#loop 415
Explore tagged Tumblr posts
solitaryspoonsofficial · 9 months ago
Text
Always watching with a sepia-toned smile
Tumblr media
( art by @scoutthegoose )
37 notes · View notes
scoutthegoose · 11 months ago
Text
Tumblr media Tumblr media Tumblr media Tumblr media Tumblr media Tumblr media Tumblr media Tumblr media Tumblr media Tumblr media
SURPRISE AUTISM ATTACK (I put all the art together)
26 notes · View notes
the-moth-archives · 2 months ago
Text
୨ৎ Fem Wolverine - SFW HCs ୨ৎ
Tumblr media
Type: Fluff, fem wolverine x fem presenting person
Word Count: 415
Notes: hello !! thank u for all the love on my other wolverine posts :D Fem wolverine has been on my mind and i wrote all of these late at night </3 sorry if i misspelled anything !!
Masterlist
- she loves you so so so much omg she will do anything for you
- she’s the ‘hands in her pockets, scowling at everyone and only smiling softly at you when you talk to her’ kinda girlfriend
- she loves buying you things. even if you glance at something for a few seconds longer, it’s already in her hands and she’s at the register
- she loves when you sit on her lap or between her thighs where your back is to her chest, no matter your size. sometimes when you walk into the room, she looks up at you and just man spreads so you can fit in her lap
- to get her attention right away, pull on her belt or jean belt loops; she’s full attention on you and only you for the rest of the night
- when she comes home to you, she loves to shove her face in your chest and just inhale deeply. bonus points if you’re wearing a tank top where she can feel your skin on hers
- she’s a big chest person; always grabbing at you (it doesn’t matter if you do or don’t have a chest for her to grab, she’ll find a way. TRUST.)
- she loves when you get your nails done because then she gets to feel your nails on her skin and scratching her scalp when you drift off to sleep. she loves it when you slowly drag your nails up and down her arms when you cuddle
- she hates baths… unless you’re with her. she’s usually behind you while you lay your back to her chest, her arms resting on the sides of the tub as she drinks a beer and you with a mug / cup of your drink of choice
- you definitely have matching stuff. matching keychains, matching necklaces, matching bracelets. she’ll even let you paint her nails black just to match with whatever color you like
- even if she loves treating and pampering you, pls do it to her too !! she will melt immediately and become a big purring mess
“you always treatn’ me so well… my good girl.” she mumbles into your chest, sneaking her hands up your shirt to rub mindlessly at your stomach. you hum with a smile when you feel her hands; she’s always a sucker for skin to skin. you run your fingers through her hair.
“you always treat me so well, Lo. you deserve some love too.”
- i just wanna be called “good girl” by fem Logan, pls.
Tumblr media
145 notes · View notes
kazoosandfannypacks · 10 months ago
Text
Tumblr media
summary: percy finds a new favorite song
word count: 415 words
a/n: "hey juliet" by tufts beelzebubs has been on my percabeth playlist and lives rent free in my mind, so i decided to write a tiny little thing about percy with this song, set probably somewhere in between the second and fourth book. ideally, you could even listen to the song while you read the fic.
taglist: @laughingphoenixleader @jedi-nurse {if you’d like to be added to my percabeth/pjo taglist, let me know!}
also on ao3!
Hey Juliet
 Percy didn't usually listen to this kind of music, but this song in particular caught his attention.
 That's a huge deal, actually, at least for Percy. Not a lot of things could reliably catch or hold his attention. Usually he'd start listening to a song, and then his mind would wander, and then he'd find himself seven tracks ahead of where he was without having even noticed a thing about the songs he missed.
 But Hey Juliet by Tufts Beelzebubs was apparently an exception.
 He wouldn't go telling any of his friends that he liked a capella music now. At that point, just tell your friends you sing Broadway hits with your mom and watch opera on the weekends; you'll spare yourself some embarrassment.
 But this a capella song was a bit different. It was fast. It had a good beat. The audio had multiple parts to listen to— several people singing or making background noises at once, and the fact that there were multiple things to focus on held Percy's attention. He'd often throw it into the background on loop when he was doing his homework, giving him something to occupy the back of his brain while the front of his brain focused on his studies.
