Spectroscopic approach for dynamic bioanalyte tracking with minimal concentration information

Equivalent Electrical Circuit Approach to Enhance a Transducer for Insulin Bioavailability Assessment

The equivalent electrical circuit approach is explored to improve a bioimpedance-based transducer for measuring the bioavailability of synthetic insulin already presented in previous studies. In particular, the electrical parameter most sensitive to the variation of insulin amount injected was identified. Eggplants were used to emulate human electrical behavior under a quasi-static assumption guaranteed by a very low measurement time compared to the estimated insulin absorption time. Measurements were conducted with the EVAL-AD5940BIOZ by applying a sinusoidal voltage signal with an amplitude of 100 mV and acquiring impedance spectra in the range [1-100] kHz. 14 units of insulin were gradually administered using a Lilly's Insulin Pen having a 0.4 cm long needle. Modified Hayden's model was adopted as a reference circuit and the electrical component modeling the extracellular fluids was found to be the most insulin-sensitive parameter. The trnasducer achieves a state-of-the-art sensitivity of 225.90 ml1. An improvement of 223 % in sensitivity, 44 % in deterministic error, 7 % in nonlinearity, and 42 % in reproducibility was achieved compared to previous experimental studies. The clinical impact of the transducer was evaluated by projecting its impact on a Smart Insulin Pen for real-time measurement of insulin bioavailability. The wide gain in sensitivity of the bioimpedance-based transducer results in a significant reduction of the uncertainty of the Smart Insulin Pen. Considering the same improvement in in-vivo applications, the uncertainty of the Smart Insulin Pen is decreased from [Formula: see text]l to [Formula: see text]l.Clinical and Translational Impact Statement: A Smart Insulin Pen based on impedance spectroscopy and equivalent electrical circuit approach could be an effective solution for the non-invasive and real-time measurement of synthetic insulin uptake after subcutaneous administration.

A Single Wavelength Mid-Infrared Photoacoustic Spectroscopy for Noninvasive Glucose Detection Using Machine Learning

According to the International Diabetes Federation, 530 million people worldwide have diabetes, with more than 6.7 million reported deaths in 2021. Monitoring blood glucose levels is essential for individuals with diabetes, and developing noninvasive monitors has been a long-standing aspiration in diabetes management. The ideal method for monitoring diabetes is to obtain the glucose concentration level with a fast, accurate, and pain-free measurement that does not require blood drawing or a surgical operation. Multiple noninvasive glucose detection techniques have been developed, including bio-impedance spectroscopy, electromagnetic sensing, and metabolic heat conformation. Nevertheless, reliability and consistency challenges were reported for these methods due to ambient temperature and environmental condition sensitivity. Among all the noninvasive glucose detection techniques, optical spectroscopy has rapidly advanced. A photoacoustic system has been developed using a single wavelength quantum cascade laser, lasing at a glucose fingerprint of 1080 cm-1 for noninvasive glucose monitoring. The system has been examined using artificial skin phantoms, covering the normal and hyperglycemia blood glucose ranges. The detection sensitivity of the system has been improved to ±25 mg/dL using a single wavelength for the entire range of blood glucose. Machine learning has been employed to detect glucose levels using photoacoustic spectroscopy in skin samples. Ensemble machine learning models have been developed to measure glucose concentration using classification techniques. The model has achieved a 90.4% prediction accuracy with 100% of the predicted data located in zones A and B of Clarke's error grid analysis. This finding fulfills the US Food and Drug Administration requirements for glucose monitors.

