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American Academy of Sleep Medicine calls for elimination of daylight saving time

DARIEN, IL – Public health and safety would benefit from eliminating daylight saving time, according to a position statement from the American Academy of Sleep Medicine.

The AASM supports a switch to permanent standard time, explaining in the statement that standard time more closely aligns with the daily rhythms of the body’s internal clock. The position statement also cites evidence of increased risks of motor vehicle accidents, cardiovascular events, and mood disturbances following the annual “spring forward” to daylight saving time.

“Permanent, year-round standard time is the best choice to most closely match our circadian sleep-wake cycle,” said lead author Dr. M. Adeel Rishi, a pulmonology, sleep medicine and critical care specialist at the Mayo Clinic in Eau Claire, Wisconsin, and vice chair of the AASM Public Safety Committee. “Daylight saving time results in more darkness in the morning and more light in the evening, disrupting the body’s natural rhythm.”

The position statement, published online as an accepted paper in the Journal of Clinical Sleep Medicine, outlines the acute effects of daylight saving time, which range from increased risk of stroke and hospital admissions to sleep loss and increased production of inflammatory markers, one of the body’s responses to stress. In addition, studies show that traffic fatalities have increased as much as six percent in the first few days following the change to daylight saving time, and a recently published research abstract found an 18 percent increase in adverse medical events related to human error in the week after switching to daylight saving time.

“There is ample evidence of the negative, short-term consequences of the annual change to daylight saving time in the spring,” said AASM President Dr. Kannan Ramar. “Because the adoption of permanent standard time would be beneficial for public health and safety, the AASM will be advocating at the federal level for this legislative change.”

In July, an AASM survey of more than 2,000 U.S. adults found that 63 percent support the elimination of seasonal time changes in favor of a national, fixed, year-round time, and only 11 percent oppose it. Additionally, a 2019 survey by the AASM found that 55 percent of adults feel extremely or somewhat tired after the spring change to daylight saving time.

The AASM position statement on daylight saving time has been endorsed by the following organizations:

American Academy of Cardiovascular Sleep Medicine
American Academy of Dental Sleep Medicine
American College of Chest Physicians (CHEST)
American College of Occupational and Environmental Medicine
California Sleep Society
Dakotas Sleep Society
Kentucky Sleep Society
Maryland Sleep Society
Michigan Academy of Sleep Medicine
Missouri Sleep Society
National PTA
National Safety Council
Society for Research on Biological Rhythms
Society of Anesthesia and Sleep Medicine
Society of Behavioral Sleep Medicine
Southern Sleep Society
Start School Later
Tennessee Sleep Society
Wisconsin Sleep Society
World Sleep Society.

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American Academy of Sleep Medicine

NASA's Terra Satellite sees the end of Bavi

image: NASA's Terra satellite provided a visible image to forecasters of Tropical Storm Bavi after it made landfall in northwestern North Korea on Aug. 27 and began moving into China.

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Image Courtesy: NASA Worldview, Earth Observing System Data and Information System (EOSDIS).

NASA's Terra satellite captured visible imagery as Tropical Storm Bavi made landfall in northwestern North Korea and moved inland.

The Moderate Resolution Imaging Spectroradiometer or MODIS instrument that flies aboard NASA's Terra satellite captured a visible image of Tropical Storm Bavi on Aug. 27. The image showed an almost shapeless tropical storm moving over North Korea and into China.

The final warning from the Joint Typhoon Warning Center was issued at 5 a.m. EDT (0900 UTC) on Aug. 27. At the time, it was located near latitude 41.6 degrees north and longitude 125.8 degrees east, about 249 nautical miles north of Inchon, South Korea. Bavi had weakened to a tropical storm with maximum sustained winds near 40 knots (46 mph/74 kph). It was moving to the north-northeast.

Bavi is quickly becoming extra-tropical after making landfall and is now moving across northeastern China.

When a storm becomes extra-tropical, it means that a tropical cyclone has lost its "tropical" characteristics. The National Hurricane Center defines "extra-tropical" as a transition that implies both poleward displacement (meaning it moves toward the north or south pole) of the cyclone and the conversion of the cyclone's primary energy source from the release of latent heat of condensation to baroclinic (the temperature contrast between warm and cold air masses) processes. It is important to note that cyclones can become extratropical and still retain winds of hurricane or tropical storm force.

Credit: 
NASA/Goddard Space Flight Center

NASA finds new Tropical Storm Iselle already battling wind shear

image: On Aug. 27 at 5:30 a.m. EDT (0930 UTC) the VIIRS instrument that flies aboard NASA-NOAA's Suomi NPP satellite revealed the most powerful thunderstorms (red) with cloud top temperatures as cold as minus 70 degrees Fahrenheit (minus 56.6. degrees Celsius) were west of the center and also dropping large amounts of rain.

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NASA/NRL

NASA infrared imagery shows that newly formed Tropical Storm Iselle is already battling for its life under wind shear.

Tropical Depression 14E formed in the Eastern Pacific Ocean on Aug. 26 by 11 a.m. EDT (1500 UTC). By 5 p.m. EDT, it strengthened into a tropical storm and was re-named Iselle.

NASA's Infrared Data Finds Push of Winds

Tropical cyclones are made up of hundreds of thunderstorms, and infrared data can show where the strongest storms are located. That is because infrared data provides temperature information, and the strongest thunderstorms that reach highest into the atmosphere have the coldest cloud top temperatures. Strongest storms with cloud top temperatures as cold as minus 70 degrees Fahrenheit (minus 56.6. degrees Celsius) were west of the center and were dropping large amounts of rain.

On Aug. 27 at 5:30 a.m. EDT (0930 UTC), the Visible Infrared Imaging Radiometer Suite (VIIRS) instrument aboard NASA-NOAA's Suomi NPP satellite captured a visible image of the structure of Iselle. The storm was elongated and strong storms appeared to be pushed southwest of the center from vertical wind shear.

National Hurricane Center (NHC) Hurricane Specialist Andrew Latto noted in the 11 a.m. EDT discussion, "Iselle consists of a rather ragged looking area of deep convection being sheared to the southwest of a partially exposed low-level center.

Moderate-to-strong easterly to northeasterly vertical wind shear will likely prevent Iselle from strengthening over the next couple of days.

What Wind Shear Does to a Tropical Cyclone

In general, wind shear is a measure of how the speed and direction of winds change with altitude. Tropical cyclones are like rotating cylinders of winds. Each level needs to be stacked on top each other vertically in order for the storm to maintain strength or intensify. Wind shear occurs when winds at different levels of the atmosphere push against the rotating cylinder of winds, weakening the rotation by pushing it apart at different levels.

