Real-time Continuous Monitoring Research Articles

WITHDRAWN: Computational efficient wearable sensor network health monitoring system for sports athletics using IoT

Abstract The rapid development and growth in the Internet of Things (IoT) area offer great potential in the healthcare sector. Currently, wireless technology, fitness trackers, and body sensors in the sports field have a major impact on living efficiency and health system reliability. Wearable devices have become increasingly interested in measuring physiological factors, promoting health, and improving adherence to the practice in different populations from elite athletes to patients. In this paper, fog assisted Computational efficient Wearable sensor networks (FCE-WSN) has been proposed in health monitoring systems for sports athletic using IoT. The wearable device for the continuous real-time monitoring of heart rate, respiratory frequency, and movement cadence during physical activity has been analyzed. Besides, the sensor collected data is uploaded to the IoT-connection system Ethernet module, and the Authorized Individual accesses the data via the internet to track the athletics health. Moreover, the wearable device's analytical model and its use illustrate how computing resources' costs can be minimized while preserving health requests for access to medical information stored in a fog and cloud distribution setting. Our assessment system depends on a queue and can estimate the minimum computing resources needed to achieve the Service Level Agreement (SLA) (both fog and cloud nodes). The experimental results show that the proposed method is user-friendly, reliable, and economical to use regularly.

Flexible, Highly Sensitive Paper-Based Screen Printed MWCNT/PDMS Composite Breath Sensor for Human Respiration Monitoring.

Accurate measurement and monitoring of respiration is vital in patients affected by severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2). Patients with severe chronic diseases and pneumonia need continuous respiration monitoring and oxygenation support. Existing respiratory sensing techniques require direct contact with the human body along with expensive and heavy Holter monitors for continuous real-time monitoring. In this work, we propose a low-cost, non-invasive and reliable paper-based wearable screen printed sensor for human respiration monitoring as an effective alternative of existing sensing systems. The proposed sensor was fabricated using traditional screen printing of multi-walled carbon nanotubes (MWCNTs) and polydimethylsiloxane (PDMS) composite based interdigitated electrodes on paper substrate. The paper substrate was used as humidity sensing material of the sensor. The hygroscopic nature of paper during inhalation and exhalation causes a change in dielectric constant, which in turn changes the capacitance of the sensor. The composite interdigitated electrode configuration exhibited better response times with a rise time of 1.178s being recorded during exhalation and fall time of 0.88s during inhalation periods. The respiration rate of sensor was successfully examined under various breathing conditions such as normal breathing, deep breathing, workout, oral breathing, nasal breathing, fast breathing and slow breathing by employing it in a wearable mask, a mandatory wearable product during the current COVID-19 pandemic situation.Thus, the above proposed sensor may hold tremendous potential in wearable/flexible healthcare technology with good sensitivity, stability, biodegradability and flexibility at this time of need.

Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies.

Neurophysiological monitoring is an important goal in the treatment of neurocritical patients, as it may prevent secondary damage and directly impact morbidity and mortality rates. However, there is currently a lack of suitable non-invasive, real-time technologies for continuous monitoring of cerebral physiology at the bedside. Diffuse optical techniques have been proposed as a potential tool for bedside measurements of cerebral blood flow and cerebral oxygenation in case of neurocritical patients. Diffuse optical spectroscopies have been previously explored to monitor patients in several clinical scenarios ranging from neonatal monitoring to cerebrovascular interventions in adults. However, the feasibility of the technique to aid clinicians by providing real-time information at the bedside remains largely unaddressed. Here, we report the translation of a diffuse optical system for continuous real-time monitoring of cerebral blood flow, cerebral oxygenation, and cerebral oxygen metabolism during intensive care. The real-time feature of the instrument could enable treatment strategies based on patient-specific cerebral physiology rather than relying on surrogate metrics, such as arterial blood pressure. By providing real-time information on the cerebral circulation at different time scales with relatively cheap and portable instrumentation, this approach may be especially useful in low-budget hospitals, in remote areas and formonitoring in open fields (e.g., defense and sports).

