Evaluation of a Continuous Blood Glucose Monitor: A Novel and Non-Invasive Wearable Using Bioimpedance Technology.

BACKGROUND: Frequent blood glucose level (BGL) monitoring is essential for effective diabetes management. Poor compliance is common due to the painful finger pricking or subcutaneous lancet implantation required from existing technologies. There are currently no commercially available non-invasive devices that can effectively measure BGL. In this real-world study, a prototype non-invasive continuous glucose monitoring system (NI-CGM) developed as a wearable ring was used to collect bioimpedance data. The aim was to develop a mathematical model that could use these bioimpedance data to estimate BGL in real time. METHODS: The prototype NI-CGM was worn by 14 adult participants with type 2 diabetes for 14 days in an observational clinical study. Bioimpedance data were collected alongside paired BGL measurements taken with a Food and Drug Administration (FDA)-approved self-monitoring blood glucose (SMBG) meter and an FDA-approved CGM. The SMBG meter data were used to improve CGM accuracy, and CGM data to develop the mathematical model. RESULTS: A gradient boosted model was developed using a randomized 80-20 training-test split of data. The estimated BGL from the model had a Mean Absolute Relative Difference (MARD) of 17.9%, with the Parkes error grid (PEG) analysis showing 99% of values in clinically acceptable zones A and B. CONCLUSIONS: This study demonstrated the reliability of the prototype NI-CGM at collecting bioimpedance data in a real-world scenario. These data were used to train a model that could successfully estimate BGL with a promising MARD and clinically relevant PEG result. These results will enable continued development of the prototype NI-CGM as a wearable ring.

Evaluating the impact of recycled fiber content on effluent recycling in newsprint manufacture.

This paper investigates the effect of using recycled fiber (RCF) in newsprint production on the effluent quality and its treatability using membrane operations for internal and external recycling and reuse. Increased chemical usage in RCF for deinking had significant impact on the silica and sodium content of the effluent which in turn limits the membrane's operation. Increasing the RCF content from 0% to 50% is estimated to increase the silica content from 4 to 119mgL(-1) and sodium content from 135 to 500mgL(-1). A process model was developed to calculate the impact of these excess chemicals on the greenhouse gas (GHG) emission and brine disposal for an integrated membrane plant design producing 4MLday(-1) of recycled water. As the ratio of RCF increased from 0% to 50% in the mill process, the operating pressure increased for nanofiltration (NF) and reverse osmosis (RO). Additionally, organics presence in the feed increased the NF operating pressure above the simulated value and reduced the silica removal efficiency by 15%. Incorporation of lime coagulation pretreatment was found to be essential to operate RO at high recoveries with relatively GHG emissions. Without pretreatment, as RCF content increased from 0% to 50%, RO recovery decreased from 80% to 22% and the expended GHG increased from 0.9 to 3.5kgCO2m(-3). Although the excess sodium concentration limits the brine disposal for irrigation purposes, a partial blending of the treated wastewater with other process streams resulted in the reduction of sodium absorption ratio by 20%.