Management of insulin administration for intake of carbohydrates and physical activity can be burdensome for people with type 1 diabetes on hybrid closed-loop systems. Bihormonal fully closed-loop ...(FCL) systems could help reduce this burden. In this trial, we assessed the long-term performance and safety of a bihormonal FCL system.
The FCL system (Inreda AP; Inreda Diabetic, Goor, Netherlands) that uses two hormones (insulin and glucagon) was assessed in a 1 year, multicentre, prospective, single-arm intervention trial in adults with type 1 diabetes. Participants were recruited in eight outpatient clinics in the Netherlands. We included adults with type 1 diabetes aged 18–75 years who had been using flash glucose monitoring or continuous glucose monitors for at least 3 months. Study visits were integrated into standard care, usually every three months, to evaluate glycaemic control, adverse events, and person-reported outcomes. The primary endpoint was time in range (TIR; glucose concentration 3·9–10·0 mmol/L) after 1 year. The study is registered in the Dutch Trial Register, NL9578.
Between June 1, 2021, and March 2, 2022, we screened 90 individuals and enrolled 82 participants; 78 were included in the analyses. 79 started the intervention and 71 were included in the 12 month analysis. Mean age was 47.7 (SD 12·4) years and 38 (49%) were female participants. The mean preintervention TIR of participants was 55·5% (SD 17·2). After 1 year of FCL treatment, mean TIR was 80·3% (SD 5·4) and median time below range was 1·36% (IQR 0·80–2·11). Questionnaire scores improved on Problem Areas in Diabetes (PAID) from 30·0 (IQR 18·8–41·3) preintervention to 10·0 (IQR 3·8–21·3; p<0·0001) at 12 months and on World Health Organization-Five Well-Being Index (WHO-5) from 60·0 (IQR 44·0–72·0) preintervention to 76·0 (IQR 60·0–80·0; p<0·0001) at 12 months. Five serious adverse events were reported (one cerebellar stroke, two severe hypoglycaemic, and two hyperglycaemic events).
Real-world data obtained in this trial demonstrate that use of the bihormonal FCL system was associated with good glycaemic control in patients who completed 1 year of treatment, and could help relieve these individuals with type 1 diabetes from making treatment decisions and the burden of carbohydrate counting.
Inreda Diabetic.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In this paper, we propose a game-theoretic framework for analysing competing double auction marketplaces that vie for traders and make profits by charging fees.
Firstly
, we analyse the equilibrium ...strategies for the traders’ market selection decision for given market fees using evolutionary game theory. Using this approach, we investigate how traders dynamically change their strategies, and thus, which equilibrium, if any, can be reached. In so doing, we show that, when the same type of fees are charged by two marketplaces, it is unlikely that competing marketplaces will continue to co-exist when traders converge to their equilibrium market selection strategies. Eventually, all the traders will congregate in one marketplace. However, when different types of fees are allowed (registration fees and profit fees), competing marketplaces are more likely to co-exist in equilibrium. We also find that sometimes all the traders eventually migrate to the marketplace that charges higher fees. We then further analyse this phenomenon, and specifically analyse how bidding strategies and random exploration of traders affects this migration respectively.
Secondly
, we analyse the equilibrium strategies of the marketplaces when they have the ability to vary their fees in response to changes in the traders’ market selection strategies. In this case, we consider the competition of the marketplaces as a two-stage game, where the traders’ market selection strategies are conditional on the market fees. In particular, we use a co-evolutionary approach to analyse how competing marketplaces dynamically set fees while taking into account the dynamics of the traders’ market selection strategies. In so doing, we find that two identical marketplaces undercut each other, and they will eventually charge the minimal fee as we set that guarantees positive market profits for them. Furthermore, we extend the co-evolutionary analysis of the marketplaces’ fee strategies to more general cases. Specifically, we analyse how an initially disadvantaged marketplace with an adaptive fee strategy can outperform an initially advantaged one with a fixed fee strategy, or even one with an adaptive fee strategy, and how competing marketplaces evolve their fee strategies when different types of fees are allowed.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
•We investigate traders’ market selection and bidding strategies in multiple double auctions.•We model the setting as a Bayesian game with continuous private values.•We consider different trading ...environments with independent, substitutable and complementary goods.•We use a modified fictitious play algorithm to compute Bayes–Nash equilibrium trading strategies.•We draw various insights such as that traders may not participate when trading perfectly complementary goods.
