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Li G, Xue P, Fan H, Ma Y, Wang H, Lu D, Gao J, Wen D. AuNi bimetallic aerogel with ultra-high stability applied in smart and portable biosensing. Anal Chim Acta 2024; 1306:342613. [PMID: 38692794 DOI: 10.1016/j.aca.2024.342613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/03/2024] [Accepted: 04/13/2024] [Indexed: 05/03/2024]
Abstract
Glucose detection is of significant importance in providing information to the human health management. However, conventional enzymatic glucose sensors suffer from a limited long-term stability due to the losing activity of the enzymes. In this work, the AuNi bimetallic aerogel with a well-defined nanowire network is synthesized and applied as the sensing nanomaterial in the non-enzymatic glucose detection. The three-dimensional (3D) hierarchical porous structure of the AuNi bimetallic aerogel ensures the high sensitivity of the sensor (40.34 μA mM-1 cm-2). Theoretical investigation unveiled the mechanism of the boosting electrocatalytic activity of the AuNi bimetallic aerogel toward glucose. A better adhesion between the sensing nanomaterial and the screen-printing electrodes (SPEs) is obtained after the introduction of Ni. On the basis of a wide linearity in the range of 0.1-5 mM, an excellent selectivity, an outstanding long-term stability (90 days) as well as the help of the signal processing circuit and an M5stack development board, the as-prepared glucose sensor successfully realizes remote monitoring of the glucose concentration. We speculate that this work is favorable to motivating the technological innovations of the non-enzymatic glucose sensors and intelligent sensing devices.
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Affiliation(s)
- Guanglei Li
- Interdisciplinary Research Center of Biology & Catalysis, School of Life Sciences, Northwestern Polytechnical University (NPU), Xi'an, 710072, PR China; State Key Laboratory of Solidification Processing, Center for Nano Energy Materials, School of Materials Science and Engineering, NPU and Shaanxi Joint Laboratory of Graphene, Xi'an, 710072, PR China
| | - Pengxin Xue
- Interdisciplinary Research Center of Biology & Catalysis, School of Life Sciences, Northwestern Polytechnical University (NPU), Xi'an, 710072, PR China
| | - Haoxin Fan
- State Key Laboratory of Solidification Processing, Center for Nano Energy Materials, School of Materials Science and Engineering, NPU and Shaanxi Joint Laboratory of Graphene, Xi'an, 710072, PR China
| | - Yuan Ma
- Interdisciplinary Research Center of Biology & Catalysis, School of Life Sciences, Northwestern Polytechnical University (NPU), Xi'an, 710072, PR China
| | - Haoyu Wang
- Interdisciplinary Research Center of Biology & Catalysis, School of Life Sciences, Northwestern Polytechnical University (NPU), Xi'an, 710072, PR China
| | - Danfeng Lu
- Faculty of Printing, Packaging Engineering, and Digital Media Technology, Xi'an University of Technology, Xi'an, 710048, PR China
| | - Jie Gao
- Interdisciplinary Research Center of Biology & Catalysis, School of Life Sciences, Northwestern Polytechnical University (NPU), Xi'an, 710072, PR China; Research Institute of Industrial Technology, Zhengzhou University, Zhengzhou, 450001, PR China.
| | - Dan Wen
- State Key Laboratory of Solidification Processing, Center for Nano Energy Materials, School of Materials Science and Engineering, NPU and Shaanxi Joint Laboratory of Graphene, Xi'an, 710072, PR China.
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2
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Medhi D, Kamidi SR, Mamatha Sree KP, Shaikh S, Rasheed S, Thengu Murichathil AH, Nazir Z. Artificial Intelligence and Its Role in Diagnosing Heart Failure: A Narrative Review. Cureus 2024; 16:e59661. [PMID: 38836155 PMCID: PMC11148729 DOI: 10.7759/cureus.59661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 06/06/2024] Open
Abstract
Heart failure (HF) is prevalent globally. It is a dynamic disease with varying definitions and classifications due to multiple pathophysiologies and etiologies. The diagnosis, clinical staging, and treatment of HF become complex and subjective, impacting patient prognosis and mortality. Technological advancements, like artificial intelligence (AI), have been significant roleplays in medicine and are increasingly used in cardiovascular medicine to transform drug discovery, clinical care, risk prediction, diagnosis, and treatment. Medical and surgical interventions specific to HF patients rely significantly on early identification of HF. Hospitalization and treatment costs for HF are high, with readmissions increasing the burden. AI can help improve diagnostic accuracy by recognizing patterns and using them in multiple areas of HF management. AI has shown promise in offering early detection and precise diagnoses with the help of ECG analysis, advanced cardiac imaging, leveraging biomarkers, and cardiopulmonary stress testing. However, its challenges include data access, model interpretability, ethical concerns, and generalizability across diverse populations. Despite these ongoing efforts to refine AI models, it suggests a promising future for HF diagnosis. After applying exclusion and inclusion criteria, we searched for data available on PubMed, Google Scholar, and the Cochrane Library and found 150 relevant papers. This review focuses on AI's significant contribution to HF diagnosis in recent years, drastically altering HF treatment and outcomes.
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Affiliation(s)
- Diptiman Medhi
- Internal Medicine, Gauhati Medical College and Hospital, Guwahati, Guwahati, IND
| | | | | | - Shifa Shaikh
- Cardiology, SMBT Institute of Medical Sciences and Research Centre, Igatpuri, IND
| | - Shanida Rasheed
- Emergency Medicine, East Sussex Healthcare NHS Trust, Eastbourne, GBR
| | | | - Zahra Nazir
- Internal Medicine, Combined Military Hospital, Quetta, Quetta, PAK
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3
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Sengupta PP, Kluin J, Lee SP, Oh JK, Smits AIPM. The future of valvular heart disease assessment and therapy. Lancet 2024; 403:1590-1602. [PMID: 38554727 DOI: 10.1016/s0140-6736(23)02754-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/15/2023] [Accepted: 12/06/2023] [Indexed: 04/02/2024]
Abstract
Valvular heart disease (VHD) is becoming more prevalent in an ageing population, leading to challenges in diagnosis and management. This two-part Series offers a comprehensive review of changing concepts in VHD, covering diagnosis, intervention timing, novel management strategies, and the current state of research. The first paper highlights the remarkable progress made in imaging and transcatheter techniques, effectively addressing the treatment paradox wherein populations at the highest risk of VHD often receive the least treatment. These advances have attracted the attention of clinicians, researchers, engineers, device manufacturers, and investors, leading to the exploration and proposal of treatment approaches grounded in pathophysiology and multidisciplinary strategies for VHD management. This Series paper focuses on innovations involving computational, pharmacological, and bioengineering approaches that are transforming the diagnosis and management of patients with VHD. Artificial intelligence and digital methods are enhancing screening, diagnosis, and planning procedures, and the integration of imaging and clinical data is improving the classification of VHD severity. The emergence of artificial intelligence techniques, including so-called digital twins-eg, computer-generated replicas of the heart-is aiding the development of new strategies for enhanced risk stratification, prognostication, and individualised therapeutic targeting. Various new molecular targets and novel pharmacological strategies are being developed, including multiomics-ie, analytical methods used to integrate complex biological big data to find novel pathways to halt the progression of VHD. In addition, efforts have been undertaken to engineer heart valve tissue and provide a living valve conduit capable of growth and biological integration. Overall, these advances emphasise the importance of early detection, personalised management, and cutting-edge interventions to optimise outcomes amid the evolving landscape of VHD. Although several challenges must be overcome, these breakthroughs represent opportunities to advance patient-centred investigations.
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Affiliation(s)
- Partho P Sengupta
- Division of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Cardiovascular Services, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
| | - Jolanda Kluin
- Department of Cardiothoracic Surgery, Erasmus MC Rotterdam, Thorax Center, Rotterdam, Netherlands
| | - Seung-Pyo Lee
- Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Jae K Oh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anthal I P M Smits
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, Netherlands
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4
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Islam T, Washington P. Non-Invasive Biosensing for Healthcare Using Artificial Intelligence: A Semi-Systematic Review. BIOSENSORS 2024; 14:183. [PMID: 38667177 PMCID: PMC11048540 DOI: 10.3390/bios14040183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
The rapid development of biosensing technologies together with the advent of deep learning has marked an era in healthcare and biomedical research where widespread devices like smartphones, smartwatches, and health-specific technologies have the potential to facilitate remote and accessible diagnosis, monitoring, and adaptive therapy in a naturalistic environment. This systematic review focuses on the impact of combining multiple biosensing techniques with deep learning algorithms and the application of these models to healthcare. We explore the key areas that researchers and engineers must consider when developing a deep learning model for biosensing: the data modality, the model architecture, and the real-world use case for the model. We also discuss key ongoing challenges and potential future directions for research in this field. We aim to provide useful insights for researchers who seek to use intelligent biosensing to advance precision healthcare.
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5
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Du Y, Kim JH, Kong H, Li AA, Jin ML, Kim DH, Wang Y. Biocompatible Electronic Skins for Cardiovascular Health Monitoring. Adv Healthc Mater 2024:e2303461. [PMID: 38569196 DOI: 10.1002/adhm.202303461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/27/2024] [Indexed: 04/05/2024]
Abstract
Cardiovascular diseases represent a significant threat to the overall well-being of the global population. Continuous monitoring of vital signs related to cardiovascular health is essential for improving daily health management. Currently, there has been remarkable proliferation of technology focused on collecting data related to cardiovascular diseases through daily electronic skin monitoring. However, concerns have arisen regarding potential skin irritation and inflammation due to the necessity for prolonged wear of wearable devices. To ensure comfortable and uninterrupted cardiovascular health monitoring, the concept of biocompatible electronic skin has gained substantial attention. In this review, biocompatible electronic skins for cardiovascular health monitoring are comprehensively summarized and discussed. The recent achievements of biocompatible electronic skin in cardiovascular health monitoring are introduced. Their working principles, fabrication processes, and performances in sensing technologies, materials, and integration systems are highlighted, and comparisons are made with other electronic skins used for cardiovascular monitoring. In addition, the significance of integrating sensing systems and the updating wireless communication for the development of the smart medical field is explored. Finally, the opportunities and challenges for wearable electronic skin are also examined.
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Affiliation(s)
- Yucong Du
- Institute of Translational Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao, 266071, China
- Institute for Future, Shandong Key Laboratory of Industrial Control Technology, School of Automation, Qingdao University, Qingdao, 266071, China
| | - Ji Hong Kim
- Department of Chemical Engineering, Hanyang University, Seoul, 04763, Republic of Korea
- Institute of Nano Science and Technology, Hanyang University, Seoul, 04763, Republic of Korea
- Clean-Energy Research Institute, Hanyang University, Seoul, 04763, Republic of Korea
| | - Hui Kong
- Institute for Future, Shandong Key Laboratory of Industrial Control Technology, School of Automation, Qingdao University, Qingdao, 266071, China
| | - Anne Ailina Li
- Institute for Future, Shandong Key Laboratory of Industrial Control Technology, School of Automation, Qingdao University, Qingdao, 266071, China
| | - Ming Liang Jin
- Institute for Future, Shandong Key Laboratory of Industrial Control Technology, School of Automation, Qingdao University, Qingdao, 266071, China
| | - Do Hwan Kim
- Department of Chemical Engineering, Hanyang University, Seoul, 04763, Republic of Korea
- Institute of Nano Science and Technology, Hanyang University, Seoul, 04763, Republic of Korea
- Clean-Energy Research Institute, Hanyang University, Seoul, 04763, Republic of Korea
| | - Yin Wang
- Institute of Translational Medicine, The Affiliated Hospital of Qingdao University, College of Medicine, Qingdao University, Qingdao, 266071, China
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6
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Armoundas AA, Narayan SM, Arnett DK, Spector-Bagdady K, Bennett DA, Celi LA, Friedman PA, Gollob MH, Hall JL, Kwitek AE, Lett E, Menon BK, Sheehan KA, Al-Zaiti SS. Use of Artificial Intelligence in Improving Outcomes in Heart Disease: A Scientific Statement From the American Heart Association. Circulation 2024; 149:e1028-e1050. [PMID: 38415358 PMCID: PMC11042786 DOI: 10.1161/cir.0000000000001201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
A major focus of academia, industry, and global governmental agencies is to develop and apply artificial intelligence and other advanced analytical tools to transform health care delivery. The American Heart Association supports the creation of tools and services that would further the science and practice of precision medicine by enabling more precise approaches to cardiovascular and stroke research, prevention, and care of individuals and populations. Nevertheless, several challenges exist, and few artificial intelligence tools have been shown to improve cardiovascular and stroke care sufficiently to be widely adopted. This scientific statement outlines the current state of the art on the use of artificial intelligence algorithms and data science in the diagnosis, classification, and treatment of cardiovascular disease. It also sets out to advance this mission, focusing on how digital tools and, in particular, artificial intelligence may provide clinical and mechanistic insights, address bias in clinical studies, and facilitate education and implementation science to improve cardiovascular and stroke outcomes. Last, a key objective of this scientific statement is to further the field by identifying best practices, gaps, and challenges for interested stakeholders.