 But every now and then, he'd stop his work and listen to the words.
 "I just want you to know, I wanna be your Romeo. Hey, Juliet…"
 "I never got the big deal with Romeo and Juliet anyways," Percy mumbled, "some guy wrote a hard-to-read-play about two people who love each other so much that they die? What's the point?"
 But he knew there was a little more to it than that. Something about Romeo and Juliet's parents hating each other, but that those two main characters loved each other anyways, which apparently was interesting to most people.
 Percy Jackson, however, was not like most people.
 "That's actually ridiculous," Percy thought, "that would be like if I fell in love with the kid of one of my dad's rivals, like... like one of Athena's kids… like… oh shoot."
 He winced as one of Athena's kids came to mind: Annabeth Chase.
 "Yeah," he thought, "it would be as ridiculous as me falling in love with Annabeth."
 But ever since that moment, every time Hey Juliet came on, he found himself with another thing to focus on— the thought of Annabeth smiling at him, and the idea that maybe having a Juliet wouldn't be such a bad thing after all.
26 notes · View notes
qrfit · 5 months ago
Text
Tumblr media
Day 1 of 5 day workout week:
It’s only Monday and this week already started off challenging. I developed some upper back spasms over the weekend and had to rest and use anti-inflammatories and relaxers. This has happened in the past. Some rest works well in the beginning for this, but too much can actually cause stiffness. So, eventually, I needed to get moving again! By this morning, I felt much better, but I was extremely cautious with the weight training.
-I reduced the load and reps. I did no bent-over rows or pushups. I tried to avoid anything too jarring. I also used resistance loops and ankle weights for lower body, instead of weighted lunges and squats. I put in 30 minutes of good work here! 💪🏽
-I also nixed kickboxing, as jabs and punches were contraindicated. I chose step aerobics instead and modified any movement that I felt could aggravate things.
Total calorie burn = 415 kcals 😊
All in all, I managed through! We’ll see how I feel tomorrow. Hopefully, things continue to improve and I can continue to progress. 🙏🏽 For those of us dealing with this heat wave, stay safe out there! 🫶🏽
7 notes · View notes
lanshappycorner · 1 year ago
Note
Trick or treat!! :)
Tumblr media
💌 omg a cat!!! For you I have something extra special
Tumblr media
GE SIGNA 3.0T
The 2009 GE Signa 3.0T MRI machine will provide you a new range of diagnostic capability for whole body. Each GE Signa 3.0T MRI system is equipped with the widest range of advanced clinical applications possible to accommodate an array diagnostic challenges.
Specifications: 
- Field Strength: 3.0T
- Configuration: Cylindrical - high homogeneity;
- Synchronization: Respiratory Gating, ECG/Peripheral;
- Imaging modes: Cine, Multi-Slab, POMP, Fast, Volume, Multi Slice, Single;
- FOV: 1 cm - 40 cm continuous;
- Magnet type: Superconducting;
- Bore diameter: 55cm;
- Magnet weight: 15102 kg incl. cryogens;
- Dimension: 260 x 238 x 265 cm;
- Power requirements: 480 or 380/415 V, 3-phase II;
- Cooling system: Closed-Loop Water Cooled;
- Cryogen Use: Less than 0.14 L/hr liquid He;
- Strength: 40 mT/m;
- 5 Guass Fringe Field: 5.4 m x 3.2 m
4 notes · View notes
maniculum · 2 years ago
Text
New episode! The text we're looking at is not what you'd call a literary masterpiece, but I think it's so bad that it loops around to being funny. Also Zoe's incredulous exclamations during the plot summary make it worth it.
Ever wonder what would happen if a medieval priest challenged a group of pagans to a god-off? Well, in this episode, we're diving into Sidrak and Bokkus, a lyrical poem of 415 questions and answers to the universe, framed by Sidrak, the Christian paragon, destroying a group of pagan priests with Facts and Logic (TM). We're more than confused by his approach, but hey, at least he makes his point with pizzazz!
Join our discord community! Support us on patreon! Check out our merch!
