Trending Technology of Glucose Monitoring during COVID-19 Pandemic: Challenges in Personalized Healthcare

Technology and Continuous Glucose Monitoring Access, Literacy, and Use Among Patients at the Diabetes Center of an Inner-City Safety-Net Hospital: Mixed Methods Study

BACKGROUND

Despite the existence of an increasing array of digital technologies and tools for diabetes management, there are disparities in access to and uptake and use of continuous glucose monitoring (CGM) devices, particularly for those most at risk of poor diabetes outcomes.

OBJECTIVE

This study aims to assess communication technology and CGM access, literacy, and use among patients receiving treatment for diabetes at an inner-city safety-net hospital.

METHODS

A survey on digital technology ownership and use was self-administered by 75 adults with type 1 and type 2 diabetes at the diabetes clinic of Grady Memorial Hospital in Atlanta, Georgia. In-depth interviews were conducted with 16% (12/75) of these patient participants and 6 health care providers (HCPs) to obtain additional insights into the use of communication technology and CGM to support diabetes self-management.

RESULTS

Most participants were African American (66/75, 88%), over half (39/75, 52%) were unemployed or working part time, and 29% (22/75) had no health insurance coverage, while 61% (46/75) had federal coverage. Smartphone ownership and use were near universal; texting and email use were common (63/75, 84% in both cases). Ownership and use of tablets and computers and use and daily use of various forms of media were more prevalent among younger participants and those with type 1 diabetes, who also rated them as easier to use. Technology use specifically for diabetes and health management was low. Participants were supportive of a potential smartphone app for diabetes management, with a high interest in such an app helping them track blood sugar levels and communicate with their care teams. Younger participants showed higher levels of interest, perceived value, and self-efficacy for using an app with these capabilities. History of CGM use was reported by 56% (42/75) of the participants, although half (20/42, 48%) had discontinued use, above all due to the cost of the device and issues with its adhesive. Nonuse was primarily due to not being offered CGM by their HCP. Reasons given for continued use included convenience, improved blood glucose control, and better tracking of blood glucose. The in-depth interviews (n=18) revealed high levels of satisfaction with CGM by users and supported the survey findings regarding reasons for continued use. They also highlighted the value of CGM data to enhance communication between patients and HCPs.

CONCLUSIONS

Smartphone ownership was near universal among patients receiving care at an inner-city hospital. Alongside the need to address barriers to CGM access and continued use, there is an opportunity to leverage increased access to communication technology in combination with CGM to improve diabetes outcomes among underresourced populations.

A Small Highly Sensitive Glucose Sensor Based on a Glucose Oxidase-Modified U-Shaped Microfiber

Diabetes patients need to monitor blood glucose all year round. In this article, a novel scheme is proposed for blood glucose detection. The proposed sensor is based on a U-shaped microfiber prepared using hydrogen-oxygen flame-heating technology, and then 3-aminopropyltriethoxysilane (APTES) and glucose oxidase (GOD) are successively coated on the surface of the U-shaped microfiber via a coating technique. The glucose reacts with the GOD of the sensor surface to produce gluconic acid, which changes the effective refractive index and then shifts the interference wavelength. The structure and morphology of the sensor were characterized via scanning electron microscope (SEM) and confocal laser microscopy (CLM). The experimental results show that the sensitivity of the sensor is as high as 5.73 nm/(mg/mL). Compared with the glucose sensor composed of the same material, the sensitivity of the sensor increased by 329%. The proposed sensor has a broad application prospect in blood glucose detection of diabetic patients due to the advantages of miniaturization, high sensitivity, and good stability.