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7
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Muse ED, Topol EJ. Transforming the cardiometabolic disease landscape: Multimodal AI-powered approaches in prevention and management. Cell Metab 2024; 36:670-683. [PMID: 38428435 PMCID: PMC10990799 DOI: 10.1016/j.cmet.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/25/2024] [Accepted: 02/06/2024] [Indexed: 03/03/2024]
Abstract
The rise of artificial intelligence (AI) has revolutionized various scientific fields, particularly in medicine, where it has enabled the modeling of complex relationships from massive datasets. Initially, AI algorithms focused on improved interpretation of diagnostic studies such as chest X-rays and electrocardiograms in addition to predicting patient outcomes and future disease onset. However, AI has evolved with the introduction of transformer models, allowing analysis of the diverse, multimodal data sources existing in medicine today. Multimodal AI holds great promise in more accurate disease risk assessment and stratification as well as optimizing the key driving factors in cardiometabolic disease: blood pressure, sleep, stress, glucose control, weight, nutrition, and physical activity. In this article we outline the current state of medical AI in cardiometabolic disease, highlighting the potential of multimodal AI to augment personalized prevention and treatment strategies in cardiometabolic disease.
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Affiliation(s)
- Evan D Muse
- Scripps Research Translational Institute, Scripps Research, La Jolla, CA 92037, USA; Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA 92037, USA
| | - Eric J Topol
- Scripps Research Translational Institute, Scripps Research, La Jolla, CA 92037, USA; Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA 92037, USA.
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8
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Narayan SM, Wan EY, Andrade JG, Avari Silva JN, Bhatia NK, Deneke T, Deshmukh AJ, Chon KH, Erickson L, Ghanbari H, Noseworthy PA, Pathak RK, Roelle L, Seiler A, Singh JP, Srivatsa UN, Trela A, Tsiperfal A, Varma N, Yousuf OK. Visions for digital integrated cardiovascular care: HRS Digital Health Committee perspectives. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2024; 5:37-49. [PMID: 38765620 PMCID: PMC11096652 DOI: 10.1016/j.cvdhj.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Affiliation(s)
| | - Elaine Y Wan
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | | | | | | | | | | | - Ki H Chon
- University of Connecticut, Storrs, Connecticut
| | | | | | | | | | - Lisa Roelle
- Washington University School of Medicine, Saint Louis, Missouri
| | | | - Jagmeet P Singh
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Anthony Trela
- Lucile Packard Children's Hospital, Palo Alto, California
| | - Angela Tsiperfal
- Stanford Arrhythmia Service, Stanford Healthcare, Palo Alto, California
| | | | - Omair K Yousuf
- Inova Heart and Vascular Institute; Carient Heart and Vascular; and University of Virginia Health, Fairfax, Virginia
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9
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Palermi S, Vecchiato M, Saglietto A, Niederseer D, Oxborough D, Ortega-Martorell S, Olier I, Castelletti S, Baggish A, Maffessanti F, Biffi A, D'Andrea A, Zorzi A, Cavarretta E, D'Ascenzi F. Unlocking the potential of artificial intelligence in sports cardiology: does it have a role in evaluating athlete's heart? Eur J Prev Cardiol 2024; 31:470-482. [PMID: 38198776 DOI: 10.1093/eurjpc/zwae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
The integration of artificial intelligence (AI) technologies is evolving in different fields of cardiology and in particular in sports cardiology. Artificial intelligence offers significant opportunities to enhance risk assessment, diagnosis, treatment planning, and monitoring of athletes. This article explores the application of AI in various aspects of sports cardiology, including imaging techniques, genetic testing, and wearable devices. The use of machine learning and deep neural networks enables improved analysis and interpretation of complex datasets. However, ethical and legal dilemmas must be addressed, including informed consent, algorithmic fairness, data privacy, and intellectual property issues. The integration of AI technologies should complement the expertise of physicians, allowing for a balanced approach that optimizes patient care and outcomes. Ongoing research and collaborations are vital to harness the full potential of AI in sports cardiology and advance our management of cardiovascular health in athletes.
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Affiliation(s)
- Stefano Palermi
- Public Health Department, University of Naples Federico II, via Pansini 5, 80131 Naples, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy
| | - Andrea Saglietto
- Division of Cardiology, Cardiovascular and Thoracic Department, 'Citta della Salute e della Scienza' Hospital, 10129 Turin, Italy
- Department of Medical Sciences, University of Turin, 10129 Turin, Italy
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - David Oxborough
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Sandra Ortega-Martorell
- Data Science Research Centre, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Ivan Olier
- Data Science Research Centre, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Silvia Castelletti
- Cardiology Department, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - Alessandro Biffi
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Antonello D'Andrea
- Department of Cardiology, Umberto I Hospital, 84014 Nocera Inferiore, Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
- Mediterranea Cardiocentro, 80122 Naples, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
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Movahed MR, Irannejad K, Bates S. The Majority of Participants With Suspected Hypertrophic Cardiomyopathy Documented During Screening Echocardiography Have a Normal Electrocardiogram. Crit Pathw Cardiol 2024; 23:20-25. [PMID: 38381652 DOI: 10.1097/hpc.0000000000000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
BACKGROUND Patients with hypertrophic cardiomyopathy (HCM) usually have abnormal electrocardiograms consistent with left ventricular hypertrophy (LVH). The goal of this study was to evaluate the prevalence of abnormal ECG findings (LVH, T wave inversion, left bundle branch block, and left atrial enlargement) in participants with suspected HCM detected during screening echocardiography. METHOD The Anthony Bates Foundation has been performing screening echocardiography across the United States for the prevention of sudden death since 2001. A total of 682 subjects between the ages of 8 and 71 underwent echocardiographic screening together with ECG documentation. We evaluated the prevalence of abnormal ECG in participants with suspected HCM defined as any left ventricular wall thickness ≥15 mm. RESULTS The prevalence of LVH and T wave inversion were higher in HCM subjects as expected [HCM occurred in 23.5% (4/17) vs. 5.6% (37/665), P = 0.002, T wave inversion occurred in 17.6% (3/17) vs. 4.1% (27/664), P = 0.007]. However, despite adding these 2 common ECG abnormalities in this population, the presence of detected abnormal ECG remained less than 25% (23.5% of HCM subjects had LVH or T wave inversion on ECG vs. 8.7% of control, P = 0.036). Left bundle branch block or abnormal left atrium on ECG were not found in any participants with suspected HCM. CONCLUSIONS The prevalence of abnormal ECG in the participants with suspected HCM detected during screening echocardiography is less than 25%. This suggests that ECG alone is not a sensitive marker for the detection of HCM.
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Affiliation(s)
- Mohammad Reza Movahed
- From the Department of Medicine, University of Arizona Sarver Heart Center, Tucson
- Department of Medicine, University of Arizona, College of Medicine, Phoenix
| | - Kyvan Irannejad
- Department of Medicine, Jamaica Hospital Medical Center, Queens, NY
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Edgar R, Scholte NTB, Ebrahimkheil K, Brouwer MA, Beukema RJ, Mafi-Rad M, Vernooy K, Yap SC, Ronner E, van Mieghem N, Boersma E, Stas PC, van Royen N, Bonnes JL. Automated cardiac arrest detection using a photoplethysmography wristband: algorithm development and validation in patients with induced circulatory arrest in the DETECT-1 study. Lancet Digit Health 2024; 6:e201-e210. [PMID: 38395540 DOI: 10.1016/s2589-7500(23)00249-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND Unwitnessed out-of-hospital cardiac arrest is associated with low survival chances because of the delayed activation of the emergency medical system in most cases. Automated cardiac arrest detection and alarming using biosensor technology would offer a potential solution to provide early help. We developed and validated an algorithm for automated circulatory arrest detection using wrist-derived photoplethysmography from patients with induced circulatory arrests. METHODS In this prospective multicentre study in three university medical centres in the Netherlands, adult patients (aged 18 years or older) in whom short-lasting circulatory arrest was induced as part of routine practice (transcatheter aortic valve implantation, defibrillation testing, or ventricular tachycardia induction) were eligible for inclusion. Exclusion criteria were a known bilateral significant subclavian artery stenosis or medical issues interfering with the wearing of the wristband. After providing informed consent, patients were equipped with a photoplethysmography wristband during the procedure. Invasive arterial blood pressure and electrocardiography were continuously monitored as the reference standard. Development of the photoplethysmography algorithm was based on three consecutive training cohorts. For each cohort, patients were consecutively enrolled. When a total of 50 patients with at least one event of circulatory arrest were enrolled, that cohort was closed. Validation was performed on the fourth set of included patients. The primary outcome was sensitivity for the detection of circulatory arrest. FINDINGS Of 306 patients enrolled between March 14, 2022, and April 21, 2023, 291 patients were included in the data analysis. In the development phase (n=205), the first training set yielded a sensitivity for circulatory arrest detection of 100% (95% CI 94-100) and four false positive alarms; the second training set yielded a sensitivity of 100% (94-100), with six false positive alarms; and the third training set yielded a sensitivity of 100% (94-100), with two false positive alarms. In the validation phase (n=86), the sensitivity for circulatory arrest detection was 98% (92-100) and 11 false positive circulatory arrest alarms. The positive predictive value was 90% (95% CI 82-94). INTERPRETATION The automated detection of induced circulatory arrests using wrist-derived photoplethysmography is feasible with good sensitivity and low false positives. These promising findings warrant further development of this wearable technology to enable automated cardiac arrest detection and alarming in a home setting. FUNDING Dutch Heart Foundation (Hartstichting).
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Affiliation(s)
- Roos Edgar
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Niels T B Scholte
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Marc A Brouwer
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rypko J Beukema
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Masih Mafi-Rad
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Eelko Ronner
- Department of Cardiology, Reinier de Graaf hospital, Delft, Netherlands
| | - Nicolas van Mieghem
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Niels van Royen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith L Bonnes
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands.
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12
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Gong S, Lu Y, Yin J, Levin A, Cheng W. Materials-Driven Soft Wearable Bioelectronics for Connected Healthcare. Chem Rev 2024; 124:455-553. [PMID: 38174868 DOI: 10.1021/acs.chemrev.3c00502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
In the era of Internet-of-things, many things can stay connected; however, biological systems, including those necessary for human health, remain unable to stay connected to the global Internet due to the lack of soft conformal biosensors. The fundamental challenge lies in the fact that electronics and biology are distinct and incompatible, as they are based on different materials via different functioning principles. In particular, the human body is soft and curvilinear, yet electronics are typically rigid and planar. Recent advances in materials and materials design have generated tremendous opportunities to design soft wearable bioelectronics, which may bridge the gap, enabling the ultimate dream of connected healthcare for anyone, anytime, and anywhere. We begin with a review of the historical development of healthcare, indicating the significant trend of connected healthcare. This is followed by the focal point of discussion about new materials and materials design, particularly low-dimensional nanomaterials. We summarize material types and their attributes for designing soft bioelectronic sensors; we also cover their synthesis and fabrication methods, including top-down, bottom-up, and their combined approaches. Next, we discuss the wearable energy challenges and progress made to date. In addition to front-end wearable devices, we also describe back-end machine learning algorithms, artificial intelligence, telecommunication, and software. Afterward, we describe the integration of soft wearable bioelectronic systems which have been applied in various testbeds in real-world settings, including laboratories that are preclinical and clinical environments. Finally, we narrate the remaining challenges and opportunities in conjunction with our perspectives.
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Affiliation(s)
- Shu Gong
- Department of Chemical & Biological Engineering, Monash University, Clayton, Victoria 3800, Australia
| | - Yan Lu
- Department of Chemical & Biological Engineering, Monash University, Clayton, Victoria 3800, Australia
| | - Jialiang Yin
- Department of Chemical & Biological Engineering, Monash University, Clayton, Victoria 3800, Australia
| | - Arie Levin
- Department of Chemical & Biological Engineering, Monash University, Clayton, Victoria 3800, Australia
| | - Wenlong Cheng
- Department of Chemical & Biological Engineering, Monash University, Clayton, Victoria 3800, Australia
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13
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Huang B, Hu S, Liu Z, Lin CL, Su J, Zhao C, Wang L, Wang W. Challenges and prospects of visual contactless physiological monitoring in clinical study. NPJ Digit Med 2023; 6:231. [PMID: 38097771 PMCID: PMC10721846 DOI: 10.1038/s41746-023-00973-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
The monitoring of physiological parameters is a crucial topic in promoting human health and an indispensable approach for assessing physiological status and diagnosing diseases. Particularly, it holds significant value for patients who require long-term monitoring or with underlying cardiovascular disease. To this end, Visual Contactless Physiological Monitoring (VCPM) is capable of using videos recorded by a consumer camera to monitor blood volume pulse (BVP) signal, heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2) and blood pressure (BP). Recently, deep learning-based pipelines have attracted numerous scholars and achieved unprecedented development. Although VCPM is still an emerging digital medical technology and presents many challenges and opportunities, it has the potential to revolutionize clinical medicine, digital health, telemedicine as well as other areas. The VCPM technology presents a viable solution that can be integrated into these systems for measuring vital parameters during video consultation, owing to its merits of contactless measurement, cost-effectiveness, user-friendly passive monitoring and the sole requirement of an off-the-shelf camera. In fact, the studies of VCPM technologies have been rocketing recently, particularly AI-based approaches, but few are employed in clinical settings. Here we provide a comprehensive overview of the applications, challenges, and prospects of VCPM from the perspective of clinical settings and AI technologies for the first time. The thorough exploration and analysis of clinical scenarios will provide profound guidance for the research and development of VCPM technologies in clinical settings.
