A novel weight-drop closed head focal traumatic brain injury: A candidate to translational studies?

Traumatic brain injury (TBI) is a neurotrauma with a complex pathophysiology caused by an external mechanical force. This global public health problem is a leading cause of death and disability in young adults. In this scenario, many models were developed to try to simulate human TBI. The weight drop model allows the investigation of the pathophysiological cascades of TBI without surgical interference. In this protocol, a new closed-head weight-drop rat model consisting of a 48.5g weight projectile that free falls from 1.10m high onto the skull of the animals was built. We classify the present TBI model performed as moderately severe due to its mortality rate. Animals from TBI and Control (Sham) groups underwent weight for 7 days and temperature assessments within 1 hour after TBI and for 7 days. Results demonstrated that the TBI group showed less body weight gain in the days after the injury. Temperature oscillations within the first-hour post-injury and on the 3rd day after injury were observed. As the results of this study demonstrated similarity to human TBI vital parameters, this new adaptation of the Weight-drop model injury can be a suitable candidate for translational studies.•We developed a novel closed head focal traumatic brain injury using a projectile.•This TBI model does not require surgical intervention.•The validation of this method demonstrates that the vital parameters of the injured rats exhibit similarities with those of TBI patients.

Comparison of Metabolic Control in Children and Adolescents Treated with Insulin Pumps.

BACKGROUND: While insulin pumps remain the most common form of therapy for youths with type 1 diabetes (T1DM), they differ in the extent to which they utilize data from continuous glucose monitoring (CGM) and automate insulin delivery. METHODS: The aim of the study was to compare metabolic control in patients using different models of insulin pumps. This retrospective single-center study randomly sampled 30 patients for each of the following treatments: Medtronic 720G without PLGS (predictive low glucose suspend), Medtronic 640G or 740G with PLGS and Medtronic 780G. In the whole study group, we used CGM systems to assess patients' metabolic control, and we collected lipid profiles. In three groups of patients, we utilized CGM sensors (Guardian 3, Guardian 4, Libre 2 and Dexcom G6) to measure the following glycemic variability proxy values: time in range (TIR), time below 70 mg/dL (TBR), time above 180 mg/dL (TAR), coefficient of variation (CV) and mean sensor glucose. RESULTS: Medtronic 640G or 740G and 780G users were more likely to achieve a target time in the target range 70-180 mg/dL (≥80%) [Medtronic 720G = 4 users (13.3%) vs. Medtronic 640G/740G = 10 users (33.3%) vs. Medtronic 780G = 13 users (43.3%); p = 0.0357)] or low glucose variability [Medtronic 720G = 9 users (30%) vs. Medtronic 640G/740G = 18 users (60%) vs. Medtronic 780G = 19 users (63.3%); p = 0.0175)]. CONCLUSIONS: Any integration between the insulin pump and CGM was associated with better glycemic control. More advanced technologies and artificial intelligence in diabetes help patients maintain better glycemia by eliminating various factors affecting postprandial glycemia.

Microbes and nutrient shift in a Closed Aquatic Ecosystem (CAES) during four weeks of operation.

A Closed Aquatic Ecosystem (CAES) housed an aquatic plant Ceratophyllum demersum, zebrafish (Danio rerio), and microbes that were simultaneously obtained with the zebrafish, and it was used to study the operation of the ecosystem. The results indicated that the CAES can operate steadily for about 4 weeks. The dissolved oxygen (DO), pH, and conductivity values of the ecosystem regularly oscillated, while the total nitrogen of the water decreased and the total phosphate slightly increased. Additionally, the chemical oxygen demand (COD, a measure of organic compounds) of the water after the experiment increased to 39 times more than that of the water before the experiment. The meta-genomic data showed that the number of genera decreased by 38 % and the top 10 most abundant genera were almost completely different before and after the experiment, which demonstrated a great shift in the microbes during the operation process. These results suggested that although the CAES operated steadily during the 28-day experiment, there were more organic materials and less nitrogen in the water by the end of the experiment, which may have influenced the structure and operation of the ecosystem. Thus, it is necessary to remove superfluous plant biomass from the CAES and supply nitrogen to keep the ecosystem stable.

