This application describes biomedical systems and methods. More specifically, the application describes systems and methods for analyzing biological fluids, such as saliva and sweat, assessing water and electrolyte loss in a human subject using one or more biomarkers, and recommending a fluid replenishment protocol.
Sweating (or “perspiration”) is a technique the human body uses to regulate its temperature. During periods of physical exertion and/or environmental heat stress, sweat is excreted by the skin, which results in cooling via evaporation on the skin surface. While sweat is made up of approximately 99% water, sweat also typically contains other compounds, such as metabolites and ions. The excretion rate and composition of sweat are intrinsic to an individual and subject to biological variation. Excretion rate and sweat composition can also differ greatly, based on age, diet, activity, current fitness level and environmental conditions.
Appropriate hydration in the human body is vital for health and proper functioning of the body organs. Water is lost from the body during respiration, perspiration and urination. Decrease in body mass related to fluid loss of just a few percent can negatively impact cardiovascular function, thermal dissipation, and exercise performance. Dehydration can cause headaches, light-headedness, dizziness, fainting, and in extreme cases delirium, unconsciousness and even death. Large losses of body mass (e.g., greater than 5%) may result in heat exhaustion, heat stroke, loss of consciousness, organ damage and even death. Additionally, the loss of ions, predominantly sodium, through perspiration can result in fatigue and muscle cramping if not effectively replaced though ingested fluids. As there is a large amount of inter- and intra-individual variability in the volume and composition of sweat loss, fluid replacement strategies should ideally be individually tailored, to ensure both water and sodium losses are replenished to minimize the detrimental effects of physical exertion and/or heat stress on health and performance. Hyponatremia (“over-hydration”) can also detrimentally affect the body's functioning, particularly during exercising, and can even lead to death in extreme cases.
Dehydration is an excessive loss of body fluid. In physiological terms, dehydration may entail a deficiency of fluid within an organism. Dehydration can be caused by losing too much fluid, not drinking enough fluid, or both. Vomiting, diarrhea, and excessive perspiration without sufficient liquid intake are other causes of dehydration, which may be particularly worrisome for athletes and people that work under hot, dry conditions. There are three main types of dehydration: hypotonic (primarily a loss of electrolytes, especially sodium), hypertonic (primarily a loss of water), and isotonic (equal loss of water and electrolytes). While isotonic dehydration is the most common, distinction between the three types of dehydration may be important for administering proper fluid replacement strategies.
Relying on thirst as a feedback mechanism to trigger demand for fluid intake may not be adequate to maintain an optimal hydration level, since a sensation of thirst sufficient to cause a subject to drink is often not triggered until after the subject is already dehydrated. Unfortunately, there are currently no practical, affordable, non-invasive devices for measuring a person's hydration level. Measurement devices that use blood or urine to measure hydration are impractical, invasive, and/or prohibitively expensive.
Many other physiological parameters and levels of various substances in the human or animal body are frequently tested or would be desirable to test for. Unfortunately, it is often necessary to sample blood, urine or other bodily substances, such as cerebrospinal fluid, to measure a desired parameter. Some physiological parameters involve even more invasive or costly measurement techniques.
Therefore, it would be highly beneficial to have a practical, affordable, non-invasive system and method for measuring a person's hydration status and quantifying the volume of fluid and electrolytes that need to be replenished following dehydration. It would also be very desirable to have practical, affordable, non-invasive systems and methods for testing other parameters in the body.
Point-of-care testing systems allow for measurement of biomarkers (e.g., metabolites, hormones, electrolytes) in biological samples outside of a laboratory, such as in a clinic or personal residence. By reducing labor and transport costs, point-of-care testing is an attractive alternative to laboratory testing, especially for frequent and/or routine tests.
Point-of-care testing systems typically consist of a handheld meter, which interfaces with a single-use test strip chemically responsive to an analyte (e.g., glucose). Typically, the handheld meter will perform all the steps necessary for sample analysis (signal generation, signal measurement, data processing) and display the result on an built-in screen. Some more advanced testing systems are capable of measuring multiple analytes using different test strips based on the same detection method (e.g., amperometric detection of glucose and beta-hydroxybutyrate) and/or communicating the test result wirelessly to a phone or tablet for data logging.
Currently available point-of-care testing systems are appropriate for individual users who monitor only one or two of their own biomarkers (e.g., a patient with diabetes who measures blood glucose each day). Such systems are less ideal, however, for large organizations, where many different biomarkers are assayed by multiple operators on tens or hundreds of different subjects (e.g., a hospital where hundreds of patients are tested each day for one or multiple biomarkers by multiple health professionals). For these organizations, test administrators must collect and curate results from many different devices, each measuring a different biomarker with a different detection method.