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Affiliation(s)
- Bin Huang
- AI Research Center, Hangzhou Innovation Institute, Beihang University, 99 Juhang Rd., Binjiang Dist., Hangzhou, Zhejiang, China.
- School of Automation Science and Electrical Engineering, Beihang University, Beijing, China.
| | - Shen Hu
- Department of Obstetrics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Epidemiology, The Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Zimeng Liu
- School of Automation Science and Electrical Engineering, Beihang University, Beijing, China
| | - Chun-Liang Lin
- College of Electrical Engineering and Computer Science, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung, Taiwan.
| | - Junfeng Su
- Department of General Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Key Laboratory of Early Warning and Intervention of Multiple Organ Failure, China National Ministry of Education, Hangzhou, Zhejiang, China
| | - Changchen Zhao
- AI Research Center, Hangzhou Innovation Institute, Beihang University, 99 Juhang Rd., Binjiang Dist., Hangzhou, Zhejiang, China
| | - Li Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenjin Wang
- Department of Biomedical Engineering, Southern University of Science and Technology, 1088 Xueyuan Ave, Nanshan Dist., Shenzhen, Guangdong, China.
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14
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Xu C, Solomon SA, Gao W. Artificial Intelligence-Powered Electronic Skin. NAT MACH INTELL 2023; 5:1344-1355. [PMID: 38370145 PMCID: PMC10868719 DOI: 10.1038/s42256-023-00760-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/18/2023] [Indexed: 02/20/2024]
Abstract
Skin-interfaced electronics is gradually changing medical practices by enabling continuous and noninvasive tracking of physiological and biochemical information. With the rise of big data and digital medicine, next-generation electronic skin (e-skin) will be able to use artificial intelligence (AI) to optimize its design as well as uncover user-personalized health profiles. Recent multimodal e-skin platforms have already employed machine learning (ML) algorithms for autonomous data analytics. Unfortunately, there is a lack of appropriate AI protocols and guidelines for e-skin devices, resulting in overly complex models and non-reproducible conclusions for simple applications. This review aims to present AI technologies in e-skin hardware and assess their potential for new inspired integrated platform solutions. We outline recent breakthroughs in AI strategies and their applications in engineering e-skins as well as understanding health information collected by e-skins, highlighting the transformative deployment of AI in robotics, prosthetics, virtual reality, and personalized healthcare. We also discuss the challenges and prospects of AI-powered e-skins as well as predictions for the future trajectory of smart e-skins.
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Affiliation(s)
- Changhao Xu
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Samuel A. Solomon
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
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15
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Li H, Hu J, Luo R, Yang K, Du B, Zhou S, Zhou X. Synergy of Organic/Inorganic and Inner/Outer Cooperative Conductive Networks in Polydimethylsiloxane-Based Porous Foam on High-Performance Flexible Sensors. ACS APPLIED MATERIALS & INTERFACES 2023; 15:54933-54941. [PMID: 37967098 DOI: 10.1021/acsami.3c12636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
The development of low-cost and high-performance flexible sensor materials is crucial for the advancement of wearable electronic devices, medical monitoring, and human-machine interfaces. In this study, a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS)-coated multiwalled carbon nanotube (MWCNT)-reinforced polydimethylsiloxane (PDMS) composite foam with a uniform organic/inorganic and inner/outer cooperative conductive network was developed to detect tensile and compressive forces. The study demonstrates that the internally cross-linked MWCNTs and PEDOT:PSS coatings within the foam framework play a crucial role in the porous structure and sensing properties of the composite foam. Due to the excellent hierarchical pore structure and dual-channel electronic pathway of the PP@MWCNTs/PDMS foam, the sensor exhibited not only high sensitivity to small pressures but also notable perception capability within the stretchable range. It also maintained excellent stability during multiple stretching and compression loading cycles. In terms of applications, the sensor could be used not only to monitor external stimuli and detect subtle movements within the human body in the field of wearable monitoring but also to sense spatial pressure distribution, which validates its potential in the development of flexible wearable sensing devices.
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Affiliation(s)
- Haibin Li
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an 710048, China
| | - Jingbo Hu
- Faculty of Printing, Packaging Engineering and Digital Media Technology, Xi'an University of Technology, Xi'an 710048, China
- Shanxi Key Laboratory of Advanced Manufacturing Technology, North University of China, Taiyuan 038507, China
| | - Rubai Luo
- Faculty of Printing, Packaging Engineering and Digital Media Technology, Xi'an University of Technology, Xi'an 710048, China
- Shanxi Key Laboratory of Advanced Manufacturing Technology, North University of China, Taiyuan 038507, China
| | - Kenan Yang
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an 710048, China
| | - Bin Du
- Faculty of Printing, Packaging Engineering and Digital Media Technology, Xi'an University of Technology, Xi'an 710048, China
- Shaanxi Provincial Key Laboratory of Printing and Packaging Engineering, Xi'an University of Technology, Xi'an 710048, China
| | - Shisheng Zhou
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an 710048, China
- Faculty of Printing, Packaging Engineering and Digital Media Technology, Xi'an University of Technology, Xi'an 710048, China
- Shaanxi Provincial Key Laboratory of Printing and Packaging Engineering, Xi'an University of Technology, Xi'an 710048, China
| | - Xing Zhou
- Faculty of Printing, Packaging Engineering and Digital Media Technology, Xi'an University of Technology, Xi'an 710048, China
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16
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Elgendi M, van der Bijl K, Menon C. An Open-Source Graphical User Interface-Embedded Automated Electrocardiogram Quality Assessment: A Balanced Class Representation Approach. Diagnostics (Basel) 2023; 13:3479. [PMID: 37998615 PMCID: PMC10670552 DOI: 10.3390/diagnostics13223479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
The rise in cardiovascular diseases necessitates accurate electrocardiogram (ECG) diagnostics, making high-quality ECG recordings essential. Our CNN-LSTM model, embedded in an open-access GUI and trained on balanced datasets collected in clinical settings, excels in automating ECG quality assessment. When tested across three datasets featuring varying ratios of acceptable to unacceptable ECG signals, it achieved an F1 score ranging from 95.87% to 98.40%. Training the model on real noise sources significantly enhances its applicability in real-life scenarios, compared to simulations. Integrated into a user-friendly toolbox, the model offers practical utility in clinical environments. Furthermore, our study underscores the importance of balanced class representation during training and testing phases. We observed a notable F1 score change from 98.09% to 95.87% when the class ratio shifted from 85:15 to 50:50 in the same testing dataset with equal representation. This finding is crucial for future ECG quality assessment research, highlighting the impact of class distribution on the reliability of model training outcomes.
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Affiliation(s)
| | | | - Carlo Menon
- Biomedical and Mobile Health Technology Lab, Department of Health Sciences and Technology, ETH Zurich, 8008 Zurich, Switzerland
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17
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Ullah M, Hamayun S, Wahab A, Khan SU, Rehman MU, Haq ZU, Rehman KU, Ullah A, Mehreen A, Awan UA, Qayum M, Naeem M. Smart Technologies used as Smart Tools in the Management of Cardiovascular Disease and their Future Perspective. Curr Probl Cardiol 2023; 48:101922. [PMID: 37437703 DOI: 10.1016/j.cpcardiol.2023.101922] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. The advent of smart technologies has significantly impacted the management of CVD, offering innovative tools and solutions to improve patient outcomes. Smart technologies have revolutionized and transformed the management of CVD, providing innovative tools to improve patient care, enhance diagnostics, and enable more personalized treatment approaches. These smart tools encompass a wide range of technologies, including wearable devices, mobile applications,3D printing technologies, artificial intelligence (AI), remote monitoring systems, and electronic health records (EHR). They offer numerous advantages, such as real-time monitoring, early detection of abnormalities, remote patient management, and data-driven decision-making. However, they also come with certain limitations and challenges, including data privacy concerns, technical issues, and the need for regulatory frameworks. In this review, despite these challenges, the future of smart technologies in CVD management looks promising, with advancements in AI algorithms, telemedicine platforms, and bio fabrication techniques opening new possibilities for personalized and efficient care. In this article, we also explore the role of smart technologies in CVD management, their advantages and disadvantages, limitations, current applications, and their smart future.
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Affiliation(s)
- Muneeb Ullah
- Department of Pharmacy, Kohat University of Science and technology (KUST), Kohat, 26000, Khyber Pakhtunkhwa, Pakistan
| | - Shah Hamayun
- Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, 04485 Punjab, Pakistan
| | - Abdul Wahab
- Department of Pharmacy, Kohat University of Science and technology (KUST), Kohat, 26000, Khyber Pakhtunkhwa, Pakistan
| | - Shahid Ullah Khan
- Department of Biochemistry, Women Medical and Dental College, Khyber Medical University, Abbottabad, 22080, Khyber Pakhtunkhwa, Pakistan
| | - Mahboob Ur Rehman
- Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, 04485 Punjab, Pakistan
| | - Zia Ul Haq
- Department of Public Health, Institute of Public Health Sciences, Khyber Medical University, Peshawar 25120, Pakistan
| | - Khalil Ur Rehman
- Department of Chemistry, Institute of chemical Sciences, Gomel University, Dera Ismail Khan, KPK, Pakistan
| | - Aziz Ullah
- Department of Chemical Engineering, Pukyong National University, Busan 48513, Republic of Korea
| | - Aqsa Mehreen
- Department of Biological Sciences, National University of Medical Sciences (NUMS) Rawalpindi, Punjab, Pakistan
| | - Uzma A Awan
- Department of Biological Sciences, National University of Medical Sciences (NUMS) Rawalpindi, Punjab, Pakistan
| | - Mughal Qayum
- Department of Pharmacy, Kohat University of Science and technology (KUST), Kohat, 26000, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Naeem
- Department of Biological Sciences, National University of Medical Sciences (NUMS) Rawalpindi, Punjab, Pakistan.
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18
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Alavi R, Wang Q, Gorji H, Pahlevan NM. A machine learning approach for computation of cardiovascular intrinsic frequencies. PLoS One 2023; 18:e0285228. [PMID: 37883430 PMCID: PMC10602266 DOI: 10.1371/journal.pone.0285228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/17/2023] [Indexed: 10/28/2023] Open
Abstract
Analysis of cardiovascular waveforms provides valuable clinical information about the state of health and disease. The intrinsic frequency (IF) method is a recently introduced framework that uses a single arterial pressure waveform to extract physiologically relevant information about the cardiovascular system. The clinical usefulness and physiological accuracy of the IF method have been well-established via several preclinical and clinical studies. However, the computational complexity of the current L2 optimization solver for IF calculations remains a bottleneck for practical deployment of the IF method in real-time settings. In this paper, we propose a machine learning (ML)-based methodology for determination of IF parameters from a single carotid waveform. We use a sequentially-reduced Feedforward Neural Network (FNN) model for mapping carotid waveforms to the output parameters of the IF method, thereby avoiding the non-convex L2 minimization problem arising from the conventional IF approach. Our methodology also includes procedures for data pre-processing, model training, and model evaluation. In our model development, we used both clinical and synthetic waveforms. Our clinical database is composed of carotid waveforms from two different sources: the Huntington Medical Research Institutes (HMRI) iPhone Heart Study and the Framingham Heart Study (FHS). In the HMRI and FHS clinical studies, various device platforms such as piezoelectric tonometry, optical tonometry (Vivio), and an iPhone camera were used to measure arterial waveforms. Our blind clinical test shows very strong correlations between IF parameters computed from the FNN-based method and those computed from the standard L2 optimization-based method (i.e., R≥0.93 and P-value ≤0.005 for each IF parameter). Our results also demonstrate that the performance of the FNN-based IF model introduced in this work is independent of measurement apparatus and of device sampling rate.
