Continuous Pump Research Articles

Rare-Earth-Doped Selenide Glasses as Laser Materials for the 5–6 μm Spectral Range

This paper provides an overview of mid-infrared lasers based on rare-earth-ion-doped selenide glasses. Laser action was demonstrated at the transitions between the first excited and the ground levels of Ce3+, Pr3+, Nd3+ and Tb3+ ions. The highest output parameters for bulk glass lasers (over 40 mJ of output energy) and wavelength tuning in the range of 4.6–5.6 microns were obtained with Ce3+-doped glass. The highest output parameters for fiber lasers (150 mW at 5.1–5.3 μm under continuous pumping) were demonstrated with Tb3+ ions. The longest lasing wavelengths for any glass laser and tunability within the 5.56–6.01 µm spectral band were shown with Nd3+ ions in a Tb3+-Nd3+ co-doped system.

A retrospective study on the efficacy and safety of Endostar with chemotherapy in EGFR-TKI-resistant NSCLC

BackgroundEndostar is a strong angiogenesis inhibitor that is effective in treating non-small cell lung cancer (NSCLC), but the effect of Endostar in the treatment of patients with EGFR-TKI-resistant NSCLC remains unclear. We evaluated the clinical efficacy and safety of Endostar in EGFR-mutant NSCLC patients resistant to EGFR inhibition treatment.MethodsFrom January 1, 2016 to June 30, 2018, 68 patients were selected from the 4 institutions for the study. Patients with NSCLC received Endostar plus chemotherapy every 21-day cycle. Chemotherapy types included platinum-containing dual drugs and platinum-free single drugs. Endostar was administered by intermittent intravenous infusion or continuous microinfusion pump infusion. The overall response rate (ORR), disease control rate (DCR) and adverse events were analyzed. Survival of patients was also evaluated.ResultsFor all patients, the median progression-free survival (PFS) was 2.8 months, and the median overall survival (OS) was 14.2 months. PFS and OS in the Endostar pump continuous group were better than those in the Endostar intravenous infusion group. The disease control rate (DCR) was 79.4%. A total of 28 (41.2%) patients experienced varying grades of adverse events during treatment. No treatment-associated deaths were observed. The grade 3 treatment-emergent adverse events (TEAEs) were myelosuppression, weakness, and nausea/vomiting.ConclusionsEndostar was effective and well tolerated in advanced NSCLC patients. Endostar treatment showed promising survival results in EGFR-mutant NSCLC patients.

Abstract 18803: Extended Duration Impella Support: A Review of 107 Patients Successfully Supported With Impella 5.5 Device at a Single Institution

Introduction: Impella 5.5 is an FDA-approved microaxial, continuous flow pump intended to provide left ventricular hemodynamic support for 14 days. We report 107 consecutive patients supported with this device, many for extended durations. Methods: The outcomes of consecutive patients supported with Impella 5.5 at an academic hospital from March 2021 to June 2023 are included. Results: 107 patients required 112 Impella 5.5 devices. The majority of patients had a heart failure etiology of NICMP (57, 53%), followed by ICMP (36, 34%), post cardiotomy shock (6, 5%), other (4, 4%), planned post cardiotomy cardiac protection (3, 3%), and congenital heart disease (1, 1%). 60 patients (56%) were SCAI D, 30 patients (28%) SCAI E, and 17 patients (16%) were SCAI C. The majority patients (70,65%) were Intermacs 2. The majority of Impella 5.5 devices were placed as a bridge to decision (55 patients, 51%), followed by BTT (28 patients, 26%), BTR (16 patients, 15%), Bridge to LVAD (7 patients, 7%), and one patient (1%) device was placed for post cardiotomy cardiac protection. 11 patients required interval escalation to concomitant VA-ECMO. Patients requiring ECPELLA were placed on PVA ECMO after an average of 22 days of impella support, and average time of support on ECPELLA was 5.4 days. All patients transitioned to cardiac replacement therapy. Among patients with explant data, 43 supported for < 2 weeks, 38 for 2-4 weeks, and 17 for > 4 weeks. Longest duration of support was 92 days. Of patients reaching a primary endpoint, 42 were transplanted (39%), 21 patients died (20%), 18 patients received durable VAD (17%), 12 were discharged without transplant or VAD (11%), 10 were transferred while on support (9%) and 4 patients are still supported (4%). With respect to complications, 5 patients suffered from strokes, 3 pump thrombosis, 2 had fiber optic cable malfunctions, 2 had purge line leaks, and there were 3 patients with a broken optical sensor, and 2 arterial (brachial and axillary) thrombus. Conclusion: The Impella 5.5 device is a left ventricular support device placed most frequently to successfully stabilize patients undergoing evaluation for advanced therapies who were failing despite inotropic therapy.

