Continuous Pump Research Articles

The role of technology in the care of diabetes mellitus in pregnancy: an expert review

Diabetes mellitus is one of the most commonly encountered pregnancy complications and is associated with multiple adverse perinatal outcomes. Technology has progressed to address the unique challenges patients face in managing diabetes mellitus in pregnancy. Technology has bolstered diabetes mellitus education with smartphone applications focused on nutrition counseling and carbohydrate intake advice. Continuous glucose monitors and insulin infusion systems have shown benefit by simplifying glycemic monitoring and insulin administration. Improvements in glycemic control and perinatal outcomes have been seen with continuous glucose monitor use when compared with intermittent blood glucose monitoring, and more pregnant people are using insulin pumps instead of multiple daily insulin injections. Hybrid closed-loop systems are emerging and are able to integrate continuous glucose monitoring and insulin pump technologies while maximizing automated features in the nonpregnant population, but these have not been endorsed for use in pregnancy yet. Applying telehealth practices has been associated with high patient satisfaction among those with diabetes mellitus in pregnancy, and leveraging remote patient monitoring through telehealth platforms and short-range wireless technologies can reduce the burden of patient visits. As technology becomes more integrated into routine management of diabetes mellitus in pregnancy, practitioners should emphasize individualized counseling and device selection to ensure patient autonomy and safety.

Routing to mid-infrared microcomb via near-infrared direct pump.

Mid-infrared (MIR) microcomb provides a new way into the "molecular fingerprint" region. However, it remains rather a challenge to realize the broadband mode-locked soliton microcomb, which is often limited by the performance of available MIR pump sources and coupling devices. Here, we propose an effective approach towards broadband MIR soliton microcombs generation via a direct pump in the near-infrared (NIR) region, through full utilization of the second- and third-order nonlinearities in a thin-film lithium niobate microresonator. The optical parametric oscillation process contributes to conversion from the pump at 1550 nm to the signal around 3100 nm, and the four-wave mixing effect promotes spectrum expansion and mode-locking process. While the second-harmonic and sum-frequency generation effects facilitate simultaneous emission of the NIR comb teeth. Both the continuous wave and pulse pump sources with relatively low power can support a MIR soliton with a bandwidth over 600 nm and a concomitant NIR microcomb with a bandwidth of 100 nm. This work can provide a promising solution for broadband MIR microcombs by breaking through the limitation of available MIR pump sources, and can deepen the understanding of the physical mechanism of the quadratic soliton assisted by the Kerr effect.

BIO17: Diurnal Variation of Operational Data in Preclinical Evaluation of a Continuous Flow Intra-aortic Blood Pump

Background: The Aortix pump (Procyrion Inc.) is a percutaneously deployed mechanical circulatory support (pMCS) device positioned in the descending thoracic aorta above the renal arteries. The device is undergoing clinical trials to treat cardio-renal syndrome for up to 7 days. A longer implant providing sustained reduction of cardiac afterload and additional hemodynamic benefit may promote cardiac rest and reverse remodeling and offer a minimally invasive bridge-to-recovery therapy. Methods: To evaluate long-term safety, 4 devices were implanted in untethered sheep for 90-142 days. Animals wore support vests to carry the pump controller and battery and were administered twice-daily subcutaneous enoxaparin. All animals were electively terminated. In addition to clinical pathology, pump speed and current were monitored at 5 Hz. The data was reviewed with a 30-minute mean down-sampling to facilitate analysis of longer duration phenomenon. Results: There was no evidence of kidney or vascular damage, aortic adhesion, clinically significant hemolysis, or infection. A novel observation was made in the recorded pump data. In all 4 animals, a small but regular variation in pump current was noted which correlates to diurnal periods of higher animal activity during the day (feeding, handler care) and lower activity overnight. The median half-hourly current varies as much as 1.5% above and below the mean of the two-week sample period (Figure 1). Conclusion: This novel observation of pump current variation underscores the link between operation and performance of a pMCS device and physiologic characteristics of the implanted subject. Further refinement of such techniques may present new avenues for monitoring patient activity, hemodynamics, and state of therapy which could be used to improve the standard of care. Future work may investigate similar phenomenon from in vivo clinical use of the Aortix device.Figure 1. For each animal, current is shown as the median current for each 30-minute window over a representative 14-day period relative to the mean current over the same period.