Iselle's Status on Aug. 27, 2020

At 11 a.m. EDT (1500 UTC) on Aug. 27, the center of Tropical Storm Iselle was located near latitude 17.0 degrees north and longitude 115.8 degrees west. Iselle is far from land at about 560 miles (900 km) southwest of the southern tip of Baja California, Mexico.  Iselle is moving toward the northeast near 5 mph (7 kph), and this motion is expected to continue through Friday. Maximum sustained winds are near 45 mph (75 kph) with higher gusts. The estimated minimum central pressure is 1001 millibars.

Forecast from NHC

Little change in strength is forecast during the next couple of days. Iselle is expected to begin weakening late this weekend.

NASA Researches Earth from Space

For more than five decades, NASA has used the vantage point of space to understand and explore our home planet, improve lives and safeguard our future. NASA brings together technology, science, and unique global Earth observations to provide societal benefits and strengthen our nation. Advancing knowledge of our home planet contributes directly to America's leadership in space and scientific exploration.

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NASA/Goddard Space Flight Center

A nighttime view of Tropical Storm Hernan from a NASA-NOAA satellite

image: NASA-NOAA's Suomi NPP satellite passed the Eastern Pacific Ocean overnight on Aug. 26 at 10 p.m. EDT (Aug. 27 at 0000 UTC) and captured a nighttime image of Tropical Storm Hernan along the western coast of Mexico.

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NASA Worldview, Earth Observing System Data and Information System (EOSDIS)

Nighttime imagery from NASA-NOAA's Suomi NPP satellite revealed the Eastern Pacific Ocean's Tropical Storm Hernan along the coast of western Mexico. By the weekend, Hernan is expected to absorb nearby Tropical Storm Iselle.

Tropical Depression 13E formed by 5 a.m. EDT on Aug. 26 in the Eastern Pacific. Twelve hours later it strengthened to a tropical storm and was renamed Hernan.

NASA's Night-Time View

The Visible Infrared Imaging Radiometer Suite (VIIRS) instrument aboard Suomi NPP provided a nighttime image of Hernan on Aug. 26 at 10 p.m. EDT (Aug. 27 at 0000 UTC).

At 5 a.m. EDT on Aug. 27, the National Hurricane Center noted, "Although Hernan is a sheared tropical cyclone, another strong burst of deep convection with cloud tops of minus 83 to minus 86 degrees Celsius has developed near and south through west of the center." NASA research has shown that cloud tops that cold have the ability to generate heavy rainfall. By 11 a.m. EDT, first light visible satellite imagery reveals that Hernan remains a sheared tropical cyclone with most of the deep convection confined to the western semicircle.

Hernan's Status of Aug. 27

At 11 a.m. EDT (1500 UTC) NOAA's National Hurricane Center noted the center of Tropical Storm Hernan was located near latitude 19.1 degrees north and longitude 106.2 degrees west. That is 95 miles (155 km) southwest of Cabo Corrientes, Mexico. Hernan was moving toward the north-northwest near 5 mph (7 kph). Maximum sustained winds are near 45 mph (75 km/h) with higher gusts. The estimated minimum central pressure is 1001 millibars.

Hernan's Forecast Track

NHC predicts Hernan will turn to the northwest, along with an increase in forward speed is expected to occur by tonight. A turn to the west is forecast this weekend. On the forecast track, the center of Hernan, along with the strongest winds and heaviest rains, is expected to remain just offshore of the southwestern coast of Mexico. Nearby Tropical Storm Iselle is expected to begin weakening on Friday, and the system is forecast to degenerate into a remnant low-pressure area on Saturday. Iselle's remnants are expected to be absorbed by the circulation of Hernan to its west on Sunday.

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NASA/Goddard Space Flight Center

A.I. tool promises faster, more accurate Alzheimer's diagnosis

By detecting subtle differences in the way that Alzheimer's sufferers use language, researchers at Stevens Institute of Technology have developed an A.I. algorithm that promises to accurately diagnose Alzheimer's without the need for expensive scans or in-person testing. The software not only can diagnose Alzheimer's, at negligible cost, with more than 95 percent accuracy, but is also capable of explaining its conclusions, allowing physicians to double check the accuracy of its diagnosis.

"This is a real breakthrough," said the tool's creator, K.P. Subbalakshmi, founding director of Stevens Institute of Artificial Intelligence and professor of electrical and computer engineering at the Charles V. Schaeffer School of Engineering. "We're opening an exciting new field of research, and making it far easier to explain to patients why the A.I. came to the conclusion that it did, while diagnosing patients. This addresses the important question of trustability of A.I .systems in the medical field"

It has long been known that Alzheimer's can affect a person's use of language. People with Alzheimer's typically replace nouns with pronouns, such as by saying 'He sat on it' rather than 'The boy sat on the chair.' Patients might also use awkward circumlocutions, saying "My stomach feels bad because I haven't eaten" instead of simply "I'm hungry." By designing an explainable A.I. engine which uses attention mechanisms and convolutional neural network-- a form of A.I. that learns over time -- Subbalakshmi and her students were able to develop software that could not only accurately identify well-known telltale signs of Alzheimer's, but also detect subtle linguistic patterns previously overlooked.

Subbalakshmi and her team trained her algorithm using texts produced by both healthy subjects and known Alzheimer's sufferers as they described a drawing of children stealing cookies from a jar. Using tools developed by Google, Subbalakshmi and her team converted each individual sentence into a unique numerical sequence, or vector, representing a specific point in a 512-dimensional space.

Such an approach allows even complex sentences to be assigned a concrete numerical value, making it easier to analyze structural and thematic relationships between sentences. By using those vectors along with handcrafted features - those that subject matter experts have identified - the A.I. system gradually learned to spot similarities and differences between sentences spoken by healthy or unhealthy subjects, and thus to determine with remarkable accuracy how likely any given text was to have been produced by an Alzheimer's sufferer.

"This is absolutely state-of-the-art," said Subbalakshmi, who presented her work, in collaboration with her doctorate students, Mingxuan Chen and Ning Wang, on Aug. 24 at the 19th International Workshop on Data Mining in Bioinformatics at BioKDD. "Our A.I. software is the most accurate diagnostic tool currently available while also being explainable."

The system can also easily incorporate new criteria that may be identified by other research teams in the future, so it will only get more accurate over time. "We designed our system to be both modular and transparent," Subbalakshmi explained. "If other researchers identify new markers of Alzheimer's, we can simply plug those into our architecture to generate even better results."

