3,919 research outputs found

    Development of a near-infrared spectroscopic system for monitoring urine glucose level for the use of long-term home healthcare

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    We have been developing a new technique for measuring urine glucose concentration using near infrared spectroscopy (NIRS) in conjunction with the Partial Least Square (PLS) method. In the previous study, we reported some results of preliminary experiments for assessing feasibility of this method using a FT-IR spectrometer. In this study, considering practicability of the system, a flow-through cell with the optical path length of 10 mm was newly introduced. Accuracy of the system was verified by the preliminary experiments using urine samples. From the results obtained, it was clearly demonstrated that the present method had a capability of predicting individual urine glucose level with reasonable accuracy (the minimum value of standard error of prediction: SEP = 22.3 mg/dl) and appeared to be a useful means for long-term home health care. However, mean value of SEP obtained by the urine samples from ten subjects was not satisfactorily low (53.7 mg/dl). For improving the accuracy, (1) mechanical stability of the optical system should be improved, (2) the method for normalizing the spectrum should be reconsidered, and (3) the number of subject should be increased

    Intelligent Remote Monitoring and Management system for Type1 Diabetes

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    The work presented in this thesis focuses on developing a telemedicine system for better management of type1 diabetes in children and teenagers. The research and development of the system is motivated by the inadequate communication in the current system of management of the disease, which results in non-compliance of patients following the regimen. This non-compliance generally results in uncontrolled blood glucose levels, which can result in hypoglycaemia, hyperglycaemia and later life health complications. This further results in an increase in health care costs. In this context, the thesis presents a novel end-to-end, low cost telemedicine system, WithCare+, developed in close collaboration between the University of Sheffield (Electronics & Electrical Engineering) and Sheffield Children’s Hospital. The system was developed to address the challenges of implementing modern telemedicine in type 1 diabetic care with particular relevance to National Health Service children’s clinics in the United Kingdom, by adopting a holistic care driven approach (involving all stakeholders) based on specific key enabler technologies such as low cost and reconfigurable design. However, one of the major issues with current telemedicine system is non-compliance of the patients due to invasive procedure of the glucose measurement which could be clearly addressed by non-invasive method of glucose measurement. Hence, the thesis also makes a contribution towards non-invasive glucose measurement using Near Infrared spectroscopy in terms of addressing the calibration challenge; two methods are proposed to improve the calibration of the Near Infrared instrument. The first method combines locally weighted regression and partial least square regression and the second method combines digital band pass filtering with support vector regression. The efficacy of the proposed methods is validated in experiments carried out in a non-controlled environment and the results obtained demonstrate that the proposed methods improved the performance of the calibration model in comparison to traditional calibration techniques such as Principal Component Regression and Partial Least Squares regression

    The Association of Kangaroo Mother Care, Energy Conservation, and Bonding in Preterm Neonates