Abstract 13262: A Self-Administered Home Inotrope Program for Unfunded Patients With End-Stage Heart Failure

Introduction: Uninsured patients with inotrope-dependent end-stage heart failure (HF) pose a formidable challenge to the healthcare system and innovative solutions are required. We created a health system funded home program for palliative and bridge-to-funding inotrope strategies for unfunded patients. Herein, we report our updated experiences. Methods: We reviewed records of all patients enrolled in the home inotrope program since inception in 2019. Patients must have demonstrated a low cardiac index that was stabilized on a single inotrope. Advanced HF and palliative care consultations are mandatory. Next, a multidisciplinary team educates the patient via a teach-teach back method on how to self-administer intravenous inotropes via a provided continuous infusion pump. After discharge, patients attended weekly clinic appointments for assessment and dressing changes. Clinic appointments, supplies, and medications are provided by the health system at minimal cost to the patient. This project was deemed IRB exempt as a quality improvement project. Results: Thus far the program has enrolled 15 uninsured patients through April 24, 2023 (table). The median duration of inotropic support was 70 (32-143) days. Patients remained at home for 90% of the 1500 total supported days. To date, one patient has received a heart transplant and three patients have received LVAD surgery after obtaining health insurance. Three (20%) patients experienced a catheter-associated infection, with two developing bacteremia. All patients endorsed satisfaction with increased time spent outside of the hospital. This was estimated to have saved >$2,363,000 in self-pay discounted charges for a general care telemetry bed and >$586,000 in professional charges (CPT 99233, estimates via price transparency act). Conclusion: A self-administered home inotrope program for select patients is feasible, safe, and cost-effective. It may also serve as a bridge to funding for advanced therapies.

A superradiant two-level laser with intrinsic light force generated gain

The implementation of a superradiant laser as an active frequency standard is predicted to provide better short-term stability and robustness to thermal and mechanical fluctuations when compared to standard passive optical clocks. However, despite significant recent progress, the experimental realization of continuous wave superradiant lasing still remains an open challenge as it requires continuous loading, cooling, and pumping of active atoms within an optical resonator. Here we propose a new scenario for creating continuous gain by using optical forces acting on the states of a two-level atom via bichromatic coherent pumping of a cold atomic gas trapped inside a single-mode cavity. Analogous to atomic maser setups, tailored state-dependent forces are used to gather and concentrate excited-state atoms in regions of strong atom-cavity coupling while ground-state atoms are repelled. To facilitate numerical simulations of a sufficiently large atomic ensemble, we rely on a second-order cumulant expansion and describe the atomic motion in a semi-classical point-particle approximation subject to position-dependent light shifts which induce optical gradient forces along the cavity axis. We study minimal conditions on pump laser intensities and detunings required for collective superradiant emission. Balancing Doppler cooling and gain-induced heating we identify a parameter regime of a continuous narrow-band laser operation close to the bare atomic frequency.

Benchmarking Diabetes Technology Use Among 21 U.S. Pediatric Diabetes Centers.

