Micro-needle implantable electrochemical oxygen sensor: ex-vivo and in-vivo studies

Recent advances in materials and manufacturing of implantable devices for continuous health monitoring

Implantable devices are vital in healthcare, enabling continuous monitoring, early disease detection, informed decision-making, enhanced outcomes, cost reduction, and chronic condition management. These devices provide real-time data, allowing proactive healthcare interventions, and contribute to overall improvements in patient care and quality of life. The success of implantable devices relies on the careful selection of materials and manufacturing methods. Recent materials research and manufacturing advancements have yielded implantable devices with enhanced biocompatibility, reliability, and functionality, benefiting human healthcare. This paper provides a comprehensive overview of the latest developments in implantable medical devices, emphasizing the importance of material selection and manufacturing methods, including biocompatibility, self-healing capabilities, corrosion resistance, mechanical properties, and conductivity. It explores various manufacturing techniques such as microfabrication, 3D printing, laser micromachining, electrospinning, screen printing, inkjet printing, and nanofabrication. The paper also discusses challenges and limitations in the field, including biocompatibility concerns, privacy and data security issues, and regulatory hurdles for implantable devices.

Exploring role of microbatteries in enhancing sustainability and functionality of implantable biosensors and bioelectronics

Microbatteries are emerging as a sustainable, miniaturized power source, crucial for implantable biomedical devices. Their significance lies in offering high energy density, longevity, and rechargeability, facilitating uninterrupted health monitoring and treatment within the body. The review delves into the development of microbatteries, emphasizing their miniaturization and biocompatibility, crucial for long-term, safe in-vivo use. It examines cutting-edge manufacturing techniques like physical and chemical vapor deposition, and atomic layer deposition, essential for the precision manufacture of the microbatteries. The paper contrasts primary and secondary batteries, highlighting the advantages of zinc-ion and magnesium-ion batteries for enhanced stability and reduced reactivity. It also explores biodegradable batteries, potentially obviating the need for surgical extraction post-use. The integration of microbatteries into diagnostic and therapeutic devices is also discussed, illustrating how they enhance the efficacy and sustainability of implantable biosensors and bioelectronics.

Asthma management in the digital age

Asthma affects 25 million people in the United States, and its prevalence is increasing. Access to care and adherence to prescribed asthma-treatment programs remain the principal formidable challenges for asthma management. Telemedicine offers substantial opportunities for improved asthma care of patients across the full range of socioeconomic strata. Ever-improving digital tools for asthma assessment and treatment are key components of telemedicine platforms for asthma management. These include a variety of remote patient-monitoring devices, digital inhaler systems, and mobile-health applications that facilitate ongoing assessment and adherence to treatment protocols. Digital tools for monitoring treatment focus on tracking medication use, inhalation technique, and physiological markers such as peak-flow rate and pulse-oximetry. Telemedicine visits allow for elements of assessment via video, approximating or duplicating many aspects of in-person visits, such as evaluating a patient's general appearance, breathing effort, and cough. Challenges remain in ensuring equitable access to these technologies, especially in rural and low-income areas, and in maintaining patient privacy and data security in digital platforms.

Investigation of biosensing properties in magnetron sputtered metallized UV-curable polymer microneedle electrodes

Direct management and assessment of metal film properties applied to polymer microneedle (MN) biosensors remains difficult due to constraints inherent to their morphology. By simplifying the three-dimensional structure of MNs and adjusting the deposition time, different thicknesses of Au films were deposited on the UV-cured polymer planar and MN substrates. Several properties relevant to the biosensing of the Au films grown on the polymer surfaces were investigated. The results demonstrate the successful deposition of pure and stable Au nanoparticles onto the surface of UV-curable polymer materials. Initially, Au islands formed within the first minute of deposition; however, as the sputtering time extended, these islands transformed into Au nanoparticle films and disappeared. The hydrophilicity of the surface remains unchanged, while the surface resistance of the thin film decreases with increasing thickness, and the adhesion to the substrate decreases as the thickness increases. In short, a sputtering time of 5-6 min results in Au films with a thickness of 100-200 nm, which exhibit exceptional comprehensive biosensing performance. Additionally, MNs made of Au/UV-curable polymers and produced using magnetron sputtering maintain their original shape, enhance their mechanical characteristics, and gain new functionalities. The Au/UV-curable polymer MNs exhibited remarkable electrode performance despite being soaked in a 37 °C PBS solution for 14 days. These discoveries have important implications in terms of decreasing the dependence on valuable metals in MN biosensors, lowering production expenses, and providing guidance for the choice and design of materials for UV-curable polymer MN metallization films.