Twenty-four-hour real-time continuous monitoring of acute focal cerebral ischemia in rabbits based on magnetic inductive phase shift

BackgroundAs a serious clinical disease, ischemic stroke is usually detected through magnetic resonance imaging and computed tomography. In this study, a noninvasive, non-contact, real-time continuous monitoring system was constructed on the basis of magnetic induction phase shift (MIPS) technology. The “thrombin induction method”, which conformed to the clinical pathological development process of ischemic stroke, was used to construct an acute focal cerebral ischemia model of rabbits. In the MIPS measurement, a “symmetric cancellation-type” magnetic induction sensor was used to improve the sensitivity and antijamming capability of phase detection.MethodsA 24-h MIPS monitoring experiment was carried out on 15 rabbits (10 in the experimental group and five in the control group). Brain tissues were taken from seven rabbits for the 2% triphenyl tetrazolium chloride staining and verification of the animal model.ResultsThe nonparametric independent-sample Wilcoxon rank sum test showed significant differences (p < 0.05) between the experimental group and the control group in MIPS. Results showed that the rabbit MIPS presented a declining trend at first and then an increasing trend in the experimental group, which may reflect the pathological development process of cerebral ischemic stroke. Moreover, TTC staining results showed that the focal cerebral infarction area increased with the development of timeConclusionsOur experimental study indicated that the MIPS technology has a potential ability of differentiating the development process of cytotoxic edema from that of vasogenic edema, both of which are caused by cerebral ischemia.

Estimation of Organs Doses for People (Male and Female) Exposed to Indoor Radon in Al-Najaf

In this paper, the radon concentrations in the houses of (10) locations were measured using real-time continuous radon monitor RAD-7 detector together with estimating the corresponding female and male organ doses using Monte Carlo (MC) simulation software at Al- Najaf city-Iraq. It is found that the radon concentrations varied from (8.75±1.1 Bq/m3) to (32.32±4.0 Bq/m3 with an average (20.57±2.90 Bq/m3). The resulted data for male reveal that the bladder received the highest dose at 9.78E-05 μGy/h in Missan, while the salivary gland was noticed to have the highest dose in each of Jmhorria, Adalh, Saad and Milad regions with dose rates of 4.65E-05, 3.59E-05, 5.72E-05 and 3.45E-05 μGy/h respectively. In Asskry Najaf regions the highest dose was seen to be with the Lung with 9.30E-05 μGy/h. In Asskiry Kufa and Mutnaby the highest organ doses were attributed to the bone surface at 9.73E-05 and 9.62E-05 μGy/h respectively. In Tmoz and Sirai regions, the highest organ doses were with Extrathor airways and thyroid at 6.64E-05 and 9.65E-05 μGy/h respectively. By contrast, the female findings reveal the doses for all organs and across all considered neighborhoods ranged from 1. E-04 μGy/h to 9E-05 μGy/h. Finally, it can be concluded that all results of radon concentrations in ten locations samples were within the range allowed according to ICRP. The organ doses seem to be very low which in turn reduce the concern realted to the effect of radiation.

Evaluating visually a new apoptosis-induced reagent by a ratiometric two-photon fluorescent pH probe

The level of apoptosis is directly related to the occurrence of cancer and other diseases. Real-time continuous monitoring of apoptotic process of living cells has great potential for early diagnosis of related diseases, as well as evaluation of therapeutic effect and screening of apoptotic drugs. This work proposed a ratiometric two-photon fluorescent probe Lyso-PCE equipped with a dual-function pyridine, as a pH-sensitive and specific lysosome-targeted group. A clear linearity relationship between two-channel fluorescence intensity ratios of Lyso-PCE and pH values was established in both solutions and living cells. Thanks to its ability of quantitative detection of pH, probe Lyso-PCE can detect the dynamic pH changes of lysosomes treated by chloroquine, and also can be used to in situ monitor dexamethasone-induced apoptosis. More importantly, reagent potassium bisperoxo (1,10-phenanthroline) oxovanadate (bpV(phen)) was evaluated and testified as a new apoptotic drug by Lyso-PCE, and the real-time visualization of bpV(phen)-induced apoptosis was realized under two-photon excitation. Our results provide a new and promising strategy for evaluating and screening apoptosis-related drugs.

Transcatheter mitral valve repair and replacement: the next frontier of transcatheter valve intervention.

