Non-invasive Monitoring Device Research Articles

Development of Chobmons Prototype: Cholesterol and Blood Sugar Level Monitoring System Based on Internet of Things (IoT) using Blynk Application

In the era of the industrial revolution 4.0, we need remote technology and products that d not created new medical waste piles. An unhealthy lifestyle can cause many diseases, either degenerative diseases, namely over rate cholesterol and blood sugar level. High cholesterol and blood sugar levels are causes of major influence on atherosclerosis, stroke, micro-vascular, and cardiovascular complications. We offer a non-invasive cholesterol and blood sugar monitoring device based on red LED and infrared light absorption using the Nellcor DS-100A sensor. This technology can help reduce cumulative medical waste and help health workers to monitor patients remotely. This study used ten random samples to calibrate cholesterol and blood sugar levels. The coefficient of determination values were 0.9580 and 0.9581, respectively, which gave excellent values so that the study is continued by collecting data. Data retrieval use 20 random sample data to measure cholesterol and blood sugar levels, the average accuracy prototype is 90.26% and 91.16%, respectively. It shows great potential in determining estimation value at cholesterol and blood sugar levels. The monitoring system can show the data on the LCD display in Blynk Application with the average time required of 1.07 s.

Is Raman the best strategy towards the development of non-invasive continuous glucose monitoring devices for diabetes management?

Diabetes has no well-established cure; thus, its management is critical for avoiding severe health complications involving multiple organs. This requires frequent glycaemia monitoring, and the gold standards for this are fingerstick tests. During the last decades, several blood-withdrawal-free platforms have been being studied to replace this test and to improve significantly the quality of life of people with diabetes (PWD). Devices estimating glycaemia level targeting blood or biofluids such as tears, saliva, breath and sweat, are gaining attention; however, most are not reliable, user-friendly and/or cheap. Given the complexity of the topic and the rise of diabetes, a careful analysis is essential to track scientific and industrial progresses in developing diabetes management systems. Here, we summarize the emerging blood glucose level (BGL) measurement methods and report some examples of devices which have been under development in the last decades, discussing the reasons for them not reaching the market or not being really non-invasive and continuous. After discussing more in depth the history of Raman spectroscopy-based researches and devices for BGL measurements, we will examine if this technique could have the potential for the development of a user-friendly, miniaturized, non-invasive and continuous blood glucose-monitoring device, which can operate reliably, without inter-patient variability, over sustained periods.

Continuous cardiac rhythm monitoring post-stroke: A feasibility study in REGARDS

ObjectivesCardiac rhythm monitoring is increasingly used after stroke. We studied feasibility of telephone guided, mail-in ambulatory long-term cardiac rhythm monitoring in Black and White stroke survivors. Materials and methods;We contacted 28 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who had an ischemic stroke during follow-up. After obtaining informed consent by telephone, a noninvasive 14-day cardiac rhythm monitoring device (ZIO® XT patch; iRhythm Technologies, San Francisco, CA) was mailed to each participant. We evaluated the results of telephone consent, follow-up calls, compliance and wear time as the primary objective. Secondarily, we reported prevalence of atrial and ventricular arrhythmias. ResultsThe majority of those contacted (20/28 = 71%) agreed to enroll in the monitoring study. Non-participation was nominally more common in Black than White participants; 6/16 (37.5%) vs. 2/12 (17%). Of those who agreed, 15 participants (75%, 6 Black, 9 White) completed ambulatory monitoring with mean wear time 12.9 ± 2.5 days. Arrhythmias were observed in two-thirds of the 15 participants: AF in 2, brief atrial tachycardia in 12, NSVT in 2, premature ventricular contractions in 3, and pause or atrioventricular block in 2. ConclusionsNon-invasive rhythm monitoring was feasible in this pilot from a large, national cohort study of stroke survivors that employed a telephone guided, mail-in monitoring system, and these preliminary results suggest a high prevalence of arrhythmias. Increased emphasis on recruitment strategies for Black stroke survivors may be required. We demonstrated a high yield of significant cardiac arrhythmias among post-stroke participants who completed monitoring.

