Training of carbohydrate estimation for people with diabetes using mobile augmented reality.

BACKGROUND: Imprecise carbohydrate counting as a measure to guide the treatment of diabetes may be a source of errors resulting in problems in glycemic control. Exact measurements can be tedious, leading most patients to estimate their carbohydrate intake. In the presented pilot study a smartphone application (BE(AR)), that guides the estimation of the amounts of carbohydrates, was used by a group of diabetic patients. METHODS: Eight adult patients with diabetes mellitus type 1 were recruited for the study. At the beginning of the study patients were introduced to BE(AR) in sessions lasting 45 minutes per patient. Patients redraw the real food in 3D on the smartphone screen. Based on a selected food type and the 3D form created using BE(AR) an estimation of carbohydrate content is calculated. Patients were supplied with the application on their personal smartphone or a loaner device and were instructed to use the application in real-world context during the study period. For evaluation purpose a test measuring carbohydrate estimation quality was designed and performed at the beginning and the end of the study. RESULTS: In 44% of the estimations performed at the end of the study the error reduced by at least 6 grams of carbohydrate. This improvement occurred albeit several problems with the usage of BE(AR) were reported. CONCLUSIONS: Despite user interaction problems in this group of patients the provided intervention resulted in a reduction in the absolute error of carbohydrate estimation. Intervention with smartphone applications to assist carbohydrate counting apparently results in more accurate estimations.

Can smartphone-based logging support diabetologists in solving glycemic control problems?

Treatment of diabetic patients strongly relies on the continuous logging of parameters relevant to glycemic control. Keeping diabetes diaries can be tedious which can affect the data quality and completeness. Mobile technologies could provide means to overcome these limitations. However, studies analyzing the direct effect on the treatment of patients are rare. In the presented study diabetic patients were supplied with a smartphone application to record various parameters relevant for glycemic control. Questions regarding the completeness of diabetes diaries were answered by the patients before and after the study. The attending diabetologist analyzed the data obtained from the smartphone-based diaries to determine whether these provided solutions for problems in glycemic control. The analysis of the available smartphone data provided the basis for therapeutic recommendations that can improve the daily glycemic control for almost all participants. Importantly, especially the newly developed implicit-activity logging, registering the participants' movements, provided important means to generate these recommendations.

Real space refinement of crystal structures with canonical distributions of electrons.

Recurring groups of atoms in molecules are surrounded by specific canonical distributions of electrons. Deviations from these distributions reveal unrealistic molecular geometries. Here, we show how canonical electron densities can be combined with classical electron densities derived from X-ray diffraction experiments to drive the real space refinement of crystal structures. The refinement process generally yields superior molecular models with reduced excess electron densities and improved stereochemistry without compromising the agreement between molecular models and experimental data.

SHIFTX2: significantly improved protein chemical shift prediction.

A new computer program, called SHIFTX2, is described which is capable of rapidly and accurately calculating diamagnetic (1)H, (13)C and (15)N chemical shifts from protein coordinate data. Compared to its predecessor (SHIFTX) and to other existing protein chemical shift prediction programs, SHIFTX2 is substantially more accurate (up to 26% better by correlation coefficient with an RMS error that is up to 3.3× smaller) than the next best performing program. It also provides significantly more coverage (up to 10% more), is significantly faster (up to 8.5×) and capable of calculating a wider variety of backbone and side chain chemical shifts (up to 6×) than many other shift predictors. In particular, SHIFTX2 is able to attain correlation coefficients between experimentally observed and predicted backbone chemical shifts of 0.9800 ((15)N), 0.9959 ((13)Cα), 0.9992 ((13)Cß), 0.9676 ((13)C'), 0.9714 ((1)HN), 0.9744 ((1)Hα) and RMS errors of 1.1169, 0.4412, 0.5163, 0.5330, 0.1711, and 0.1231 ppm, respectively. The correlation between SHIFTX2's predicted and observed side chain chemical shifts is 0.9787 ((13)C) and 0.9482 ((1)H) with RMS errors of 0.9754 and 0.1723 ppm, respectively. SHIFTX2 is able to achieve such a high level of accuracy by using a large, high quality database of training proteins (>190), by utilizing advanced machine learning techniques, by incorporating many more features (χ(2) and χ(3) angles, solvent accessibility, H-bond geometry, pH, temperature), and by combining sequence-based with structure-based chemical shift prediction techniques. With this substantial improvement in accuracy we believe that SHIFTX2 will open the door to many long-anticipated applications of chemical shift prediction to protein structure determination, refinement and validation. SHIFTX2 is available both as a standalone program and as a web server ( http://www.shiftx2.ca ).