Socials: Website Twitter Instagram Facebook
4 notes · View notes
cinnabar-music · 2 years ago
Text
fear and anxiety
putting yourself out there is horrifying. the idea of actual people seeing something ive written or made is nightmare inducing. i understand that fear or anxiety is an integral part of the process in making something that's actually decent, but the fear of publicly making a mistake kind of makes me, and im sure plenty of others, want to curl up into a ball and pretend you don't exist. fear can stop you from making mistakes but it can also stop you from making something you can be proud of, something meaningful.
creating something, especially from scratch, you are absolutely going to make mistakes. you're going to make really stupid mistakes. somehow you have to continue on. for someone like me that struggles with the idea of being seen out of fear that ill make a stupid mistake that ill never be able to live down its important to find a way to be semi ok with that potentially happening. in my opinion there's a few things you can do with fear; when it comes to music there's 3.
1.) you can take all the fear and anxiety and put it into your song. plenty of amazing artists have expressed their fears, in creating music, in daily problems, and in the general nightmares of our dystopian lives, into their music and arts. it makes for an amazing motivator and brings life to your art.
2.) exposure therapy. make something you know will not be good. a silly song you can make fun of for years to come in a healthy "i meant to do this" way. personally i like to go into garageband, go to loops, and select loops at random and see if i can make a song out of the loops i end up with. it rarely turns out good but its always fun to mess around with. another thing i do is make a song that is purposefully bad, either mixing songs that sound horribly chaotic together or write a song that just objectively makes no sense. then there's no pressure to be good and you can get straight to having fun while still furthering your skill-set.
3.) wither up and cry from the sheer stress of it all.
not recommended.
today i decided to go with exposure therapy and made a song with random loops
youtube
personally i think it needs a lot of work but there's parts i really like, i might revisit this and make it into something that's actually decent.
[415]
2 notes · View notes
teawiththespleen · 2 years ago
Text
AAAAAAA went back to the website i used to play loop the loop/slitherlink on and
Tumblr media
415 T-T days
2 notes · View notes
solitaryspoonsofficial · 9 months ago
Text
The Second Cast aka, The Girls
Tumblr media Tumblr media Tumblr media Tumblr media
( art by @scoutthegoose )
9 notes · View notes
scoutthegoose · 11 months ago
Text
Tumblr media Tumblr media Tumblr media
drawing my au designs for all of them. please appreciate Them
9 notes · View notes
jobprofessionalscentralfl · 2 months ago
Text
youtube
Welcome to Job Professionals of Central Florida! If you're looking for a trusted partner for Mims kitchen remodeling, you've come to the right place. Our team is dedicated to transforming kitchens into beautiful, functional spaces that meet your unique needs. We know how important it is for your kitchen to reflect your style, and that's why we focus on delivering results that exceed your expectations.
At Job Professionals of Central Florida, we have more than ten years of experience in the industry, making us your go-to kitchen remodeling contractor Mims residents rely on. Our services are designed to meet all your kitchen renovation needs. Whether you need new cabinets or a complete makeover, our team is here to help. We offer a wide range of services, from remodeling kitchen cabinets Mims residents love to full-scale renovations. No project is too big or small for our dedicated professionals!
🌟 What makes us different? Here’s why you should choose us for your next kitchen renovation Mims project:
🛠 Customized Solutions: We provide tailored remodeling plans that fit your style, space, and budget, ensuring your kitchen looks just the way you want.
🗓 Timely Completion: We respect your time. Our team ensures that every project is completed on schedule, allowing you to enjoy your new kitchen as soon as possible.
💰 Affordable Pricing: Our pricing is competitive without compromising on quality. We believe in offering great value for every dollar you spend.
🏠 Wide Range of Services: As a top kitchen remodeling company Mims, we offer everything from cabinet upgrades to complete kitchen transformations.
👷 Skilled Craftsmanship: Our craftsmen have a keen eye for detail, ensuring every aspect of your remodel is executed flawlessly. From Mims kitchen cabinet renovation to full redesigns, we take pride in our work.
✅ Customer Satisfaction: We prioritize your satisfaction above all else. Our collaborative approach means you'll always be in the loop, and we won’t rest until you're thrilled with the results.
We understand that your kitchen is more than just a place to cook. It's where memories are made, where families gather, and where creativity thrives. That's why we are committed to offering kitchen remodeling services Mims can count on for quality and reliability. We’re not just any Mims kitchen remodeler; we’re a partner who understands the value of your home.
