All posts by Wild Cats Photography™ & Sanctuary Blog

Pete Cento was born in Havana, Cuba. He's an alumnus of Archbishop Curley Notre Dame College Prep, Miami-Dade College, Florida International University & U.S. Fire Academy in Emmitsburg, Md. Peter Cento is an experienced film and digital photographer, and multilingual MarComm, Social Media and Public Relations strategist with more than 30 years experience helping clients, academia, government and not-for-profit organizations. Cento is the principal & founder of Wild Cats Photography (formerly Atlantis Photography & Design), The Cento Group, Cento Marketing Group & Wild Cats Enterprises, Inc. Cento first made a name for himself in broadcast journalism in the late 80s as a writer, news assignment desk editor/planner/manager, news producer, special project producer and managing news editor at CBS Miami 4, ABC 7 Fort Myers, NBC/Telemundo Miami and Univision Miami WLTV 23. Cento is also a disaster survivor in the aftermath of Hurricane Andrew, a category 5 hurricane impacted south Miami-Dade County in the early morning hours of August 24, 1992. While working at WFOR CBS 4, he was a part of the station’s community rebuilding through Neighbors 4 Neighbors which recently celebrated its 20th Anniversary. Cento was also part of the award-winning Univision Arizona news team that was honored with a newsroom Emmy in 2003 for developing a comprehensive bilingual water safety and drowning prevention campaign aimed at educating the Hispanic/Latino community in Arizona. Cento has successfully managed crisis situations for BURGER KING® Corporation, University of Miami, BellSouth, AT&T Wireless, USACE Comprehensive Everglades Restoration Plan and the Miami-Dade Expressway Authority during the annual Atlantic hurricane season. From 2005 to 2013, Cento was deployed as Multilingual PIO and External Affairs Field Specialist with the U.S. Department of Homeland Security’s Federal Emergency Management Agency (FEMA) covering more than 45 natural disasters from California to Massachusetts and has managed crisis communications for numerous clients. As the face of Wild Casts Enterprises, Inc., clients are assured that Peter Cento will be heading their team and getting them the quality results they expect. Cento’s well-earned reputation, extensive multi-industry background, ability to “pitch” the media and uncanny ability to connect people, presents a great benefit to all of his clients.

8 networking tips to strengthen reporter relationships

8 networking tips to strengthen reporter relationships

By Andy Crestodina | Posted: July 17, 2017

Media coverage offers a prime opportunity to grow relationships and expand your circle of influence, but you have to strike—thoughtfully and strategically—while the iron’s hot.

Here are eight networking tips to stretch your reach, create new allies and maximize your coverage:

1. Send a handwritten thank-you note to the blogger, editor or journalist who wrote about you

Putting a handwritten thank-you message in a writer’s mailbox immediately separates you from 99 percent of other communicators. Just get out a pen, write something thoughtful and add a stamp.

Thank-you notes are a networker’s secret weapon.

2. Ask your community to thank the blogger, editor or journalist

Having a few friends send a quick note to the writer is always an unexpected, pleasant surprise.

It shows you have connections who are paying attention. It’s also a good way to connect people who may become valuable contacts in the future.

[RELATED: How to land blockbuster coverage during and after a PR event.]

3. Connect with the writer on LinkedIn

A LinkedIn connection request can be another form of thank-you message.

It’s also an easy way to create a more enduring connection so you can stay in touch and gin up goodwill.

4. Add the writer to your list

Another way to keep track of writers in social media is to add them to your Twitter lists and Facebook groups.

journo-twitterfeed

5. Invite the writer to your next event

Do you have an event of your own scheduled? Invite the writer to attend. This will build a better connection and might lead to a bit of press for your event.

Are you going to an upcoming event? Invite the writer to join you. Maybe you can meet up for coffee beforehand or a beer after.

Inviting others to meet you at an event is a great way to create more personal connections and solidify your reputation as a reliable source.

6. Send the article to other journalists, outlets and bloggers

Don’t be afraid to reach beyond the original writer. Seek out other bloggers and members of the press who write about the topics covered in your piece. They may be interested in writing something similar for their audience or consider you as a source for another topic.

Once you have press, getting more of it is easier. The goal is to create a snowball effect. Here are a few places to find more members of the press:

When you share links with reporters, mention how well the story performed—including the number of shares.

7. Send the article to bloggers who write roundups

Bloggers who write roundups are always looking for relevant content. If the article fits their beat, send a quick message suggesting they include it.