We summarize the recent developments in transcatheter mitral valve repair (TMVr) and replacement (TMVR), discuss determinants of MitraClip outcomes in various mitral regurgitation causes, and highlight newly emerging devices and randomized trials. The discordant results published in the two recent randomized trials for MitraClip, the COAPT and the MITRA-FR trial have led to the emergence of a new conceptual framework such as the proportionate versus disproportionate mitral regurgitation and hemodynamics assessment tools like the real-time continuous left atrial pressure monitoring. Learning curve and volume-outcome analyses and studies examining the MitraClip usage in patients with degenerative mitral regurgitation are recent developments that have influenced MitraClip regulation and coverage. Several trials for TMVr devices that take an alternative approach to the edge-to-edge repair are underway and advancements in the TMVR technologies are continuing to progress to fill the unmet needs of treating high surgical risk patients whose complex valve anatomy make TMVr unfeasible. Evidence supports careful analysis of the valve area and left ventricular function in addition to the left atrial hemodynamics will improve the MitraClip outcome. Operator experience plays a greater effect when achieving excellent results with 1+ or less residual mitral regurgitation whereas surgical MVr volume did not influence TMVr outcome. Interventions on the complex primary mitral regurgitation remain under the surgical domain, but MITRA high risk (HR) and REPAIR mitral regurgitation trials are underway to evaluate the role of MitraClip in high to intermediate surgical risk patients with primary mitral regurgitation. Despite the slow developments in TMVR, the results of the early trials of its devices are promising.

Wastewater Quality Estimation Through Spectrophotometry-Based Statistical Models.

Local administrations are increasingly demanding real-time continuous monitoring of pollution in the sanitation system to improve and optimize its operation, to comply with EU environmental policies and to reach European Green Deal targets. The present work shows a full-scale Wastewater Treatment Plant field-sampling campaign to estimate COD, BOD5, TSS, P, TN and NO3−N in both influent and effluent, in the absence of pre-treatment or chemicals addition to the samples, resulting in a reduction of the duration and cost of analysis. Different regression models were developed to estimate the pollution load of sewage systems from the spectral response of wastewater samples measured at 380–700 nm through multivariate linear regressions and machine learning genetic algorithms. The tests carried out concluded that the models calculated by means of genetic algorithms can estimate the levels of five of the pollutants under study (COD, BOD5, TSS, TN and NO3−N), including both raw and treated wastewater, with an error rate below 4%. In the case of the multilinear regression models, these are limited to raw water and the estimate is limited to COD and TSS, with less than a 0.5% error rate.

Wearable Microwave Imaging Sensor for Deep Tissue Real-Time Monitoring Using a New Loss-Compensated Backpropagation Technique

We present a new imaging method for continuous real-time monitoring of deep human tissues using a body-worn radio-frequency sensor. The sensor consists of a set of transmitting and receiving dipole-like probes placed around the human body. The Green’s function of the medium is derived by modeling the scattering of the cross-sectional pixels using metallic cylinders of equivalent sections. A new method of overcoming the signal path loss in the biological medium is then introduced, which increases the image resolution. For the first time, the proposed wearable sensor is shown to overcome a number of challenges with body-worn imaging including the shape uncertainty of the torso. To analyze this, a new boundary mismatch parameter (BMP) is introduced and its effect on image recovery is examined quantitatively. Demonstration of the concept is carried out by retrieving differential permittivity image of the underlying cross-section, employing data obtained from several imaging scenarios using both full-wave simulations involving deep human tissues with multiple outer layers (i.e. skin, fat, muscle, bone) and experiments. Overall, the proposed sensor can be the basis for a portable and low-cost complement to conventional imaging techniques (such as, X-Ray CT, MRI etc.) suitable for a wide range of applications, such as, prevention of pulmonary diseases, brain functionality imaging and monitoring of gastric emptying etc.

Application of big data technology in prediction and prevention of rock burst

Coal and rock dynamic disasters, especially the impact ground pressure dynamic disasters, are major safety technical problems in deep resources mining in China. In view of the basic theory and key technology of ground pressure monitoring and early warning during coal mining, in order to reveal the scale and timing effect of physical field response and the relation with energy accumulation-release, the cooperative relation and equivalent transformation mode of multi-field multi-parameter precursor information, constructing the monitoring and warning index system, big data technology is used to study the characteristics of ground pressure stress-energy-physical parameter coupling feed-off and time-space evolution, while considering the whole mechanical process of ground pressure development, and establish the theory and model of multi-field multi-parameter monitoring and early warning under the background of big data based on space-time complementarity; The purpose of this paper is to establish the theory and method of intelligent identification and early warning of impact ground pressure through studying the intelligent identification method and expert system of the main control factors, disaster risk and precursor information of impact ground pressure under big data. In order to ensure the correctness and accuracy of monitoring information, construct the integrated monitoring and warning technology of shock ground pressure-electric-seismic multi-source information under the complex geological conditions of coal mine, this paper on the one hand studies the accurate monitoring, extraction and identification theory and optimization algorithm of shock ground pressure precursor information based on multi-parameter information fusion, on the other hand develops the active controllable stress inversion technology and equipment based on vibration wave CT, the continuous real-time monitoring theory method of ground stress, and ultra-low frequency electromagnetic radiation monitoring technology. Finally the theory and technology system of impact ground pressure risk identification and monitoring can be concluded.

