DSpace Repository :: Browsing by Author "Moscoso-Vásquez, Marcela"

Browsing by Author "Moscoso-Vásquez, Marcela"

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Artificial pancreas: clinical study in Latin America without premeal insulin boluses
(2018-09) Sánchez-Peña, Ricardo; Colmegna, Patricio; Garelli, Fabricio; De Battista, Hernán; García Violini, Demián; Moscoso-Vásquez, Marcela; Rosales, Nicolás; Fushimi, Emilia; Campos-Náñez, Enrique; Breton, Marc; Beruto, Valeria; Scibona, Paula; Rodriguez, Cintia; Giunta, Javier; Simonovich, Ventura; Belloso, Waldo H.; Cherñavvsky, Daniel; Grosembacher, Luis
"Background: Emerging therapies such as closed-loop (CL) glucose control, also known as artificial pancreas (AP) systems, have shown significant improvement in type 1 diabetes mellitus (T1DM) management. However, demanding patient intervention is still required, particularly at meal times. To reduce treatment burden, the automatic regulation of glucose (ARG) algorithm mitigates postprandial glucose excursions without feedforward insulin boluses. This work assesses feasibility of this new strategy in a clinical trial. Methods: A 36-hour pilot study was performed on five T1DM subjects to validate the ARG algorithm. Subjects wore a subcutaneous continuous glucose monitor (CGM) and an insulin pump. Insulin delivery was solely commanded by the ARG algorithm, without premeal insulin boluses. This was the first clinical trial in Latin America to validate an AP controller. Results: For the total 36-hour period, results were as follows: average time of CGM readings in range 70-250 mg/dl: 88.6%, in range 70-180 mg/dl: 74.7%, <70 mg/dl: 5.8%, and <50 mg/dl: 0.8%. Results improved analyzing the final 15-hour period of this trial. In that case, the time spent in range was 70-250 mg/dl: 94.7%, in range 70-180 mg/dl: 82.6%, <70 mg/dl: 4.1%, and <50 mg/dl: 0.2%. During the last night the time spent in range was 70-250 mg/dl: 95%, in range 70-180 mg/dl: 87.7%, <70 mg/dl: 5.0%, and <50 mg/dl: 0.0%. No severe hypoglycemia occurred. No serious adverse events were reported. Conclusions: The ARG algorithm was successfully validated in a pilot clinical trial, encouraging further tests with a larger number of patients and in outpatient settings."
Control-oriented model with intra-patient variations for an artificial pancreas
(2020) Moscoso-Vásquez, Marcela; Colmegna, Patricio; Rosales, Nicolás; Garelli, Fabricio; Sánchez-Peña, Ricardo
"In this work, a low-order model designed for glucose regulation in Type 1 Diabetes Mellitus (T1DM) is obtained from the UVA/Padova metabolic simulator. It captures not only the nonlinear behavior of the glucose-insulin system, but also intrapatient variations related to daily insulin sensitivity (SI) changes. To overcome the large inter-subject variability, the model can also be personalized based on a priori patient information. The structure is amenable for linear parameter varying (LPV) controller design, and represents the dynamics from the subcutaneous insulin input to the subcutaneous glucose output. The eficacy of this model is evaluated in comparison with a previous control-oriented model which in turn is an improvement of previous models. Both models are compared in terms of their open- and closed-loop differences with respect to the UVA/Padova model. The proposed model outperforms previous T1DM control oriented models, which could potentially lead to more robust and reliable controllers for glycemia regulation."
Control-oriented models with intra-patient variations for artificial pancreas systems
(2019) Moscoso-Vásquez, Marcela; Sánchez-Peña, Ricardo; Colmegna, Patricio
"En los últimos años se ha incrementado el número de investigaciones orientadas al desarrollo de un Páncreas Articial (AP) para la regulación automática de glucosa en pacientes con Diabetes Mellitus Tipo 1 (T1DM). Sin embargo, el riesgo de hiper- e hipoglucemia sigue siendo un impedimento para una regulación adecuada de la glucemia en algunos casos. Una fuente importante de limitaciones se origina a partir de la incertidumbre del modelo, y la alta variabilidad inter- e intra-paciente que afecta la dinámica de la regulación de la glucosa. Por lo tanto, considerando que se requieren herramientas para el diseño de estrategias de control robustas y variables en el tiempo que permitan considerar estos aspectos, esta tesis se centra en desarrollar modelos que permitan integrarlos en la etapa de diseño del controlador."
First outpatient clinical trial of a full closed-loop artificial pancreas system in South America
