Effects of Continuous Non-Invasive Blood Pressure Monitoring on Intraoperative Hemodynamics and Postoperative Myocardial Injury in Craniotomy:Comparison Between Groups Based on Self-Control and Propensity Score Matching

Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.

Progress in Intraoperative Neurophysiological Monitoring for the Surgical Treatment of Thoracic Spinal Stenosis

Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%.Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation. This article illustrates the theoretical basis of applying IONM in thoracic decompression surgery, and elaborates on the relationship between signal changes in IONM and postoperative neurological function recovery of the spinal cord. It also introduces updated information in multimodality IONM, the factors influencing evoked potentials,and remedial measures to improve the prognosis.

An intraoperative lumbar neurological force monitoring system with high-density flexible pressure sensor array

In the surgery of lumbar disc herniation(LDH),the nerve root retractor is used to pull the nerve root to prevent damage.The traditional medical nerve root retractor cannot quantify the force on the nerve root.In order to improve the nerve root retractor,this paper proposes an intraoperative lumbar neurological force monitoring system.The core module of this system is the improved nerve root retractor equipped with the high density flexible pressure sensor array.The high density microneedle array and multiple pressure detection units are used in the pressure sensor to realise sensitive pressure monitoring in a narrow surgical operation area.The sensing area is 4 mm×17 mm,including 6 detection units.The sensitivity of sensor is 67.30%/N in the range of 0-5 N.This system is used for in vitro animal experiments,which can continuously detect pressure.

Review of intraoperative parathormone monitoring with the miami criterion: A 25-year experience

With the development of imaging and localization studies,focused parathyroidectomy with use of intraope-rative parathormone monitoring(IPM)is the mainstay of treatment for primary hyperparathyroidism at many health care centers both nationally and internationally.Focused parathyroidectomy guided by IPM allows for surgical excision of the offending parathyroid gland through smaller incisions.The Miami criterion is a protocol that uses a">50%parathormone(PTH)drop"from either the greatest pre-incision or pre-excision measurement of PTH in a blood sample taken 10 min following resection of hyperfunctioning glands.Following removal of the hyperfunctioning parathyroid gland,a>50%PTH drop at 10 min indicates completion of parathyroidectomy,and predicts operative success at6 mo.IPM using the Miami criterion has demonstrated equal curative rates of>97%,which is comparable to the traditional bilateral neck exploration.The focused approach,however,is associated with shorter recovery times,improved cosmesis,and lower risk of postoperative hypocalcemia.

Evolution and Role of Intraoperative Neurophysiological Monitoring in Intramedullary Spinal Cord Surgery: A 2-Year Series from Saudi Arabia

Introduction: Despite recent advances in neuroimaging and microsurgical techniques, surgical resection of spinal cord tumours remains a challenge. However, the evolution with advances and refinement of neurophysiological equipment and methodologies, intra-operative neurophysiolo- gical monitoring (IONM) is now regarded as an essential adjunct to the surgical management of intramedullary spinal cord tumours. This study aims to report our preliminary experience with IONM and emphasise its effective role of achieving maximum tumour resection and minimising neurological injury. Methods: This is a retrospective study performed at our institution between July 2012 and August 2013. It included a cohort of 6 consecutive patients presented with intramedullary spinal cord tumours. Their mean age was 26 years (range, 4 months - 37 years), all were males, and the mean follow up was 11.6 months. Results: We combined the use of somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) in spinal cord surgery. SSEPs are monitored during the incision of the dorsal midline of the spinal cord and this was used in two of our patients and MEPs were used as an essential monitoring during the tumour resection. In addition, we used free-running electromyography (EMG) and muscle MEPs (mMEPs) during tumour resection. Four of our patients (two with ependymoma, one with ganglioglioma, and one with pilocytic astrocytoma) had complete tumour resection and two patients (pilocytic and diffuse astrocytoma) had IONM changes during surgery and had partial tumour resection. At 6-month follow up all our patients had made a good recovery with no new neurological sequelae. Conclusion: This small series and literature review is presented to add and improve the understanding of IONM in intramedullary spinal cord procedures and to reinforce the importance of IONM in optimising tumour resection and neurological outcome. Our series confirm that without D-wave monitoring, free-running EMG and MEP monitoring during tumour resection remain an important adjunct. We also draw attention to the fact that changes in the free-running EMG occur before any changes in the MEPs are noted.

