R, Priem, H, Deschoolmeester, Mj, Ebeling, P, Sinisalo, M, Koivisto, Va, Idziorwalus, B, Solnica, B, Szopinskaciba, L, Solnica, K, Krans, Hmj, Lemkes, Hhpj, Jansen, Jj, Eltedewever, Bm, Nunescorrea, J, Boavida, J, Carvalho, R, Afonso, Mj, Monteiro, M, Mitchell, DAVID ROSS, Jepson, E, Mchardyyoung, S, Fuller, Jh, Betteridge, Dj, Milne, M, Thompson, T, Michel, G, Wirion, R, Paquet, S, Hornick, H, Boulton, Ajm, Ashe, H, Fernando, Djs, Curwell, J, Pozza, G, Slaviero, G, Comi, G, Fattor, B, Bandello, F, Marchi, Manuel, Mehnert, H, Nuber, A, Janka, H, Nichting, M, Standl, E, Crepaldi, G, Nosadini, R, Cathelineau, G, Cathelineau, Bv, Jellal, M, Grodner, N, Feiss, Pg, Baclet, N, Santeusanio, F, Rosi, G, Ventura, Mrm, Cagini, C, Marino, C, Navalesi, R, Penno, G, Miccoli, R, Nannipieri, M, Manfredi, S, Bertolotto, A, Ghirlanda, G, Cotroneo, P, Manto, A, Teodonio, C, Minnella, A, Careddu, G, Ward, Jd, Tesfaye, S, Mody, C, Rudd, C, Molinatti, Gm, Vitelli, F, Porta, M, Pagano, Gf, Estivi, Sivieri, P., R, Carta, Q, Petraroli, G, Papazoglu, N, Goutzourela, M, Manes, C, Bensoussan, D, Fallas, Mc, Fallas, P, Dhanaeus, C, Muggeo, M, Cacciatori, V, Bellavere, F, Galante, P, Gemma, Ml, Branzi, P, Irsigler, K, Abrahamian, H, Gurdet, C, Hornlein, B, Willinger, C, Strohner, H, Just, M, Walford, S, Wardle, Henio, Ev, S, Cooke, H, Roglic, G, Resman, Z, Metelko, Z, Skrabalo, Z, Vrhovac, V., Toeller, M, Buyken, A, Heitkamp, G, Bramswig, S, Mann, J, Milne, R, Gries, Fa, Keen, H, Karamanos, B, Tountas, C, Kofinis, A, Petrou, K, Katsilambros, N, Roussipenessi, D, Cignarelli, M, Giorgino, R, Degeco, Ml, Ramunni, I, Ionescutirgoviste, C, Strachinariu, R, Nicolau, A, Tamas, G, Kerenyi, Z, Ahmed, Am, Toth, J, Kempler, P, Muntoni, S, Songini, M, Stabilini, M, Fossarello, M, Pintus, S, Ferriss, B, Cronin, Cc, Humphreys, M, Klischan, A, Forst, T, Schumacher, W, Rottiers, R, Priem, H, Deschoolmeester, Mj, Ebeling, P, Sinisalo, M, Koivisto, Va, Idziorwalus, B, Solnica, B, Szopinskaciba, L, Solnica, K, Krans, Hmj, Lemkes, Hhpj, Jansen, Jj, Eltedewever, Bm, Nunescorrea, J, Boavida, J, Carvalho, R, Afonso, Mj, Monteiro, M, David, R, Jepson, E, Mchardyyoung, S, Fuller, Jh, Betteridge, Dj, Milne, M, Thompson, T, Michel, G, Wirion, R, Paquet, S, Hornick, H, Boulton, Ajm, Ashe, H, Fernando, Dj, Curwell, J, Pozza, G, Slaviero, G, Comi, G, Fattor, B, Bandello, F, Marchi, M, Mehnert, H, Nuber, A, Janka, H, Nichting, M, Standl, E, Crepaldi, G, Nosadini, R, Cathelineau, G, Cathelineau, Bv, Jellal, M, Grodner, N, Feiss, Pg, Baclet, N, Santeusanio, F, Rosi, G, Ventura, Mrm, Cagini, C, Marino, C, Navalesi, R, Penno, G, Miccoli, R, Nannipieri, M, Manfredi, S, Bertolotto, A, Ghirlanda, G, Cotroneo, P, Manto, A, Teodonio, C, Minnella, A, Careddu, G, Ward, Jd, Tesfaye, S, Mody, C, Rudd, C, Molinatti, Gm, Vitelli, F, Porta, M, Pagano, Gf, Estivi, P, Sivieri, R, Carta, Q, Petraroli, G, Papazoglu, N, Goutzourela, M, Manes, C, Bensoussan, D, Fallas, Mc, Fallas, P, Dhanaeus, C, Muggeo, M, Cacciatori, V, Bellavere, F, Galante, P, Gemma, Ml, Branzi, P, Irsigler, K, Abrahamian, H, Gurdet, C, Hornlein, B, Willinger, C, Strohner, H, Just, M, Walford, S, Wardle, Ev, Henio, S, Cooke, H, Roglic, G, Resman, Z, Metelko, Z, Skrabalo, Z, and Vrhovac, V