Ready to transform your kitchen? Don’t wait! Reach out to Job Professionals of Central Florida today. Let us show you why we’re the trusted name in kitchen and bathroom remodeling Mims residents choose time and time again. Contact us now to schedule your free consultation and take the first step toward the kitchen of your dreams. Your perfect kitchen awaits—let's build it together!
Contact us:
Job Professionals of Central Florida 2428 US-1, Mims FL 32754 321-415-9633
Find us online: 
Our Website: https://jobpros.biz/ 
Google Maps: https://www.google.com/maps/place/?cid=14007100303419405799 
Facebook: https://www.facebook.com/jpcfl/ 
Pinterest: https://www.pinterest.com/jobprofessionalscentralflorida/ 
Yelp: https://www.yelp.com/biz/job-professionals-of-central-florida-mims 
Waze: https://www.waze.com/en/live-map/directions/us/fl/mims/job-professionals-of-central-florida?to=place.ChIJxXDhSkxL54gR53WUXoM3Y8I 
Proven Expert: https://www.provenexpert.com/job-professionals-of-central-florida/ 
Best Local Contractors: https://bestlocal.contractors/contractor/job-professionals-of-central-florida/ 
0 notes
insightfulblogz · 3 months ago
Text
Telecom Power System Market by Top Key Players, Types, Applications and Future Forecast to 2032
The Telecom Power System Market is Witnessing Steady Growth, Fueled by the Increasing Demand for Reliable Power Solutions in Telecommunications Networks. The latest telecom power system market research report provides a comprehensive analysis of key factors driving the industry, including emerging trends, growth opportunities, challenges, and technological innovations.
Telecom power systems are crucial for ensuring uninterrupted power supply to telecommunications equipment, which is essential for maintaining the reliability and efficiency of networks. With the rapid expansion of mobile communication infrastructure and the advent of 5G technology, the demand for advanced power solutions is on the rise. Additionally, the growing emphasis on renewable energy sources and energy-efficient solutions is further propelling the market forward.
Request a Free Sample Report: https://www.snsinsider.com/sample-request/1565 
Competitive Landscape
A detailed examination of the competitive landscape reveals the key players leading the telecom power system market. These companies are at the forefront of innovation, continuously enhancing their product offerings to meet the evolving needs of the telecommunications sector. Insights into their market share, product portfolios, financial performance, and strategic initiatives are included in the report.
Key companies operating in the telecom power system market include:
Alpha Technologies, Services, Inc.
Eaton
Emerson Network Power
Schneider Electric
Mitsubishi Electric Corporation
Delta Electronics
Ascot
GE Industrial Solutions
Huawei Technologies Co., Ltd.
Microtek International Inc
ZTE Corporation
Market Segmentation
The telecom power system market can be segmented based on several criteria, providing a clearer understanding of market dynamics and growth potential. This segmentation includes:
BY PRODUCT
AC Power Systems
DC Power Systems
Digital Electricity
BY COMPONENT
Rectifiers
Convertors
Heat Management Systems
Inverters
Generators
Others
BY GRID TYPE
On-Grid
Off-Grid
Bad Grid
BY POWER SOURCE
Diesel-Battery
Diesel-Wind
Diesel-Solar
Other Sources
Regional Insights
The report offers an extensive analysis of the telecom power system market across key regions. North America is expected to lead the market due to the presence of established telecommunications infrastructure and significant investments in network upgrades. The Asia-Pacific region is projected to experience rapid growth, driven by increasing mobile subscriptions and the expansion of telecommunication networks in emerging economies.
Buy Now: https://www.snsinsider.com/checkout/1565 
Key Questions Addressed
What are the main factors driving growth in the telecom power system market?
How are advancements in technology influencing the development of telecom power solutions?
What challenges do manufacturers face in this evolving market?
Which regions are expected to see the highest demand for telecom power systems in the coming years?
窗体顶端
窗体底端
Related Report:
Rugged Tablet Market Size
Industrial Gas Sensors Market Size
High Voltage Interlock Loop (HVIL) Connector Market Size
Distributed Fiber Optic Sensor Market Size
About Us:
SNS Insider is one of the leading market research and consulting agencies that dominates the market research industry globally. Our company’s aim is to give clients the knowledge they require in order to function in changing circumstances. In order to give you current, accurate market data, consumer insights, and opinions so that you can make decisions with confidence, we employ a variety of techniques, including surveys, video talks, and focus groups around the world.