Surgical strategies for peripheral nerve schwannoma based on the intraoperative neurophysiological monitoring

Objective:To present our classification for peripheral nerve schwannomas as well as explore the surgical strategies and operative management of peripheral nerve schwannomas based on the intraoperative neurophysiological monitoring(INM)technique and to decrease the risk of postoperative neurological deficits in the management of these schwannomas.Materials and methods:A retrospective study was conducted on 92 cases of peripheral nerve microsurgery performed,using the INM technique.We also made the classification for peripheral nerve schwannomas into two types according to operative findings and proceeded corresponding surgical strategies.Results:All tumors were removed completely under microscopy and INM.Three patients developed residual neurological deficits at final follow-up.There were different results about temporary(18/92,19.6%)and permanent(3/92,3.3%)neurological deficits.The incidence of temporary and permanent neurological deficits in type II group was significantly higher than that in type I group(p<0.01).The incidence of permanent neurological deficits in larger size tumors was significantly higher than that of smaller size(p<0.01).Conclusions:We made the classification for peripheral nerve schwannomas according to operative findings based on INM that is helpful to our surgical strategies.Intracapsular enucleation was the preferred strategy with satisfactory results and low risk of nerve injury.The size and location of tumors seem to be related to the risk of fascicular injury.

BIS Monitoring on Intraoperative Awareness： A Meta-analysis

Intraoperative awareness is a very serious complication of general anesthesia. Several studies have evaluated the potential association between bispectral index （BIS） and intraoperative awareness, however, the results obtained were controversial. Therefore, we performed a metaanalysis to further assess the association between the BIS monitoring and the incidence of intraoperative awareness. A comprehensive search was conducted to identify all eligible studies from the online literature databases published prior to Feb. 2017. A total of five studies with 17 432 cases and 16 749 controls were included. An odds ratio （OR） and a 95% confidence interval （CI） were calculated to examine the strength of the association. The results showed that in the overall analysis, the association between the BIS monitoring and the incidence of intraoperative awareness was not significant （OR=0.58, 95% CI= 0.22-1.58, P=0.29）. A stratified analysis by comparing different anesthesia methods revealed that BIS monitoring group showed a lower incidence of intraoperative awareness in patients with intravenous anesthesia when compared with non-BIS monitoring group （OR=0.20, 95% CI=0.08-0.49, P=-0.0004）, whereas there was no statistically significant difference in the incidence of intraoperative awareness between BIS and non-BIS monitoring groups in patients with inhalation anesthesia （OR=1. 13, 95% CI=0.56- 2.26, P=-0.73）. In conclusion, our meta-analysis showed that BIS monitoring had no appreciable advantage in the reduction of the intraoperative awareness incidence in inhalation anesthesia, while showed a remarkable superiority in intravenous anesthesia.

Application and management of continuous glucose monitoring in diabetic kidney disease

Diabetic kidney disease(DKD)is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease(ESKD).Wide glycemic var-iations,such as hypoglycemia and hyperglycemia,are broadly found in diabetic patients with DKD and especially ESKD,as a result of impaired renal metabolism.It is essential to monitor glycemia for effective management of DKD.Hemoglobin A1c(HbA1c)has long been considered as the gold standard for monitoring glycemia for>3 months.However,assessment of HbA1c has some bias as it is susceptible to factors such as anemia and liver or kidney dysfunction.Continuous glucose monitoring(CGM)has provided new insights on glycemic assessment and management.CGM directly measures glucose level in interstitial fluid,reports real-time or retrospective glucose concentration,and provides multiple glycemic metrics.It avoids the pitfalls of HbA1c in some contexts,and may serve as a precise alternative to estimation of mean glucose and glycemic variability.Emerging studies have demonstrated the merits of CGM for precise monitoring,which allows fine-tuning of glycemic management in diabetic patients.Therefore,CGM technology has the potential for better glycemic monitoring in DKD patients.More research is needed to explore its application and management in different stages of DKD,including hemodialysis,peritoneal dialysis and kidney transplantation.