CARC5: Midterm Impella Support: A Review of Seventy-Two Patients Successfully Supported with Impella 5.5 Device

Introduction: Impella 5.5 is an FDA-approved microaxial, continuous flow pump intended to provide left ventricular hemodynamic support for 14 days. We report 72 consecutive patients supported with this device, many for extended durations. Methods: The outcomes of patients at an academic hospital from March 2021 to December 2022 are included. Results: Seventy-two patients required 76 Impella 5.5 devices. Of the 72 patients, 65 patients (90.3%) were male with a mean age of 55.4 (+/- 12.5). The majority of patients had a heart failure etiology of NICMP (40, 55.6%), followed by ICMP (24, 33.3%), post cardiotomy shock (3, 4.2%), planned post cardiotomy support (3, 4.2%), and other (2, 2.8%). Fourteen patients (19.4%) were SCAI C, 35 patients (48.6%) SCAI D, and 23 patients (31.9%) SCAI E. Twenty-three (31.9%) patients were INTERMACS 1 (IMX), followed by 46 (63.9%) with IMX 2. The majority of Impella 5.5 devices were placed as a bridge to decision (37 patients, 51.4%), followed by bridge to transplant (19 patients, 26.4%), bridge to recovery (11 patients, 15.3%) and bridge to durable LVAD (5 patients, 6.9%). Pre-Impella 5.5 MCS was provided by VA-ECMO (24 patients, 33.3%), temporary LVAD (8, 11.1%), RVAD (1, 1.4%) and IABP (11 patients, 15.2%). Nine patients required interval escalation to concomitant VA-ECMO. Among patients with explant data, 30 received Impella 5.5 support for < 2 weeks, 26 for 2-4 weeks, and 12 for > 4 weeks. Of patients reaching a primary endpoint, 29 were transplanted (40.3%), 12 patients received a durable LVAD (16.7%), 9 were discharged without VAD or transplant (12.5%), 15 died (20.8%), 4 were transferred while still on Impella support (5.6%), 2 patients are currently still supported (2.8%), and 1 patient (1.4%) was explanted pending final outcome. With respect to complications, 3 patients suffered strokes while on support, 2 had a pump thrombosis (one with additional brachial thrombus), 2 had fiberoptic cable malfunctions, 2 had purge line leaks, and there was 1 patient each with a broken optical sensor, disrupted connector cable halting device function, and axillary thrombus. Conclusion: The Impella 5.5 device is an excellent left ventricular support device, which can provide extended periods of hemodynamic supplementation, facilitating bridge to durable support or recovery.

New concept infusion pump with an anticancer drug exposure prevention function.

e18722 Background: In recent years, cancer chemotherapy has taken measures to prevent exposure to anticancer drugs. Major exposure prevention measures include the use of safety cabinets and closed dispensing devices during preparation, closed infusion sets, and patient education to avoid exposure to the surrounding environment, such as through defecation. On the other hand, the closed circuit needs to be opened after the continuous infusion pumping of anticancer drugs, and the risk of exposure to anticancer drugs during this process remains an issue. In response to this issue, we aimed to develop a pump with an anticancer drug exposure prevention function. Methods: We designed a pump for the continuous infusion of anticancer drugs equipped with an additional circuit in the pump vessel for root flushing and heparin lock without opening the closed circuit. The additional circuit was connected downstream of the continuous infusion flow control mechanism to allow the circuit to be flushed without opening the closed circuit. Results: We successfully developed a continuous infusion pump (PCT/JP2020/017083) with anticancer drug exposure protection. Our newly developed hexagonal cylindrical pump (length: 6 cm; width: 6 cm; height: 13.5 cm) is portable, lightweight (70 g), has a maximum capacity of 85 mL, and allows 46-h continuous infusion of anticancer drugs such as FOLFOX, FOLFIRI, FOLFOXIRI, and FOLFIRINOX. The port for flushing is covered with a sterile seal to keep it clean until use. Our new pump eliminates the risk of releasing routes filled with anticancer drugs and prevents unnecessary exposure to anticancer drugs by handlers such as health-care professionals, patients, family members, and caregivers. Furthermore, the risk of infection is reduced as the system can be cleaned while closed. Conclusions: Our newly developed infusion pump with an anticancer drug exposure prevention function may help enable the next generation of cancer drug exposure prevention measures. Support: Japan Agency for Medical Research and Development, Medical Innovation Project, Development and Commercialization Project (Adoption No.: 21he0122019j000).