Contact Us:
Akash Anand - Head of Business Development & Strategy
Phone: +1–415–230–0044 (US) | +91–7798602273 (IND) 
0 notes
haanhhuynh · 9 months ago
Text
Digital Citizenship in the Age of Social Media: Navigating the Impact on Political Engagement
Tumblr media
In our rapidly evolving digital age, the concept of digital citizenship has become increasingly crucial, especially as social media plays a significant role in shaping the dynamics of political engagement. Digital citizenship is defined as “those who use the Internet regularly and effectively” (Mossberger, Tolbert & Mcneal 2010). A digital citizen should possess characteristics that include a comprehensive understanding of human, cultural, and societal issues related to technology, associated with the commitment to practising legal and ethical behavior (Ribble 2008).
Social media, acting as a catalyst for change, serves as a powerful tool for informed political political news (Zhuravskaya, Petrova & Enikolopov 2020). Digital citizens use quick access to information to stay in the loop about what's happening worldwide, breaking down distance barriers and creating connections. It's important to use this ability responsibly, especially when keeping up with political news.
However, challenges arise in the form of algorithmic echo chambers that reinforce biases, threatening the principles of digital citizenship. Responsible online engagement demands that citizens break free from these bubbles, actively seeking diverse perspectives, and participating in open dialogues to reduce disagreement. Additionally, according to Papakyriakopoulos, Serrano and Hegelich (2020), people who participate in online discussions, expressing their opinions, have the power to shape how others, both active and passive users, understand political information. They can also directly impact the actions of political figures.
On the other hand, while certain studies suggest that using social media for news has a positive impact on democracy, encouraging political engagement, other research indicates a negative influence as it contributes to the dissemination of misinformation (Valenzuela et al. 2019). For this reason, digital citizens must be vigilant in critically evaluating information, fact-checking, and resisting the potential manipulation that threatens the integrity of democratic discourse.
Despite these challenges, social media remains a powerful tool for political mobilization, requiring digital citizens to engage responsibly. Grassroots movements, fueled by hashtag activism, exemplify the positive impact of digital citizenship in mobilizing individuals worldwide to advocate for change. The dissemination of information to a broad audience empowers citizens, fostering active engagement in shaping the narratives within the political sphere.
In conclusion, the multifaceted impact of social media on political engagement underscores the need for a strong foundation in digital citizenship. Being responsible digital citizens involves navigating the digital landscape with a critical eye, actively participating in diverse dialogues, and leveraging the power of social media to contribute positively to the democratic discourse of our times.
Tumblr media
Reference list
Mossberger, K, Tolbert, CJ & Mcneal, RS 2010, Digital citizenship : the internet, society, and participation, Mit Press, Cambridge, Mass.
Papakyriakopoulos, O, Serrano, JCM & Hegelich, S 2020, ‘Political communication on social media: A tale of hyperactive users and bias in recommender systems’, Online Social Networks and Media, vol. 15, p. 100058.
Ribble, M 2008, Passport to Digital Citizenship, viewed <https://elem.hcdsb.org/stbernadette/wp-content/uploads/sites/30/2019/05/Passport-to-Digital-Citizenship-article.pdf>.
Valenzuela, S, Halpern, D, Katz, JE & Miranda, JP 2019, ‘The Paradox of Participation Versus Misinformation: Social Media, Political Engagement, and the Spread of Misinformation’, Digital Journalism, vol. 7, no. 6, pp. 802–823.
Zhuravskaya, E, Petrova, M & Enikolopov, R 2020, ‘Political effects of the internet and social media’, Annual Review of Economics, vol. 12, no. 1, pp. 415–438.
1 note · View note
theboardwalkbody · 2 years ago
Text
Time to play:Is it Taltz causing my immune system to fail or is it Normal?
Two weeks ago I had sinusitis symptoms. Took antibiotics and it helped.