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Urinary system, Physiology, Albuminuria, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Dietary Proteins, Europe, Female, Humans, Middle Aged, Nephropathy, Protein intake, urinary albumin, Diabetic nephropathy, Excretion, Diabetes mellitus, Internal medicine, Diabetes Mellitus, Internal Medicine, Medicine, Proteinuria, business.industry, medicine.disease, Endocrinology, Blood pressure, medicine.symptom, business, Type 1, Kidney disease
Abstract

For people with insulin-dependent diabetes mellitus (IDDM) renal disease represents a life-threatening and costly complication. The EURODIAB IDDM Complications Study, a cross-sectional, clinic-based study, was designed to determine the prevalence of renal complications and putative risk factors in stratified samples of European individuals with IDDM. The present study examined the relationship between dietary protein intake and urinary albumin excretion rate (AER). Food intake was assessed centrally by a standardized 3-day dietary record. Urinary AER was determined in a central laboratory from a timed 24-h urine collection. Complete data were available from 2696 persons with IDDM from 30 centres in 16 European countries. In individuals who reported protein consumption less than 20 % of total food energy intake, mean AER was below 20 μg/min. In those in whom protein intake constituted more than 20 %, mean AER increased, a trend particularly pronounced in individuals with hypertension and/or poor metabolic control. Trends reached statistical significance for intakes of total protein (% of energy, p = 0.01) and animal protein (% of energy, p = 0.02), while no association was seen for vegetable protein (p = 0.83). These findings support the current recommendation for people with diabetes not to exceed a protein intake of 20 % of total energy. Monitoring and adjustment of dietary protein appears particularly desirable for individuals with AER exceeding 20 μg/min (approximately 30 mg/24 h), especially when arterial pressure is raised and/or diabetic control is poor. [Diabetologia (1997) 40: 1219–1226]

Published
1997

66. Repeatability of three-day dietary records in the EURODIAB IDDM Complications Study

Author

Toeller M, Buyken A, Heitkamp G, Milne R, Klischan A, Gries FA, Fuller JH, Keen H, Krans HMJ, Navalesi R, Sjolie AK, Stephenson JM, Viberti GC, Karamanos B, Tountas C, Kofinis A, Petrou K, Katsilambros N, RoussiPenessi D, Cignarelli M, Giorgino R, DeGeco ML, Ramunni I, IonescuTirgoviste C, Strachinariu R, Nicolau A, Tamas G, Kerenyi Z, Ahmed AM, Toth J, Kempler P, Muntoni S, Songini M, Stabilini M, Fossarello M, Pintus S, Ferriss B, Cronin CC, Humphreys M, Forst T, Schumacher W, Wagener W, Venhaus A, Rottiers R, Priem H, Deschoolmeester MJ, Ebeling P, Sinisalo M, Koivisto VA, IdziorWalus B, Solnica B, SzopinskaCiba L, Solnica K, Lemkes HHPJ, Jansen JJ, EltedeWever BM, NunesCorrea J, Boavida J, Carvalho R, Afonso MJ, Monteiro M, David R, Jepson E, McHardyYoung S, Betteridge DJ, Milne M, Thompson T, Michel G, Wirion R, Paquet S, Hornick H, Boulton AJM, Ashe H, Fernando DJS, Curwell J, Pozza G, Slaviero G, Comi G, Fattor B, Marchi M, Mehnert H, Nuber A, Janka H, Nichting M, Standl E, Crepaldi G, Nosadini R, Cathelineau G, Cathelineau BV, Jellal M, Grodner N, Feiss PG, Baclet N, Santeusanio F, Rosi G, Ventura MRM, Cagini C, Marino C, Penno G, Miccoli R, Nannipieri M, Manfredi S, Bertolotto A, Ghirlanda G, Manto A, Cotroneo P, Ward JD, Tesfaye S, Mody C, Rudd C, Papazoglou N, Goutzourela M, Manes C, Molinatti GM, Vitelli F, Porta M, Pagano GF, Estivi P, Sivieri R, Carta Q, Petraroli G, BenSoussan D, Fallas MC, Fallas P, Dhanaeus C, Bourgeois MD, Muggeo M, Cacciatori V, Bellavere F, Galante P, Gemma ML, Branzi P, Irsigler K, Abrahamian H, Gurdet C, Hornlein B, Willinger C, Strohner H, Just M, Walford S, Wardle EV, Henio S, Cooke H, Roglic G, Resman Z, Metelko Z, Skrabalo Z., BANDELLO , FRANCESCO, Toeller, M, Buyken, A, Heitkamp, G, Milne, R, Klischan, A, Gries, Fa, Fuller, Jh, Keen, H, Krans, Hmj, Navalesi, R, Sjolie, Ak, Stephenson, Jm, Viberti, Gc, Karamanos, B, Tountas, C, Kofinis, A, Petrou, K, Katsilambros, N, Roussipenessi, D, Cignarelli, M, Giorgino, R, Degeco, Ml, Ramunni, I, Ionescutirgoviste, C, Strachinariu, R, Nicolau, A, Tamas, G, Kerenyi, Z, Ahmed, Am, Toth, J, Kempler, P, Muntoni, S, Songini, M, Stabilini, M, Fossarello, M, Pintus, S, Ferriss, B, Cronin, Cc, Humphreys, M, Forst, T, Schumacher, W, Wagener, W, Venhaus, A, Rottiers, R, Priem, H, Deschoolmeester, Mj, Ebeling, P, Sinisalo, M, Koivisto, Va, Idziorwalus, B, Solnica, B, Szopinskaciba, L, Solnica, K, Lemkes, Hhpj, Jansen, Jj, Eltedewever, Bm, Nunescorrea, J, Boavida, J, Carvalho, R, Afonso, Mj, Monteiro, M, David, R, Jepson, E, Mchardyyoung, S, Betteridge, Dj, Milne, M, Thompson, T, Michel, G, Wirion, R, Paquet, S, Hornick, H, Boulton, Ajm, Ashe, H, Fernando, Dj, Curwell, J, Pozza, G, Slaviero, G, Comi, G, Fattor, B, Bandello, Francesco, Marchi, M, Mehnert, H, Nuber, A, Janka, H, Nichting, M, Standl, E, Crepaldi, G, Nosadini, R, Cathelineau, G, Cathelineau, Bv, Jellal, M, Grodner, N, Feiss, Pg, Baclet, N, Santeusanio, F, Rosi, G, Ventura, Mrm, Cagini, C, Marino, C, Penno, G, Miccoli, R, Nannipieri, M, Manfredi, S, Bertolotto, A, Ghirlanda, G, Manto, A, Cotroneo, P, Ward, Jd, Tesfaye, S, Mody, C, Rudd, C, Papazoglou, N, Goutzourela, M, Manes, C, Molinatti, Gm, Vitelli, F, Porta, M, Pagano, Gf, Estivi, P, Sivieri, R, Carta, Q, Petraroli, G, Bensoussan, D, Fallas, Mc, Fallas, P, Dhanaeus, C, Bourgeois, Md, Muggeo, M, Cacciatori, V, Bellavere, F, Galante, P, Gemma, Ml, Branzi, P, Irsigler, K, Abrahamian, H, Gurdet, C, Hornlein, B, Willinger, C, Strohner, H, Just, M, Walford, S, Wardle, Ev, Henio, S, Cooke, H, Roglic, G, Resman, Z, Metelko, Z, and Skrabalo, Z.

