Harnessing the Synergy of SGLT2 Inhibitors and Continuous Ketone Monitoring (CKM) in Managing Heart Failure among Patients with Type 1 Diabetes.

Heart failure (HF) management in type 1 diabetes (T1D) is particularly challenging due to its increased prevalence and the associated risks of hospitalization and mortality, driven by diabetic cardiomyopathy. Sodium-glucose cotransporter-2 inhibitors (SGLT2-is) offer a promising avenue for treating HF, specifically the preserved ejection fraction variant most common in T1D, but their utility is hampered by the risk of euglycemic diabetic ketoacidosis (DKA). This review investigates the potential of SGLT2-is in T1D HF management alongside emergent Continuous Ketone Monitoring (CKM) technology as a means to mitigate DKA risk through a comprehensive analysis of clinical trials, observational studies, and reviews. The evidence suggests that SGLT2-is significantly reduce HF hospitalization and enhance cardiovascular outcomes. However, their application in T1D patients remains limited due to DKA concerns. CKM technology emerges as a crucial tool in this context, offering real-time monitoring of ketone levels, which enables the safe incorporation of SGLT2-is into treatment regimes by allowing for early detection and intervention in the development of ketosis. The synergy between SGLT2-is and CKM has the potential to revolutionize HF treatment in T1D, promising improved patient safety, quality of life, and reduced HF-related morbidity and mortality. Future research should aim to employ clinical trials directly assessing this integrated approach, potentially guiding new management protocols for HF in T1D.

The Use of Artificial Intelligence Approaches for Performance Improvement of Low-Cost Integrated Navigation Systems.

In this paper, the authors investigate the possibility of applying artificial intelligence algorithms to the outputs of a low-cost Kalman filter-based navigation solution in order to achieve performance similar to that of high-end MEMS inertial sensors. To further improve the results of the prototype and simultaneously lighten filter requirements, different AI models are compared in this paper to determine their performance in terms of complexity and accuracy. By overcoming some known limitations (e.g., sensitivity on the dimension of input data from inertial sensors) and starting from Kalman filter applications (whose raw noise parameter estimates were obtained from a simple analysis of sensor specifications), such a solution presents an intermediate behavior compared to the current state of the art. It allows the exploitation of the power of AI models. Different Neural Network models have been taken into account and compared in terms of measurement accuracy and a number of model parameters; in particular, Dense, 1-Dimension Convolutional, and Long Short Term Memory Neural networks. As can be excepted, the higher the NN complexity, the higher the measurement accuracy; the models' performance has been assessed by means of the root-mean-square error (RMSE) between the target and predicted values of all the navigation parameters.

Innovative Fusion Strategy for MEMS Redundant-IMU Exploiting Custom 3D Components.

In recent years, the overall performances of inertial Micro-Electro Mechanical Sensors (MEMSs) exhibited substantial improvements to values very close or similar to so-called tactical-grade sensors. However, due to their high costs, numerous researchers are currently focusing on the performance enhancement of cheap consumer-grade MEMS inertial sensors for all those applications (as an example, small unmanned aerial vehicles, UAVs), where cost effectiveness is a relevant request; the use of redundancy proves to be a feasible method for this purpose. In this regard, the authors propose, hereinafter, a suitable strategy aimed at fusing raw measurements provided by multiple inertial sensors mounted on a 3D-printed structure. In particular, accelerations and angular rates measured by the sensors are averaged according to weights associated with the results of an Allan variance approach; the lower the noise figure of the sensors, the greater their weight on the final averaged values. On the other hand, possible effects on the measurements due to the use of a 3D structure in reinforced ONYX (a material capable of providing better mechanical specifications for avionic applications with respect to other solutions for additive manufacturing) were evaluated. The performance of a prototype implementing the considered strategy is compared with that of a tactical-grade inertial measurement unit in stationary conditions, exhibiting differences as low as 0.3 degrees in heading measurements. Moreover, the reinforced ONYX structure does not significantly affect the measured values in terms of both thermal and magnetic field while assuring better mechanical characteristics with respect to other 3D printing materials, thanks to a tensile strength of about 250 MPa and a specific stacking sequence of continuous fibers. Finally, a test conducted on an actual UAV highlights performance very close to that of a reference unit, with root-mean-square error in heading measurements as low as 0.3 degrees in observation intervals up to 140 s.