In theory, A.I. systems could one day diagnose Alzheimer's based on any text, from a personal email to a social-media post. First, though, an algorithm would need to be trained using many different kinds of texts produced by known Alzheimer's sufferers, rather than just picture descriptions, and that kind of data isn't yet available. "The algorithm itself is incredibly powerful," Subbalakshmi said. "We're only constrained by the data available to us."

In coming months, Subbalakshmi hopes to gather new data that will allow her software to be used to diagnose patients based on speech in languages other than English. Her team is also exploring the ways that other neurological conditions -- such as aphasia, stroke, traumatic brain injuries, and depression -- can affect language use. "This method is definitely generalizable to other diseases," said Subbalakshmi. "As we acquire more and better data, we'll be able to create streamlined, accurate diagnostic tools for many other illnesses too."

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Stevens Institute of Technology

Older adults's faced mental health issues during the pandemic

image: by Anne Krendl, associate professor in IU's Department of Psychological and Brain Sciences.

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Indiana University

Older adults experienced greater depression and loneliness during the COVID-19 pandemic, according to a new study by Indiana University researchers, and relationship strength (perceived closeness to network members) moderated the relationship between loneliness and depression

The study, published in The Journal of Gerontology: Series B, was authored by Anne Krendl, associate professor in the College of Arts and Sciences' Department of Psychological and Brain Sciences and Brea Perry, professor in the Department to Sociology at IU Bloomington.

"What we found is the pandemic was associated with worse mental health outcomes for many older adults," Krendl said. "However, for some, having close social networks seemed to serve as a protector against negative mental health outcomes."

Krendl and Perry's study examined whether social isolation due to the COVID-19 shelter-in-place orders was associated with greater loneliness and greater depression for older adults, and, if so, whether declines in social engagement or relationship strength moderated that relationship. Researchers compared personal social networks, subjective loneliness and depression of 93 older adults in the Bloomington community, six to nine months prior to the pandemic and from late April to late May when most people were under stay-at-home orders.

Two-thirds (68 percent) of older adults reported spending less time than before with people they loved, according to the study, and 79 percent felt like their social life decreased or was negatively affected by COVID-19. However, 60 percent reported spending somewhat or much more time reconnecting or catching up with people they cared about and 78 percent were using some form of internet technology to keep in touch during the pandemic. On average, older adults reported spending about 76 minutes socializing virtually or over the phone each day.

"Although prior research has shown that people in this age group are not avid users of social media, the pandemic seems to have moved the needle, with more older people relying on social media to try to stay connected," Krendl said.

Research has shown that loneliness is associated with a number of negative outcomes for older adults, including higher rates of depression and higher mortality, while closeness to individuals in their networks can result in greater emotional well-being .

"Although older adults were relatively adaptable in staying connected during the pandemic, we found that adults who felt less close to their social network during the pandemic experienced increased depression. However, for older adults who felt closer to their social networks during the pandemic, depression only increased markedly for those who also had experienced a large increase in loneliness."

It is important, Krendl said, to fully understand the short-term impact the pandemic has had on older adults' mental health well-being so resources and services can be available to those who need it. Furthermore, Krendl will continue to follow up with those who took part in the survey, to see if changes in their mental health remain short-term or lead to permanent changes.

"One period of increased mental health problems does not necessarily mean a permanent change," she said. "But certainly, periods of mental health distress can have longer term implications for health and well-being. Characterizing those shifts will be important for understanding the full impact of the pandemic on older adults' mental and social wellbeing."

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Indiana University

Black children with cancer three times less likely to receive proton radiotherapy than White children

A deep concern among pediatric oncologists has been confirmed by the data: Black children enrolled in national clinical trials have been found to be three times less likely to receive proton radiotherapy than their white counterparts. Previous studies have shown that proton radiotherapy is equally effective at treating cancer and may decrease the incidence of long-term side effects in children compared to other forms of radiation therapy. But a retrospective analysis led by investigators from Brigham and Women's Hospital has found racial disparities in the use of the therapy for patients enrolled in trials. Results are published in JAMA Oncology.

"We were motivated to carry out this investigation based on our anecdotal experiences in clinic that children who receive proton therapy are predominantly white," said corresponding author Daphne Haas-Kogan, MD, chair of the Department of Radiation Oncology at the Brigham. "The strongest evidence for proton therapy is in childhood cancer, and we were concerned that imbalances in who receives this treatment could translate to long-term health disparities in our patients. This question was particularly urgent to us because of the rapidly growing number of proton centers in the country, which could potentiate any existing disparities if there is imbalanced distribution and use of these expensive technologies."

"We found that even when we think we are treating patients in as standard a way as possible, we may not be offering the same access to advancements in treatment," said lead author Danielle Bitterman, MD, a resident in the Department of Radiation Oncology at the Brigham. "These results call for introspection and to proactively address barriers to access to make sure patients who most need proton therapy are prioritized based on medical need so that these treatments are distributed equitably and fairly."

Proton radiotherapy is a high-cost, limited resource but may offer increased quality of life for pediatric patients compared to standard photon therapy. Cancer centers that offer proton radiotherapy are concentrated in metropolitan areas and may require travel or even relocation for families seeking treatment.

Most children with cancer enroll in clinical trials. To assess access to proton radiotherapy, Haas-Kogan, Bitterman and colleagues analyzed data from children enrolled in the Children's Oncology Group prospective trials between 2010 and 2018. They found that among 1,240 patients, approximately 85 percent received photon therapy and 15 percent received proton therapy.

Black pediatric patients were less likely to receive proton therapy than non-Hispanic white patients. While the study is retrospective and could not account for all confounding variables, the team did adjust for many confounders, including distance to the cancer center, metastatic disease and more. Even with these adjustments, Black patients remained less likely to receive proton therapy.

The study did not assess survival or patient side effect outcomes and cannot make conclusions about the clinical effect of the imbalance in proton treatment on patients. However, the findings suggest that Black children with solid cancers may be at higher risk for more side effects, some of which may be severe and lifelong.

"Future research should drill down on whether and how geography contributes to disparities, as this could guide more ethical distribution of high cost technologies," said Haas-Kogan. "And, perhaps most importantly, health care provider bias and racism may influence referral and treatment patterns for high cost medical treatments. This needs to be measured, recognized, and addressed in order to narrow the glaring health care disparities in our country."

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Brigham and Women's Hospital

Artificial pancreas effectively controls type 1 diabetes in children age 6 and up

AURORA, Colo. (August 26, 2020) - A clinical trial at the Barbara Davis Center for Childhood Diabetes at the University of Colorado Anschutz Medical Center and three other pediatric diabetes centers in the United States has found that a new artificial pancreas system -- which automatically monitors and regulates blood glucose levels -- is safe and effective at managing blood glucose levels in children as young as age six with type 1 diabetes. The trial was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. Results from the trial were published August 26 in the New England Journal of Medicine.