Therefore, it would be desirable to have an analysis system that is versatile enough to test for an extensive range of biomarkers using a single testing system. Ideally, such a test system would allow multiple users to conveniently administer and analyze test results while minimizing user error.
Sweat testing to determine the volume and composition of sweat is an increasingly popular method of generating personal rehydration strategies. This service is primarily used by athletes to determine their fluid replacement needs and gain a competitive edge. Typically, these services involve a one-off collection of activity-stimulated or chemically-stimulated sweat, through a patch affixed to the skin. The collected sweat is then assessed by a chemical analysis system to determine sweat sodium concentration (in millimoles or parts per million). These measurements are paired with exercise induced body mass change when following an exercise protocol to determine sweat rate and fluid loss (e.g., liters/hour). With this information, a personalized rehydration protocol is developed to assist in fluid replacement during and/or after exercise.
A key flaw of this methodology is the assumption that both sweat electrolyte content and sweating rate are consistent for an individual under all conditions. In fact, both sweat composition and rate can differ dramatically, based on many factors, including the activity being undertaken, the degree of exertion, the environmental conditions, and how acclimatized an individual is to these conditions. To ascertain this information for an individual, multiple measures are required over several conditions. With conventional approaches for estimation of sweat composition and sweat rate, this is prohibitively time consuming.
Therefore, it would be highly beneficial to have a practical, affordable, non-invasive system and method for measuring a person's hydration status and quantifying the volume of fluid and electrolytes that need to be replenished to prevent or treat dehydration. It would also be very desirable to have practical, affordable, non-invasive systems and methods for testing other parameters in the body. It would also be desirable to develop an accurate, rapid method of determining individual fluid volume and composition requirements on a case-by-case basis. Ideally, such a method would be relatively easy to employ and cost effective to make it accessible to many users. This application addresses at least some of these objectives.
Saliva may be an ideal bodily substance for use in measuring hydration and dehydration. Saliva is easily obtained with minimal invasiveness, but it is a complex fluid. Approximately 99% of saliva is water, and the remaining 1% comprises large organic molecules (such as proteins), small organic molecules (such as urea), and electrolytes (such as sodium and potassium). Whole saliva, considered as the total fluid content of the mouth, contains many other constituents, including serum components, blood cells, bacteria, bacterial products, epithelial cells, cell products, food debris and bronchial secretions. Thus, processing saliva to measure an individual's hydration level is challenging but likely highly beneficial if done effectively.
The assignee of the present application has filed previous patent applications describing systems, methods and devices for testing, measuring and analyzing saliva, to measure a subject's hydration level, as well as for measuring other substances and/or physiological parameters in a human or animal subject. These previous patent applications include U.S. patent application Ser. No. 16/197,530 (U.S. Pub No. 2019/0150836), titled “Saliva Testing System,” filed Nov. 21, 2018; and Ser. No. 16/598,000, titled “Ion Selective Sensor,” filed Oct. 10, 2019 (U.S. Pub No. 2019/0150836). The applications also include U.S. Provisional patent application Ser. No. 62/872,339, titled “Saliva Test Strip and Method,” filed Jul. 10, 2019; 62/961,438, titled “Assessment of Biomarker Concentration in a Fluid,” filed Jan. 15, 2020; and 62/967,694, titled “Biological Fluid Sample Assessment,” filed Jan. 30, 2020. All of the above-referenced patent applications are hereby incorporated by reference into the present application, and they are referred to collectively herein as “the Incorporated Applications.” The present application adds to the technologies in the Incorporated Applications by describing a biological fluid analysis system and method that addresses at least some of the objectives described above in the Background section.
The present application also adds to the technologies in the Incorporated Applications by describing a system and method for assessing hydration levels and electrolyte deficits and recommending hydration protocols before, during and after physical exertion. Specifically, this application describes a system and method of determining a personalized reference dataset, based on measurements of salivary osmolarity, body mass loss, sweat rate of exertion driven fluid volume and salt (electrolyte) loss under a variety of conditions. This reference dataset is used to establish an algorithm that can predict an individual's fluid and sodium replacement requirements, specific to environmental conditions, and may include biological measurements (e.g. salivary osmolarity), and degree of exertion, based on activity and/or standard rating of perceived exertion (RPE) scales. These requirements are then communicated to the individual to provide detailed guidance of when and what to ingest to offset fluid and sodium losses during exertion and to replenish and recover fluid and sodium losses following exertion or heat stress on a case-by-case basis.
