| 1. |
- Adolfsson, Peter, 1963, et al.
(författare)
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Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen
- 2020
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Ingår i: Diabetes Technology & Therapeutics. - : Mary Ann Liebert Inc. - 1520-9156 .- 1557-8593. ; 22:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: This observational study investigated whether the connected NovoPen(R) 6 could influence insulin regimen management and glycemic control in people with type 1 diabetes (T1D) using a basal-bolus insulin regimen and continuous glucose monitoring in a real-world setting. Methods: Participants from 12 Swedish diabetes clinics downloaded pen data at each visit (final cohort: n = 94). Outcomes included time in range (TIR; sensor glucose 3.9-10.0 mmol/L), time in hyperglycemia (>10 mmol/L), and hypoglycemia (L1: 3.0- <3.9 mmol/L; L2: <3.0 mmol/L). Missed bolus dose (MBD) injections were meals without bolus injection within -15 and +60 min from the start of a meal. Outcomes were compared between the baseline and follow-up periods (>= 5 health care professional visits). Data were analyzed from the first 14 days following each visit. For the TIR and total insulin dose analyses (n = 94), a linear mixed model was used, and for the MBD analysis (n = 81), a mixed Poisson model was used. Results: TIR significantly increased (+1.9 [0.8; 3.0](95% CI) h/day; P < 0.001) from baseline to follow-up period, with a corresponding reduction in time in hyperglycemia (-1.8 [-3.0; -0.6](95% CI) h/day; P = 0.003) and L2 hypoglycemia (-0.3 [-0.6; -0.1](95% CI) h/day; P = 0.005), and no change in time in L1 hypoglycemia. MBD injections decreased by 43% over the study (P = 0.002). Change in MBD injections corresponded to a decrease from 25% to 14% based on the assumption that participants had three main meals per day. Conclusions: Our study highlights the potential benefit on glycemic control and dosing behavior when reliable insulin dose data from a connected pen contribute to insulin management in people with T1D.
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| 2. |
- Jendle, Johan, 1963-, et al.
(författare)
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A European Cost-Utility Analysis of the MiniMedTM 780G Advanced Hybrid Closed-Loop System versus Intermittently Scanned Continuous Glucose Monitoring with Multiple Daily Insulin Injections in People Living with Type 1 Diabetes
- 2023
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Ingår i: Diabetes Technology & Therapeutics. - : Mary Ann Liebert. - 1520-9156 .- 1557-8593. ; 25:12, s. 864-876
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Tidskriftsartikel (refereegranskat)abstract
- Background: Advanced hybrid closed-loop (AHCL) automated insulin delivery systems are the most effective therapy in terms of assisting people with type 1 diabetes (T1D) to achieve glycemic targets; however, the cost can represent a barrier to uptake. Here, a cost-utility analysis of the MiniMedTM 780G AHCL system (MM780G) versus intermittently-scanned continuous glucose monitoring (is-CGM) plus multiple daily insulin injections (MDI) in people with T1D not achieving glycemic goals was performed across six European countries.Methods: Clinical input data were sourced from the ADAPT trial. Assuming a baseline HbA1c of 9.04%, HbA1c reductions of 1.54% for AHCL and 0.2% for is-CGM+MDI were assumed. The analyses were performed from a payer perspective over a time horizon of 40 years and an annual discount rate of 3% was applied.Results: Across all countries, the use of AHCL was projected to result in an incremental gain in quality-adjusted life expectancy of >2 quality-adjusted life years (QALYs) versus is-CGM+MDI. Lifetime direct costs were higher with AHCL resulting in incremental cost-utility ratios for AHCL versus is-CGM+MDI ranging from EUR 11,765 per QALY gained in Austria to EUR 43,963 per QALY gained in Italy.Conclusions: For people with T1D managed with is-CGM+MDI not achieving glycemic targets, initiation of the MM780G system was projected to improve long-term clinical outcomes; however, due to differences in healthcare costs between countries, the health economic outcomes differ. In the countries included here, AHCL is likely to be cost-effective relative to is-CGM+MDI for people not achieving glycemic goals with is-CGM+MDI. The ADAPT trial is registered with ClinicalTrials.gov, NCT04235504.
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| 3. |
- Jendle, J., 1963-, et al.