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Affiliation(s)
- Rashid Alavi
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, California, United States of America
| | - Qian Wang
- Beijing Computational Science Research Center, Beijing, China
| | - Hossein Gorji
- Swiss Federal Laboratories for Materials Science and Technology (EMPA), Dubendorf, Switzerland
| | - Niema M. Pahlevan
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, California, United States of America
- Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, CA, United States of America
- Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
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19
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Huang S, Gao Y, Hu Y, Shen F, Jin Z, Cho Y. Recent development of piezoelectric biosensors for physiological signal detection and machine learning assisted cardiovascular disease diagnosis. RSC Adv 2023; 13:29174-29194. [PMID: 37818271 PMCID: PMC10561672 DOI: 10.1039/d3ra05932d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
As cardiovascular disease stands as a global primary cause of mortality, there has been an urgent need for continuous and real-time heart monitoring to effectively identify irregular heart rhythms and to offer timely patient alerts. However, conventional cardiac monitoring systems encounter challenges due to inflexible interfaces and discomfort during prolonged monitoring. In this review article, we address these issues by emphasizing the recent development of the flexible, wearable, and comfortable piezoelectric passive sensor assisted by machine learning technology for diagnosis. This innovative device not only harmonizes with the dynamic mechanical properties of human skin but also facilitates continuous and real-time collection of physiological signals. Addressing identified challenges and constraints, this review provides insights into recent advances in piezoelectric cardiac sensors, from devices to circuit systems. Furthermore, this review delves into the integration of machine learning technologies, showcasing their pivotal role in facilitating continuous and real-time assessment of cardiac status. The synergistic combination of flexible piezoelectric sensor design and machine learning holds substantial potential in automating the detection of cardiac irregularities with minimal human intervention. This transformative approach has the power to revolutionize patient care paradigms.
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Affiliation(s)
- Shunyao Huang
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University Minhang District Shanghai 200240 China
| | - Yujia Gao
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University Minhang District Shanghai 200240 China
| | - Yian Hu
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University Minhang District Shanghai 200240 China
| | - Fengyi Shen
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University Minhang District Shanghai 200240 China
| | - Zhangsiyuan Jin
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University Minhang District Shanghai 200240 China
| | - Yuljae Cho
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University Minhang District Shanghai 200240 China
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20
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Sun L, Liu X, Liu S, Chen X, Li Z. Rapid Diagnosis of Urinary Tract Cancers on a LEGO-Inspired Detection Platform via Chemiresistive Profiling of Volatile Metabolites. Anal Chem 2023; 95:14822-14829. [PMID: 37738107 DOI: 10.1021/acs.analchem.3c03252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Rapid and in situ profiling of volatile metabolites from body fluids represents a new trend in cancer diagnosis and classification in the early stages. We report herein an on-chip strategy that combines an array of conductive nanosensors with a chaotic gas micromixer for real-time monitoring of volatiles from urine and for accurate diagnosis and classification of urinary tract cancers. By integrating a class of LEGO-inspired microchambers immobilized with MXene-based sensing nanofilms and zigzag microfluidic gas channels, it enables the intensive intermingling of volatile organic chemicals with sensor elements that tremendously facilitate their ion-dipole interactions for molecular recognition. Aided with an all-in-one, point-of-care platform and an effective machine-learning algorithm, healthy or diseased samples from subpopulations (i.e., tumor subtypes, staging, lymph node metastasis, and distant metastasis) of urinary tract cancers can be reliably fingerprinted in a few minutes with high sensitivity and specificity. The developed detection platform has proven to be a noninvasive supplement to the liquid biopsies available for facile screening of urinary tract cancers, which holds great potential for large-scale personalized healthcare in low-resource areas.
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Affiliation(s)
- Linlin Sun
- Institute for Advanced Study, Shenzhen University, 3688 Nanhai Road, Shenzhen, Guangdong 518060, P. R. China
| | - Xueliang Liu
- Department of Chemistry, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, Henan 453003, P. R. China
| | - Sihui Liu
- Institute for Advanced Study, Shenzhen University, 3688 Nanhai Road, Shenzhen, Guangdong 518060, P. R. China
| | - Xiaofeng Chen
- Institute for Advanced Study, Shenzhen University, 3688 Nanhai Road, Shenzhen, Guangdong 518060, P. R. China
| | - Zheng Li
- Institute for Advanced Study, Shenzhen University, 3688 Nanhai Road, Shenzhen, Guangdong 518060, P. R. China
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21
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Carter J, Swack N, Isselbacher E, Donelan K, Thorndike AN. Feasibility and Acceptability of a Combined Digital Platform and Community Health Worker Intervention for Patients With Heart Failure: Single-Arm Pilot Study. JMIR Cardio 2023; 7:e47818. [PMID: 37698975 PMCID: PMC10580132 DOI: 10.2196/47818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Heart failure (HF) is one of the leading causes of hospital admissions. Clinical (eg, complex comorbidities and low ejection fraction) and social needs factors (eg, access to transportation, food security, and housing security) have both contributed to hospitalizations, emphasizing the importance of increased clinical and social needs support at home. Digital platforms designed for remote monitoring of HF can improve clinical outcomes, but their effectiveness has been limited by patient barriers such as lack of familiarity with technology and unmet social care needs. To address these barriers, this study explored combining a digital platform with community health worker (CHW) social needs care for patients with HF. OBJECTIVE We aim to determine the feasibility and acceptability of an intervention combining digital platform use and CHW social needs care for patients with HF. METHODS Adults (aged ≥18 years) with HF receiving care at a single health care institution and with a history of hospital admission in the previous 12 months were enrolled in a single-arm pilot study from July to November 2021 (N=14). The 30-day intervention used a digital platform within a mobile app that included symptom questionnaire and educational videos connected to a biometric sensor (tracking heart rate, oxygenation, and steps taken), a digital weight scale, and a digital blood pressure monitor. All patients were paired with a CHW who had access to the digital platform data. A CHW provided routine phone calls to patients throughout the study period to discuss their biometric data and to address barriers to any social needs. Feasibility outcomes were patient use of the platform and engagement with the CHW. The acceptability outcome was patient willingness to use the intervention again. RESULTS Participants (N=14) were 67.7 (SD 11.7) years old; 8 (57.1%) were women, and 7 (50%) were insured by Medicare. Participants wore the sensor for 82.2% (n=24.66) of study days with an average of 13.5 (SD 2.1) hours per day. Participants used the digital blood pressure monitor and digital weight scale for an average of 1.2 (SD 0.17) times per day and 1.1 (SD 0.12) times per day, respectively. All participants completed the symptom questionnaire on at least 71% (n=21.3) of study days; 11 (78.6%) participants had ≥3 CHW interactions, and 11 (78.6%) indicated that if given the opportunity, they would use the platform again in the future. Exit interviews found that despite some platform "glitches," participants generally found the remote monitoring platform to be "helpful" and "motivating." CONCLUSIONS A novel intervention combining a digital platform with CHW social needs care for patients with HF was feasible and acceptable. The majority of participants were engaged throughout the study and indicated their willingness to use the intervention again. A future clinical trial is needed to determine the effectiveness of this intervention.
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Affiliation(s)
- Jocelyn Carter
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Natalia Swack
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Eric Isselbacher
- Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Karen Donelan
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Anne N Thorndike
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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22
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Lam CSP, Docherty KF, Ho JE, McMurray JJV, Myhre PL, Omland T. Recent successes in heart failure treatment. Nat Med 2023; 29:2424-2437. [PMID: 37814060 DOI: 10.1038/s41591-023-02567-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/25/2023] [Indexed: 10/11/2023]
Abstract
Remarkable recent advances have revolutionized the field of heart failure. Survival has improved among individuals with heart failure and a reduced ejection fraction and for the first time, new therapies have been shown to improve outcomes across the entire ejection fraction spectrum of heart failure. Great strides have been taken in the treatment of specific cardiomyopathies such as cardiac amyloidosis and hypertrophic cardiomyopathy, whereby conditions once considered incurable can now be effectively managed with novel genetic and molecular approaches. Yet there remain substantial residual unmet needs in heart failure. The translation of successful clinical trials to improved patient outcomes is limited by large gaps in implementation of care, widespread lack of disease awareness and poor understanding of the socioeconomic determinants of outcomes and how to address disparities. Ongoing clinical trials, advances in phenotype segmentation for precision medicine and the rise in technology solutions all offer hope for the future.
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Affiliation(s)
- Carolyn S P Lam
- Duke-NUS Medical School, Singapore, Singapore.
- National Heart Centre Singapore, Singapore, Singapore.
- University Medical Center Groningen, Groningen, the Netherlands.
| | - Kieran F Docherty
- University of Glasgow, School of Cardiovascular and Metabolic Health, Glasgow, UK
| | - Jennifer E Ho
- CardioVascular Institute and Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - John J V McMurray
- University of Glasgow, School of Cardiovascular and Metabolic Health, Glasgow, UK
| | - Peder L Myhre
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, Oslo, Norway
| | - Torbjørn Omland
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, Oslo, Norway
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23
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Zhang Z, Zhu Z, Zhou P, Zou Y, Yang J, Haick H, Wang Y. Soft Bioelectronics for Therapeutics. ACS NANO 2023; 17:17634-17667. [PMID: 37677154 DOI: 10.1021/acsnano.3c02513] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Soft bioelectronics play an increasingly crucial role in high-precision therapeutics due to their softness, biocompatibility, clinical accuracy, long-term stability, and patient-friendliness. In this review, we provide a comprehensive overview of the latest representative therapeutic applications of advanced soft bioelectronics, ranging from wearable therapeutics for skin wounds, diabetes, ophthalmic diseases, muscle disorders, and other diseases to implantable therapeutics against complex diseases, such as cardiac arrhythmias, cancer, neurological diseases, and others. We also highlight key challenges and opportunities for future clinical translation and commercialization of soft therapeutic bioelectronics toward personalized medicine.
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Affiliation(s)
- Zongman Zhang
- Department of Chemical Engineering, Guangdong Technion-Israel Institute of Technology, 241 Daxue Road, Shantou, Guangdong 515063, China
- The Wolfson Department of Chemical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Zhongtai Zhu
- Department of Chemical Engineering, Guangdong Technion-Israel Institute of Technology, 241 Daxue Road, Shantou, Guangdong 515063, China
| | - Pengcheng Zhou
- Department of Chemical Engineering, Guangdong Technion-Israel Institute of Technology, 241 Daxue Road, Shantou, Guangdong 515063, China
- The Wolfson Department of Chemical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Yunfan Zou
- Department of Biotechnology and Food Engineering, Guangdong Technion-Israel Institute of Technology, 241 Daxue Road, Shantou, Guangdong 515063, China
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, United States
| | - Jiawei Yang
- Department of Chemical Engineering, Guangdong Technion-Israel Institute of Technology, 241 Daxue Road, Shantou, Guangdong 515063, China
- The Wolfson Department of Chemical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Hossam Haick
- The Wolfson Department of Chemical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Yan Wang
- Department of Chemical Engineering, Guangdong Technion-Israel Institute of Technology, 241 Daxue Road, Shantou, Guangdong 515063, China
- The Wolfson Department of Chemical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
- Guangdong Provincial Key Laboratory of Materials and Technologies for Energy Conversion, Guangdong Technion-Israel Institute of Technology, 241 Daxue Road, Shantou, Guangdong 515063, China
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24
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Gálvez-Barrón C, Pérez-López C, Villar-Álvarez F, Ribas J, Formiga F, Chivite D, Boixeda R, Iborra C, Rodríguez-Molinero A. Machine learning for the development of diagnostic models of decompensated heart failure or exacerbation of chronic obstructive pulmonary disease. Sci Rep 2023; 13:12709. [PMID: 37543661 PMCID: PMC10404284 DOI: 10.1038/s41598-023-39329-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/24/2023] [Indexed: 08/07/2023] Open
Abstract
Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are two chronic diseases with the greatest adverse impact on the general population, and early detection of their decompensation is an important objective. However, very few diagnostic models have achieved adequate diagnostic performance. The aim of this trial was to develop diagnostic models of decompensated heart failure or COPD exacerbation with machine learning techniques based on physiological parameters. A total of 135 patients hospitalized for decompensated heart failure and/or COPD exacerbation were recruited. Each patient underwent three evaluations: one in the decompensated phase (during hospital admission) and two more consecutively in the compensated phase (at home, 30 days after discharge). In each evaluation, heart rate (HR) and oxygen saturation (Ox) were recorded continuously (with a pulse oximeter) during a period of walking for 6 min, followed by a recovery period of 4 min. To develop the diagnostic models, predictive characteristics related to HR and Ox were initially selected through classification algorithms. Potential predictors included age, sex and baseline disease (heart failure or COPD). Next, diagnostic classification models (compensated vs. decompensated phase) were developed through different machine learning techniques. The diagnostic performance of the developed models was evaluated according to sensitivity (S), specificity (E) and accuracy (A). Data from 22 patients with decompensated heart failure, 25 with COPD exacerbation and 13 with both decompensated pathologies were included in the analyses. Of the 96 characteristics of HR and Ox initially evaluated, 19 were selected. Age, sex and baseline disease did not provide greater discriminative power to the models. The techniques with S and E values above 80% were the logistic regression (S: 80.83%; E: 86.25%; A: 83.61%) and support vector machine (S: 81.67%; E: 85%; A: 82.78%) techniques. The diagnostic models developed achieved good diagnostic performance for decompensated HF or COPD exacerbation. To our knowledge, this study is the first to report diagnostic models of decompensation potentially applicable to both COPD and HF patients. However, these results are preliminary and warrant further investigation to be confirmed.