The artificial pancreas, also known as closed-loop control, is an "all-in-one" diabetes management system that tracks blood glucose levels using a continuous glucose monitor (CGM) and automatically delivers the insulin when needed using an insulin pump. The system replaces reliance on testing by fingerstick or CGM with delivery of insulin by multiple daily injections or a pump controlled by the patient or caregiver.

The study enrolled 101 children between ages 6 and 13 and assigned them to either the experimental group, which used the new artificial pancreas system or to the control group which used a standard CGM and separate insulin pump. Check-ins and data collection were conducted every other week for four months.

Study participants were instructed to continue about their daily lives so that the researchers could best understand how the system works in the typical routines of the children.

The study found that youth using the artificial pancreas system had 7% improvement in keeping blood glucose in range during the daytime, and a 26% improvement in nighttime control compared to the control group. Nighttime control is of particular importance for people with type 1 diabetes, as severe, unchecked hypoglycemia can lead to seizure, coma or even death. The overall time-in-range goal for the artificial pancreas reflected a nearly 11% improvement, which translated to 2.6 more hours per day in range.

"The improvement in blood glucose control in this study was impressive, especially during the overnight hours, letting parents and caregivers sleep better at night knowing their kids are safer," said protocol chair R. Paul Wadwa, M.D., professor of pediatrics at the Barbara Davis Center for Childhood Diabetes at the University of Colorado Anschutz Medical Campus. "Artificial pancreas technology can mean fewer times children and their families have to stop everything to take care of their diabetes. Instead, kids can focus on being kids."

Sixteen adverse events, all classified as minor, occurred in the artificial pancreas group during the study, with most due to problems with the insulin pump equipment. Three events occurred in the control group. No cases of severe hypoglycemia or diabetic ketoacidosis occurred during the study.

"For decades, NIDDK has funded research and technology development to create a user-friendly automated device that could ease the constant burden of type 1 diabetes, from the finger sticks and insulin injections, to the insulin dose calculations and constant monitoring while improving diabetes control outcomes and preventing both short- and long-term complications of the disease," said Arreaza-Rubín. "The artificial pancreas is a culmination of these years of effort, and it's exciting to see how this technology may benefit children with type 1 diabetes and their families, and hopefully benefit everyone with diabetes in the future."

The artificial pancreas technology used in this study, the Control-IQ system, has an insulin pump that is programmed with advanced control algorithms based on a mathematical model using the person's glucose monitoring information to automatically adjust the insulin dose. This technology was derived from a system originally developed at the University of Virginia (UVA), Charlottesville, with funding support from NIDDK.

This four-month study was part of a series of trials conducted in the International Diabetes Closed-Loop (iDCL) Study. In addition to CU and UVA, study sites included Stanford University School of Medicine, Palo Alto, California; and Yale University School of Medicine, New Haven, Connecticut. Jaeb Center for Health Research served as the data coordinating center.

Based on data from the iDCL trials, Tandem Diabetes Care has received clearance from the U.S. Food and Drug Administration for use of the Control-IQ system in children as young as age six.

"As we continue to search for a cure for type 1 diabetes, making artificial pancreas technology that is safe and effective, such as the technology used in this study, available to children with type 1 diabetes is a major step in improving the quality of life and disease management in these youth," said NIDDK Director Dr. Griffin P. Rodgers.

The iDCL Study is one of four major research efforts funded by NIDDK through the Special Statutory Funding Program for Type 1 Diabetes to test and refine advanced artificial pancreas systems. The studies, with additional results forthcoming, are looking at factors including safety, efficacy, user-friendliness, physical and emotional health of participants, and cost.

Credit: 
University of Colorado Anschutz Medical Campus

Octupole corner state in a three-dimensional topological circuit

image: (a) Experimentally measured and (b) theoretically calculated impedance spectra at node A. Note that the two-point impedance Zab for node A is measured across node A and the next nearest node along the x-direction. A Q-factor of 40 is set for the inductors in the calculations. (c) Experimentally measured and (d) theoretically calculated impedance distributions of all nodes at the corner mode frequency 2.77 MHz.

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by Shuo Liu, Shaojie Ma, Qian Zhang, Lei Zhang, Cheng Yang, Oubo You, Wenlong Gao, Yuanjiang Xiang, Tie Jun Cui & Shuang Zhang

Topological phases of matter have been one of the research interests in the field of condensed matter physics due to its unique properties in designing fascinating materials possessing quantized invariants in both electronics and photonics systems, and have shown great potential in lasing, quantum computing platform, and robust signal transmission in optics, acoustic, and mechanical systems. While most of the research interests of topological insulators have focused on observation of protected nontrivial mode localized at the surface of a bulk material, recent emergence of higher-order topological insulators (HOTIs) has led to discoveries of topological boundary states with dimensions lower than that of the bulk by more than 1. These quantized higher order multipole corner states are localized at the intersection of edges of a square (2D, quadrupole moment) or cubic (3D, octupole moment) lattice, and are protected by specially designed spatial symmetries. So far, the study of HOTIs are mostly limited to 2D cases, and their corner states are either induced by the quadrupole moment or the 2D Zak phase of the bulk lattice.

In a new paper published in Light Science & Application, a team of scientists, led by Professor Shuang Zhang from School of Physics and Astronomy, University of Birmingham, United Kingdom, Prof Tiejun Cui from State Key Laboratory of Millimeter Waves, Southeast University, Nanjing, China, Prof. Yuanjiang Xiang from School of Physics and Electronics, Hunan University, Changsha, China and co-workers have reported the experimental observation of 0D corner state in a three-dimensional (3D) topological circuit, which is built from a 3D cubic network of inductors and capacitors with deliberately designed values. They verify that such corner state is induced by the nontrivial octupole moment of the 3D circuit, and is topologically protected by three anticommuting reflection symmetries of the bulk lattice. This is achieved by engineering the dimerized coupling in each smallest loop (plaquette) in the circuit to have opposite sign to the other three, making this circuit a cubic lattice version of the famous Hofstadter model with π-flux per plaquette. 'This is critical for generating a synthetic magnetic π-flux threading the plaquette that finally gives the octuple corner state in the finite-sized system.' they emphasized.