In one aspect of the present disclosure, an analysis system includes a portable, handheld analyzer and one or more analyte specific test strips used to monitor multiple analytes from human or animal body fluids. The handheld analyzer can perform impedimetric, potentiometric and/or amperometric analysis and, using analyte-specific test strips, it can determine the concentration of multiple analytes. To improve ease of use, the handheld analyzer may automatically detect test strip type and batch and automatically apply temperature compensation to accommodate ambient conditions. In one embodiment, the handheld analyzer may be used independently in a stand-alone mode. In another embodiment, the handheld analyzer may be wirelessly connected to a phone, tablet or the like, to upload measurement data to a cloud database. The cloud database may be accessed using a phone or tablet to view and analyze data from multiple users and devices. To improve validity and accuracy, the system may integrate a method for measurement interpretation that is personalized to an individual user, a method for detection of abnormal readings, an error detection algorithm, and/or a method for compensating for temperature effects on measurement value.
In another aspect of the disclosure, a method of measuring an analyte in a bodily fluid sample and combining measurement data from multiple users may first involve initiating a wireless connection between a handheld analyzer and a smart computing device on which an analyte analysis application has been downloaded and inserting a test strip into the handheld analyzer. The method may also involve collecting a sample of a bodily fluid on the test strip, measuring, with the handheld analyzer, a concentration of at least one analyte in the sample, wirelessly communicating the measured concentration from the handheld analyzer to the smart computing device, and displaying the measured concentration on the smart computing device. Finally, the method may involve transmitting the measured concentration to a database, and organizing data including the measured concentration and at least one additional measured analyte concentration from at least one additional user on the database. The order of these method steps may be altered in various alternative embodiments.
In some embodiments, the method may further involve initiating a wireless connection between the smart computing device and the Internet, where the database is located on a cloud storage location, and where transmitting the measured concentration to the database involves wirelessly transmitting the measured concentration from the smart computing device to the cloud storage location via the Internet. In some embodiments, the data is organized based upon in groups of multiple users belonging to multiple organizations. In some embodiments, the method may also involve initiating the measuring step via the smart computing device, and initiating the measuring step may involve: logging into an operator account on the analyte analysis application; selecting a specific source from which the sample will be taken; and confirming the wireless connection between the handheld analyzer and the smart computing device.
The method may optionally further include automatically downloading and storing, on the handheld analyzer, a test strip type and batch data. For example, in some embodiments, automatically downloading and storing the test strip type and batch data may involve measuring a resistance-encoded test strip identification on the test strip and comparing the test strip identification with data in a memory of the handheld analyzer to determine the test strip type and batch data. Optionally, such a method may further involve communicating the test strip type and batch data to the smart computing device and alerting a user through an error message on the handheld analyzer and smart computing device if the test strip type is an unknown test strip type.
In some embodiments, the method may also involve preventing use of a used or faulty test strip by determining that the test strip has already been used or is faulty and prompting the user to discard the test strip on at least one of the handheld analyzer or the smart computing device. The method may also optionally involve providing instructions to a user regarding how to collect the sample, using the application and/or the handheld analyzer. Also optionally, the method may involve using the handheld analyzer for determining an ambient temperature, applying a detection technique based on the ambient temperature, and determining the concentration of the analyte(s) using batch specific calibration coefficients and the ambient temperature. The method may also involve determining, with the handheld analyzer, that a measurement is inaccurate by measuring a signal inconsistency and detecting an abnormally high signal or an abnormally low signal for the test strip. In some embodiments, the method may further involve using the smart computing device to analyze the measured concentration to assist in user interpretation. In some embodiments, the smart computing device refers a raw measured concentration to a previously established individual specific reference value.
In another aspect of the present disclosure, a method of measuring at least one analyte in a bodily fluid sample from a subject may involve: inserting a test strip into a handheld analyzer; collecting the bodily fluid sample on the test strip by bringing the test strip in contact with a body part of the subject where a bodily fluid is present; removing the test strip from contact with the body part after the handheld analyzer indicates that a sufficient amount of the bodily fluid sample has been collected; applying an electrical signal to the test strip; measuring, with the handheld analyzer, a response of a combination of the test strip and the bodily fluid sample to the applied electrical signal; analyzing the response with the handheld analyzer to determine that the bodily fluid sample is a valid sample; measuring a concentration of the at least one analyte in the bodily fluid sample; and displaying the measured concentration on the handheld analyzer and/or transferring the measured concentration to another device to display the measured concentration, generate further calculations and/or store the measured concentration. Again, the order of these steps may be altered without departing from the scope of the present invention.
