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Objectives: Impaired awareness of hyperglycaemia (IAH) affects approximately 20–40% of people living with type 1 diabetes (T1D), predisposing them to severe hypoglycaemia. This systematic review evaluated the efficacy of closed-loop automated insulin delivery systems (CL-AID) in restoring IAH compared with standard diabetes care, including other diabetes technologies. Methods: Six electronic databases were searched for published and unpublished observational and randomised-control studies (RCTs) from inception to 29th of May 2024. The results of observational studies and RCTs were meta-analysed separately to calculate the effect of CL-AID on IAH in people living with T1D. Quality assessment of studies was performed using the Joanna-Briggs appraisal tool for cohort studies and the Risk of Bias (Rob-2) tool for RCTs. Results: Meta-analysis of four prospective observations studies (n = 583) demonstrated a statistically significant improvement in hypoglycaemia awareness upon transition to a hybrid closed-loop (HCL) system compared with standard diabetes care in people with T1D, Clarke score mean difference (MD) of -0.45 (-0.69 to -0.22, p = 0.0001). However, this was less than 1 point, which is the minimum clinically important difference (MCID) of Clarke score. Meta-analysis of three RCTs (n = 55) comparing standard diabetes care did not demonstrate any statistically significant effect on hypoglycaemia awareness, Clarke score MD of -0.69 (-1.89 to 0.50, p = 0.26). Conclusions: This systematic review demonstrated that transition from standard diabetes care to HCL has the potential to improve hypoglycaemia awareness in people with T1D and IAH, but this might not be of major clinical significance. Hence, psychoeducational interventions continue to be the cornerstone of IAH management. Novel therapeutic modalities, such as bi-hormonal automated delivery systems, need to be further explored to help restore hypoglycaemia awareness. [ABSTRACT FROM AUTHOR]

This review explores the integration of Circular Economy (CE) principles in manufacturing, focusing on its potential to transform industrial practices by promoting sustainability, economic adaptability, and social welfare. As manufacturers face the depletion of natural resources and growing environmental concerns, CE presents a regenerative model that prioritizes resource efficiency, waste reduction, and closed-loop systems. The study provides a detailed analysis of the current state of CE adoption, outlining significant barriers such as economic, technological, and regulatory and showcase innovative strategies and business models that successfully apply circular principles. Additionally, the paper emphasizes the role of supportive legislative frameworks, economic incentives, and educational initiatives in accelerating CE adoption. The review offers actionable recommendations for industry stakeholders, emphasizing the importance of collaboration, continuous learning, and robust monitoring systems to ensure a smooth transition. By uniting manufacturers, policymakers, and consumers under shared CE principles, this review advocates for a sustainable, resilient, and prosperous future for the manufacturing sector. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the psychometric properties of a patient-reported outcome measure, the Automated Insulin Delivery—Benefits and Burdens Scale (AID-BBS), which was designed to assess benefits and burdens of AID use in adults with type 1 diabetes (T1D). The measure was hypothesized to have validity, reliability, and clinical utility for predicting likelihood of continued use of an AID system. Research Design and Methods: A total of 217 adults with T1D (ages from 18 to 82 years) who were enrolled in an AID system research trial completed AID-BBS items at study midpoint (6 weeks) and at the end of the trial (13 weeks). Data were collected on pre-post glycemic outcomes. Participants completed other patient-reported psychosocial outcome measures (e.g., emotional well-being, diabetes distress, attitudes toward diabetes technology, diabetes treatment satisfaction) at Week 13. Likelihood of continued device use was assessed with three items at 13 weeks. Results: Exploratory factor analysis supported a one-factor structure for each subscale (15-item benefit and 9-item burden subscale) when evaluated separately. Convergent, discriminant, and predictive validity, internal consistency, and test–retest reliability were supported. Benefit and burden subscales at week 6 predicted usage intention above and beyond device impact on glycemic outcomes, also controlling for baseline glycemic outcomes. Conclusion: Findings support the AID-BBS as a psychometrically valid, reliable, and useful instrument for assessing burdens and benefits associated with AID system use in adults with T1D. The measure can be used to help health care providers set realistic expectations and proactively address modifiable burdens. Clinical Trial Registration Number: NCT04200313. [ABSTRACT FROM AUTHOR]

Abstract This review explores the integration of Circular Economy (CE) principles in manufacturing, focusing on its potential to transform industrial practices by promoting sustainability, economic adaptability, and social welfare. As manufacturers face the depletion of natural resources and growing environmental concerns, CE presents a regenerative model that prioritizes resource efficiency, waste reduction, and closed-loop systems. The study provides a detailed analysis of the current state of CE adoption, outlining significant barriers such as economic, technological, and regulatory and showcase innovative strategies and business models that successfully apply circular principles. Additionally, the paper emphasizes the role of supportive legislative frameworks, economic incentives, and educational initiatives in accelerating CE adoption. The review offers actionable recommendations for industry stakeholders, emphasizing the importance of collaboration, continuous learning, and robust monitoring systems to ensure a smooth transition. By uniting manufacturers, policymakers, and consumers under shared CE principles, this review advocates for a sustainable, resilient, and prosperous future for the manufacturing sector.

