XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

http://ieeexplore.ieee.org/iel5/5/31047/01444179.pdf

Fundamentals of acoustics

Photoacoustic imaging is a promising method for visualizing biological tissues with optical absorbers. This article provides an overview of the rapidly developing field of photoacoustic imaging. Photoacoustics, the physical basis of photoacoustic imaging, is analyzed briefly. The merits of photoacoustic technology, compared with optical imaging and ultrasonic imaging, are described. Various imaging techniques are also discussed, including scanning tomography, computed tomography and original detection of photoacoustic imaging. Finally, some biomedical applications of photoacoustic imaging are summarized.

Photoacoustic imaging in biomedicine

Photoacoustic (PA) imaging as a fast-developing imaging technique has great potential in biomedical and clinical applications. It is a noninvasive imaging modality that depends on the light-absorption coefficient of the imaged tissue and the injected PA-imaging contrast agents. Furthermore, PA imaging provides superb contrast, super spatial resolution, and high penetrability and sensitivity to tissue functional characteristics by detecting the acoustic wave to construct PA images. In recent years, a series of PA-imaging contrast agents are developed to improve the PA-imaging performance in biomedical applications. Here, recent progress of PA contrast agents and their biomedical applications are outlined. PA contrast agents are classified according to their components and function, and gold nanocrystals, gold-nanocrystal assembly, transition-metal chalcogenides/MXene-based nanomaterials, carbon-based nanomaterials, other inorganic imaging agents, small organic molecules, semiconducting polymer nanoparticles, and nonlinear PA-imaging contrast agents are discussed. The applications of PA contrast agents as biosensors (in the sensing of metal ions, pH, enzymes, temperature, hypoxia, reactive oxygen species, and reactive nitrogen species) and in bioimaging (lymph nodes, vasculature, tumors, and brain tissue) are discussed in detail. Finally, an outlook on the future research and investigation of PA-imaging contrast agents and their significance in biomedical research is presented.

Photoacoustic Imaging: Contrast Agents and Their Biomedical Applications.

Current glucose monitoring methods for the ever-increasing number of diabetic people around the world are invasive, painful, time-consuming, and a constant burden for the household budget. The non-invasive glucose monitoring technology overcomes these limitations, for which this topic is significantly being researched and represents an exciting and highly sought after market for many companies. This review aims to offer an up-to-date report on the leading technologies for non-invasive (NI) and minimally-invasive (MI) glucose monitoring sensors, devices currently available in the market, regulatory framework for accuracy assessment, new approaches currently under study by representative groups and developers, and algorithm types for signal enhancement and value prediction. The review also discusses the future trend of glucose detection by analyzing the usage of the different bands in the electromagnetic spectrum. The review concludes that the adoption and use of new technologies for glucose detection is unavoidable and closer to become a reality.

The Progress of Glucose Monitoring—A Review of Invasive to Minimally and Non-Invasive Techniques, Devices and Sensors

Photoacoustic sensing and imaging techniques have been studied widely to explore optical absorption contrast based on nanosecond laser illumination. In this paper, we report a long laser pulse induced dual photoacoustic (LDPA) nonlinear effect, which originates from unsatisfied stress and thermal confinements. Being different from conventional short laser pulse illumination, the proposed method utilizes a long square-profile laser pulse to induce dual photoacoustic signals. Without satisfying the stress confinement, the dual photoacoustic signals are generated following the positive and negative edges of the long laser pulse. More interestingly, the first expansion-induced photoacoustic signal exhibits positive waveform due to the initial sharp rising of temperature. On the contrary, the second contraction-induced photoacoustic signal exhibits exactly negative waveform due to the falling of temperature, as well as pulse-width-dependent signal amplitude. An analytical model is derived to describe the generation of the dual photoacoustic pulses, incorporating Gruneisen saturation and thermal diffusion effect, which is experimentally proved. Lastly, an alternate of LDPA technique using quasi-CW laser excitation is also introduced and demonstrated for both super-contrast in vitro and in vivo imaging. Compared with existing nonlinear PA techniques, the proposed LDPA nonlinear effect could enable a much broader range of potential applications.

/pdf/single-laser-pulse-generates-dual-photoacoustic-signals-for-1r0hwx25rf.pdf

Single laser pulse generates dual photoacoustic signals for differential contrast photoacoustic imaging

Diabetic patients need long-term and frequent glucose monitoring to assist in insulin intake. The current finger-prick devices are painful and costly, which places noninvasive glucose sensors in high demand. In this review paper, we list several advanced electromagnetic (EM)-wave-based technologies for noninvasive glucose measurement, including infrared (IR) spectroscopy, photoacoustic (PA) spectroscopy, Raman spectroscopy, fluorescence, optical coherence tomography (OCT), Terahertz (THz) spectroscopy, and microwave sensing. The development of each method is discussed regarding the fundamental principle, system setup, and experimental results. Despite the promising achievements that have been previously reported, no established product has obtained FDA approval or survived a marketing test. The limitations of, and prospects for, these techniques are presented at the end of this review.

Noninvasive Electromagnetic Wave Sensing of Glucose

https://dr.ntu.edu.sg/bitstream/10356/144385/2/Evaluation%20of%20social%20life-cycle%20performance%20of%20buildings-%20theoretical%20framework%20and%20impact%20assessment%20approach.pdf

Evaluation of social life-cycle performance of buildings : theoretical framework and impact assessment approach

https://dr.ntu.edu.sg/bitstream/10356/88533/1/An%20analytical%20study%20of%20photoacoustic%20and%20thermoacoustic%20generation%20efficiency%20towards%20contrast%20agent%20and%20film%20design%20optimization.pdf

An analytical study of photoacoustic and thermoacoustic generation efficiency towards contrast agent and film design optimization.

Photoacoustic tomography has emerged as a promising non-invasive imaging technique that integrates the merits of high optical contrast with high ultrasound resolution in deep scattering medium. Unfortunately, the blood background in vivo seriously impedes the quality of imaging due to its comparable optical absorption with contrast agents, especially in conventional linear photoacoustic imaging modality. In this study, we demonstrated that two hybrids consisting of gold nanorods (Au NRs) and zinc tetra(4-pyridyl)porphyrin (ZnTPP) exhibited a synergetic effect in improving optical absorption, conversion efficiency from light to heat, and thermoelastic expansion, leading to a notable enhancement in both linear (four times greater) and nonlinear (more than six times) photoacoustic signals as compared with conventional Au NRs. Subsequently, we carefully investigated the interesting factors that may influence photoacoustic signal amplification, suggesting that the coating of ZnTPP on Au NRs could result in the reduction of gold interfacial thermal conductance with a solvent, so that the heat is more confined within the nanoparticle clusters for a significant enhancement of local temperature. Hence, both the linear and nonlinear photoacoustic signals are enhanced on account of better thermal confinement. The present work not only shows that ZnTPP coated Au NRs could serve as excellent photoacoustic nanoamplifiers, but also brings a perspective for photoacoustic image-guided therapy.

Siyu Liu

Papers

Single laser pulse generates dual photoacoustic signals for differential contrast photoacoustic imaging

Noninvasive Electromagnetic Wave Sensing of Glucose

Evaluation of social life-cycle performance of buildings : theoretical framework and impact assessment approach

An analytical study of photoacoustic and thermoacoustic generation efficiency towards contrast agent and film design optimization.

Rationally encapsulated gold nanorods improving both linear and nonlinear photoacoustic imaging contrast in vivo