In another aspect of the present disclosure, a handheld analyzer for determining a concentration of one or more analytes in a bodily fluid may include: a housing; a test strip port in the housing; a display screen on the housing; a temperature sensor in the housing; and multiple electronic components in the housing. The multiple electronic components may include: at least one of a direct digital synthesis (DDS) chip or a digital-to-analog converter (DAC) chip; an analog-to-digital converter (ADC) chip; a wireless communication chip; processing circuitry; and computer memory.
In some embodiments, the test strip port is configured to accept a test strip selected from the group consisting of analyte specific test strips and test strips capable of measuring multiple analytes. In some embodiments, the multiple electronic components are configured to automatically transfer test strip configuration settings to the computer memory when the handheld analyzer is connected to a database via a mobile application. In some embodiments, the handheld analyzer is configured to determine a test strip type and batch data using a resistance-encoded identification on a test strip and data stored in the computer memory. In some embodiments, the multiple electronic components are configured to automatically adjust a detection method, an excitation waveform and gain settings for multiple types of test strips. In some embodiments, the temperature sensor is configured to measure an ambient temperature, and wherein the processing circuitry is configured to process the measured ambient temperature using a temperature detection algorithm. In some embodiments, the multiple electronic components are configured to automatically detect and interpret application of a bodily fluid sample to a test strip, using a fluid detection algorithm, and at least one of initiate measurement or ensure sample consistency.
In some embodiments, the processor is configured to compare a measured concentration and a measured temperature to reference data specific to a test strip type and batch to determine analyte concentration. In some embodiments, the processor is configured to analyze raw measurement by an error detection algorithm to ensure sample consistency and measurement integrity. In some embodiments, the handheld analyzer is configured to display an error message on the display screen if a test strip is inserted while the handheld analyzer is being charged. In some embodiments, the processor is configured to count a number of measurements that have been conducted with the handheld analyzer and provide an alert to perform routine maintenance procedures on the device. In some embodiments, the handheld analyzer is configured to perform auto-calibration and self-testing to account for manufacturing variability.
In another aspect of the disclosure, a method for interpreting an analyte concentration for a subject may involve: taking at least one or measurement of an analyte under controlled conditions on at least one occasion from the subject; using an algorithm to determine a personalized reference range for the analyte specific to the subject under the controlled conditions; and using the personalized reference range to provide a specific measurement interpretation customized for the subject.
In some embodiments, the method may further involve using a protocol to establish a physiological state in which controlled measurements can be collected as desired by a user. In some embodiments, the method may further involve using a protocol to establish a physiological state in which measurements are specially outlined as part of the protocol. In some embodiments, the method may further involve outlining specific conditions in which controlled measurements may be conducted. In some embodiments, the method may further involve establishing multiple personalized reference ranges for a single analyte using multiple protocols. In some embodiments, the method may further involve using at least one personalized reference range from a single analyte to provide individual-specific interpretation of subsequent measurements. In some embodiments, the method may further involve using personalized reference ranges for multiple analytes to provide individual-specific interpretation of subsequent measurements.
In another aspect of the disclosure, a method for assessing measurement integrity may involve: applying at least one signal to a test strip by a handheld analyzer; monitoring the at least one signal for inconsistency, using the handheld analyzer; and classifying a measurement as normal or abnormal, based on whether there is inconsistency of the signal(s). In some embodiments, the signal includes multiple signals. signal comprises part of a measurement signal. In some embodiments, the signal is independent of a measurement signal. In some embodiments, measurement inconsistency is used to categorize a measurement as unreliable and the operator is directed to discard the measurement. In some embodiments, measurement inconsistency is used to categorize a measurement as unreliable and the measurement is not reported to the operator. Some embodiments may further involve using measurement inconsistency to categorize a measurement as unreliable and reporting an unreliable measurement to a user. Some embodiments further involve using measurement inconsistency to categorize a measurement as unreliable and automatically prompting a user to perform another measurement. Optionally, the method may further involve using measurement inconsistency to change at least one of a method of detection or a measurement interpretation algorithm applied by the handheld analyzer.
In another aspect of the present disclosure, a method of compensating for temperature when measuring an analyte may involve: monitoring temperature with a temperature sensor; using an algorithm housed in a handheld analyzer to determine ambient temperature; and using the determined ambient temperature to change at least one of signal generation parameters, signal detection parameters, or signal interpretation for measuring the analyte.
In some embodiments, temperature is monitored by the handheld analyzer with a built-in temperature sensor. In some embodiments, temperature is monitored by the handheld analyzer with an external temperature sensor. In some embodiments, a rate of change in temperature is used to determine the ambient temperature. In some embodiments, the method may further involve using at least one of the ambient temperature or a rate of change in temperature to determine a time need to equilibrate a sample to a target temperature before a detection method is applied.