Effects of Hypoglycemia on Cardiovascular Function in Patients with Diabetes.

Hypoglycemia is common in patients with type 1 and type 2 diabetes (T1D, T2D), treated with insulin or sulfonylureas, and has multiple short- and long-term clinical implications. Whether acute or recurrent, hypoglycemia significantly affects the cardiovascular system with the potential to cause cardiovascular dysfunction. Several pathophysiological mechanisms have been proposed linking hypoglycemia to increased cardiovascular risk, including hemodynamic changes, myocardial ischemia, abnormal cardiac repolarization, cardiac arrhythmias, prothrombotic and proinflammatory effects, and induction of oxidative stress. Hypoglycemia-induced changes can promote the development of endothelial dysfunction, which is an early marker of atherosclerosis. Although data from clinical trials and real-world studies suggest an association between hypoglycemia and cardiovascular events in patients with diabetes, it remains uncertain whether this association is causal. New therapeutic agents for patients with T2D do not cause hypoglycemia and have cardioprotective benefits, whereas increasing the use of new technologies, such as continuous glucose monitoring devices and insulin pumps, has the potential to reduce hypoglycemia and its adverse cardiovascular outcomes in patients with T1D.

Glycemic variability leads to higher levels of auto-oxidized oxysterol species in patients with type 1 diabetes mellitus.

Hyperglycemia and glycemic variability (GV) are associated with oxidative stress in patients with diabetes mellitus (DM). Oxysterol species, produced by the non-enzymatic oxidation of cholesterol, are potential biomarkers of oxidative stress. This study examined the relationship between auto-oxidizedoxysterols and GV in patients with type 1 DM. Thirty patients with type 1 DM using a continuous subcutaneous insulin infusion pump therapy and a healthy control group (n = 30) were included in this prospective study. A Continuous Glucose Monitoring System device was applied for 72h. Blood samples were taken for oxysterols produced by non-enzymatic oxidation [7-ketocholesterol (7-KC) and cholestane-3β, 5α, 6β-triol (Chol-Triol)] levels at 72h. Short-term glycemic variability parameters, mean amplitude of glycemic excursions (MAGE), the standard deviation of glucose measurements (Glucose-SD), and mean of daily differences (MODD) were calculated with continuous glucose monitoring data. HbA1c was used to evaluate glycemic control and HbA1c-SD (the SD of HbA1c over the past year) for long-term glycemic variability. 7-KC and Chol-triol levels were significantly higher in the study group than in the control group. Strong positive correlations were found between 7-KC with MAGE(24-48h) and Glucose-SD(24-48h). 7-KC was positively correlated with MAGE(0-72h) and Glucose-SD(0-72h). No significant correlation was found between HbA1c and HbA1c -SD with oxysterol levels. The regression models showed that SD(24-48h) and MAGE(24-48h) predicted 7-KC levels while HbA1c did not. Glycemic variability leads to higher levels of auto-oxidized oxysterol species in patients with type 1 DM independent of long-term glycemic control.

In Vitro Hemolytic Performance of the Realheart® V11C TAH Prototype with Porcine Blood.

Hemolysis testing of new devices to treat heart failure is a regulatory requirement. The ASTM F1841-97 standard for hemolysis testing was developed for continuous flow pumps and does not specify test rig design. When research groups use different methodologies, results are difficult to compare. Pulsatile flow pump rigs require compliance chambers, thus the Aachen rig (Gräf et al) was developed for the pulsatile Reinheart TAH. The study objective was to use this rig to test the early Realheart TAH prototype V11C hemolysis performance compared to literature. The experimental control was the continuous flow pump BPX-80 (Medtronic) and pooled heparinized porcine blood was used. The mgNIH of BPX-80 and V11C was 5.42 ± 1.47 and 25.20 ± 5.46 mg/100 L, respectively. The NIH ratio of V11C over BPX-80 was 5.5. The absolute and the relative hemolysis of the V11C are lower compared to both the large and small Reinheart TAH devices published values. Pulsatile pumps create more hemolysis in the Aachen rig, and it is not known if this is because how the rig handles pulsatile flow or due to the devices. Future studies will therefore use a pulsatile pump such as the SynCardia as clinical comparator and human blood to test the performance of future Realheart TAH prototypes.