That same weekend I ended up in the hospital with what turned out to be a bladder infection (which I had 0 symptoms of prior to the extreme pain it ended up causing) and, according to the scan at the hospital I also have a cyst of "significant size" on my ovary which between that and the swollen bladder have been working together to cause chaos.
Plus I got a cold sore. My paternal grandmother got them all the time and passed them to my sister and I as babies and sometimes if I've been sick enough they come out. It's had me in a bad place mentally because of my own personal feelings about it.
Still battling some issues with that despite the antibiotics but now I'm not sure if it's infection or just the cyst.
Now last Friday I woke up with a sore throat and mild congestion. Over the weekend both things have been getting worse.
I couldn't sleep At All last night. I tried going to bed around midnight but my throat was so dry and my sinuses hurt I was too uncomfortable and just kept tossing and turning until about 230. At that point I remembered the window was open and thought maybe the dry air coming in was causing it so I shut it. It helped a little. I wanted to drink something but I've been hesitant since the bladder issues are worse at night and it makes me not want to drink anything.
I tried to do some day dreaming hoping it would lead to real dreaming and it did but only for about 40 minutes.
From 315 to 415 I once again struggled with the intense dry throat and pain.
Now from 415 to 6 I couldn't shut my brain up. Intense racing thoughts and anxiety related to work.
I missed work last Monday because of the bladder stuff. I was in so much pain and had added nausea from the antibiotics.
I was supposed to start a new case today, a new patient's first day with our company. I really wanted this case for a few different reasons and I think it would be a really good fit.
But I've been awake all night, I feel run down, I feel hot, my throat is hurting, my sinuses are burning, I feel so tired.
They said it's OK and to feel better when I called (finally made the decision at like 615 because I was supposed to be up and getting ready to leave for 730) but I feel so guilty. I feel like it reflects bad on me and the company and it's day one and I really wanted this case and I hope they don't take me off it for good because of this and idk.
I spent hours beating myself up over it before I called and now I'm still beating myself up over it. Despite knowing I'd be suffering during a full 8hr hands on shift with the night I had and how I feel in general because of whatever is going on.
So I'm kinda miserable all around.
I keep trying to convince myself it's just allergies. Because the pollen and the blooming trees, and the change of weather, etc. But I took allergy meds and they didn't do anything. I took the 24hr pseudoephedrine and still nothing. I think it's either the sinus infection has come back or maybe it's a new one, or possibly tonsillitis because on Saturday I did have some spots on my tonsils (I get tonsil stones though and because of my cold sore I didn't poke around at them to see if it was stones or not) and they are swollen (which for me is normal anymore but they look extra swollen and red now).
So idk.
Part of me wants to be like que cera, cera
But the bigger part of me (where the anxiety and mental health issues live) is going to beat myself up over today.
My Lola knows I'm not feeling great and I'm upset because, despite the fan being on which she doesn't enjoy, she jumped down from her loop/perch and is laying on the bed with me (she did use the opportunity to scratch the curtain, though). She's going to snuggle with me and then get zoomies. It is prime for zoomies.