The American Diabetes Association's Standards of Care in Diabetes recommends the use of diabetes technology such as continuous glucose monitoring systems and insulin pumps for people living with type 1 diabetes. Unfortunately, there are multiple barriers to uptake of these devices, including local diabetes center practices. This study aimed to examine overall change and center-to-center variation in uptake of diabetes technology across 21 pediatric centers in the T1D Exchange Quality Improvement Collaborative. It found an overall increase in diabetes technology use for most centers from 2021 to 2022 with significant variation.

Solutions to increase the C-2P well production performance at X oil field, Block 09-2

The well C-2P had its first oil production in July 2008, the initial production rate is 3,000 barrels/day. Due to the reservoir pressure depletion in 2017-2018, the well faced difficulties in kicking off to open the well for production. In November 2018, when the C-5PST2 well was put into production, the C-2P well was not produced by natural flowing. The kicking off has been attempted many times but the well still won't flow. The main reason the well couldn’t flow is due to low reservoir pressure which has not enough energy to push all the fluid in the well to the surface after each well shutdown. The flow assurance study shows, at the reservoir pressure of 3,000 Psi, and tubing head pressure of 950 Psi, the well can’t flow naturally. In addition, with the reservoir pressure of 3,000 psia and applying the gaslift injection rate of 1.0 MMscf/d, injection point at 3,030 mTVD, the well flowed. The continuous gaslift pump helps maintain the well's production in case the reservoir pressure drops even lower to 2,000 psi, and at the same time, optimizing the gaslift pump flow helps to increase the well production by 100-300 barrels of oil/day. When the reservoir pressure drops lower, it is necessary to lower the gaslift valve deeper to continue kicking off the well and maintain the well production performance. On the other hand, due to the lack of a gaslift valve for the original design of C-2P well so it's necessary to have gaslift tubing pack off in order to bring the well back to production, maintain stability and improve production. This paper, therefore, presents the results of the research on the solution to increase the production output of the C-2P well located in X oil field used gaslift valve combining with the tubing pack off. Results of the research on the application of solution show that the well's production output has increased significantly (0.354 million barrels) in the first year of applying the solution.

Effectiveness and safety of a disposable elastomeric continuous infusion pump for outpatient parenteral antimicrobial therapy (OPAT) in a UK setting

We evaluated the effectiveness and safety of continuous antimicrobial infusion using a disposable elastomeric device in an outpatient parenteral antimicrobial therapy (OPAT) setting. We conducted a retrospective analysis of all patients who received either flucloxacillin (n = 131 episodes) or piperacillin/tazobactam (n = 301 episodes) as continuous infusion via elastomeric devices over 5 years (January 2018-December 2022) at a tertiary referral hospital in Derbyshire, UK. Overall, 81 adverse events were recorded in 77 (18%; 77/432) patient-episodes. Most adverse events were vascular access-related (59%; 4.6 events per 1000 OPAT-days), including one line-related infection (0.2%; 0.1 events per 1000 OPAT-days). 165 (38%) patient-episodes experienced at least one incident of incomplete infusion. Successful outcome (cure or improvement) occurred in 364 (84%) episodes. Our findings suggest that elastomeric infusion pumps are safe and effective for administering selected antimicrobial agents in OPAT. However, close monitoring of patients and the device are essential to ensure optimal delivery of prescribed therapy.

Utility and precision evidence of technology in the treatment of type 1 diabetes: a systematic review

BackgroundThe greatest change in the treatment of people living with type 1 diabetes in the last decade has been the explosion of technology assisting in all aspects of diabetes therapy, from glucose monitoring to insulin delivery and decision making. As such, the aim of our systematic review was to assess the utility of these technologies as well as identify any precision medicine-directed findings to personalize care.MethodsScreening of 835 peer-reviewed articles was followed by systematic review of 70 of them (focusing on randomized trials and extension studies with ≥50 participants from the past 10 years).ResultsWe find that novel technologies, ranging from continuous glucose monitoring systems, insulin pumps and decision support tools to the most advanced hybrid closed loop systems, improve important measures like HbA1c, time in range, and glycemic variability, while reducing hypoglycemia risk. Several studies included person-reported outcomes, allowing assessment of the burden or benefit of the technology in the lives of those with type 1 diabetes, demonstrating positive results or, at a minimum, no increase in self-care burden compared with standard care. Important limitations of the trials to date are their small size, the scarcity of pre-planned or powered analyses in sub-populations such as children, racial/ethnic minorities, people with advanced complications, and variations in baseline glycemic levels. In addition, confounders including education with device initiation, concomitant behavioral modifications, and frequent contact with the healthcare team are rarely described in enough detail to assess their impact.ConclusionsOur review highlights the potential of technology in the treatment of people living with type 1 diabetes and provides suggestions for optimization of outcomes and areas of further study for precision medicine-directed technology use in type 1 diabetes.