8. Email the link to top sales prospects

Here’s how to use media coverage to lift sales:

  • If you already have leads in your pipeline, you may be looking for reasons to reach out to them. A press mention is a perfect tool for that.
  • If there are organizations out there you’d like to connect with, a press mention is a good way to reach out. Just find the relevant person on LinkedIn or ask a mutual connection for an introduction.

A short, simple email with a link to the article is a smart way to get on someone’s radar and build your credibility. If you want to know whether an email recipient clicked the link you sent, use a URL shortener like bit.ly. This lets you track the link. If clicks = 0, the recipient didn’t read it. If clicks = 1, he or she did.

Thoughtful, gracious networking that builds personal relationships and establishes genuine connections pays big dividends in the present, and it also lays the groundwork for more coverage down the road.

Andy Crestodina is Orbit Media’s chief strategy officer. A version of this post first ran on Orbit’s blog.

10 digital tools recommended by social media pros

https://www.prdaily.com/SocialMedia/SocialMedia.aspx

10 digital tools recommended by social media pros

By Hana Bieliauskas
A while back, I attended a Ragan Communications Social Media Roundtable in Chicago. It was perfect timing, because I’ve felt lately as if my relationships with my steady collection of digital tools and resources has hit a rut. After getting more than a few ideas for spicing things up through picking the brains of some of the best in the business, I’m feeling much more optimistic about the future.

So, for anyone who’s also feeling in a bit of a relationship slump, let the following 10 tools help you break free too.

1. Feedly. I was one of those people who clung to Google Reader, holding out hope until it smacked me with a breakup notification. I was forced to play the field. I reluctantly gave Feedly a chance, and now I realize what I had before: nothing. Feedly enables me to embrace my passion for organization. I can create folders for various topics and then add content to them, so everything is easily accessible. My inner journalism major digs the clean “magazine” view, which displays large images with articles.

2. Offerpop. I’ve planned dozens of social media promotions for clients, so I’ve tried out quite a few different apps. Offerpop offers a wide range of products across social platforms—Facebook, Twitter, Pinterest, Instagram, even Tumblr and Vine—and it’s not lacking in options for promotions, from Pinterest contests to Facebook and Twitter sweepstakes. Maybe most important: It’s easy to get along with. We can draft customized content for each promotion, and the text instructions and image dimensions are out there for everyone to see. So, our graphic designer can easily come up with visuals and drop them in, no coding needed.

3. PromoJam. Though it doesn’t have quite the number of promotion options as Offerpop, PromoJam is significantly more affordable (about $30 each month for a basic account), so it works well for one-off Facebook promotions and for clients with limited budgets. The interface is user-friendly and requires no coding, so customizable promotions can be set up quickly. I’ll also give them kudos for customer service. I had an issue a couple of weeks ago setting up a promotion on a client’s Facebook page, and they were enthusiastic about helping to fix it.

4. GroupHigh. I was not a fan of GroupHigh a couple of years ago, but since its makeover it is growing on me again. I work closely with food bloggers on behalf of clients almost every day, so a database of bloggers sounds like it’d be a stellar fit for me. It is, to a point. GroupHigh is a useful tool for identifying topic-specific bloggers in various locations. It is also very helpful for quickly finding bloggers’ social media stats and information, which I often include in proposals and in reports for clients. What it isn’t is a substitute for creating genuine, strong relationships with bloggers and for really getting to know them. A food blogger does not want to know that you found them through a search on GroupHigh. They want you to read their blog, connect on social media, and get to know them before shooting off a blind invitation to get together.

5. Followerwonk. Just who are your Twitter followers? Scrolling through to find information about followers—and search for new users to follow— quickly becomes exhausting. Followerwonk enables you to see where Twitter followers are located, analyze Twitter profiles, and search for keywords in Twitter bios. It also has a simple display that organizes data into basic graphs and charts that are easy to understand and use. One other function I find useful for clients: Comparing the social graph of one Twitter account to as many as two others, such as those of competitors, friends, or industry leaders.

6. Sprout Social. People at the roundtable were raving about Sprout Social. I like that it focuses on a team approach, as there are usually multiple people managing social media within an agency. Also, all the functions to manage and monitor engagement across platforms are quite attractive.

7. Canva. Looks really do matter. Visual social media content has been on the rise since 2012, when Pinterest and Instagram saw a huge surge in popularity. Some predicted 2014 would be the year visual content truly takes over in social media, and that seems accurate. Think of Canva as an affordable personal stylist to help you stand out at the overcrowded social media party. This free app enables users to create basic design pieces in a snap, such as graphics for blogs and social media. It clearly makes the distinction between itself and pro tools such as Photoshop or InDesign. Instead, Canva simply helps with content layout, and it may be helpful to those who don’t always have access to a graphic designer and just need to create simple, attractive graphic content.