(författare)
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BETTER GLYCEMIC CONTROL AND HIGHER USE OF ADVANCED DIABETES TECHNOLOGY IN AGE GROUP 0-17 YRS COMPARED TO 18-25 YRS WITH TYPE 1 DIABETES
- 2022
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Ingår i: Diabetes Technology & Therapeutics. - : Mary Ann Liebert. - 1520-9156 .- 1557-8593. ; 24:Suppl. 1, s. A127-A127
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and Aims: The development of diabetes technology is rapid and needs both education and resources to be successfully implemented in diabetes care management. The aims were to identify factors associated with glucose control andcosts.Methods: In an observational study we evaluated the use of advanced diabetes technology, resource utilization, glycemic control, and costs. The study population was all T1D individuals in the Region Halland in Sweden. The study cohort was followed for 7 years (2013-2019).Results: Children aged 0-17 years have significantly better glucose control than young adults aged 18-25 years. The mean HbA1c difference between children and young adults was 8 mmol/mol. Significant difference was noted from 6 months after diabetes diagnoses and onwards. Co-morbidities such as ADHD, anxiety, depression, and eating disorders were associated with higher HbA1c. All groups, irrelevant of age and co-morbidity, had positive effect on glucose control after a visit to a dietitian or psychologist. Differences were found between the age groups in terms of more advanced diabetes technology and more frequent visits to a physician in children.Conclusions: More frequent visits to physicians, dietitians, and psychologists are linked to improved glucose control. Increased resources including access to more advanced technology are required in young adults. A young adult diabetes team could be implemented to mitigate this inequality between age groups found in our study. Increased resources and strategies to improve glucose control, will likely lead to numerous positive effects, reduction of the burden of disease, and reduction of long-term costs in T1D.
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| 4. |
- Jendle, J, 1963-, et al.
(författare)
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COST-EFFECTIVENESS ANALYSIS OF THE MINIMED (TM) 780G SYSTEM VERSUS MULTIPLE DAILY INJECTIONS WITH INTERMITTENTLY SCANNED CONTINUOUS GLUCOSE MONITORING IN INDIVIDUALS WITH TYPE1 DIABETES ACROSS EUROPE
- 2023
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Ingår i: Diabetes Technology & Therapeutics. - : Mary Ann Liebert. - 1520-9156 .- 1557-8593. ; 25:Suppl. 2, s. A119-A119
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and Aims: The standard of care for people with type 1 diabetes (T1D) is continually evolving and Automated Insulin Delivery system (AID) systems and continuous glucose monitoring (CGM) are emerging as the standard of care for many individuals with T1D. This study aimed to compare the long-term cost-effec-tiveness of the MiniMedTM 780G system versus MDI+ intermittently scanning CGM in people with T1D across European countries.Methods: Long-term costs and clinical outcomes were estimated using the CORE Diabetes Model. Clinical data were derived from ADAPT, prospective, multicentre, open-label, randomized control trial [1]. MiniMedTM 780G system was associated with a reduction in HbA1c of 1.54%, from 9.04% (75 mmol/mol) at baseline to 7.5% (58 mmol/mol) at the end oft he study; isCGM was associated with a reduction in HbA1c of 0.2%1. Quality of life benefits associated with a reduced fear of hypoglycaemia were also applied. Analyses were conducted in Sweden and other countries across Europe.Results: The MiniMedTM 780G system was associated with aquality-adjusted life-year (QALY) gain of 2.24 with higher overall costs versus MDI+isCGM, leading to an incremental cost-effectiveness ratio of SEK 366,919 (33,757 Euro) per QALY-gained. MiniMedTM 780G system resulted in a lower cumulative incidence of diabetes-related complications. Higher acquisition costs were partially offset by reduced complications costs. Extensive analysis of key drivers and analysis conducted across different countries confirmed the robustness of the results.Conclusions: Over patient lifetimes, for adults with T1D, the use of the AID system is projected to be cost-effective when compared with MDI+isCGM.1. Choudhary P, et al. Lancet Diabetes Endocrinol 2022 https://doi.org/10.1016/S2213-8587(22)00212-1.
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| 5. |
- An, Sining, 1991, et al.