Non-Invasive Real-Time Monitoring of Glucose Level Using Novel Microwave Biosensor Based on Triple-Pole CSRR

Planar microwave sensors are considered an attractive choice to noninvasively probe the dielectric attributes of biological tissues due to their low cost, simple fabrication, miniature scale, and minimum risk to human health. This paper develops and measures a novel microwave biosensor for non-invasive real-time monitoring of glucose level. The design comprises a rectangular plexiglass channel integrated on a triple-pole complementary split ring resonator (TP-CSRR). The proposed sensor operates in the centimeter-wave range 1-6 GHz and is manufactured using PCB on top of an FR4 dielectric substrate. The sensor elements are excited via a coupled microstrip transmission-line etched on the bottom side of the substrate. The integrated CSRR-based sensor is used as a near-field probe to non-invasively monitor the glucose level changes in the blood mimicking solutions of clinically relevant concentrations to Type-2 normal diabetes (70-120 mg/dL), by recording the frequency response of the harmonic reflection and transmission resonances. This indicates the sensor's capability of detecting small variations in the dielectric properties of the blood samples that are responsive to the electromagnetic fields. The proposed sensor is verified through practical measurements of the fabricated design. Experimental results obtained using a Vector Network Analyzer (VNA) demonstrate a sensitivity performance of about 6.2 dB/(mg/ml) for the developed triple-pole sensor that significantly outperforms the conventional single-pole and other proposed sensors in the literature in terms of the resonance amplitude resolution.

Low-cost portable microwave sensor for non-invasive monitoring of blood glucose level: novel design utilizing a four-cell CSRR hexagonal configuration

This article presents a novel design of portable planar microwave sensor for fast, accurate, and non-invasive monitoring of the blood glucose level as an effective technique for diabetes control and prevention. The proposed sensor design incorporates four cells of hexagonal-shaped complementary split ring resonators (CSRRs), arranged in a honey-cell configuration, and fabricated on a thin sheet of an FR4 dielectric substrate.The CSRR sensing elements are coupled via a planar microstrip-line to a radar board operating in the ISM band 2.4-2.5 GHz. The integrated sensor shows an impressive detection capability and a remarkable sensitivity of blood glucose levels (BGLs). The superior detection capability is attributed to the enhanced design of the CSRR sensing elements that expose the glucose samples to an intense interaction with the electromagnetic fields highly concentrated around the sensing region at the induced resonances. This feature enables the developed sensor to detect extremely delicate variations in the electromagnetic properties that characterize the varying-level glucose samples. The desired performance of the fabricated sensor is practically validated through in-vitro measurements using a convenient setup of Vector Network Analyzer (VNA) that records notable traces of frequency-shift responses when the sensor is loaded with samples of 70-120 mg/dL glucose concentrations. This is also demonstrated in the radar-driven prototype where the raw data collected at the radar receiving channel shows obvious patterns that reflect glucose-level variations. Furthermore, the differences in the sensor responses for tested glucose samples are quantified by applying the Principal Component Analysis (PCA) machine learning algorithm. The proposed sensor, beside its impressive detection capability of the diabetes-spectrum glucose levels, has several other favorable attributes including compact size, simple fabrication, affordable cost, non-ionizing nature, and minimum health risk or impact. Such attractive features promote the proposed sensor as a possible candidate for non-invasive glucose levels monitoring for diabetes as evidenced by the preliminary results from a proof-of-concept in-vivo experiment of tracking an individual's BGL by placing his fingertip onto the sensor. The presented system is a developmental platform towards radar-driven wearable continuous BGL monitors.

Non-invasive continuous-time glucose monitoring system using a chipless printable sensor based on split ring microwave resonators

This paper reports a highly sensitive, non-invasive sensor for real-time glucose monitoring from interstitial fluid. The structure is comprised of a chip-less tag sensor which may be taped over the patient’s skin and a reader, that can be embedded in a smartwatch. The tag sensor is energized through the established electromagnetic coupling between the tag and the reader and its frequency response is reflected on the spectrum of the reader in the same manner. The tag sensor consumes zero power as there is no requirement for any active readout or communication circuitry on the tag side. When measuring changes in glucose concentrations within saline replicating interstitial fluid, the sensor was able to detect glucose with an accuracy of ~ 1 mM/l over a physiological range of glucose concentrations with 38 kHz of the resonance frequency shift. This high sensitivity is attained as a result of the proposed new design and extended field concentration on the tag. The impact of some of the possible interferences on the response of the sensor’s performance was also investigated. Variations in electrolyte concentrations within the test samples have a negligible effect on the response of the sensor unless these variations are supra-physiologically large.