Two Decades' advancements and Research trends in needle-type Sensor technology: A scientometric analysis

Needle-type sensor, characterized by its slender, elongated shape, is a promising sensing method due to its rapid response, high sensitivity, and portability. Recently, the needle-type sensor technology has garnered increasing attention, leading to its accelerated development and extensive use in medical and healthcare, environmental monitoring, and geosciences. However, there remains a need for a comprehensive review of existing research. Here, we utilize scientometric analysis, which is booming recently, to conduct a comprehensive investigation of the needle-type sensor field. This analysis covers various aspects, including annual trends, journals, institutions, countries, disciplines, authors, references, and keywords of 136,667 publications from the Web of Science Core Collection (WoSCC) database spanning from January 1, 2004, to January 1, 2024. Additionally, we identify current hotspots, frontiers, and predict future trends. Eventually, three research hotspots are refined: multidisciplinary materials science, sensor miniaturization and integration, and biomedical engineering, indicating that further investigations may focus on creating biocompatible materials to enhance sensing properties, optimizing sensor structure through miniaturization and integration methods, and improving clinical applications in biomedical engineering. This work may facilitate the development of needle-type sensors.

[Ru(dpp)3 ]Cl2 -Embedded Oxygen Nano Polymeric Sensors: A Promising Tool for Monitoring Intracellular and Intratumoral Oxygen Gradients with High Quantum Yield and Long Lifetime

Unraveling the intricacies between oxygen dynamics and cellular processes in the tumor microenvironment (TME) hinges upon precise monitoring of intracellular and intratumoral oxygen levels, which holds paramount significance. The majority of these reported oxygen nanoprobes suffer compromised lifetime and quantum yield when exposed to the robust ROS activities prevalent in TME, limiting their prolonged in vitro usability. Herein, the ruthenium-embedded oxygen nano polymeric sensor (Ru-ONPS) is proposed for precise oxygen gradient monitoring within the cellular environment and TME. Ru-ONPS (≈64±7 nm) incorporates [Ru(dpp)3 ]Cl2 dye into F-127 and crosslinks it with urea and paraformaldehyde, ensuring a prolonged lifetime (5.4 µs), high quantum yield (66.65 ± 2.43% in N2 and 49.80 ± 3.14% in O2 ), superior photostability (>30 min), and excellent stability in diverse environmental conditions. Based on the Stern-Volmer plot, the Ru-ONPS shows complete linearity for a wide dynamic range (0-23 mg L-1 ), with a detection limit of 10 µg mL-1 . Confocal imaging reveals Ru-ONPS cellular uptake and intratumoral distribution. After 72 h, HCT-8 cells show 5.20±1.03% oxygen levels, while NIH3T3 cells have 7.07±1.90%. Co-culture spheroids display declining oxygen levels of 17.90±0.88%, 10.90±0.88%, and 5.10±1.18%, at 48, 120, and 216 h, respectively. Ru-ONPS advances cellular oxygen measurement and facilitates hypoxia-dependent metastatic research and therapeutic target identification.

Intradermal Glycine Detection with a Wearable Microneedle Biosensor: The First In Vivo Assay

Glycine (GLY) is gaining importance in medical diagnoses due to its relationship with multiple physiological functions. Today, GLY is exclusively analyzed using instrumentation centralized in clinical labs, and a tangible point-of-care tool that gathers real-time data from the patient for effective and fast evaluations is lacking. Relevant clinical advances are expected as soon as the rapid provision of both punctual and continuous measurements is possible. In that context, this work presents a microneedle (MN)-based biosensor for intradermal GLY detection in interstitial fluid (ISF). The MN tip is externally tailored to detect GLY levels through the hydrogen peroxide formed in its reaction with a quinoprotein-based GLY oxidase enzyme. The analytical performance of the MN biosensor indicates a fast response time (<7 s); acceptable reversibility, reproducibility, and stability; as well as a wide linear range of response (25–600 μM) that covers the physiological levels of GLY in ISF. The MN biosensor conveniently exhibits high selectivity for GLY over other compounds commonly found in ISF, and the response is not influenced by temperature, pH, or skin insertions. Validated intradermal measurements of GLY were obtained at the in vitro (with pieces of rat skin), ex vivo (on-body tests of euthanized rats) and in vivo (on-body tests of anesthetized rats) levels, demonstrating its ability to produce accurate physiological data. The developed GLY MN biosensor is skin-wearable and provides reliable, real-time intradermal GLY measurements in ISF by means of a minimally invasive approach.

