CA2504661C - Method and device for monitoring an analyte concentration in the living body of a human or animal - Google Patents
Method and device for monitoring an analyte concentration in the living body of a human or animal Download PDFInfo
- Publication number
- CA2504661C CA2504661C CA002504661A CA2504661A CA2504661C CA 2504661 C CA2504661 C CA 2504661C CA 002504661 A CA002504661 A CA 002504661A CA 2504661 A CA2504661 A CA 2504661A CA 2504661 C CA2504661 C CA 2504661C
- Authority
- CA
- Canada
- Prior art keywords
- delta
- analyte
- values
- determined
- function
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
- 239000012491 analyte Substances 0.000 title claims abstract description 103
- 238000000034 method Methods 0.000 title claims abstract description 45
- 241001465754 Metazoa Species 0.000 title claims abstract description 13
- 238000012544 monitoring process Methods 0.000 title claims abstract description 12
- 230000009466 transformation Effects 0.000 claims description 7
- 230000002596 correlated effect Effects 0.000 claims description 6
- 238000012886 linear function Methods 0.000 claims description 4
- 238000012545 processing Methods 0.000 claims description 4
- 230000000875 corresponding effect Effects 0.000 claims description 3
- 238000001914 filtration Methods 0.000 claims 1
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 21
- 239000008103 glucose Substances 0.000 description 21
- NOESYZHRGYRDHS-UHFFFAOYSA-N insulin Chemical compound N1C(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(NC(=O)CN)C(C)CC)CSSCC(C(NC(CO)C(=O)NC(CC(C)C)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CCC(N)=O)C(=O)NC(CC(C)C)C(=O)NC(CCC(O)=O)C(=O)NC(CC(N)=O)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CSSCC(NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2C=CC(O)=CC=2)NC(=O)C(CC(C)C)NC(=O)C(C)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2NC=NC=2)NC(=O)C(CO)NC(=O)CNC2=O)C(=O)NCC(=O)NC(CCC(O)=O)C(=O)NC(CCCNC(N)=N)C(=O)NCC(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC(O)=CC=3)C(=O)NC(C(C)O)C(=O)N3C(CCC3)C(=O)NC(CCCCN)C(=O)NC(C)C(O)=O)C(=O)NC(CC(N)=O)C(O)=O)=O)NC(=O)C(C(C)CC)NC(=O)C(CO)NC(=O)C(C(C)O)NC(=O)C1CSSCC2NC(=O)C(CC(C)C)NC(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CC(N)=O)NC(=O)C(NC(=O)C(N)CC=1C=CC=CC=1)C(C)C)CC1=CN=CN1 NOESYZHRGYRDHS-UHFFFAOYSA-N 0.000 description 20
- 239000008280 blood Substances 0.000 description 18
- 210000004369 blood Anatomy 0.000 description 18
- 102000004877 Insulin Human genes 0.000 description 10
- 108090001061 Insulin Proteins 0.000 description 10
- 229940125396 insulin Drugs 0.000 description 10
- 150000001720 carbohydrates Chemical class 0.000 description 5
- 235000014633 carbohydrates Nutrition 0.000 description 5
- 206010012601 diabetes mellitus Diseases 0.000 description 5
- 235000008429 bread Nutrition 0.000 description 3
- 238000004364 calculation method Methods 0.000 description 3
- 229940079593 drug Drugs 0.000 description 3
- 239000003814 drug Substances 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 238000005259 measurement Methods 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- MHAJPDPJQMAIIY-UHFFFAOYSA-N Hydrogen peroxide Chemical compound OO MHAJPDPJQMAIIY-UHFFFAOYSA-N 0.000 description 2
- 210000004027 cell Anatomy 0.000 description 2
- DDRJAANPRJIHGJ-UHFFFAOYSA-N creatinine Chemical compound CN1CC(=O)NC1=N DDRJAANPRJIHGJ-UHFFFAOYSA-N 0.000 description 2
- 238000011161 development Methods 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 235000013305 food Nutrition 0.000 description 2
- 230000037406 food intake Effects 0.000 description 2