Background: The Omnipod® 5 Automated Insulin Delivery System was associated with favorable glycemic outcomes for people with type 1 diabetes (T1D) in two pivotal clinical trials. Real-world evidence is needed to explore effectiveness in nonstudy conditions. Methods: A retrospective analysis of the United States Omnipod 5 System users (aged ≥2 years) with T1D and sufficient data (≥90 days of data; ≥75% of days with ≥220 continuous glucose monitor readings/day) available in Insulet Corporation's device and person-reported datasets as of July 2023 was performed. Target glucose setting usage (i.e., 110–150 mg/dL in 10 mg/dL increments) was summarized and glycemic outcomes were examined. Subgroup analyses of those using the lowest average glucose target (110 mg/dL) and stratification by baseline characteristics (e.g., age, prior therapy, health insurance coverage) were conducted. Results: In total, 69,902 users were included. Multiple and higher glucose targets were more commonly used in younger age groups. Median percentage of time in range (TIR; 70–180 mg/dL) was 68.8%, 61.3%, and 53.6% for users with average glucose targets of 110, 120, and 130–150 mg/dL, respectively, with minimal time <70 mg/dL (all median <1.13%). Among those with an average glucose target of 110 mg/dL (n = 37,640), median TIR was 65.0% in children and adolescents (2–17 years) and 69.9% in adults (≥18 years). Subgroup analyses of users transitioning from Omnipod DASH or multiple daily injections and of Medicaid/Medicare users demonstrated favorable glycemic outcomes among these groups. Conclusion: These glycemic outcomes from a large and diverse sample of nearly 70,000 children and adults demonstrate effective use of the Omnipod 5 System under real-world conditions. [ABSTRACT FROM AUTHOR]

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 workingmemory experiment in the presence of personalizedmusical 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 encompassingmultiple 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. [ABSTRACT FROM AUTHOR]

Background: To evaluate the long-term safety and effectiveness of the Omnipod® 5 Automated Insulin Delivery (AID) System in very young children with type 1 diabetes with up to 2 years of use. Methods: Following a 13-week single-arm, multicenter, pivotal trial that took place after 14 days of standard therapy data collection, participating children (2–5.9 years of age at study enrollment) were provided the option to continue use of the AID system in an extension phase. HbA1c was measured every 3 months, up to 15 months of total use, and continuous glucose monitor metrics were collected through the completion of the extension study (for up to 2 years). Results: Participants (N = 80) completed 18.2 [17.4, 23.4] (median [interquartile range]) total months of AID, inclusive of the 3-month pivotal trial. During the pivotal trial, HbA1c decreased from 7.4% ± 1.0% (57 ± 10.9 mmol/mol) to 6.9% ± 0.7% (52 ± 7.7 mmol/mol, P < 0.0001) and was maintained at 7.0% ± 0.7% (53 ± 7.7 mmol/mol) after 15 months total use (P < 0.0001 from baseline). Time in target range (70–180 mg/dL) increased from 57.2% ± 15.3% during standard therapy to 68.1% ± 9.0% during the pivotal trial (P < 0.0001) and was maintained at 67.2% ± 9.3% during the extension phase (P < 0.0001 from standard therapy). Participants spent a median 97.1% of time in Automated Mode during the extension phase, with one episode of severe hypoglycemia and one episode of diabetic ketoacidosis. Conclusion: This evaluation of the Omnipod 5 AID System indicates that long-term use can safely maintain improvements in glycemic outcomes with up to 2 years of use in very young children with type 1 diabetes. Clinical Trials Registration Number: NCT04476472 [ABSTRACT FROM AUTHOR]

Background: Treatment of type 1 diabetes mellitus (T1DM) has become increasingly technical with rapid developments in integration of pumps and sensors to regulate insulin dosage, and patient-initiated solutions as open-source automated insulin delivery (OS-AID) systems, have gained popularity in people with diabetes. Studies have shown increased glycemic control and mental wellbeing in users of OS-AID systems. The aim of this study was to estimate the prevalence, the effect on metabolic control, the risk, and the effect on everyday life for users and their parents of OS-AID systems in Danish children and adolescents with T1DM. Methods: This retrospective cohort study recruited participants through pediatric diabetes outpatient clinics and social media. Surveys were distributed and current and retrospective data on glycemic control (HbA1c, time in range [TIR] etc.) were collected. Results: Fifty-six users of OS-AID systems out of 2950 Danish children and adolescents with T1DM were identified from all outpatient clinics in Denmark. Thirty-one responded on contact and were included (55% of the identified), median age 12 [interquartile range: 11–14] years, 51% females, and mean duration of use of OS-AID systems 2.37 ± 0.86 years. Glycemic control increased significantly with TIR increasing from mean 62.29% ± 13.68% to 70.12% ± 10.08%, *P < 0.01, and HbA1c decreasing from mean 50.13 ± 5.76 mmol/mol (6.7% ± 2.7%) to 47.86 ± 6.24 mmol/mol (6.5% ± 2.7%), **P < 0.05. No changes were found in safety parameters. Parents reported better quality of sleep evaluated by Pittsburgh Sleep Quality Index. Conclusion: This study is the first to provide knowledge on pediatric users of OS-AID systems in Denmark and found a prevalence of 1.89% for OS-AID systems, improved TIR, and no increased risk associated with use of OS-AID systems. [ABSTRACT FROM AUTHOR]

Abstract In this paper, a novel non‐linear model‐based approach is presented for maximum power point (MPP) tracking of thermoelectric generators (TEGs) using the backstepping controller. Considering the output voltage range of the thermoelectric devices, a step‐up DC–DC converter is employed as an interface between the load and input power source. According to the maximum power transfer theorem, if the equivalent input resistance of the converter (Rin) is equal to the internal resistance of the input source (RTEG), the TEG operation at the MPP will be achieved. Hence, defining the RTEG as a reference value and Rin as a feedback variable for a closed‐loop controller, the backstepping non‐linear controller is developed for input resistance control of the boost DC–DC converter. Owing to the non‐linear nature of the error variable in the input resistance control of the converters, conventional linear controllers cannot guarantee the system's closed‐loop stability within an extensive operational range. However, despite changes in generator's open‐circuit voltage (VOC) and RTEG, the designed closed‐loop controller can successfully stabilize the thermoelectric converter in different operational conditions. Considering the Lyapunov theorem and the Barbalat lemma, the asymptotic stability of the backstepping controller is proved. During the steady‐state operation, the actual values of the VOC and RTEG are updated periodically by the measurement of the converter input voltage/current values. To verify the functionality of the designed control method, PC‐based simulations are carried out in MATLAB/Simulink software. Moreover, by using TMS320F28335 digital signal processor from Texas Instruments and a simple thermoelectric simulator, the experimental response of the proposed controller is evaluated in dynamic and steady‐state conditions. The developed closed‐loop system can track the MPP of a TEG with zero steady‐state error, regardless of uncertain parameter variations.