Hypoxia and hypoxia-inducible factor signals regulate the development, metabolism, and function of B cells

Hypoxia is a common hallmark of healthy tissues in physiological states or chronically inflamed tissues in pathological states. Mammalian cells sense and adapt to hypoxia mainly through hypoxia-inducible factor (HIF) signaling. Many studies have shown that hypoxia and HIF signaling play an important regulatory role in development and function of innate immune cells and T cells, but their role in B cell biology is still controversial. B cells experience a complex life cycle (including hematopoietic stem cells, pro-B cells, pre-B cells, immature B cells, mature naïve B cells, activated B cells, plasma cells, and memory B cells), and the partial pressure of oxygen (PO2) in the corresponding developmental niche of stage-specific B cells is highly dynamic, which suggests that hypoxia and HIF signaling may play an indispensable role in B cell biology. Based on the fact that hypoxia niches exist in the B cell life cycle, this review focuses on recent discoveries about how hypoxia and HIF signaling regulate the development, metabolism, and function of B cells, to facilitate a deep understanding of the role of hypoxia in B cell-mediated adaptive immunity and to provide novel strategies for vaccine adjuvant research and the treatment of immunity-related or infectious diseases.

Smart implanted access port catheter for therapy intervention with pH and lactate biosensors

Totally implanted access ports (TIAP) are widely used with oncology patients requiring long term central venous access for the delivery of chemotherapeutic agents, infusions, transfusions, blood sample collection and parenteral nutrition. Such devices offer a significant improvement to the quality of life for patients and reduced complication rates, particularly infection, in contrast to the classical central venous catheters. Nevertheless, infections do occur, with biofilm formation bringing difficulties to the treatment of infection-related complications that can ultimately lead to the explantation of the device. A smart TIAP device that is sensor-enabled to detect infection prior to extensive biofilm formation would reduce the cases for potential device explantation, whereas biomarkers detection within body fluids such as pH or lactate would provide vital information regarding metabolic processes occurring inside the body. In this paper, we propose a novel batteryless and wireless device suitable for the interrogation of such markers in an embodiment model of an TIAP, with miniature biochemical sensing needles. Device readings can be carried out by a smartphone equipped with Near Field Communication (NFC) interface at relative short distances off-body, while providing radiofrequency energy harvesting capability to the TIAP, useful for assessing patient's health and potential port infection on demand.

Biomedical polymers: synthesis, properties, and applications

Biomedical polymers have been extensively developed for promising applications in a lot of biomedical fields, such as therapeutic medicine delivery, disease detection and diagnosis, biosensing, regenerative medicine, and disease treatment. In this review, we summarize the most recent advances in the synthesis and application of biomedical polymers, and discuss the comprehensive understanding of their property-function relationship for corresponding biomedical applications. In particular, a few burgeoning bioactive polymers, such as peptide/biomembrane/microorganism/cell-based biomedical polymers, are also introduced and highlighted as the emerging biomaterials for cancer precision therapy. Furthermore, the foreseeable challenges and outlook of the development of more efficient, healthier and safer biomedical polymers are discussed. We wish this systemic and comprehensive review on highlighting frontier progress of biomedical polymers could inspire and promote new breakthrough in fundamental research and clinical translation.

Fast-Response Oxygen Optical Fiber Sensor based on PEA2 SnI4 Perovskite with Extremely Low Limit of Detection

Oxygen sensor is an important technique in various applications including industrial process control, medical equipment, biological fabrication, etc. The reported optical fiber-based configurations so far, using gas-sensitive coating do not meet the stringent performance targets, such as fast response time and low limit of detection (LOD). Tin-based halide perovskites are sensitive to oxygen with potential use for sensor applications. Here, the halide perovskite-based oxygen optical fiber sensor by combining phenylethylammonium tin iodide (PEA₂ SnI₄ ) and tilted fiber Bragg grating (TFBG) is demonstrated. The PEA₂ SnI₄ -based oxygen optical fiber sensor is reversible at room temperature with a response time of about 10 s, and the experimental LOD approaches to an extremely low oxygen concentration of about 50 ppm. The as-fabricated oxygen sensor shows a relative response change of 0.6 dB for an oxygen concentration increase from 50 ppm to 5% with good gas selection against NO₂ , CO, CO₂ , H₂ . This work extends the sensor applications of halide perovskites, providing a novel technique for rapid and repeatable oxygen gas detection at a low level.