8. Pulse. This app aims to simplify our news experience by delivering news direct from influencers (identified through LinkedIn) that interests us most, all in one place. Basically, it’s a personalized newsfeed.

9. Camtasia. Shorter is better when it comes to video these days, and this tool makes it a snap to edit or combine short videos. I’d like to try this out for projects that don’t require—or don’t have the budget for—professional video but still have to look somewhat polished.

10. LinkedIn tags. Did you know you could tag your LinkedIn contacts? Similar to Twitter lists (another one of my go-to tools), you can assign tags to your LinkedIn connections, such as “Clients” or “Social Media Roundtable Participants,” for easy access.

I’d love to know about some of your favorite tools and resources, too, so please share them in the comments section.

Hana Bieliauskas is an account manager in the Columbus, Ohio, office of CMA, a national public relations agency based in Kansas City, Mo. Follow her on Twitter @hanab08. A version of this story originally appeared on the author’s blog, Follow My Footnotes.

A Great Teacher

http://www.dailyom.com/cgi-bin/display/articledisplay.cgi?aid=58604&aff=

A Great Teacher

BY MADISYN TAYLOR

Water is a great teacher that shows us how to move through the world with grace, ease, determination, and humility.

 

The journey of water as it flows upon the earth can be a mirror of our own paths through life. Water begins its residence on earth as it falls from the sky or melts from ice and streams down a mountain into a tributary or stream. In the same way, we come into the world and begin our lives on earth. Like a river that flows within the confines of its banks, we are born with certain defining characteristics that govern our identity. We are born in a specific time and place, within a specific family, and with certain gifts and challenges. Within these parameters, we move through life, encountering many twists, turns, and obstacles along the way just as a river flows.

Water is a great teacher that shows us how to move through the world with grace, ease, determination, and humility. When a river breaks at a waterfall, it gains energy and moves on, as we encounter our own waterfalls, we may fall hard but we always keep moving on. Water can inspire us to not become rigid with fear or cling to what’s familiar. Water is brave and does not waste time clinging to its past, but flows onward without looking back. At the same time, when there is a hole to be filled, water does not run away from it in fear of the dark; instead, water humbly and bravely fills the empty space. In the same way, we can face the dark moments of our life rather than run away from them.

Eventually, a river will empty into the sea. Water does not hold back from joining with a larger body, nor does it fear a loss of identity or control. It gracefully and humbly tumbles into the vastness by contributing its energy and merging without resistance. Each time we move beyond our individual egos to become part of something bigger, we can try our best to follow the lead of the river.

 

2018 ACURA TLX FIRST DRIVE: LUXURY AND LOGIC

http://www.motortrend.com/cars/acura/tlx/2018/2018-acura-tlx-first-drive-review/?bt_alias=eyJ1c2VySWQiOiAiYWQ4OTZhZTItNmYxYy00ZjdjLWJkZjQtNzRjYzM3NjM4YjIyIn0%3D&wc_mid=4035%3A6552&wc_rid=4035%3A1354341

 

BUYER’S GUIDE

2018 ACURA TLX FIRST DRIVE: LUXURY AND LOGIC

Refreshed TLX offers some intriguing options and lots of value

Luxury isn’t logical. Every Toyota Corolla includes LED headlights and active safety tech, yet the cheap, slow compact would never be considered by someone seeking a name-brand compact luxury sedan. But luxury isn’t just about features—sometimes you pay more for a less spacious car with fewer standard features because of how it drives and because you want to be associated with the brand. The refreshed 2018 Acura TLXattempts to strike a balance between luxury and logic, with updates that strengthen the value Acuras have often had while adding an emotional pull some recent models have lacked. We drove the 2018 TLX to determine where the Acura fits in an overwhelming segment with more than 10 choices.

Every 2018 Acura TLX, from the base model four-cylinder to the six-cylinder A-Spec and Advance-package cars, comes with an impressive amount of standard equipment for a luxury sport sedan. The car starts at $33,950 and includes LED headlights, Android Auto and Apple CarPlay compatibility, a proximity key, heated front seats, an electric parking brake with auto brake hold, and adaptive safety tech. If your smartphone will work with Android Auto or Apple CarPlay, you effectively have an in-car navigation system anywhere your phone has reception, too. Active safety tech isn’t for everyone, but like the HID headlights on my personal first-generation Acura TSX, it’s the kind of thing you might appreciate after driving with it for a while, from the 2018 TLX’s collision mitigation braking system to the lane keeping assist system that can help you stay in your lane on a highway or two-lane road.