0 notes
moremedtech · 2 years ago
Text
Artificial pancreas successfully trialed for use by patients living with type 2 diabetes
Tumblr media
Cambridge scientists successfully trialed Artificial pancreas for use by patients living with type 2 diabetes. Cambridge scientists have successfully trialed an artificial pancreas for use by patients living with type 2 diabetes. The device – powered by an algorithm developed at the University of Cambridge – doubled the amount of time patients were in the target range for glucose compared to standard treatment and halved the time spent experiencing high glucose levels. Around 415 million people worldwide are estimated to be living with type 2 diabetes, which costs around $760 billion in annual global health expenditure. According to Diabetes UK, in the UK alone, more than 4.9million people have diabetes, of whom 90% have type 2 diabetes, and this is estimated to cost the NHS £10bn per year. Type 2 diabetes causes levels of glucose – blood sugar – to become too high. Ordinarily, blood sugar levels are controlled by the release of insulin, but in type 2 diabetes insulin production is disrupted. Over time, this can cause serious problems including eye, kidney and nerve damage and heart disease. The disease is usually managed through a combination of lifestyle changes – improved diet and more exercise, for example – and medication, with the aim of keeping glucose levels low. Researchers from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge have developed an artificial pancreas that can help maintain healthy glucose levels. The device combines an off-the-shelf glucose monitor and insulin pump with an app developed by the team, known as CamAPS HX. This app is run by an algorithm that predicts how much insulin is required to maintain glucose levels in the target range. The researchers have previously shown that an artificial pancreas run by a similar algorithm is effective for patients living with type 1 diabetes, from adults through to very young children. They have also successfully trialled the device in patients with type 2 diabetes who require kidney dialysis. Today, in Nature Medicine, the team report the first trial of the device in a wider population living with type 2 diabetes (not requiring kidney dialysis). Unlike the artificial pancreas used for type 1 diabetes, this new version is a fully closed loop system – whereas patients with type 1 diabetes need to tell their artificial pancreas that they are about to eat to allow adjustment of insulin, for example, with this version they can leave the device to function entirely automatically. The researchers recruited 26 patients from the Wolfson Diabetes and Endocrine Clinic at Addenbrooke’s Hospital, part of Cambridge University Hospitals NHS Foundation Trust, and a local group of GP surgeries. Patients were randomly allocated to one of two groups – the first group would trial the artificial pancreas for eight weeks and then switch to the standard therapy of multiple daily insulin injections; the second group would take this control therapy first and then switch to the artificial pancreas after eight weeks. The team used several measures to assess how effectively the artificial pancreas worked. The first was the proportion of time that patients spent with their glucose levels within a target range of between 3.9 and 10.0mmol/L. On average, patients using the artificial pancreas spent two-thirds (66%) of their time within the target range – double that while on the control (32%). A second measure was the proportion of time spent with glucose levels above 10.0mmol/L. Over time, high glucose levels raise the risk of potentially serious complications. Patients taking the control therapy spent two-thirds (67%) of their time with high glucose levels – this was halved to 33% when using the artificial pancreas. Average glucose levels fell – from 12.6mmol/L when taking the control therapy to 9.2mmol/L while using the artificial pancreas. The app also reduced levels of a molecule known as glycated hemoglobin, or HbA1c. Glycated hemoglobin develops when hemoglobin, a protein within red blood cells that carries oxygen throughout the body, joins with glucose in the blood, becoming ‘glycated’. By measuring HbA1c, clinicians are able to get an overall picture of what a person's average blood sugar levels have been over a period of weeks or months. For people with diabetes, the higher the HbA1c, the greater the risk of developing diabetes-related complications. After the control therapy, average HbA1c levels were 8.7%, while after using the artificial pancreas they were 7.3%. No patients experienced dangerously low blood sugar levels (hypoglycemia) during the study. One patient was admitted to hospital while using the artificial pancreas, due to an abscess at the site of the pump cannula. Many people with type 2 diabetes struggle to manage their blood sugar levels using the currently available treatments, such as insulin injections. The artificial pancreas can provide a safe and effective approach to help them Dr Charlotte Boughton from the Wellcome-MRC Institute of Metabolic Science at the University of Cambridge, who co-led the study, said “One of the barriers to widespread use of insulin therapy has been concern over the risk of severe ‘hypos’ – dangerously low blood sugar levels. But we found that no patients on our trial experienced these and patients spent very little time with blood sugar levels lower than the target levels.” Dr Aideen Daly, also from the Wellcome-MRC Institute of Metabolic Science, said Feedback from participants suggested that participants were happy to have their glucose levels controlled automatically by the system, and nine out of ten (89%) reported spending less time managing their diabetes overall. Users highlighted the elimination of the need for injections or fingerprick testing, and increased confidence in managing blood glucose as key benefits. Downsides included increased anxiety about the risk of hypoglycemia, which the researchers say may reflect increased awareness and monitoring of glucose levels, and practical annoyances with wearing of devices. The team now plan to carry out a much larger multicenter study to build on their findings and have submitted the device for regulatory approval with a view to making it commercially available for outpatients with type 2 diabetes. The research was supported by the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre. Reference Daly, AB, Boughton, CK, et al. Fully automated closed-loop insulin delivery in adults with type 2 diabetes: an open-label, single-centre randomised crossover trial. Nat Med; 11 Jan 2023; DOI: 10.1038/s41591-022-02144-z Source: University of Cambridge Read the full article
0 notes