Subjects
Dietary Fiber, medicine.medical_specialty, Alcohol Drinking, European community, Saturated fat, Population, Medicine (miscellaneous), the EURODIAB IDDM Study, Diabetes mellitus, Dietary Carbohydrates, medicine, Humans, education, education.field_of_study, Nutrition and Dietetics, business.industry, Reproducibility of Results, Repeatability, medicine.disease, Dietary Fats, Diet Records, Confidence interval, Surgery, Europe, three-day dietary records, Diabetes Mellitus, Type 1, Nutrition Assessment, Quartile, Cohort, Dietary Proteins, Energy Intake, business, Demography
Abstract

Objectives: Repeatability of a dietary method is important in determining the quality of nutritional data. It should be assessed in the population of interest. This study evaluated the repeatability of nutritional data from standardized three-day dietary records, from the clinic-based, cross-sectional multi-centre EURODIAB IDDM Complications Study. Design and Subjects: 15% of the total EURODIAB cohort was randomly selected to test the repeatability of nutritional intake data. Two three-day records, completed three weeks apart, were available for 216 diabetic patients (7.5%) representative of the total cohort. All records were analysed centrally, for intakes of protein (animal and vegetable), fat (saturated fat and cholesterol), carbohydrate, fibre, alcohol and energy. Repeatability was measured comparing mean intakes, determining the proportion of patients classified into the same/opposite quartile by the two three-day records and assessing mean differences with standard deviations (s.d.d). Results: There were no significant differences in mean energy and nutrient intakes between the first and second records. Classification of individuals into the opposite quartile occurred only in 0–4% of patients and overall about 50% (range 44–74%) of the subjects were classified into the same quartiles of intakes. Only small mean differences were found for energy intake (−156 (1633) kJ; 95% confidence limits −375, 63 kJ) and nutrients with s.d.ds comparable to intra-individual variations in the general population. The differences in energy intake were randomly distributed over the range of intakes. Conclusions: The present study demonstrates that standardized three day dietary records show a high degree of repeatability within a short period of time in a sample of European IDDM patients. The good repeatability strengthens the conclusions drawn from the nutritional data in the EURODIAB IDDM Complications Study. Sponsorship: Nutrition Co-ordinating Centre research funds, Diabetes Research Institute at Heinrich-Heine University, Dusseldorf. The EURODIAB IDDM Complications Study was supported by the European Community.

Published
1997

67. Whi5 phosphorylation embedded in the G 1 /S network dynamically controls critical cell size and cell fate

Author

Palumbo, P, Vanoni, M, Cusimano, V, Busti, S, Marano, F, Manes, C, Alberghina, L, VANONI, MARCO ERCOLE, BUSTI, STEFANO, MARANO, FRANCESCA, ALBERGHINA, LILIA, Palumbo, P, Vanoni, M, Cusimano, V, Busti, S, Marano, F, Manes, C, Alberghina, L, VANONI, MARCO ERCOLE, BUSTI, STEFANO, MARANO, FRANCESCA, and ALBERGHINA, LILIA

Abstract

In budding yeast, overcoming of a critical size to enter S phase and the mitosis/mating switch - two central cell fate events - take place in the G 1 phase of the cell cycle. Here we present a mathematical model of the basic molecular mechanism controlling the G 1 /S transition, whose major regulatory feature is multisite phosphorylation of nuclear Whi5. Cln3-Cdk1, whose nuclear amount is proportional to cell size, and then Cln1,2-Cdk1, randomly phosphorylate both decoy and functional Whi5 sites. Full phosphorylation of functional sites releases Whi5 inhibitory activity, activating G 1 /S transcription. Simulation analysis shows that this mechanism ensures coherent release of Whi5 inhibitory action and accounts for many experimentally observed properties of mitotically growing or conjugating G 1 cells. Cell cycle progression and transcriptional analyses of a Whi5 phosphomimetic mutant verify the model prediction that coherent transcription of the G 1 /S regulon and ensuing G 1 /S transition requires full phosphorylation of Whi5 functional sites.