Impact of Optically Pumped Nonequilibrium Steady States on Luminescence Emission of Atomically Thin Semiconductor Excitons.

The interplay of the nonequivalent corners in the Brillouin zone of transition metal dichalcogenides (TMDCs) has been investigated extensively. While experimental and theoretical works contributed to a detailed understanding of the relaxation of selective optical excitations and the related relaxation rates, only limited microscopic descriptions of stationary experiments are available so far. Here we present microscopic calculations for the nonequilibrium steady state properties of excitons during continuous wave pumping exemplary for monolayer MoSe_{2}. We find sharp features in photoluminescence excitation spectra and degree of polarization which result from phonon assisted excitonic transitions dominating over exciton recombination and intervalley exchange coupling.

Improving Hydraulic Fracturing Productivity in Khalda Oil Fields (Western Desert -Egypt)

The hydraulic fracturing technique is used to create a highly conductive path between the reservoir and wellbore at an economic rate. There are two types of hydraulic fracturing based on the pumping schedule: the first is the conventional hydraulic fracturing which uses continuous pumping schedule and forms a proppant pack inside the fracture. The second is the channel hydraulic fracturing which uses intermittent (pulsing) pumping schedule and forms proppant pillars inside the fracture. The aim of this work is to study the factors affecting the fracture conductivity of the channel fracturing technique. Technical and economical comparison has been conducted between the above-mentioned two types of fracturing using real production data. The Fracturing Computer-Aided Design and Evaluation (FracCADE) simulator was utilized for this purpose. The results indicate that the conductivity of the channel fracturing technique is greater than that of the conventional one. The pulse time and perforated cluster length were found to have a significant effect on the fracture conductivity because of their influence on the pillar spacing. The results indicate also that: the cost of the channel fracturing is greater than that of the conventional one by about 26.28 %. However, the NPV of the produced oil by the channel fracturing is more than the same of the conventional one. In addition, the payout time of the channel fracturing is shorter which means a faster return of investments.

2023 Clinical Practice Guidelines for Diabetes: Continuous Glucose Monitoring and Insulin Pumps

With the expanding use of continuous glucose monitoring (CGM) and insulin pumps worldwide, several international guidelines dedicated to diabetes technology have been developed. Recently, the Korean Diabetes Association released a new version of their clinical practice guidelines including substantial changes in recommendations on the use of CGM and insulin pumps. Of note, continuous use of real-time CGM is now recommended to all people with diabetes using insulin, including people with type 2 diabetes using once daily basal insulin. Convincing evidence from recent automated insulin delivery (AID) trials supports the recommendation of AID as standard therapy in type 1 diabetes. This review summarizes the results of recent clinical studies on CGM and AID and their influence on the new clinical recommendations.

Longitudinal Trends in Glycemic Outcomes and Technology Use for Over 48,000 People with Type 1 Diabetes (2016-2022) from the T1D Exchange Quality Improvement Collaborative.