- 230000001537 neural effect Effects 0.000 description 2
- 230000001502 supplementing effect Effects 0.000 description 2
- JVTAAEKCZFNVCJ-UHFFFAOYSA-M Lactate Chemical compound CC(O)C([O-])=O JVTAAEKCZFNVCJ-UHFFFAOYSA-M 0.000 description 1
- 208000017442 Retinal disease Diseases 0.000 description 1
- 206010038923 Retinopathy Diseases 0.000 description 1
- 210000000577 adipose tissue Anatomy 0.000 description 1
- 235000021074 carbohydrate intake Nutrition 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 229940109239 creatinine Drugs 0.000 description 1
- 238000013500 data storage Methods 0.000 description 1
- 238000000354 decomposition reaction Methods 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000000835 electrochemical detection Methods 0.000 description 1
- 230000002255 enzymatic effect Effects 0.000 description 1
- 210000003722 extracellular fluid Anatomy 0.000 description 1
- 238000013213 extrapolation Methods 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 150000002303 glucose derivatives Chemical class 0.000 description 1
- 230000003054 hormonal effect Effects 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 238000000513 principal component analysis Methods 0.000 description 1
- 230000008844 regulatory mechanism Effects 0.000 description 1
- 238000007920 subcutaneous administration Methods 0.000 description 1
- 206010042772 syncope Diseases 0.000 description 1
- 230000002123 temporal effect Effects 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 238000012549 training Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
- A61B5/14532—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Physics & Mathematics (AREA)
- Medical Informatics (AREA)
- Surgery (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Emergency Medicine (AREA)
- Molecular Biology (AREA)
- Optics & Photonics (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Investigating Or Analysing Biological Materials (AREA)
- Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
- Investigating Or Analysing Materials By Optical Means (AREA)
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE102004020160.9 | 2004-04-24 | ||
| DE102004020160A DE102004020160A1 (de) | 2004-04-24 | 2004-04-24 | Verfahren und Vorrichtung zum Überwachen einer Konzentration eines Analyten im lebenden Körper eines Menschen oder Tieres |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2504661A1 CA2504661A1 (en) | 2005-10-24 |
| CA2504661C true CA2504661C (en) | 2009-08-18 |
Family
ID=34934888
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002504661A Expired - Fee Related CA2504661C (en) | 2004-04-24 | 2005-04-21 | Method and device for monitoring an analyte concentration in the living body of a human or animal |
Country Status (5)
| Country | Link |
|---|---|
| US (2) | US7188034B2 (enExample) |
| EP (1) | EP1589438B1 (enExample) |
| JP (1) | JP4693474B2 (enExample) |
| CA (1) | CA2504661C (enExample) |
| DE (1) | DE102004020160A1 (enExample) |
Families Citing this family (63)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6391005B1 (en) | 1998-03-30 | 2002-05-21 | Agilent Technologies, Inc. | Apparatus and method for penetration with shaft having a sensor for sensing penetration depth |
| US8641644B2 (en) | 2000-11-21 | 2014-02-04 | Sanofi-Aventis Deutschland Gmbh | Blood testing apparatus having a rotatable cartridge with multiple lancing elements and testing means |
| EP1395185B1 (en) | 2001-06-12 | 2010-10-27 | Pelikan Technologies Inc. | Electric lancet actuator |
| US9427532B2 (en) | 2001-06-12 | 2016-08-30 | Sanofi-Aventis Deutschland Gmbh | Tissue penetration device |