Continuous glucose monitoring metrics in pregnancy with type 1 diabetes mellitus

Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.

The Value of Continuous Noninvasive Hemoglobin Monitoring in Intraoperative Blood Transfusion Practice during Abdominal Cancer Surgery

Introduction: Patients undergoing major oncological surgery may suffer from severe bleeding. Sometimes, it is difficult to anesthesiologist to take decision about timing of administration blood products to such patients. The aim of this study is to evaluate the use of continuous noninvasive hemoglobin monitoring as a guide for blood transfusion practice. Methods: One hundred patients undergoing elective abdominal cancer surgeries were randomly allocated into two groups, Group I (n = 50): laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Group II (n = 50): The probe of Masimo for SpHb monitoring was applied immediately after induction of anesthesia at the index finger. Laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Results: A number of transfused units of RBC were significantly lower in SpHb group than in control group (p value 0.05). Conclusion: SpHb monitoring had clinically acceptable absolute and trend accuracy. SpHb monitoring altered transfusion decision making and resulted in decreased RBC utilization and decreased RBC costs while facilitating earlier transfusions when indicated.

Tunnel, Infrastructure Convergences/Monitoring and Engineering Role

Worldwide we see that the construction industry is expanding, requiring new directions, new perspectives that can help reduce time, cost, and make transportation easy, safe, and affordable. For decades now, most of the large cities have completed their surface infrastructure. It has become urgent to address their issues for overpopulated cities where nowadays all infrastructure is overwhelmed, these issues must be addressed, solved and have vision to build underground infrastructure. Developed countries are focused on expanding their infrastructure for road systems, subway network, railway, storm, and sanitary systems. The emergency for underground infrastructure development requires more large-scale projects to be built and it is becoming more crucial building tunnels/underground structures for the future than ever before. Engineering focus, scientific searches are looking to develop their ideas for designing and delivering project underground, but government, agencies and engineers are concerned about the safety, durability, functionality, and the lifetime of this structures planned to be functional for decades. To address all this concerns this study provides information of how to identify the risk on tunnels and underground structures by capturing data from the beginning phases of construction, to analyze, evaluate and produce bulletins and engineering reports through convergences and monitoring. Convergences are the key factor on development of infrastructure underground as it is the only way to explore and analyze the rock mass disturbance during excavation. Convergences and monitoring in infrastructure are the safety coefficient for building underground, preventing accidents, and assessing real risks associated with tunnel/mine works and ensuring progress of the construction in underground structures. This study delves into the engineering role of convergence monitoring, during construction activities on project excavated using New Austrian Tunnelling method and Sequential Excavation Method. The primary objective of convergence monitoring is to gather critical information on ground movements and disturbances, thereby enhancing safety measures during tunnel construction. The monitoring process serves as an early warning system offering evidence of the real risks associated with underground infrastructure, bringing results and engineering data to be used for the design as key coefficient for structural design, type of material, type and strength of the concrete, rebars, concrete mix design. By using the convergence and monitoring system on underground infrastructure this study represents information that can contribute to risk assessment, structural analysis, and the lifetime of a project.