Learn seven cool facts about the 2018 TLX here.

The 2018 TLX hasn’t yet been safety tested by the NHTSA or IIHS, but Acura says it is targeting a Top Safety Pick rating with the latter organization.

 

Beyond the addition of a few new features, the 2018 TLX’s major changes are bolder styling details, the sportier A-Spec model, and colorful brand-boosting ads that remind viewers the front-drive sedan is made by the same company that brought us the advanced NSX hybrid supercar. The TLX’s interesting diamond pentagon grille is an improvement over the more chrome-filled 2015-2017 model’s look, yet besides the front and rear fascia changes, the car is still on the more conservative side. That’s mostly good—it means that, except for maybe the A-Spec model, you’ll probably feel the same way you do about the 2018 TLX’s styling today as you will 10 years from now.

Although the 2018 TLX has lots of new features and updated styling, the engines and transmissions remain the same. The base car remains front-drive only, with a naturally aspirated 2.4-liter I-4 producing 206 hp and 182 lb-ft of torque, mated to an eight-speed dual-clutch automatic. Like the front-drive V-6 models, all-wheel-drive TLXs are powered by a 3.5-liter naturally aspirated V-6 good for 290 hp and 267 lb-ft of torque, mated to a nine-speed automatic. Sixty percent of TLX customers are expected to go with a V-6 model over the I-4, and that makes sense if you’re comparing the TLX to a BMW 330i and Audi A4 2.0T instead of a BMW 320i, Audi A4 Ultra, or even a loaded Honda Accord V-6. The 2018 TLX’s V-6 engine won’t produce its peak power and torque as low in the rev range as turbocharged four-cylinder competitors, but it will sound better as you make your way across that highway on-ramp.

Even with the new 2018 TLX A-Spec model, whose Active Sound Cancellation system is tuned to pump up the engine sound above 4,000 rpm, the V-6 never shouts and always sounds refined. The A-Spec model represents a more involved effort from Acura than the ILX A-Spec, which mostly enhances that car’s already good looks. The TLX A-Spec is offered on front- and all-wheel-drive V-6 models, and rides on slightly fatter 245/40 R19 tires with dark-painted 19-inch wheels (compared to the regular V-6’s 225/50 R18 tires and 18-inch wheels). The steering and suspension systems are also retuned, and exterior and interior badges accompany the more aggressive styling touches and larger exhaust outlets.

On the road, you really can tell a difference between a 2018 TLX A-Spec and a non-A-Spec V-6 car. It’s subtle, but the TLX A-Spec’s suspension is firmer (but still everyday-livable), and the steering feels tighter, with slightly greater effort. No, the A-Spec car doesn’t make any more power than the other V-6 models, but we tested a 2015 TLX with all-wheel drive and the same engine/transmission combination hitting 60 mph in a respectable 5.9 seconds. As for the four-cylinder model, we’ve tested a 2015 TLX 2.4 reaching 60 mph in 7.2 seconds. On a winding road in a 2017 TLX recently, I found the 206-hp engine plenty powerful for driving on winding roads, and I appreciated its surprising snarl in Sport+ mode. We look forward to track testing 2018 TLX variants, including the A-Spec variant, to see how their performance has changed.

The Acura TLX’s auto brake hold can hold the brakes at long red lights, and it works smoothly as long as the V-6 model’s engine stop/start feature is turned off.

 

Having previously driven a 2017 TLX V-6 with all-wheel drive, I noticed the nine-speed auto in the 2018 TLX V-6 was better behaved during a day I spent with the updated cars. Hopefully this reflects the multiple minor improvements Acura tells us it has made since the V-6/nine-speed combination first appeared on the 2015 TLX, though it will take another few years to see any potential improvements in quality and reliability surveys. What remained consistent on the 2017 and 2018 TLXs I drove was the brake feel—there was a bit too much travel in the pedal before any actual slowing down happens.

With Acura carrying over the TLX’s engines and transmissions, EPA-rated fuel economy is expected to remain about the same. We don’t yet have the 2018 TLX’s official ratings, but the 2017 TLX came in at 24/35 mpg city/highway with the four-cylinder version, 21/34 mpg with the 2017 TLX V-6 FWD, and 21/31 mpg on the 2017 TLX V-6 AWD. Those are average numbers if you’re comparing the TLX to turbo-four-powered compact luxury sport sedans. The 2017 Audi A4 2.0T scoots from 0 to 60 mph in just 5.0 seconds, yet is EPA-rated at 24/31, three mpg better than the equivalent 2017 TLX in the city. The front-drive 2017 A4 2.0T is rated 25/33 and the 2017 Mercedes-Benz C300, which we tested in rear-drive form reaching 60 mph in 6.0 seconds, is rated 24/34 mpg (or 24/31 with all-wheel drive).