Real-World Use of Hybrid Closed-Loop Systems during Diabetes Camp: A Preliminary Study for Secure Configuration Strategies in Children and Adolescents.

The introduction of closed-loop systems in the pediatric population has been a revolution in the management and evolution of diabetes. However, there are not many published studies in situations in which the feeding, schedules, and activities of the children deviate from the routine for which the systems were programmed, as in the case of a summer camp for children and adolescents with diabetes, where the specific programming of this device is not well known. It was a single-center prospective preliminary study. A total of twenty-seven patients (mean age 11.9 ± 1.9 years, 40% male, duration of diabetes 6.44 ± 2.83 years) were included (twenty with Medtronic MiniMed 780G system and seven with Tandem Control-IQ). Glucometric variables and pump functionality were monitored during the 7-day camp and in the following 3 weeks. There was no decrease from the objective TIR 70% at any moment. The worst results in Time Below Range were at 72 h from starting the camp, and the worst results in Time Above Range were in the first 24 h, with a progressive improvement after that. No episodes of level 3 hypoglycemia or ketoacidosis occurred. The use of specific programming in two integrated systems, with complex blood glucose regulation algorithms and not-prepared-for situations with increased levels of physical activity or abrupt changes in feeding routines, did not result in an increased risk of level 3 hypoglycemia and ketoacidosis for our pediatric type 1 diabetes (T1D) patients, regardless of the closed-loop device.

A Clean and Health-Care-Focused Way to Reduce Indoor Airborne Bacteria in Calf House with Long-Wave Ultraviolet.

Long-term exposure to a relatively high concentration of airborne bacteria emitted from intensive livestock houses could potentially threaten the health and welfare of animals and workers. There is a dual effect of air sterilization and promotion of vitamin D synthesis for the specific bands of ultraviolet light. This study investigated the potential use of A-band ultraviolet (UVA) tubes as a clean and safe way of reducing airborne bacteria and improving calf health. The composition and emission characteristics of airborne bacteria were investigated and used to determine the correct operating regime of UVA tubes in calf houses. Intermittent exceedances of indoor airborne bacteria were observed in closed calf houses. The measured emission intensity of airborne bacteria was 1.13 ± 0.09 × 107 CFU h-1 per calf. Proteobacteria were the dominant microbial species in the air inside and outside calf houses. After UVA radiation, the indoor culturable airborne bacteria decreased in all particle size ranges of the Anderson sampler, and it showed the highest reduction rate in the size range of 3.3-4.7 µm. The results of this study would enrich the knowledge of the source characteristics of the airborne bacteria in intensive livestock farming and contribute to the environmental control of cattle in intensive livestock production.

Non-Invasive Brain Sensing Technologies for Modulation of Neurological Disorders.

The non-invasive brain sensing modulation technology field is experiencing rapid development, with new techniques constantly emerging. This study delves into the field of non-invasive brain neuromodulation, a safer and potentially effective approach for treating a spectrum of neurological and psychiatric disorders. Unlike traditional deep brain stimulation (DBS) surgery, non-invasive techniques employ ultrasound, electrical currents, and electromagnetic field stimulation to stimulate the brain from outside the skull, thereby eliminating surgery risks and enhancing patient comfort. This study explores the mechanisms of various modalities, including transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), highlighting their potential to address chronic pain, anxiety, Parkinson's disease, and depression. We also probe into the concept of closed-loop neuromodulation, which personalizes stimulation based on real-time brain activity. While we acknowledge the limitations of current technologies, our study concludes by proposing future research avenues to advance this rapidly evolving field with its immense potential to revolutionize neurological and psychiatric care and lay the foundation for the continuing advancement of innovative non-invasive brain sensing technologies.

