Corneal confocal microscopy predicts 4-year incident peripheral neuropathy in Type 1 diabetes

OBJECTIVE This study determined if deficits in corneal nerve fiber length (CNFL) assessed using corneal confocal microscopy (CCM) can predict future onset of diabetic peripheral neuropathy (DPN). RESEARCH DESIGN AND METHODS CNFL and a range of other baseline measures were compared between 90 nonneuropathic patients with type 1 diabetes who did or did not develop DPN after 4 years. The receiver operator characteristic (ROC) curve was used to determine the capability of single and combined measures of neuropathy to predict DPN. RESULTS DPN developed in 16 participants (18%) after 4 years. Factors predictive of 4-year incident DPN were lower CNFL (P = 0.041); longer duration of diabetes (P = 0.002); higher triglycerides (P = 0.023); retinopathy (higher on the Early Treatment of Diabetic Retinopathy Study scale) (P = 0.008); nephropathy (higher albumin-to-creatinine ratio) (P = 0.001); higher neuropathy disability score (P = 0.037); lower cold sensation (P = 0.001) and cold pain (P = 0.027) thresholds; higher warm sensation (P = 0.008), warm pain (P = 0.024), and vibration (P = 0.003) thresholds; impaired monofilament response (P = 0.003); and slower peroneal (P = 0.013) and sural (P = 0.002) nerve conduction velocity. CCM could predict the 4-year incident DPN with 63% sensitivity and 74% specificity for a CNFL threshold cutoff of 14.1 mm/mm2 (area under ROC curve = 0.66, P = 0.041). Combining neuropathy measures did not improve predictive capability. CONCLUSIONS DPN can be predicted by various demographic, metabolic, and conventional neuropathy measures. The ability of CCM to predict DPN broadens the already impressive diagnostic capabilities of this novel ophthalmic marker.

Risk factors associated with corneal nerve alteration in type 1 diabetes in the absence of neuropathy: A longitudinal in vivo corneal confocal microscopy study

Purpose The aim of this study was to determine alterations to the corneal subbasal nerve plexus (SNP) over four years using in vivo corneal confocal microscopy (IVCM) in participants with type 1 diabetes and to identify significant risk factors associated with these alterations. Methods A cohort of 108 individuals with type 1 diabetes and no evidence of peripheral neuropathy at enrollment underwent laser-scanning IVCM, ocular screening, and health and metabolic assessment at baseline and the examinations continued for four subsequent annual visits. At each annual visit, eight central corneal images of the SNP were selected and analyzed to quantify corneal nerve fiber density (CNFD), branch density (CNBD) and fiber length (CNFL). Linear mixed model approaches were fitted to examine the relationship between risk factors and corneal nerve parameters. Results A total of 96 participants completed the final visit and 91 participants completed all visits. No significant relationships were found between corneal nerve parameters and time, sex, duration of diabetes, smoking, alcohol consumption, blood pressure or BMI. However, CNFD was negatively associated with HbA1c (β=-0.76, P<0.01) and age (β=-0.13, P<0.01) and positively related to high density lipids (HDL) (β=2.01, P=0.03). Higher HbA1c (β=-1.58, P=0.04) and age (β=-0.23, P<0.01) also negatively impacted CNBD. CNFL was only affected by higher age (β=-0.06, P<0.01). Conclusions Glycemic control, HDL and age have significant effects on SNP structure. These findings highlight the importance of diabetic management to prevent corneal nerve damage as well as the capability of IVCM for monitoring subclinical alterations in the corneal SNP in diabetes.