Published
2016

68. Polynomial extended Kalman filtering for discrete-time nonlinear stochastic systems

Author

Germani, A, Manes, C, Palumbo, P, Manes,C, Germani, A, Manes, C, Palumbo, P, and Manes,C

Abstract

This paper deals with the state estimation problem for a discrete-time nonlinear system driven by additive noise (not necessarily Gaussian). The solution here proposed is a filtering algorithm which is a polynomial transformation of the measurements. The first step for the filter derivation is the embedding of the nonlinear system into an infinite-dimensional bilinear system (linear drift and multiplicative noise), following the Carleman approach. Then, the infinite dimensional system is approximated by neglecting all the powers of the state up to a chosen degree mu, and the minimum variance estimate among all the mu-degree polynomial transformations of the measurements is computed. The proposed filter can be considered a Polynomial Extended Kalman Filter (PEKF), because when mu = 1 the classical EKF algorithm is recovered. Numerical simulations support the theoretical results and show the improvements of a quadratic filter with respect to the classical EKF.

Published
2003

69. State space representation of a class of MIMO systems via combination of positive systems

Author

Germani, A., Manes, C., Palumbo, P., Palumbo, P, Manes, C, and Germani, A

Subjects
State-space realization, Positive system, Linear systems
Abstract

In many technological frameworks the only choice to implement the designed signal processing scheme (filter or control law) is to provide a positive state-space realization. On the other hand, by setting an a priori positivity constraint to the processing algorithm could be a heavy restriction to its performances. It is worthwhile, then, to look for a state-space realization through combination of positive systems. In this paper a state-space representation for a class of MIMO systems is proposed in the discrete-time framework. The approach followed provides an easy implementation by means of combinations of positive systems, whose total order is fixed regardless of the poles location in the complex plane. The stability of the positive realization of a stable system is also investigated.

Published
2007

70. Optimal linear filtering for stochastic non-Gaussian descriptor systems

Author

Germani, A, Manes, C, Palumbo, P, Germani A, Manes C, Palumbo P, Germani, A, Manes, C, Palumbo, P, Germani A, Manes C, and Palumbo P

Abstract

Stochastic linear discrete-time singular systems, also named descriptor systems, have been widely investigated in recent years and important results on optimal filtering according to the maximum likelihood (ML) criterion have been achieved in the Gaussian framework. The ML approach can not be easily extended to non-Gaussian systems. In this paper the estimation problem for non-Gaussian descriptor systems is studied following the minimum error variance criterion and the optimal linear filter is developed by constructing the best estimator among a suitable class of linear output transformations. It is shown that when applied in the Gaussian case, the proposed filter gives back the ML filter. Simulations support theoretical results.

Published
2001

72. An approximation scheme for the LQG control of flexible structures

Author

Manes, C, Palumbo, P, Pepe, P, Manes, C, Palumbo, P, and Pepe, P

Abstract

This paper deals with the LQG control problem of flexible structures. Since the solution to this problem is given by infinite dimension equations, an approximation scheme is necessary to find an implementable control law. Here a Galerkin approach is used. The novelty of the paper is the successful use of the eigenfunctions of the system instead of usual splines to build up finite dimensional approximating subspaces. By using the Trotter-Kato theorem, it is proved that the state of the system evolving when the approximating input is applied converges in L2 norm to the state evolving when the optimal one is applied.

Published
2015

74. Polynomial approach for filtering and identification of a class of uncertain systems

Author

Palumbo, P, Germani, A, Di Martino, D, Manes, C, Palumbo, P, Germani, A, Di Martino, D, and Manes, C

Subjects
Polynomial filtering, Stochastic system, Uncertain systems
Abstract

This paper considers the filtering and identification problems for a class of discrete-time uncertain stochastic systems that admit a finite number of linear working modes. It is shown here that this class of uncertain systems can be modeled by using a suitably defined extended system, whose state evolves according to a bilinear model. A polynomial filtering algorithm is derived for such extended system, which readily provides the polynomial estimates of both the original state and the working mode. Simulations show the effectiveness of the proposed approach and the improvements with respect to standard linear filtering algorithms.