DEMIGOD: A Low-Cost Microcontroller-Based Closed-Loop System Integrating Nanoengineered Sweat-Based Glucose Monitoring and Controlled Transdermal Nanoemulsion Release of Hypoglycemic Treatment with a Software Application for Noninvasive Personalized Diabetes Care.

This study endeavored to design and develop an innovative closed-loop diagnostic and therapeutic system with the following objectives: (a) the noninvasive detection of glucose concentration in sweat utilizing nanonengineered screen-printed biosensors; (b) the management of measured data through a specialized computer system comprising both hardware and software components, thereby enabling the precise control of therapeutic responses via a patch-based nanomedicine delivery system. This initiative addresses the significant challenges inherent in the management of diabetes mellitus, including the imperative need for glucose-level monitoring to optimize glycemic control. Leveraging chronoamperometric results as a foundational dataset and the in vivo hypoglycemic activity of nanoemulsion formulations, this research underscores the efficacy and accuracy of glucose concentration estimation, decision-making mechanism responses, and transdermal hypoglycemic treatment effects, within the proposed system.

Durability of Evoked Compound Action Potential (ECAP)-Controlled, Closed-Loop Spinal Cord Stimulation (SCS) in a Real-World European Chronic Pain Population.

INTRODUCTION: Closed-loop spinal cord stimulation (CL-SCS) is a recently introduced system that records evoked compound action potentials (ECAPs) from the spinal cord elicited by each stimulation pulse and uses this information to automatically adjust the stimulation strength in real time, known as ECAP-controlled SCS. This innovative system compensates for fluctuations in the distance between the epidural leads and the spinal cord by maintaining the neural response (ECAP) at a predetermined target level. This data collection study was designed to assess the performance of the first CL-SCS system in a real-world setting under normal conditions of use in multiple European centers. The study analyzes and presents clinical outcomes and electrophysiological and device data and compares these findings with those reported in earlier pre-market studies of the same system. METHODS: This prospective, multicenter, observational study was conducted in 13 European centers and aimed to gather electrophysiological and device data. The study focused on the real-world application of this system in treating chronic pain affecting the trunk and/or limbs, adhering to standard conditions of use. In addition to collecting and analyzing basic demographic information, the study presents data from the inaugural patient cohort permanently implanted at multiple European centers. RESULTS: A significant decrease in pain intensity was observed for overall back or leg pain scores (verbal numerical rating score [VNRS]) between baseline (mean ± standard error of the mean [SEM]; n = 135; 8.2 ± 0.1), 3 months (n = 93; 2.3 ± 0.2), 6 months (n = 82; 2.5 ± 0.3), and 12 months (n = 76; 2.5 ± 0.3). Comparison of overall pain relief (%) to the AVALON and EVOKE studies showed no significant differences at 3 and 12 months between the real-world data release (RWE; 71.3%; 69.6%) and the AVALON (71.2%; 73.6%) and EVOKE (78.1%; 76.7%) studies. Further investigation was undertaken to objectively characterize the physiological parameters of SCS therapy in this cohort using the metrics of percent time above ECAP threshold (%), dose ratio, and dose accuracy (µV), according to previously described methods. Results showed that a median of 90% (40.7-99.2) of stimuli were above the ECAP threshold, with a dose ratio of 1.3 (1.1-1.4) and dose accuracy of 4.4 µV (0.0-7.1), based on data from 236, 230, and 254 patients, respectively. Thus, across all three metrics, the majority of patients had objective therapy metrics corresponding to the highest levels of pain relief in previously reported studies (usage over threshold > 80%, dose ratio > 1.2, and error < 10 µV). CONCLUSIONS: In conclusion, this study provides valuable insights into the real-world application of the ECAP-controlled CL-SCS system, highlighting its potential for maintaining effective pain relief and objective neurophysiological therapy metrics at levels seen in randomized control trials, and potential for quantifying patient burden associated with SCS system use via patient-device interaction metrics. CLINICAL TRIAL REGISTRATION: In the Netherlands, the study is duly registered on the International Clinical Trials Registry Platform (Trial NL7889). In Germany, the study is duly registered as NCT05272137 and in the United Kingdom as ISCRTN27710516 and has been reviewed by the ethics committee in both countries.