Small nerve fiber quantification in the diagnosis of diabetic sensorimotor polyneuropathy: Comparing corneal confocal microscopy with intraepidermal nerve fiber density

OBJECTIVE Quantitative assessment of small fiber damage is key to the early diagnosis and assessment of progression or regression of diabetic sensorimotor polyneuropathy (DSPN). Intraepidermal nerve fiber density (IENFD) is the current gold standard, but corneal confocal microscopy (CCM), an in vivo ophthalmic imaging modality, has the potential to be a noninvasive and objective image biomarker for identifying small fiber damage. The purpose of this study was to determine the diagnostic performance of CCM and IENFD by using the current guidelines as the reference standard. RESEARCH DESIGN AND METHODS Eighty-nine subjects (26 control subjects and 63 patients with type 1 diabetes), with and without DSPN, underwent a detailed assessment of neuropathy, including CCM and skin biopsy. RESULTS Manual and automated corneal nerve fiber density (CNFD) (P < 0.0001), branch density (CNBD) (P < 0.0001) and length (CNFL) (P < 0.0001), and IENFD (P < 0.001) were significantly reduced in patients with diabetes with DSPN compared with control subjects. The area under the receiver operating characteristic curve for identifying DSPN was 0.82 for manual CNFD, 0.80 for automated CNFD, and 0.66 for IENFD, which did not differ significantly (P = 0.14). CONCLUSIONS This study shows comparable diagnostic efficiency between CCM and IENFD, providing further support for the clinical utility of CCM as a surrogate end point for DSPN.

Optimal configurations of active fiber composites based on asymptotic torsional analysis - art. no. 641413

Active Fiber Composites (AFC) possess desirable characteristics over a wide range of smart structure applications, such as vibration, shape and flow control as well as structural health monitoring. This type of material, capable of collocated actuation and sensing, call be used in smart structures with self-sensing circuits. This paper proposes four novel applications of AFC structures undergoing torsion: sensors and actuators shaped as strips and tubes; and concludes with a preliminary failure analysis. To enable this, a powerful mathematical technique, the Variational Asymptotic Method (VAM) was used to perform cross-sectional analyses of thin generally anisotropic AFC beams. The resulting closed form expressions have been utilized in the applications presented herein.

A novel interrogation system for fiber Bragg grating sensor array

Interrogation techniques for fiber Bragg grating sensor arrays need particular attention in the case of structural health monitoring applications involving dynamic strain measurement. Typically the performance of the sensing system is dependent on both the sensor type and the interrogation method employed. A novel interrogation system is proposed here that consists of different interrogation units for each sensor in the array, each unit comprising of a circulator, chirped grating and a Mach-Zehnder interferometer. We present an analysis that consists of tracking the spectral changes as the light passes through various elements in the interrogation system. This is expected to help in the optimization of sensor and interrogation elements leading to improved performance of the health monitoring system.

Dual functional performance of fiber Bragg gratings coated with metals using flash evaporation technique

Metallic and other type of coatings on fiber Bragg grating (FBG) sensors alter their sensitivity with thermal and mechanical stress while protecting the fragile optical fiber in harsh sensing surroundings. The behavior of the coated materials is unique in their response to thermal and mechanical stress depending on the thickness and the mode of coating. The thermal stress during the coating affects the temperature sensitivity of FBG sensors. We have explored the thermal response of FBGs coated with Al and Pb to an average thickness of 80 nm using flash evaporation technique where the FBG sensor is mounted in a region at room temperature in an evacuated chamber having a pressure of 10(6) Torr which will minimize any thermal stress during the coating process. The coating thickness is chosen in the nanometer region with the aim to study thermal behavior of nanocoatings and their effect on FBG sensitivity. The sensitivity of FBGs is evaluated from the wavelengths recorded using an optical sensing interrogator sm 130 (Micron Optics) from room temperature to 300 degrees C both during heating and cooling. It is observed that the sensitivity of the metal coated fibers is better than the reference FBG with no coating for the entire range of temperature. For a coating thickness of 80 nm, Al coated FBG is more sensitive than the one coated with Pb up to 170 degrees C and it reverses at higher temperatures. This point is identified as a reversible phase transition in Pb monolayers as the 2-dimensional aspects of the metal layers are dominant in the nanocoatings of Pb. On cooling, the phase transition reverses and the FBGs return to the original state and for repeated cycles of heating and cooling the same pattern is observed. Thus the FBG functions as a sensor of the phase transitions of the coatings also. (C) 2012 Elsevier Inc. All rights reserved.