Telemedicine and Remote Rehabilitation for Patients with Cardiac Disease Post COVID-19 Era

Background The COVID-19 pandemic has accelerated the changes of daily practice in medical care worldwide. Telemedicine is one of the most stimulated fields among these changes, even in the cardiovascular disease care. In the past decade, remote monitoring has become an important tool that provides valuable clinical information via respiratory assist devices and implantable pacemakers from patients at home. Objective The objective of our study was to investigate whether these remote monitoring approaches could include a broader spectrum of patients with cardiac disease with the development of noninvasive monitoring devices. Methods Several pilot studies of telemedicine-based monitoring systems using commercially available digital devices were conducted in the infectious disease wards and other clinical settings during the COVID-19 pandemic. We evaluated the effectiveness of a remote heart monitoring system that provides real-time electrocardiogram and other vital signs monitoring in patients with cardiovascular disease. A newly developed remote cardiac rehabilitation system was also evaluated. Results We found that current remote monitoring technology could provide sufficient monitoring of vital signs, suggesting a potential to predict a worsening of heart failure in advance. Remote cardiac rehabilitation could be effectively and safely provided in patients with low to medium risk. Conclusions Telemedicine and remote cardiac rehabilitation possess a great potential in the cardiovascular disease practice post COVID-19 era; however, there are several unsolved issues regarding their implementation in the real-world clinical practice.

Waveform Morphology Comparison in Wearable Blood Pressure Sensors.

Wearable devices for continuous non-invasive blood pressure monitoring must be capable of providing a continuous waveform representative of arterial blood pressure. This paper establishes the distinctions in waveform morphology between wearable sensor modalities, specifically millimeter-wave radar and photoplethysmography, when compared to a reference continuous non-invasive blood pressure monitor. An analysis of a 115-subject dataset was conducted to assess waveform suitability. Millimeter-wave radar waveform morphology was found to more closely resemble continuous non-invasive blood pressure than photoplethysmography. Clinical Relevance- This paper compares the waveform morphology and content of signals from wearable sensors in the context of continuous non-invasive blood pressure monitoring.

Noninvasive Blood Glucose Monitoring Systems Using Near-Infrared Technology-A Review.

The past few decades have seen ongoing development of continuous glucose monitoring (CGM) systems that are noninvasive and accurately measure blood glucose levels. The conventional finger-prick method, though accurate, is not feasible for use multiple times a day, as it is painful and test strips are expensive. Although minimally invasive and noninvasive CGM systems have been introduced into the market, they are expensive and require finger-prick calibrations. As the diabetes trend is high in low- and middle-income countries, a cost-effective and easy-to-use noninvasive glucose monitoring device is the need of the hour. This review paper briefly discusses the noninvasive glucose measuring technologies and their related research work. The technologies discussed are optical, transdermal, and enzymatic. The paper focuses on Near Infrared (NIR) technology and NIR Photoplethysmography (PPG) for blood glucose prediction. Feature extraction from PPG signals and glucose prediction with machine learning methods are discussed. The review concludes with key points and insights for future development of PPG NIR-based blood glucose monitoring systems.

From disease to noninvasive intracranial monitoring.

Professor Sérgio Mascarenhas was a Brazilian researcher with a vast legacy. His work paved the way for new research possibilities by consolidating the use of innovation and transdisciplinary science. In Medicine, he proposed changes to what had previously been well-accepted concepts, and his contributions have influenced medical practices. Although many authors consider intracranial pressure (ICP) as an unrivaled variable for monitoring and diagnosis of many diseases, its clinical applicability is still the subject of debate in the literature because of the difficulty in standardizing protocols. Mascarenhas's research and the creation of a device for noninvasive monitoring of intracranial compliance are discussed and are shown to have led to the creation of Brain4care, a start-up, and a new perspective on the debate on ICP monitoring.