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Affiliation(s)
- César Gálvez-Barrón
- Research Area, Consorci Sanitari Alt Penedès i Garraf, Sant Pere de Ribes-Barcelona, Barcelona, Spain.
| | - Carlos Pérez-López
- Research Area, Consorci Sanitari Alt Penedès i Garraf, Sant Pere de Ribes-Barcelona, Barcelona, Spain
| | | | - Jesús Ribas
- Department of Pneumology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Francesc Formiga
- Geriatric Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - David Chivite
- Geriatric Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Ramón Boixeda
- Department of Internal Medicine, Hospital de Mataró, Mataró-Barcelona, Spain
| | - Cristian Iborra
- Department of Cardiology, IIS Fundación Jiménez Díaz, Madrid, Spain
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25
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Choi Y, Ho DH, Kim S, Choi YJ, Roe DG, Kwak IC, Min J, Han H, Gao W, Cho JH. Physically defined long-term and short-term synapses for the development of reconfigurable analog-type operators capable of performing health care tasks. SCIENCE ADVANCES 2023; 9:eadg5946. [PMID: 37406117 PMCID: PMC10321737 DOI: 10.1126/sciadv.adg5946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/30/2023] [Indexed: 07/07/2023]
Abstract
Extracting valuable information from the overflowing data is a critical yet challenging task. Dealing with high volumes of biometric data, which are often unstructured, nonstatic, and ambiguous, requires extensive computer resources and data specialists. Emerging neuromorphic computing technologies that mimic the data processing properties of biological neural networks offer a promising solution for handling overflowing data. Here, the development of an electrolyte-gated organic transistor featuring a selective transition from short-term to long-term plasticity of the biological synapse is presented. The memory behaviors of the synaptic device were precisely modulated by restricting ion penetration through an organic channel via photochemical reactions of the cross-linking molecules. Furthermore, the applicability of the memory-controlled synaptic device was verified by constructing a reconfigurable synaptic logic gate for implementing a medical algorithm without further weight-update process. Last, the presented neuromorphic device demonstrated feasibility to handle biometric information with various update periods and perform health care tasks.
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Affiliation(s)
- Yongsuk Choi
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Dong Hae Ho
- Mechanical Engineering, Soft Materials and Structures Lab, Virginia Tech, Blacksburg, VA 24061, USA
| | - Seongchan Kim
- SKKU Advanced Institute of Nanotechnology (SAINT), Sungkyunkwan University, Suwon 16419, Korea
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Young Jin Choi
- Department of Chemical and Biomolecular Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Dong Gue Roe
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - In Cheol Kwak
- Department of Chemical and Biomolecular Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Jihong Min
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Hong Han
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Jeong Ho Cho
- Department of Chemical and Biomolecular Engineering, Yonsei University, Seoul 03722, Republic of Korea
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26
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Williams GJ, Al-Baraikan A, Rademakers FE, Ciravegna F, van de Vosse FN, Lawrie A, Rothman A, Ashley EA, Wilkins MR, Lawford PV, Omholt SW, Wisløff U, Hose DR, Chico TJA, Gunn JP, Morris PD. Wearable technology and the cardiovascular system: the future of patient assessment. Lancet Digit Health 2023; 5:e467-e476. [PMID: 37391266 DOI: 10.1016/s2589-7500(23)00087-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 02/26/2023] [Accepted: 04/19/2023] [Indexed: 07/02/2023]
Abstract
The past decade has seen a dramatic rise in consumer technologies able to monitor a variety of cardiovascular parameters. Such devices initially recorded markers of exercise, but now include physiological and health-care focused measurements. The public are keen to adopt these devices in the belief that they are useful to identify and monitor cardiovascular disease. Clinicians are therefore often presented with health app data accompanied by a diverse range of concerns and queries. Herein, we assess whether these devices are accurate, their outputs validated, and whether they are suitable for professionals to make management decisions. We review underpinning methods and technologies and explore the evidence supporting the use of these devices as diagnostic and monitoring tools in hypertension, arrhythmia, heart failure, coronary artery disease, pulmonary hypertension, and valvular heart disease. Used correctly, they might improve health care and support research.
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Affiliation(s)
- Gareth J Williams
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Abdulaziz Al-Baraikan
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Frank E Rademakers
- Faculty of Medicine, Department of Cardiology, KU Leuven, Leuven, Belgium
| | - Fabio Ciravegna
- Dipartimento di Informatica, Universitàdi Torino, Turin, Italy
| | - Frans N van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Allan Lawrie
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Alexander Rothman
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Euan A Ashley
- Department of Medicine, Stanford University, Stanford, CA, US
| | - Martin R Wilkins
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Patricia V Lawford
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | - Stig W Omholt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, QLD, Australia
| | - D Rodney Hose
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK
| | - Timothy J A Chico
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; BHF Data Centre, Health Data Research UK, London, UK
| | - Julian P Gunn
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Paul D Morris
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, UK; Academic Directorate of Cardiothoracic Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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27
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Chalacheva P, Khoo MCK. Integrating Machine Learning with Biomedical Signal Processing and Systems Analysis: An Applications-based Course. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38082972 DOI: 10.1109/embc40787.2023.10340498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The growing importance of data analytics in biomedicine is increasingly becoming recognized in biomedical engineering curricula through the introduction of machine learning classes that generally run in parallel to, but separately from, more traditional engineering courses, such as signal and systems analysis. We propose a new approach that systematically integrates signal processing and systems analysis with key techniques in machine learning. In the proposed course, the student obtains hands-on experience in applying algorithms that can be applied to practical problems of physiological signal conditioning, analysis and interpretation. This is achieved by exposing the student to a sequence of 4 applications-based modules that represent different biomedical engineering problems: human activity recognition from wearable devices, epileptic seizure detection, quantification of dynamic respiratory-cardiac coupling in humans under different conditions, and detection of sleep apnea episodes from heart rate variability data. Within each module, the student gains the experience of working with the data in question "from the ground up". We also introduce a general plan for assessment of student learning, and discuss the expected outcomes and limitations of this integrative approach to teaching.Clinical Relevance- The proposed course is targeted at biomedical engineering students at the senior undergraduate or first-year graduate level who are interested in learning how to analyze physiological signals. The course would also be suitable for clinician-scientists who have prior training in statistics with some exposure to engineering mathematics.
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28
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Shiwani MA, Chico TJA, Ciravegna F, Mihaylova L. Continuous Monitoring of Health and Mobility Indicators in Patients with Cardiovascular Disease: A Review of Recent Technologies. SENSORS (BASEL, SWITZERLAND) 2023; 23:5752. [PMID: 37420916 DOI: 10.3390/s23125752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 07/09/2023]
Abstract
Cardiovascular diseases kill 18 million people each year. Currently, a patient's health is assessed only during clinical visits, which are often infrequent and provide little information on the person's health during daily life. Advances in mobile health technologies have allowed for the continuous monitoring of indicators of health and mobility during daily life by wearable and other devices. The ability to obtain such longitudinal, clinically relevant measurements could enhance the prevention, detection and treatment of cardiovascular diseases. This review discusses the advantages and disadvantages of various methods for monitoring patients with cardiovascular disease during daily life using wearable devices. We specifically discuss three distinct monitoring domains: physical activity monitoring, indoor home monitoring and physiological parameter monitoring.
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Affiliation(s)
- Muhammad Ali Shiwani
- Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield S1 3JD, UK
| | - Timothy J A Chico
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield S10 2RX, UK
| | - Fabio Ciravegna
- Dipartimento di Informatica, Università di Torino, 10124 Turin, Italy
| | - Lyudmila Mihaylova
- Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield S1 3JD, UK
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29
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Zhu Y, Li J, Kim J, Li S, Zhao Y, Bahari J, Eliahoo P, Li G, Kawakita S, Haghniaz R, Gao X, Falcone N, Ermis M, Kang H, Liu H, Kim H, Tabish T, Yu H, Li B, Akbari M, Emaminejad S, Khademhosseini A. Skin-interfaced electronics: A promising and intelligent paradigm for personalized healthcare. Biomaterials 2023; 296:122075. [PMID: 36931103 PMCID: PMC10085866 DOI: 10.1016/j.biomaterials.2023.122075] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
Skin-interfaced electronics (skintronics) have received considerable attention due to their thinness, skin-like mechanical softness, excellent conformability, and multifunctional integration. Current advancements in skintronics have enabled health monitoring and digital medicine. Particularly, skintronics offer a personalized platform for early-stage disease diagnosis and treatment. In this comprehensive review, we discuss (1) the state-of-the-art skintronic devices, (2) material selections and platform considerations of future skintronics toward intelligent healthcare, (3) device fabrication and system integrations of skintronics, (4) an overview of the skintronic platform for personalized healthcare applications, including biosensing as well as wound healing, sleep monitoring, the assessment of SARS-CoV-2, and the augmented reality-/virtual reality-enhanced human-machine interfaces, and (5) current challenges and future opportunities of skintronics and their potentials in clinical translation and commercialization. The field of skintronics will not only minimize physical and physiological mismatches with the skin but also shift the paradigm in intelligent and personalized healthcare and offer unprecedented promise to revolutionize conventional medical practices.
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Affiliation(s)
- Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States.
| | - Jinghang Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Jinjoo Kim
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Shaopei Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Yichao Zhao
- Interconnected and Integrated Bioelectronics Lab, Department of Electrical and Computer Engineering, and Materials Science and Engineering, University of California, Los Angeles, CA, 90095, United States
| | - Jamal Bahari
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Payam Eliahoo
- Biomedical Engineering Department, University of Southern California, Los Angeles, CA, 90007, United States
| | - Guanghui Li
- The Centre of Nanoscale Science and Technology and Key Laboratory of Functional Polymer Materials, Institute of Polymer Chemistry, College of Chemistry, Nankai University, Tianjin, 300071, China; Renewable Energy Conversion and Storage Center (RECAST), Nankai University, Tianjin, 300071, China
| | - Satoru Kawakita
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Xiaoxiang Gao
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA, 92093, United States
| | - Natashya Falcone
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Menekse Ermis
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States
| | - Heemin Kang
- Department of Materials Science and Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Hao Liu
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - HanJun Kim
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States; College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea
| | - Tanveer Tabish
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 7BN, United Kingdom
| | - Haidong Yu
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, Xi'an, 710072, PR China
| | - Bingbing Li
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States; Department of Manufacturing Systems Engineering and Management, California State University, Northridge, CA, 91330, United States
| | - Mohsen Akbari
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States; Laboratory for Innovation in Microengineering (LiME), Department of Mechanical Engineering, Center for Biomedical Research, University of Victoria, Victoria, BC V8P 2C5, Canada
| | - Sam Emaminejad
- Interconnected and Integrated Bioelectronics Lab, Department of Electrical and Computer Engineering, and Materials Science and Engineering, University of California, Los Angeles, CA, 90095, United States
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064, United States.
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30
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Gehr S, Balasubramaniam NK, Russmann C. Use of mobile diagnostics and digital clinical trials in cardiology. Nat Med 2023; 29:781-784. [PMID: 37002368 DOI: 10.1038/s41591-023-02263-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Affiliation(s)
- Sinje Gehr
- Charité Universitätsmedizin Berlin, Berlin, Germany
- Health Campus Goettingen, University of Applied Sciences and Arts, Goettingen, Lower Saxony, Germany
| | | | - Christoph Russmann
- Health Campus Goettingen, University of Applied Sciences and Arts, Goettingen, Lower Saxony, Germany.
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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31
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Luo Y, Abidian MR, Ahn JH, Akinwande D, Andrews AM, Antonietti M, Bao Z, Berggren M, Berkey CA, Bettinger CJ, Chen J, Chen P, Cheng W, Cheng X, Choi SJ, Chortos A, Dagdeviren C, Dauskardt RH, Di CA, Dickey MD, Duan X, Facchetti A, Fan Z, Fang Y, Feng J, Feng X, Gao H, Gao W, Gong X, Guo CF, Guo X, Hartel MC, He Z, Ho JS, Hu Y, Huang Q, Huang Y, Huo F, Hussain MM, Javey A, Jeong U, Jiang C, Jiang X, Kang J, Karnaushenko D, Khademhosseini A, Kim DH, Kim ID, Kireev D, Kong L, Lee C, Lee NE, Lee PS, Lee TW, Li F, Li J, Liang C, Lim CT, Lin Y, Lipomi DJ, Liu J, Liu K, Liu N, Liu R, Liu Y, Liu Y, Liu Z, Liu Z, Loh XJ, Lu N, Lv Z, Magdassi S, Malliaras GG, Matsuhisa N, Nathan A, Niu S, Pan J, Pang C, Pei Q, Peng H, Qi D, Ren H, Rogers JA, Rowe A, Schmidt OG, Sekitani T, Seo DG, Shen G, Sheng X, Shi Q, Someya T, Song Y, Stavrinidou E, Su M, Sun X, Takei K, Tao XM, Tee BCK, Thean AVY, Trung TQ, Wan C, Wang H, Wang J, Wang M, Wang S, Wang T, Wang ZL, Weiss PS, Wen H, Xu S, Xu T, Yan H, Yan X, Yang H, Yang L, Yang S, Yin L, Yu C, Yu G, Yu J, Yu SH, Yu X, Zamburg E, Zhang H, Zhang X, Zhang X, Zhang X, Zhang Y, Zhang Y, Zhao S, Zhao X, Zheng Y, Zheng YQ, Zheng Z, Zhou T, Zhu B, Zhu M, Zhu R, Zhu Y, Zhu Y, Zou G, Chen X. Technology Roadmap for Flexible Sensors. ACS NANO 2023; 17:5211-5295. [PMID: 36892156 DOI: 10.1021/acsnano.2c12606] [Citation(s) in RCA: 153] [Impact Index Per Article: 153.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.