Soft ionization mechanisms in flexible µ-tube plasma-from FµTP to closed µ-tube plasma.

In order to find an explanation for the mechanism in a plasma operated with an alternating voltage, or rather a square wave voltage, such a plasma was investigated. It was found that Penning ionization, charge transfer, and photoionization played a minor or even no role in the soft ionization mechanism of a FµTP. If the collision of plasma gases with air does not contribute to soft ionization, it should also be possible to use a separated plasma for soft ionization. Preliminary investigations show that it is possible to ignite a diagnosis gas with a plasma gas even when there is a barrier such as glass between those gases. A temporally and locally limited potential must be produced at the outer surface to achieve this. This potential should be sufficient to ionize the environment softly and to be able to use this so-called closed µ-tube plasma as a new ionization source.

Recycling channel strategy in the presence of free-riding in the carbon neutrality era.

Recycling has become a critical response to the goals of reaching a carbon peak and achieving carbon neutrality. This study explores the effects of consumer free-riding behavior, the quality of recycling services, and the costs of channel transfers on the profitability of manufacturers and retailers in a dual-channel closed-loop supply chain (CLSC), focusing on the importance of recycling practices for carbon neutrality. Using consumer utility theory and a Stackelberg game model, we analyze the dynamics among these factors. Our results show that: (i) Consumer free-riding behavior slightly increases market demand and recycling volumes, enhancing profitability for both manufacturers and retailers in the dual-channel CLSC. (ii) The quality of recycling services and the transfer costs associated with retailer free-riding behavior jointly influence the profits of manufacturers and retailers. (iii) The effect of free-riding behavior on recycling services affects both forward sales and reverse recycling channels equally. This study provides valuable insights for decision-making in sustainable development practices in the recycling sector, significantly contributing to the goal of achieving carbon neutrality.

Morphological Changes and Concentricity of the Hip Joint During Gradual Reduction in Infants with Late-Detected Developmental Dysplasia of the Hip: A Retrospective Study.

Background: The relationship between hip morphological changes and joint concentricity in infants with late-detected developmental dysplasia of the hip (DDH) treated with gradual reduction remains unclear. Therefore, we investigated hip morphological changes and concentricity in infants with late-detected unilateral DDH using magnetic resonance imaging (MRI) during gradual reduction. Methods: We enrolled 20 infants aged ≥ 12 months with unilateral DDH. Treatment comprised continuous traction, a hip-spica cast, and an abduction brace. MRI was performed before treatment, immediately after hip-spica cast placement, after cast removal, and at the end of the brace. We evaluated the acetabulum and femoral head morphology and joint concentricity. Results: The mean age was 25 months, and female sex and the left side were predominant. Before treatment, the acetabulum was small and shallow and the femoral head was spherically flat on the affected side. Immediately after the continuous traction, the affected acetabulum and femoral head were still smaller than the healthy/contralateral one. However, they improved to a deeper acetabulum and round femoral head. Intra-articular soft tissue (IAST) and femoral-acetabular distance (FAD) continuously decreased, indicating gradual improvement in joint concentricity. Deeper formation of the acetabulum and round shaping of the femoral head had occurred even in non-concentric reduction. Conclusion: The shape and concentricity of the hip joint improved after treatment; however, the acetabulum and femoral head remained small. The deeper acetabulum and round femoral head were observed the non-concentric reduction before the concentric reduction was achieved. The continuous decrease in IAST and FAD indicates effective post-traction therapy.