Review and Prospect of Research on Structural Health Monitoring Technology for Bridges

As a crucial infrastructure in the transport system,the safe operation of bridges is directly related to all aspects of people’s daily lives.The development of bridge structural health monitoring technology and its application play an important role in ensuring the safety and extending the service life of bridges.This paper carries out in-depth research and analysis on the related technology of bridge structural health monitoring.Firstly,the existing monitoring technologies at home and abroad are sorted out,and the advantages and problems of various methods are compared and analyzed,including nondestructive testing,stress measurement,vibration characteristic identification,and other commonly used monitoring technologies.Secondly,the key technologies and equipment in the bridge health monitoring system,such as sensor technology,data acquisition,and processing technology,are introduced in detail.Finally,the development trend in the field of bridge health monitoring is prospected from both theoretical research and technical application.In the future,with the development of emerging technologies such as big data,cloud computing,and the Internet of Things,it is expected that bridge health monitoring with intelligent and systematic features will be more widely applied to provide a stronger guarantee for the safe and efficient operation of bridges.

Application of GNSS-PPP on Dynamic Deformation Monitoring of Offshore Platforms

The real-time dynamic deformation monitoring of offshore platforms under environmental excitation is crucial to their safe operation.Although Global Navigation Satellite System-Precise Point Positioning(GNSS-PPP)has been considered for this purpose,its monitoring accuracy is relatively low.Moreover,the influence of background noise on the dynamic monitoring accuracy of GNSS-PPP remains unclear.Hence,it is imperative to further validate the feasibility of GNSS-PPP for deformation monitoring of offshore platforms.To address these concerns,vibration table tests with different amplitudes and frequencies are conducted.The results demonstrate that GNSS-PPP can effectively monitor horizontal vibration displacement as low as±30 mm,which is consistent with GNSS-RTK.Furthermore,the spectral characteristic of background noise in GNSS-PPP is similar to that of GNSS-RTK(Real Time Kinematic).Building on this observation,an improved Complete Ensemble Empirical Mode Decomposition with Adaptive Noise(CEEMDAN)has been proposed to de-noise the data and enhance the dynamic monitoring accuracy of GNSS-PPP.Field monitoring application research is also undertaken,successfully extracting and analyzing the dynamic deformation of an offshore platform structure under environmental excitation using GNSS-PPP monitoring in conjunction with improved CEEMDAN de-noising.By comparing the de-noised dynamic deformation trajectories of the offshore platform during different periods,it is observed that the platform exhibits reversible alternating vibration responses under environmental excitation,with more pronounced displacement deformation in the direction of load action.The research results confirm the feasibility and potential of GNSS-PPP for dynamic deformation monitoring of offshore platforms.

Natural Disaster Risk Monitoring for Immovable Cultural Relics Based on Digital Twin

Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicators of natural disaster risk monitoring are complex.How to achieve intelligent perception and monitoring of natural disaster risk for immovable cultural relics has always been a focus and a challenge for researchers.Based on the analysis of the concepts and issues related to the natural disaster risk of immovable cultural relics,this paper proposes a framework for natural disaster risk monitoring for immovable cultural relics based on the digital twin.This framework focuses on risk monitoring,including the physical entities of natural disaster risk for immovable cultural relics,monitoring indicators,and virtual entity construction.A platform for monitoring the natural disaster risk of immovable cultural relics is proposed.Using the Puzhou Ancient City Site as a test bed,the proposed concept can be used for monitoring the natural disaster risk of immovable cultural relics at different scales.

The role of intraoperative neurophysiological monitoring in intramedullary spinal cord tumor surgery

Intramedullary tumors are a class of central nervous system tumors with an incidence of 2 to 4%.As they are located very deep and frequently cause postoperative neurological complications,surgical resection is difficult.In recent years,many surgeons have performed electrophysiological monitoring to effectively reduce the occurrence of post-operative neurological complications.Modern electrophysiological monitoring technology has advanced considerably,leading to the development of many monitoring methods,such as SSEPs,MEPs,DCM,and EMG,to monitor intramedullary tumors.However,electrophysiological monitoring in tumor resection is still being studied.In this article,we discussed the different monitoring methods and their role in monitoring intramedullary tumors by reviewing previous studies.Intratumorally tumors need to be monitored for a summary of the condition of the patient.Only by using various monitoring methods flexibly and through clear communication between surgeons and neurophysiological experts can good decisions be made during surgery and positive surgical results be achieved.

