scholarly journals Response to the Comment by K. Hood to “Do It Yourself” (DIY)—Automated Insulin Delivery (AID) Systems: Current Status From a German Point of View

2021 ◽  
Vol 15 (1) ◽  
pp. 203-205
Author(s):  
Lutz Heinemann ◽  
Karin Lange
2019 ◽  
Vol 14 (01) ◽  
pp. 31-43 ◽  
Author(s):  
Lutz Heinemann ◽  
Karin Lange

AbstractOver the past few years, a group of dedicated people with an affinity for technology and type 1 diabetes has developed systems that enable automated insulin delivery (AID). Patients build these AID systems themselves (do it yourself; DIY). The quality of glucose control achieved with DIY AID systems is impressively good, but the effort for users in everyday life is considerable. So far, no results of clinical studies have been obtained that prove these individual experiences.Main obstacles for the use (also by more patients) are legal questions, because DIY AID systems do not represent approved medical devices. They must be regarded as “experimental” systems. As long as patients build and use these systems for themselves and do not endanger other people, they act at their own risk. Legal questions are more complex and more difficult to answer if, for example, a traffic accident occurs. A legal assessment (in particular of the medical situation) of such systems, initiated by the German Diabetes Society (DDG) (see DDG homepage), comes to the following key statements:– From the patient’s point of view, the assembly of a DIY AID system does not constitute a criminal offence. However, since the intended purpose of the devices is violated, there is no liability on the part of the manufacturers of the medical devices used for this purpose.– Patients who assemble DIY AID systems and “sell” them to other patients are liable to prosecution under the Medical Devices Act (MPG).– Doctors do not have to refer patients with type 1 diabetes to DIY AID systems.If a patient expresses interest in such a system or is already using it, the attending physician must inform the patient about the improper use of the medical devices used and about the associated risks. He should document this information accordingly.This overview presents the current status of this development from various points of view.


2019 ◽  
Vol 14 (6) ◽  
pp. 1028-1034 ◽  
Author(s):  
Lutz Heinemann ◽  
Karin Lange

A group of dedicated people with a high affinity for technology and good understanding of how to treat their type 1 diabetes have developed systems that enable automated insulin delivery (AID). These persons build these AID systems only for themselves (do it yourself [DIY]) and the quality of glucose control achieved with DIY AID systems is impressively good. This overview presents the current status of this development from a German point of view. A high degree of efforts is required to start and maintain this type of therapy and the user must always remain aware of what she/he is doing in everyday life. One main obstacle is liability, because the medicinal products used by persons with diabetes for DIY AID systems are not approved for this indication. They must be regarded as experimental systems. As long as persons with diabetes build and use these systems for themselves and not for other people, they act at their own risk. If a person with diabetes expresses interest in such a system or is already using it, the diabetologist should inform him about the improper use of the medical devices and about the associated risks. The physician should document this information accordingly.


Author(s):  
Hirotake Kobayashi ◽  
Tetsuo Tatsumi ◽  
Takashi Nakashima ◽  
Isashi Takehara ◽  
Yoshihiro Ichikawa

In Japan, from the point of view of energy saving and environmental protection, a 300kW Ceramic Gas Turbine (CGT) Research and Development program started in 1988 and is still continuing as a part of “the New Sunshine Project” promoted by the Ministry of International Trade and Industry (MITT). The final target of the program is to achieve 42% thermal efficiency at 1350°C of turbine inlet temperature (TIT) and to keep NOx emissions below present national regulations. Under contract to the New Energy and Industrial Technology Development Organization (NEDO), Kawasaki Heavy Industries, Ltd. (KHI) has been developing the CGT302 with Kyocera Corporation and Sumitomo Precision Products Co., Ltd. By the end of the fiscal year 1996, the CGT302 achieved 37.0% thermal efficiency at 1280°C of TIT. In 1997, TIT reached 1350°C and a durability operation for 20 hours at 1350°C was conducted successfully. Also fairly low NOx was proved at 1300°C of TIT. In January 1998, the CGT302 has achieved 37.4% thermal efficiency at 1250°C TIT. In this paper, we will describe our approaches to the target performance of the CGT302 and current status.


2016 ◽  
Vol 23 (1) ◽  
Author(s):  
José G. Vargas-Hernández ◽  
Irving Daniel Agustín Cruz

Globalization has become a trigger factor in international trade due to its role as an integral part of the world economy and social standardization in the context of technological, cultural and universal knowledge which allows free access to resource with minimal effort.  The study is a contribution to theories based on the Industry, the Dynamic Resources and Institutions; all around the Mexican Port System. Data was gathered using a qualitative approach of literature review about the current status of the ports and its global environment. The results were organized around the statement of the problem and research objective that guide the study. The results indicated that Manzanillo Port holds dynamic capabilities that increase its competitiveness in the global port industry as strategic locations, and its natural and human resources.