The use of automated insulin delivery (AID) has led to a decrease in the burden of diabetes, allowing for better sleep, decreased anxiety about hypoglycemia, and automatic corrections doses, and meal recognition algorithms have provided "forgiveness" for imprecise carbohydrate (CHO) entries and missed or late meal boluses. We provide a case report and review of the current literature assessing the effect of AID on the burden of meal bolus. The case also demonstrates how sensor and pump data provide insight into insulin bolus behavior, and access to integrated cloud-based data has allowed for virtual patient visits. Glucose sensor metrics provides time in range and time below range, and the sensor-derived glucose management indicator provides an assessment of the long-term risk of complications when a laboratory glycated hemoglobin is not available. [ABSTRACT FROM AUTHOR]

Intensive therapy with exogenous insulin is the treatment of choice for individuals living with type 1 diabetes (T1D) and some with type 2 diabetes, alongside regular glucose monitoring. The development of systems allowing (semi-)automated insulin delivery (AID), by connecting glucose sensors with insulin pumps and algorithms, has revolutionized insulin therapy. Indeed, AID systems have demonstrated a proven impact on overall glucose control, as indicated by effects on glycated hemoglobin (HbA1c), risk of severe hypoglycemia, and quality of life measures. An alternative endpoint for glucose control that has arisen from the use of sensor-based continuous glucose monitoring is the time in range (TIR) measure, which offers an indication of overall glucose control, while adding information on the quality of control with regard to blood glucose level stability. A review of literature on the health-economic value of AID systems was conducted, with a focus placed on the growing place of TIR as an endpoint in studies involving AID systems. Results showed that the majority of economic evaluations of AID systems focused on individuals with T1D and found AID systems to be cost-effective. Most studies incorporated HbA1c, rather than TIR, as a clinical endpoint to determine treatment effects on glucose control and subsequent quality-adjusted life year (QALY) gains. Likely reasons for the choice of HbA1c as the chosen endpoint is the use of this metric in most validated and established economic models, as well as the limited publicly available evidence on appropriate methodologies for TIR data incorporation within conventional economic evaluations. Future studies could include the novel TIR metric in health-economic evaluations as an additional measure of treatment effects and subsequent QALY gains, to facilitate a holistic representation of the impact of AID systems on glycemic control. This would provide decision makers with robust evidence to inform future recommendations for health care interventions. [ABSTRACT FROM AUTHOR]

The presence of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) is associated with higher glycated hemoglobin levels over time. We evaluated whether hybrid-closed loop (HCL) therapy from onset of T1D could prevent the adverse impact of DKA at diagnosis on long-term glycemic outcomes. This was a posthoc analysis from 51 adolescents using HCL from diagnosis of T1D as part of the CLOuD trial (NCT02871089). We compared glycemic and insulin metrics between adolescents with (n = 17) and without (n = 34) DKA at diagnosis. Participants with and without DKA at diagnosis had similar time in target glucose range 3.9–10.0 mmol/L (70–180 mg/dL), time below range (<3.9 mmol/L, <70 mg/dL) and HbA1c at 6, 12, and 24 months. While insulin requirements at 6 months were higher in those with DKA at diagnosis, this was not statistically significant after adjusting for bodyweight. Residual C-peptide secretion was similar between groups. We conclude that HCL therapy may mitigate against the negative glycemic effects of DKA at T1D diagnosis. [ABSTRACT FROM AUTHOR]

To evaluate the percentage of patients with type 1 diabetes (T1D) and very poor metabolic control who would agree to be treated with a hybrid closed-loop (HCL) insulin delivery system, and to assess metabolic improvement and safety. In a single center, we identified all patients aged >18 years with hemoglobin A1c (HbA1c) >11% (97 mmol/mol) before HCL treatment. We collected metabolic control and safety data up to 1 year post-HCL in those who accepted HCL after it was proposed to them. We identified 65 patients eligible for the study, 32 (50%) already used, or accepted to start using HCL. Patients were aged 18–49 years; mean(±standard deviation) baseline HbA1c was 12.5(±1.8)% (113 ± 20 mmol/mol). After 1 year, 25 patients (78%) were still using HCL and their mean HbA1c decreased to 9.4(±1.9)% (79 mmol/mol) (P < 0.001). The rate of acute metabolic events was similar during the year of follow-up to the rate in the 3 years before HCL initiation. HCL systems should be considered in patients with T1D and very poor metabolic control. ClinicalTrials registration no. NCT05282264. [ABSTRACT FROM AUTHOR]