We investigate how automated traders strategically select marketplaces and submit offers across multiple double auction marketplaces. We model the problem as a Bayesian game with traders that have continuous private values, and use fictitious play to analyse the traders’ Nash equilibrium market selection and bidding strategies. We do this for different trading environments (isolated, single-home, multi-home and hybrid) and different types of goods (independent, substitutable and complementary). We find that, in an isolated marketplace, the fictitious play algorithm converges to a Bayes–Nash equilibrium. In the single-home setting, all traders eventually converge to the same marketplace and the setting reduces to that of an isolated marketplace. In the multi-home setting with perfectly substitutable goods, buyers with high values only bid in one marketplace, whereas buyers with low values bid in multiple marketplaces. Then, for perfectly complementary goods, only buyers with high values bid in multiple marketplaces and buyers with low values enter no marketplaces. Finally, in the hybrid setting with perfectly complementary goods, traders choose no marketplaces.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Inhibition of the acetyl-CoA carboxylase (ACC) system, consisting of the isozymes ACC1 and ACC2, may be beneficial for treatment of insulin resistance and/or obesity by interfering with de novo ...lipogenesis and β-oxidation. We have evaluated effects of pharmacological inhibition of ACC by soraphen (SP) on high fat (HF) diet-induced insulin resistance in mice. Male C57Bl6/J mice were fed control chow, a HF diet or a HF diet supplemented with SP (50 or 100 mg/kg/day). Body weight gain and total body fat content of SP-treated animals were significantly reduced compared with HF-fed mice. Fractional synthesis of palmitate was significantly reduced in mice treated with SP, indicative for ACC1 inhibition. Plasma β-hydroxybutyrate levels were significantly elevated by SP, reflecting simultaneous inhibition of ACC2 activity. Mice treated with SP showed improved peripheral insulin sensitivity, as assessed by hyperinsulinaemic euglycaemic clamps. Pharmacological inhibition of the ACC system is of potential use for treatment of key components of the metabolic syndrome.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Antimicrobial resistance results in increased morbidity, mortality, and costs of health care. Prevention of the emergence of resistance and the dissemination of resistant microorganisms will reduce ...these adverse effects and their attendant costs. Appropriate antimicrobial stewardship that includes optimal selection, dose, and duration of treatment, as well as control of antibiotic use, will prevent or slow the emergence of resistance among microorganisms. A comprehensively applied infection control program will interdict the dissemination of resistant strains.
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BFBNIB, NUK, PNG, UL, UM, UPUK
Bile acid sequestrants (BAS) reduce plasma glucose levels in type II diabetics and in murine models of diabetes but the mechanism herein is unknown. We hypothesized that sequestrant-induced changes ...in hepatic glucose metabolism would underlie reduced plasma glucose levels. Therefore, in vivo glucose metabolism was assessed in db/db mice on and off BAS using tracer methodology.
Lean and diabetic db/db mice were treated with 2% (wt/wt in diet) Colesevelam HCl (BAS) for 2 weeks. Parameters of in vivo glucose metabolism were assessed by infusing U-(13)C-glucose, 2-(13)C-glycerol, 1-(2)H-galactose and paracetamol for 6 hours, followed by mass isotopologue distribution analysis, and related to metabolic parameters as well as gene expression patterns.
Compared to lean mice, db/db mice displayed an almost 3-fold lower metabolic clearance rate of glucose (p = 0.0001), a ∼300% increased glucokinase flux (p = 0.001) and a ∼200% increased total hepatic glucose production rate (p = 0.0002). BAS treatment increased glucose metabolic clearance rate by ∼37% but had no effects on glucokinase flux nor total hepatic or endogenous glucose production. Strikingly, BAS-treated db/db mice displayed reduced long-chain acylcarnitine content in skeletal muscle (p = 0.0317) but not in liver (p = 0.189). Unexpectedly, BAS treatment increased hepatic FGF21 mRNA expression 2-fold in lean mice (p = 0.030) and 3-fold in db/db mice (p = 0.002).
BAS induced plasma glucose lowering in db/db mice by increasing metabolic clearance rate of glucose in peripheral tissues, which coincided with decreased skeletal muscle long-chain acylcarnitine content.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Antimicrobial resistance results in increased morbidity, mortality, and costs of health care. Prevention of the emergence of resistance and the dissemination of resistant microorganisms will reduce ...these adverse effects and their attendant costs. Appropriate antimicrobial stewardship that includes optimal selection, dose, and duration of treatment, as well as control of antibiotic use, will prevent or slow the emergence of resistance among microorganisms. A comprehensively applied infection control program will interdict the dissemination of resistant strains.
This volume contains 9 thoroughly refereed and revised papers detailing recent advances in research on designing trading agents and mechanisms for agent-mediated e-commerce. They were originally ...presented at the 12th International Workshop on Agent-Mediated Electronic Commerce (AMEC 2010), collocated with AAMAS 2010 in Toronto, Canada, or the 2010 Workshop on Trading Agent Design and Analysis (TADA 2010), collocated with EC 2010 in Cambridge, MA, USA.The papers examine emerging topics such as ad auctions and supply chains, or the interactions between competing markets, and present novel algorithms and rigorous theoretical results. Several of them evaluate their results using real data from large e-commerce sites or from experiments with human traders.
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FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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