The use of technology in type 2 diabetes and prediabetes: a narrative review.

The increasing incidence of type 2 diabetes, which represents 90% of diabetes cases globally, is a major public health concern. Improved glucose management reduces the risk of vascular complications and mortality; however, only a small proportion of the type 2 diabetes population have blood glucose levels within the recommended treatment targets. In recent years, diabetes technologies have revolutionised the care of people with type 1 diabetes, and it is becoming increasingly evident that people with type 2 diabetes can also benefit from these advances. In this review, we describe the current knowledge regarding the role of technologies for people living with type 2 diabetes and the evidence supporting their use in clinical practice. We conclude that continuous glucose monitoring systems deliver glycaemic benefits for individuals with type 2 diabetes, whether treated with insulin or non-insulin therapy; further data are required to evaluate the role of these systems in those with prediabetes (defined as impaired glucose tolerance and/or impaired fasting glucose and/or HbA1c levels between 39 mmol/mol [5.7%] and 47 mmol/mol [6.4%]). The use of insulin pumps seems to be safe and effective in people with type 2 diabetes, especially in those with an HbA1c significantly above target. Initial results from studies exploring the impact of closed-loop systems in type 2 diabetes are promising. We discuss directions for future research to fully understand the potential benefits of integrating evidence-based technology into care for people living with type 2 diabetes and prediabetes.

A multimodal dataset for investigating working memory in presence of music: a pilot study.

Introduction: Decoding an individual's hidden brain states in responses to musical stimuli under various cognitive loads can unleash the potential of developing a non-invasive closed-loop brain-machine interface (CLBMI). To perform a pilot study and investigate the brain response in the context of CLBMI, we collect multimodal physiological signals and behavioral data within the working memory experiment in the presence of personalized musical stimuli. Methods: Participants perform a working memory experiment called the n-back task in the presence of calming music and exciting music. Utilizing the skin conductance signal and behavioral data, we decode the brain's cognitive arousal and performance states, respectively. We determine the association of oxygenated hemoglobin (HbO) data with performance state. Furthermore, we evaluate the total hemoglobin (HbT) signal energy over each music session. Results: A relatively low arousal variation was observed with respect to task difficulty, while the arousal baseline changes considerably with respect to the type of music. Overall, the performance index is enhanced within the exciting session. The highest positive correlation between the HbO concentration and performance was observed within the higher cognitive loads (3-back task) for all of the participants. Also, the HbT signal energy peak occurs within the exciting session. Discussion: Findings may underline the potential of using music as an intervention to regulate the brain cognitive states. Additionally, the experiment provides a diverse array of data encompassing multiple physiological signals that can be used in the brain state decoder paradigm to shed light on the human-in-the-loop experiments and understand the network-level mechanisms of auditory stimulation.

Technology advances in diabetes pregnancy: right technology, right person, right time.

This review outlines some of the extraordinary recent advances in diabetes technology, which are transforming the management of type 1 diabetes before, during and after pregnancy. It highlights recent improvements associated with use of continuous glucose monitoring (CGM) but acknowledges that neither CGM nor insulin pump therapy are adequate for achieving the pregnancy glucose targets. Furthermore, even hybrid closed-loop (HCL) systems that are clinically effective outside of pregnancy may not confer additional benefits throughout pregnancy. To date, there is only one HCL system, the CamAPS FX, with a strong evidence base for use during pregnancy, suggesting that the pregnancy benefits are HCL system specific. This is in stark contrast to HCL system use outside of pregnancy, where benefits are HCL category specific. The CamAPS FX HCL system has a rapidly adaptive algorithm and lower glucose targets with benefits across all maternal glucose categories, meaning that it is applicable for all women with type 1 diabetes, before and during pregnancy. For women of reproductive years living with type 2 diabetes, the relative merits of using non-insulin pharmacotherapies vs diabetes technology (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors) are unknown. Despite the urgent unmet need and potential benefits, studies of pharmacotherapy and technology use are extremely limited in pregnant women with type 2 diabetes.