Published
2004

75. Randomised placebo-controlled trial of lisinopril in normotensive patients with insulin-dependent diabetes and normoalbuminuria or microalbuminuria

Author

Chaturvedi, N, Stevenson, J, Fuller, Jh, Rottiers, R, Ferriss, B, Karamanos, B, Kofinis, A, Petrou, C, Ionescutirgovisite, C, Iosif, C, Tamas, G, Bibok, G, Kerenyi, Z, Kisgombos, P, Toth, J, Grealy, G, Priem, H, Koivisto, V, Tuominen, J, Kostamo, E, Idziorwalus, B, Solnica, B, Galickalatalie, D, Michel, G, Keipes, M, Giuliani, A, Herode, A, Santeusanio, F, Bueti, A, Bistoni, S, Cagini, Navalesi, R, Penno, G, Nannipieri, Monica, Rizzo, L, Miccoli, Roberto, Ghirlanda, G, Cotroneo, P, Manto, A, Minella, A, Saponara, C, Ward, J, Plater, M, Ibrahim, S, Ibbotson, S, Mody, C, Papazoglou, N, Manes, C, Soulis, K, Voukias, M, Muggeo, M, Cacciatori, V, Gemma, Ml, Dellera, A, Castellarin, A, Irsigler, K, Abrahamian, H, Gurdet, C, Willinger, C, Nelstrop, A, Feben, C, Walford, S, Mclelland, V, Hughes, S, Metelko, Z, Roglic, G, Pepeonik, Zr, Stephenson, J, Viberti, Gc, Sjolie, Ak, Holloway, J, Milne, M, Webb, D, Bulpitt, C, Fletcher, A, Shipley, M, John, G, and Newman, Dj

Subjects
medicine.medical_specialty, Proteinuria, endocrine system diseases, business.industry, Urology, Lisinopril, Renal function, Captopril, General Medicine, urologic and male genital diseases, Placebo, medicine.disease, Endocrinology, Internal medicine, ACE inhibitor, medicine, Albuminuria, Microalbuminuria, medicine.symptom, business, medicine.drug
Abstract

Summary Background Renal disease in people with insulin-dependent diabetes (IDDM) continues to pose a major health threat. Inhibitors of angiotensin-converting enzyme (ACE) slow the decline of renal function in advanced renal disease, but their effects at earlier stages are unclear, and the degree of albuminuria at which treatment should start is not known. Methods We carried out a randomised, double-blind, placebo-controlled trial of the ACE inhibitor lisinopril in 530 men and women with IDDM aged 20–59 years with normoalbuminuria or microalbuminuria. Patients were recruited from 18 European centres, and were not on medication for hypertension. Resting blood pressure at entry was at least 75 and no more than 90 mm hg diastolic, and no more than 155 mm hg systolic. Urinary albumin excretion rate (AER) was centrally assessed by means of two overnight urine collections at baseline, 6, 12, 18, and 24 months. Findings There were no differences in baseline characteristics by treatment group; mean AER was 8.0 μg/min in both groups; and prevalence of microalbuminuria was 13% and 17% in the placebo and lisinopril groups, respectively. On intention-to-treat analysis at 2 years, AER was 2.2 μg/min lower in the lisinopril than in the placebo group, a percentage difference of 18.8% (95% CI 2·0–32·7, p=0·03), adjusted for baseline AER and centre, absolute difference 2.2 μg/min. In people with normoalbuminuria, the treatment difference was 1·0 μg/min (12·7% [−2·9 to 26·0], p=0·1). In those with microalbuminuria, however, the treatment difference was 34.2 μg/min (49·7% [−14·5 to 77·9], p=0·1; for interaction, p=0·04). For patients who completed 24 months on the trial, the final treatment difference in AER was 38·5 μg/min in those with microalbuminuria at baseline (p=0·001), and 0·23 μg/min in those with normoalbuminuria at baseline (p=0·6). There was no treatment difference in hypoglycaemic events or in metabolic control as assessed by glycated haemoglobin. Interpretation Lisinopril slows the progression of renal disease in normotensive IDDM patients with little or no albuminuria, though greatest effect was in those with microalbuminuria (AER ≥20 μg/min). Our results show that lisinopril does not increase the risk of hypoglycaemic events in IDDM.

Published
1997

76. A simple new non-invasive sweat indicator test for the diagnosis of diabetic neuropathy

Author

Papanas, N. Boulton, A.J.M. Malik, R.A. Manes, C. Schnell, O. Spallone, V. Tentolouris, N. Tesfaye, S. Valensi, P. Ziegler, D. Kempler, P.

Abstract

A simple non-invasive indicator test (Neuropad®) has been developed for the assessment of sweating and, hence, cholinergic innervation in the diabetic foot. The present review summarizes current knowledge on this diagnostic test. The diagnostic ability of this test is based on a colour change from blue to pink at 10min, with excellent reproducibility, which lends itself to patient self-examination. It has a high sensitivity (65.1-100%) and negative predictive value (63-100%), with moderate specificity (32-78.5%) and positive predictive value (23.3-93.2%) for the diagnosis of diabetic peripheral neuropathy. It also has moderate to high sensitivity (59.1-89%) and negative predictive value (64.7-91%), but low to moderate specificity (27-78%) and positive predictive value (24-48.6%) for the diagnosis of diabetic cardiac autonomic neuropathy. There are some data to suggest that Neuropad can detect early diabetic neuropathy, but this needs further evaluation. It remains to be established whether this test can predict foot ulceration and amputation, thereby contributing to the identification of high-risk patients. © 2012 Diabetes UK.

Published
2013

77. Kalman Bucy filtering for linear stochastic differential systems with unknown inputs

Author

Germani, A, Manes, C, Palumbo, P, Germani, A, Manes, C, and Palumbo, P

Subjects
Kalman-Bucy filtering, descriptor system, state estimation
Abstract

This work investigates the problem of state estimation for singular stochastic differential systems. A Kalman-Bucy-like filter is proposed, based on a suitable decomposition of the descriptor vector into two components. The first one is expressed as a function of the observation, and therefore does not need to be estimated, while the second component is described by a regular linear stochastic system and can be estimated by a Kalman-Bucy filter. Numerical simulations are presented on the case of a stochastic system with an unknown input, modeled as a singular system.

