A low frequency electromagnetic sensor for indirect measurement of glucose concentration: in vitro experiments in different conductive solutions

Recent advancement in noninvasive glucose monitoring and closed-loop management system for diabetes

Diabetes can cause many complications, which has become one of the most common diseases that may lead to death. Currently, the number of diabetics continues increasing year by year. Thus,...

Toward Non-Invasive Estimation of Blood Glucose Concentration: A Comparative Performance

The present study comprises a comparison of the Mel Frequency Cepstral Coefficients (MFCC), Principal Component Analysis (PCA) and Independent Component Analysis (ICA) as feature extraction methods using ten different regression algorithms (AdaBoost, Bayesian Ridge, Decision Tree, Elastic Net, k-NN, Linear Regression, MLP, Random Forest, Ridge Regression and Support Vector Regression) to quantify the blood glucose concentration. A total of 122 participants—healthy and diagnosed with type 2 diabetes—were invited to be part of this study. The entire set of participants was divided into two partitions: a training subset of 72 participants, which was intended for model selection, and a validation subset comprising the remaining 50 participants, to test the selected model. A 3D-printed chamber for providing a light-controlled environment and a low-cost microcontroller unit were used to acquire optical measurements. The MFCC, PCA and ICA were calculated by an open-hardware computing platform. The glucose levels estimated by the system were compared to actual glucose concentrations measured by venipuncture in a laboratory test, using the mean absolute error, the mean absolute percentage error and the Clarke error grid for this purpose. The best results were obtained for MCCF with AdaBoost and Random Forest (MAE = 11.6 for both).

From reverse innovation to global innovation in animal health: A review

Reverse innovation refers to learning from or diffusion of innovations developed in low income settings and further translated to industrialized countries. There is lack of consensus regarding terminology, but the idea that innovations in low-income countries are promising for adoption in high-income contexts is not new. However, in healthcare literature globally, the vast majority of publications referring to 'disruptive innovation' were published in the last ten years. To assess the potential of innovative developments and technologies for improving animal health, we initiated a literature review in 2020. We used a combined approach, incorporating targeted searching in PubMed using a key word algorithm with a snowball technique, to identify 120 relevant publications and extract data for qualitative coding. Heterogeneity of articles precluded meta-analysis, quality scoring and risk of bias analysis. We can distinguish technical innovations like new digital devices, diagnostic tests and procedures, and social innovations of intersectoral cooperation. We profile two case studies to describe potential global innovations: an integrated surveillance and response system in Somali Regional State, Ethiopia and a blockchain secured One Health intervention to optimally provide post-exposure prophylaxis for rabies exposed people in West Africa. Innovation follows no borders and can also occur in low-income settings, under constraints of cost, lack of services and infrastructure. Lower administrative and legal barriers may contribute to produce innovations that would not be possible under conditions of high density of regulation. We recommend using the term global innovation, which highlights those emanating from international partnership to solve problems of global implications.

Study of Two Constraints Impacting Measurements of Human Glycemia Using a Microwave Sensor

The measurement of glycemia is impacted by several constraints; those constraints have to be identified and quantified when designing an electromagnetic noninvasive sensor. The second phase concerns the level of the influence of these constraints. In this work, we investigated the impact of vein radius located in the forearm on a resonant microwave sensor to measure glycemia. We performed a numerical simulation using COMSOL Multiphysics of a proposed tissue model that was in contact with a microwave resonator. Some other factors affect the measurement, such as temperature, perfusion, sensor positioning and motion, tissue heterogeneity, and other biological activity. The sensor must be robust to the above-mentioned constraints. Because vein size changes from one person to another, the dielectric properties seen by the sensor will be different. This has been demonstrated by the change created in the resonance frequency of the simulated sensor for different vein sizes. The second constraint that was assessed is the dosimetry. The specific absorption rate (SAR) of any electromagnetic device should be evaluated and compared with SAR limits in the safety standards to ensure the safety of the user. Simulation results are in good agreement with SAR limits in the safety standards.

Sugar Concentration Measurement System Using Radiofrequency Sensor

A sugar solution measurement system was developed based on the dielectric properties of the sucrose molecule. An ac conductivity and tan δ study as a function of the frequency was performed to find the suitable frequency range for the measuring system. The results indicate that it is possible to obtain a better response of the sensor using the frequencies as the maxima peak in tan δ appears. Developed setup for sucrose solution was appropriate to measure in a 0.15 to 1 g/mL range with an experimental error of about 3%. The proposed system improves the measurement time over some other methods.