In this paper, a novel non‐linear model‐based approach is presented for maximum power point (MPP) tracking of thermoelectric generators (TEGs) using the backstepping controller. Considering the output voltage range of the thermoelectric devices, a step‐up DC–DC converter is employed as an interface between the load and input power source. According to the maximum power transfer theorem, if the equivalent input resistance of the converter (Rin) is equal to the internal resistance of the input source (RTEG), the TEG operation at the MPP will be achieved. Hence, defining the RTEG as a reference value and Rin as a feedback variable for a closed‐loop controller, the backstepping non‐linear controller is developed for input resistance control of the boost DC–DC converter. Owing to the non‐linear nature of the error variable in the input resistance control of the converters, conventional linear controllers cannot guarantee the system's closed‐loop stability within an extensive operational range. However, despite changes in generator's open‐circuit voltage (VOC) and RTEG, the designed closed‐loop controller can successfully stabilize the thermoelectric converter in different operational conditions. Considering the Lyapunov theorem and the Barbalat lemma, the asymptotic stability of the backstepping controller is proved. During the steady‐state operation, the actual values of the VOC and RTEG are updated periodically by the measurement of the converter input voltage/current values. To verify the functionality of the designed control method, PC‐based simulations are carried out in MATLAB/Simulink software. Moreover, by using TMS320F28335 digital signal processor from Texas Instruments and a simple thermoelectric simulator, the experimental response of the proposed controller is evaluated in dynamic and steady‐state conditions. The developed closed‐loop system can track the MPP of a TEG with zero steady‐state error, regardless of uncertain parameter variations. [ABSTRACT FROM AUTHOR]

Background: The Omnipod® 5 Automated Insulin Delivery (AID) System was shown to be safe and effective following 3 months of use in people with type 1 diabetes (T1D); however, data on the durability of these results are limited. This study evaluated the long-term safety and effectiveness of Omnipod 5 use in people with T1D during up to 2 years of use. Materials and Methods: After a 3-month single-arm, multicenter, pivotal trial in children (6–13.9 years) and adolescents/adults (14–70 years), participants could continue system use in an extension phase. HbA1c was measured every 3 months for up to 15 months; continuous glucose monitor metrics were collected for up to 2 years. Results: Participants (N = 224) completed median (interquartile range) 22.3 (21.7, 22.7) months of AID. HbA1c was reduced in the pivotal trial from 7.7% ± 0.9% in children and 7.2% ± 0.9% in adolescents/adults to 7.0% ± 0.6% and 6.8% ± 0.7%, respectively, (P < 0.0001), and was maintained at 7.2% ± 0.7% and 6.9% ± 0.6% after 15 months (P < 0.0001 from baseline). Time in target range (70–180 mg/dL) increased from 52.4% ± 15.6% in children and 63.6% ± 16.5% in adolescents/adults at baseline to 67.9% ± 8.0% and 73.8% ± 10.8%, respectively, during the pivotal trial (P < 0.0001) and was maintained at 65.9% ± 8.9% and 72.9% ± 11.3% during the extension (P < 0.0001 from baseline). One episode of diabetic ketoacidosis and seven episodes of severe hypoglycemia occurred during the extension. Children and adolescents/adults spent median 96.1% and 96.3% of time in Automated Mode, respectively. Conclusion: Our study supports that long-term use of the Omnipod 5 AID System can safely maintain improvements in glycemic outcomes for up to 2 years of use in people with T1D. Clinical Trials Registration Number: NCT04196140 [ABSTRACT FROM AUTHOR]

Background and Aims: Automated insulin delivery (AID) improves glycaemia among people with type 1 diabetes in clinical trials and overseas real‐world studies. Whether improvements are sustained beyond 12 months in the real world, and whether they occur in the Australian context, has not yet been established. We aimed to observe, up to 2 years, the effectiveness of initiating first‐generation AID for type 1 diabetes management. Methods: Retrospective, real‐world, observational study using medical records, conducted across five sites in Australia. Adults with type 1 diabetes, who had AID initiated between February 2019 and December 2021, were observed for 6–24 months after initiation (until June 2022). Outcomes examined included glucose metrics assessed by glycated haemoglobin (HbA1c) and continuous glucose monitoring (CGM), safety and therapy continuation. Results: Ninety‐four adults were studied (median age 39 years (interquartile range, IQR: 31–51); pre‐initiation HbA1c 7.8% (7.2–8.6)). After AID initiation, HbA1c decreased by mean 0.5 percentage points (95% confidence interval (CI): −0.7 to −0.2) at 3 months (P < 0.001); CGM time in range 3.9–10.0 mmol/L increased by 11 percentage points (9–14) at 1 month (P < 0.001); these improvements were maintained up to 24 months (all P < 0.02). Median CGM time below 3.9 mmol/L was <1.5% pre‐ and post‐AID initiation. The subgroup with pre‐initiation HbA1c above 8.5% had the greatest HbA1c improvement (−1.4 percentage points (−1.8 to −1.1) at 3 months). Twelve individuals (13%) discontinued AID, predominantly citing difficulties with CGM. During the 150 person‐years observed, four diabetes‐related emergencies were documented: three severe hypoglycaemic events and one hyperglycaemic event without ketoacidosis. Conclusions: Early glucose improvements were observed after real‐world AID initiation, sustained up to 2 years, without excess adverse events. The greatest benefits were observed among individuals with highest glycaemia before initiation. Future‐generation systems with increased user‐friendliness may enhance therapy continuation. [ABSTRACT FROM AUTHOR]

IntroductionDecoding 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.MethodsParticipants 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.ResultsA 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.DiscussionFindings 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.

Abstract In the three‐phase grid‐connected current‐source inverters (CSIs), the resonance result from the AC‐side CL filter and the quality of the grid‐current waveform under the unbalanced and harmonic grid voltage conditions are two issues deserving attention. To solve the two problems, a continuous control set‐model predictive control (CCS‐MPC) method based on the optimization theory is proposed in the two‐phase synchronous coordinate frame in this paper. The constructed cost function takes grid‐connected current and output current of the inverter as control target, and obtains its optimal solution under the least‐squares method, where the optimal inverter‐side current reference is composed of inductor‐current proportional feedback, capacitor‐voltage proportional feedback, and inverter‐side current steady‐state value feedforward. The proposed method can easily realize the normal operation of three‐phase grid‐connected CSIs because the method can be determined by only one parameter under the unbalanced and distorted grids. Furthermore, in the proposed method, the proportional feedback of capacitor voltage can effectively suppress the CL filter resonance. Finally, simulation and experimental results verify the effectiveness of the proposed control strategy.