(författare)
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Coded Pilot Assisted Baseband Receiver for High Data Rate Millimeter-Wave Communications
- 2020
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Ingår i: IEEE Transactions on Microwave Theory and Techniques. - 0018-9480 .- 1557-9670. ; 68:11, s. 4719-4727
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Tidskriftsartikel (refereegranskat)abstract
- A coded pilot assisted high data rate millimeter-wave receiver topology is presented in this article. A low data rate and low power pseudorandom noise (pn) coded pilot signal is superimposed at the transmitter, and the receiver can use such pilot for carrier recovery (CR) and/or channel estimation regardless of modulation scheme or communication data rate. The proposed baseband receiver has an analog-digital hybrid structure where a low-cost digital signal processor is used. This structure requires only a low-cost analog-to-digital converter (ADC) with a sampling rate of 40 MSPS. A proof-of-concept communication link at E-band is demonstrated with 18 Gbps 64-quadrature amplitude modulation (QAM) and 24 Gbps 16-QAM.
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| 6. |
- Aronsson, S., et al.
(författare)
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A live mindset in Live Virtual Constructive simulations : a spin-up for future LVC air combat training
- 2022
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Ingår i: The Journal of Defence Modeling and Simulation. - : SAGE Publications. - 1548-5129 .- 1557-380X.
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Tidskriftsartikel (refereegranskat)abstract
- Combining Live, Virtual, and Constructive (LVC) aircraft in the same training scenario holds promise for developing and enhancing fighter pilot training. The simulator study reported here builds on joint pilot-researcher co-design work of beyond visual range LVC training (LVC-T) scenarios to provide training value to pilots in both Live and Virtual aircraft. One fourship of pilots simulated Live entities by acting under peacetime restrictions, while other pilots acted as during regular Virtual training. The objective was to investigate pilots’ reflections on the implications of LVC-T and on the methodology used to provide hands-on experience of a plausible LVC-T scenario. The purpose is to inform the design and use of future LVC in air combat training from the perspective of training value. Results indicate that pilots are positive toward the LVC scenario design, especially the dynamics that a large-scale scenario brings to training of decision making. They indicate a high degree of presence, the need for specific regulations to enforce flight safety, and that restrictions put on the simulated Live entities had implications for the other pilots. In addition to regular Live (L) and simulator (V + C) training, LVC-T may enhance pilots’ repertoires and decision-making patterns.
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| 7. |
- Aronsson, Sanna, et al.
(författare)
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LVC Allocator : Aligning training value with scenario design for envisioned LVC training of fast-jet pilots
- 2022
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Ingår i: The Journal of Defence Modeling and Simulation. - : SAGE Publications. - 1548-5129 .- 1557-380X. ; 19:3, s. 287-298
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Tidskriftsartikel (refereegranskat)abstract
- Live virtual constructive (LVC) flight simulations mix pilots flying actual aircraft, pilots flying in simulators, and computer- generated forces, in joint scenarios. Training resources invested in LVC scenarios must give a high return, and therefore pilots in both live aircraft and simulators need to experience training value for the extensive resources invested in both, an aspect not emphasized in current LVC research. Thus, there is a need for a function, in this article described as LVC Allocator, which assures that complex LVC training scenarios include aspects of training value for all participants, and, thus, purposefully align scenario design with training value. A series of workshops were carried out with 16 fast-jet pilots articulating the training challenges that LVC could contribute to solving, and allocating LVC entities in a training scenario design exercise. The training values for LVC included large scenarios, weapon delivery, flight safety, adversary performance, and weather dependence. These values guided the reasoning of how to allocate different entities to L, V, or C entities. Allocations were focused on adversaries as V, keeping entity types together, weather dependence, low-alti- tude and supersonic flying requirements, and to let L entities handle and lead complex tasks to keep the human in the loop.
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| 8. |
- Asad, Muhammad, 1986, et al.