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    Purpose:To examine the association of kangaroo mother care (KMC) on energy utilization and bonding as evidenced by reduced biochemical markers of adenosine triphosphate (ATP) degradation, hypoxanthine (Hx), xanthine (Xa), and uric acid (UA), and (allantoin), a measure of oxidative stress in preterm infants 24-36 weeks gestation. A secondary objective was to compare specific physiological parameters using bedside monitoring and perfusion and oxygenation of the gut using near-infrared spectroscopy (NIRS) during 1 hour of KMC compared to incubator care. Study design: A randomized controlled trial (RCT) examining the effects of 1-hour of KMC or 1-hour incubator care on urinary markers from samples collected 3-6 hrs before, and 3-6 hours after KMC. Preterm infants (n = 51) were assigned to intervention/control groups using stratified randomization based on weight. Urine concentrations of Hx, Xa, and UA were measured using high performance liquid chromatography (HPLC) and allantoin was quantified using gas chromatography-mass spectrometry (GC-MS) methods. Bonding was measured using the Mother-to-infant Bonding Scale, a reliable 8-item self-assessment scale linking early maternal moods to difficulties in bonding. Psychometric properties have demonstrated a two-factor model, good predictive validity, a sensitivity of 0.90 and specificity of 0.80 for a threshold score ≥ 2, and acceptable internal consistency (a= 0.71). Physiologic measures were captured using bedside monitoring and abdominal NIRS to capture gut perfusion and oxygenation. Results: There was a decrease in oxidative stress (p= 0.026) in the KMC group compared to incubator group.In both groups there were trending improvement in uric acid (p = 0.025) and xanthine (p= 0.042) over time, and in abdominal temperatures (p = 0.004) and perfusion index (p = 0.031) over time. No other physiologic or urinary measures showed statistically significant changes either between the groups or over time. A mixed model analysis of variance (ANOVA) was conducted with the use of unstructured covariance matrix adjusted using the Bonferroni method to assess the changes in the outcome measures of urinary purines and physiological measures. Mother-Infant Bonding scores were calculated using relative risk. The number and percentage of subjects who changed their MIBS scores from baseline to time 3 were measured, and the comparison of these changes between the KMC on DOL 3 and DOL 4 as measured by the Mother-Infant-Bonding-Scale (MIBS) in intervention and control groups were calculated. We found that scores showed that KMC mothers showed a higher risk of bonding problems than those in the control group. Nineteen percent more mothers in KMC group demonstrated an increase in MIBS score or a 26 percent increase relative risk for an increase of score (RR=1.26; 95% CI 0.97,1.63). However, the results were not statistically significant as the null value was included in the 95% confidence interval. Significance was set at an alpha of 0.05. Conclusions: This is the first study of its kind to evaluate the association of KMC on biochemical markers of stress and physiological parameters of abdominal near-infrared spectroscopy (NIRS) and abdominal temperatures in preterm infants 24-36 weeks gestation. The results of this study suggest that stress and inflammatory processes are decreased in the presence of KMC. Further research is needed to understand the role of biochemical markers and KMC and its implications in nursing research in preterm neonates and improved outcomes. This study has the potential to provide the physiological data to further support the benefits of energy conservation for recovery and growth in neonates

    Hybrid point-of-care devices for visual detection of biomarkers and drugs

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    Early diagnostics is a crucial part of clinical practice offering a rapid and convenient way to investigate and quantify the presence of key biomarkers related to specific pathologies and increasing the chance of successful treatments. In this regard, point-of-care testing (POCT) shows several advantages enabling simple and rapid analyses, allowing for real-time results, and permitting home testing. Metallic nanoparticles (NPs), like gold NPs (AuNPs), can be beneficially integrated into POC devices thanks to their tunable plasmonic properties which provide a naked-eye read-out. Moreover, the high sensitivity of NPs enables the detection of biomarkers in non-invasive fluids where the concentrations are typically low. These biofluids, like saliva and urine, are functionally equivalent to serum in reflecting the physiological state of the body, whilst they are easier to handle, collect, and store. In this thesis, I first reported the design and development of a colorimetric strategy based on the morphological change of multibranched plasmonic AuNPs, aimed at detecting glucose in saliva. The sensing approach relied on a target-induced reshaping process which involves the oxidation of the NP tips and the transformation into a spherical shape, characterized by a naked-eye detectable blue-to-pink color change. The platform proved to be beneficial in the early and non-invasive diagnosis of hyperglycemia. The successful technological transfer on a solid substrate paved the way for the realization of a dipstick prototype for home testing. Then, the strategy was adapted to other biomarkers, leading to the development of a multiplexing test for the simultaneous detection of three salivary analytes (cholesterol, glucose, and lactate). This multiplexing assay enabled to save reagents, costs, and time, whilst increasing the overall clinical value of the test. Exploiting the microfluidics applied on a paper sheet, I realized a monolithic and fully integrated POC device, through a low-cost and fast CO2 laser cutter. The platform showed excellent selectivity and multiplexing ability, with negligible interferences. The second part of my thesis was focused on the development of POC devices for the detection of anticancer drug contaminations in water solutions and urine samples. Antiblastic agents have revealed high toxicity for the exposed healthcare workers who prepare and administer these drugs in occupational environments. Hence, continuous monitoring is highly required, and POCT shows tremendous potential in this context. With this aim, I realized a lateral-flow (LF) device for the assessment of doxorubicin contamination, using the fluorescent properties of the drug for naked-eye detection. The pharmacological recognition of the DNA probe was exploited to overcome the lack of anti-doxorubicin antibodies. The highly sensitive strategy was successfully adapted to a real urine sample, without resorting to complex pretreatment procedures. Then, I developed a competitive LF device for the detection of methotrexate (MTX). AuNPs were employed as the label molecules and the pharmacological competition of folic acid and MTX for the capture enzyme was exploited as the recognition mechanism, instead of costly antibodies. Despite the sensitivity requires further improvements, the strategy showed fast and reliable results, demonstrating a high potential for workers’ safety control

    Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

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    Background: Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. Approach: An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. Content: In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c_{1c} (HbA1c_{1c}) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA1c_{1c}. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. Summary: The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended

    Review of present method of glucose from human blood and body fluids assessment

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    The work has been aimed to create an overview of available and used methods and ways to determine the concentration of glucose in body fluids, especially from a technical point of view. It also provides an overview of the clinical features of these methods. The survey found that today's market offers a large number of options and approaches to the issue. There are accurate reference laboratory methods, self-monitoring methods for measuring glucose levels using glucometers, or continuous methods for daily monitoring of blood glucose trends and for insulin pump control. However, it must not be forgotten that the development of full closure of feedback is still not complete today. Individual methods cannot always be compared with each other, precisely because of the focus and the use of these methods. Choosing the right method of blood glucose levels in the body measuring can help patients to manage their diabetes mellitus. The methods listed in the overview are divided in terms of measurement continuity and further according to the invasiveness of the method. Finally, the issues of accuracy in the detection of glycaemia variability and the possibility of further development of these methods are discussed, as it is clear from the survey that the development is focused mainly on continuous methods improving that get to the forefront and also on developing a biosensor that is purely non-invasive and continuous.Web of Science211art. no. 11434

    Detecting Vital Signs with Wearable Wireless Sensors

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    The emergence of wireless technologies and advancements in on-body sensor design can enable change in the conventional health-care system, replacing it with wearable health-care systems, centred on the individual. Wearable monitoring systems can provide continuous physiological data, as well as better information regarding the general health of individuals. Thus, such vital-sign monitoring systems will reduce health-care costs by disease prevention and enhance the quality of life with disease management. In this paper, recent progress in non-invasive monitoring technologies for chronic disease management is reviewed. In particular, devices and techniques for monitoring blood pressure, blood glucose levels, cardiac activity and respiratory activity are discussed; in addition, on-body propagation issues for multiple sensors are presented

    175 years of bilirubin testing : ready for point-of-care?

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    Bilirubin was first detected in blood in 1847 and since then has become one of the most widely used biomarkers for liver disease. Clinical routine bilirubin testing is performed at the hospital laboratory, and the gold standard colorimetric test is prone to interferences. The absence of a bedside test for bilirubin delays critical clinical decisions for patients with liver disease. This clinical care gap has motivated the development of a new generation of bioengineered point-of-care bilirubin assays. In this Perspective, recently developed bilirubin assays are critically discussed, and their translational potential evaluated

    Smartphone as a Portable Detector, Analytical Device, or Instrument Interface

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    The Encyclopedia Britannia defines a smartphone as a mobile telephone with a display screen, at the same time serves as a pocket watch, calendar, addresses book and calculator and uses its own operating system (OS). A smartphone is considered as a mobile telephone integrated to a handheld computer. As the market matured, solid-state computer memory and integrated circuits became less expensive over the following decade, smartphone became more computer-like, and more more-advanced services, and became ubiquitous with the introduction of mobile phone networks. The communication takes place for sending and receiving photographs, music, video clips, e-mails and more. The growing capabilities of handheld devices and transmission protocols have enabled a growing number of applications. The integration of camera, access Wi-Fi, payments, augmented reality or the global position system (GPS) are features that have been used for science because the users of smartphone have risen all over the world. This chapter deals with the importance of one of the most common communication channels, the smartphone and how it impregnates in the science. The technological characteristics of this device make it a useful tool in social sciences, medicine, chemistry, detections of contaminants, pesticides, drugs or others, like so detection of signals or image
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