Detection of unrealistic molecular environments in protein structures based on expected electron densities.

Understanding the relationship between protein structure and biological function is a central theme in structural biology. Advances are severely hampered by errors in experimentally determined protein structures. Detection and correction of such errors is therefore of utmost importance. Electron densities in molecular structures obey certain rules which depend on the molecular environment. Here we present and discuss a new approach that relates electron densities computed from a structural model to densities expected from prior observations on identical or closely related molecular environments. Strong deviations of computed from expected densities reveal unrealistic molecular structures. Most importantly, structure analysis and error detection are independent of experimental data and hence may be applied to any structural model. The comparison to state-of-the-art methods reveals that our approach is able to identify errors that formerly remained undetected. The new technique, called RefDens, is accessible as a public web service at http://refdens.services.came.sbg.ac.at.

CheckShift improved: fast chemical shift reference correction with high accuracy.

The construction of a consistent protein chemical shift database is an important step toward making more extensive use of this data in structural studies. Unfortunately, progress in this direction has been hampered by the quality of the available data, particularly with respect to chemical shift referencing, which is often either inaccurate or inconsistently annotated. Preprocessing of the data is therefore required to detect and correct referencing errors. In an earlier study we developed CheckShift, a program for performing this task automatically. Now we spent substantial effort in improving the running time of the CheckShift algorithm, which resulted in an running time decrease of 90%, thereby achieving equivalent quality to the former version of CheckShift. The reason for the running time decrease is twofold. Firstly we improved the search for the optimal re-referencing offset considerably. Secondly, as CheckShift is based on a secondary structure prediction from the amino acid sequence (formally PsiPred was used), we evaluated a wide range of available secondary structure prediction programs focusing on the special needs of the CheckShift algorithm. The results of this evaluation prove empirically that we can use faster secondary structure prediction programs than PsiPred without sacrificing CheckShift's accuracy. Very recently Wang and Markley (2009) gave a small list of extreme outliers of the former version of the CheckShift web-server. Those were due to the empirical reduction of the search space implemented in the old version. The new version of CheckShift now gives very similar results to RefDB and LACS for all outliers mentioned in Table 1 of Wang and Markley (2009).

SimShiftDB; local conformational restraints derived from chemical shift similarity searches on a large synthetic database.

We present SimShiftDB, a new program to extract conformational data from protein chemical shifts using structural alignments. The alignments are obtained in searches of a large database containing 13,000 structures and corresponding back-calculated chemical shifts. SimShiftDB makes use of chemical shift data to provide accurate results even in the case of low sequence similarity, and with even coverage of the conformational search space. We compare SimShiftDB to HHSearch, a state-of-the-art sequence-based search tool, and to TALOS, the current standard tool for the task. We show that for a significant fraction of the predicted similarities, SimShiftDB outperforms the other two methods. Particularly, the high coverage afforded by the larger database often allows predictions to be made for residues not involved in canonical secondary structure, where TALOS predictions are both less frequent and more error prone. Thus SimShiftDB can be seen as a complement to currently available methods.

CheckShift: automatic correction of inconsistent chemical shift referencing.

The construction of a consistent protein chemical shift database is an important step toward making more extensive use of this data in structural studies. Unfortunately, progress in this direction has been hampered by the quality of the available data, particularly with respect to chemical shift referencing, which is often either inaccurate or inconsistently annotated. Preprocessing of the data is therefore required to detect and correct referencing errors. We have developed a program for performing this task, based on the comparison of reported and expected chemical shift distributions. This program, named CheckShift, does not require additional data and is therefore applicable to data sets where structures are not available. Therefore CheckShift provides the possibility to re-reference chemical shifts prior to their use as structural constraints.

SimShift: identifying structural similarities from NMR chemical shifts.

MOTIVATION: An important quantity that arises in NMR spectroscopy experiments is the chemical shift. The interpretation of these data is mostly done by human experts; to our knowledge there are no algorithms that predict protein structure from chemical shift sequences alone. One approach to facilitate this process could be to compare two such sequences, where the structure of one protein has already been resolved. Our claim is that similarity of chemical shifts thereby found implies structural similarity of the respective proteins. RESULTS: We present an algorithm to identify structural similarities of proteins by aligning their associated chemical shift sequences. To evaluate the correctness of our predictions, we propose a benchmark set of protein pairs that have high structural similarity, but low sequence similarity (because with high sequence similarity the structural similarities could easily be detected by a sequence alignment algorithm). We compare our results with those of HHsearch and SSEA and show that our method outperforms both in >50% of all cases.