 

Neither of those German competitors have the Acura’s polarizing infotainment solution of two stacked screens. This is a layout we’ve seen on the prerefresh TLX, but it’s better executed now, with a lower screen that’s 30 percent quicker (and feels that way) as well as an Apple CarPlay integration that includes the ability to use the steering wheel’s voice-command button. On that lower screen, the controls for the HVAC system as well as the heated and available ventilated front seats are always visible, so making a change is easy. If you don’t understand why you’d want two screens, consider that the top screen can display a map, Apple CarPlay/Android Auto info, or fuel economy stats while the bottom one shows audio and HVAC system details. Another screen is sandwiched between the two instrument cluster gauges that are functional but not particularly modern or upscale.

https://www.instagram.com/p/BTHpZS8jCU0/embed/captioned/?cr=1&v=7#%7B%22ci%22%3A0%2C%22os%22%3A13880.2%7D 

From the front or rear seats, you might appreciate the new contrasting seat piping that’s offered on most six-cylinder TLX sedans and standard on the TLX A-Spec. The detail is included on a new comfortable seat design and, overall, Acura offers the luxury of choice with a six interior colors. The most upscale is a new saddle-brown-like color called Espresso that’s only offered on non-A-Spec V-6 models. The A-Spec gets a choice between black leather with Alcantara inserts and white piping and an option the development team worked hard to get approved: red leather. Like many cars in this class, rear-seat space is adequate for two passengers in the outboard rear seats, which can now be optioned with heating controls.

Value remains the best reason to buy a TLX, but with the 2018 model going on sale in June, it’s far from the only one. The A-Spec variant is more fun to drive and showy than other TLXs have ever been before, yet each model would make a good commuter. Fuel efficiency and brand status aren’t the car’s strong suits, but the 2018 TLX is more worthy of consideration than it’s been before. And with standard active safety tech, you’ll experience features that might have been out of reach on nonloaded first-tier luxury brand alternatives.

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#WeAreNotWaiting: Diabetics are hacking their health, because traditional systems have failed them

http://www.techrepublic.com/article/wearenotwaiting-diabetics-are-hacking-their-health-because-traditional-systems-have-failed-them/

Diabetics have been waiting for years for better technology to manage their condition. Some got tired of waiting and hacked together an open source hardware and software solution. This is their story.

By Jo Best   May 28, 2017

This is a story about what happens when people decide technology’s potential to help them is too great to leave in the hands of hardware companies. It’s about open source and commercial software, about the little guy and the regulator, about technology and your body.

For years, type 1 diabetics have been told that technology was the answer to their problems, that a solution could be found, that the daily grind of managing their condition could be fixed by the right mix of hardware and software. One day. One day soon. Just not yet.

“Diabetes sucks deeply, the technology we are given to manage it sucks deeply, and we are pretty much tired of waiting. We’ve been told a ‘cure’ (or at least, a mostly foolproof way to manage it) is just 5 years out. I’ve been told this, personally, every year for the last 25,” Scott Hanselman, a type 1 diabetic and technologist, wrote on his blog in June 2016.

But, after years of waiting for technology to do what people promised it would, something is starting to change.

“I’m actually feeling like we are on the edge of something big. I believe that now we are inside a five year window of time where we WILL make Type 1 Diabetes MUCH, MUCH easier to deal with,” Hanselman wrote.

So what’s changed? Diabetic technologists have stopped waiting for other people to make the tech they need, and started making it themselves.

The #WeAreNotWaiting movement

Artificial pancreas devices might hit the market in 2018. Maybe. But what if you’re one of the type 1 diabetics who really needs the technology now? Do you hold on, injecting yourself with insulin up to six times a day, or do you use the IT skills you already have to make a homemade version?

For the diabetics that are part of the “We Are Not Waiting” movement, there was no doubt in their minds that hacking together their own hardware and software to manage the chronic condition was the way forward.

The movement was born from frustration, particularly among the parents of young children with type 1 diabetes, at the pace at which technology that could potentially revolutionise their lives was being developed.

Diabetes may be a relatively common and well-known condition, but managing it on a day-to-day basis is anything but easy.

In type I diabetes, the body either doesn’t produce enough insulin—the chemical needed to keep blood sugar in the right range for health—or doesn’t respond to the insulin it does make. For diabetics, the condition means regularly monitoring their own blood sugar levels through a fingerstick test and then adjusting their insulin level, using frequent injections of the chemical, themselves.