Simultaneous monitoring of the middle cerebral and basilar arteries to detect right-to-left shunts using transcranial Doppler by agitated saline administration

Transcranial Doppler (TCD) is an easy, non-invasive, and real-time monitoring device for detecting right-to-left shunts (RLS). Nonetheless, it has limited benefits in patients with poor temporal windows. Therefore, we aimed to investigate whether the basilar artery (BA) window was as effective as the middle cerebral artery (MCA) in detecting RLS during TCD monitoring. Overall, we enrolled 344 patients with stroke, transient ischemic attack, headache, or dizziness. MCA and BA were monitored using a modified headset. To investigate the feasibility of the suboccipital window in detecting RLS, we instituted an evaluation tool with three tiers to evaluate microembolic signals (MESs) during TCD monitoring. Tier 1: TCD monitoring of the MCA (bilaterally) in the resting state, tier 2: TCD monitoring of the MCA (bilaterally) while performing the Valsalva maneuver, and tier 3: TCD monitoring of the index MCA and BA while performing the Valsalva maneuver. In tiers 2 and 3, a high agreement rate of 0.808 and 0.809 (p < 0.001), respectively, on the weighted kappa index, and a high intra-class correlation coefficient of 0.982 and 0.986 (p < 0.001), respectively, were observed on detecting MESs. Our data suggests that the BA window is as effective as the MCA window for detecting RLS on TCD.

Hemodynamic Monitoring in the ICU: the More Invasive, the Better?

Less invasive or even completely non-invasive haemodynamic monitoring technologies have evolved during the last decades. However, the invasive devices such as the pulmonary artery catheter and transpulmonary thermodilution technologies are still the clinical gold standard in terms of advanced haemodynamic monitoring, especially in the treatment of critically ill patients. The current data situation regarding the early use of continuous haemodynamic monitoring in this patient population, specifically flow-based variables such as stroke volume to prevent occult hypoperfusion, is overwhelming. However, the effective implementation of these technologies in daily clinical routine is remarkably low. Given the fact that perioperative morbidity and mortality are higher than anticipated, anaesthesiologists and intensivists are in charge to deal with this problem. The recent advances in minimally invasive and non-invasive haemodynamic monitoring technologies may facilitate a more widespread use in the operating theatre and in critical care patients. This review evaluates the significance of invasive, minimally- and non-invasive monitoring devices and their specific haemodynamic variables in this particular field of perioperative medicine.

Influence of enzyme immobilization and skin-sensor interface on non-invasive glucose determination from interstitial fluid obtained by magnetohydrodynamic extraction

We integrated a magnetohydrodynamic fluid extractor with an amperometric glucose biosensor to develop a wearable device for non-invasive glucose monitoring. Reproducible fluid extraction through the skin and efficient transport of the extracted fluid to the biosensor surface are prerequisites for non-invasive glucose monitoring. We optimized the enzyme immobilization and the interface layer between the sensing device and the skin. The monitoring device was evaluated by extracting fluid through porcine skin followed by glucose detection at the biosensor. The biosensor featured a screen-printed layer of Prussian Blue that was coated with a layer containing glucose oxidase. Both physical entrapment of glucose oxidase in chitosan and tethering of glucose oxidase to electrospun nanofibers were evaluated. Binding of glucose oxidase to nanofibers under mild conditions provided a stable biosensor with analytical performance suitable for accurate detection of micromolar concentrations of glucose. Hydrogels of varying thickness (95–2000 μm) as well as a thin (30 μm) nanofibrous polycaprolactone mat were studied as an interface layer between the biosensor and the skin. The effect of mass transfer phenomena at the biosensor-skin interface on the analytical performance of the biosensor was evaluated. The sensing device detected glucose extracted through porcine skin with an apparent (overall) sensitivity of −0.8 mA/(M·cm2), compared to a sensitivity of −17 mA/(M·cm2) for measurement in solution. The amperometric response of the biosensor correlated with the glucose concentration in the fluid that had been extracted through porcine skin with the magnetohydrodynamic technique.

