GoCARB in the Context of an Artificial Pancreas.

BACKGROUND: In an artificial pancreas (AP), the meals are either manually announced or detected and their size estimated from the blood glucose level. Both methods have limitations, which result in suboptimal postprandial glucose control. The GoCARB system is designed to provide the carbohydrate content of meals and is presented within the AP framework. METHOD: The combined use of GoCARB with a control algorithm is assessed in a series of 12 computer simulations. The simulations are defined according to the type of the control (open or closed loop), the use or not-use of GoCARB and the diabetics' skills in carbohydrate estimation. RESULTS: For bad estimators without GoCARB, the percentage of the time spent in target range (70-180 mg/dl) during the postprandial period is 22.5% and 66.2% for open and closed loop, respectively. When the GoCARB is used, the corresponding percentages are 99.7% and 99.8%. In case of open loop, the time spent in severe hypoglycemic events (<50 mg/dl) is 33.6% without the GoCARB and is reduced to 0.0% when the GoCARB is used. In case of closed loop, the corresponding percentage is 1.4% without the GoCARB and is reduced to 0.0% with the GoCARB. CONCLUSION: The use of GoCARB improves the control of postprandial response and glucose profiles especially in the case of open loop. However, the most efficient regulation is achieved by the combined use of the control algorithm and the GoCARB.

Wall properties of the apolipoprotein E-deficient mouse aorta.

OBJECTIVES: We quantified the dysfunction of the aortic wall, determined structural and elastic properties, and provided histological data of the thoracic aortas of apolipoprotein E (apoE)-deficient mice which are used as model of atherosclerosis. METHODS: Six young 10-12 week-old (apoE)-deficient mice of both sexes were studied and six age-matched C57BL/6J wild-type mice were used as control group. We performed extension-inflation mechanical tests at three different axial stretches (λ(z) = 1.6, 1.8, and 2.0), under maximally contracted or totally relaxed state of the vascular smooth muscle cells. Classical histology was performed to the arterial segments. RESULTS: Control aortas were generally more distensible than the (apoE)-deficient mouse aortas under both relaxed and contracted smooth muscle. Also, aortas from (apoE)-deficient mice were stiffer (higher incremental elastic modulus) than control aortas. Control aortas exhibited a higher active diameter response compared to (apoE)-deficient mouse aortas, despite the fact that vascular smooth muscle cell density was increased by approximately 15% in the (apoE)-deficient mouse aortas. CONCLUSION: We found substantial changes in the structural and elastic properties of the wall, in the active diameter response and in the histology of (apoE)-deficient mouse aortas compared to the control group. Our data can be used in the development of constituent-based models of the arterial wall and in studying the changes in arterial wall properties in presence of disease, such as atherosclerosis.

A structural constitutive model considering angular dispersion and waviness of collagen fibres of rabbit facial veins.

BACKGROUND: Structural constitutive models of vascular wall integrate information on composition and structural arrangements of tissue. In blood vessels, collagen fibres are arranged in coiled and wavy bundles and the individual collagen fibres have a deviation from their mean orientation. A complete structural constitutive model for vascular wall should incorporate both waviness and orientational distribution of fibres. We have previously developed a model, for passive properties of vascular wall, which considers the waviness of collagen fibres. However, to our knowledge there is no structural model of vascular wall which integrates both these features. METHODS: In this study, we have suggested a structural strain energy function that incorporates not only the waviness but also the angular dispersion of fibres. We studied the effect of parameters related to the orientational distribution on macro-mechanical behaviour of tissue during inflation-extension tests. The model was further applied on experimental data from rabbit facial veins. RESULTS: Our parametric study showed that the model is less sensitive to the orientational dispersion when fibres are mainly oriented circumferentially. The macro-mechanical response is less sensitive to changes in the mean orientation when fibres are more dispersed. The model accurately fitted the experimental data of veins, while not improving the quality of the fit compared to the model without dispersion. Our results showed that the orientational dispersion of collagen fibres could be compensated by a less abrupt and shifted to higher strain collagen engagement pattern. This should be considered when the model is fitted to experimental data and model parameters are used to study structural modifications of collagen fibre network in physiology and disease. CONCLUSIONS: The presented model incorporates structural features related to waviness and orientational distribution of collagen fibres and thus offers possibilities to better understand the relation between structure and function in the vascular wall. Also, the model can be used to further study mechanically induced collagen remodelling in vascular tissue in health and disease.