Blood Oxygen Sensor Using a Boron-Doped Diamond Electrode

The electrochemical behavior of oxygen (O₂) in blood was studied using boron-doped diamond (BDD) electrodes. Cyclic voltammogram of O₂ in a 0.1 M phosphate buffer solution solution containing 1 × 10^-6 M of bovine hemoglobin exhibits a reduction peak at -1.4 V (vs Ag/AgCl). Moreover, the scan rate dependence was investigated to study the reduction reaction mechanism, which was attributable to the reduction of O₂ to H₂O₂ via two electrons. A linear calibration curve was observed in the concentration range of 86.88-314.63 mg L^-1 (R² = 0.99) with a detection limit of 1.0 mg L^-1 (S/B = 3). The analytical performance was better than those with glassy carbon or platinum electrodes as the working electrode. In addition, an application to bovine blood was performed. The O₂ concentration in the blood measured on the BDD electrodes was compared to that measured using an OxyLite Pro fiber-optic oxygen sensor device. Both methods gave similar values of the O₂ concentration in the range of ∼40 to 150 mmHg. This result confirms that BDD electrodes could potentially be used to detect the O₂ concentration in blood.

Detection of Hypoxia in Cancer Models: Significance, Challenges, and Advances

The rapid proliferation of cancer cells combined with deficient vessels cause regions of nutrient and O2 deprivation in solid tumors. Some cancer cells can adapt to these extreme hypoxic conditions and persist to promote cancer progression. Intratumoral hypoxia has been consistently associated with a worse patient prognosis. In vitro, 3D models of spheroids or organoids can recapitulate spontaneous O2 gradients in solid tumors. Likewise, in vivo murine models of cancer reproduce the physiological levels of hypoxia that have been measured in human tumors. Given the potential clinical importance of hypoxia in cancer progression, there is an increasing need to design methods to measure O2 concentrations. O2 levels can be directly measured with needle-type probes, both optical and electrochemical. Alternatively, indirect, noninvasive approaches have been optimized, and include immunolabeling endogenous or exogenous markers. Fluorescent, phosphorescent, and luminescent reporters have also been employed experimentally to provide dynamic measurements of O2 in live cells or tumors. In medical imaging, modalities such as MRI and PET are often the method of choice. This review provides a comparative overview of the main methods utilized to detect hypoxia in cell culture and preclinical models of cancer.

Fetal ischemia monitoring with in vivo implanted electrochemical multiparametric microsensors

Under intrauterine growth restriction (IUGR), abnormal attainment of the nutrients and oxygen by the fetus restricts the normal evolution of the prenatal causing in many cases high morbidity being one of the top-ten causes of neonatal death. The current gold standards in hospitals to detect this relevant problem is the clinical observation by echography, cardiotocography and Doppler. These qualitative techniques are not conclusive and requires risky invasive fetal scalp blood testing and/or amniocentesis. We developed micro-implantable multiparametric electrochemical sensors for measuring ischemia in real time in fetal tissue and vascular. This implantable technology is designed to continuous monitoring for an early detection of ischemia to avoid potential fetal injury. Two miniaturized electrochemical sensors were developed based on oxygen and pH detection. The sensors were optimized in vitro under controlled concentration, to assess the selectivity and sensitivity required. The sensors were then validated in vivo in the ewe fetus model, by means of their insertion in the muscle leg and inside the iliac artery of the fetus. Ischemia was achieved by gradually obstructing the umbilical cord to regulate the amount of blood reaching the fetus. An important challenge in fetal monitoring is the detection of low levels of oxygen and pH changes under ischemic conditions, requiring high sensitivity sensors. Significant differences were observed in both; pH and pO₂ sensors under changes from normoxia to hypoxia states in the fetus tissue and vascular with both sensors. Herein, we demonstrate the feasibility of the developed sensors for future fetal monitoring in medical applications.