The topological features of the circuit were analyzed from the band structures of the circuit with both infinite and finite boundary conditions. This was achieved by constructing the circuit Laplacian and circuit Hamiltonian of the circuit based on the Kirchhoff law. They found an isolated midgap mode in the band gap of the finite band structure, which is the octupole corner state that is localized at the corner of the cubic circuit. To verify their theoretical prediction, they fabricated a sample that comprises of 2.5×2.5×2.5 unit cells (5×5×5 nodes) using five layers of circuit board, and measured the impedance spectra between every adjacent circuit node using a vector network analyzer (VNA). A distinct peak was clearly identified from the impedance spectrum at one of the circuit corners at exactly the corner mode frequency (2.77MHz), which was confirmed to be the octupole corner state they expected. The experimental results were in good agreement with the theoretical calculations for the impedance spectra at all the circuit nodes. To theoretically confirm the topology of the corner state observed in the simulation and experiment, they calculated the topological invariant of the circuit through a series of procedures called the nested Wilson loops, and obtained a quantized value of 1/2 and 0, which correspond to the nontrivial and trivial states, respectively.

'Similar to the 1D edge state (2D surface state) in conventional 2D (3D) topological materials, which exhibits excellent immunity against defects and disorder, the 0D corner state in our HOTI circuit is also highly robust against certain types of disorder.' To evaluate the robustness of the octupole corner state, they provided the statistical distribution of the frequency of the corner state and the bandgap of the bulk from a number of disordered systems with different levels of variations in the circuit components. It was observed that the level of frequency shift of the corner mode is proportional to the randomness of the component variation, but its peak persists even at 20% circuit component variation. Further analyses were also performed to reveal the relationship between the bandgap and robustness of the corner state under different level of component disorder.

'The successful realization of octupole topological insulators paves the way for future investigations of higher-dimensional topological insulators possessing multipole moments without introducing synthetic dimensions, benefitting from the convenient electrical connections among nodes at arbitrary distances.' The authors also mentioned that this work may provide an experimental platform for further investigation of 3D higher-order topological circuit combined with non-Hermitian and nonlinear effects with the employment of active and nonlinear circuit devices such as operational amplifiers and varactor diodes.

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Light Publishing Center, Changchun Institute of Optics, Fine Mechanics And Physics, CAS

COVID-19 vaccines are moving fast, but will americans agree to get them?

Only one in three U.S. adults received the flu vaccine in 2018, a number that has critical implications for the impending flu season, which threatens to overwhelm medical resources and lead to tens of thousands of deaths at a time when Americans are still reeling from the COVID-19 pandemic.

A new study led by researchers at UC San Francisco has uncovered demographics of those groups who are less likely to receive the flu shot. These findings may inform public health efforts for future COVID-19 vaccines, and raise questions about making both flu and COVID vaccines free of charge and mandatory.

In the study, which publishes in the Journal of General Internal Medicine on Aug. 26, 2020, the researchers evaluated self-reported flu vaccination rates for 2018, which included data from the 2017-18 flu season (61,000 deaths) and 2018-19 season (34,200 deaths). The data was recorded in the Behavioral Risk Factor Surveillance System, an annual national survey of 400,000-plus U.S. adults, conducted by state health departments and the Centers for Disease Control and Prevention.

"To achieve herd immunity, we would need to reach about an 80 percent vaccination rate, but no subgroup in our study exceeded 60 percent," said senior author R. Adams Dudley, MD, MBA, of the UCSF Philip R. Lee Institute for Health Policy Studies and School of Medicine; and University of Minnesota Medical School and Institute for Health Informatics. "While social distancing, mask-wearing and staying away from crowds will mitigate the spread of the flu, a dangerous type of the flu - such as the Spanish flu of 1918 - could result in more than 61,000 fatalities," he said referring to the 2017-18 flu season.

Among the researchers' findings:

Age, insurance status and having a personal doctor were among the biggest determinants of whether a given individual had a flu shot. Some 22.6 percent for those ages 18 to 24 got the flu vaccine, versus 59.3 percent of those over 75. Among those without insurance 16.1 percent were vaccinated, versus 41.6 percent for those with insurance. For patients without a personal doctor 19.4 percent were vaccinated, versus 43.6 percent for those with a personal doctor.

Not having a chronic condition was linked to lower rates. Some 31.6 percent of those with no chronic condition were vaccinated, versus 52.7 percent for people with four or more chronic conditions.

Variation by income group was smaller. Some 33.9 percent for those with a household income of less than $15,000 were vaccinated, versus 41.8 percent of those with an income of more than $50,000.

Rates were lowest in Texas (26.4 percent) and highest in Washington DC (44.2 percent). Other states with low rates were Louisiana (26.4 percent), New York (28 percent), Indiana (28.5 percent) and Tennessee (28.6 percent). Other states with high rates were West Virginia (42.6 percent), North Carolina (41.7 percent), Iowa (40.6 percent) and Pennsylvania (40.3 percent). In California 32.4 percent were vaccinated.

Rates were lower among Blacks and Hispanics (33.9 percent and 28.9 percent) than whites and Asians (41.5 percent and 38.3 percent).

Men were less likely than women to receive the flu shots (36.7 percent versus 41.6 percent).

To boost vaccination rates, both long-term and short-term interventions are needed, said first author Brandon Yan, a third-year medical student at UC San Francisco. "We need a concerted public health campaign that includes public health officials, health care providers and local communities, and reaches those groups most at risk for not getting vaccinated. And we need a proactive primary care outreach strategy to address patient concerns and provide information on how and where to get vaccinated."

In the long-term the goals are loftier, said Yan, and include making the vaccines more accessible, such as expanding availability in grocery store pharmacies, and making them free of charge for those who are uninsured. "The ongoing pandemic also raises the issue of whether the flu vaccine and the future COVID-19 vaccine should be mandated," he said. "While a federal mandate may be difficult politically, private organizations like colleges and employers could make attendance and employment contingent on getting up-to-date with vaccines."

Credit: 
University of California - San Francisco

Following 'Eatwell Guide' diet could reduce your risk of dying early and lower your environmental footprint

The research was led by the London School of Hygiene & Tropical Medicine, in collaboration with the University of Oxford and funded by the Wellcome Trust.

It found that people who adhered to any five or more of the evaluated recommendations set out in the guidelines had an estimated 7% reduction in their mortality risk - based on data from three major UK databases (UK Biobank, EPIC Oxford and the Million Women Study).

They also found that the recommendation associated with the largest reduction, when adhered to alone, was the consumption of fruit and vegetables which reduced estimated risk by 10%.

Additionally, the study showed that following Eatwell Guide recommendations could reduce the emission of greenhouse gases - one of the biggest drivers of climate change. Diets that adhered to between five and nine of the evaluated recommendations were associated with 1.6kg less CO2 emissions per day, a 30% reduction compared to average daily CO2 emissions of diets that adhered to up to two of the nine evaluated recommendations.