| US7981056B2 (en) | 2002-04-19 | 2011-07-19 | Pelikan Technologies, Inc. | Methods and apparatus for lancet actuation |
| US8337419B2 (en) | 2002-04-19 | 2012-12-25 | Sanofi-Aventis Deutschland Gmbh | Tissue penetration device |
| US7344507B2 (en) | 2002-04-19 | 2008-03-18 | Pelikan Technologies, Inc. | Method and apparatus for lancet actuation |
| AU2002315177A1 (en) | 2001-06-12 | 2002-12-23 | Pelikan Technologies, Inc. | Self optimizing lancing device with adaptation means to temporal variations in cutaneous properties |
| US9226699B2 (en) | 2002-04-19 | 2016-01-05 | Sanofi-Aventis Deutschland Gmbh | Body fluid sampling module with a continuous compression tissue interface surface |
| US9795747B2 (en) | 2010-06-02 | 2017-10-24 | Sanofi-Aventis Deutschland Gmbh | Methods and apparatus for lancet actuation |
| US7041068B2 (en) | 2001-06-12 | 2006-05-09 | Pelikan Technologies, Inc. | Sampling module device and method |
| EP1404235A4 (en) | 2001-06-12 | 2008-08-20 | Pelikan Technologies Inc | METHOD AND DEVICE FOR A LANZETTING DEVICE INTEGRATED ON A BLOOD CARTRIDGE CARTRIDGE |
| US7892183B2 (en) | 2002-04-19 | 2011-02-22 | Pelikan Technologies, Inc. | Method and apparatus for body fluid sampling and analyte sensing |
| US7297122B2 (en) | 2002-04-19 | 2007-11-20 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US7976476B2 (en) | 2002-04-19 | 2011-07-12 | Pelikan Technologies, Inc. | Device and method for variable speed lancet |
| US9314194B2 (en) | 2002-04-19 | 2016-04-19 | Sanofi-Aventis Deutschland Gmbh | Tissue penetration device |
| US9795334B2 (en) | 2002-04-19 | 2017-10-24 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for penetrating tissue |
| US7909778B2 (en) | 2002-04-19 | 2011-03-22 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US8579831B2 (en) | 2002-04-19 | 2013-11-12 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for penetrating tissue |
| US7901362B2 (en) | 2002-04-19 | 2011-03-08 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US8221334B2 (en) | 2002-04-19 | 2012-07-17 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for penetrating tissue |
| US7331931B2 (en) | 2002-04-19 | 2008-02-19 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US9248267B2 (en) | 2002-04-19 | 2016-02-02 | Sanofi-Aventis Deustchland Gmbh | Tissue penetration device |
| US7674232B2 (en) | 2002-04-19 | 2010-03-09 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US7713214B2 (en) | 2002-04-19 | 2010-05-11 | Pelikan Technologies, Inc. | Method and apparatus for a multi-use body fluid sampling device with optical analyte sensing |
| US8702624B2 (en) | 2006-09-29 | 2014-04-22 | Sanofi-Aventis Deutschland Gmbh | Analyte measurement device with a single shot actuator |
| US7232451B2 (en) | 2002-04-19 | 2007-06-19 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US7547287B2 (en) | 2002-04-19 | 2009-06-16 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US8360992B2 (en) | 2002-04-19 | 2013-01-29 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for penetrating tissue |
| US7892185B2 (en) | 2002-04-19 | 2011-02-22 | Pelikan Technologies, Inc. | Method and apparatus for body fluid sampling and analyte sensing |
| US7491178B2 (en) | 2002-04-19 | 2009-02-17 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US7229458B2 (en) | 2002-04-19 | 2007-06-12 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US8267870B2 (en) | 2002-04-19 | 2012-09-18 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for body fluid sampling with hybrid actuation |
| US8784335B2 (en) | 2002-04-19 | 2014-07-22 | Sanofi-Aventis Deutschland Gmbh | Body fluid sampling device with a capacitive sensor |