In another aspect of the present disclosure, a method of generating a personalized reference dataset of fluid loss for a human subject may involve: following a protocol or set of protocols or conducting a series of exercise sessions; collecting first data related to a sweat salt content biomarker reflective of an amount of salt in sweat collected from the human subject; collecting second data related to a body mass change biomarker reflective of a change in a body mass of the human subject through fluid loss; and processing the first data and the second data with an algorithm to generate a reference dataset.
In various embodiments, the sweat salt content biomarker may include, but is not limited to, sweat osmolarity, sweat conductivity, and/or sweat electrolyte concentration. In various embodiments, the body mass change biomarker may include, but is not limited to, salivary osmolarity, salivary conductivity, salivary electrolyte concentration, urine osmolarity, urine specific gravity, urine color, and/or direct measurement of body mass. In some embodiments, the method may further involve calibrating a saliva biomarker for fluid loss using a set of paired measurements of changes in the saliva biomarker and fluid loss as determined by a change in weight of the human subject. In some embodiments, the saliva biomarker for fluid loss is measured before and/or after a protocol or exercise session, and the sweat biomarker is measured during and/or after the a protocol or exercise session.
In some embodiments, the protocol involves engaging in an activity for a set duration at a specific level of exertion, as determined by a self-perceived exertion scale or a heartrate-based metric of exertion, under at least one defined environmental condition. In some embodiments, the protocol involves engaging in a series of activity sessions, after which the human subject reports a level of exertion and at least one environmental condition. In some embodiments, the protocol is determined using parameters defined by the human subject. In some embodiments, the exertion level is automatically logged with a personal activity monitor. In some embodiments, a blood biomarker, a sweat biomarker and/or a saliva biomarker may be used to assess a degree of exertion. In some embodiments, the method further includes collecting at least one environmental condition via manual input from the human subject. In some embodiments, the method may further include collecting at least one environmental condition via automatic input from a weather monitoring service or device.
In another aspect of the present disclosure, a method of personalizing fluid replacement guidelines for a human subject after the human subject has engaged in an activity, in which a set of reference values of fluid loss volume and salt content have been previously established for the human subject, may involve: using a body mass change biomarker of fluid loss to establish a change in body mass of the human subject through fluid loss related to a degree of exertion and at least one environmental condition; using an algorithm to predict an amount and a chemical composition of fluid lost from the human subject; and providing advice to the human subject on a volume and a composition of fluids required for replacement and recovery and a time period over which the fluids should be ingested.
In various embodiments, the body mass change biomarker may include, but is not limited to, salivary osmolarity, salivary conductivity, salivary electrolyte concentration, urine osmolarity, urine specific gravity, urine color, and/or direct measurement of body mass. In some embodiments, the degree of exertion is self-reported by the human subject. In some embodiments, the degree of exertion is established using a personal activity monitor or a heart rate monitor. In some embodiments, the method may further involve using a biomarker such as but not limited to a blood biomarker, a sweat biomarker and/or a saliva biomarker, to determine the degree of exertion.
In some embodiments, the environmental condition is self-reported by the human subject. In some embodiments, the environmental condition is determined using a weather monitoring service or device. In some embodiments, the advice is provided via a computer application for at least one of a smart phone or a tablet computing device. In some embodiments, providing the advice involves providing prompts to the human subject via the computer application regarding when to consume the fluids and at least one type of the fluids to drink.
In another aspect of the present disclosure, a method of personalizing fluid replacement guidelines for a human subject engaging in an activity, in which a set of reference values of fluid loss volume and salt content have been previously established for the human subject, may involve: establishing a degree of exertion for the human subject engaging in the activity; establishing at least one environmental condition; predicting, using an algorithm with the established degree of exertion and at least one environmental condition, an amount and a chemical composition of fluid lost by the human subject during the activity; and providing advice to the human subject regarding a volume and a composition of fluids required for recovery and a time period over which the fluids should be ingested.
In another aspect of the present disclosure, a method of personalizing fluid replacement guidelines for a human subject before engaging in an activity, in which a set of reference values of fluid loss volume and/or salt content have been previously established for the human subject, may involve: establishing at least one environmental condition; establishing a degree of exertion as predicted by the human subject; using an algorithm with the at least one environmental condition and the degree of exertion to predict an amount and a chemical composition of fluid lost by the human subject during the activity; and providing advice to the user regarding a volume and a composition of fluids for maintaining hydration during exercise and for recovery after exercise for the human subject. In some embodiments, the method may further involve using a hydration biomarker to establish a hydration state of the human subject before engaging in the activity and using the hydration biomarker to customize the advice.