Low-cost and high sensitivity glucose sandwich detection using a plasmonic nanodisk metasurface

Glucose detection using surface-enhanced Raman scattering (SERS) spectroscopy has aroused considerable attention due to its potential in the prevention and diagnosis of diabetes as a result of its unique molecular fingerprinting capability, ultrahigh sensitivity and minimal interference from water. Despite numerous solutions to improve the sensitivity of glucose detection, the development of a new SERS-based strategy to detect glucose with high sensitivity and low-cost is still required. In this study, we propose a simple and sensitive SERS-based plasmonic metasurface sensing platform for a glucose sandwich assay using self-assembled p-mercapto-phenylboronic acid (PMBA) monolayers on a gold nanodisk (Au-ND) metasurface and synthesized silver nanoparticles (Ag NPs) modified with a mixture of p-aminothiophenol (PATP) and PMBA. The localized near-field of the proposed plasmonic metasurface is markedly enhanced due to the coupling between the Au-ND and Ag NPs, which greatly improves detection sensitivity. The experimental results show that SERS signals of the glucose assay are significantly enhanced by more than 8-fold, in comparison with the SERS substrate of smooth Au films and Ag NPs. Moreover, the plasmonic metasurface-based glucose sandwich assay exhibits high selectivity and sensitivity for glucose over fructose and galactose. The developed plasmonic metasurface sensing platform shows enormous potential for highly sensitive and selective SERS-based glucose detection and opens a new avenue for scalable and cost-effective biosensing applications in the future.

Optical plasmon nanostrip probe as an effective ultrashort pulse delivery system

In this paper, we analyze the ultrafast temporal and spectral responses of optical fields in tapered and metalized optical fibers (MOFs) and optical plasmon nanostrip probes (NPs). Computational experiment shows that output pulses of the NPs are virtually unchanged in shape and duration for input pulses with a duration of >1 fs and are not sensitive to changes in the parameters of the probe (such as convergence angle and taper length), while local enhancement of the electric field intensity reaches 300 times at the NP apex. Compared with the NPs, MOFs lead to significant output pulse distortions, even for input pulses with a duration of 10 fs. In addition, the temporal response at the MOF apex is critically sensitive to changes in MOF parameters and cannot provide any significant local enhancement of the electric field. These findings reveal the high potential of optical plasmon nanostrip probes as an ultrashort pulse delivery system to nanometer-size areas and indicate that its usage can be promising for a wide variety of techniques studying ultrafast processes in nanoscopic volumes.

Evaluation of accuracy dependence of Raman spectroscopic models on the ratio of calibration and validation points for non-invasive glucose sensing

Optical monitoring of blood glucose levels for non-invasive diagnosis is a growing area of research. Recent efforts in this direction have been inclined towards reducing the requirement of calibration framework. Here, we are presenting a systematic investigation on the influence of variation in the ratio of calibration and validation points on the prospective predictive accuracy of spectral models. A fiber-optic probe coupled Raman system has been employed for transcutaneous measurements. Limit of agreement analysis between serum and partial least square regression predicted spectroscopic glucose values has been performed for accurate comparison. Findings are suggestive of strong predictive accuracy of spectroscopic models without requiring substantive calibration measurements. Graphical abstract.

Label-free Raman hyperspectral imaging analysis localizes the cyanogenic glucoside dhurrin to the cytoplasm in sorghum cells

Localisation of metabolites in sorghum coleoptiles using Raman hyperspectral imaging analysis was compared in wild type plants and mutants that lack cyanogenic glucosides. This novel method allows high spatial resolution in situ localization by detecting functional groups associated with cyanogenic glucosides using vibrational spectroscopy. Raman hyperspectral imaging revealed that dhurrin was found mainly surrounding epidermal, cortical and vascular tissue, with the greatest amount in cortical tissue. Numerous "hotspots" demonstrated dhurrin to be located within both cell walls and cytoplasm adpressed towards the plasmamembrane and not in the vacuole as previously reported. The high concentration of dhurrin in the outer cortical and epidermal cell layers is consistent with its role in defence against herbivory. This demonstrates the ability of Raman hyperspectral imaging to locate cyanogenic glucosides in intact tissues, avoiding possible perturbations and imprecision that may accompany methods that rely on bulk tissue extraction methods, such as protoplast isolation.