Abstract Induction heating offers numerous advantages over conventional methods for heating high-pressure fluids in hydraulic testing applications. It simplifies complex processes, mitigates the risks associated with high-pressure environments, and enhances overall safety. The design of an efficient induction heating system requires a clear understanding of its key components, including the resonant tank circuit, impedance matching and isolation stage, high-frequency inverter, driver circuitry, and controller. The configuration of the resonant circuit plays a crucial role in device ratings and control methods. To meet the demanding requirements of switching devices like IGBTs, the driver circuit must ensure high immunity to interferences and failure. Effective system design allows the heating circuit to operate close to resonant switching, minimizing switching losses and cooling requirements. This paper presents the design and development of a 4-kW induction heater specifically tailored for inline heating of aviation fuel under high pressure. The system aims to achieve a precise temperature profile for testing line-replaceable units (LRUs) used in aircraft. The design methodology encompasses the selection of the resonant tank circuit configuration, impedance matching and isolation stage, high-frequency inverter, driver circuitry, and control strategies. Through extensive simulations in LTspice and experimental measurements, power losses in different components of the power conversion circuits are assessed, and overall system efficiency is evaluated. The results demonstrate the proposed induction heating system’s remarkable energy efficiency, reduced switching losses, and improved reliability. Furthermore, a comprehensive comparison with existing designs and industry norms is presented, highlighting the distinct advantages of the proposed system in terms of cost-effectiveness, energy efficiency, material utilization, and processing time. This research contributes valuable insights into the design and optimization of induction heating systems for high-pressure fluid heating applications, providing a practical and efficient solution for the aviation industry.

Automated insulin delivery systems, also known as closed-loop o r ‘artificial pancreas’ systems, are transforming the management of type 1 diabetes. These systems consist of an algorithm which responds to real-time glucose sensor levels by automatically modulating insulin delivery through an insulin pump. We review the rapidly changing landscape of automated insulin-delivery systems over recent decades, from initial prototypes to the different hybrid closed-loop systems commercially available today. We discuss the growing body of clinical trials and real-world evidence demonst rating their glycaemic and psychosocial benefits. We also address future directions in auto mated insulin delivery such as dual-hormone systems and adjunct therapy as well as the chal lenges around ensuring equitable access to closed-loop technology.

In the three‐phase grid‐connected current‐source inverters (CSIs), the resonance result from the AC‐side CL filter and the quality of the grid‐current waveform under the unbalanced and harmonic grid voltage conditions are two issues deserving attention. To solve the two problems, a continuous control set‐model predictive control (CCS‐MPC) method based on the optimization theory is proposed in the two‐phase synchronous coordinate frame in this paper. The constructed cost function takes grid‐connected current and output current of the inverter as control target, and obtains its optimal solution under the least‐squares method, where the optimal inverter‐side current reference is composed of inductor‐current proportional feedback, capacitor‐voltage proportional feedback, and inverter‐side current steady‐state value feedforward. The proposed method can easily realize the normal operation of three‐phase grid‐connected CSIs because the method can be determined by only one parameter under the unbalanced and distorted grids. Furthermore, in the proposed method, the proportional feedback of capacitor voltage can effectively suppress the CL filter resonance. Finally, simulation and experimental results verify the effectiveness of the proposed control strategy. [ABSTRACT FROM AUTHOR]

Achieving optimal glucose control in individuals with type 1 diabetes (T1DM) continues to pose a significant challenge. While continuous insulin infusion systems have shown promise as an alternative to conventional insulin therapy, there remains a crucial need for greater awareness regarding the necessary adaptations for various special circumstances. Nutritional choices play an essential role in the efficacy of diabetes management and overall health status for patients with T1DM. Factors such as effective carbohydrate counting, assessment of the macronutrient composition of meals, and comprehending the concept of the glycemic index of foods are paramount in making informed pre-meal adjustments when utilizing insulin pumps. Furthermore, the ability to handle such situations as physical exercise, illness, pregnancy, and lactation by making appropriate adjustments in nutrition and pump settings should be cultivated within the patient–practitioner relationship. This review aims to provide healthcare practitioners with practical guidance on optimizing care for individuals living with T1DM. It includes recommendations on carbohydrate counting, managing mixed meals and the glycemic index, addressing exercise-related challenges, coping with illness, and managing nutritional needs during pregnancy and lactation. Additionally, considerations relating to closed-loop systems with regard to nutrition are addressed. By implementing these strategies, healthcare providers can better equip themselves to support individuals with T1DM in achieving improved diabetes management and enhanced quality of life. [ABSTRACT FROM AUTHOR]

While external stimulation can reliably trigger neuronal activity, cerebral processes can operate independently from the environment. In this study, we conceptualize autogenous cerebral processes (ACPs) as intrinsic operations of the brain that exist on multiple scales and can influence or shape stimulus responses, behavior, homeostasis, and the physiological state of an organism. We further propose that the field should consider exploring to what extent perception, arousal, behavior, or movement, as well as other cognitive functions previously investigated mainly regarding their stimulus-response dynamics, are ACP-driven. [ABSTRACT FROM AUTHOR]

University systems maintain prohibitive closures that constitute a closed-loop system: opaque academic practices, control of what counts as knowledge, financial and social exclusion, and the perpetuation of privilege. Yet this closed-loop system is also governed by adherence to values around education as a public good, openness, and authenticity, and education as a vehicle for social mobility. The closures and openings created with such systems are in tension. Open education in universities is entwined in these tensions. In this paper, we differentiate between prohibitive closures and enabling closures. We define enabling closures as closed loops of activity that allow for openings both at the boundaries of the university and within. It is through these enabling closures that universities can adhere to open education as accepted policy and practice. As such, in this paper we explore how open education sits in tension with closed technological and increasingly commercialized educational infrastructures in higher education. [ABSTRACT FROM AUTHOR]