Published
2002

79. Turbulent friction in flows over permeable walls

Author

Manes, C., Pokrajac, D., Nikora, V.I., Ridolfi, L., and Poggi, D.

Abstract

The experimental results of Nikuradse and the concept of hydraulically smooth, transitional, and rough flow regimes are commonly used as a benchmark for data interpretation and modeling of hydraulic resistance. However, Nikuradse's experiments were carried out in pipes with impermeable rough-walls whereas many geophysical flows occur over permeable walls and thus the permeability effects need to be quantified and accounted for. On the basis of our own experimental results, it is shown that wall permeability influences flow resistance dramatically and that the conventional ‘hydraulically-rough regime’, for which the friction factor depends only on the ratio of the roughness size to the flow thickness, does not apply to flows over permeable walls. Indeed, even at high Reynolds number ( Re), the friction factor progressively increases with increasing Re. Possible mechanisms that explain this behavior, as well as the implications of these results for modeling of the friction factors and hyporheic exchange in porous-bed rivers are discussed

Published
2011

80. Impaired endothelial repair capacity of early endothelial progenitor cells in prehypertension: relation to endothelial dysfunction

Author

Giannotti, G, Doerries, C, Mocharla, Ps, Mueller, Mf, Bahlmann, Fh, Horvàth, T, Jiang, H, Sorrentino, Sa, Steenken, N, Manes, C, Marzilli, Mario, Rudolph, Kl, Lüscher, Tf, Drexler, H, Landmesser, U., University of Zurich, and Giannotti, G

Subjects
2724 Internal Medicine, 10209 Clinic for Cardiology, 570 Life sciences, biology, 610 Medicine & health, 10052 Institute of Physiology
Published
2010

82. Aerodynamic roughness lengths of snow

Author

Gromke, C.B., Walter, B., Manes, C., Lehning, M., and Building Physics

Abstract

This study presents the results from a series of wind-tunnel experiments designed to investigate the aerodynamic roughness length z0 of fresh snow under no-drift conditions. A two-component hot-film anemometer was employed to obtain vertical profiles of velocity statistics in a zero pressure gradient turbulent boundary layer for flow over naturally deposited snow surfaces. The roughness of these snow surfaces was measured by means of digital photography to capture characteristic length scales that can be related to z0. Our results show that, under aerodynamically rough conditions, the mean value of the roughness length for fresh snow is =0.24 mm with a standard deviation s(z0) = 0.05 mm. In this study, we show that variations in z0 are associated with variations in the roughness geometry. The roughness measurements suggest that the estimated values of z0 are consistent with the presence of irregular roughness structures that develop during snowfalls that mimic ballistic deposition processes.

Published
2009

83. Aerodynamic and surface characteristic length scales of snow covered flat planes

Author

Gromke, C., michele guala, Manes, C., Walter, B., Lehning, M., and Building Physics

Subjects
Astrophysics::Earth and Planetary Astrophysics
Abstract

Velocity profiles over fresh fallen snow surfaces have been measured in the SLF cold atmospheric boundary layer wind tunnel. Aerodynamic roughness lengths z0 have been estimated from log-law velocity profile fitting. In parallel, photographs of the snow surfaces have been taken and evaluated using digital image analysis giving snow surface contour line coordinates. Applying structure functions to the snow surface coordinates and statistical fitting analyses resulted in sets of surface characteristic length scales (random field approach). The synthesis of both approaches suggests a linear relationship between z0 and one of the surface characteristic length scales.

Published
2009

84. Statistical properties of fresh snow roughness

Author

Manes, C., Guala, M., Löwe, H., Bartlett, S., Egli, L., and Lehning, M.

Abstract

We present results from a series of experiments in which fresh snow roughness was measured by means of digital photography and analyzed using the random field approach. The aim of the paper is to investigate the scaling properties of fresh-snow-covered surfaces and to capture key roughness length scales which can characterize the surface geometry and the size of the snow crystals. Results from our experiments show the following: (1) fresh snow roughness exhibits two distinguished scaling regimes, one at scales comparable with the crystals size and another one at larger scales; (2) we confirm that the large scales are built up during snowfall and their scaling behavior is consistent with that of Ballistic Deposition (BD) processes; and (3) we suggest that the crossover length scale separating the two scaling regimes effectively defines a representative length scale of the aggregated snow crystals on the surface. The definition of this length scale is independent of the difficulties associated with measuring snow grain sizes by means of standard microscopic analysis of disaggregated crystals. Furthermore it can be obtained from a low-cost and quick experimental procedure. Results from this study provide a plausible justification for the wide scatter of aerodynamic roughness length values encountered in the literature for fresh snow. Moreover, they provide insight on the key roughness length scales which should be used for the modeling of this parameter

Published
2008

88. On the evolution of snow roughness during snow fall

Author

Lowe, H., Egli, L., Bartlett, S.J., Guala, M., and Manes, C.