Superweak biophoton emission: possible biological significance and ways of practical use

Widespread in nature ability of biological objects to emit photons (biophotons) made it possible to create devices for non-invasive and continuous monitoring of the metabolism of organs and tissues, used as a powerful clinical diagnostic tool, as well as for visualisation and spatio-temporal analysis of functioning organs and, in particular, the brain. Numerous experimental data indicating the participation of biophotons in the processes of inter- and intracellular communication served as a theoretical basis for the medical use of low-intensity light therapy for the effective treatment of a wide range of diseases, including delayed wound healing, pain in arthritis, and acute stroke.

Combining Physiology-Based Modeling and Evolutionary Algorithms for Personalized, Noninvasive Cardiovascular Assessment Based on Electrocardiography and Ballistocardiography.

Purpose: This study proposes a novel approach to obtain personalized estimates of cardiovascular parameters by combining (i) electrocardiography and ballistocardiography for noninvasive cardiovascular monitoring, (ii) a physiology-based mathematical model for predicting personalized cardiovascular variables, and (iii) an evolutionary algorithm (EA) for searching optimal model parameters.Methods: Electrocardiogram (ECG), ballistocardiogram (BCG), and a total of six blood pressure measurements are recorded on three healthy subjects. The R peaks in the ECG are used to segment the BCG signal into single BCG curves for each heart beat. The time distance between R peaks is used as an input for a validated physiology-based mathematical model that predicts distributions of pressures and volumes in the cardiovascular system, along with the associated BCG curve. An EA is designed to search the generation of parameter values of the cardiovascular model that optimizes the match between model-predicted and experimentally-measured BCG curves. The physiological relevance of the optimal EA solution is evaluated a posteriori by comparing the model-predicted blood pressure with a cuff placed on the arm of the subjects to measure the blood pressure.Results: The proposed approach successfully captures amplitudes and timings of the most prominent peak and valley in the BCG curve, also known as the J peak and K valley. The values of cardiovascular parameters pertaining to ventricular function can be estimated by the EA in a consistent manner when the search is performed over five different BCG curves corresponding to five different heart-beats of the same subject. Notably, the blood pressure predicted by the physiology-based model with the personalized parameter values provided by the EA search exhibits a very good agreement with the cuff-based blood pressure measurement.Conclusion: The combination of EA with physiology-based modeling proved capable of providing personalized estimates of cardiovascular parameters and physiological variables of great interest, such as blood pressure. This novel approach opens the possibility for developing quantitative devices for noninvasive cardiovascular monitoring based on BCG sensing.

On the use of fiber lasers in non-invasive blood glucose monitoring

Diabetes is a chronic metabolic disorder, which may lead to a series of serious complications and endanger human life in severe cases. Regular monitoring of blood sugar levels can help patients prevent diabetes complications. In this review, firstly, the causes and classification of diabetes, the background knowledge of non-invasive blood glucose monitoring, the classification of blood glucose monitoring methods, the basic theory of optical methods, and the process of non-invasive blood glucose monitoring are described. Then, the basic structure of the fiber laser, and the significant characteristics of the output light pulse are introduced. Most importantly, five optical methods that the fiber laser can be applied to non-invasive blood glucose monitoring are described in detail. Finally, this review describes the process of electrical signal processing in the non-invasive blood glucose monitoring device, some important algorithms, and the means of device performance evaluation.

Performance of non-invasive stroke volume variation during passive leg raising as a predictor of hypotension following induction of spinal anesthesia for elective cesarean delivery: a single cohort study

BackgroundSpinal anesthesia for cesarean delivery is accompanied by hypotension in up to 70% of cases. To date, there is no gold standard for predicting hypotension after spinal anesthesia for cesarean delivery. The Clearsight™ device is a non-invasive system that uses a digital cuff to calculate stroke volume. We hypothesized that stroke volume variation induced with passive leg raising before spinal anesthesia for elective cesarean delivery could predict the occurrence of hypotension. MethodsWe conducted a prospective observational study, including third trimester parturients undergoing elective cesarean delivery with spinal anesthesia. We analyzed the stroke volume variation performance for predicting hypotension. Stroke volume was collected in the semi-recumbent position (baseline) and during passive leg raising before spinal anesthesia. Systolic arterial blood pressure measurement was followed for 15 min after spinal anesthesia. Hypotension was defined as a ≥20% decrease from the baseline measurement. All parturients received appropriate hypotension prophylaxis. ResultsData from 42 parturients were analyzed. Hypotension occurred in 45%. The area-under-the curve for predicting hypotension using the stroke volume variation was 0.83 (95% CI 0.68 to 0.98; P=0.001). The best cut-off value for predicting hypotension was 7%, having a sensitivity of 87% (95% CI 0.70 to 0.99) and a specificity of 83% (95% CI 0.69 to 0.97). ConclusionIn our study of third trimester parturients undergoing cesarean delivery and receiving appropriate hypotension prophylaxis, a digital non-invasive monitoring device of stroke volume variation analysis was useful for predicting the occurrence of hypotension after spinal anesthesia.