For adults, it’s a tricky and time-consuming process. For children, it’s a whole other matter: their parents may have to wake them in the night—the time when their glucose level will typically fall—to monitor their glucose level and administer insulin accordingly, for example. It’s a routine that takes a toll on both the children and their parents.

One way type 1 diabetics have to control their blood sugar levels is through an insulin pump. Rather than having diabetics manually inject insulin, an insulin pump can deliver the hormone directly into the wearer’s body. It can also allow a more fine-grained approach to insulin delivery by varying the amount of the hormone and intervals between doses. That helps keep blood sugar more tightly within the desired range, but it can also mean pump users have to test their blood sugar more frequently that before.

A solution to that problem comes in the form of a continuous glucose monitor (CGM), which takes a reading of the user’s blood sugar levels every five minutes, giving them a near real-time view of how their glucose levels are changing, helping them refine how they use their pump.

However, with both the monitor and pump, users can find themselves adrift in information overload—too much data for them to do anything useful with it.

“The problem with the pump is it gives you so much control, it can become a bit too much. You get a pump and people say ‘Wow, you’re cured’, but my condition has just become ten times more complicated. If I invest time into it and learn how to use it and adapt it to customise it for myself, yes, it can help,” said Tim Omer, a type 1 diabetic, IT consultant, and health hacker. “I still have to manage it and work it.”

“A lot of people with a CGM get overwhelmed, and they end up getting overwhelmed, because they feel like there’s too much pressure on them. As a diabetic, you always feel like you’re being told off all the time—by healthcare, by your medical devices shouting at you. It’s great to have more information, but if you’re just getting yelled at all the time, it’s frustrating,” he added.

Another downside is that the kit is expensive to buy and run—and like many phones, some battery-powered components will come to the end of their life when their battery completes a certain number of charging cycles, despite the rest of the hardware remaining fully-functional. The battery can’t be replaced, so when it goes, the rest of the device goes with it.

05-hacking-diabetes.jpg

#WeAreNotWaiting has turned into a community movement, with its own hashtag and technologists presenting their experiences at events like D-Data ExChange.

One project borne of the We Are Not Waiting movement was Nightscout, an open source system originally built to help the parents of diabetic children get a better handle on their children’s condition by giving them remote access to the readings from the child’s CGM.

Nightscout allows data from the CGM to be published online, by connecting a phone with the Nightscout app installed to the receiver part of the CGM. Data from the CGM can then be viewed through the Nightscout website or any web-enabled device, be it another phone or a smartwatch. While intended to help parents monitor young children’s condition while they’re away from home, it’s also used by adult diabetics to get a more user-friendly display of their blood glucose data.

A similar DIY project, called xDrip, is a device that gathers the data from the sensor part of the Dexcom G4 glucose monitors, and transmits it via Bluetooth Low Energy to an Android app, or feeds through into the Nightscout system. The drip is made of four components that are soldered together at home, and cost around £40 in total. Together, they can fit inside a housing made of a Tic Tac box.

“That does two really important things,” says Omer, who built his own xDrip at home in a couple of hours. “It means I don’t have to buy the manufacturer’s receiver [for the CGM] so my costs are significantly reduced… And it picks up the signal and it relays it to my phone. I now have control of the data.”

Closing the loop

The We Are Not Waiting movement is also turning its attentions to closed-loop systems, where the glucose monitor and pump are able to communicate with each other to keep the wearer’s blood glucose more tightly inside the right range.

One such project is OpenAPS (APS stands for artificial pancreas system), co-founded by Dana Lewis, a type 1 diabetic who found the alarm on her CGM wasn’t loud enough to wake her if her blood glucose went dangerously low while she slept. She wanted the data from her device so she could hack together to something with an alarm loud enough that she wouldn’t sleep through it, but couldn’t extract the data from her device to make it.

01-hacking-diabetes.jpg

Chris Hannemann showed how the OpenAPS solution combines hardware and software at the DiabetesMine D-Data ExChange event in 2015.

 

After a fellow diabetic shared code with her that allowed her to get the real-time data off the CGM and build a louder alarm system using her phone and computer, she created a tool to alert friends and family if certain blood-glucose parameters were crossed.

From there, Lewis was able to build an algorithm that could make predictive recommendations about what would happen in the future based on the real-time data, and then by finding a tool that would allow that data to be communicated to the pump—creating the closed-loop artificial pancreas system OpenAPS.

OpenAPS uses data on the carbohydrates in the wearer’s food and their blood sugar level, runs it through the personalised algorithm that determines how much insulin they’ll need in the future to keep their blood glucose at the right level.