In another aspect of the present disclosure, a method of personalizing fluid replacement guidelines for a human subject after engaging in an activity, in which a set of reference values for fluid loss volume and/or salt content have been previously established for the human subject, may involve: measuring salivary osmolarity after the exercise event; and providing advice to the user regarding a volume and a composition of fluids for recovery after exercise for the human subject.
Optionally, the method may further involve using a hydration biomarker, such as salivary osmolarity, to establish a hydration state of the human subject after engaging in the activity, and using the hydration biomarker to customize the rehydration advice. In other embodiments, the method may involve using a hydration biomarker to establish a hydration state of the human subject after engaging in the activity and using longitudinal (temporal) hydration biomarker markers to customize and adapt the advice based on how quickly the human subject's hydration is returning to a desirable level. In other embodiments, the method may involve using a hydration biomarker to establish a hydration state of the human subject after engaging in the activity and using longitudinal (temporal) hydration biomarker markers to customize and adapt the advice based on how quickly the human subject's hydration is returning to a desirable level. The time between hydration biomarker measurements is determined by the difference between the desired and current hydration status.
In another aspect of the present disclosure, a method for determining a sodium content of a sweat sample from a human subject may involve: collecting the sweat sample from the human subject; performing an electrochemical test on the sweat sample using a portable, handheld testing system to take a measurement of at least one of conductivity, impedance or osmolarity of the sweat sample; and converting the measurement into the sodium content using a calibration curve. In some embodiments, collecting the sweat sample involves collecting a small volume of sweat directly from the human subject's skin with a single-use test strip of the handheld, portable testing system. In some embodiments, collecting the sweat sample involves: collecting sweat from the human subject's skin via an adhesive patch directly applied to the skin; extracting the sweat from the patch; and collecting the sweat sample from the extracted sweat with a single-use test strip of the handheld, portable testing system.
In some embodiments, the sweat sample is collected using an adhesive patch that includes at least one of electrodes and microfluidics, and the adhesive patch provides on-skin analysis of the sodium content through a physical connection with the handheld, portable testing system. In some embodiments, the sweat sample is collected using an adhesive patch that includes electrodes, microfluidics and/or electronic components, and the adhesive patch performs the electrochemical test and wirelessly communicates raw data from the electrochemical test to the handheld, portable testing system. In some embodiments, the portable testing system is further configured to perform analysis of at least one additional biomarker of sweat, saliva or blood, to establish a body mass change and/or a physical exertion of the human subject.
These and other aspects and embodiments are described in greater detail below, in relation to the attached drawing figures.
The present application describes various embodiments and features of a biological fluid analysis system and method. Referring to
Test Strips
In various embodiments, the biological fluid analysis system 10 may include any suitable number and combination of types of test strips 14a-14e. In some embodiments, for example a panel of test strips 14a-14e may be provided, with each strip 14a-14e being chemically sensitive to a specific analyte (e.g., electrolytes, metabolites, hormones) or a panel of analytes (e.g., multiple electrolytes). The test strips 14a-14e are single use, disposable and configured to test for a specific biological sample type (e.g., blood, saliva, sweat, urine) or non-biological sample type (e.g., pool water, wastewater). Test strips 14a-14e may be visually distinguishable in some embodiments and/or may contain a resistor-encoded identification code. Test strips 14a-14e may use one of multiple of a range of detection methods.
Test strips 14a-14e may significantly differ in size, shape and design, but share common design elements allowing for compatibility with a single analyzer 12. In one embodiment, a test strip 14a-14e includes a sampling port and four untreated carbon electrodes, three of which are used for impedimetric measurement and the fourth of which is the resistance-encoded identification code describing the test strip type and batch. In another embodiment, the test strip 14a-14e includes a sampling port and three carbon electrodes, two of which are configured to allow for potentiometric measurement of an analyte, and the third of which is the resistance-encoded identification code describing the test strip type and batch. Common to both of these embodiments of test strips 14a-14e is the electrode structure for interfacing with the handheld analyzer 12 and test strip identification. All other features are configured for a given analyte (or set of analytes) and sample type.
In the embodiment illustrated in
Analyzer
In some embodiments, the analyzer 12 of the biological fluid analysis system 10 is a handheld, point-of-care analyzer 12 capable of signal generation, measurement and processing. The handheld analyzer 12 may automatically determine the type of test strip 14a-14e inserted into it, for example by reading a resistor-encoded identification code on the test strip 14a-14e. The handheld analyzer 12 may use the identification information to configure the detection method, excitation waveform and gain settings, and to apply a batch specific calibration curve when processing the raw measurement data.