Optical bio-sensing devices based on etched fiber Bragg gratings coated with carbon nanotubes and graphene oxide along with a specific dendrimer

We demonstrate that etched fiber Bragg gratings (eFBGs) coated with single walled carbon nanotubes (SWNTs) and graphene oxide (GO) are highly sensitive and accurate biochemical sensors. Here, for detecting protein concanavalin A (Con A), mannose-functionalized poly(propyl ether imine) (PETIM) dendrimers (DMs) have been attached to the SWNTs (or GO) coated on the surface modified eFBG. The dendrimers act as multivalent ligands, having specificity to detect lectin Con A. The specificity of the sensor is shown by a much weaker response (factor of similar to 2500 for the SWNT and similar to 2000 for the GO coated eFBG) to detect non specific lectin peanut agglutinin. DM molecules functionalized GO coated eFBG sensors showed excellent specificity to Con A even in the presence of excess amount of an interfering protein bovine serum albumin. The shift in the Bragg wavelength (Delta lambda(B)) with respect to the lambda(B) values of SWNT (or GO)-DM coated eFBG for various concentrations of lectin follows Langmuir type adsorption isotherm, giving an affinity constant of similar to 4 x 10(7) M-1 for SWNTs coated eFBG and similar to 3 x 10(8) M-1 for the GO coated eFBG. (C) 2014 Elsevier B.V. All rights reserved.

Modified Generalized Beam Lattice Model Associated With Fracture Of Reinforced Fiber/Particle Composites

Lattice-type model can simulate in a straightforward manner heterogeneous brittle media. Mohr-Coulomb failure criterion has recently been involved into the generalized beam (GB) lattice model, and as a result, numerical experiments on concrete under various loading conditions can be conducted. The GB lattice model is further used to investigate the reinforced fiber/particle composites instead of only particle composites as the model did before. Numerical examples are given to show the effectiveness of the modeling procedure, and influences of inclusions (particle, fiber and rebar) on the fracture processes are also discussed. (c) 2008 Elsevier Ltd. All rights reserved.

An Optical Fiber Bundle Sensor for Tip Clearance and Tip Timing Measurements in a Turbine Rig

When it comes to measuring blade-tip clearance or blade-tip timing in turbines, reflective intensity-modulated optical fiber sensors overcome several traditional limitations of capacitive, inductive or discharging probe sensors. This paper presents the signals and results corresponding to the third stage of a multistage turbine rig, obtained from a transonic wind-tunnel test. The probe is based on a trifurcated bundle of optical fibers that is mounted on the turbine casing. To eliminate the influence of light source intensity variations and blade surface reflectivity, the sensing principle is based on the quotient of the voltages obtained from the two receiving bundle legs. A discrepancy lower than 3% with respect to a commercial sensor was observed in tip clearance measurements. Regarding tip timing measurements, the travel wave spectrum was obtained, which provides the average vibration amplitude for all blades at a particular nodal diameter. With this approach, both blade-tip timing and tip clearance measurements can be carried out simultaneously. The results obtained on the test turbine rig demonstrate the suitability and reliability of the type of sensor used, and suggest the possibility of performing these measurements in real turbines under real working conditions.

Influence of Humidity on Fiber Bragg Grating Sensors

We demonstrate the influence of the relative humidity (RH) on the wavelength of fiber Bragg grating sensors (FBGS), performing tests with five FBGS at different humidity and temperature conditions. These tests were performed in a climate chamber whose RH changes according to a scheduled profile from 30% to 90%, in steps of 10%. These profiles were repeated for a wide range of temperatures from to , in steps of . Two different types of instrumentation methods have been tested, spot welding and epoxy bonding, in two different materials, steel and carbon fiber reinforced polymer (CFRP). We discuss the results for each type of sensor and instrumentation method by analyzing the linearity of the Bragg wavelength with RH and temperature.