Design and Construction of Automatic Monitoring System for Open-pit Coal Mine Slopes

[Objectives]To monitor the stability of open-pit coal mine slopes in real time and ensure the safety of coal mine production.[Methods]The automatic monitoring system of coal mine slope was explored in depth,and the core functions of the system were designed comprehensively.According to the design function of the automatic monitoring system,the slope automatic monitoring system was constructed.Besides,in accordance with the actual situation of the slope,the monitoring frequency of slopes was set scientifically,and the key indicators such as rainfall,deep displacement and surface displacement of the slopes were monitored in an all-round and multi-angle way.[Results]During the monitoring period,the overall condition of the slope remained good,and no landslides or other geological disasters occurred.At the same time,the overall rainfall in the slope area remained low.In terms of monitoring data,the horizontal displacement and settlement of the slopes increased first and then tended to be stable.Specifically,the maximum horizontal displacement during the monitoring period was 22.74 mm,while the maximum settlement was 18.65 mm.[Conclusions]The automatic slope monitoring system has obtained remarkable achievements in practical application.It not only improves the accuracy and efficiency of slope stability monitoring,but also provides valuable reference experience for similar projects.

Accuracy of FreeStyle Libre flash glucose monitoring in patients with type 2 diabetes who migrated from highlands to plains

BACKGROUND The FreeStyle Libre flash glucose monitoring(FGM)system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose.Due to its increased usage in clinics,the number of studies investigating its accuracy has increased.However,its accuracy has not been investigated in highland populations in China.AIM To evaluate measurements recorded using the FreeStyle Libre FGM system compared with capillary blood glucose measured using the enzyme electrode method in patients with type 2 diabetes(T2D)who had migrated within 3 mo from highlands to plains.METHODS Overall,68 patients with T2D,selected from those who had recently migrated from highlands to plains(within 3 mo),were hospitalized at the Department of Endocrinology from August to October 2017 and underwent continuous glucose monitoring(CGM)with the FreeStyle Libre FGM system for 14 d.Throughout the study period,fingertip capillary blood glucose was measured daily using the enzyme electrode method(Super GL,China),and blood glucose levels were read from the scanning probe during fasting and 2 h after all three meals.Moreover,the time interval between reading the data from the scanning probe and collecting fingertip capillary blood was controlled to<5 min.The accuracy of the FGM system was evaluated according to the CGM guidelines.Subsequently,the factors influencing the mean absolute relative difference(MARD)of this system were analyzed by a multiple linear regression method.RESULTS Pearson’s correlation analysis showed that the fingertip and scanned glucose levels were positively correlated(R=0.86,P=0.00).The aggregated MARD of scanned glucose was 14.28±13.40%.Parker's error analysis showed that 99.30%of the data pairs were located in areas A and B.According to the probe wear time of the FreeStyle Libre FGM system,MARD_(1 d) and MARD_(2-14 d) were 16.55%and 14.35%,respectively(t=1.23,P=0.22).Multiple stepwise regression analysis showed that MARD did not correlate with blood glucose when the largest amplitude of glycemic excursion(LAGE)was<5.80 mmol/L but negatively correlated with blood glucose when the LAGE was≥5.80 mmol/L.CONCLUSION The FreeStyle Libre FGM system has good accuracy in patients with T2D who had recently migrated from highlands to plains.This system might be ideal for avoiding the effects of high hematocrit on blood glucose monitoring in populations that recently migrated to plains.MARD is mainly influenced by glucose levels and fluctuations,and the accuracy of the system is higher when the blood glucose fluctuation is small.In case of higher blood glucose level fluctuations,deviation in the scanned glucose levels is the highest at extremely low blood glucose levels.