Interstitial Glucose and Physical Exercise in Type 1 Diabetes: Integrative Physiology, Technology, and the Gap In-Between

Continuous and flash glucose monitoring systems measure interstitial fluid glucose concentrations within a body compartment that is dramatically altered by posture and is responsive to the physiological and metabolic changes that enable exercise performance in individuals with type 1 diabetes. Body fluid redistribution within the interstitial compartment, alterations in interstitial fluid volume, changes in rate and direction of fluid flow between the vasculature, interstitium and lymphatics, as well as alterations in the rate of glucose production and uptake by exercising tissues, make for caution when interpreting device read-outs in a rapidly changing internal environment during acute exercise. We present an understanding of the physiological and metabolic changes taking place with acute exercise and detail the blood and interstitial glucose responses with different forms of exercise, namely sustained endurance, high-intensity, and strength exercises in individuals with type 1 diabetes. Further, we detail novel technical information on currently available patient devices. As more health services and insurance companies advocate their use, understanding continuous and flash glucose monitoring for its strengths and limitations may offer more confidence for patients aiming to manage glycemia around exercise.

Verification of Non-Invasive Blood Glucose Measurement Method Based on Pulse Wave Signal Detected by FBG Sensor System

This paper describes and verifies a non-invasive blood glucose measurement method using a fiber Bragg grating (FBG) sensor system. The FBG sensor is installed on the radial artery, and the strain (pulse wave) that is propagated from the heartbeat is measured. The measured pulse wave signal was used as a collection of feature vectors for multivariate analysis aiming to determine the blood glucose level. The time axis of the pulse wave signal was normalized by two signal processing methods: the shortest-time-cut process and 1-s-normalization process. The measurement accuracy of the calculated blood glucose level was compared with the accuracy of these signal processing methods. It was impossible to calculate a blood glucose level exceeding 200 mg/dL in the calibration curve that was constructed by the shortest-time-cut process. In the 1-s-normalization process, the measurement accuracy of the blood glucose level was improved, and a blood glucose level exceeding 200 mg/dL could be calculated. By verifying the loading vector of each calibration curve to calculate the blood glucose level with a high measurement accuracy, we found the gradient of the peak of the pulse wave at the acceleration plethysmogram greatly affected.

Noninvasive Continuous Glucose Monitoring Using a Multisensor-Based Glucometer and Time Series Analysis

Daily continuous glucose monitoring is very helpful in the control of glucose levels for people with diabetes and impaired glucose tolerance. In this study, a multisensor-based, noninvasive continuous glucometer was developed, which can continuously estimate glucose levels via monitoring of physiological parameter changes such as impedance spectroscopy at low and high frequency, optical properties, temperature and humidity. Thirty-three experiments were conducted for six healthy volunteers and three volunteers with diabetes. Results showed that the average correlation coefficient between the estimated glucose profiles and reference glucose profiles reached 0.8314, with a normalized root mean squared error (NRMSE) of 14.6064. The peak time of postprandial glucose was extracted from the glucose profile, and its estimated value had a correlation coefficient of 0.9449 with the reference value, wherein the root mean square error (RMSE) was 6.8958 min. Using Clarke error grid (CEG) analysis, 100% of the estimated glucose values fell in the clinically acceptable zones A and B, and 92.86% fell in zone A. The application of a multisensor-based, noninvasive continuous glucometer and time series analysis can endure the time delay between human physiological parameters and glucose level changes, so as to potentially accomplish noninvasive daily continuous glucose monitoring.

Glucose Sensing for Diabetes Monitoring: Recent Developments

This review highlights recent advances towards non-invasive and continuous glucose monitoring devices, with a particular focus placed on monitoring glucose concentrations in alternative physiological fluids to blood.