| US8574895B2 (en) | 2002-12-30 | 2013-11-05 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus using optical techniques to measure analyte levels |
| WO2004107975A2 (en) | 2003-05-30 | 2004-12-16 | Pelikan Technologies, Inc. | Method and apparatus for fluid injection |
| WO2004107964A2 (en) | 2003-06-06 | 2004-12-16 | Pelikan Technologies, Inc. | Blood harvesting device with electronic control |
| WO2006001797A1 (en) | 2004-06-14 | 2006-01-05 | Pelikan Technologies, Inc. | Low pain penetrating |
| WO2005033659A2 (en) | 2003-09-29 | 2005-04-14 | Pelikan Technologies, Inc. | Method and apparatus for an improved sample capture device |
| WO2005037095A1 (en) | 2003-10-14 | 2005-04-28 | Pelikan Technologies, Inc. | Method and apparatus for a variable user interface |
| US7822454B1 (en) | 2005-01-03 | 2010-10-26 | Pelikan Technologies, Inc. | Fluid sampling device with improved analyte detecting member configuration |
| US8668656B2 (en) | 2003-12-31 | 2014-03-11 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for improving fluidic flow and sample capture |
| EP1751546A2 (en) | 2004-05-20 | 2007-02-14 | Albatros Technologies GmbH & Co. KG | Printable hydrogel for biosensors |
| US9775553B2 (en) | 2004-06-03 | 2017-10-03 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for a fluid sampling device |
| WO2005120365A1 (en) | 2004-06-03 | 2005-12-22 | Pelikan Technologies, Inc. | Method and apparatus for a fluid sampling device |
| US8652831B2 (en) | 2004-12-30 | 2014-02-18 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for analyte measurement test time |
| EP1728468A1 (de) * | 2005-06-04 | 2006-12-06 | Roche Diagnostics GmbH | Bewertung von Werten der Blutglucosekonzentration zur Einstellung der Insulindosierung |
| ATE465674T1 (de) * | 2006-08-08 | 2010-05-15 | Koninkl Philips Electronics Nv | Verfahren und vorrichtung zur überwachung eines physiologischen parameters |
| US8439837B2 (en) * | 2006-10-31 | 2013-05-14 | Lifescan, Inc. | Systems and methods for detecting hypoglycemic events having a reduced incidence of false alarms |
| MX2009007843A (es) * | 2007-01-23 | 2009-07-31 | Bayer Healthcare Llc | Dispositivo para prueba de analitos. |
| EP1967132B8 (de) | 2007-03-09 | 2015-06-03 | Roche Diagnostics GmbH | Medizinisches Datenübertragungssystem |
| US20090160656A1 (en) * | 2007-10-11 | 2009-06-25 | Mahesh Seetharaman | Analyte monitoring system alarms |
| DE102007046864A1 (de) * | 2007-09-28 | 2009-04-09 | Endress + Hauser Conducta Gesellschaft für Mess- und Regeltechnik mbH + Co. KG | Verfahren und Vorrichtung zur Bewertung eines Messwertes |
| US7731659B2 (en) * | 2007-10-18 | 2010-06-08 | Lifescan Scotland Limited | Method for predicting a user's future glycemic state |
| US7695434B2 (en) * | 2007-10-19 | 2010-04-13 | Lifescan Scotland, Ltd. | Medical device for predicting a user's future glycemic state |
| US9386944B2 (en) | 2008-04-11 | 2016-07-12 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for analyte detecting device |
| WO2010014963A2 (en) * | 2008-07-31 | 2010-02-04 | Government Of The United States As Represented By The Secretary Of The Army | Universal models for predicting glucose concentration in humans |
| US9375169B2 (en) | 2009-01-30 | 2016-06-28 | Sanofi-Aventis Deutschland Gmbh | Cam drive for managing disposable penetrating member actions with a single motor and motor and control system |
| EP2420184B1 (en) | 2009-04-17 | 2016-05-11 | ARKRAY, Inc. | Data provision method, program and server device |