Direct detection of Yersinia pestis from the infected animal specimens by a fiber optic biosensor

The FOB-3, anew type fiber optic biosensor, is designed to rapidly detect a variety of biological agents or analytes with better stability, sensitivity and specificity. In order to detect Y. Pestis, a sandwich immunoassay was developed by using the purified antibody against antigen FI immobilized on polystyrene probes as the capture antibody and the monoclonal antibody-Cy5 conjugate as the detector. After a series of optimization for the stability, sensitivity and specificity of the FOB-3, 50-1000 ng/ml of antigen FI and 6 x 10(1)-6 x 10(7) CFU/ml Y. pestis could be detected constantly in about 20 min, and Y pestis could be detected specifically from Y. pseudotuberculosis, Y. enterocolitica, B. anthracis and E. coli. Then, 39 blind samples, including 27 tissues of mice infected with Y pestis and 12 tissues of healthy mice as negative control, were detected with the FOB-3. 92.6% infected tissues were identified from the tissues of healthy mice and the tissues containing more than 100 CFU/ml bacteria could be detected by the biosensor. The results demonstrated the feasibility of the FOB-3 as an effective method to detect Y. pestis rapidly and directly from the infected animal specimens with the advantage of portability, simple-operation as well as high sensitivity and specificity. (c) 2006 Elsevier B.V. All rights reserved.

Influence of Humidity on Fiber Bragg Grating Sensors

We demonstrate the influence of the relative humidity (RH) on the wavelength of fiber Bragg grating sensors (FBGS), performing tests with five FBGS at different humidity and temperature conditions. These tests were performed in a climate chamber whose RH changes according to a scheduled profile from 30% to 90%, in steps of 10%. These profiles were repeated for a wide range of temperatures from 10 degrees C to 70 degrees C, in steps of 10 degrees C. Two different types of instrumentation methods have been tested, spot welding and epoxy bonding, in two different materials, steel and carbon fiber reinforced polymer (CFRP). We discuss the results for each type of sensor and instrumentation method by analyzing the linearity of the Bragg wavelength with RH and temperature.

New type of multimode-interference-type thermo-optic variable optical attenuator

A thermo-optic variable optical attenuator (VOA) based on a Mach-Zehnder interferometer and multimode-interference coupler is fabricated. Not a single-mode but a multimode waveguide is used as the input and output structures of the optical field, which greatly reduces the coupling loss of the VOA with a normal single-mode fiber. The insertion loss of the fabricated VOA is 2.52 to 2.82 dB at the wavelength of 1520 to 1570 nm. The polarization dependent loss is 0.28 to 0.45 dB at the same wavelength range. Its maximum attenuation range is up to 26.3 dB when its power consumption is 369 mW. The response frequency of the fabricated VOA is about 10 kHz. (C) 2004 Society of Photo-Optical Instrumentation Engineers.

Long-wavelength Si-based MQW photodetectors for application in optical fiber communication

Si-based SiGe/Si strained MQW long-wavelength photodetectors (PD) with cycle type (Ring Shape) waveguide (CWG) and resonant-cavity-enhanced (RCE) structure have been investigated for the first time for improving the quantum efficiency and response time. The results show that the responsivities are higher than that of conventional PD with a same Ge content reported previously. In addition, RCE-PD has an obvious narrow band response with FWHM less than 6nm.

Design and optimization of highly nonlinear low-dispersion crystal fiber with high birefringence for four-wave mixing

We have proposed a novel type of photonic crystal fiber (PCF) with low dispersion and high nonlinearity for four-wave mixing. This type of fiber is composed of a solid silica core and a cladding with a squeezed hexagonal lattice elliptical airhole along the fiber length. Its dispersion and nonlinearity coefficient are investigated simultaneously by using the full vectorial finite element method. Numerical results show that the proposed highly nonlinear low-dispersion fiber has a total dispersion as low as +/- 2.5 ps nm(-1) km(-1) over an ultrabroad wavelength range from 1.43 to 1.8 mu m, and the corresponding nonlinearity coefficient and birefringence are about 150 W-1 km(-1) and 2.5 x 10(-3) at 1.55 mu m, respectively. The proposed PCF with low ultraflattened dispersion, high nonlinearity, and high birefringence can have important application in four-wave mixing. (C) 2010 Optical Society of America