Machine-learning enabled wireless wearable sensors to study individuality of respiratory behaviors

Exhale-Focused Thermal Image Segmentation Using Optical Flow-Based Frame Filtering and Transformer-Aided Deep Networks

Since the COVID-19 pandemic, interest in non-contact diagnostic technologies has grown, leading to increased research into remote biosignal monitoring. The respiratory rate, widely used in previous studies, offers limited insight into pulmonary volume. To redress this, we propose a thermal imaging-based framework for respiratory segmentation aimed at estimating non-invasive pulmonary function. The proposed method uses an optical flow magnitude-based thresholding technique to automatically extract exhalation frames and segment them into frame sequences. A TransUNet-based network, combining a Convolutional Neural Network (CNN) encoder-decoder architecture with a Transformer module in the bottleneck, is trained on these sequences. The model's Accuracy, Precision, Recall, IoU, Dice, and F1-score were 0.9832, 0.9833, 0.9830, 0.9651, 0.9822, and 0.9831, respectively, which results demonstrate high segmentation performance. The method enables the respiratory volume to be estimated by detecting exhalation behavior, suggesting its potential as a non-contact tool to monitor pulmonary function and estimate lung volume. Furthermore, research on thermal imaging-based respiratory volume analysis remains limited. This study expands upon conventional respiratory rate-based approaches to provide a new direction for respiratory analysis using vision-based techniques.

Artificial intelligence in abdominal and pelvic ultrasound imaging: current applications

BACKGROUND

In recent years, the integration of artificial intelligence (AI) techniques into medical imaging has shown great potential to transform the diagnostic process. This review aims to provide a comprehensive overview of current state-of-the-art applications for AI in abdominal and pelvic ultrasound imaging.

METHODS

We searched the PubMed, FDA, and ClinicalTrials.gov databases for applications of AI in abdominal and pelvic ultrasound imaging.

RESULTS

A total of 128 titles were identified from the database search and were eligible for screening. After screening, 57 manuscripts were included in the final review. The main anatomical applications included multi-organ detection (n = 16, 28%), gynecology (n = 15, 26%), hepatobiliary system (n = 13, 23%), and musculoskeletal (n = 8, 14%). The main methodological applications included deep learning (n = 37, 65%), machine learning (n = 13, 23%), natural language processing (n = 5, 9%), and robots (n = 2, 4%). The majority of the studies were single-center (n = 43, 75%) and retrospective (n = 56, 98%). We identified 17 FDA approved AI ultrasound devices, with only a few being specifically used for abdominal/pelvic imaging (infertility monitoring and follicle development).

CONCLUSION

The application of AI in abdominal/pelvic ultrasound shows promising early results for disease diagnosis, monitoring, and report refinement. However, the risk of bias remains high because very few of these applications have been prospectively validated (in multi-center studies) or have received FDA clearance.

Age of Flexible Electronics: Emerging Trends in Soft Multifunctional Sensors

With the commercialization of first-generation flexible mobiles and displays in the late 2010s, humanity has stepped into the age of flexible electronics. Inevitably, soft multifunctional sensors, as essential components of next-generation flexible electronics, have attracted tremendous research interest like never before. This review is dedicated to offering an overview of the latest emerging trends in soft multifunctional sensors and their accordant future research and development (R&D) directions for the coming decade. First, key characteristics and the predominant target stimuli for soft multifunctional sensors are highlighted. Second, important selection criteria for soft multifunctional sensors are introduced. Next, emerging materials/structures and trends for soft multifunctional sensors are identified. Specifically, the future R&D directions of these sensors are envisaged based on their emerging trends, namely i) decoupling of multiple stimuli, ii) data processing, iii) skin conformability, and iv) energy sources. Finally, the challenges and potential opportunities for these sensors in future are discussed, offering new insights into prospects in the fast-emerging technology.

Wireless Battery-free and Fully Implantable Organ Interfaces

Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.

Flexible Antibacterial Respiratory Monitoring Sensor Based on Controllable Au-Modified Surface of Highly {001} Preferred Anatase Titanium Dioxide Thin Film

Respiratory signals are critical clinical diagnostic criteria for respiratory diseases and health conditions, and respiratory sensors play a crucial role in achieving the desired respiratory monitoring effect. High sensitivity to a single factor can improve the reliability of respiratory monitoring, and maintaining the hygiene of the sensors is also important for daily health monitoring. Herein, we propose a flexible Au-modified anatase titanium dioxide resistive respiratory sensor, which can be mechanically compliantly attached to curved surfaces for respiratory monitoring in different modalities (i.e., respiratory intensity, frequency, and rate). The uniform and preferentially oriented anatase titanium dioxide films gained by the polymer-assisted deposition technique can be fabricated on flexible substrates through a liquid-assisted transferring process. The Au modification can enhance surface plasmon resonance to facilitate the photocatalytic activity of titanium dioxide, and the optimized distribution of Au on the surface of titanium dioxide film made the sensor have an excellent antibacterial effect. The uniquely designed encapsulation can effectively control the contact between the surface of titanium dioxide films and electrodes, allowing the flexible sensor to exhibit fast response time (0.71 s) and recovery time (1.06 s) to respiratory as well as insensitivity or low sensitivity to other factors (i.e., gas composition, humidity, temperature, stress, and strain). This work provided an effective strategy for flexible wearable respiratory sensors and has great potential in daily respiratory monitoring for health management and pandemic control.