The Progress of Glucose Monitoring-A Review of Invasive to Minimally and Non-Invasive Techniques, Devices and Sensors

Current glucose monitoring methods for the ever-increasing number of diabetic people around the world are invasive, painful, time-consuming, and a constant burden for the household budget. The non-invasive glucose monitoring technology overcomes these limitations, for which this topic is significantly being researched and represents an exciting and highly sought after market for many companies. This review aims to offer an up-to-date report on the leading technologies for non-invasive (NI) and minimally-invasive (MI) glucose monitoring sensors, devices currently available in the market, regulatory framework for accuracy assessment, new approaches currently under study by representative groups and developers, and algorithm types for signal enhancement and value prediction. The review also discusses the future trend of glucose detection by analyzing the usage of the different bands in the electromagnetic spectrum. The review concludes that the adoption and use of new technologies for glucose detection is unavoidable and closer to become a reality.

New insights on the cardiac safety factor: Unraveling the relationship between conduction velocity and robustness of propagation

Cardiac conduction disturbances are linked with arrhythmia development. The concept of safety factor (SF) has been derived to describe the robustness of conduction, but the usefulness of this metric has been constrained by several limitations. For example, due to the difficulty of measuring the necessary input variables, SF calculations have only been applied to synthetic data. Moreover, quantitative validation of SF is lacking; specifically, the practical meaning of particular SF values is unclear, aside from the fact that propagation failure (i.e., conduction block) is characterized by SF < 1. This study aims to resolve these limitations for our previously published SF formulation and explore its relationship to relevant electrophysiological properties of cardiac tissue. First, HL-1 cardiomyocyte monolayers were grown on multi-electrode arrays and the robustness of propagation was estimated using extracellular potential recordings. SF values reconstructed purely from experimental data were largely between 1 and 5 (up to 89.1% of sites characterized). This range is consistent with values derived from synthetic data, proving that the formulation is sound and its applicability is not limited to analysis of computational models. Second, for simulations conducted in 1-, 2-, and 3-dimensional tissue blocks, we calculated true SF values at locations surrounding the site of current injection for sub- and supra-threshold stimuli and found that they differed from values estimated by our SF formulation by <10%. Finally, we examined SF dynamics under conditions relevant to arrhythmia development in order to provide physiological insight. Our analysis shows that reduced conduction velocity (Θ) caused by impaired intrinsic cell-scale excitability (e.g., due to sodium current a loss-of-function mutation) is associated with less robust conduction (i.e., lower SF); however, intriguingly, Θ variability resulting from modulation of tissue scale conductivity has no effect on SF. These findings are supported by analytic derivation of the relevant relationships from first principles. We conclude that our SF formulation, which can be applied to both experimental and synthetic data, produces values that vary linearly with the excess charge needed for propagation. SF calculations can provide insights helpful in understanding the initiation and perpetuation of cardiac arrhythmia.

Technology platforms for remote monitoring of vital signs in the new era of telemedicine

Driven by healthcare cost and home healthcare need, the development of remote monitoring technologies is poised to improve and revolutionize healthcare delivery and accessibility. This paper reviews the recent progress in the field of remote monitoring technologies that may have the potential to become the basic platforms for telemedicine. In particular, key techniques and devices for monitoring cardiorespiratory activity, blood pressure and blood glucose concentration are summarized and discussed. In addition, the US FDA approved remote vital signs monitoring devices currently available on the market are presented.

A reusable robust radio frequency biosensor using microwave resonator by integrated passive device technology for quantitative detection of glucose level

A reusable robust radio frequency (RF) biosensor with a rectangular meandered line (RML) resonator on a gallium arsenide substrate by integrated passive device (IPD) technology was designed, fabricated and tested to enable the real-time identification of the glucose level in human serum. The air-bridge structure fabricated by an IPD technology was applied to the RML resonator to improve its sensitivity by increasing the magnitude of the return loss (S21). The resonance behaviour, based on S21 characteristics of the biosensor, was analysed at 9.20 GHz with human serum containing different glucose concentration ranging from 148-268 mg dl(-1), 105-225 mg dl(-1) and at a deionised (D) water glucose concentration in the range of 25- 500 mg dl(-1) for seven different samples. A calibration analysis was performed for the human serum from two different subjects and for D-glucose at a response time of 60 s; the reproducibility, the minimum shift in resonance frequency and the long-term stability of the signal were investigated. The feature characteristics based on the resonance concept after the use of serum as an analyte are modelled as an inductor, capacitor and resistor. The findings support the development of resonance-based sensing with an excellent sensitivity of 1.08 MHz per 1 mg dl(-1), a detection limit of 8.01 mg dl(-1), and a limit of quantisation of 24.30 mg dl(-1).