(författare)
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Enhanced high-frequency performance of top-gated graphene FETs due to substrate-induced improvements in charge carrier saturation velocity
- 2021
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Ingår i: IEEE Transactions on Electron Devices. - 1557-9646 .- 0018-9383. ; 68:2, s. 899-902
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Tidskriftsartikel (refereegranskat)abstract
- High-frequency performance of top-gated graphene field-effect transistors (GFETs) depends to a large extent on the saturation velocity of the charge car-riers, a velocity limited by inelastic scattering by surface optical phonons from the dielectrics surrounding the chan-nel. In this work, we show that by simply changing the graphene channel surrounding dielectric with a material having higher optical phonon energy, one could improve the transit frequency and maximum frequency of oscillation of GFETs. We fabricated GFETs on conventional SiO2/Si substrates by adding a thin Al2O3 interfacial buffer layer on top of SiO2/Si substrates, a material with about 30% higher optical phonon energy than that of SiO2, and compared performance with that of GFETs fabricated without adding the interfacial layer. From S-parameter measurements, a transit frequency and a maximum frequency of oscillation of 43 GHz and 46 GHz, respectively, were obtained for GFETs on Al2O3 with 0.5 µm gate length. These values are approximately 30% higher than those for state-of-the-art GFETs of the same gate length on SiO2. For relating the improvement of GFET high-frequency performance to improvements in the charge carrier saturation velocity, we used standard methods to extract the charge carrier veloc-ity from the channel transit time. A comparison between two sets of GFETs with and without the interfacial Al2O3 layer showed that the charge carrier saturation velocity had increased to 2·10^7 cm/s from 1.5·10^7 cm/s.
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| 9. |
- Bonmann, Marlene, 1988, et al.
(författare)
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Effects of self-heating on fT and fmax performance of graphene field-effect transistors
- 2020
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Ingår i: IEEE Transactions on Electron Devices. - 1557-9646 .- 0018-9383. ; 67:3, s. 1277-1284
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Tidskriftsartikel (refereegranskat)abstract
- It has been shown that there can be a significant temperature increase in graphene field-effect transistors (GFETs) operating under high drain bias, which is required for power gain. However, the possible effects of self-heating on the high-frequency performance of GFETs have been weakly addressed so far. In this article, we report on an experimental and theoretical study of the effects of self-heating on dc and high-frequency performance of GFETs by introducing a method that allows accurate evaluation of the effective channel temperature of GFETs with a submicrometer gate length. In the method, theoretical expressions for the transit frequency (fT) and the maximum frequency of oscillation (fmax) based on the small-signal equivalent circuit parameters are used in combination with the models of the field- and temperature-dependent charge carrier concentration, velocity, and saturation velocity of GFETs. The thermal resistances found by our method are in good agreement with those obtained by the solution of the Laplace equation and by the method of thermo-sensitive electrical parameters. Our experiments and modeling indicate that the self-heating can significantly degrade the fT and fmax of GFETs at power densities above 1 mW/μm², from approximately 25 to 20 GHz. This article provides valuable insights for further development of GFETs, taking into account the self-heating effects on the high-frequency performance.
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| 10. |
- Cavalli, Marco, et al.
(författare)
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A Multi-Omics Approach to Liver Diseases : Integration of Single Nuclei Transcriptomics with Proteomics and HiCap Bulk Data in Human Liver
- 2020
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Ingår i: Omics. - : Mary Ann Liebert Inc. - 1536-2310 .- 1557-8100. ; 24:4, s. 180-194
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Tidskriftsartikel (refereegranskat)abstract
- The liver is the largest solid organ and a primary metabolic hub. In recent years, intact cell nuclei were used to perform single-nuclei RNA-seq (snRNA-seq) for tissues difficult to dissociate and for flash-frozen archived tissue samples to discover unknown and rare cell subpopulations. In this study, we performed snRNA-seq of a liver sample to identify subpopulations of cells based on nuclear transcriptomics. In 4282 single nuclei, we detected, on average, 1377 active genes and we identified seven major cell types. We integrated data from 94,286 distal interactions (p < 0.05) for 7682 promoters from a targeted chromosome conformation capture technique (HiCap) and mass spectrometry proteomics for the same liver sample. We observed a reasonable correlation between proteomics and in silico bulk snRNA-seq (r = 0.47) using tissue-independent gene-specific protein abundancy estimation factors. We specifically looked at genes of medical importance. The DPYD gene is involved in the pharmacogenetics of fluoropyrimidine toxicity and some of its variants are analyzed for clinical purposes. We identified a new putative polymorphic regulatory element, which may contribute to variation in toxicity. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and we investigated all known risk genes. We identified a complex regulatory landscape for the SLC2A2 gene with 16 candidate enhancers. Three of them harbor somatic motif breaking and other mutations in HCC in the Pan Cancer Analysis of Whole Genomes dataset and are candidates to contribute to malignancy. Our results highlight the potential of a multi-omics approach in the study of human diseases.
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