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Affiliation(s)
- Yifei Luo
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, #08-03 Innovis, Singapore 138634, Republic of Singapore
- Innovative Centre for Flexible Devices (iFLEX), School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Mohammad Reza Abidian
- Department of Biomedical Engineering, University of Houston, Houston, Texas 77024, United States
| | - Jong-Hyun Ahn
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Deji Akinwande
- Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, Texas 78712, United States
- Microelectronics Research Center, The University of Texas at Austin, Austin, Texas 78758, United States
| | - Anne M Andrews
- Department of Chemistry and Biochemistry, California NanoSystems Institute, and Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, and Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Markus Antonietti
- Colloid Chemistry Department, Max Planck Institute of Colloids and Interfaces, 14476 Potsdam, Germany
| | - Zhenan Bao
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States
| | - Magnus Berggren
- Laboratory of Organic Electronics, Department of Science and Technology, Campus Norrköping, Linköping University, 83 Linköping, Sweden
- Wallenberg Initiative Materials Science for Sustainability (WISE) and Wallenberg Wood Science Center (WWSC), SE-100 44 Stockholm, Sweden
| | - Christopher A Berkey
- Department of Materials Science and Engineering, Stanford University, Stanford, California 94301, United States
| | - Christopher John Bettinger
- Department of Biomedical Engineering and Department of Materials Science and Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
| | - Jun Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Peng Chen
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore 637457, Singapore
| | - Wenlong Cheng
- Nanobionics Group, Department of Chemical and Biological Engineering, Monash University, Clayton, Australia, 3800
- Monash Institute of Medical Engineering, Monash University, Clayton, Australia3800
| | - Xu Cheng
- Applied Mechanics Laboratory, Department of Engineering Mechanics, Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, PR China
| | - Seon-Jin Choi
- Division of Materials of Science and Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea
| | - Alex Chortos
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana 47906, United States
| | - Canan Dagdeviren
- Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Reinhold H Dauskardt
- Department of Materials Science and Engineering, Stanford University, Stanford, California 94301, United States
| | - Chong-An Di
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Michael D Dickey
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, North Carolina 27606, United States
| | - Xiangfeng Duan
- Department of Chemistry and Biochemistry, California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Antonio Facchetti
- Department of Chemistry and the Materials Research Center, Northwestern University, Evanston, Illinois 60208, United States
| | - Zhiyong Fan
- Department of Electronic and Computer Engineering and Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China
| | - Yin Fang
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore 637457, Singapore
| | - Jianyou Feng
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, and Laboratory of Advanced Materials, Fudan University, Shanghai 200438, PR China
| | - Xue Feng
- Laboratory of Flexible Electronics Technology, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, China
| | - Huajian Gao
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, #16-16 Connexis, Singapore 138632, Republic of Singapore
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, California, 91125, United States
| | - Xiwen Gong
- Department of Chemical Engineering, Department of Materials Science and Engineering, Department of Electrical Engineering and Computer Science, Applied Physics Program, and Macromolecular Science and Engineering Program, University of Michigan, Ann Arbor, Michigan, 48109 United States
| | - Chuan Fei Guo
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Xiaojun Guo
- National Key Laboratory of Science and Technology on Micro/Nano Fabrication, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Martin C Hartel
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Zihan He
- Beijing National Laboratory for Molecular Sciences, CAS Key Laboratory of Organic Solids, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - John S Ho
- Institute for Health Innovation and Technology, National University of Singapore, Singapore 117599, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore 117456, Singapore
| | - Youfan Hu
- School of Electronics and Center for Carbon-Based Electronics, Peking University, Beijing 100871, China
| | - Qiyao Huang
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Yu Huang
- Department of Materials Science and Engineering, California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Fengwei Huo
- Key Laboratory of Flexible Electronics (KLOFE) and Institute of Advanced Materials (IAM), Nanjing Tech University (NanjingTech), 30 South Puzhu Road, Nanjing 211816, PR China
| | - Muhammad M Hussain
- mmh Labs, Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana 47906, United States
| | - Ali Javey
- Electrical Engineering and Computer Sciences, University of California, Berkeley, California 94720, United States
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Unyong Jeong
- Department of Materials Science and Engineering, Pohang University of Science and Engineering (POSTECH), Pohang, Gyeong-buk 37673, Korea
| | - Chen Jiang
- Department of Electronic Engineering, Tsinghua University, Beijing 100084, China
| | - Xingyu Jiang
- Department of Biomedical Engineering, Southern University of Science and Technology, No 1088, Xueyuan Road, Xili, Nanshan District, Shenzhen, Guangdong 518055, PR China
| | - Jiheong Kang
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Republic of Korea
| | - Daniil Karnaushenko
- Research Center for Materials, Architectures and Integration of Nanomembranes (MAIN), Chemnitz University of Technology, Chemnitz 09126, Germany
| | | | - Dae-Hyeong Kim
- Center for Nanoparticle Research, Institute for Basic Science (IBS), School of Chemical and Biological Engineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Il-Doo Kim
- Department of Materials Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Dmitry Kireev
- Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, Texas 78712, United States
- Microelectronics Research Center, The University of Texas at Austin, Austin, Texas 78758, United States
| | - Lingxuan Kong
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore 637457, Singapore
| | - Chengkuo Lee
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
- Center for Intelligent Sensors and MEMS (CISM), National University of Singapore, Singapore 117608, Singapore
- National University of Singapore Suzhou Research Institute (NUSRI), Suzhou Industrial Park, Suzhou 215123, China
- NUS Graduate School-Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore 119077, Singapore
| | - Nae-Eung Lee
- School of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon, Kyunggi-do 16419, Republic of Korea
| | - Pooi See Lee
- School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
- Singapore-HUJ Alliance for Research and Enterprise (SHARE), Campus for Research Excellence and Technological Enterprise (CREATE), Singapore 138602, Singapore
| | - Tae-Woo Lee
- Department of Materials Science and Engineering, Seoul National University, Seoul 08826, Republic of Korea
- School of Chemical and Biological Engineering, Seoul National University, Seoul 08826, Republic of Korea
- Institute of Engineering Research, Research Institute of Advanced Materials, Seoul National University, Soft Foundry, Seoul 08826, Republic of Korea
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Fengyu Li
- College of Chemistry and Materials Science, Jinan University, Guangzhou, Guangdong 510632, China
| | - Jinxing Li
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, Neuroscience Program, BioMolecular Science Program, and Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, Michigan 48823, United States
| | - Cuiyuan Liang
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China
| | - Chwee Teck Lim
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
- Mechanobiology Institute, National University of Singapore, Singapore 117411, Singapore
- Institute for Health Innovation and Technology, National University of Singapore, Singapore 119276, Singapore
| | - Yuanjing Lin
- School of Microelectronics, Southern University of Science and Technology, Shenzhen 518055, China
| | - Darren J Lipomi
- Department of Nano and Chemical Engineering, University of California, San Diego, La Jolla, California 92093-0448, United States
| | - Jia Liu
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, Massachusetts, 02134, United States
| | - Kai Liu
- School of Chemistry and Chemical Engineering, Frontiers Science Center for Transformative Molecules, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Nan Liu
- Beijing Key Laboratory of Energy Conversion and Storage Materials, College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Ren Liu
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, Massachusetts, 02134, United States
| | - Yuxin Liu
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, #08-03 Innovis, Singapore 138634, Republic of Singapore
- Department of Biomedical Engineering, N.1 Institute for Health, Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
| | - Yuxuan Liu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina 27695, United States
| | - Zhiyuan Liu
- Neural Engineering Centre, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China 518055
| | - Zhuangjian Liu
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, #16-16 Connexis, Singapore 138632, Republic of Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, #08-03 Innovis, Singapore 138634, Republic of Singapore
| | - Nanshu Lu
- Department of Aerospace Engineering and Engineering Mechanics, Department of Electrical and Computer Engineering, Department of Mechanical Engineering, Department of Biomedical Engineering, Texas Materials Institute, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Zhisheng Lv
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, #08-03 Innovis, Singapore 138634, Republic of Singapore
| | - Shlomo Magdassi
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel
| | - George G Malliaras
- Electrical Engineering Division, Department of Engineering, University of Cambridge CB3 0FA, Cambridge United Kingdom
| | - Naoji Matsuhisa
- Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505, Japan
| | - Arokia Nathan
- Darwin College, University of Cambridge, Cambridge CB3 9EU, United Kingdom
| | - Simiao Niu
- Department of Biomedical Engineering, Rutgers University, Piscataway, New Jersey 08854, United States
| | - Jieming Pan
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Changhyun Pang
- School of Chemical Engineering and Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Qibing Pei
- Department of Materials Science and Engineering, Department of Mechanical and Aerospace Engineering, California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Huisheng Peng
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, and Laboratory of Advanced Materials, Fudan University, Shanghai 200438, PR China
| | - Dianpeng Qi
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China
| | - Huaying Ren
- Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, California, 90095, United States
| | - John A Rogers
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois 60208, United States
- Department of Materials Science and Engineering, Department of Mechanical Engineering, Department of Biomedical Engineering, Departments of Electrical and Computer Engineering and Chemistry, and Department of Neurological Surgery, Northwestern University, Evanston, Illinois 60208, United States
| | - Aaron Rowe
- Becton, Dickinson and Company, 1268 N. Lakeview Avenue, Anaheim, California 92807, United States
- Ready, Set, Food! 15821 Ventura Blvd #450, Encino, California 91436, United States
| | - Oliver G Schmidt
- Research Center for Materials, Architectures and Integration of Nanomembranes (MAIN), Chemnitz University of Technology, Chemnitz 09126, Germany
- Material Systems for Nanoelectronics, Chemnitz University of Technology, Chemnitz 09107, Germany
- Nanophysics, Faculty of Physics, TU Dresden, Dresden 01062, Germany
| | - Tsuyoshi Sekitani
- The Institute of Scientific and Industrial Research (SANKEN), Osaka University, Osaka, Japan 5670047
| | - Dae-Gyo Seo
- Department of Materials Science and Engineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Guozhen Shen
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Xing Sheng
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Center for Flexible Electronics Technology, and IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China
| | - Qiongfeng Shi
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
- Center for Intelligent Sensors and MEMS (CISM), National University of Singapore, Singapore 117608, Singapore
- National University of Singapore Suzhou Research Institute (NUSRI), Suzhou Industrial Park, Suzhou 215123, China
| | - Takao Someya
- Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan
| | - Yanlin Song
- Key Laboratory of Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing, Beijing 100190, China
| | - Eleni Stavrinidou
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, SE-601 74 Norrkoping, Sweden
| | - Meng Su
- Key Laboratory of Green Printing, Institute of Chemistry, Chinese Academy of Sciences, Beijing, Beijing 100190, China
| | - Xuemei Sun
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, and Laboratory of Advanced Materials, Fudan University, Shanghai 200438, PR China
| | - Kuniharu Takei
- Department of Physics and Electronics, Osaka Metropolitan University, Sakai, Osaka 599-8531, Japan
| | - Xiao-Ming Tao
- Research Institute for Intelligent Wearable Systems, School of Fashion and Textiles, Hong Kong Polytechnic University, Hong Kong, China
| | - Benjamin C K Tee
- Materials Science and Engineering, National University of Singapore, Singapore 117575, Singapore
- iHealthtech, National University of Singapore, Singapore 119276, Singapore
| | - Aaron Voon-Yew Thean
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
- Singapore Hybrid-Integrated Next-Generation μ-Electronics Centre (SHINE), Singapore 117583, Singapore
| | - Tran Quang Trung
- School of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon, Kyunggi-do 16419, Republic of Korea
| | - Changjin Wan
- School of Electronic Science and Engineering, Nanjing University, Nanjing 210023, China
| | - Huiliang Wang
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas 78712, United States
| | - Joseph Wang
- Department of Nanoengineering, University of California, San Diego, California 92093, United States
| | - Ming Wang
- Frontier Institute of Chip and System, State Key Laboratory of Integrated Chip and Systems, Zhangjiang Fudan International Innovation Center, Fudan University, Shanghai, 200433, China
- the Shanghai Qi Zhi Institute, 41th Floor, AI Tower, No.701 Yunjin Road, Xuhui District, Shanghai 200232, China
| | - Sihong Wang
- Pritzker School of Molecular Engineering, The University of Chicago, Chicago, Illinois, 60637, United States
| | - Ting Wang
- State Key Laboratory of Organic Electronics and Information Displays and Jiangsu Key Laboratory for Biosensors, Institute of Advanced Materials (IAM), Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Nanjing 210023, China
| | - Zhong Lin Wang
- Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
- Georgia Institute of Technology, Atlanta, Georgia 30332-0245, United States
| | - Paul S Weiss
- California NanoSystems Institute, Department of Chemistry and Biochemistry, Department of Bioengineering, and Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Hanqi Wen