Electrolytic Seawater Mineralization and the Mass Balances That Demonstrate Carbon Dioxide Removal.

We present the mass balances associated with carbon dioxide (CO2) removal (CDR) using seawater as both the source of reactants and as the reaction medium via electrolysis following the "Equatic" (formerly known as "SeaChange") process. This process, extensively detailed in La Plante E.C.; ACS Sustain. Chem. Eng.2021, 9, ( (3), ), 1073-1089, involves the application of an electric overpotential that splits water to form H+ and OH- ions, producing acidity and alkalinity, i.e., in addition to gaseous coproducts, at the anode and cathode, respectively. The alkalinity that results, i.e., via the "continuous electrolytic pH pump" results in the instantaneous precipitation of calcium carbonate (CaCO3), hydrated magnesium carbonates (e.g., nesquehonite: MgCO3·3H2O, hydromagnesite: Mg5(CO3)4(OH)2·4H2O, etc.), and/or magnesium hydroxide (Mg(OH)2) depending on the CO32- ion-activity in solution. This results in the trapping and, hence, durable and permanent (at least ∼10 000-100 000 years) immobilization of CO2 that was originally dissolved in water, and that is additionally drawn down from the atmosphere within: (a) mineral carbonates, and/or (b) as solvated bicarbonate (HCO3-) and carbonate (CO32-) ions (i.e., due to the absorption of atmospheric CO2 into seawater having enhanced alkalinity). Taken together, these actions result in the net removal of ∼4.6 kg of CO2 per m3 of seawater catholyte processed. Geochemical simulations quantify the extents of net CO2 removal including the dependencies on the process configuration. It is furthermore indicated that the efficiency of realkalinization of the acidic anolyte using alkaline solids depends on their acid neutralization capacity and dissolution reactivity. We also assess changes in seawater chemistry resulting from Mg(OH)2 dissolution with emphasis on the change in seawater alkalinity and saturation state. Overall, this analysis provides direct quantifications of the ability of the Equatic process to serve as a means for technological CDR to mitigate the worst effects of accelerating climate change.

Monitored care during anesthesia with remifentanil and lidocaine in pediatric strabismus surgery: A single center experience

Purpose: To evaluate the use of monitored anesthesia care (MAC) in pediatric strabismus surgery. Methods: A total of 17 cases undergoing strabismus surgery with MAC were included in this study. The protocol for sedation was standardized and data were collected prospectively for an ongoing quality assurance project. Intravenous channels were established in the ward for all the children, and penehyclidine 0.01 mg/kg and ondansetron 0.1 mg/kg were injected intravenously. After communicating with children the second time, 0.05 mg/kg midazolam, 0.1 μg/kg sufentanil, and 2 mg/kg propofol were injected intravenously. Continuous intravenous pumping of remifentanil 0.1 ~ 0.2 μg/kg/min while local infiltration anesthesia was performed with 1 % lidocaine after the loss of consciousness. Results: It took 7.0 ± 3.5 min to wake up successfully. There was no nausea, vomiting, or delirium after the operation. The children had good postoperative recovery and no bad memories, and they and their families were highly satisfied with the surgery.Conclusion: Local anesthesia and MAC produces satisfactory sedation in most patients without switching to general anesthesia. However, it has to be fully demonstrated that MAC local anesthesia is superior to general anesthesia in pediatric strabismus surgery via multi-centered studies.

