Background: Clinical guidelines on driving for people with diabetes exist, but there are limited studies analyzing glucose data and hypoglycemia risk while driving. No published studies have analyzed teenage or emerging adult drivers with type 1 diabetes (T1D). The primary aim of our pilot study was to explore the glycemic patterns of young drivers with T1D as they relate to clinical guidelines and identify trends that could be used to improve road safety. Methods: In this pilot study, we collected continuous glucose monitoring (CGM) data from five drivers with T1D (median age 19, range 17–21 years) over a 1‐month period. The driving trips were divided into two categories: (1) Short trips (<60 min) and (2) Long trips (≥60 min). Hypoglycemia was defined as <70 mg/dL as recorded by CGM for at least four consecutive readings. Trips <10 min were excluded from the analysis. Results: Data on 284 total trips with associated CGM readings were recorded. The average number of trips taken by drivers during the study was 56.8 trips (range 9–82). For short trips ( n = 276), no episodes of hypoglycemia occurred when starting glucose was >90 mg/dL ( n = 227). For short trips with starting glucose of 70–90 mg/dL ( n = 32), each hypoglycemic event ( n = 5) had a drop in the first CGM glucose value while driving. Seventeen (5.7%) of short trips started with a glucose <70 mg/dL. A total of eight long trips (>60 min) were recorded, all had a starting CGM value of >90 mg/dL, and none had hypoglycemia events. Conclusions: These real‐world findings from a small sample of teenage and young adult drivers with T1D support the American Diabetes Association (ADA) recommendation for starting glucose of >90 mg/dL when driving. Larger studies would be helpful in clearly identifying and improving road safety concerns in young drivers with T1D.
Abstract Outcomes for children with hypoplastic left heart syndrome have improved over the years, but there remains a subgroup for which the mortality rate remains extremely high: those with an intact/restrictive atrial septum. Fetal surgical approaches for this group involve balloon septoplasty or stenting (off-label use of adult coronary stents) of the atrial septum to relieve left atrial hypertension. However, significant challenges exist with these approaches on account of atrial recoil and the lack of devices engineered for this application. We present two device concepts that demonstrate potential to address these challenges. The first is a self-expanding flanged stent that eases positioning challenges and reduces the risk of stent migration. The second is a balloon with an electrode array that uses radiofrequency electrical energy to denature the atrial septal tissue following a balloon septoplasty to reduce the degree of tissue recoil. The two device concepts were tested for first-order feasibility on an atrial septum analogue. The stent device was fabricated from a commercially available self-expanding carotid stent and the balloon device was simulated using an electrode array bonded to a dilating mandrel. Both devices successfully created a channel in the atrial septum analogue, demonstrating the feasibility of these device concepts.
Thoracic aortic dissections are associated with a significant risk of morbidity and mortality, and currently challenge our understanding of the biomechanical factors leading to their initiation and propagation. We quantified the biaxial mechanical properties of human type A dissections (n = 16) and modeled the stress-strain data using a microstructurally motivated form of strain energy function. Our results show significantly higher stiffness for dissected tissues as compared to control aorta without arterial disease. Higher stiffness of dissected tissues did not, however, correlate with greater aortic diameter measured prior to surgery nor were there any age dependent differences in the tissue properties.
Lung biopsies are often used to aid in the diagnosis of cancers. However, the procedure carries the dual risk of air (pneumothorax) or blood (hemothorax) filling the pleural cavity, increasing the risk of a collapsed lung and chest intubation. This work demonstrates the effectiveness of a polyurethane-based shape memory polymer foam as a biopsy tract sealant. The impact of diameter, length, pore size, and shape memory effect was evaluated to determine the ideal device design for tract sealing. Characterization in an
Pediatric patients who undergo surgery for long-segment congenital tracheal stenosis (LSCTS) have suboptimal outcomes and postsurgical complications. To address this, we propose a biosynthetic graft comprising (1) a porcine small intestinal submucosa extracellular matrix (SIS-ECM) patch for tracheal repair, and (2) a resorbable polymeric exostent for biomechanical support. The SIS-ECM patch was evaluated in vivo in an ovine trachea model over an 8 month period. Concurrently, the biosynthetic graft was evaluated in a benchtop lamb trachea model for biomechanical stability. In vivo results show that SIS-ECM performs better than bovine pericardium (control) by preventing granulation tissue/restenosis, restoring tracheal architecture, blood vessels, matrix components, pseudostratified columnar and stratified epithelium, ciliary structures, mucin production, and goblet cells. In vitro tests show that the biosynthetic graft can provide the desired axial and flexural stability, and biomechanical function approaching that of native trachea. These results encourage future studies to evaluate safety and efficacy, including biomechanics and collapse risk, biodegradation, and in vivo response enabling a stable long-term tracheal repair option for pediatric patients with LSCTS and other tracheal defects.
Persons with transfemoral and transtibial protheses experience changes in the volume of their residual limb during the course of the day. These changes in volume unavoidably lead to changes in quality of fit of the prosthesis, skin irritations, and soft tissue injuries. The associated pain and discomfort can become debilitating by reducing one’s ability to perform daily activities. While significant advancements have been made in prostheses, the undesirable pain and discomfort that occurs due to the volume change is still a major challenge that needs to be solved. The goal of this program is to develop smart prosthetic sockets that can accommodate for volume fluctuations in the residual limb. In this research, fluidic flexible matrix composite wafers (f2mc) are integrated into the prosthetic socket for volume regulation. The f2mc’s are flexible tubular elements embedded in a flexible matrix. These tubular elements are connected to a reservoir, and contain an internal fluid such as air or water. Fluid flow between the tubes and reservoir is controlled by valves. The f2mc’s can achieve more than 300% increase in volume and potentially several orders of magnitude of change in stiffness. Experimental results for a prosthetic socket demonstrate that the flexible matrix composite wafers can achieve changes in volume when pressurized.