Microbial biofilms for self-powered noncontact sensing

Noncontact sensing technology plays a vital role in the intelligent human-machine interface, as the essential medium for exchanging information between human and electronic devices. To date, several inorganic materials-based noncontact sensing techniques have been used to accurately detect touch, electrical property, and physical motion. However, limited available materials, dependence on additional power supplies, and poor power production performance, have seriously obstructed the practical applications of noncontact sensing technology. Here, we developed simple self-powered noncontact sensors (SNSs) assembled using a typical G. sulfurreducens biofilm as the core component. In noncontact mode, the sensor demonstrated excellent self-powered sensing performance with maximum voltage output of 10 V and a current of 60 nA, a maximum sensing range of 40 cm which is the farthest reported to date. Depending on its excellent sensing characteristic, the SNSs was used to monitor human breathing in this work. Furthermore, an array of united SNSs was able to localize external electric fields and effectively extend the sensing area by increasing the number of devices. Compared to traditional inorganic materials, microbial biofilms have the advantages of wide existence, self-proliferation, low cost, environmental friendliness, and ultra-fast self-healing property (seconds level). The proposed biofilm SNSs in our work provides new insights for noncontact power generation of biomaterials and self-driven sensing.

Smartwatch-based algorithm for early detection of pulmonary infection: Validation and performance evaluation

Background

The proliferation of smart devices provides the possibility of early detection of the signs of pulmonary infections (PI). This study validates a smartwatch-based algorithm to monitor the risk of PI in adults.

Methods

An algorithm that runs on smartwatches was developed and tested in 87 patients with PI and 408 healthy subjects. The algorithm examines heart rate variability, respiratory rate, oxygen saturation, body temperature, and cough sound. It was embedded into the Respiratory Health Study app for a smartwatch to detect the risk of PI and was further validated in the hospital. Doctors diagnosed PI using a clinical evaluation, lab tests, and imaging examination, the gold standard for diagnosis. The accuracy, sensitivity, and specificity of the algorithm predicting PI were evaluated.

Results

In all, 80 patients with PI and 85 healthy volunteers were recruited to validate the accuracy of the algorithm. The area under the curve of the algorithm for predicting PI was 0.86 (95% confidence interval: 0.82-0.91) (P < 0.001). Compared to the gold standard, the overall accuracy of the algorithm was 85.9%, the sensitivity was 81.4%, and the specificity was 90.4%. The algorithm for heart rate, respiratory rate, oxygen saturation, and body temperature had an accuracy of 68.2%, and the accuracy of the algorithm including cough sound was 82.6%.

Conclusion

Our wearable system facilitated the detection of risk of PI. Multi-source features were useful for enhancing the performance of the lung infection screening algorithm.

Trial Registration

Chinese Clinical Trial Registry of the International Clinical Trials Registry Platform of the World Health Organization ChiCTR2100050843; https://www.chictr.org.cn/showproj.html?proj = 126556.

Wearable Nano-Based Gas Sensors for Environmental Monitoring and Encountered Challenges in Optimization

With a rising emphasis on public safety and quality of life, there is an urgent need to ensure optimal air quality, both indoors and outdoors. Detecting toxic gaseous compounds plays a pivotal role in shaping our sustainable future. This review aims to elucidate the advancements in smart wearable (nano)sensors for monitoring harmful gaseous pollutants, such as ammonia (NH3), nitric oxide (NO), nitrous oxide (N2O), nitrogen dioxide (NO2), carbon monoxide (CO), carbon dioxide (CO2), hydrogen sulfide (H2S), sulfur dioxide (SO2), ozone (O3), hydrocarbons (CxHy), and hydrogen fluoride (HF). Differentiating this review from its predecessors, we shed light on the challenges faced in enhancing sensor performance and offer a deep dive into the evolution of sensing materials, wearable substrates, electrodes, and types of sensors. Noteworthy materials for robust detection systems encompass 2D nanostructures, carbon nanomaterials, conducting polymers, nanohybrids, and metal oxide semiconductors. A dedicated section dissects the significance of circuit integration, miniaturization, real-time sensing, repeatability, reusability, power efficiency, gas-sensitive material deposition, selectivity, sensitivity, stability, and response/recovery time, pinpointing gaps in the current knowledge and offering avenues for further research. To conclude, we provide insights and suggestions for the prospective trajectory of smart wearable nanosensors in addressing the extant challenges.