Hydrogeological and geophysical properties of the very-slow-moving Ripley Landslide, Thompson River valley, British Columbia

Landslides along a 10 km reach of Thompson River south of Ashcroft, British Columbia, have repeatedly damaged vital railway infrastructure, while also placing public safety, the environment, natural resources, and cultural heritage features at risk. Government agencies, universities, and the railway industry are focusing research efforts on a representative test site — the very-slow-moving Ripley Landslide — to manage better the geohazard risk in this corridor. We characterize the landslide’s form and function through hydrogeological and geophysical mapping. Field mapping and exploratory drilling distinguish 10 hydrogeological units in surficial deposits and fractured bedrock. Electrical resistivity tomography, frequency domain electromagnetic conductivity measurements, ground-penetrating radar, seismic pressure wave refraction, and multispectral analysis of shear waves; in conjunction with downhole measurement of natural gamma radiation, induction conductivity, and magnetic susceptibility provide a detailed, static picture of soil moisture and groundwater conditions within the hydrogeological units. Differences in electrical resistivity of the units reflect a combination of hydrogeological characteristics and climatic factors, namely temperature and precipitation. Resistive earth materials include dry glaciofluvial outwash and nonfractured bedrock; whereas glaciolacustrine clay and silt, water-bearing fractured bedrock, and periodically saturated subglacial till and outwash are conductive. Dynamic, continuous real-time monitoring of electrical resistivity, now underway, will help characterize water-flow paths, and possible relationships to independently monitor pore pressures and slope creep. These new hydrogeological and geophysical data sets enhance understanding of the composition and internal structure of this landslide and provide important context to interpret multiyear slope stability monitoring ongoing in the valley.

Real-time continuous monitoring of injection pressure during peripheral nerve blocks in fresh cadavers

BackgroundThe incidence of unintentional intraneural injection while performing peripheral nerve block has been estimated to be 15% under real-time ultrasound guidance. Injection pressure increase may detect an intraneural injection. Real-time injection pressure changes throughout an entire nerve block procedure in relationship with needle tip location have never been reported. MethodsA new method was developed to precisely monitor the injection pressure curve during nerve blocks, based on a miniaturised Fabbri-Perrot pressure sensor. We tested in three fresh cadavers the ability of continuous pressure monitoring to discriminate between different tissues, as the injection pressure curve ascending slope, shape and plateau pressure value depend on tissue compliance. Injections of saline were performed by an electronic syringe pump with three different constant flow rates. Pressure was measured simultaneously at the tip and in the tubing of the needle. ResultsAt 10 mL/min injection flow, median peak injection pressure in the intraneural group at the needle tip was 315 mmHg, while at the perineural location it was 100 mmHg (p < 0.05). Median injection pressure was 95 mmHg in the intramuscular locations group, and 819 mmHg when a muscular fascia was indented (p < 0.05). A significant difference was noted for pressure measurements between the proximal port of the needle and the tip, 625 and 417 respectively. ConclusionsBased on significant differences in injection pressure values and curve shapes, the system was able to discriminate between four needle tip locations. This may help with needle tracking while performing a peripheral nerve block.

Non – Invasive Haemoglobin Measurement

Haemoglobin is one of the main constituents in characterizing the physiological condition of a human body. Currently, invasive techniques which are being used, are not suitable for real-time continuous monitoring and also include delay. On the other hand, the non-invasive method of haemoglobin measurement ensures painless and continuous real-time monitoring. This paper discusses the method and technique involved in designing a prototype for the non-invasive measurement of haemoglobin.