Non-Invasive Hemoglobin Monitoring Device using K-Nearest Neighbor and Artificial Neural Network Back Propagation Algorithms

Non-Invasive Hemoglobin Monitoring Device using K-Nearest Neighbor and Artificial Neural Network Back Propagation Algorithms

Exhaled Breath Analysis for Diabetes Diagnosis and Monitoring: Relevance, Challenges and Possibilities.

With the global population prevalence of diabetes surpassing 463 million cases in 2019 and diabetes leading to millions of deaths each year, there is a critical need for feasible, rapid, and non-invasive methodologies for continuous blood glucose monitoring in contrast to the current procedures that are either invasive, complicated, or expensive. Breath analysis is a viable methodology for non-invasive diabetes management owing to its potential for multiple disease diagnoses, the nominal requirement of sample processing, and immense sample accessibility; however, the development of functional commercial sensors is challenging due to the low concentration of volatile organic compounds (VOCs) present in exhaled breath and the confounding factors influencing the exhaled breath profile. Given the complexity of the topic and the skyrocketing spread of diabetes, a multifarious review of exhaled breath analysis for diabetes monitoring is essential to track the technological progress in the field and comprehend the obstacles in developing a breath analysis-based diabetes management system. In this review, we consolidate the relevance of exhaled breath analysis through a critical assessment of current technologies and recent advancements in sensing methods to address the shortcomings associated with blood glucose monitoring. We provide a detailed assessment of the intricacies involved in the development of non-invasive diabetes monitoring devices. In addition, we spotlight the need to consider breath biomarker clusters as opposed to standalone biomarkers for the clinical applicability of exhaled breath monitoring. We present potential VOC clusters suitable for diabetes management and highlight the recent buildout of breath sensing methodologies, focusing on novel sensing materials and transduction mechanisms. Finally, we portray a multifaceted comparison of exhaled breath analysis for diabetes monitoring and highlight remaining challenges on the path to realizing breath analysis as a non-invasive healthcare approach.

Intensive Care in Sub-Saharan Africa: A National Review of the Service Status in Ethiopia.

BACKGROUND:The burden of critical illness in low-income countries is high and expected to rise. This has implications for wider public health measures including maternal mortality, deaths from communicable diseases, and the global burden of disease related to injury. There is a paucity of data pertaining to the provision of critical care in low-income countries. This study provides a review of critical care services in Ethiopia.METHODS:Multicenter structured onsite surveys incorporating face-to-face interviews, narrative discussions, and on-site assessment were conducted at intensive care units (ICUs) in September 2020 to ascertain structure, organization, workforce, resources, and service capacity. The 12 recommended variables and classification criteria of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) taskforce criteria were utilized to provide an overview of service and service classification.RESULTS:A total of 51 of 53 (96%) ICUs were included, representing 324 beds, for a population of 114 million; this corresponds to approximately 0.3 public ICU beds per 100,000 population. Services were concentrated in the capital Addis Ababa with 25% of bed capacity and 51% of critical care physicians. No ICU had piped oxygen. Only 33% (106) beds had all of the 3 basic recommended noninvasive monitoring devices (sphygmomanometer, pulse oximetry, and electrocardiography). There was limited capacity for ventilation (n = 189; 58%), invasive monitoring (n = 9; 3%), and renal dialysis (n = 4; 8%). Infection prevention and control strategies were lacking.CONCLUSIONS:This study highlights major deficiencies in quantity, distribution, organization, and provision of intensive care in Ethiopia. Improvement efforts led by the Ministry of Health with input from the acute care workforce are an urgent priority.

