Regulation of hypnosis level on bi‐spectral index monitor (BIS) during a surgical procedure in propofol anaesthesia administration is a challenging task for an anaesthesiologist in multi‐tasking environment of the operation theater. Automation in anaesthesia has the potential to solve issues arising from manual administration. Automation in anaesthesia is based on developing the three‐compartmental model including pharmacokinetics and pharmacodynamic of the silico patients. This study focuses on regulation of the hypnosis level in the presence of surgical stimulus including skin incision, surgical diathermy and laryngoscopy as well as inter‐patient variability by designing super‐twisting sliding mode control (STSMC). The depth of the hypnosis level is maintained to 50 on the BIS level in the maintenance phase after improving the induction phase to 60 s using the conventional sliding mode control and 30 s with STSMC. The proposed scheme also compensates the inter‐patient variability dynamics including height, age and weight of the different silico patients. Moreover, the surgical stimuli direct the hypnosis level towards the state of consciousness and stimulate the controller to provide continuous drug infusion during the interval 80–90 s. Simulation results witness that the oscillatory behaviour is observed in drug infusion to ensure the moderate level of hypnosis (40–60) for general surgery.
This is an increasing belief that consequences due to hyperglycemia can be mitigated using a close loop control system. This paper investigates a robust non-linear control approach based on sliding mode control (SMC) algorithm for type 1 diabetes patients. Bergman's minimal model have been used to analyse the behaviour of glucose and insulin dynamics in blood plasma inside human body. Control law based on super twisting SMC algorithm is formulated and simulated. Results demonstrated the performance and effectiveness of the proposed control scheme. Also the proposed control scheme is compared with traditional SMC on the basis of performance parameters in the presence of external disturbances. Results dictate that the proposed control law exhibits robustness and overperforms by demonstrating accurate trajectory tracking with relatively less control efforts and alleviating chattering.
Preclinical testing and validation of therapeutic strategies developed for patients with type 1 diabetes (T1D) require a cohort of virtual patients (VPs). However, current simulators provide a limited number of VPs, lack real-life scenarios, and inadequately represent intra- and inter-day variability in insulin sensitivity and blood glucose (BG) profile. The generation of a realistic scenario was achieved by using the meal patterns, insulin profiles (basal and bolus), and exercise sessions estimated as disturbances using clinical data from a cohort of 14 T1D patients using the Medtronic 640G insulin pump provided by the Hospital Clínic de Barcelona. The UVa/Padova’s cohort of adult patients was used for the generation of a new cohort of VPs. Insulin model parameters were optimized and adjusted in a day-by-day fashion to replicate the clinical data to create a cohort of 75 VPs. All primary and secondary outcomes reflecting the BG profile of a T1D patient were analyzed and compared to the clinical data. The mean BG 166.3 versus 162.2 mg/dL ( = 0.19), coefficient of variation 32% versus 33% ( = 0.54), and percent of time in range (70 to 180 mg/dL) 59.6% versus 66.8% ( = 0.35) were achieved. The proposed methodology for generating a cohort of VPs is capable of mimicking the BG metrics of a real cohort of T1D patients from the Hospital Clínic de Barcelona. It can adopt the inter-day variations in the BG profile, similar to the observed clinical data, and thus provide a benchmark for preclinical testing of control techniques and therapy strategies for T1D patients.
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