“The beauty of it is it provides a recommendation in real time with real-time data. While a person with diabetes may make that calculation a dozen times a day, the system is doing it every five minutes. If something starts happening, the system is able to react and give a recommendation a lot sooner than a human, who might not otherwise notice something is happening and take action,” Lewis said.

“It won’t sense something coming that you don’t know about, but it has that attention — it takes a reading every five minutes — unlike the person who might be in a meeting, or playing with their kids, or out running, and not necessarily wanting to think about diabetes all the time.”

OpenAPS systems can send the diabetic’s basal rate to the pump, which means it can only make small adjustments to their insulin dose—small adjustments that the user can undo if they want. The dose will act over half an hour, so if the pump fails for any reason, the pump will revert back to its standard operating procedure.

OpenAPS technologies are not only helping adults to get a better handle on their condition, some children are also using it, too.

“They spend a lot less time in the nurse’s office, and more time in the classroom. It’s helping them learn about how to treat their diabetes, they’re learning self-management skills much more quickly than they would have without the system,” Lewis said.

“The beauty of it is it provides a recommendation in real time with real-time data. While a person with diabetes may make that calculation a dozen times a day, the system is doing it every five minutes.”

DANA LEWIS, CO-FOUNDER OF OPENAPS

As the parents can remotely see the data from their child’s system, they can speak to the teacher or the nurse if anything is going awry to head off problems. Similarly, data from both children and adults can be shared with clinicians to help give them a better idea about how an individual is managing their diabetes, and potentially refine basal rates for new diabetics.

The brave new world of healthcare hacking still has its problems. For one, it’s outside the traditional, regulated world of medicine. Commercial devices and software used to manage or treat medical conditions undergo lengthy clinical trials to assess their safety and benefits, and have to be regulated by the US Food and Drug Administration. That means they take far longer to reach the market, and are far more expensive. It also means they come with reasonable expectations of safety among users.

For those developing their own homemade devices, there’s none of that. People writing code and publishing advice on how to build systems are not regulated, but they can’t distribute their hardware or software without running afoul of the regulator. While they can publish their source code, offer tips and advice to others about how to build devices, but that’s about as far as they can take it.

That means anyone who wants such a device has to build it themselves at home—they have to be convinced about how safe it is, and be confident they have the necessary skills to do so.

They also need to be able to get their hands on the right hardware. The OpenAPS system needs certain older models of CGM that the manufacturer has stopped making. And you can see why, from the manufacturer’s point of view. After discovering a vulnerability that could allow the pump to be hijacked, they turned off the ability for the hardware to be commanded remotely for most models. Only some earlier versions still have that capability, and so can be used in OpenAPS systems.

02-hacking-diabetes.jpg

Here’s the data the OpenAPS artificial pancreas provides in mobile apps on Android and iPhone.

So far, around 110 people have built their own OpenAPS systems, according to Lewis, and that number is growing. It has also inspired others to use it as the basis for new diabetic-aiding technologies. Omer used the algorithm to make an open loop artificial pancreas notification system based on an Android app he created called HAPP.

“I originally started the project as a mess-around, not thinking it would be useful, but once I had something quite crude up and working, it was incredibly useful. The system works every 15 minutes when it will crunch the data, and then my watch will vibrate and it will say ‘make this adjustment’. It was massively useful in the sense I didn’t have to sync and check and monitor stuff. I could let the system do that for me and just tell me when I need to action something,” Omer said. (Disclosure: Omer previously worked for CBS Interactive which owns TechRepublic and ZDNet).

For now, the FDA is taking a wait-and-see approach towards homemade diabetic tech, exercising what it calls “enforcement discretion”—keeping tabs on the healthcare hackers, monitoring the situation, and choosing not to take any action. That’s not to say the regulator doesn’t have its concerns about homemade tech.

What happens if the systems break down and users who haven’t had to inject insulin before aren’t confident enough to do so, for example. But, it hasn’t take any action against those that publish instructions on how to build devices, and has been actively engaging with the DIY community.

“We understand why people are doing it, but we want to make sure they do it safely,” Dr. Courtney Lias, director of the FDA’s Division of Chemistry and Toxicology Devices, told a conference recently.

The FDA is also working with those medical hardware companies that are seeking to bring artificial pancreas systems to market, going through the regulatory hoops that the DIYers don’t have to. Similarly, the regulator seems to be taking a pragmatic approach to getting commercial hardware out into the wild, tolerating a level of risk to ensure the systems can be launched.