Working memory enhancement using real-time phase-tuned transcranial alternating current stimulation.

BACKGROUND: Prior work has shown that transcranial alternating current stimulation (tACS) of parietooccipital alpha oscillations (8-14 Hz) can modulate working memory (WM) performance as a function of the phase lag to endogenous oscillations. However, leveraging this effect using real-time phase-tuned tACS has not been feasible so far due to stimulation artifacts preventing continuous phase tracking. OBJECTIVES AND HYPOTHESIS: We aimed to develop a system that tracks and adapts the phase lag between tACS and ongoing parietooccipital alpha oscillations in real-time. We hypothesized that such real-time phase-tuned tACS enhances working memory performance, depending on the phase lag. METHODS: We developed real-time phase-tuned closed-loop amplitude-modulated tACS (CLAM-tACS) targeting parietooccipital alpha oscillations. CLAM-tACS was applied at six different phase lags relative to ongoing alpha oscillations while participants (N = 21) performed a working memory task. To exclude that behavioral effects of CLAM-tACS were mediated by other factors such as sensory co-stimulation, a second group of participants (N = 25) received equivalent stimulation of the forehead. RESULTS: WM accuracy improved in a phase lag dependent manner (p = 0.0350) in the group receiving parietooccipital stimulation, with the strongest enhancement observed at 330° phase lag between tACS and ongoing alpha oscillations (p = 0.00273, d = 0.976). Moreover, across participants, modulation of frontoparietal alpha oscillations correlated both in amplitude (p = 0.0248) and phase (p = 0.0270) with the modulation of WM accuracy. No such effects were observed in the control group receiving frontal stimulation. CONCLUSIONS: Our results demonstrate the feasibility and efficacy of real-time phase-tuned CLAM-tACS in modulating both brain activity and behavior, thereby paving the way for further investigation into brain-behavior relationships and the exploration of innovative therapeutic applications.

Adaptive Disturbance Suppression Method for Servo Systems Based on State Equalizer.

Disturbances in the aviation environment can compromise the stability of the aviation optoelectronic stabilization platform. Traditional methods, such as the proportional integral adaptive robust (PI + ARC) control algorithm, face a challenge: once high-frequency disturbances are introduced, their effectiveness is constrained by the control system's bandwidth, preventing further stability enhancement. A state equalizer speed closed-loop control algorithm is proposed, which combines proportional integral adaptive robustness with state equalizer (PI + ARC + State equalizer) control algorithm. This new control structure can suppress high-frequency disturbances caused by mechanical resonance, improve the bandwidth of the control system, and further achieve fast convergence and stability of the PI + ARC algorithm. Experimental results indicate that, in comparison to the control algorithm of PI + ARC, the inclusion of a state equalizer speed closed-loop compensation in the model significantly increases the closed-loop bandwidth by 47.6%, significantly enhances the control system's resistance to disturbances, and exhibits robustness in the face of variations in the model parameters and feedback sensors of the control object. In summary, integrating a state equalizer speed closed-loop with PI + ARC significantly enhances the suppression of high-frequency disturbances and the performance of control systems.

Closed-Loop Direct Upcycling of Spent Ni-Rich Layered Cathodes into High-Voltage Cathode Materials.