In this paper, the problem of closed-loop intermittent sensor fault (ISF) detection is investigated for a class of linear stochastic time-delay systems with unknown disturbances. A modified unknown input observer (UIO) is proposed to eliminate the influence of delayed errors caused by the discrete-time proportional-integral controller and constant time delay. In order to detect the appearing time and disappearing time of the ISF, a truncated residual is designed by introducing a sliding-time window. Moreover, two hypothesis tests are utilised to set the ISF detection thresholds, and the detectability, false alarm rates as well as missing alarm rates of the ISF are analysed in the framework of statistical analysis. Finally, the effectiveness of the proposed method is validated via a simulation example of a simplified radial flight control system. [ABSTRACT FROM AUTHOR]

While external stimulation can reliably trigger neuronal activity, cerebral processes can operate independently from the environment. In this study, we conceptualize autogenous cerebral processes (ACPs) as intrinsic operations of the brain that exist on multiple scales and can influence or shape stimulus responses, behavior, homeostasis, and the physiological state of an organism. We further propose that the field should consider exploring to what extent perception, arousal, behavior, or movement, as well as other cognitive functions previously investigated mainly regarding their stimulus–response dynamics, are ACP-driven.

Induction heating offers numerous advantages over conventional methods for heating high-pressure fluids in hydraulic testing applications. It simplifies complex processes, mitigates the risks associated with high-pressure environments, and enhances overall safety. The design of an efficient induction heating system requires a clear understanding of its key components, including the resonant tank circuit, impedance matching and isolation stage, high-frequency inverter, driver circuitry, and controller. The configuration of the resonant circuit plays a crucial role in device ratings and control methods. To meet the demanding requirements of switching devices like IGBTs, the driver circuit must ensure high immunity to interferences and failure. Effective system design allows the heating circuit to operate close to resonant switching, minimizing switching losses and cooling requirements. This paper presents the design and development of a 4-kW induction heater specifically tailored for inline heating of aviation fuel under high pressure. The system aims to achieve a precise temperature profile for testing line-replaceable units (LRUs) used in aircraft. The design methodology encompasses the selection of the resonant tank circuit configuration, impedance matching and isolation stage, high-frequency inverter, driver circuitry, and control strategies. Through extensive simulations in LTspice and experimental measurements, power losses in different components of the power conversion circuits are assessed, and overall system efficiency is evaluated. The results demonstrate the proposed induction heating system's remarkable energy efficiency, reduced switching losses, and improved reliability. Furthermore, a comprehensive comparison with existing designs and industry norms is presented, highlighting the distinct advantages of the proposed system in terms of cost-effectiveness, energy efficiency, material utilization, and processing time. This research contributes valuable insights into the design and optimization of induction heating systems for high-pressure fluid heating applications, providing a practical and efficient solution for the aviation industry. [ABSTRACT FROM AUTHOR]

This paper proposes a method to identify a Koopman model of a feedback-controlled system given a known controller. The Koopman operator allows a nonlinear system to be rewritten as an infinite-dimensional linear system by viewing it in terms of an infinite set of lifting functions. A finite-dimensional approximation of the Koopman operator can be identified from data by choosing a finite subset of lifting functions and solving a regression problem in the lifted space. Existing methods are designed to identify open-loop systems. However, it is impractical or impossible to run experiments on some systems, such as unstable systems, in an open-loop fashion. The proposed method leverages the linearity of the Koopman operator, along with knowledge of the controller and the structure of the closed-loop (CL) system, to simultaneously identify the CL and plant systems. The advantages of the proposed CL Koopman operator approximation method are demonstrated in simulation using a Duffing oscillator and experimentally using a rotary inverted pendulum system. An open-source software implementation of the proposed method is publicly available, along with the experimental dataset generated for this paper.

Aims: Hybrid closed loop (HCL) insulin delivery systems improve glycemia and quality of life among youth with type 1 diabetes (T1D), however there are inequities in use. We aimed to evaluate whether differences in positive expectancy of HCL systems may explain differences in use. Methods: Fifteen publicly-insured, non-Hispanic Black (NHB) youth with hemoglobin A1C (HbA1c) ≥ 10% enrolled in a study exploring changes in glycemia and person reported outcomes (PRO) during 6 months of Tandem t:slim X2 insulin pump with Control-IQ technology. At baseline youth and parents completed PROs, including Insulin Delivery Systems: Perceptions, Ideas, Reflections and Expectations (INSPIRE) survey assessing positive expectancy of HCL use, and Problem Areas in Diabetes (PAID) survey assessing diabetes-related distress. Differences between this cohort and the Tandem Control-IQ pediatric pivotal trial (DCLP5) cohort were assessed. Results: As compared to the DCLP5 cohort (0% NHB, 10% publicly-insured), baseline glycemic indicators were suboptimal (MHbA1c 11.9 ± 1.4% vs 7.6 ± 0.9%, p 180 mg/dL 82 ± 15% vs 45 ± 18%, p