Subjects
Astrophysics::Earth and Planetary Astrophysics, Physics::Geophysics
Abstract

The deposition and attachment mechanism of settling snow crystals during snowfall dictates the very initial structure of ice within a natural snowpack. In this letter we apply ballistic deposition as a simple model to study the structural evolution of the growing surface of a snowpack during its formation. The roughness of the snow surface is predicted from the behaviour of the time dependent height correlation function. The predictions are verified by simple measurements of the growing snow surface based on digital photography during snowfall. The measurements are in agreement with the theoretical predictions within the limitations of the model which are discussed. The application of ballistic deposition type growth models illuminates structural aspects of snow from the perspective of formation which has been ignored so far. Implications of this type of growth on the aerodynamic roughness length, density, and the density correlation function of new snow are discussed

Published
2007

90. Nutritional intake of 2868 IDDM patients from 30 centres in Europe

Author

Toeller, M, Klischan, A, Heitkamp, G, Schumacher, W, Milne, R, Buyken, A, Karamanos, B, Gries, Fa, Fuller, Jh, Keen, H, Krans, Hmj, Navalesi, R, Sjolie, Ak, Stephenson, Jm, Viberti, Gc, Tountas, C, Kofinis, A, Petrou, K, Katsilambros, N, Roussipenessi, D, Cignarelli, M, Giorgino, R, Degeco, Ml, Ramunni, I, Ionescutirgoviste, C, Strachinariu, R, Nicolau, A, Tamas, G, Kerenyi, Z, Ahmed, Am, Toth, J, Kempler, P, Muntoni, S, Songini, M, Stabilini, M, Fossarello, M, Pintus, S, Ferriss, B, Cronin, Cc, Humphreys, M, Forst, T, Wagener, W, Venhaus, A, Rottiers, R, Priem, H, Deschoolmeester, Mj, Ebeling, P, Sinisalo, M, Koivisto, Va, Idziorwalus, B, Solnica, B, Szopinskaciba, L, Solnica, K, Lemkes, Hhpj, Janse, Jj, Eltedewever, Bm, Nunescorrea, J, Boavida, J, Carvalho, R, Alfonso, Mj, Monteiro, M, David, R, Jepson, E, Mchardyyoung, S, Betteridge, Dj, Milne, M, Michel, G, Wirion, R, Paquet, S, Hornick, H, Boulton, Ajm, Ashe, H, Fernando, Djs, Curwell, J, Pozza, G, Slaviero, G, Comi, G, Fattor, B, Bandello, F, Marchi, M, Mehnert, H, Nuber, A, Janka, H, Nichting, M, Crepaldi, G, Nosadini, R, Cathelineau, G, Cathelineau, Bv, Jellal, M, Grodner, N, Feiss, Pg, Baclet, N, Santeusanio, F, Rosi, G, Ventura, Mrm, Cagini, C, Marino, C, Penno, G, Miccoli, Roberto, Nannipieri, Monica, Manfredi, S, Bertolotto, A, Ghirlanda, G, Cotroneo, P, Manto, A, Teodonio, C, Minnella, A, Careddu, G, Ward, Jd, Tesfaye, S, Mody, C, Rudd, C, Molinatti, Gm, Vitelli, F, Porta, M, Pagano, Gf, Estivi, P, Sivieri, R, Carta, Q, Petraroli, G, Papazoglou, N, Goutzourela, M, Manes, C, Bensoussan, D, Fallas, Mc, Fallas, P, Dhanaeus, C, Bourgeois, Md, Muggeo, M, Cacciatori, V, Bellavere, F, Galante, P, Gemma, Ml, Branzi, P, Irsigler, K, Abrahamian, H, Gurdet, C, Hornlein, B, Willinger, C, Strohner, H, Just, M, Walford, S, Wardle, Ev, Henio, S, Cooke, H, Roglic, G, Resman, Z, Metelko, Z, Skrabalo, Z., Toeller, M, Klischan, A, Heitkamp, G, Schumacher, W, Milne, R, Buyken, A, Karamanos, B, Gries, Fa, Fuller, Jh, Keen, H, Krans, Hmj, Navalesi, R, Sjolie, Ak, Stephenson, Jm, Viberti, Gc, Tountas, C, Kofinis, A, Petrou, K, Katsilambros, N, Roussipenessi, D, Cignarelli, M, Giorgino, R, Degeco, Ml, Ramunni, I, Ionescutirgoviste, C, Strachinariu, R, Nicolau, A, Tamas, G, Kerenyi, Z, Ahmed, Am, Toth, J, Kempler, P, Muntoni, S, Songini, M, Stabilini, M, Fossarello, M, Pintus, S, Ferriss, B, Cronin, Cc, Humphreys, M, Forst, T, Wagener, W, Venhaus, A, Rottiers, R, Priem, H, Deschoolmeester, Mj, Ebeling, P, Sinisalo, M, Koivisto, Va, Idziorwalus, B, Solnica, B, Szopinskaciba, L, Solnica, K, Lemkes, Hhpj, Janse, Jj, Eltedewever, Bm, Nunescorrea, J, Boavida, J, Carvalho, R, Alfonso, Mj, Monteiro, M, David, R, Jepson, E, Mchardyyoung, S, Betteridge, Dj, Milne, M, Michel, G, Wirion, R, Paquet, S, Hornick, H, Boulton, Ajm, Ashe, H, Fernando, Dj, Curwell, J, Pozza, G, Slaviero, G, Comi, G, Fattor, B, Bandello, Francesco, Marchi, M, Mehnert, H, Nuber, A, Janka, H, Nichting, M, Crepaldi, G, Nosadini, R, Cathelineau, G, Cathelineau, Bv, Jellal, M, Grodner, N, Feiss, Pg, Baclet, N, Santeusanio, F, Rosi, G, Ventura, Mrm, Cagini, C, Marino, C, Penno, G, Miccoli, R, Nannipieri, M, Manfredi, S, Bertolotto, A, Ghirlanda, G, Cotroneo, P, Manto, A, Teodonio, C, Minnella, A, Careddu, G, Ward, Jd, Tesfaye, S, Mody, C, Rudd, C, Molinatti, Gm, Vitelli, F, Porta, M, Pagano, Gf, Estivi, P, Sivieri, R, Carta, Q, Petraroli, G, Papazoglou, N, Goutzourela, M, Manes, C, Bensoussan, D, Fallas, Mc, Fallas, P, Dhanaeus, C, Bourgeois, Md, Muggeo, M, Cacciatori, V, Bellavere, F, Galante, P, Gemma, Ml, Branzi, P, Irsigler, K, Abrahamian, H, Gurdet, C, Hornlein, B, Willinger, C, Strohner, H, Just, M, Walford, S, Wardle, Ev, Henio, S, Cooke, H, Roglic, G, Resman, Z, Metelko, Z, and Skrabalo, Z.