High peak inspiratory pressure may be associated with intraoperative coughing during neurosurgery under general anesthesia without neuromuscular blockade: a retrospective study

BackgroundThe endotracheal cuff pressure depends on the airway pressure during positive-pressure ventilation. A high endotracheal cuff pressure may be related to intraoperative coughing, which can be detrimental during neurosurgery. We investigated the incidence of intraoperative coughing and its association with peak inspiratory pressure (PIP) during neurosurgery under general anesthesia without neuromuscular blockade.MethodsThis retrospective study divided 1656 neurosurgical patients who underwent total intravenous anesthesia without additional neuromuscular blockade after tracheal intubation into high (PIP > 21.6 cmH2O, n = 318) and low (PIP ≤ 21.6 cmH2O, n = 1338) PIP groups. After propensity score matching, 206 patients were selected in each group. Demographic, preoperative, surgical, and anesthetic data were collected retrospectively from electronic medical records and continuous ventilator, infusion pump, and bispectral index data from a data registry.ResultsIntraoperative coughing occurred in 30 (1.8%) patients, including 9 (0.5%) during the main surgical procedure. Intraoperative coughing was more frequent in the high PIP group than in the low PIP group before (14/318 [4.4%] vs. 16/1338 [1.2%], P < 0.001) and after (13/206 [6.3%] vs. 1/206 [0.5%], P = 0.003) propensity score matching. In multivariable logistic regression analysis after propensity score matching, a high PIP (odds ratio [95% confidence interval] 14.22 [1.81-111.73], P = 0.012), tidal volume divided by predicted body weight (mL/kg, 1.36 [1.09–1.69], P = 0.006), and surgical duration (min, 1.01 [1.00–1.01], P = 0.025) predicted intraoperative coughing.ConclusionThe incidence of intraoperative coughing was 1.8% in neurosurgical patients undergoing general anesthesia without neuromuscular blockade and might be associated with a high PIP.

Systemic exposure of floxuridine after hepatic arterial infusion pump chemotherapy with floxuridine in patients with resected colorectal liver metastases

BackgroundFloxuridine’s high hepatic extraction ratio and short elimination half-life allows maximum liver exposure with minimal systemic side-effects. This study attempts to quantify the systemic exposure of floxuridine. MethodsPatients undergoing continuous hepatic arterial infusion pump (HAIP) floxuridine after resection of colorectal liver metastases (CRLM) in two centres underwent six cycles of floxuridine at start dose 0.12 mg/kg/day. No concomitant systemic chemotherapy was administered. Peripheral venous blood samples were drawn during the first two cycles: pre-dose (only in the second cycle), 30 min, 1 h, 2 h, 7 h, and 15 days after floxuridine infusion. Foxuridine concentration in the residual pump reservoir was measured on day 15 of both cycles. A floxuridine assay with a lower boundary of detection of 0.250 ng/mL was developed. Results265 blood samples were collected in the 25 patient included in this study. Floxuridine was mostly measurable at day 7 and day 15 (86 % and 88 % of patients respectively). The median dose corrected concentrations were 0.607 ng/mL [IQR: 0.472–0.747] for cycle 1 day 7, 0.579 ng/mL [IQR: 0.470–0.693] for cycle 1 day 15, 0.646 ng/mL [IQR: 0.463–0.8546] for cycle 2 day 7, and 0.534 ng/mL [IQR: 0.4257–0.7075] for cycle 2 day 15. One patient had remarkably high floxuridine concentrations reaching up to 44 ng/mL during the second cycle, without a clear explanation.The floxuridine concentration in the pump decreased by 14.7 % (range 0.5 %−37.8 %) over a period of 15 days (n = 18). ConclusionOverall, negligible systemic concentrations of floxuridine were detected. However, remarkably increased levels were detected in one patient. Floxuridine concentration in the pump decreases over time.

Initial phase and frequency modulations of pumping a playground swing.

The playground swing is a dynamic, coupled oscillator system consisting of the swing as an object and a human as the swinger. Here, we propose a model for capturing the effect of the initial phase of natural upper body motion on the continuous pumping of a swing and validate this model from the motion data of ten participants pumping swings of three different swing chain lengths. Our model predicts that the swing pumps the most if the phase of maximum lean back, which we call the initial phase, occurs when the swing is at a vertical (midpoint) position and moving forward when the amplitude is small. As the amplitude grows, the optimal initial phase gradually shifts towards an earlier phase of the cycle, the back extreme of the swing's trajectory. As predicted by our model, all participants shifted the initial phase of their upper body movements earlier as swing amplitude increased. This indicated that swingers adjust both the frequency and initial phase of their upper body movements to successfully pump a playground swing.