- School of Chemistry, Chemical Engineering and Biotechnology, Nanyang Technological University, Singapore 637457, Singapore
- Institute of Flexible Electronics Technology of THU, Jiaxing, Zhejiang, China 314000
| | - Sheng Xu
- Department of Nanoengineering, Department of Electrical and Computer Engineering, Materials Science and Engineering Program, and Department of Bioengineering, University of California San Diego, La Jolla, California, 92093, United States
| | - Tailin Xu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, Guangdong, 518060, PR China
| | - Hongping Yan
- Department of Chemical Engineering, Stanford University, Stanford, California 94305, United States
| | - Xuzhou Yan
- School of Chemistry and Chemical Engineering, Frontiers Science Center for Transformative Molecules, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Hui Yang
- Tianjin Key Laboratory of Molecular Optoelectronic Sciences, Department of Chemistry, School of Science, Tianjin University, Tianjin, China, 300072
| | - Le Yang
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, #08-03 Innovis, Singapore 138634, Republic of Singapore
- Department of Materials Science and Engineering, National University of Singapore (NUS), 9 Engineering Drive 1, #03-09 EA, Singapore 117575, Singapore
| | - Shuaijian Yang
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Lan Yin
- School of Materials Science and Engineering, The Key Laboratory of Advanced Materials of Ministry of Education, State Key Laboratory of New Ceramics and Fine Processing, and Center for Flexible Electronics Technology, Tsinghua University, Beijing, 100084, China
| | - Cunjiang Yu
- Department of Engineering Science and Mechanics, Department of Biomedical Engineering, Department of Material Science and Engineering, Materials Research Institute, Pennsylvania State University, University Park, Pennsylvania, 16802, United States
| | - Guihua Yu
- Materials Science and Engineering Program and Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, Texas, 78712, United States
| | - Jing Yu
- School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Shu-Hong Yu
- Department of Chemistry, Institute of Biomimetic Materials and Chemistry, Hefei National Research Center for Physical Science at the Microscale, University of Science and Technology of China, Hefei 230026, China
| | - Xinge Yu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
| | - Evgeny Zamburg
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
- Singapore Hybrid-Integrated Next-Generation μ-Electronics Centre (SHINE), Singapore 117583, Singapore
| | - Haixia Zhang
- National Key Laboratory of Science and Technology on Micro/Nano Fabrication; Beijing Advanced Innovation Center for Integrated Circuits, School of Integrated Circuits, Peking University, Beijing 100871, China
| | - Xiangyu Zhang
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
- Singapore Hybrid-Integrated Next-Generation μ-Electronics Centre (SHINE), Singapore 117583, Singapore
| | - Xiaosheng Zhang
- School of Electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Xueji Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, Guangdong 518060, PR China
| | - Yihui Zhang
- Applied Mechanics Laboratory, Department of Engineering Mechanics; Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, PR China
| | - Yu Zhang
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
- Singapore Hybrid-Integrated Next-Generation μ-Electronics Centre (SHINE), Singapore 117583, Singapore
| | - Siyuan Zhao
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, Massachusetts, 02134, United States
| | - Xuanhe Zhao
- Department of Mechanical Engineering, Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, 02139, United States
| | - Yuanjin Zheng
- Center for Integrated Circuits and Systems, School of Electrical and Electronic Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Yu-Qing Zheng
- National Key Laboratory of Science and Technology on Micro/Nano Fabrication; School of Integrated Circuits, Peking University, Beijing 100871, China
| | - Zijian Zheng
- Department of Applied Biology and Chemical Technology, Faculty of Science, Research Institute for Intelligent Wearable Systems, Research Institute for Smart Energy, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Tao Zhou
- Center for Neural Engineering, Department of Engineering Science and Mechanics, The Huck Institutes of the Life Sciences, Materials Research Institute, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Bowen Zhu
- Key Laboratory of 3D Micro/Nano Fabrication and Characterization of Zhejiang Province, School of Engineering, Westlake University, Hangzhou 310024, China
| | - Ming Zhu
- Institute for Digital Molecular Analytics and Science (IDMxS), Nanyang Technological University, 59 Nanyang Drive, Singapore 636921, Singapore
| | - Rong Zhu
- Department of Precision Instrument, Tsinghua University, Beijing 100084, China
| | - Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation, Los Angeles, California, 90064, United States
| | - Yong Zhu
- Department of Mechanical and Aerospace Engineering, Department of Materials Science and Engineering, and Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina 27695, United States
| | - Guijin Zou
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, #16-16 Connexis, Singapore 138632, Republic of Singapore
| | - Xiaodong Chen
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), 2 Fusionopolis Way, #08-03 Innovis, Singapore 138634, Republic of Singapore
- Innovative Center for Flexible Devices (iFLEX), Max Planck-NTU Joint Laboratory for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
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Abstract
Wearable devices, such as smartwatches and activity trackers, are commonly used by patients in their everyday lives to manage their health and well-being. These devices collect and analyze long-term continuous data on measures of behavioral or physiologic function, which may provide clinicians with a more comprehensive view of a patients' health compared with the traditional sporadic measures captured by office visits and hospitalizations. Wearable devices have a wide range of potential clinical applications ranging from arrhythmia screening of high-risk individuals to remote management of chronic conditions such as heart failure or peripheral artery disease. As the use of wearable devices continues to grow, we must adopt a multifaceted approach with collaboration among all key stakeholders to effectively and safely integrate these technologies into routine clinical practice. In this Review, we summarize the features of wearable devices and associated machine learning techniques. We describe key research studies that illustrate the role of wearable devices in the screening and management of cardiovascular conditions and identify directions for future research. Last, we highlight the challenges that are currently hindering the widespread use of wearable devices in cardiovascular medicine and provide short- and long-term solutions to promote increased use of wearable devices in clinical care.
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Affiliation(s)
- Andrew Hughes
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | | | - Hiral Master
- Vanderbilt Institute of Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN
| | - Jessilyn Dunn
- Department of Biomedical Engineering, Duke University, Durham, NC
- Department of Biostatistics & Bioinformatics, Duke University, Durham, NC
| | - Evan Brittain
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
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Leiner J, König S, Mouratis K, Kim I, Schmitz P, Joshi T, Schanner C, Wohlrab L, Hohenstein S, Pellissier V, Nitsche A, Kuhlen R, Hindricks G, Bollmann A. A Digital Infrastructure for Cardiovascular Patient Care Based on Mobile Health Data and Patient-Reported Outcomes: Concept Details of the Helios TeleWear Project Including Preliminary Experiences. JMIR Form Res 2023; 7:e41115. [PMID: 36867450 PMCID: PMC10029859 DOI: 10.2196/41115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/02/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) approaches are already having a fundamental impact on clinical practice in cardiovascular medicine. A variety of different health apps and wearable devices for capturing health data such as electrocardiograms (ECGs) exist. However, most mHealth technologies focus on distinct variables without integrating patients' quality of life, and the impact on clinical outcome measures of implementing those digital solutions into cardiovascular health care is still to be determined. OBJECTIVE Within this document, we describe the TeleWear project, which was recently initiated as an approach for contemporary patient management integrating mobile-collected health data and the standardized mHealth-guided measurement of patient-reported outcomes (PROs) in patients with cardiovascular disease. METHODS The specifically designed mobile app and clinical frontend form the central elements of our TeleWear infrastructure. Because of its flexible framework, the platform allows far-reaching customization with the possibility to add different mHealth data sources and respective questionnaires (patient-reported outcome measures). RESULTS With initial focus on patients with cardiac arrhythmias, a feasibility study is currently carried out to assess wearable-recorded ECG and PRO transmission and its evaluation by physicians using the TeleWear app and clinical frontend. First experiences made during the feasibility study yielded positive results and confirmed the platform's functionality and usability. CONCLUSIONS TeleWear represents a unique mHealth approach comprising PRO and mHealth data capturing. With the currently running TeleWear feasibility study, we aim to test and further develop the platform in a real-world setting. A randomized controlled trial including patients with atrial fibrillation that investigates PRO- and ECG-based clinical management based on the established TeleWear infrastructure will evaluate its clinical benefits. Widening the spectrum of health data collection and interpretation beyond the ECG and use of the TeleWear infrastructure in different patient subcohorts with focus on cardiovascular diseases are further milestones of the project with the ultimate goal to establish a comprehensive telemedical center entrenched by mHealth.
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Affiliation(s)
- Johannes Leiner
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, Leipzig, Germany
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Sebastian König
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, Leipzig, Germany
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Konstantinos Mouratis
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Igor Kim
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Pia Schmitz
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Tanvi Joshi
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Carolin Schanner
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Lisa Wohlrab
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Sven Hohenstein
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Vincent Pellissier
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Anne Nitsche
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Ralf Kuhlen
- Helios Health GmbH, Berlin, Germany
- Helios Health Institute, Berlin, Germany
| | - Gerhard Hindricks
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Andreas Bollmann
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, Leipzig, Germany
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
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Liem DA, Cadeiras M, Setty SP. Insights and perspectives into clinical biomarker discovery in pediatric heart failure and congenital heart disease-a narrative review. Cardiovasc Diagn Ther 2023; 13:83-99. [PMID: 36864972 PMCID: PMC9971290 DOI: 10.21037/cdt-22-386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/02/2022] [Indexed: 01/11/2023]
Abstract
Background and Objective Heart failure (HF) in the pediatric population is a multi-factorial process with a wide spectrum of etiologies and clinical manifestations, that are distinct from the adult HF population, with congenital heart disease (CHD) as the most common cause. CHD has high morbidity/mortality with nearly 60% developing HF during the first 12 months of life. Hence, early discovery and diagnosis of CHD in neonates is pivotal. Plasma B-type natriuretic peptide (BNP) is an increasingly popular clinical marker in pediatric HF, however, in contrast to adult HF, it is not yet included in pediatric HF guidelines and there is no standardized reference cut-off value. We explore the current trends and prospects of biomarkers in pediatric HF, including CHD that can aid in diagnosis and management. Methods As a narrative review, we will analyze biomarkers with respect to diagnosis and monitoring in specific anatomical types of CHD in the pediatric population considering all English PubMed publications till June 2022. Key Content and Findings We present a concise description of our own experience in applying plasma BNP as a clinical biomarker in pediatric HF and CHD (tetralogy of fallot vs. ventricular septal defect) in the context of surgical correction, as well as untargeted metabolomics analyses. In the current age of Information Technology and large data sets we also explored new biomarker discovery using Text Mining of 33M manuscripts currently on PubMed. Conclusions (Multi) Omics studies from patient samples as well as Data Mining can be considered for the discovery of potential pediatric HF biomarkers useful in clinical care. Future research should focus on validation and defining evidence-based value limits and reference ranges for specific indications using the most up-to-date assays in parallel to commonly used studies.
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Affiliation(s)
- David A. Liem
- Department of Medicine, Division of Cardiovascular Disease, University of California, Davis, CA, USA
| | - Martin Cadeiras
- Department of Medicine, Division of Cardiovascular Disease, University of California, Davis, CA, USA
| | - Shaun P. Setty
- Department of Pediatric and Adult Congenital Cardiac Surgery, Miller Children’s and Women’s Hospital and Long Beach Memorial Hospital, Long Beach, CA, USA
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35
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Smartwatch detection of left ventricular dysfunction. Nat Rev Cardiol 2023; 20:75. [PMID: 36446919 DOI: 10.1038/s41569-022-00822-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Moradi H, Al-Hourani A, Concilia G, Khoshmanesh F, Nezami FR, Needham S, Baratchi S, Khoshmanesh K. Recent developments in modeling, imaging, and monitoring of cardiovascular diseases using machine learning. Biophys Rev 2023; 15:19-33. [PMID: 36909958 PMCID: PMC9995635 DOI: 10.1007/s12551-022-01040-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Cardiovascular diseases are the leading cause of mortality, morbidity, and hospitalization around the world. Recent technological advances have facilitated analyzing, visualizing, and monitoring cardiovascular diseases using emerging computational fluid dynamics, blood flow imaging, and wearable sensing technologies. Yet, computational cost, limited spatiotemporal resolution, and obstacles for thorough data analysis have hindered the utility of such techniques to curb cardiovascular diseases. We herein discuss how leveraging machine learning techniques, and in particular deep learning methods, could overcome these limitations and offer promise for translation. We discuss the remarkable capacity of recently developed machine learning techniques to accelerate flow modeling, enhance the resolution while reduce the noise and scanning time of current blood flow imaging techniques, and accurate detection of cardiovascular diseases using a plethora of data collected by wearable sensors.