However, data from the National Diet and Nutrition Survey revealed that less than 0.1% of people adhered to all nine guidelines. The majority of people (44%) followed three or four of the recommendations, with the consumption of dietary fibre and oily fish being the least commonly met category.

Globally, around 1.9 billion adults are overweight or obese, 462 million are underweight and a third are suffering from essential nutrient deficiencies. Governments are putting more emphasis on the need for a balanced, healthy diet - especially one which is more sustainable and environmentally friendly.

The government's current Eatwell Guide (EWG), published in 2016, provides advice on balanced and healthy diets. The recommendations include advice to consume five portions of fruit and vegetables per day, wholegrain, higher fibre carbohydrates and lower fat and sugar dairy options. The EWG also recommends consumption of no more than 70g of red and processed meat a day, and replacing meat with lower fat, higher fibre proteins such as beans, pulses, fish and eggs.

Other recommendations include choosing unsaturated oils and spreads, limiting consumption of foods high in fat, salt and sugar, and drinking six to eight glasses of fluid every day.

Previous studies have shown that fruit, vegetable and fibre consumption, in combination with limited sugar and processed meat intake, is associated with improved cardiovascular health and reduced cancer risk.

Dr Pauline Scheelbeek, Assistant Professor in Nutritional and Environmental Epidemiology at the London School of Hygiene & Tropical Medicine (LSHTM) and study lead author, said:

"Our study demonstrates that the Eatwell Guide forms an effective first step towards more healthy and sustainable diets in the UK. Further adherence to the guidelines would not only result in population health benefits, but is also associated with lower environmental footprint due to reduced greenhouse gas emission.

"However, more transformational dietary shifts than those recommended in the Eatwell Guide will be necessary if we want to meet the Paris Agreement targets.

"The Eatwell Guide does not specifically target environmental sustainability of diets. We therefore need to investigate ways to further reduce environmental footprints of our diets in ways that would be culturally acceptable and could be implemented by the UK population, both from a consumption and a production side, without compromising population health."

The research team used greenhouse gas emissions and water footprints - the amount of ground or surface water a crop or livestock used - to estimate the total environmental footprint of the diets. The dietary water footprints of those with low to high adherence to the recommendations differed very little.

The consumption of red or processed meat has been shown to contribute considerably to greenhouse gas emissions. This study indicates that by limiting how much of them we eat in order to reduce our dietary footprint, instead eating more beans, pulses and sustainably sourced fish which typically have less impact on the environment, the dietary CO2 emission were reduced by 1.5kg per day.

Professor Alan Dangour, Director of the Centre on Climate Change and Planetary Health at LSHTM and study senior author, said:

"National dietary recommendations provide important evidence-based guidance for people on the components of a healthy diet. Our new analysis demonstrates that following the Eatwell Guide would substantially improve human health in the UK and reduce our nation's footprint on the planet."

"Public Health England has an opportunity to reach across government and define national dietary guidelines that meet both health and environmental targets and we urge the UK government to develop a stronger joined-up approach to tackle the impending health and environmental crises."

The authors acknowledge limitations in the analysis. The authors did not rank dietary recommendations, and their analyses assumed that all recommendations had equal value, regardless of which were adhered to. Finally, despite the fact that large UK-based studies were used for this analysis, the exact impact of adhering to specific dietary guidelines on disease and mortality risk is subject to some uncertainty.

Credit: 
London School of Hygiene & Tropical Medicine

Tag team gut bacteria worsen symptoms of multiple sclerosis

Researchers at the RIKEN Center for Integrative Medical Sciences (IMS) have discovered that a particular combination of microorganisms in the gut can worsen symptoms in a mouse model of multiple sclerosis. The study published in the scientific journal Nature shows that two specific gut bacteria enhance the activity of immune cells that attack the body's own brain and spinal cord.

Multiple sclerosis is an autoimmune disease in which the immune system attacks the myelin that covers the nerve cells of the brain and spinal cord. Demyelination affects how rapidly neurons communicate with each other and with muscles, causing a variety of symptoms including numbness, weak muscles, tremors, and the inability to walk. Gut microorganisms have been reported to affect symptoms of multiple sclerosis, but how bacteria in the intestines can affect myelin of the brain and spinal cord remained a mystery.

Researchers led by Hiroshi Ohno at RIKEN IMS set out find this connection using a mouse model of the disease. These mice experience similar demyelination of the spinal cord that results from autoimmune attacks by T cells that produce the cytokine IL-17A. However, giving these mice the antibiotic ampicillin reduced demyelination. The treatment also prevented the activation of a particular type of T cell. As Ohno explains, "we found that treatment with ampicillin, and only ampicillin, selectively reduced activity of T cells that attack an important protein called myelin oligodendrocyte glycoprotein [MOG], which helps myelin stick to neurons."

This was confirmed by taking immune cells from the small intestines and other regions and measuring their cytokine production in the presence of MOG. Production was only reduced by ampicillin and only when the T cells came from the small intestine. At this point, the team knew that microorganisms in the small intestine activate MOG-specific T cells, which can then go and attack myelin. The next step was to figure out which bacteria were responsible.

Because only ampicillin reduced symptoms in the model mice, they looked for microbiota that were almost completely deleted only in ampicillin-treated mice. They found only one such bacteria, a new strain called OTU002. To test the hypothesis that OTU002 was the culprit, they examined mice that lacked all bacteria except OTU002. They found that symptoms in these mice were more severe than those in germ-free mice. At this point, the team knew that their newly discovered gut bacterium was responsible for the worsening symptoms.

"But, there was a problem," says first author Eiji Miyauchi. "Symptoms in the OTU002-only mice were not as bad as those in the regular model mice. This means that the original effect must involve more than one microorganism." The team hypothesized that a different bacterium was cross-reacting with MOG-specific T cells, mimicking the location on MOG that the T cells recognize. Shotgun genome sequencing revealed that a protein expressed by Lactobacillus reuteri does resemble a region of MOG, and when tested, it weakly activated MOG-specific T cells. The symptoms in mice co-colonized with L. reuteri and OTU002 were more severe than those in OTU002-only mice and were just as severe as those in the original model mice, indicating that when these two bacteria work together, the results are devastating.

"Other studies have focused on fecal microbes, or a single microbe, in patients with multiple sclerosis or in model mice," says Miyauchi. "Our data emphasize the necessity of considering the synergistic effects of intestinal microbes on autoimmune diseases and give hope to people looking for effective treatments for multiple sclerosis."

"But, because gut microbes and T cell binding locations on myelin differ between mouse and human, further studies using human microbes and autoreactive T cells are now needed."