Current Status of HbA1c Biosensors

Glycated hemoglobin (HbA1c) is formed via non-enzymatic glycosylation reactions at the α–amino group of βVal1 residues in the tetrameric Hb, and it can reflect the ambient glycemic level over the past two to three months. A variety of HbA1c detection methods, including chromatography, immunoassay, enzymatic measurement, electrochemical sensor and capillary electrophoresis have been developed and used in research laboratories and in clinics as well. In this review, we summarize the current status of HbA1c biosensors based on the recognition of the sugar moiety on the protein and also their applications in the whole blood sample measurements.

The EFLM strategy for harmonization of the preanalytical phase

The Working Group for the Preanalytical Phase (WG-PRE) was officially established by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) in 2013, with the aim of improving harmonization in the preanalytical phase across European member societies. Since its early birth, the WG-PRE has already completed a number of projects, including harmonizing the definition of fasting status, patient and blood tubes identification, color coding of blood collection tubes, sequence of tubes during blood drawing and participation in the development of suitable preanalytical quality indicators. The WG-PRE has also provided guidance on local validation of blood collection tubes, has performed two European surveys on blood sampling procedures and has organized four European meetings to promote the importance of quality in the preanalytical phase. The future activities entail development and validation of an external quality assessment scheme focused on preanalytical variables, development and dissemination of a survey about the local management of unsuitable samples in clinical laboratories, as well as release of EFLM phlebotomy guidelines. This article summarizes all recent achievements of the WG-PRE and illustrates future projects to promote harmonization in the preanalytical phase.

Noninvasive Monitoring of Blood Glucose with Raman Spectroscopy

The successful development of a noninvasive blood glucose sensor that can operate reliably over sustained periods of time has been a much sought after but elusive goal in diabetes management. Since diabetes has no well-established cure, control of elevated glucose levels is critical for avoiding severe secondary health complications in multiple organs including the retina, kidney and vasculature. While fingerstick testing continues to be the mainstay of blood glucose detection, advances in electrochemical sensing-based minimally invasive approaches have opened the door for alternate methods that would considerably improve the quality of life for people with diabetes. In the quest for better sensing approaches, optical technologies have surfaced as attractive candidates as researchers have sought to exploit the endogenous contrast of glucose, notably its absorption, scattering, and polarization properties. Vibrational spectroscopy, especially spontaneous Raman scattering, has exhibited substantial promise due to its exquisite molecular specificity and minimal interference of water in the spectral profiles acquired from the blood-tissue matrix. Yet, it has hitherto been challenging to leverage the Raman scattering signatures of glucose for prediction in all but the most basic studies and under the least demanding conditions. In this Account, we discuss the newly developed array of methodologies that address the key challenges in measuring blood glucose accurately using Raman spectroscopy and unlock new prospects for translation to sustained noninvasive measurements in people with diabetes. Owing to the weak intensity of spontaneous Raman scattering, recent research has focused on enhancement of signals from the blood constituents by designing novel excitation-collection geometries and tissue modulation methods while our attempts have led to the incorporation of nonimaging optical elements. Additionally, invoking mass transfer modeling into chemometric algorithms has not only addressed the physiological lag between the actual blood glucose and the measured interstitial fluid glucose values but also offered a powerful tool for predictive measurements of hypoglycemia. This framework has recently been extended to provide longitudinal tracking of glucose concentration without necessitating extensive a priori concentration information. These findings are advanced by the results of recent glucose tolerance studies in human subjects, which also hint at the need for designing nonlinear calibration models that can account for subject-to-subject variations in skin heterogeneity and hematocrit levels. Together, the emerging evidence underscores the promise of a blood withdrawal-free optical platform-featuring a combination of high-throughput Raman spectroscopic instrumentation and data analysis of subtle variations in spectral expression-for diabetes screening in the clinic and, ultimately, for personalized monitoring.