Facing the resource and environmental pressures brought by the retiring wave of lithium-ion batteries (LIBs), direct recycling methods are considered to be the next generation's solution. However, the contradiction between limited battery life and the demand for rapidly iterating technology forces the direct recovery paradigm to shift toward "direct upcycling." Herein, a closed-loop direct upcycling strategy that converts waste current collector debris into dopants is proposed, and a highly inclusive eutectic molten salt system is utilized to repair structural defects in degraded polycrystalline LiNi0.83Co0.12Mn0.05O2 cathodes while achieving single-crystallization transformation and introducing Al/Cu dual-doping. Upcycled materials can effectively overcome the two key challenges at high voltages: strain accumulation and lattice oxygen evolution. It exhibits comprehensive electrochemical performance far superior to commercial materials at 4.6 V, especially its fast charging capability at 15 C, and an impressive 91.1% capacity retention after 200 cycles in a 1.2 Ah pouch cell. Importantly, this approach demonstrates broad applicability to various spent layered cathodes, particularly showcasing its value in the recycling of mixed spent cathodes. This work effectively bridges the gap between waste management and material performance enhancement, offering a sustainable path for the recycling of spent LIBs and the production of next-generation high-voltage cathodes.

Porcine lungs perfused with three different flows using the 8-h open-atrium cellular ex vivo lung perfusion technique.

The number of lung transplantations is limited due to the shortage of donor lungs fulfilling the standard criteria. The ex vivo lung perfusion (EVLP) technique provides the ability of re-evaluating and potentially improving and treating marginal donor lungs. Accordingly, the technique has emerged as an essential tool to increase the much-needed donor lung pool. One of the major EVLP protocols, the Lund protocol, characterized by high pulmonary artery flow (100% of cardiac output [CO]), an open atrium, and a cellular perfusate, has demonstrated encouraging short-EVLP duration results. However, the potential of the longer EVLP duration of the protocol is yet to be investigated, a duration which is considered necessary to rescue more marginal donor lungs in future. This study aimed to achieve stable 8-h EVLP using an open-atrium cellular model with three different pulmonary artery flows in addition to determining the most optimal flow in terms of best lung performance, including lung electrolytes and least lung edema formation, perfusate and tissue inflammation, and histopathological changes, using the porcine model. EVLP was performed using a flow of either 40% (n = 6), 80% (n = 6), or 100% (n = 6) of CO. No flow rate demonstrated stable 8-h EVLP. Stable 2-h EVLP was observed in all three groups. Insignificant deterioration was observed in dynamic compliance, peak airway pressure, and oxygenation between the groups. Pulmonary vascular resistance increased significantly in the 40% group (p < .05). Electrolytes demonstrated an insignificant worsening trend with longer EVLP. Interleukin-8 (IL-8) in perfusate and tissue, wet-to-dry weight ratio, and histopathological changes after EVLP were insignificantly time dependent between the groups. This study demonstrated that stable 8-h EVLP was not feasible in an open-atrium cellular model regardless of the flow of 40%, 80%, or 100% of CO. No flow was superior in terms of lung performance, lung electrolytes changes, least lung edema formation, minimal IL-8 expression in perfusate and tissue, and histopathological changes.

Offlabel use of Medtronic MiniMed 780G in the management of cystic fibrosis related diabetes in people requiring insulin total daily doses below 8 units: encouraging data from our population.

Cystic fibrosis (CF)-related diabetes (CFRD), characterized by partial to complete impaired insulin secretion, is the most common extra-pulmonary complication of CF. Actually, insulin is the only approved therapy for its management. Advanced hybrid closed loop (AHCL) systems are the gold standard therapy for type 1 diabetes and have been proposed for other insulin-dependent forms of diabetes, including CFRD. With AHCL systems, people with CFRD can better manage several typical disease-related issues, such as minimal insulin requirements, its variability due to exacerbations or concomitant steroid therapies, nutritional behaviors, the co-existence of CF complications as intestinal malabsorption or liver disease. SmartGuard, the AHCL system for Medtronic Minimed 780G, requires a minimum of 8 units per day to operate. In this paper, we expose a case of two young women with CFRD with total daily insulin requirements < 8 UI, using off-label SmartGuard system over a 3 years of follow-up period, suggesting an evaluation of its use also in people with minimal insulin needs, considering its beneficial impact in glucose control and quality of life.