Recent Advances in Biosensor Technologies for Point-of-Care Urinalysis

Human urine samples are non-invasive, readily available, and contain several components that can provide useful indicators of the health status of patients. Hence, urine is a desirable and important template to aid in the diagnosis of common clinical conditions. Conventional methods such as dipstick tests, urine culture, and urine microscopy are commonly used for urinalysis. Among them, the dipstick test is undoubtedly the most popular owing to its ease of use, low cost, and quick response. Despite these advantages, the dipstick test has limitations in terms of sensitivity, selectivity, reusability, and quantitative evaluation of diseases. Various biosensor technologies give it the potential for being developed into point-of-care (POC) applications by overcoming these limitations of the dipstick test. Here, we present a review of the biosensor technologies available to identify urine-based biomarkers that are typically detected by the dipstick test and discuss the present limitations and challenges that future development for their translation into POC applications for urinalysis.

Multifunctional Flexible Humidity Sensor Systems Towards Noncontact Wearable Electronics

In the past decade, the global industry and research attentions on intelligent skin-like electronics have boosted their applications in diverse fields including human healthcare, Internet of Things, human-machine interfaces, artificial intelligence and soft robotics. Among them, flexible humidity sensors play a vital role in noncontact measurements relying on the unique property of rapid response to humidity change. This work presents an overview of recent advances in flexible humidity sensors using various active functional materials for contactless monitoring. Four categories of humidity sensors are highlighted based on resistive, capacitive, impedance-type and voltage-type working mechanisms. Furthermore, typical strategies including chemical doping, structural design and Joule heating are introduced to enhance the performance of humidity sensors. Drawing on the noncontact perception capability, human/plant healthcare management, human-machine interactions as well as integrated humidity sensor-based feedback systems are presented. The burgeoning innovations in this research field will benefit human society, especially during the COVID-19 epidemic, where cross-infection should be averted and contactless sensation is highly desired.

The Impact of Sustainable Management Strategies of Sports Apparel Brands on Brand Reliability and Purchase Intention through Single Person Media during COVID-19 Pandemic: A Path Analysis

Recently, a variety of efforts have been taken to convey sustainable management strategies of sports apparel brands through single-person media. However, there is a lack of theoretical information on the path that leads these corporate marketing activities to brand reliability and purchase intention of consumers. Therefore, this study aims to analyze the path through which the sustainable management strategy established by a sports apparel brand affects the brand awareness and reliability, as well as the purchase intention of consumers when experiencing this strategy through single-person media. The results are summarized as follows: Firstly, the sustainable management strategies of a sports apparel brand carried out through single-person media had statistically significant positive impacts on the benevolence reliability perceived by single-person media viewers. Secondly, benevolence also had a statistically significant positive impact on the consumers’ purchase intention. It is expected that the results of this study will serve as an important resource for the methods of utilizing sustainable management strategies among sports apparel brands in the future.

Construction of a binder-free non-enzymatic glucose sensor based on Cu@Ni core-shell nanoparticles anchored on 3D chiral carbon nanocoils-nickel foam hierarchical scaffold

Bimetallic nanostructures composited with carbonaceous materials are the potential contenders for quantitative glucose measurement owing to their unique nanostructures, high biomimetic activity, synergistic effects, good conductivity and chemical stability. In the present work, chemical vapors deposition technique has been employed to grow 3D carbon nanocoils (CNCs) with a chiral morphology on hierarchical macroporous nickel foam (NF) to get a CNCs/NF scaffold. Following, bimetallic Cu@Ni core-shell nanoparticles (CSNPs) are effectively coupled with this scaffold through a facile solvothermal route in order to fabricate a binder-free novel Cu@Ni CSNPs/CNCs/NF hybrid nanostructure. The constructed free-standing 3D hierarchical composite electrode guarantees highly efficient glucose redox activity due to core-shell synergistic effects, enhanced electrochemical active surface area, excellent electrochemical stability, improved conductivity with better ion diffusivity and accelerated reaction kinetics. Being a non-enzymatic glucose sensor, this electrode achieves highly swift response time of 0.1 s, ultra-high sensitivity of 6905 μA mM^-1 cm^-2, low limit of detection of 0.03 μM along with potential selectivity and good storage stability. Moreover, the proposed sensor is also tested successfully for the determination of glucose concentration in human serum samples under good recovery ranging from 96.6 to 102.1 %. The 3D Cu@Ni CSNPs/CNCs/NF composite electrode with unprecedented catalytic performance can be utilized as an ideal biomimetic catalyst in the field of non-enzymatic glucose sensing.