An Improved Method Based on Bluetooth Low-Energy Fingerprinting for the Implementation of PEPS System.

In the automotive field, the introduction of keyless access systems is revolutionizing car entry techniques currently dominated by a physical key. In this context, this paper investigates the possible use of smartphones to create a PEPS (Passive Entry Passive Start) system using the BLE (Bluetooth Low-Energy) Fingerprinting technique that allows, along with a connection to a low-cost BLE micro-controllers network, determining the driver's position, either inside or outside the vehicle. Several issues have been taken into account to assure the reliability of the proposal; in particular, (i) spatial orientation of each microcontroller-based BLE node which ensures the best performance at 180° and 90° referred to as the BLE scanner and the advertiser, respectively; (ii) data filtering techniques based on Kalman Filter; and (iii) definition of new network topology, resulting from the merger of two standard network topologies. Particular attention has been paid to the selection of the appropriate measurement method capable of assuring the most reliable positioning results by means of the adoption of only six embedded BLE devices. This way, the global accuracy of the system reaches 98.5%, while minimum and maximum accuracy values relative to the individual zones equal, respectively, to 97.3% and 99.4% have been observed, thus confirming the capability of the proposed method of recognizing whether the driver is inside or outside the vehicle.

Low-Cost and High-Performance Solution for Positioning and Monitoring of Large Structures.

Systems for accurate attitude and position monitoring of large structures, such as bridges, tunnels, and offshore platforms are changing in recent years thanks to the exploitation of sensors based on Micro-ElectroMechanical Systems (MEMS) as an Inertial Measurement Unit (IMU). Currently adopted solutions are, in fact, mainly based on fiber optic sensors (characterized by high performance in attitude estimation to the detriment of relevant costs large volumes and heavy weights) and integrated with a Global Position System (GPS) capable of providing low-frequency or single-update information about the position. To provide a cost-effective alternative and overcome the limitations in terms of dimensions and position update frequency, a suitable solution and a corresponding prototype, exhibiting performance very close to those of the traditional solutions, are presented and described hereinafter. The solution leverages a real-time Kalman filter that, along with the proper features of the MEMS inertial sensor and Real-Time Kinematic (RTK) GPS, allows achieving performance in terms of attitude and position estimates suitable for this kind of application. The results obtained in a number of tests underline the promising reliability and effectiveness of the solution in estimating the attitude and position of large structures. In particular, several tests carried out in the laboratory highlighted high system stability; standard deviations of attitude estimates as low as 0.04° were, in fact, experienced in tests conducted in static conditions. Moreover, the prototype performance was also compared with a fiber optic sensor in tests emulating actual operating conditions; differences in the order of a few hundredths of a degree were found in the attitude measurements.

Performance Enhancement of Consumer-Grade MEMS Sensors through Geometrical Redundancy.

The paper deals with performance enhancement of low-cost, consumer-grade inertial sensors realized by means of Micro Electro-Mechanical Systems (MEMS) technology. Focusing their attention on the reduction of bias instability and random walk-driven drift of cost-effective MEMS accelerometers and gyroscopes, the authors hereinafter propose a suitable method, based on a redundant configuration and complemented with a proper measurement procedure, to improve the performance of low-cost, consumer-grade MEMS sensors. The performance of the method is assessed by means of an adequate prototype and compared with that assured by a commercial, expensive, tactical-grade MEMS inertial measurement unit, taken as reference. Obtained results highlight the promising reliability and efficacy of the method in estimating position, velocity, and attitude of vehicles; in particular, bias instability and random walk reduction greater than 25% is, in fact, experienced. Moreover, differences as low as 0.025 rad and 0.89 m are obtained when comparing position and attitude estimates provided by the prototype and those granted by the tactical-grade MEMS IMU.