A Wearable Multimodal Wireless Sensing System for Respiratory Monitoring and Analysis

Wireless sensing systems are required for continuous health monitoring and data collection. It allows for patient data collection in real time rather than through time-consuming and expensive hospital or lab visits. This technology employs wearable sensors, signal processing, and wireless data transfer to remotely monitor patients' health. The research offers a novel approach to providing primary diagnostics remotely with a digital health system for monitoring pulmonary health status using a multimodal wireless sensor device. The technology uses a compact wearable with new integration of acoustics and biopotentials sensors to monitor cardiovascular and respiratory activity to provide comprehensive and fast health status monitoring. Furthermore, the small wearable sensor size may stick to human skin and record heart and lung activities to monitor respiratory health. This paper proposes a sensor data fusion method of lung sounds and cardiograms for potential real-time respiration pattern diagnostics, including respiratory episodes like low tidal volume and coughing. With a p-value of 0.003 for sound signals and 0.004 for electrocardiogram (ECG), preliminary tests demonstrated that it was possible to detect shallow breathing and coughing at a meaningful level.

Intelligent wearable devices based on nanomaterials and nanostructures for healthcare

Emerging classes of flexible electronic sensors as alternatives to conventional rigid sensors offer a powerful set of capabilities for detecting and quantifying physiological and physical signals from human skin in personal healthcare. Unfortunately, the practical applications and commercialization of flexible sensors are generally limited by certain unsatisfactory aspects of their performance, such as biocompatibility, low sensing range, power supply, or single sensory function. This review intends to provide up-to-date literature on wearable devices for smart healthcare. A systematic review is provided, from sensors based on nanomaterials and nanostructures, algorithms, to multifunctional integrated devices with stretchability, self-powered performance, and biocompatibility. Typical electromechanical sensors are investigated with a specific focus on the strategies for constructing high-performance sensors based on nanomaterials and nanostructures. Then, the review emphasizes the importance of tailoring the fabrication techniques in order to improve stretchability, biocompatibility, and self-powered performance. The construction of wearable devices with high integration, high performance, and multi-functionalization for multiparameter healthcare is discussed in depth. Integrating wearable devices with appropriate machine learning algorithms is summarized. After interpretation of the algorithms, intelligent predictions are produced to give instructions or predictions for smart implementations. It is desired that this review will offer guidance for future excellence in flexible wearable sensing technologies and provide insight into commercial wearable sensors.

End-to-end design of wearable sensors

Wearable devices provide an alternative pathway to clinical diagnostics by exploiting various physical, chemical and biological sensors to mine physiological (biophysical and/or biochemical) information in real time (preferably, continuously) and in a non-invasive or minimally invasive manner. These sensors can be worn in the form of glasses, jewellery, face masks, wristwatches, fitness bands, tattoo-like devices, bandages or other patches, and textiles. Wearables such as smartwatches have already proved their capability for the early detection and monitoring of the progression and treatment of various diseases, such as COVID-19 and Parkinson disease, through biophysical signals. Next-generation wearable sensors that enable the multimodal and/or multiplexed measurement of physical parameters and biochemical markers in real time and continuously could be a transformative technology for diagnostics, allowing for high-resolution and time-resolved historical recording of the health status of an individual. In this Review, we examine the building blocks of such wearable sensors, including the substrate materials, sensing mechanisms, power modules and decision-making units, by reflecting on the recent developments in the materials, engineering and data science of these components. Finally, we synthesize current trends in the field to provide predictions for the future trajectory of wearable sensors.

Application of Machine Learning Algorithms for Asthma Management with mHealth: A Clinical Review

Background

Asthma is a variable long-term condition. Currently, there is no cure for asthma and the focus is, therefore, on long-term management. Mobile health (mHealth) is promising for chronic disease management but to be able to realize its potential, it needs to go beyond simply monitoring. mHealth therefore needs to leverage machine learning to provide tailored feedback with personalized algorithms. There is a need to understand the extent of machine learning that has been leveraged in the context of mHealth for asthma management. This review aims to fill this gap.

Methods

We searched PubMed for peer-reviewed studies that applied machine learning to data derived from mHealth for asthma management in the last five years. We selected studies that included some human data other than routinely collected in primary care and used at least one machine learning algorithm.

Results

Out of 90 studies, we identified 22 relevant studies that were then further reviewed. Broadly, existing research efforts can be categorized into three types: 1) technology development, 2) attack prediction, 3) patient clustering. Using data from a variety of devices (smartphones, smartwatches, peak flow meters, electronic noses, smart inhalers, and pulse oximeters), most applications used supervised learning algorithms (logistic regression, decision trees, and related algorithms) while a few used unsupervised learning algorithms. The vast majority used traditional machine learning techniques, but a few studies investigated the use of deep learning algorithms.