Ultra-Low Power Sensor Node for On-Board Railway Wagon Monitoring

Continuous real-time monitoring of unpowered railway vehicles such as general freight and heavy haul wagons is still limited by hardware scalability and power consumption challenges. This paper proposes an innovative sensor node hardware architecture that reduces power consumption and hardware costs by introducing an Analogue Fault Detector based on analogue signal processing. This technique allows data intensive fault detection and condition monitoring algorithms to be run by simple microcontrollers, reducing memory, execution time and computational requirements. An on-board wheel flat detection sensor node was tested in laboratory conditions using a hardware-in-the-loop setup, to quantify the improvements and explore the viability of the proposed sensor node architecture approach. The power required to detect a wheel flat defect in a simulated acceleration signal was reduced by one order of magnitude and the memory requirement was reduced by three orders of magnitude for the data acquisition and processing stage, compared to traditional sensor node hardware architectures. This is particularly relevant in data intensive applications using accelerometers for monitoring railway vehicles. The improvements delivered by the introduction of an Analogue Fault Detector in a sensor node hardware architecture are promising for further development of on-board ultra-low power condition monitoring sensor nodes for railway applications.

Functional miRNA Screening Identifies Wide-ranging Antitumor Properties of miR-3622b-5p and Reveals a New Therapeutic Combination Strategy in Ovarian Tumor Organoids.

Novel therapeutic strategies are urgently required for the clinical management of chemoresistant ovarian carcinoma, which is the most lethal of the gynecologic malignancies. miRNAs hold promise because they play a critical role in determining the cell phenotype by regulating several hundreds of targets, which could constitute vulnerabilities of cancer cells. A combination of gain-of-function miRNA screening and real-time continuous cell monitoring allows the identification of miRNAs with robust cytotoxic effects in chemoresistant ovarian cancer cells. Focusing on miR-3622b-5p, we show that it induces apoptosis in several ovarian cancer cell lines by both directly targeting Bcl-xL and EGFR-mediating BIM upregulation. miR-3622b-5p also sensitizes cells to cisplatin by inhibiting Bcl-xL in ovarian cancer cell lines escaping BIM induction. miR-3622b-5p also exerts antimigratory capacities by targeting both LIMK1 and NOTCH1. These wide-ranging antitumor properties of miR-3622b-5p in ovarian cancer cells are mimicked by the associations of pharmacologic inhibitors targeting these proteins. The combination of an EGFR inhibitor together with a BH3-mimetic molecule induced a large decrease in cell viability in a panel of ovarian cancer cell lines and several ovarian patient-derived tumor organoids, suggesting the value of pursuing such a combination therapy in ovarian carcinoma. Altogether, our work highlights the potential of phenotype-based miRNA screening approaches to identify lethal interactions which might lead to new drug combinations and clinically applicable strategies.

Organic NIR-II molecule with long blood half-life for in vivo dynamic vascular imaging

Real-time monitoring of vessel dysfunction is of great significance in preclinical research. Optical bioimaging in the second near-infrared (NIR-II) window provides advantages including high resolution and fast feedback. However, the reported molecular dyes are hampered by limited blood circulation time (~ 5–60 min) and short absorption and emission wavelength, which impede the accurate long-term monitoring. Here, we report a NIR-II molecule (LZ-1105) with absorption and emission beyond 1000 nm. Thanks to the long blood circulation time (half-life of 3.2 h), the fluorophore is used for continuous real-time monitoring of dynamic vascular processes, including ischemic reperfusion in hindlimbs, thrombolysis in carotid artery and opening and recovery of the blood brain barrier (BBB). LZ-1105 provides an approach for researchers to assess vessel dysfunction due to the long excitation and emission wavelength and long-term blood circulation properties.

Study of the quality of life and adherence to treatment in patients from 2 to 16 years-old with type 1 diabetes mellitus in Andalusia, Spain