Abstract 2886: Investigation of tumor-intrinsic activated Wnt/B-catenin signaling in immune avoidance of HCC

Abstract Background: Recent evidence have indicated several tumor-intrinsic oncogene pathways in T cell exclusion and immune evasion of cancers . In hepatocellular carcinoma (HCC), Wnt/β-catenin (CTNNB1) signaling activation is highly prevalent and has been reported to be associated with an immune avoided tumor microenvironment. ICG-001 is a small molecule inhibitor that prevents β-catenin from binding to cyclic AMP response element-binding protein (CBP) by competitively binding itself to CBP. The inhibition of CBP/β-catenin selectively induces apoptosis in transformed cells and have shown tumor suppressive effects in several cancers. Aim: This study aims to investigate the role of tumor-intrinsic Wnt/β-catenin pathway in controlling the expression of chemoattractants in HCC that influence immune cell migration into the tumor site. Methods: We established a syngeneic C57BL/6 mouse model using a hepatoma murine Hepa1-6 isogenic cell line to allow us to interrogate how gain-of-function CTNNB1 mutation (S45P) affects immune surveillance and response to ICG-001 in HCC. The mice were divided into two groups and were subcutaneously injected with either Hepa1-6 vector (n=29) or Hepa1-6 CTNNB1 (S45P) (n=29). At day 6, each group were subdivided into two treatment groups: ICG-001 and untreated. The effect of ICG-001 on immune infiltrates was investigated by Opal multiplex fluorescent immunohistochemistry (IHC) in formalin-fixed, paraffin-embedded (FFPE) tissues. Results: Untreated mice bearing CTNNB1 (S45P) HCCs (n=15) showed larger tumor growth in comparison to their vector controls (n=14), suggesting CTNNB1 (S45P) conferred a more aggressive clone. After a week of ICG-001 treatment by continuous osmotic pump perfusion, 42.9% (6/14) of CTNNB1 (S45P) mice showed a positive response to ICG-001, where a tumor regressed volume was indicated in 4 mice and stable disease in 2 mice. Progressive disease with continuous tumor growth, on the other hand, was shown in all untreated mice. Multiplex fluorescent IHC of tumors obtained from ICG-001 treated CTNNB1 (S45P) mice showed an increased influx of M1 macrophage and CD8 T cells in the tumor site compared to an immune avoidance phenotype in untreated controls. Accordingly, our vector control group did exhibit response to ICG-001 when compared to their respective untreated groups. Based on these findings, it is plausible that CTNNB1 activation impairs the expression of chemoattractant in HCC, and prevents immune cell migration into the tumor site. Consequently, we further examined tumor tissues for chemokine expressions and found higher levels of CXCL9, CXCL10 and CXCL11 in ICG-001 treated CTNNB1 (S45P) when compared to their untreated control groups. In conclusion, our results suggested Wnt/β-catenin activation plays a role in immune evasion and contribution to a “cold” immune tumor microenvironment in HCC. Citation Format: Aikha Melissa Go Wong, Alissa Michelle Go Wong, Loucia KY Can, Joseph Kwong, Anthony WH Chan, Jinna Chen, Michael Kahn, Nathalie Wong. Investigation of tumor-intrinsic activated Wnt/B-catenin signaling in immune avoidance of HCC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2886.

A COMPARATIVE EVALUATION OF CONTINUOUS AND INTERMITTENT NASOGASTRIC FEEDING IN LBW NEONATES.

Background: To compare outcome between continuous and intermittent nasogastric feeding in low birth neonates. Objective: The aim of this study was to compare outcome between continuous and intermittent nasogastric feeding in low birth neonates. Methods: 80 Patients were randomally divided in two groups i.e group A and group B. The neonates in the Group A received continuous nasogastric feed via continuous infusion pump while in Group B neonates received intermittent nasogastric feed in the form of boluses every 2-3 hour over 15-20 minute duration. Each neonate was followed for 15 days, Then data was collected and analysed. If there were no other clinical signs, feeding was stopped for three hours . After 15 days outcomes were recorded and analaysed that which feed had better results. Result: Mortality was reported more in group B as compared to group A. Morbidity was reported more in group B as compared to group A. Regaining of birth weight (in days) was found earlier in group A as compared to Group B. Conclusion : While comparing continuous feeding with intermittent feeding in low birth weight neonates we reached on conclusion that continuous feeding is better then intermittent feeding in terms of various outcomes.

