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We report a CW-pumped Ho:YLF regenerative amplifier (RA) delivering pulses with 22.5-mJ energy and 2.0-ps duration at 1 kHz. The RA emitting at 2051 nm is broadband-seeded and implemented in a chirped pulse amplification system. © 2024 The Author(s)

Nonlinear self-compression of few-cycle multi-mJ pulses at 4.9 µm in ZnS is presented. 80 fs input pulses are compressed to 37 fs with 2.1 mJ energy at a 1 kHz repetition rate. © 2024 The Author(s)

Background: Multiple clinician adjustable parameters impact upon glycemia in people with type 1 diabetes (T1D) using Medtronic Mini Med 780G (MM780G) AHCL. These include glucose targets, carbohydrate ratios (CR), and active insulin time (AIT). Algorithm-based decision support advising upon potential settings adjustments may enhance clinical decision-making. Methods: Single-arm, two-phase exploratory study developing decision support to commence and sustain AHCL. Participants commenced investigational MM780G, then 8 weeks Phase 1-initial optimization tool evaluation, involving algorithm-based decision support with weekly AIT and CR recommendations. Clinicians approved or rejected CR and AIT recommendations based on perceived safety per protocol. Co-design resulted in a refined algorithm evaluated in a further identically configured Phase 2. Phase 2 participants also transitioned to commercial MM780G following "Quick Start" (algorithm-derived tool determining initial AHCL settings using daily insulin dose and weight). We assessed efficacy, safety, and acceptability of decision support using glycemic metrics, and the proportion of accepted CR and AIT settings per phase. Results: Fifty three participants commenced Phase 1 (mean age 24.4; Hba1c 61.5mmol/7.7%). The proportion of CR and AIT accepted by clinicians increased between Phases 1 and 2 respectively: CR 89.2% vs. 98.6%, p < 0.01; AIT 95.2% vs. 99.3%, p < 0.01. Between Phases, mean glucose percentage time < 3.9mmol (< 70mg/dl) reduced (2.1% vs. 1.4%, p = 0.04); change in mean TIR 3.9-10mmol/L (70-180mg/dl) was not statistically significant: 72.9% ± 7.8 and 73.5% ± 8.6. Quick start resulted in stable TIR, and glycemic metrics compared to international guidelines. Conclusion: The co-designed decision support tools were able to deliver safe and effective therapy. They can potentially reduce the burden of diabetes management related decision making for both health care practitioners and patients. Trial registration: Prospectively registered with Australia/New Zealand Clinical Trials Registry(ANZCTR) on 30th March 2021 as study ACTRN12621000360819. [ABSTRACT FROM AUTHOR]

Aims: To investigate the impact of real‐time continuous glucose monitoring (rtCGM) on glycaemia in a predominantly indigenous (Māori) population of adults with insulin‐requiring type 2 diabetes (T2D) in New Zealand. Methods: Twelve‐week, multicentre randomised controlled trial (RCT) of adults with T2D using ≥0.2 units/kg/day of insulin and elevated glycated haemoglobin (HbA1c) ≥64 mmol/mol (8.0%). Following a 2‐week blinded CGM run‐in phase, participants were randomised to rtCGM or control (self‐monitoring blood glucose [SMBG]). The primary outcome was time in the target glucose range (3.9–10 mmol/L; TIR) during weeks 10–12, with data collected by blinded rtCGM in the control group. Results: Sixty‐seven participants entered the RCT phase (54% Māori, 57% female), median age 53 (range 16–70 years), HbA1c 85 (IQR 74, 94) mmol/mol (9.9 [IQR 8.9, 10.8]%), body mass index (36.7 ± 7.7 kg/m2). Mean (±SD) TIR increased from 37 (24)% to 53 (24)% [Δ 13%; 95% CI 4.2 to 22; P = 0.007] in the rtCGM group but did not change in the SMBG group [45 (21)% to 45 (25)%, Δ 2.5%, 95% CI −6.1 to 11, P = 0.84]. Baseline‐adjusted between‐group difference in TIR was 10.4% [95% CI −0.9 to 21.7; P = 0.070]. Mean HbA1c (±SD) decreased in both groups from 85 (18) mmol/mol (10.0 [1.7]%) to 64 (16) mmol/mol (8.0 [1.4]%) in the rtCGM arm and from 81 (12) mmol/mol (9.6 [1.1]%) to 65 (13) mmol/mol (8.1 [1.2]%) in the SMBG arm (P < 0.001 for both). There were no severe hypoglycaemic or ketoacidosis events in either group. Conclusions: Real‐time CGM use in a supportive treat‐to‐target model of care likely improves glycaemia in a population with insulin‐treated T2D and elevated HbA1c. [ABSTRACT FROM AUTHOR]