A novel NiVP/Pi-based flexible sensor for direct electrochemical ultrasensitive detection of cholesterol

A novel non-enzymatic electrochemical sensor was constructed to achieve a highly selective and ultrasensitive detection of cholesterol to address the problems related to serious coronary heart disease. The NiVP/Pi-based sensor exhibited ultra-high sensitivity of 5510.18 μA μM^-1 cm^-2 and 36.8 μA μM^-1 cm^-2 for 1 nM to 10 μM and 100 μM to 10 mM of cholesterol, respectively, with an ultra-low detection limit of 1 aM, along with superior selectivity for cholesterol when exposed to various interferents such as ascorbic acid, glucose and uric acid. Also, a novel NiVP/Pi-based flexible sensor coated onto Whatman filter paper was developed and displayed superior sensitivity, even with a human blood serum sample at physiological pH.

Investigating host-virus interaction mechanism and phylogenetic analysis of viral proteins involved in the pathogenesis

Since the emergence of yellow fever in the Americas and the devastating 1918 influenza pandemic, biologists and clinicians have been drawn to human infecting viruses to understand their mechanisms of infection better and develop effective therapeutics against them. However, the complex molecular and cellular processes that these viruses use to infect and multiply in human cells have been a source of great concern for the scientific community since the discovery of the first human infecting virus. Viral disease outbreaks, such as the recent COVID-19 pandemic caused by a novel coronavirus, have claimed millions of lives and caused significant economic damage worldwide. In this study, we investigated the mechanisms of host-virus interaction and the molecular machinery involved in the pathogenesis of some common human viruses. We also performed a phylogenetic analysis of viral proteins involved in host-virus interaction to understand the changes in the sequence organization of these proteins during evolution for various strains of viruses to gain insights into the viral origin's evolutionary perspectives.

The Application of Wearable Glucose Sensors in Point-of-Care Testing

Diabetes and its complications have become a worldwide concern that influences human health negatively and even leads to death. The real-time and convenient glucose detection in biofluids is urgently needed. Traditional glucose testing is detecting glucose in blood and is invasive, which cannot be continuous and results in discomfort for the users. Consequently, wearable glucose sensors toward continuous point-of-care glucose testing in biofluids have attracted great attention, and the trend of glucose testing is from invasive to non-invasive. In this review, the wearable point-of-care glucose sensors for the detection of different biofluids including blood, sweat, saliva, tears, and interstitial fluid are discussed, and the future trend of development is prospected.

Highly sensitive non-enzymatic electrochemical glucose sensor surpassing water oxidation interference

An electrochemical non-enzymatic sensor based on a NiVP/Pi material was developed for the selective and sensitive determination of glucose. The novel sensor showed a high sensitivity of 6.04 mA μM-1 cm-2 with a lowest detection limit of 3.7 nM in a wide detection range of 100 nM-10 mM. The proposed sensor exhibited a superior selectivity without any interference from the oxygen evolution reaction during glucose sensing. We also found that this glucose sensor showed negligible interference from various interferents, such as ascorbic acid, uric acid, dopamine and sodium chloride. Additionally, a novel flexible sensor was developed by coating the NiVP/Pi over Whatman filter paper, which exhibited two linear ranges of 100 nM to 1 μM and 100 μM to 10 mM with an ultra-sensitivity of 1.130 mA μM-1 cm-2 and 0.746 mA μM-1 cm-2, respectively, in 0.1 M NaOH. The proposed sensor was tested with human blood serum samples demonstrating its practical application. Our findings provide a new route by fine tuning the composition of nickel and vanadium that sheds new light on better understanding the processes. This NiVP/Pi-based sensor offers a new approach towards the electrochemical detection of glucose, enabling glucose monitoring in a convenient way.