Referring now to
The handheld analyzer may also include three multiplexers (“MUX”) 46, 48, 50. The first multiplexer 46 is configured to regulate the connection between the sensor circuitry 42 and a sensor port 54. The second multiplexer 48 is configured to regulate the connection between the sensor circuitry 42 and a high-resolution ADC 52. The third multiplexer 50 is configured to regulate the connection between the sensor circuitry 42 and the micro-controller 20.
The features of this embodiment of the handheld analyzer 12 allow a diverse range of analytical techniques to be employed with a single analyzer 12. Specifically, the multiplexing of signal generation, gain settings and a second high-resolution ADC allow for impedimetric, amperometric and potentiometric analysis.
An error detection algorithm may used to identify suspect readings. In one embodiment, a periodic stimulus signal is applied and consistency between measurements used to assess accuracy of results. In another embodiment, this periodic signal is applied at multiple distinct frequencies and these are investigated. A reference range of values may also be used to determine whether a result is of an appropriate range for a given analyte or sample type.
If step 108 or step 110 indicate a “bad” strip has been inserted, the analyzer provides the user with an error code or other prompt (steps 112 and 114), so that the user knows to remove the test strip from the analyzer 12 and start the method again. If the test strip is accepted by the analyzer 12, the user receives a prompt in step 116 to apply a fluid sample to the test strip. Instructions for sample collection and error messages may be relayed to the user on a built-in display screen. In step 118, the analyzer 12 applies a fluid detection algorithm to the fluid sample to determine if the sample is adequate. If the sample is insufficient, the user receives another prompt (repeating step 116) to add more fluid to the test strip. If the sample is sufficient, the analyzer may provide another prompt to the indicate that fluid was detected and to please wait for results (step 120). Data processing is performed on the handheld analyzer 12 in step 122, and an error detection algorithm is applied in step 124. If the analyzer 12 detects an error, the user is prompted accordingly in step 126, and the test strip is removed and replaced with a new strip to start the method again. If the error detection algorithm confirms a good reading of the fluid sample, the results of the measurement are displayed to the user on the analyzer and/or a smart device coupled with the analyzer in step 128. In some embodiments, the handheld analyzer 12 may include integrated cellular or wireless capability. In such embodiments, the handheld analyzer 12 can upload measurement results for storage in a cloud server or other database.
The handheld analyzer 12 may record the number of measurements performed on its internal memory. Using this information, the user is prompted to perform routine maintenance at specific milestones. In one embodiment the user is prompted to replace the test-strip port after a certain number of measurements have been performed. In some embodiments, the handheld analyzer also contains an internal reference load, which may be used to perform start-up calibration and account for manufacturing variability.
Phone/Tablet Application
Referring back to
Referring to
Next the user is prompted to insert a test strip into the handheld analyzer (steps 212 and 232), the user inserts the test strip, and the analyzer walks the user through steps similar to or the same as those described in relation to
In some embodiments, a user specific reference panel may be previously established through a protocol or set of protocols. This information may be used to provide user specific interpretive information.
Database
Referring again to
The present application describes various embodiments and features of a hydration assessment system and method, for determining a human subject's level of hydration and recommending a hydration protocol. Although the following disclosure focuses on the analysis of sweat and/or saliva, the embodiments described below, or variations of those embodiments, may be used for analysis of any other bodily fluid, such as blood, urine or the like.
The Reference Dataset
Environmental condition data 304 may be collected, for example, by manually logging parameter data from external equipment, automated data logging from a purpose-built testing system, or automated logging of these parameters from a weather monitoring service based on time and location data. The degree of physical exertion 310 may be determined, for example, through self-reporting on a standard rating of perceived exertion (RPE) rating scale and/or may be inferred from one or more measured biomarkers of physical exertion (e.g., activity, heart rate, VO2 max, lactic acid concentration in blood, sweat or saliva). These measurements may be manually reported and/or automatically logged with a personal monitoring device, such as a fitness watch or heart rate chest-strap. The percentage body mass loss 306 may be established, for example, through direct measurement of body mass before and after a period of exertion, accounting for any fluid ingested or lost through urination or inferred from a biomarker of change in body mass (e.g., increased salivary osmolarity or salinity, urine osmolarity or urine specific gravity). The sweat sodium content 308 may be established through direct measurement of the sweat sodium content 308 with a chemical analysis system or estimated from the conductivity or osmolarity of a sweat sample.