• An advanced closed-loop geothermal system (ACGS) is proposed and its efficiency is analyzed. • A partitioning fracture is introduced into the closed-loop system's fluid circulation. • Polyurethane foam is found to be an excellent tubing material for the ACGS. • Heat production from ACGSs with complex fracture structures is explored. • Complex fractures may improve cumulative extracted heat over 20 years by 321.77 %. Heat production through conventional closed-loop geothermal systems is constrained by the limited contact area for heat exchange between rock formations and the wellbore. To address this challenge, an advanced closed-loop geothermal system (ACGS) is proposed to enhance heat production in this research. The ACGS incorporates a hydraulic fracture, partitioned by a horizontal insulator for vertical zonal isolation of fluid flow in the fracture, into the closed-loop system's fluid circulation. To assess heat production from the ACGS, a three-dimensional ACGS numerical model is established and validated, utilized to simulate heat production through the ACGS under conditions of different fracture dimensions and structures, tubing materials, and fluid heat capacities. Performances of complicated fracture structures, including a branched fracture and a multiple-wing fracture, in improving heat production are evaluated. It is found that due to the incorporation of a double-wing fracture, the cumulative extracted heat of a closed-loop system over 20 years is enhanced by 162.94 %. Increasing fracture half-length and fracture height both enhances the heat production of the ACGS considerably. Polyurethane foam proves an excellent tubing material for the ACGS due to its low cost and outstanding adiabatic functionality. Compared with a multiple-wing fracture, a branched fracture results in better heat production through the ACGS, with more fracture branches leading to higher heat production. A branched fracture can improve the cumulative extracted heat from a closed-loop system over 20 years by 321.77 %, and increasing the inter-branch angle further enhances heat production. Working fluid with smaller heat capacity yields considerably higher outlet temperature. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this study was to evaluate the glycemic outcomes in children and adolescents with Type 1 Diabetes (T1D) previously treated with Multiple Daily Injections (MDI) using a structured initiation protocol for the Advanced Hybrid Closed Loop (AHCL) Minimed 780G insulin pump system. Methods In this prospective open label single-arm, single-center, clinical investigation, we recruited children and adolescents (aged 7–17 years) with T1D on MDI therapy and HbA1c below 12.5%. All participants followed a 10-day structured initiation protocol which included 4 steps: step 1: AHCL system assessment; step 2: AHCL system training; step 3: Sensor augmented pump therapy (SAP) for 3 days; step 4: AHCL system use for 12 weeks, successfully completing the training from MDI to AHCL in 10 days. The primary outcome of the study was the change in the time spent in the target in range (TIR) of 70–180 mg/dl and HbA1c from baseline (MDI + CGM, 1 week) to study phase (AHCL, 12 weeks). The paired student t-test was used for statistical analysis and a value 70% and a HbA1c of

Vibration stimulation has been shown to have the potential to improve the activation pattern of unilateral motor imagery (MI) and to promote motor recovery. However, in the widely used left and right hand MI brain-computer interface (BCI) paradigm, the vibration stimuli cannot be directly applied to the imaginary side due to the spontaneity of imagery. In this study, we proposed a method of phase-dependent closed-loop vibration stimulation to be applied on both hands, and explored the effects of different vibration stimuli on the left and right hand MI-BCI. Eighteen healthy subjects were recruited and asked to perform, in sequence, MI tasks under three different conditions of vibratory feedback, which were no vibration stimulus (MI), phase-dependent closed-loop vibration stimulus (PDS), and continuous vibration stimulus (CS). Then the performance of the left and right hand MI-BCI and the patterns of brain oscillation were compared and analyzed under these different stimulation conditions. The results showed that vibration stimulation effectively boosted the activation of the sensorimotor cortex and enhanced the functional connectivity among sensorimotor-related brain regions during MI. The closed-loop stimulation evoked stronger event-related desynchronization patterns on the contralateral side of the imagined hand compared to continuous stimulation. There was a more obvious distinction between left hand task and right hand task. In addition, phase-dependent closed-loop vibration stimulation increased classification accuracy by approximately 7% (paired t-test, p=0.004, n=18) compared to MI alone, while continuous vibration stimulation only increased it by 4% (paired t-test, p=0.067, n=18). This result further demonstrated the effectiveness of the phase-dependent closed-loop vibration stimulation method in improving the overall performance of the MI paradigm and is expected to be further applied in areas such as stroke rehabilitation in the future.

Transcranial focused ultrasound stimulation (tFUS) is an effective noninvasive treatment modality for brain disorders with high clinical potential. However, the therapeutic effects of ultrasound neuromodulation are not widely explored due to limitations in preclinical systems. The current preclinical studies are head‐fixed, anesthesia‐dependent, and acute, limiting clinical translatability. Here, this work reports a general‐purpose ultrasound neuromodulation system for chronic, closed‐loop preclinical studies in freely behaving rodents. This work uses microelectromechanical systems (MEMS) technology to design and fabricate a small and lightweight transducer capable of artifact‐free stimulation and simultaneous neural recording. Using the general‐purpose system, it can be observed that state‐dependent ultrasound neuromodulation of the prefrontal cortex increases rapid eye movement (REM) sleep and protects spatial working memory to REM sleep deprivation. The system will allow explorative studies in brain disease therapeutics and neuromodulation using ultrasound stimulation for widespread clinical adoption. [ABSTRACT FROM AUTHOR]

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The Medtronic advanced hybrid closed-loop (AHCL) and MiniMed™ 670G hybrid closed-loop (HCL) systems provide the option to temporarily increase the glucose target to 150 mg/dL (8.3 mmol/L). This analysis investigated the efficacy of the AHCL compared with that of the HCL after the use of this setting. Data from 60 participants in the Fuzzy Logic Automated Insulin Regulation (FLAIR) study were used to compare the AHCL and HCL systems after the use of the temporary target (TT), and during analogous periods where this setting was not used. Differences in time in range 70-180 mg/dL between the systems were similar after the use of the TT setting and during analogous non-TT periods (interaction P = 0.87). Similar trends were observed for mean glucose, percentage time >180 mg/dL, and percentage time >250 mg/dL. Differences between AHCL and HCL systems were similar after the use of the TT setting compared with those of non-TT periods. ClinicalTrials.gov NCT03040414. [ABSTRACT FROM AUTHOR]