Diabetes mellitus 1 is the second most frequent chronic disease, and the most frequent endocrine-metabolic disorder in childhood. The estimated prevalence is between 1.1 and 1.4 / 1000 children under 15 years years-old. In Andalusia the prevalence is higher (1.7 per thousand). The objective of the study is to evaluatehealth-related quality of life (HRQoL) and adherence to treatment, specifically in the paediatric population of Andalusia. A multicentre cross-sectional observational analytical study was conducted on a sample of 178 patients from six hospitals with a Paediatric Endocrinology Unit. Each patient received two questionnaires; quality of life (PedsQL version 3.0) and adherence to the self-care recommendations (SCI-R) treatment. The demographic, clinical, metabolic control data, and possible complications were also collected. High levels were obtained in both adherence and health-related quality of life (HRQoL). Adherence was inversely related to age and HbA1c. The health-related quality of life (HRQoL) was associated with the use of a continuous real-time glucose monitoring system (MCG-TR) combined with continuous subcutaneous insulin infusion (CSII), as well as with a lower number of severe hypoglycaemia and renal complications. The mean HbA1c was 7.1%. 12,9% of patients used ISCI. 83.2% used capillary glycemia exclusively, while 16.8% used some interstitial glucose monitoring device. This is the first study in Andalusia that analyzes the health-related quality of life (HRQoL) of pediatric patients. The results show high levels of adherence and health-related quality of life (HRQoL), as well as good metabolic control.

Leak Detection System for Long-Distance Onshore and Offshore Gas Pipeline Using Acoustic Emission Technology. A Review

Many petroleum products like oil and gas are transported from one place to another through pipelines, although they can undergo leakage due to pipeline leaks and cause risks to industries, the environment, and people. In this review work, we have presented a comprehensive overview of acoustic emission technology for gas pipeline leak detection. Essential gas leak detection system requirements, principles, terminologies, and risks due to failure of the natural gas pipeline system have been discussed while proposing a surface acoustic wave sensor with a combination of the Hilbert–Huang transforms (HHTs) as the best method for real-time leak detection system in the gas pipeline network. The variation of wave energy causes propagation of elastic waves that can be detected by sensors mounted on the pipeline. Natural gas pipeline networks require a continuous real-time monitoring system to ensure that the pipelines are delivering the products from one station to another at optimum conditions.

Continuous real-time monitoring of pulmonary arterial pressure using a tip deflecting microcatheter in an infant with pulmonary arterial hypertension

We present the case of a 3-month-old boy with pulmonary arterial hypertension after corrective repair of total anomalous pulmonary venous connection. The patient developed severe pulmonary arterial hypertension with a high mean pulmonary arterial pressure of 45 mmHg. We performed continuous monitoring of pulmonary arterial pressure using a tip deflecting microcatheter in the intensive care unit. We successfully managed this patient based on real-time pulmonary arterial pressure measurements. Continuous real-time monitoring of pulmonary arterial pressure using this microcatheter enables individualized targeted therapy for infants with pulmonary arterial hypertension.

852-P: Is Real-Time CGM Superior to Flash Glucose Monitoring? Results of the Type 1 Diabetes CORRIDA Randomized Control Trial

Background: The trial aim was to compare the efficacy of real-time and intermittently-scanned continuous glucose monitoring (rtCGM and isCGM, respectively) in maintaining optimal glycemic control. Methods: In this randomized study, adults with T1D and normal hypoglycemia awareness (GOLD score Results: Sixty adults with T1D (age 38±13 years, HbA1c 7.8±1.1% [62±12 mmol/mol]) were randomized to rtCGM (n=30) or isCGM (n=30). All participants completed the study. Time in hypoglycemia ( Conclusion: rtCGM was superior to isCGM in preventing hypoglycemia and improving time in range in T1D adults with normal hypoglycemia awareness, demonstrating the value of rtCGM alarms during exercise and in daily diabetes self-management. Disclosure J. Soupal: Advisory Panel; Self; Abbott. Consultant; Self; Medtronic, Roche Diabetes Care. Speaker’s Bureau; Self; Dexcom, Inc. A. Haskova: None. G. Grunberger: Research Support; Self; Medtronic. L. Petruzelkova: None. C. Parkin: Consultant; Self; Abbott, CeQur Corporation, Dexcom, Inc., DreaMed Diabetes, Novo Nordisk Inc., Onduo, Roche Diabetes Care, Valeritas, Inc. J. Skrha: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Speaker’s Bureau; Self; Eli Lilly and Company, Merck Sharp & Dohme Corp. L. Radovnicka: None. E. Horova: None. M. Prazny: Speaker’s Bureau; Self; Novartis Pharmaceuticals Corporation, Roche Diabetes Care. Other Relationship; Self; Abbott, Boehringer Ingelheim International GmbH, Lilly Diabetes, Medtronic, Novo Nordisk A/S, Sanofi, Teva Pharmaceutical Industries Ltd. Funding 15-26705A (Program RVO-VFN00064165)