Nanoparticle-free tissue-mimicking phantoms with intrinsic scattering

We present an alternative to the conventional approach, phantoms without scattering nanoparticles, where scattering is achieved by the material itself: spherical cavities trapped in a silicone matrix. We describe the properties and fabrication of novel optical phantoms based on a silicone elastomer polydimethylsiloxane (PDMS) and glycerol mixture. Optical properties (absorption coefficient µa , reduced scattering coefficient µs' , and anisotropy factor g) of the fabricated phantoms were retrieved from spectrophotometric measurements (in the 400-1100 nm wavelength range) using the inverse adding-doubling method. The internal structure of the phantoms was studied under a scanning electron microscope, and the chemical composition was assessed by Raman spectroscopy. Composition of the phantom material is reported along with the full characterization of the produced phantoms and ways to control their parameters.

HbA1c and Risks of All-Cause and Cause-Specific Death in Subjects without Known Diabetes: A Dose-Response Meta-Analysis of Prospective Cohort Studies

Whether HbA_1c levels are associated with mortality in subjects without known diabetes remains controversial. Moreover, the shape of the dose–response relationship on this topic is unclear. Therefore, a dose–response meta-analysis was conducted. PubMed and EMBASE were searched. Summary hazard ratios (HRs) were calculated using a random-effects model. Twelve studies were included. The summary HR per 1% increase in HbA_1c level was 1.03 [95% confidence interval (CI) = 1.01–1.04] for all-cause mortality, 1.05 [95% CI = 1.02–1.07) for cardiovascular disease (CVD) mortality, and 1.02 (95% CI = 0.99–1.07) for cancer mortality. After excluding subjects with undiagnosed diabetes, the aforementioned associations remained significant for CVD mortality only. After further excluding subjects with prediabetes, all aforementioned associations presented non-significance. Evidence of a non-linear association between HbA_1c and mortality from all causes, CVD and cancer was found (all P_{non-linearity} < 0.05). The dose–response curves were relatively flat for HbA_1c less than around 5.7%, and rose steeply thereafter. In conclusion, higher HbA_1c level is associated with increased mortality from all causes and CVD among subjects without known diabetes. However, this association is driven by those with undiagnosed diabetes or prediabetes. The results regarding cancer mortality should be treated with caution due to limited studies.

High spectral specificity of local chemical components characterization with multichannel shift-excitation Raman spectroscopy

Raman spectroscopy has emerged as a promising tool for its noninvasive and nondestructive characterization of local chemical structures. However, spectrally overlapping components prevent the specific identification of hyperfine molecular information of different substances, because of limitations in the spectral resolving power. The challenge is to find a way of preserving scattered photons and retrieving hidden/buried Raman signatures to take full advantage of its chemical specificity. Here, we demonstrate a multichannel acquisition framework based on shift-excitation and slit-modulation, followed by mathematical post-processing, which enables a significant improvement in the spectral specificity of Raman characterization. The present technique, termed shift-excitation blind super-resolution Raman spectroscopy (SEBSR), uses multiple degraded spectra to beat the dispersion-loss trade-off and facilitate high-resolution applications. It overcomes a fundamental problem that has previously plagued high-resolution Raman spectroscopy: fine spectral resolution requires large dispersion, which is accompanied by extreme optical loss. Applicability is demonstrated by the perfect recovery of fine structure of the C-Cl bending mode as well as the clear discrimination of different polymorphs of mannitol. Due to its enhanced discrimination capability, this method offers a feasible route at encouraging a broader range of applications in analytical chemistry, materials and biomedicine.

Discerning the differential molecular pathology of proliferative middle ear lesions using Raman spectroscopy

Despite its widespread prevalence, middle ear pathology, especially the development of proliferative lesions, remains largely unexplored and poorly understood. Diagnostic evaluation is still predicated upon a high index of clinical suspicion on otoscopic examination of gross morphologic features. We report the first technique that has the potential to non-invasively identify two key lesions, namely cholesteatoma and myringosclerosis, by providing real-time information of differentially expressed molecules. In addition to revealing signatures consistent with the known pathobiology of these lesions, our observations provide the first evidence of the presence of carbonate- and silicate-substitutions in the calcium phosphate plaques found in myringosclerosis. Collectively, these results demonstrate the potential of Raman spectroscopy to not only provide new understanding of the etiology of these conditions by defining objective molecular markers but also aid in margin assessment to improve surgical outcome.