Credit: 
RIKEN

Cosmic rays may soon stymie quantum computing

The practicality of quantum computing hangs on the integrity of the quantum bit, or qubit.

Qubits, the logic elements of quantum computers, are coherent two-level systems that represent quantum information. Each qubit has the strange ability to be in a quantum superposition, carrying aspects of both states simultaneously, enabling a quantum version of parallel computation. Quantum computers, if they can be scaled to accommodate many qubits on one processor, could be dizzyingly faster, and able to handle far more complex problems, than today's conventional computers.

But that all depends on a qubit's integrity, or how long it can operate before its superposition and the quantum information are lost -- a process called decoherence, which ultimately limits the computer run-time. Superconducting qubits -- a leading qubit modality today -- have achieved exponential improvement in this key metric, from less than one nanosecond in 1999 to around 200 microseconds today for the best-performing devices.

But researchers at MIT, MIT Lincoln Laboratory, and Pacific Northwest National Laboratory (PNNL) have found that a qubit's performance will soon hit a wall. In a paper published in Nature, the team reports that the low-level, otherwise harmless background radiation that is emitted by trace elements in concrete walls and incoming cosmic rays are enough to cause decoherence in qubits. They found that this effect, if left unmitigated, will limit the performance of qubits to just a few milliseconds.

Given the rate at which scientists have been improving qubits, they may hit this radiation-induced wall in just a few years. To overcome this barrier, scientists will have to find ways to shield qubits -- and any practical quantum computers -- from low-level radiation, perhaps by building the computers underground or designing qubits that are tolerant to radiation's effects.

"These decoherence mechanisms are like an onion, and we've been peeling back the layers for past 20 years, but there's another layer that left unabated is going to limit us in a couple years, which is environmental radiation," says William Oliver, associate professor of electrical engineering and computer science and Lincoln Laboratory Fellow at MIT. "This is an exciting result, because it motivates us to think of other ways to design qubits to get around this problem."

The paper's lead author is Antti Vepsäläinen, a postdoc in MIT's Research Laboratory of Electronics.

"It is fascinating how sensitive superconducting qubits are to the weak radiation. Understanding these effects in our devices can also be helpful in other applications such as superconducting sensors used in astronomy," Vepsäläinen says.

Co-authors at MIT include Amir Karamlou, Akshunna Dogra, Francisca Vasconcelos, Simon Gustavsson, and physics professor Joseph Formaggio, along with David Kim, Alexander Melville, Bethany Niedzielski, and Jonilyn Yoder at Lincoln Laboratory, and John Orrell, Ben Loer, and Brent VanDevender of PNNL.

A cosmic effect

Superconducting qubits are electrical circuits made from superconducting materials. They comprise multitudes of paired electrons, known as Cooper pairs, that flow through the circuit without resistance and work together to maintain the qubit's tenuous superposition state. If the circuit is heated or otherwise disrupted, electron pairs can split up into "quasiparticles," causing decoherence in the qubit that limits its operation.

There are many sources of decoherence that could destabilize a qubit, such as fluctuating magnetic and electric fields, thermal energy, and even interference between qubits.

Scientists have long suspected that very low levels of radiation may have a similar destabilizing effect in qubits.

"I the last five years, the quality of superconducting qubits has become much better, and now we're within a factor of 10 of where the effects of radiation are going to matter," adds Kim, a technical staff member at MIT Lincoln Laboratotry.

So Oliver and Formaggio teamed up to see how they might nail down the effect of low-level environmental radiation on qubits. As a neutrino physicist, Formaggio has expertise in designing experiments that shield against the smallest sources of radiation, to be able to see neutrinos and other hard-to-detect particles.

"Calibration is key"

The team, working with collaborators at Lincoln Laboratory and PNNL, first had to design an experiment to calibrate the impact of known levels of radiation on superconducting qubit performance. To do this, they needed a known radioactive source -- one which became less radioactive slowly enough to assess the impact at essentially constant radiation levels, yet quickly enough to assess a range of radiation levels within a few weeks, down to the level of background radiation.

The group chose to irradiate a foil of high purity copper. When exposed to a high flux of neutrons, copper produces copious amounts of copper-64, an unstable isotope with exactly the desired properties.

"Copper just absorbs neutrons like a sponge," says Formaggio, who worked with operators at MIT's Nuclear Reactor Laboratory to irradiate two small disks of copper for several minutes. They then placed one of the disks next to the superconducting qubits in a dilution refrigerator in Oliver's lab on campus. At temperatures about 200 times colder than outer space, they measured the impact of the copper's radioactivity on qubits' coherence while the radioactivity decreased -- down toward environmental background levels.

The radioactivity of the second disk was measured at room temperature as a gauge for the levels hitting the qubit. Through these measurements and related simulations, the team understood the relation between radiation levels and qubit performance, one that could be used to infer the effect of naturally occurring environmental radiation. Based on these measurements, the qubit coherence time would be limited to about 4 milliseconds.

"Not game over"

The team then removed the radioactive source and proceeded to demonstrate that shielding the qubits from the environmental radiation improves the coherence time. To do this, the researchers built a 2-ton wall of lead bricks that could be raised and lowered on a scissor lift, to either shield or expose the refrigerator to surrounding radiation.

"We built a little castle around this fridge," Oliver says.

Every 10 minutes, and over several weeks, students in Oliver's lab alternated pushing a button to either lift or lower the wall, as a detector measured the qubits' integrity, or "relaxation rate," a measure of how the environmental radiation impacts the qubit, with and without the shield. By comparing the two results, they effectively extracted the impact attributed to environmental radiation, confirming the 4 millisecond prediction and demonstrating that shielding improved qubit performance.

"Cosmic ray radiation is hard to get rid of," Formaggio says. "It's very penetrating, and goes right through everything like a jet stream. If you go underground, that gets less and less. It's probably not necessary to build quantum computers deep underground, like neutrino experiments, but maybe deep basement facilities could probably get qubits operating at improved levels."

Going underground isn't the only option, and Oliver has ideas for how to design quantum computing devices that still work in the face of background radiation.

"If we want to build an industry, we'd likely prefer to mitigate the effects of radiation above ground," Oliver says. "We can think about designing qubits in a way that makes them 'rad-hard,' and less sensitive to quasiparticles, or design traps for quasiparticles so that even if they're constantly being generated by radiation, they can flow away from the qubit. So it's definitely not game-over, it's just the next layer of the onion we need to address."