Background: Use of Continuous Subcutaneous Insulin Infusion (CSII) has been shown to improve glycemic outcomes in Type 1 Diabetes (T1D), but high costs limit accessibility. To address this issue, an inter-operable, open-source Ultra-Low-Cost Insulin Pump (ULCIP) was developed and previously shown to demonstrate comparable delivery accuracy to commercial models in standardised laboratory tests. This study aims to evaluate the updated ULCIP in-vivo, assessing its viability as an affordable alternative for those who cannot afford commercially available devices. Methods: This first-in-human feasibility study recruited six participants with T1D. During a nine-hour inpatient stay, participants used the ULCIP under clinical supervision. Venous glucose, insulin, and β-Hydroxybutyrate were monitored to assess device performance. Results: Participants displayed expected blood glucose and blood insulin levels in response to programmed basal and bolus insulin dosing. One participant developed mild ketosis, which was treated and did not recur when a new pump reservoir was placed. All other participants maintained β-Hydroxybutyrate < 0.6 mmol/L throughout. Conclusion: The ULCIP safely delivered insulin therapy to users in a supervised inpatient environment. Future work should focus on correcting a pump hardware issue identified in this trial and extending device capabilities for use in closed loop control. Longer-term outpatient studies are warranted. Trial Registration: The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623001288617) on the 11 December 2023. [ABSTRACT FROM AUTHOR]

Aims: To survey the national workforce that manages children and adolescents with type 1 diabetes (T1D) in Aotearoa New Zealand and compare with glycaemic outcomes for 2021. Methods: A representative from each tertiary and regional diabetes service in Aotearoa New Zealand was asked to participate in an online survey assessing health‐care professional (HCP) workforce numbers operating for the 2021 calendar year. Regional full‐time‐equivalent (FTE), glycaemic outcomes and population demographics were compared to a previously reported workforce surveys (2015 and 2019). Results: Seventeen sites responded – including all four large tertiary centres – serving >99% of children and adolescents with T1D in Aotearoa New Zealand. HCP resourcing varied across sites, with median (range) HCP/100 patient ratios of: doctors: 0.40 (0.16–1.11), nurses: 1.19 (0.29–5.56), dietitians: 0.25 (0–1.11) and psychologist/social workers: 0 (0–0.26). No site met all of the International Society of Paediatric and Adolescent Diabetes (ISPAD) recommendations of HCP/100 patient ratios. Measures of socio‐economic deprivation predicted HbA1c, rather than the diabetes clinic attended. Overall, only 15.1% (240/1585) of patients had an HbA1c less than the recommended 53 mmol/mol. Conclusions: The Aotearoa New Zealand workforce for children and adolescents with T1D is under‐resourced and no site meets the ISPAD recommendations. There has been no significant increase in HCP/100 patient ratios compared to previous workforce surveys over the last decade. Few children and adolescents with T1D meet the recommended HbA1c. Resourcing according to recommended clinical need is required if equity in outcomes for young people with T1D is to be addressed. [ABSTRACT FROM AUTHOR]

The generation of sub-five optical cycle pulses centered at 11.2 µm wavelength with 50 µJ energy at a 1 kHz repetition rate is reported. A GaSe optical parametric chirped pulse amplifier (OPCPA) is driven by the residual 2.0 µm pump and 5 µm idler of a high-energy midwave-IR OPCPA. The latter serves as driver for hard X-ray generation and this makes the achieved fs longwave-IR pulses available for X-ray pump-probe experiments.

The recognition, decoding and tracking of vortex patterns is of increasing importance in many fields, ranging from the astronomical observations of distant galaxies to turbulence phenomena in liquids or gases. Currently, coherent light beams with orbital angular momentum (OAM) are of particular interest for optical communication, metrology, micro-machining or particle manipulation. One common task is to identify characteristic spiral patterns in pixelated intensity maps at real-world signal-to-noise ratios. A recently introduced combination of polar mapping and Fast Fourier Transform (FFT) was extended to novel sampling configurations and applied to the quantitative analysis of the spiral interference patterns of OAM beams. It is demonstrated that specific information on topological parameters in non-uniform arrays of OAM beams can be obtained from significantly distorted and noisy intensity maps by extracting one- or two-dimensional angular frequency spectra from single or concatenated circular cuts in either spatially fixed or scanning mode. The method also enables the evaluation of the quality of beam shaping and optical transmission. Results of proof-of-principle experiments are presented, resolution limits are discussed, and the potential for applications is addressed. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Technology use in type 1 diabetes (T1D) is impacted by socioeconomic status (SES). This analysis explored relationships between SES, glycemic outcomes, and technology use. RESEARCH DESIGN AND METHODS: A cross-sectional analysis of HbA1c data from 2,822 Australian youth with T1D was undertaken. Residential postcodes were used to assign SES based on the Index of Relative Socio-Economic Disadvantage (IRSD). Linear regression models were used to evaluate associations among IRSD quintile, HbA1c, and management regimen. RESULTS: Insulin pump therapy, continuous glucose monitoring, and their concurrent use were associated with lower mean HbA1c across all IRSD quintiles (P < 0.001). There was no interaction between technology use and IRSD quintile on HbA1c (P = 0.624), reflecting a similar association of lower HbA1c with technology use across all IRSD quintiles. CONCLUSIONS: Technology use was associated with lower HbA1c across all socioeconomic backgrounds. Socioeconomic disadvantage does not preclude glycemic benefits of diabetes technologies, highlighting the need to remove barriers to technology access. [ABSTRACT FROM AUTHOR]