(2022-05) Garelli, Fabricio; Fushimi, Emilia; Rosales, Nicolás; Arambarri, Delfina; Mendoza, Leandro; Serafini, María Cecilia; Moscoso-Vásquez, Marcela; Stasi, Marianela; Duette, Patricia; García Arabehety, Julia; Giunta, Javier; De Battista, Hernán; Sánchez-Peña, Ricardo; Grosembacher, Luis
"The first two studies of an artificial pancreas (AP) system carried out in Latin America took place in 2016 (phase 1) and 2017 (phase 2). They evaluated a hybrid algorithm from the University of Virginia (UVA) and the automatic regulation of glucose (ARG) algorithm in an inpatient setting using an AP platform developed by the UVA. The ARG algorithm does not require carbohydrate (CHO) counting and does not deliver meal priming insulin boluses. Here, the first outpatient trial of the ARG algorithm using an own AP platform and doubling the duration of previous phases is presented."
Invalidation and low-order model set for artificial pancreas robust control design
(2019) Bianchi, Fernando D.; Moscoso-Vásquez, Marcela; Colmegna, Patricio; Sánchez-Peña, Ricardo
"The purpose of this work is to compute a linear parameter-varying (LPV) model set that describes the insulin-glucose dynamics in type 1 diabetes (T1D). This set includes a nominal LPV model and dynamic uncertainty and is amenable to controller design. The nominal model is an LPV control-oriented model previously published by the authors that is (in)validated in this work against the UVA/Padova metabolic simulator. The result is a set of models that is used to design a switched LPV robust controller to account for nonlinearities and variations in insulin sensitivity (SI). Closed-loop responses obtained with the robust controller and a nominal one are compared. Results illustrate the convenience of including robust strategies in designing control laws for an artificial pancreas (AP). "
Non-pharmaceutical intervention to reduce COVID-19 impact in Argentina
(2021-06-21) García Violini, Demián; Sánchez-Peña, Ricardo; Moscoso-Vásquez, Marcela; Garelli, Fabricio
"This work is focused on the multilevel control of the population confinement in the city of Buenos Aires and its surroundings due to the pandemic generated by the COVID-19 outbreak. The model used here is known as SEIRD and two objectives are sought: a time-varying identification of the infection rate and the inclusion of a controller. A control differential equation has been added to regulate the transitions between confinement and normal life, according to five different levels. The plasma treatment from recovered patients has also been considered in the control algorithm. Using the proposed strategy the ICU occupancy is reduced, and as a consequence, the number of deaths is also decreased."
Non-pharmaceutical intervention to reduce COVID-19 impact in Argentina
(2022-05) García Violini, Demián; Sánchez-Peña, Ricardo; Moscoso-Vásquez, Marcela; Garelli, Fabricio
"This work is focused on the multilevel control of the population confinement in the city of Buenos Aires and its surroundings due to the pandemic generated by the COVID-19 outbreak. The model used here is known as SEIRD and two objectives are sought: a time-varying identification of the infection rate and the inclusion of a controller. A control differential equation has been added to regulate the transitions between confinement and normal life, according to five different levels. The plasma treatment from recovered patients has also been considered in the control algorithm. Using the proposed strategy the ICU occupancy is reduced, and as a consequence, the number of deaths is also decreased."
Two-dimensional posture evaluation in Parkinson’s disease: effect of loads on the spinal angle during gait
(2016) Celoria, Paula; Nanni, Federico; Pastore, Flavia Carina; Pulenta, Sebastián; Tajerian, Matías Nazareth; Pantazis, Lucio; Moscoso-Vásquez, Marcela; Cerquetti, Daniel; Merello, Marcelo; Risk, Marcelo
"Parkinson’s Disease patients present diminished coordination caused by neural degeneration. This leads to large motor difficulties during gait such as balance loss and pronounced forward inclination of the upper body. This work assessed the spinal sagittal plane angle alterations in two groups: six parkinsonian patients and six control healthy subjects. This parameter was analyzed during gait under three conditions: without external loads and with external loads applied either on the chest or on the lower back area. Results were statistically compared by means of t-test of paired samples in both groups. For patients, a significant effect was found when loads were applied on the chest. On the other hand, healthy subjects showed no significant differences in either case."

Browsing by Author "Moscoso-Vásquez, Marcela"

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