“Artificial pancreas devices do not have to be perfect with zero risk to be beneficial,” Lias said. “The approval decision is a benefit/risk decision. We make this decision in the context of the high risks that people with diabetes face every day.”

Because of the inherent risks to the overall health of people with type 1 diabetes from their condition, and glucose that isn’t well-managed, the FDA is ready to accept systems that come with some degree of risk.

“The FDA is really supportive of that technology reaching people with type 1 diabetes… They’re saying the community is willing to accept things that aren’t bulletproof and we won’t stand in the way. It’s amazing,” Dr. Roman Havorka, who leads research into artificial pancreas systems at Cambridge University research, told ZDNet recently.

“Diabetes sucks deeply, the technology we are given to manage it sucks deeply, and we are pretty much tired of waiting.”

SCOTT HANSELMAN, MICROSOFT SOFTWARE ENGINEER

If all goes well, artificial pancreases built on the work of groups like Havorka’s could be approved by the FDA in 2017, with commercial units reaching the market the year after. That would mean that those who don’t feel they have the technology skills to build their own devices will have another option to get one, and healthcare providers will be able to fund those units getting into the hands of diabetics across the world.

Does that mean that an end to the We Are Not Waiting movement? Perhaps not. After all, diabetics in less developed parts of the world are still waiting for systems that they can afford, which the first versions of the commercial artificial pancreases won’t help. Others may want functionality that commercial systems don’t deliver, or to export the data in a way that manufacturers don’t allow.

Instead, it’s likely that, much like in the software world elsewhere, the majority of people prefer to get black-box systems from a single commercial provider that provides support and updates they need along the way. Others, however, will remain part of the open source community, putting together new systems and sharing them with others on the same path—despite the risks—because they’ve waited too long for the traditional channels to help them.

 

Atlantic Hurricane Season Is Expected to Be Busy

Cocoa Beach, Fla., was hit by Hurricane Matthew, one of four named storms last year that were Category 3 or higher. CreditMark Wilson/Getty Images North America

The United States can expect an Atlantic hurricane season with more than the usual number of storms, government forecasters said Thursday.

The season, which begins June 1 and runs to Nov. 30, is likely to produce 11 to 17 named storms, experts at the National Oceanic and Atmospheric Administration said. As many as nine of those could become hurricanes, with winds of 74 miles per hour or higher, and as many as four could be major hurricanes with winds of 111 m.p.h. or greater, also known as Category 3 or higher.

In an average season, 12 named storms develop, and three of them become major hurricanes. The agency said there was only a 20 percent chance of a below-normal season this year.

The Atlantic season is off to an early start with the brief appearance of a rare preseason tropical storm, Arlene, in April.

Gerry Bell, the lead seasonal hurricane forecaster with NOAA’s Climate Prediction Center, said the agency anticipated warm sea surface temperatures in the Atlantic Ocean, which can increase the power of storms. But forecasters expect weak or even nonexistent El Niño conditions; that weather phenomenon, which warms the waters of the Pacific Ocean, tends to suppress Atlantic storms.

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In 2016, NOAA forecast 10 to 16 named storms; fifteen storms developed, including four hurricanes of Category 3 or higher.

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Recovery from Hurricane Matthew continued this year as workers cleared a canal in Virginia Beach last month. CreditL. Todd Spencer/The Virginian-Pilot, via Associated Press

Kerry A. Emanuel, an atmospheric scientist at the Massachusetts Institute of Technology, said that publicizing the annual hurricane forecasts can be “inadvertently misleading.” Whatever the number of named storms, he said, the real concern is the number of damaging storms that actually reach land and affect people and property — and “no one pretends to be able to forecast the incidence of dangerous, landfalling storms.”

An active season might not include any storms that strike the United States, while a quiet season can still produce hurricanes like Andrew in 1992, one of the most destructive to hit the country.

Regardless of the forecast, being ready for storms — knowing one’s personal risk, buying flood insurance, discussing an evacuation plan and storing emergency supplies — is vitally important, said Mary Erickson, the deputy director of the National Weather Service. “Preparedness saves lives,” she said.

NOAA said it was offering new tools online to help people determine their risk from approaching storms, including more precise predictions of a storm’s arrival time than have previously been available.

This year’s hurricane outlook arrives as the White House is proposing budget cuts for NOAA programs, which could undermine initiatives intended to strengthen the agency’s forecasts.

David W. Titley, a former chief operating officer at NOAA, said the proposal would be dead on arrival in Congress. Lawmakers recently passed a bill calling for more funding for forecasting, so “there’s no way they’re going to approve this,” he said.

The forecasting bill, he noted, was signed last month by President Trump.

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https://nyti.ms/2s0NToO

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