Voltammetry in sheep's blood: Membrane-free amperometric measurement of O2 concentration

An amperometric method was applied for the electroanalytical measurement of oxygen content in sheep's blood. This method was based on a bare platinum microdisc electrode coupled with the use of chronoamperometry. A linear relationship between the chronoamperometric current and the oxygen concentration was observed in both saline solution and sheep's blood. The developed method was able to measure the oxygen percentage with an error of ca. 1.3% in sheep's blood. In addition, this article presents the first study on direct voltammetry in sheep's blood and a dissociative CE process was proposed to explain the electrochemical behaviour of oxygen reduction in blood on a platinum electrode in which the 'free' oxygen was first dissociated from oxyhaemoglobin prior to electron transfer with the magnitude of the observed current controlled by the diffusion of oxyhaemoglobin to the electrode where for sufficiently large electrodes (greater than ca. 1 μm in radius) the dissociation proceeds to completion on the voltammetric timescale allowing quantitative measurements.

Miniaturized Electrochemical Sensors to Monitor Fetal Hypoxia and Acidosis in a Pregnant Sheep Model

Perinatal asphyxia is a major cause of severe brain damage and death. For its prenatal identification, Doppler ultrasound has been used as a surrogate marker of fetal hypoxia. However, Doppler evaluation cannot be performed continuously. We have evaluated the performance of a miniaturized multiparametric sensor aiming to evaluate tissular oxygen and pH changes continuously in an umbilical cord occlusion (UCO) sheep model. The electrochemical sensors were inserted in fetal hindlimb skeletal muscle and electrochemical signals were recorded. Fetal hemodynamic changes and metabolic status were also monitored during the experiment. Additionally, histological assessment of the tissue surrounding the sensors was performed. Both electrochemical sensors detected the pO₂ and pH changes induced by the UCO and these changes were correlated with hemodynamic parameters as well as with pH and oxygen content in the blood. Finally, histological assessment revealed no signs of alteration on the same day of insertion. This study provides the first evidence showing the application of miniaturized multiparametric electrochemical sensors detecting changes in oxygen and pH in skeletal muscular tissue in a fetal sheep model.

Recent Advances in Microneedle-Based Sensors for Sampling, Diagnosis and Monitoring of Chronic Diseases

Chronic diseases (CDs) are noncommunicable illnesses with long-term symptoms accounting for ~70% of all deaths worldwide. For the diagnosis and prognosis of CDs, accurate biomarker detection is essential. Currently, the detection of CD-associated biomarkers is employed through complex platforms with certain limitations in their applicability and performance. There is hence unmet need to present innovative strategies that are applicable to the point-of-care (PoC) settings, and also, provide the precise detection of biomarkers. On the other hand, especially at PoC settings, microneedle (MN) technology, which comprises micron-size needles arranged on a miniature patch, has risen as a revolutionary approach in biosensing strategies, opening novel horizons to improve the existing PoC devices. Various MN-based platforms have been manufactured for distinctive purposes employing several techniques and materials. The development of MN-based biosensors for real-time monitoring of CD-associated biomarkers has garnered huge attention in recent years. Herein, we summarize basic concepts of MNs, including microfabrication techniques, design parameters, and their mechanism of action as a biosensing platform for CD diagnosis. Moreover, recent advances in the use of MNs for CD diagnosis are introduced and finally relevant clinical trials carried out using MNs as biosensing devices are highlighted. This review aims to address the potential use of MNs in CD diagnosis.

Recent Advances in In Vivo Neurochemical Monitoring

The brain is a complex network that accounts for only 5% of human mass but consumes 20% of our energy. Uncovering the mysteries of the brain's functions in motion, memory, learning, behavior, and mental health remains a hot but challenging topic. Neurochemicals in the brain, such as neurotransmitters, neuromodulators, gliotransmitters, hormones, and metabolism substrates and products, play vital roles in mediating and modulating normal brain function, and their abnormal release or imbalanced concentrations can cause various diseases, such as epilepsy, Alzheimer's disease, and Parkinson's disease. A wide range of techniques have been used to probe the concentrations of neurochemicals under normal, stimulated, diseased, and drug-induced conditions in order to understand the neurochemistry of drug mechanisms and develop diagnostic tools or therapies. Recent advancements in detection methods, device fabrication, and new materials have resulted in the development of neurochemical sensors with improved performance. However, direct in vivo measurements require a robust sensor that is highly sensitive and selective with minimal fouling and reduced inflammatory foreign body responses. Here, we review recent advances in neurochemical sensor development for in vivo studies, with a focus on electrochemical and optical probes. Other alternative methods are also compared. We discuss in detail the in vivo challenges for these methods and provide an outlook for future directions.