2019 ◽  
Vol 13 (25) ◽  
pp. 19-26
Author(s):  
Jaime Pancorbo Crespo ◽  
Luis Guerrero Gomez ◽  
Javier Gonzalo Arias

Currently, as a result of new communications technologies, autonomous ships are even closer to our seas than we could think. But, besides un-doubted advantages, it gives rise to uncertainties and challenges in several aspects, which include those related to the fields of cybersecurity and legislation, in relation to international regulations and national laws. The aspects of autonomous shipping are included in the information regulations of Bureau Veritas, and additional specific tags have been created to collect the cybersecurity/cyberprotection aspects of such ships. The objective of this article is to present the current status and the foreseeable evolution of the regulations on autonomous shipping from the point of view of a Classification Society, as well as the current evolution of the methodologies concerning cybersecurity.


Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5216
Author(s):  
Justus Körfer ◽  
Florian Lordick ◽  
Ulrich T. Hacker

Gastric cancer is a leading cause of cancer death worldwide. Systemic treatment comprising chemotherapy and targeted therapy is the standard of care in advanced/metastatic gastric cancer. Comprehensive molecular characterization of gastric adenocarcinomas by the TCGA Consortium and ACRG has resulted in the definition of distinct molecular subtypes. These efforts have in parallel built a basis for the development of novel molecularly stratified treatment approaches. Based on this molecular characterization, an increasing number of specific genomic alterations can potentially serve as treatment targets. Consequently, the development of promising compounds is ongoing. In this review, key molecular alterations in gastric and gastroesophageal junction cancers will be addressed. Finally, the current status of the translation of targeted therapy towards clinical applications will be reviewed.


2021 ◽  
Vol 65 (3) ◽  
pp. 42-51
Author(s):  
N. Pyzhikov ◽  
E. Gushchin

The article analyses the current status of the Belt and Road Initiative (BRI), its key achievements and challenges, including those related to the COVID 19 pandemic. In the 2010s China has become one of world’s largest investors and BRI is one of the most important tools of Chinese investment policy. Due to its flexible structure, BRI has been able to adjust and develop in the context of the U.S. – China trade war and the growing anti-Chinese sentiment in the world that included the concerns over so called China’s debt diplomacy. But this lack of rigidity is also a challenge to those who study BRI because there is no official list of projects (estimations vary between 118 and 374) and countries participating in BRI (up to 138). China’s key BRI partner is Pakistan. The total value of projects implemented by China in Pakistan as part of the China-Pakistan Economic Corridor was initially estimated at $46 billion but now exceeds $70 billion (new projects were signed even during the pandemic). BRI is increasing the number of its participants. In March 2019 Italy became the first G7 country to sign a BRI MoU with China. While implementing BRI China has faced such challenges as rising concerns of “China’s debt trap”, as well as ecological and political issues. In 2020 BRI is facing a new challenge with the COVID-19 pandemic. Some BRI projects were postponed because of the pandemic, but in some cases they were unaffected. There are 64 out of 138 countries participating in BRI that come from low and lower-middle income groups according to the World Bank classification. Their average ratio of foreign debt to GDP was 54% in 2018–2019. It is most likely that these countries will be hit hard by the coronacrisis. Thus the pandemic will encourage China to tighten the selection process for BRI projects with a focus on the most strategically important and cost effective ones. From the point of view of China’s BRI partners, the effect can be two-fold: the most unstable economies will increase their dependence on China, while with the economically strong countries China will be more willing to make concessions and offer more favorable conditions for cooperation.


2020 ◽  
Vol 7 (10) ◽  
pp. 1597
Author(s):  
Lopamudra Roy ◽  
Mounamukhar Bhattacharjee

Diabetes mellitus is the chronic pathogenic condition which is primarily due to inadequate insulin secretion and is responsible for major healthcare problems worldwide cost billions of dollars annually. For more than 84 years of time, Insulin replacement therapy had been used to manage to overcome the complications and this present review is based on the various routes of insulin delivery based on its safety and efficacy. Depending upon the effective duration of action, insulin activity varies from 1.5 to 27 hours and to reduce insulin burden, now a days it can be delivered in sensor-augmented pump therapy, various types of insulin Pen as well as routes like inhalation, colonic insulin, buccal, intra- peritonea and ocular, rectal, vaginal delivery of insulin etc. had been added to it. This review examines some of the recent proposals for various routes of application of Insulin delivery system along with the particular attention to its latest intervention of novel drug delivery system.


2014 ◽  
Vol 519-520 ◽  
pp. 1451-1454 ◽  
Author(s):  
Ya Kun Shi

BIM technology used more widely in construction industry in developed countries in Europe and the United States, the integration of building information modeling (BIM) in the domestic large-scale propulsion was still difficult, and further the trend of widening the gap with foreign advanced level. In order to identify problems and solve the current status quo, and cut into the integrated information from project management point of view of China's architectural design, and analysis the status quo of BIM technology in our project management and developmental disabilities, and BIM-based technology and related parties mutual relations, to explain the development prospects of its application in China.


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