Everything You Wanted to Know About Continuous Glucose Monitoring

Diabetes is a chronicle disease where the body of a human is irregular to dissolve the blood glucose properly. The diabetes is due to lack of insulin in human body. The continuous monitoring of blood glucose is main important aspect for health care. Most of the successful glucose monitoring devices is based on methodology of pricking of blood. However, such kind of approach may not be advisable for frequent measurement. The paper presents the extensive review of glucose measurement techniques. The paper covers various non-invasive glucose methods and its control with smart healthcare technology. To fulfill the imperatives for non-invasive blood glucose monitoring system, there is a need to configure an accurate measurement device. Noninvasive glucose-level monitoring device for clinical test overcomes the problem of frequent pricking for blood samples. There is requirement to develop the Internet-Medical-Things (IoMT) integrated Healthcare Cyber-Physical System (H-CPS) based Smart Healthcare framework for glucose measurement with purpose of continuous health monitoring. The paper also covers selective consumer products along with selected state of art glucose measurement approaches. The paper has also listed several challenges and open problems for glucose measurement.

In vivo optical coherence tomography-guided photodynamic therapy for skin pre-cancer and cancer

BackgroundThe primary aim of this prospective study is to demonstrate the technical feasibility of OCT to map real tumor margins and to monitor skin changes that occurred post- PDT. Moreover, to optimize PDT efficacy based on the relationship between measured OCT features and treatment outcome. Material and MethodsA series of 12 patients with overall 18 facial skin lesions were investigated by OCT before surface illumination by PDT to determine tumor free margins. Monitoring of the healing process was undertaken at 3, 6 and 12 months post-PDT. Parameters measured by the in vivo OCT during healing phase were the organization of skin layer and the degree skin fibroses for the active center and peripheral transit zone of the treated lesion. Clinical and aesthetics assessment was carried out at 12-month post-PDT. ResultsDistinct microstructural differences between normal skin, pre-cancer, cancer, and the transition zone between the two tissues were observed on OCT images. In the subsequent healing phase, OCT demonstrate marked delineation and organization of skin layer at late stage of healing. Early features showing bizarre non-homogenous disorganized layering (scab) but afterwards, OCT was able to differentiate between different histological layers. One lesion demonstrated clinical healing by fibrosis (scar) without sign of recurrence. Another lesion demonstrated skin erythema. Only one lesion did not response to treatment despite margins clearance. The CR rate was 95% at the end of the study. The cosmetic effect was "excellent" in 89% of the patients. ConclusionsThis feasibility study lays the groundwork for using OCT as a real-time, noninvasive monitoring device for PDT in patients with skin cancer.

NB-SQI: A novel non-binary signal quality index for continuous blood pressure waveforms

Continuous blood pressure monitoring has utmost importance in healthcare, but is usually realised by invasive arterial cannulation. Non-invasive solutions are starting to become a viable option, but these solutions are more sensitive to sensor placement and patient movement. To support these non-invasive monitoring devices, a continuous signal quality feedback would be advantageous. The aim of this study is to define a non-binary signal quality index (NB-SQI) for continuous blood pressure waveforms that can be used for monitoring devices. The definition of this NB-SQI is based on features derived from the continuous waveform of the cardiac cycle and it tests the abnormality of the signal and measures the normalised deviation of its characteristics from an expected value. The method was validated with a dataset of 20 signals, each 10 s long, and labelled by senior specialists in the field of vascular surgery and anesthesiology. The NB-SQI showed a 0.95 correlation with the labels of the validation set. The tendency of the NB-SQI was tested on generated and measured signals corrupted by generated noises on different levels. The results showed that the NB-SQI gives a quantitative estimation in the higher quality range, and recognises the abnormal and noise corrupted segments. The defined NB-SQI can have a significant contribution to the development of non-invasive continuous blood pressure monitors, but it can also be used in signal processing or signal classification for diagnostic purposes.