Artificial lung (AL) systems provide respiratory support to patients with severe lung disease, but none can adapt to the changing respiratory needs of the patients. Precisely, none can automatically adjust carbon dioxide ( CO 2 ) removal from the blood in response to changes in patient activity or disease status. Because of this, all current systems limit patient comfort, activity level, and rehabilitation. A portable servoregulation controller that automatically modulates CO 2 removal in ALs to meet the real-time metabolic demands of the patient is described. The controller is based on a proportional-integral-derivative (PID) based closed-loop feedback control system that modulates sweep gas (air) flow through the AL to maintain a target exhaust gas CO 2 partial pressure (target EGCO 2 or tEGCO 2 ). The presented work advances previous research by (1) using gas-side sensing that avoids complications and clotting associated with blood-based sensors, (2) incorporating all components into a portable, battery-powered package, and (3) integrating smart moisture removal from the AL to enable long term operation. The performance of the controller was tested in vitro for ∼12 h with anti-coagulated bovine blood and 5 days with distilled water. In tests with blood, the sweep gas flow was automatically adjusted by the controller rapidly (<2 min) meeting the specified tEG CO 2 level when confronted with changes in inlet blood partial pressure of CO 2 (p CO 2 ) levels at various AL blood flows. Overall, the CO 2 removal from the AL showed a strong correlation with blood flow rate and blood p CO 2 levels. The controller successfully operated continuously for 5 days when tested with water. This study demonstrates an important step toward ambulatory AL systems that automatically modulate CO 2 removal as required by lung disease patients, thereby allowing for physiotherapy, comfort, and activity. [ABSTRACT FROM AUTHOR]

Aims: New technology has been reported as a factor driving people to choose an automatic insulin delivery system (AIDs) and to sustain its acceptance. We aimed to explore the role of continuous glucose monitoring (CGM) technology (instant scanning vs. real-time) and insulin treatment modality to determine the future acceptance of AIDs among T1D individuals., Methods: 239 consecutively enrolled T1D youth and their parents returned the AP questionnaire. All individuals were on CGM, using multiple daily injections (MDI) or sensor-augmented pump (SAP) therapy., Results: The AP-acceptance was more than neutral, with mean overall scores of 3.91 ± 0.47 and 3.99 ± 0.43 (p = 0.07), youths and parents, respectively. Domains' analysis revealed high scores in intention to use, usefulness, and trust in AIDs, with favorable expected judgments by others. The items with the highest overall mean scores revealed high glucose control and QoL benefits; the main hassle was the size and discomfort of wearing two devices. Multivariate analysis found that male gender and SAP therapy were associated with a higher AP-acceptance overall score (p = 0.045, 0.015, 0.0001, respectively)., Conclusions: Participants receiving SAP therapy demonstrated higher expectations and optimistic views about AIDs. This treatment modality can act as a trampoline to AIDs despite individuals' glucose control and diabetes history., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The introduction of automated insulin delivery (AID) systems represents a significant advancement in diabetes care, offering substantial benefits in outpatient settings. Although clinical studies suggest that these systems can also help improve glycemic control in acutely ill patients, several barriers remain for the actual implementation and use of these technologies in clinical practice. Three main contexts for inpatient use are addressed, including: (a) continuation of personal AID systems, (b) initiation of AID during hospitalization, and (c) initiation of AID systems at discharge. A research road map with immediate to long-term actions is presented. Initially, it calls for clinical studies assessing in-hospital efficacy, safety, and utility, addressing specific patient needs and health care operational impacts. Midterm, it focuses on practical integration, simplifying AID use, ensuring electronic health record compatibility, clarifying regulatory uncertainties, and supporting health care professionals and patients. Long-term goals include system optimizations and policy advocacy for in-hospital AID use.

Abstract Transcranial focused ultrasound stimulation (tFUS) is an effective noninvasive treatment modality for brain disorders with high clinical potential. However, the therapeutic effects of ultrasound neuromodulation are not widely explored due to limitations in preclinical systems. The current preclinical studies are head‐fixed, anesthesia‐dependent, and acute, limiting clinical translatability. Here, this work reports a general‐purpose ultrasound neuromodulation system for chronic, closed‐loop preclinical studies in freely behaving rodents. This work uses microelectromechanical systems (MEMS) technology to design and fabricate a small and lightweight transducer capable of artifact‐free stimulation and simultaneous neural recording. Using the general‐purpose system, it can be observed that state‐dependent ultrasound neuromodulation of the prefrontal cortex increases rapid eye movement (REM) sleep and protects spatial working memory to REM sleep deprivation. The system will allow explorative studies in brain disease therapeutics and neuromodulation using ultrasound stimulation for widespread clinical adoption.

Sleep-related effects of closed-loop therapy among older adults with type 1 diabetes have not been well established. In the OldeR Adult Closed-Loop (ORACL) randomized, crossover trial of first-generation closed-loop therapy (MiniMed 670G), participants wore actigraphy and completed sleep diaries for 14-day periods at stage end. During objectively measured sleep (actigraphy) with closed-loop versus sensor-augmented pump therapy, glucose time-in-range 70-180 mg/dL (3.9-10.0 mmol/L) was greater (90.3% vs. 78.7%, respectively; difference 8.2 percentage points [95% confidence interval {CI} 1.5 to 13.0]; P = 0.008), and there were fewer sensor hypoglycemia episodes (18 vs. 43, respectively; incident rate ratio 0.40 [95% CI 0.20 to 0.55]; P = 0.007). Sleep quality recorded daily was worse with closed-loop therapy (P = 0.006); Pittsburgh Sleep Quality Index did not differ. There were 30% more system alarms during monitored sleep with closed-loop therapy (P < 0.001). First-generation closed-loop therapy has important glycemic benefits during sleep for older adults, with deterioration in some sleep quality measures. Sleep quality warrants prioritization and investigation during advancement of closed-loop technology. [ABSTRACT FROM AUTHOR]