Thus, the hydration assessment system 300 may include multiple data capturing devices (or programs or applications on devices), to gather, for example, the environmental conditions 304, the body mass loss 306, the sweat sodium content 308 and/or the heart rate or other measure of exertion 310. Each measurement device is used over multiple measurement sessions 312 to collect the various types of data 304, 306, 308, 310, and provide the data to the reference dataset 302, which may be located in a database stored on a computer or in the cloud. The reference dataset 302 may be generated, for example, by following a set of predefined exercise protocols that specify duration and intensity of exertion prior to collection of measurements or by taking measurements over time during regular activity. In the illustrated example, data is collected over four trial measurement sessions 312 (trials 1-4). The human subject runs for 60 minutes during each session, at different outdoor temperatures and with different RPEs. Collected data from all four measurement sessions 312 feeds into the reference dataset 302. The reference dataset 302 may then be used to establish an algorithm, which may be used to estimate sweat rate and/or sweat sodium composition of the human subject under various conditions.
In the embodiment of
Fluid Replacement Guidelines
Referring now to
In the embodiment illustrated in
In another embodiment, salivary osmolarity is measured post-exercise. The reference dataset together with final salivary osmolarity, or changes of salivary osmolarity before and after the event, or difference between an individuals optimal hydration zone, is used to predict changes in body mass. Sodium and electrolyte loss are estimated from sweat composition based on the recorded information. The phone application generates a protocol outlining what to drink, how much to drink and when to drink assist in hydration recovery after exercise.
In another embodiment, the user may be periodically alerted during post-exercise recovery to measure their salivary osmolarity. These other salivary measurements are used to estimate the effectiveness of the initial hydration protocol and to permit the hydration protocol to be adapted in order to increase its effectiveness and to return the individual to a desirable hydration status.
In another embodiment, the user may be periodically alerted during post-exercise recovery to measure their salivary osmolarity. The time period between prompts is based upon how far the individual salivary osmolarity and hydration status is from their desirable hydration status.
In the embodiment illustrated in
Testing Method
Currently, chemical analysis of sweat is performed using laboratory tools. These are bulky and expensive and require large samples for analysis. As the reference dataset described above requires multiple sweat measurements to be performed across multiple training sessions, laboratory-style analysis of samples may be impractical. To facilitate the methods described herein for hydration assessment and hydration recommendations, this application also describes a method of rapid assessment of sweat sodium content through measurement of sweat conductivity, impedance or osmolarity, using a handheld portable testing system.
Referring now to the diagrammatic flow chart of
After the measurement device 534 takes a measurement from the first test strip 532, the user removes the first test strip 532, inserts a second test strip 532 into the handheld measurement device 534, inserts the free end of the test strip 532 into the sweat sample, and takes a second measurement. These last steps of the method are repeated for a third test strip 532. In alternative embodiments, fewer than three test strips 532 or more than three test strips 532 may be used for one measurement set. It may be advantageous to use three strips 532, to allow for averaging of three measurements and thus increase accuracy of the test results as compared to using only one or two test strips 532. The handheld measurement device 534 may provide measurements of sweat sodium concentration, sweat osmolarity and/or other sweat characteristics. Measurement data may then be used in any of the methods and algorithms described herein. For example, sweat osmolarity and/or sodium concentration may be used to help the test subject determine how much fluid to consume and what type of fluid (e.g., what quantity and type of electrolytes).
Referring now to
In another embodiment, a saliva sample is collected directly from the tongue with integrated microfluidics and electrodes. The handheld device 534 wirelessly communicates saliva data to a phone application for integration into the reference dataset. This same system may be capable of performing other measurements for establishing the reference dataset, such as but not limited to saliva osmolarity change and blood lactate concentration.
In another embodiment, a saliva sample is collected by a test subject providing a saliva sample into a receptacle. The sample is then analyzed with integrated microfluidics and electrodes. The handheld device 534 wirelessly communicates saliva data to a phone application for integration into the reference dataset. This same system may be capable of performing other measurements for establishing the reference dataset, such as but not limited to saliva osmolarity change and blood lactate concentration.
Although the above description is believed to be complete and accurate, various changes to any of the embodiments and features described herein may be made, without departing from the scope of the invention.
This application claims priority to U.S. Provisional patent application Ser. No. 62/869,210, titled “Biological Fluid Analysis System,” filed Jul. 1, 2019; 62/876,263, titled “Personalized Hydration Assessment and Fluid Replenishment,” filed Jul. 19, 2020; and 62/957,527, titled “Personalized Hydration Assessment and Fluid Replenishment,” filed Jan. 6, 2020. The full disclosures of all the above-referenced provisional patent applications are hereby incorporated by reference herein.
Number | Date | Country | |
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62957527 | Jan 2020 | US | |
62876263 | Jul 2019 | US | |
62869210 | Jul 2019 | US |