A Fuzzy Trust Management Mechanism with Dynamic Behavior Monitoring for Wireless Sensor Networks

Traditional wireless sensor networks(WSNs)are typically deployed in remote and hostile environments for information collection.The wireless communication methods adopted by sensor nodes may make the network highly vulnerable to various attacks.Traditional encryption and authentication mechanisms cannot prevent attacks launched by internal malicious nodes.The trust-based security mechanism is usually adopted to solve this problem in WSNs.However,the behavioral evidence used for trust estimation presents some uncertainties due to the open wireless medium and the inexpensive sensor nodes.Moreover,how to efficiently collect behavioral evidences are rarely discussed.To address these issues,in this paper,we present a trust management mechanism based on fuzzy logic and a cloud model.First,a type-II fuzzy logic system is used to preprocess the behavioral evidences and alleviate uncertainty.Then,the cloud model is introduced to estimate the trust values for sensor nodes.Finally,a dynamic behavior monitoring protocol is proposed to provide a balance between energy conservation and safety assurance.Simulation results demonstrate that our trust management mechanism can effectively protect the network from internal malicious attacks while enhancing the energy efficiency of behavior monitoring.

Push forward LC-MS-based therapeutic drug monitoring and pharmacometabolomics for anti-tuberculosis precision dosing and comprehensive clinical management

The spread of tuberculosis(TB),especially multidrug-resistant TB and extensively drug-resistant TB,has strongly motivated the research and development of new anti-TB drugs.New strategies to facilitate drug combinations,including pharmacokinetics-guided dose optimization and toxicology studies of first-and second-line anti-TB drugs have also been introduced and recommended.Liquid chromatography-mass spectrometry(LC-MS)has arguably become the gold standard in the analysis of both endo-and exo-genous compounds.This technique has been applied successfully not only for therapeutic drug monitoring(TDM)but also for pharmacometabolomics analysis.TDM improves the effectiveness of treatment,reduces adverse drug reactions,and the likelihood of drug resistance development in TB patients by determining dosage regimens that produce concentrations within the therapeutic target window.Based on TDM,the dose would be optimized individually to achieve favorable outcomes.Pharmacometabolomics is essential in generating and validating hypotheses regarding the metabolism of anti-TB drugs,aiding in the discovery of potential biomarkers for TB diagnostics,treatment monitoring,and outcome evaluation.This article highlighted the current progresses in TDM of anti-TB drugs based on LC-MS bioassay in the last two decades.Besides,we discussed the advantages and disadvantages of this technique in practical use.The pressing need for non-invasive sampling approaches and stability studies of anti-TB drugs was highlighted.Lastly,we provided perspectives on the prospects of combining LC-MS-based TDM and pharmacometabolomics with other advanced strategies(pharmacometrics,drug and vaccine developments,machine learning/artificial intelligence,among others)to encapsulate in an all-inclusive approach to improve treatment outcomes of TB patients.

Nanomaterial-assisted wearable glucose biosensors for noninvasive real-time monitoring:Pioneering point-of-care and beyond

This review explores glucose monitoring and management strategies,emphasizing the need for reliable and userfriendly wearable sensors that are the next generation of sensors for continuous glucose detection.In addition,examines key strategies for designing glucose sensors that are multi-functional,reliable,and cost-effective in a variety of contexts.The unique features of effective diabetes management technology are highlighted,with a focus on using nano/biosensor devices that can quickly and accurately detect glucose levels in the blood,improving patient treatment and control of potential diabetes-related infections.The potential of next-generation wearable and touch-sensitive nano biomedical sensor engineering designs for providing full control in assessing implantable,continuous glucose monitoring is also explored.The challenges of standardizing drug or insulin delivery doses,low-cost,real-time detection of increased blood sugar levels in diabetics,and early digital health awareness controls for the adverse effects of injectable medication are identified as unmet needs.Also,the market for biosensors is expected to expand significantly due to the rising need for portable diagnostic equipment and an ever-increasing diabetic population.The paper concludes by emphasizing the need for further research and development of glucose biosensors to meet the stringent requirements for sensitivity and specificity imposed by clinical diagnostics while being cost-effective,stable,and durable.