Discussion

In the past five years, many studies have successfully applied machine learning to asthma mHealth data. However, most have been developed on small datasets with internal validation at best. Small sample sizes and lack of external validation limit the generalizability of these studies. Future research should collect data that are more representative of the wider asthma population and focus on validating the derived algorithms and technologies in a real-world setting.

A Wearable Bioimpedance Chest Patch for Real-Time Ambulatory Respiratory Monitoring

OBJECTIVE

This paper aims to introduce a wearable solution and a low-complexity algorithm for real-time continuous ambulatory respiratory monitoring.

METHODS

A wearable chest-worn patch is designed using a bioimpedance (BioZ) sensor to measure the changes in chest impedance caused by breathing. Besides, a medical-grade infrared temperature sensor is utilized to monitor body temperature. The computing algorithm implemented on the patch enables computation of breath-by-breath respiratory rate and chest temperature in real-time. Two wireless communication protocols are included in the system, namely Bluetooth and Long Range (LoRa), which enable both short-range and long-range data transmission.

RESULTS

The breathing rate measured in static (i.e., standing, sitting, supine, and lateral lying) and dynamic (i.e., walking, running, and cycling) positions by our device yielded an accuracy of more than 97.8% and 98.5% to the ground truth, respectively. Additionally, the devices performance is evaluated in real-world scenarios both indoors and outdoors.

CONCLUSION

The proposed system is capable of measuring breathing rate throughout a variety of daily activities. To the best of our knowledge, this is the first BioZ-based wearable patch capable of detecting breath-by-breath respiratory rate in real-time remotely under unrestricted ambulatory conditions.

SIGNIFICANCE

This study establishes a strategy for continuous respiratory monitoring that could aid in the early detection of cardiopulmonary disorders in everyday life.

Flexible Ti3C2Tx MXene/PANI/Bacterial Cellulose Aerogel for e-Skins and Gas Sensing

Flexible pressure sensors made of carbon materials have been used in electronic skins (e-skins), whose performance can be enhanced if composite sensing materials are used. Herein, an MXene/polyaniline/bacterial cellulose (MXene/PANI/BC) aerogel sensor has been fabricated through the self-assembly process between the MXene and one-dimensional active material. Combined with fewer-layer or single-layer MXenes, the as-fabricated aerogel could be used as the active layer of the pressure sensor, monitoring tiny motion signals of finger bending, wrist bending, and pulse beating. Bluetooth wireless transmission could also be realized to monitor the real-time spatial pressure distributions on the mobile phone, making the aerogel-based sensor an ideal candidate in e-skins. Meanwhile, the aerogel-based sensor is sensitive toward NH₃ due to the unique three-dimensional (3D) structure of the aerogel and the abundant terminal groups (such as -O, -OH, and -F) of the MXene in the system that ensure efficient electronic transfer for the sensing process and create active sites for the absorption with the target gas. This work offers a versatile platform to develop MXenes to fabricate 3D composite aerogels for high-performance flexible multiple sensors.

Extraction and Analysis of Respiratory Motion Using a Comprehensive Wearable Health Monitoring System

Respiratory activity is an important vital sign of life that can indicate health status. Diseases such as bronchitis, emphysema, pneumonia and coronavirus cause respiratory disorders that affect the respiratory systems. Typically, the diagnosis of these diseases is facilitated by pulmonary auscultation using a stethoscope. We present a new attempt to develop a lightweight, comprehensive wearable sensor system to monitor respiration using a multi-sensor approach. We employed new wearable sensor technology using a novel integration of acoustics and biopotentials to monitor various vital signs on two volunteers. In this study, a new method to monitor lung function, such as respiration rate and tidal volume, is presented using the multi-sensor approach. Using the new sensor, we obtained lung sound, electrocardiogram (ECG), and electromyogram (EMG) measurements at the external intercostal muscles (EIM) and at the diaphragm during breathing cycles with 500 mL, 625 mL, 750 mL, 875 mL, and 1000 mL tidal volume. The tidal volumes were controlled with a spirometer. The duration of each breathing cycle was 8 s and was timed using a metronome. For each of the different tidal volumes, the EMG data was plotted against time and the area under the curve (AUC) was calculated. The AUC calculated from EMG data obtained at the diaphragm and EIM represent the expansion of the diaphragm and EIM respectively. AUC obtained from EMG data collected at the diaphragm had a lower variance between samples per tidal volume compared to those monitored at the EIM. Using cubic spline interpolation, we built a model for computing tidal volume from EMG data at the diaphragm. Our findings show that the new sensor can be used to measure respiration rate and variations thereof and holds potential to estimate tidal lung volume from EMG measurements obtained from the diaphragm.