Sodium concentration measurement during hemodialysis through ion-exchange resin and conductivity measure approach: in vitro experiments

Sodium measurement during hemodialysis treatment is important to preserve the patient from clinical events related to hypo- or hyper-natremia Usually, sodium measurement is performed through laboratory equipment which is typically expensive, and requires manual intervention. We propose a new method, based on conductivity measurement after treatment of dialysate solution through ion-exchange resin. To test this method, we performed in vitro experiments. We prepared 40 ml sodium chloride (NaCl) samples at 280, 140, 70, 35, 17.5, 8.75, 4.375 mEq/l, and some “mixed samples”, i.e., with added potassium chloride (KCl) at different concentrations (4.375-17.5 mEq/l), to simulate the confounding factors in a conductivity-based sodium measurement. We measured the conductivity of all samples. Afterwards, each sample was treated for 1 min with 1 g of Dowex G-26 resin, and conductivity was measured again. On average, the difference in the conductivity between mixed samples and corresponding pure NaCl samples (at the same NaCl concentration) was 20.9%. After treatment with the exchange resin, it was 14.7%, i.e., 42% lower. Similar experiments were performed with calcium chloride and magnesium chloride as confounding factors, with similar results. We also performed some experiments on actual dialysate solution during hemodialysis sessions in 15 patients, and found that the correlation between conductivity measures and sodium concentration improved after resin treatment (R=0.839 before treatment, R=0.924 after treatment, P<0.0001). We conclude that ion-exchange resin treatment coupled with conductivity measures may improve the measurement of sodium compared to conductivity measures alone, and may become a possible simple approach for continuous and automatic sodium measurement during hemodialysis.

Italian contributions to the development of continuous glucose monitoring sensors for diabetes management

Monitoring glucose concentration in the blood is essential in the therapy of diabetes, a pathology which affects about 350 million people around the World (three million in Italy), causes more than four million deaths per year and consumes a significant portion of the budget of national health systems (10% in Italy). In the last 15 years, several sensors with different degree of invasiveness have been proposed to monitor glycemia in a quasi-continuous way (up to 1 sample/min rate) for relatively long intervals (up to 7 consecutive days). These continuous glucose monitoring (CGM) sensors have opened new scenarios to assess, off-line, the effectiveness of individual patient therapeutic plans from the retrospective analysis of glucose time-series, but have also stimulated the development of innovative on-line applications, such as hypo/hyper-glycemia alert systems and artificial pancreas closed-loop control algorithms. In this review, we illustrate some significant Italian contributions, both from industry and academia, to the growth of the CGM sensors research area. In particular, technological, algorithmic and clinical developments performed in Italy will be discussed and put in relation with the advances obtained in the field in the wider international research community.

Recent advances in noninvasive glucose monitoring

The race for the next generation of painless and reliable glucose monitoring for diabetes mellitus is on. As technology advances, both diagnostic techniques and equipment improve. This review describes the main technologies currently being explored for noninvasive glucose monitoring. The principle of each technology is mentioned; its advantages and limitations are then discussed. The general description and the corresponding results for each device are illustrated, as well as the current status of the device and the manufacturer; internet references for the devices are listed where appropriate. Ten technologies and eleven potential devices are included in this review. Near infrared spectroscopy has become a promising technology, among others, for blood glucose monitoring. Although some reviews have been published already, the rapid development of technologies and information makes constant updating mandatory. While advances have been made, the reliability and the calibration of noninvasive instruments could still be improved, and more studies carried out under different physiological conditions of metabolism, bodily fluid circulation, and blood components are needed.

Noninvasive in vitro measurement of pig-blood d-glucose by using a microwave cavity sensor

We have developed an electromagnetic microwave cavity sensor based on the resonant frequency shift for real time measurement of the glycemia in pig blood. We could determine the concentration of d-glucose in pig blood in the range of 150-550mg/dl at the resonance frequency near 4.75GHz with a bandwidth of 300MHz. The change in the d-glucose concentration in blood brings microwave reflection coefficient S(11) changes of about 6.26dB and resonance frequency shifts of about 11.25MHz due to the electromagnetic interaction between the cavity resonator and the blood filled plastic tube inserted into the cavity. This proposed system provides a unique approach for real time noninvasive and contactless glucose monitoring.