Subjects
medicine.medical_specialty, education.field_of_study, Cross-sectional study, business.industry, Endocrinology, Diabetes and Metabolism, Saturated fat, Population, Nutritional intake, IDDM patients, medicine.disease, Diet Records, Endocrinology, Internal medicine, Diabetes mellitus, Cohort, Internal Medicine, medicine, Population study, education, business, Cohort study
Abstract

The EURODIAB IDDM Complications Study, a cross-sectional, clinic-based study, was designed to measure the prevalence of diabetic complications in stratified samples of European insulin-dependent diabetic (IDDM) patients. As diet may be related to diabetic complications, nutritional intake was analysed in the study population. The aims of this first nutritional paper are to describe the nutrient intake in 2868 IDDM patients from 30 centres in 16 countries throughout Europe, to investigate the degree of regional differences in nutrient intake and to compare current intakes with recommended levels. Nutritional intake from 1458 male and 1410 female IDDM patients was assessed by a validated 3-day record (two weekdays, Sunday) and centrally analysed. Mean energy intake for all patients was 2390 +/- 707 kcal/day. Mean protein intake was 1.5 +/- 0.5 g/kg body weight. Carbohydrate intake was 43% and fibre intake 18 g/day. Alcohol intake for the total cohort was 2% of energy. Total fat contributed 38% of energy, with 14% from saturated fat. The Italian centres reported lower total and saturated fat intakes compared with other centres. Recommendations from the Diabetes and Nutrition Study Group of the EASD for total fat, saturated fatty acids and carbohydrate were only achieved by 14%, 14% and 15% of patients, respectively. The data of the present study clearly indicate current problems in the nutritional intake of European IDDM patients. These findings contribute to the definition of future targets in the nutritional management of IDDM patients, to be achieved as part of the initiatives taken by the St. Vincent Declaration action programme.

Published
1996

94. Risk factors for coronary heart disease in type 1 diabetic patients in Europe : The EURODIAB Prospective Complications Study

Author

Soedamah-Muthu, S.S., Chaturvedi, N., Toeller, M., Ferris, B., Reboldi, P., Michel, G., Manes, C., and Fuller, J.H.

Subjects
Nutrition and Disease, cohort, vascular-disease, density lipoprotein cholesterol, insulin-resistance, cardiovascular mortality, extremity arterial-disease, Voeding en Ziekte, follow-up, cardiovascular diseases, urinary albumin, iddm complications, VLAG, mellitus
Abstract

OBJECTIVE—The goal of the study was to examine risk factors in the prediction of coronary heart disease (CHD) and differences in men and women in the EURODIAB Prospective Complications Study. RESEARCH DESIGN AND METHODS—Baseline risk factors and CHD at follow-up were assessed in 2,329 type 1 diabetic patients without prior CHD. CHD was defined as physician-diagnosed myocardial infarction, angina pectoris, coronary artery bypass graft surgery, and/or Minnesota-coded ischemic electrocardiograms or fatal CHD. RESULTS—There were 151 patients who developed CHD, and the 7-year incidence rate was 8.0 (per 1,000 person-years) in men and 10.2 in women. After adjustment for age and/or duration of diabetes, the following risk factors were related to CHD in men: age, GHb, waist-to-hip ratio (WHR), HDL cholesterol, smoking, albumin excretion rate (AER), and autonomic neuropathy. The following risk factors were related to CHD in women: age, systolic blood pressure (BP), fasting triglycerides, AER, and retinopathy. Multivariate standardized Cox proportional hazards models showed that age (hazard ratio 1.5), AER (1.3 in men and 1.6 in women), WHR (1.3 in men), smoking (1.5 in men), fasting triglycerides (1.3 in women) or HDL cholesterol (0.74 in women), and systolic BP (1.3 in women) were predictors of CHD. CONCLUSIONS—This study supports the evidence for a strong predictive role of baseline albuminuria in the pathogenesis of CHD in type 1 diabetes. Furthermore, sex-specific risk factors such as systolic BP, fasting triglycerides (or HDL cholesterol), and WHR were found to be important in the development of CHD

Published
2004

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