Previous studies revealed that HbA1c increased overall in the U.S. in the past decade. Additionally, health inequities in type 1 diabetes (T1D) outcomes by race-ethnicity and insurance type persist. This study examines the trends in HbA1c from 2016 to 2022 stratified by race-ethnicity and insurance in a large multicenter national database. We analyzed glycemic outcomes and diabetes device use trends for over 48,000 people living with type 1 diabetes (PwT1D) from three adult and twelve pediatric centers in the T1D Exchange Quality Improvement Collaborative (T1DX-QI), comparing data from 2016-2017 with data from 2021-2022. The mean HbA1c in 2021-2022 was lower at 8.4% compared to the mean HbA1c in 2016-2017 of 8.7% (0.3% improvement; p<0.01). Over the same period, the percentage of PwT1D using a continuous glucose monitor (CGM), insulin pump, or hybrid closed-loop system increased (45%, 12%, and 33%, respectively). However, these improvements were not equitably demonstrated across racial-ethnic groups or insurance types. Racial-ethnic and insurance-based inequities persisted over all seven years across all outcomes; comparing non-Hispanic White and non-Hispanic Black PwT1D, disparate gaps in HbA1c (1.2-1.6%), CGM (30%), pump (25-35%), and HCLS (up to 20%) are illuminated. Population-level data on outcomes, including hemoglobin A1c (HbA1c), can provide trends and insights into strategies to improve health for PwT1D. The T1DX-QI cohort showed a significant improvement in HbA1c from 2016-2022. Improvements in diabetes device use are also demonstrated. However, these increases were inconsistent across all racial-ethnic groups or insurance types, an important focus for future T1D population health improvement work.

In situ high-temperature X-Ray diffraction study of tantalum metal

An in-situ thermal behavior study was conducted on the metallic tantalum under two conditions. The experimentation was carried out on tantalum pellets which were heated progressively “underwent reaction and under continuous pumping or under controlled monoxide pressure” in a graphite resistance high temperature X-ray diffractometer up to 2300 K. Through the in-situ study, a thermodynamic analysis showed that this involved the formation of Ta2O, Ta2O5 (low temperature modification) and Ta2C likely to be formed between 293 and 2300 K, in agreement with a reaction mechanism that we established to occur in four stages.

Amplified Spontaneous Emission from Optical Fibers Containing Anisotropic Morphology CdSe/CdS Quantum Dots Under Continuous Wave Excitation

Fiber laser field is typically dominated by rare earth ions as gain material in the core of a silica optical waveguide. Due to their specific emission wavelengths, rare‐earth‐doped fiber lasers are available only at few predefined wavelengths. However, quantum dots (QDs) are materials which show tunable emission with change in size and composition. Due to such tunability, QDs seem to be promising candidates for obtaining fiber lasers at a spectrum of wavelengths which is not possible using rare earth ions. To replace rare earth ions with QDs, it is of paramount importance that QDs show signatures of optical gain. Herein, the synthesis of asymmetric pod‐shaped CdSe/CdS QDs is reported, which demonstrate efficient gain on pumping. The intrinsic gain properties of the QDs are evaluated through transient absorption (TA) spectroscopy. Later, the exquisite QDs are used to fabricate specialty fibers from which amplified spontaneous emission (ASE) is obtained using continuous wave laser pump at room temperature. Finally, emission signal stability is checked by studying photobleaching and controlling the concentration of the QDs.

Demographic Variables Associated With Diabetes Technology Awareness or Use in Adults With Type 2 Diabetes.

Studies in populations with type 1 diabetes highlight racial/ethnic disparities in the use of diabetes technology; however, little is known about disparities among those with type 2 diabetes. This project investigates the racial/ethnic and socioeconomic disparities in diabetes technology awareness and use in adults with type 2 diabetes in the ambulatory setting. Adults ≥40 years of age with type 2 diabetes in ambulatory care were invited to participate via an e-mail link to a de-identified REDCap (Research Electronic Data Capture) questionnaire. Variables, including awareness and use of continuous glucose monitoring (CGM) and insulin pumps, were summarized descriptively using frequencies and percentages and were compared across racial/ethnic groups, education level, and income using Pearson χ2 or Fisher exact tests. The study included 116 participants, most of whom (62%) were White, elderly Medicare recipients. Compared with White participants, those of racially/ethnically minoritized groups were less likely to be aware of CGM (P = 0.013) or insulin pumps (P = 0.001). Participants with a high school education or less were also less likely to be aware of insulin pumps (P = 0.041). Interestingly, neither awareness nor use of CGM or insulin pumps was found to be associated with income. This cross-sectional analysis suggests that racially/ethnically minoritized groups and individuals with lower education have less awareness of CGM or insulin pumps.