(609) Small Patient or Small Left Ventricular Cavity associated with Left Ventricular End-Systolic Dimension and Mortality after Implantation of a Third-Generation Continuous Flow Centrifugal Pumps in Pediatric Patients

(609) Small Patient or Small Left Ventricular Cavity associated with Left Ventricular End-Systolic Dimension and Mortality after Implantation of a Third-Generation Continuous Flow Centrifugal Pumps in Pediatric Patients

Preparation of superhydrophobic, green, and eco-friendly modified polylactic acid foams for separation oil from water

Developing a facile and green strategy to fabricate polymer foams with super hydrophobicity and eco-friendliness for large-scale oil-water separation remains a challenge. In this study, biocompatible polylactic acid polymer foam modified by nanochitosan and stearic acid was used to remove petroleum and organic contaminants in water. All three materials used to prepare and modify this foam are green and inexpensive. F4d foam (prepared by solvent displacement method) and F8d foam (prepared by freeze dryer) can selectively remove oil pollutants in water with a contact angle of 164.01° and 168.51°, respectively. The maximum absorption capacity of oil pollutants by F4d and F8d are related to chloroform with values of 32.7 g/g and 48.51 g/g, respectively. Also, the minimum absorption capacity is related to n-hexane with values of 24.83 g/g and 32.06 g/g. The absorption percentage range of F4d and F8d foams after 15 cycles of absorption-desorption for chloroform is 82.56 % and 87.81 %, respectively, and for n-hexane, is 77.28 % and 85.99 %, respectively. During the continuous water-oil pumping test, the efficiency of foam can be maintained for >15 h, which shows promising hope for large-scale oil pollution cleaning.

Asymmetric electrodes for droplet directional actuation by a square wave on an open surface

The large-scale electrowetting-on-dielectric (EWOD) digital microfluidic platforms always require complex electrode-addressing schemes and high-cost fabrication methods of dielectric and hydrophobic layers. Hence, the voltage polarity-dependent electrowetting was used to actuate droplets with asymmetric printed circuit board (PCB) electrodes on an open slippery liquid-infused porous surface (SLIPS) chip. The V-shaped, convex-shaped, and curve-shaped coplanar asymmetric electrode arrays were designed to achieve the directional motion of a droplet by a square wave voltage signal. The operation ranges of voltage amplitude and frequency for continuously actuating a 10 µl droplet were obtained on the three asymmetric electrode arrays. Our results found that the curve-shaped electrode array has a broader voltage operation range than the other two for continuous pumping of a 10 µl droplet. It is because the droplet has a long effective width of contact line with the front curve-shaped electrode and does not overlap with the rear electrode during the movement. Meanwhile, a reconfigurable convex-shaped electrode structure was also proposed to achieve bidirectional actuation of a droplet by controlling the square wave voltage. This work provides a low-cost, straightforward electrode-addressing scheme for designing digital microfluidic devices.

Hemodynamic Evaluation of a Centrifugal Left Atrial Decompression Pump for Heart Failure with Preserved Ejection Fraction.

This article discusses a new continuous flow mini pump that has been developed to improve symptoms and prognosis in patients with Heart Failure with Preserved Ejection Fraction (HFpEF), for which there are currently no established treatments. The pump is designed to discharge a reduced percentage of blood volume from the left atrium to the subclavian artery, clamped at the bifurcation with the aortic arch. The overall specifications, design parameters, and hemodynamics of this new device are discussed, along with data from in vitro circulation loop tests and numerical simulations. The article also compares the results for two configurations of the pump with respect to key indicators of hemocompatibility used in blood pump development.

Increasing Use of Diabetes Devices: What Do Health Care Professionals Need?

Despite evidence of improved diabetes outcomes with diabetes technology such as continuous glucose monitoring (CGM) systems, insulin pumps, and hybrid closed-loop (HCL) insulin delivery systems, these devices are underutilized in clinical practice for the management of insulin-requiring diabetes. This low uptake may be the result of health care providers' (HCPs') lack of confidence or time to prescribe and manage devices for people with diabetes. We administered a survey to HCPs in primary care, pediatric endocrinology, and adult endocrinology practices in the United States. Responding HCPs expressed a need for device-related insurance coverage tools and online data platforms with integration to electronic health record systems to improve diabetes technology uptake in these practice settings across the United States.