Non-invasive monitoring of pH and oxygen using miniaturized electrochemical sensors in an animal model of acute hypoxia

Background

One of the most prevalent causes of fetal hypoxia leading to stillbirth is placental insufficiency. Hemodynamic changes evaluated with Doppler ultrasound have been used as a surrogate marker of fetal hypoxia. However, Doppler evaluation cannot be performed continuously. As a first step, the present work aimed to evaluate the performance of miniaturized electrochemical sensors in the continuous monitoring of oxygen and pH changes in a model of acute hypoxia-acidosis.

Methods

pH and oxygen electrochemical sensors were evaluated in a ventilatory hypoxia rabbit model. The ventilator hypoxia protocol included 3 differential phases: basal (100% FiO₂), the hypoxia-acidosis period (10% FiO₂) and recovery (100% FiO₂). Sensors were tested in blood tissue (ex vivo sensing) and in muscular tissue (in vivo sensing). pH electrochemical and oxygen sensors were evaluated on the day of insertion (short-term evaluation) and pH electrochemical sensors were also tested after 5 days of insertion (long-term evaluation). pH and oxygen sensing were registered throughout the ventilatory hypoxia protocol (basal, hypoxia-acidosis, and recovery) and were compared with blood gas metabolites results from carotid artery catheterization (obtained with the EPOC blood analyzer). Finally, histological assessment was performed on the sensor insertion site. One-way ANOVA was used for the analysis of the evolution of acid-based metabolites and electrochemical sensor signaling results; a t-test was used for pre- and post-calibration analyses; and chi-square analyses for categorical variables.

Results

At the short-term evaluation, both the pH and oxygen electrochemical sensors distinguished the basal and hypoxia-acidosis periods in both the in vivo and ex vivo sensing. However, only the ex vivo sensing detected the recovery period. In the long-term evaluation, the pH electrochemical sensor signal seemed to lose sensibility. Finally, histological assessment revealed no signs of alteration on the day of evaluation (short-term), whereas in the long-term evaluation a sub-acute inflammatory reaction adjacent to the implantation site was detected.

Conclusions

Miniaturized electrochemical sensors represent a new generation of tools for the continuous monitoring of hypoxia-acidosis, which is especially indicated in high-risk pregnancies. Further studies including more tissue-compatible material would be required in order to improve long-term electrochemical sensing.

In vivo O2 imaging in hepatic tissues by phosphorescence lifetime imaging microscopy using Ir(III) complexes as intracellular probes

Phosphorescence lifetime imaging microscopy (PLIM) combined with an oxygen (O₂)-sensitive luminescent probe allows for high-resolution O₂ imaging of living tissues. Herein, we present phosphorescent Ir(III) complexes, (btp)₂Ir(acac-DM) (Ir-1) and (btp-OH)₃Ir (Ir-2), as useful O₂ probes for PLIM measurement. These small-molecule probes were efficiently taken up into cultured cells and accumulated in specific organelles. Their excellent cell-permeable properties allowed for efficient staining of three-dimensional cell spheroids, and thereby phosphorescence lifetime measurements enabled the evaluation of the O₂ level and distribution in spheroids, including the detection of alterations in O₂ levels by metabolic stimulation with an effector. We took PLIM images of hepatic tissues of living mice by intravenously administrating these probes. The PLIM images clearly visualized the O₂ gradient in hepatic lobules with cellular-level resolution, and the O₂ levels were derived based on calibration using cultured cells; the phosphorescence lifetime of Ir-1 gave reasonable O₂ levels, whereas Ir-2 exhibited much lower O₂ levels. Intravenous administration of NH₄Cl to mice caused the hepatic tissues to experience hypoxia, presumably due to O₂ consumption to produce ATP required for ammonia detoxification, suggesting that the metabolism of the probe molecule might affect liver O₂ levels.