| US8843321B2 (en) * | 2010-01-26 | 2014-09-23 | Roche Diagnostics Operations, Inc. | Methods and systems for processing glucose data measured from a person having diabetes |
| US8965476B2 (en) | 2010-04-16 | 2015-02-24 | Sanofi-Aventis Deutschland Gmbh | Tissue penetration device |
| CN103959291B (zh) * | 2011-04-20 | 2018-05-11 | 诺沃—诺迪斯克有限公司 | 基于具有自适应选择的核和正则化参数的正则化网络的葡萄糖预测器 |
| KR101962315B1 (ko) * | 2017-03-29 | 2019-07-17 | 이화여자대학교 산학협력단 | 혈중수은농도 예측방법 |
Family Cites Families (15)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FI931234A7 (fi) | 1993-03-19 | 1994-09-20 | Instr Oy | Menetelmä potilaan tilan seuraamiseksi |
| US5748851A (en) | 1994-02-28 | 1998-05-05 | Kabushiki Kaisha Meidensha | Method and apparatus for executing short-term prediction of timeseries data |
| DE4415896A1 (de) | 1994-05-05 | 1995-11-09 | Boehringer Mannheim Gmbh | Analysesystem zur Überwachung der Konzentration eines Analyten im Blut eines Patienten |
| EP0910023A2 (de) * | 1997-10-17 | 1999-04-21 | Siemens Aktiengesellschaft | Verfahren und Anordnung zur neuronalen Modellierung eines dynamischen Systems mit nichtlinearem stochastischem Verhalten |
| JPH11296598A (ja) | 1998-04-07 | 1999-10-29 | Seizaburo Arita | 血糖値の予測システム及び予測方法並びにこの方法を記録した記録媒体 |
| JP3454789B2 (ja) * | 1998-05-13 | 2003-10-06 | シグナス， インコーポレイテッド | 生理学的な値を予測するための方法およびデバイス |
| US6925393B1 (en) | 1999-11-18 | 2005-08-02 | Roche Diagnostics Gmbh | System for the extrapolation of glucose concentration |
| JP3563333B2 (ja) | 2000-08-04 | 2004-09-08 | Ｎｅｃエレクトロニクス株式会社 | インラッシュ電流対応ハイサイドスイッチ及び過電流制御方法 |
| DE60133653T2 (de) | 2000-08-18 | 2009-06-04 | Animas Technologies Llc | Vorrichtung zum vorhersagen von hypoglyecemiefällen |
| WO2003082098A2 (en) | 2002-03-22 | 2003-10-09 | Cygnus, Inc. | Improving performance of an analyte monitoring device |
| US7278983B2 (en) * | 2002-07-24 | 2007-10-09 | Medtronic Minimed, Inc. | Physiological monitoring device for controlling a medication infusion device |
| EP2327359B1 (en) | 2002-08-13 | 2015-01-21 | University Of Virginia Patent Foundation | Method, system, and computer program product for processing of self-monitoring blood glucose (smbg) data to enhance diabetic self-management |
| DE10343863A1 (de) * | 2003-09-23 | 2005-04-14 | Roche Diagnostics Gmbh | Verfahren und Gerät zur laufenden Überwachung der Konzentration eines Analyten |
| US20070060869A1 (en) * | 2005-08-16 | 2007-03-15 | Tolle Mike C V | Controller device for an infusion pump |
| US20070060870A1 (en) * | 2005-08-16 | 2007-03-15 | Tolle Mike Charles V | Controller device for an infusion pump |
-
2004
- 2004-04-24 DE DE102004020160A patent/DE102004020160A1/de not_active Withdrawn
-
2005
- 2005-04-08 EP EP05007701.5A patent/EP1589438B1/de not_active Expired - Lifetime
- 2005-04-14 JP JP2005117542A patent/JP4693474B2/ja not_active Expired - Fee Related
- 2005-04-21 CA CA002504661A patent/CA2504661C/en not_active Expired - Fee Related
- 2005-04-25 US US11/113,606 patent/US7188034B2/en not_active Expired - Lifetime
-
2007
- 2007-02-15 US US11/675,580 patent/US7650244B2/en active Active
Also Published As
| Publication number | Publication date |
|---|---|
| US7188034B2 (en) | 2007-03-06 |
| EP1589438B1 (de) | 2015-11-04 |
| EP1589438A3 (de) | 2006-03-22 |
| US20050240356A1 (en) | 2005-10-27 |
| US20070148778A1 (en) | 2007-06-28 |
| DE102004020160A1 (de) | 2005-11-10 |
| JP2005308742A (ja) | 2005-11-04 |
| EP1589438A2 (de) | 2005-10-26 |
| JP4693474B2 (ja) | 2011-06-01 |
| US7650244B2 (en) | 2010-01-19 |
| CA2504661A1 (en) | 2005-10-24 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKLA | Lapsed |
Effective date: 20170421 |
|
| MKLA | Lapsed |
Effective date: 20170421 |