Credit: 
Massachusetts Institute of Technology

Mandatory vote-by-mail modestly increases voter turnout without giving either party an edge in elections, study suggests

Mandatory vote-by-mail modestly increases voter turnout without advantaging one party over the other, according to a causal inference analysis of 30 years of nationwide U.S. county-level data and more than 40 million individual-level voter records from the states of Washington and Utah. The results support that this alternative to in-person voting - which has recently become a heated partisan issue - would not, in fact, give one party an edge over another in the upcoming 2020 U.S. presidential election and could offer a safe pathway to a fair election during the COVID-19 pandemic. "Our paper uses a combination of rich individual- and county-level data, which allows us to account for many factors that could bias our estimates. Consistently across all of our approaches used, we find the same thing--that vote-by-mail does not advantage either party at the ballot box." While many experts have suggested that mandatory vote-by-mail could help minimize the spread of the virus during election season while still enabling voters to have their voices heard, recent polls reveal stark divisions along party lines, with only 4 in 10 Republicans supporting all-mail elections compared with more than 8 in 10 Democrats. Previous studies have investigated the effects of both mandatory and voluntary vote-by-mail initiatives on voter turnout, but no previous research has explored whether voting by mail gives the Democratic or Republican Party an advantage. To determine the effect of mandatory vote-by-mail on U.S. election outcomes, Michael Barber and colleagues combined data from counties across the nation that have offered mail-in ballots between 1992 and 2018 with individual-level voter records from Washington and Utah, the only two states that have recently transitioned to mandatory vote-by-mail. Applying a variety of causal inference models to analyze this body of data, the researchers determined that vote-by-mail increased voter turnout by between 1.8 and 2.9% - a finding consistent with previous research, but expanded to a larger scale. While Barber et al.'s estimates also find that vote-by-mail increased Democratic shares of the vote by 0.7%, the effect was not statistically significant, suggesting this remote style of voting did not exhibit even a modest effect on either party's election performance.

Credit: 
American Association for the Advancement of Science (AAAS)

Artificial pancreas effectively controls type 1 diabetes in children age 6 and up

image: A study participant reviews his information on his artificial pancreas device.

Image: 
University of Colorado Barbara Davis Center for Diabetes

A clinical trial at four pediatric diabetes centers in the United States has found that a new artificial pancreas system -- which automatically monitors and regulates blood glucose levels -- is safe and effective at managing blood glucose levels in children as young as age six with type 1 diabetes. The trial was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. Results from the trial were published August 26 in the New England Journal of Medicine.

"Fewer than 1 in 5 children with type 1 diabetes are able to successfully keep their blood glucose in a healthy range with current treatment, which may have serious consequences on their long-term health and quality of life," said Guillermo Arreaza-Rubín, M.D., director of NIDDK's Diabetes Technology Program and project scientist for the study. "Earlier research showed that the system tested in this study was safe and effective for people ages 14 and older. This trial now shows us this system works in a real-world setting with younger children."

The artificial pancreas, also known as closed-loop control, is an "all-in-one" diabetes management system that tracks blood glucose levels using a continuous glucose monitor (CGM) and automatically delivers the insulin when needed using an insulin pump. The system replaces reliance on testing by fingerstick or CGM with delivery of insulin by multiple daily injections or a pump controlled by the patient or caregiver.

The study enrolled 101 children between ages 6 and 13 and assigned them to either the experimental group, which used the new artificial pancreas system or to the control group which used a standard CGM and separate insulin pump. Check-ins and data collection were conducted every other week for four months.

Study participants were instructed to continue about their daily lives so that the researchers could best understand how the system works in the typical routines of the children.

The study found that youth using the artificial pancreas system had 7% improvement in keeping blood glucose in range during the daytime, and a 26% improvement in nighttime control compared to the control group. Nighttime control is of particular importance for people with type 1 diabetes, as severe, unchecked hypoglycemia can lead to seizure, coma or even death. The overall time-in-range goal for the artificial pancreas reflected a nearly 11% improvement, which translated to 2.6 more hours per day in range.

"The improvement in blood glucose control in this study was impressive, especially during the overnight hours, letting parents and caregivers sleep better at night knowing their kids are safer," said protocol chair R. Paul Wadwa, M.D., professor of pediatrics at the Barbara Davis Center for Childhood Diabetes at the University of Colorado, Aurora (CU). "Artificial pancreas technology can mean fewer times children and their families have to stop everything to take care of their diabetes. Instead, kids can focus on being kids."

Sixteen adverse events, all classified as minor, occurred in the artificial pancreas group during the study, with most due to problems with the insulin pump equipment. Three events occurred in the control group. No cases of severe hypoglycemia or diabetic ketoacidosis occurred during the study.

"For decades, NIDDK has funded research and technology development to create a user-friendly automated device that could ease the constant burden of type 1 diabetes, from the finger sticks and insulin injections, to the insulin dose calculations and constant monitoring while improving diabetes control outcomes and preventing both short- and long-term complications of the disease," said Arreaza-Rubín.

"The artificial pancreas is a culmination of these years of effort, and it's exciting to see how this technology may benefit children with type 1 diabetes and their families, and hopefully benefit everyone with diabetes in the future."

The artificial pancreas technology used in this study, the Control-IQ system, has an insulin pump that is programmed with advanced control algorithms based on a mathematical model using the person's glucose monitoring information to automatically adjust the insulin dose. This technology was derived from a system originally developed at the University of Virginia (UVA), Charlottesville, with funding support from NIDDK.

This four-month study was part of a series of trials conducted in the International Diabetes Closed-Loop (iDCL) Study. In addition to CU and UVA, study sites included Stanford University School of Medicine, Palo Alto, California; and Yale University School of Medicine, New Haven, Connecticut. Jaeb Center for Health Research served as the data coordinating center.

Based on data from the iDCL trials, Tandem Diabetes Care has received clearance from the U.S. Food and Drug Administration for use of the Control-IQ system in children as young as age six years.

"As we continue to search for a cure for type 1 diabetes, making artificial pancreas technology that is safe and effective, such as the technology used in this study, available to children with type 1 diabetes is a major step in improving the quality of life and disease management in these youth," said NIDDK Director Dr. Griffin P. Rodgers.

The iDCL Study is one of four major research efforts funded by NIDDK through the Special Statutory Funding Program for Type 1 Diabetes to test and refine advanced artificial pancreas systems. The studies, with additional results forthcoming, are looking at factors including safety, efficacy, user-friendliness, physical and emotional health of participants, and cost.

This study was funded by NIDDK and Tandem Diabetes, Inc. Tandem provided the experimental closed-loop systems used in the trial, system-related supplies including the Dexcom CGM and Roche glucometer, and technical expertise.

Credit: 
NIH/National Institute of Diabetes and Digestive and Kidney Diseases