Overcoming barriers to technology in special groups

AbstractDiabetes demands a high volume of self‐care and management, which poses many obstacles for those with advanced age, cognitive impairment, or physical disability. The latest diabetes technologies, including smart insulin pens, continuous glucose monitoring and insulin pumps, have great potential to improve glycaemic control and quality of life, particularly for those affected by impairment or disability. Although these groups may face barriers to using diabetes technology, accessing and harnessing the benefits and opportunities of the technologies can be achieved with appropriate support and education. This article explores the role of diabetes technology in the care of individuals in special groups, including those with visual impairment, learning disability, cognitive impairment, or reduced dexterity, and elderly people. Copyright © 2023 John Wiley &amp; Sons.

Cryogenic cold energy recovery in liquid hydrogen refueling station with double-pipe heat exchanger

Recovering the cryogenic cold energy of liquid hydrogen (LH2) for precooling high-pressure hydrogen gas before refueling can significantly reduce the electricity and energy consumption of liquid hydrogen refueling stations. Existing methods, such as blending, require continuous cryogenic pump operation and are not suitable for various operating conditions. This work proposes a novel method to recover LH2 cryogenic cold energy using a double-pipe heat exchanger, which can decouple the compression and refueling process and meet the fluctuating demand for the cryogenic cold energy required by the hydrogen dispenser. The lumped parameter method and temperature partition method were adopted to design the heat exchanger structure. Numerical simulations of a 2D axisymmetric swirl model were done to verify the accuracy of the temperature partition method applied to high-pressure cryogenic hydrogen. Due to the low temperature of LH2, the secondary refrigerant dichloromethane (CH2Cl2) risks freezing. Comparing the outer wall surface temperature of the inner pipe with the CH2Cl2 freezing point temperature, the optimal anti-freezing condition is that the outer pipe nominal diameter should be selected as 0.032 m and CH2Cl2 mass flow rate should be at least 1.72 kg s−1. Recovery efficiency can reach over 75.39% without freezing.

연속 접촉 헬리컬 기어펌프의 수치해석 연구: 모델 개발 및 적용

연속 접촉 헬리컬 기어펌프의 수치해석 연구: 모델 개발 및 적용

Long-Term Benefits of an Integrated Continuous Glucose Monitoring and Insulin Pump System for Emergency Admissions, Hospitalization, and Metabolic Control in a Cohort of People With Diabetes: Retrospective Cohort Study.

There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with high-complexity diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. This study describes outcomes for metabolic control, incidence of hospitalizations, and emergency room visits in a specific population using this technology. We aimed to assess long-term glycemic and clinical outcomes after the use of continuous subcutaneous insulin infusion and continuous glucose monitoring in people with diabetes. A retrospective cohort study was carried out in patients with diabetes previously treated with an intensive insulin regimen at a specialized diabetes treatment center who required a sensor-augmented insulin pump due to nonoptimal glycemic control. Glycated hemoglobin, severe hypoglycemic episodes, nonsevere hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. Between January 2013 and August 2020, 74 patients with a median age of 36 (IQR 27-46) years were included in the study with a median 4 (IQR 2-7) years of follow-up. We found a statistically significant reduction in glycated hemoglobin (8.35% vs 7%; P<.001), nonsevere hypoglycemic episodes (71/74, 96% vs 62/74, 84%; P=.01), emergency room visits (42/73, 58% vs 4/62, 6%; P<.001), and hospitalizations (36/72, 50% vs 10/72, 14%; P<.001) after use of continuous subcutaneous insulin infusion. The use of a sensor-augmented insulin pump associated with a strict follow-up program for patients with high-complexity diabetes led to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results encourage the adoption of this technology in patients who do not achieve metabolic control with optimal management of diabetes.