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Affiliation(s)
- Hamed Moradi
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Akram Al-Hourani
- School of Engineering, RMIT University, Melbourne, Victoria Australia
| | | | - Farnaz Khoshmanesh
- School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, Victoria Australia
| | - Farhad R. Nezami
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Scott Needham
- Leading Technology Group, Melbourne, Victoria Australia
| | - Sara Baratchi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria Australia
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37
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Holčapek T, Šolc M, Šustek P. Telemedicine and the standard of care: a call for a new approach? Front Public Health 2023; 11:1184971. [PMID: 37213629 PMCID: PMC10192621 DOI: 10.3389/fpubh.2023.1184971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
Telemedicine, understood as the provision of health care by a health professional to a patient who is physically not in the same location as the health professional, has many actual and potential benefits. It also has some disadvantages though, including a higher risk of misdiagnosis or another unfavorable outcome of certain remotely-provided services. In principle, the regime of legal liability for medical malpractice is the same for telemedicine as for traditional physical care. The general outline of the standard of care, which includes respect for medical science, the patient's individuality and objective possibilities, is abstract and flexible enough to be used for remote care without the need for redefinition. The quality of health care should be evaluated on the basis of the whole scale of risks and benefits it brings to a particular patient, including accessibility and comfort. In general, it should be permissible to provide a medical service remotely on the condition that its overall quality is at least as good as its comparable physical alternative. In other words, certain decrease in quality of some aspects of remote care can be compensated by other advantages. In terms of public health, support for telemedicine may bring a great improvement in the access to health care, and thus help significantly the individual members of the population. From the individual perspective, respect for personal autonomy implies that a patient should have every right to opt for a remote service, provided that there exists a true choice between meaningful options which is made on the basis of full information. If telemedicine is to fulfill its potential without sacrificing the protection of patients and their rights, reasonable guidelines for remote services need to be defined for particular medical fields, and for specific procedures within them. Among other issues, these guidelines must address the question of when it is necessary to refer the patient to physical care.
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Affiliation(s)
- Tomáš Holčapek
- Department of Medical Law, Faculty of Law, Charles University, Prague, Czechia
- Department of Civil Law, Faculty of Law, Charles University, Prague, Czechia
- *Correspondence: Tomáš Holčapek
| | - Martin Šolc
- Department of Medical Law, Faculty of Law, Charles University, Prague, Czechia
- Department of Civil Law, Faculty of Law, Charles University, Prague, Czechia
| | - Petr Šustek
- Department of Medical Law, Faculty of Law, Charles University, Prague, Czechia
- Department of Civil Law, Faculty of Law, Charles University, Prague, Czechia
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Krittanawong C, Singh NK, Scheuring RA, Urquieta E, Bershad EM, Macaulay TR, Kaplin S, Dunn C, Kry SF, Russomano T, Shepanek M, Stowe RP, Kirkpatrick AW, Broderick TJ, Sibonga JD, Lee AG, Crucian BE. Human Health during Space Travel: State-of-the-Art Review. Cells 2022; 12:cells12010040. [PMID: 36611835 PMCID: PMC9818606 DOI: 10.3390/cells12010040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
The field of human space travel is in the midst of a dramatic revolution. Upcoming missions are looking to push the boundaries of space travel, with plans to travel for longer distances and durations than ever before. Both the National Aeronautics and Space Administration (NASA) and several commercial space companies (e.g., Blue Origin, SpaceX, Virgin Galactic) have already started the process of preparing for long-distance, long-duration space exploration and currently plan to explore inner solar planets (e.g., Mars) by the 2030s. With the emergence of space tourism, space travel has materialized as a potential new, exciting frontier of business, hospitality, medicine, and technology in the coming years. However, current evidence regarding human health in space is very limited, particularly pertaining to short-term and long-term space travel. This review synthesizes developments across the continuum of space health including prior studies and unpublished data from NASA related to each individual organ system, and medical screening prior to space travel. We categorized the extraterrestrial environment into exogenous (e.g., space radiation and microgravity) and endogenous processes (e.g., alteration of humans' natural circadian rhythm and mental health due to confinement, isolation, immobilization, and lack of social interaction) and their various effects on human health. The aim of this review is to explore the potential health challenges associated with space travel and how they may be overcome in order to enable new paradigms for space health, as well as the use of emerging Artificial Intelligence based (AI) technology to propel future space health research.
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Affiliation(s)
- Chayakrit Krittanawong
- Department of Medicine and Center for Space Medicine, Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA
- Translational Research Institute for Space Health, Houston, TX 77030, USA
- Department of Cardiovascular Diseases, New York University School of Medicine, New York, NY 10016, USA
- Correspondence: or (C.K.); (B.E.C.); Tel.: +1-713-798-4951 (C.K.); +1-281-483-0123 (B.E.C.)
| | - Nitin Kumar Singh
- Biotechnology and Planetary Protection Group, Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | | | - Emmanuel Urquieta
- Translational Research Institute for Space Health, Houston, TX 77030, USA
- Department of Emergency Medicine and Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Eric M. Bershad
- Department of Neurology, Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | | | - Scott Kaplin
- Department of Cardiovascular Diseases, New York University School of Medicine, New York, NY 10016, USA
| | - Carly Dunn
- Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Stephen F. Kry
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | - Marc Shepanek
- Office of the Chief Health and Medical Officer, NASA, Washington, DC 20546, USA
| | | | - Andrew W. Kirkpatrick
- Department of Surgery and Critical Care Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | | | - Jean D. Sibonga
- Division of Biomedical Research and Environmental Sciences, NASA Lyndon B. Johnson Space Center, Houston, TX 77058, USA
| | - Andrew G. Lee
- Department of Ophthalmology, University of Texas Medical Branch School of Medicine, Galveston, TX 77555, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX 77030, USA
- Department of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Ophthalmology, Texas A and M College of Medicine, College Station, TX 77807, USA
- Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY 10021, USA
| | - Brian E. Crucian
- National Aeronautics and Space Administration (NASA) Johnson Space Center, Human Health and Performance Directorate, Houston, TX 77058, USA
- Correspondence: or (C.K.); (B.E.C.); Tel.: +1-713-798-4951 (C.K.); +1-281-483-0123 (B.E.C.)
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Zito A, Princi G, Romiti GF, Galli M, Basili S, Liuzzo G, Sanna T, Restivo A, Ciliberti G, Trani C, Burzotta F, Cesario A, Savarese G, Crea F, D'Amario D. Device-based remote monitoring strategies for congestion-guided management of patients with heart failure: a systematic review and meta-analysis. Eur J Heart Fail 2022; 24:2333-2341. [PMID: 36054801 PMCID: PMC10086988 DOI: 10.1002/ejhf.2655] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/02/2022] [Accepted: 08/13/2022] [Indexed: 01/18/2023] Open
Abstract
AIMS Pre-clinical congestion markers of worsening heart failure (HF) can be monitored by devices and may support the management of patients with HF. We aimed to assess whether congestion-guided HF management according to device-based remote monitoring strategies is more effective than standard therapy. METHODS AND RESULTS A comprehensive literature research for randomized controlled trials (RCTs) comparing device-based remote monitoring strategies for congestion-guided HF management versus standard therapy was performed on PubMed, Embase, and CENTRAL databases. Incidence rate ratios (IRRs) and associated 95% confidence intervals (CIs) were calculated using the Poisson regression model with random study effects. The primary outcome was a composite of all-cause death and HF hospitalizations. Secondary endpoints included the individual components of the primary outcome. A total of 4347 patients from eight RCTs were included. Findings varied according to the type of parameters monitored. Compared with standard therapy, haemodynamic-guided strategy (4 trials, 2224 patients, 12-month follow-up) reduced the risk of the primary composite outcome (IRR 0.79, 95% CI 0.70-0.89) and HF hospitalizations (IRR 0.76, 95% CI 0.67-0.86), without a significant impact on all-cause death (IRR 0.93, 95% CI 0.72-1.21). In contrast, impedance-guided strategy (4 trials, 2123 patients, 19-month follow-up) did not provide significant benefits. CONCLUSION Haemodynamic-guided HF management is associated with better clinical outcomes as compared to standard clinical care.
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Affiliation(s)
- Andrea Zito
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Giuseppe Princi
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Mattia Galli
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giovanna Liuzzo
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Tommaso Sanna
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Attilio Restivo
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Giuseppe Ciliberti
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Carlo Trani
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Burzotta
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alfredo Cesario
- Open Innovation Unit, Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Innovation Sprint Sprl, Brussels, Belgium
| | - Gianluigi Savarese
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Filippo Crea
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Domenico D'Amario
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.,Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Rodrigues G, Adragão P. Cardiac device remote monitoring in 2022: Are digital and remote monitoring synonymous with ease and improvement? Rev Port Cardiol 2022; 41:999-1000. [PMID: 36228666 DOI: 10.1016/j.repc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gustavo Rodrigues
- Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Carnaxide, Portugal
| | - Pedro Adragão
- Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Carnaxide, Portugal.
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41
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Lilja D, Schalit I, Espinoza A, Pettersen FJ, Elle OJ, Halvorsen PS. Detection of inflow obstruction in left ventricular assist devices by accelerometer: An in vitro study. Med Eng Phys 2022; 110:103917. [PMID: 36564132 DOI: 10.1016/j.medengphy.2022.103917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
Inflow obstruction in left ventricular assist devices (LVAD) may lead to embolic stroke and pump malfunction. We investigated if an accelerometer detected graded LVAD inflow obstructions. Detection performances were compared to the current continuous surveillance routine based on the pump power consumption (PLVAD). In ten mock circuit experiments, four different-sized pendulating balloons obstructed HVAD™ inflow conduits cross-section areas by 14%-75%. Nonharmonic amplitudes (NHA) of continuous signals from a triaxial accelerometer attached to the LVAD were compared against single-point PLVAD values, using load and speed alterations as control interventions. We analyzed the NHA band power with a pairwise nonparametric statistical test. The detection performances were analyzed by receiver operating characteristics with areas under the curves (AUC). The NHA remained unaffected during load alterations. In contrast, NHA increased significantly from the 27% obstruction level (AUC≥0.82), an effect amplified by increased pump speed. PLVAD did not change significantly below the maximal 75% obstruction level (AUC≤0.36). In conclusion, NHA detected the inflow obstructions much better than PLVAD. The technique may provide a future monitoring modality of any pendulating obstructive inflow pathology.
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Affiliation(s)
- Didrik Lilja
- The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Itai Schalit
- The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Andreas Espinoza
- The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway
| | - Fred-Johan Pettersen
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway; Department of Physics, University of Oslo, Norway
| | - Ole Jakob Elle
- The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Department of Informatics, The University of Oslo, Norway
| | - Per Steinar Halvorsen
- The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Alugubelli N, Abuissa H, Roka A. Wearable Devices for Remote Monitoring of Heart Rate and Heart Rate Variability-What We Know and What Is Coming. SENSORS (BASEL, SWITZERLAND) 2022; 22:8903. [PMID: 36433498 PMCID: PMC9695982 DOI: 10.3390/s22228903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/27/2022] [Accepted: 11/15/2022] [Indexed: 05/26/2023]
Abstract
Heart rate at rest and exercise may predict cardiovascular risk. Heart rate variability is a measure of variation in time between each heartbeat, representing the balance between the parasympathetic and sympathetic nervous system and may predict adverse cardiovascular events. With advances in technology and increasing commercial interest, the scope of remote monitoring health systems has expanded. In this review, we discuss the concepts behind cardiac signal generation and recording, wearable devices, pros and cons focusing on accuracy, ease of application of commercial and medical grade diagnostic devices, which showed promising results in terms of reliability and value. Incorporation of artificial intelligence and cloud based remote monitoring have been evolving to facilitate timely data processing, improve patient convenience and ensure data security.
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Affiliation(s)
| | | | - Attila Roka
- Division of Cardiology, Creighton University and CHI Health, 7500 Mercy Rd, Omaha, NE 68124, USA
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Sempionatto JR, Lasalde-Ramírez JA, Mahato K, Wang J, Gao W. Wearable chemical sensors for biomarker discovery in the omics era. Nat Rev Chem 2022; 6:899-915. [PMID: 37117704 DOI: 10.1038/s41570-022-00439-w] [Citation(s) in RCA: 93] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/16/2022]
Abstract
Biomarkers are crucial biological indicators in medical diagnostics and therapy. However, the process of biomarker discovery and validation is hindered by a lack of standardized protocols for analytical studies, storage and sample collection. Wearable chemical sensors provide a real-time, non-invasive alternative to typical laboratory blood analysis, and are an effective tool for exploring novel biomarkers in alternative body fluids, such as sweat, saliva, tears and interstitial fluid. These devices may enable remote at-home personalized health monitoring and substantially reduce the healthcare costs. This Review introduces criteria, strategies and technologies involved in biomarker discovery using wearable chemical sensors. Electrochemical and optical detection techniques are discussed, along with the materials and system-level considerations for wearable chemical sensors. Lastly, this Review describes how the large sets of temporal data collected by wearable sensors, coupled with modern data analysis approaches, would open the door for discovering new biomarkers towards precision medicine.
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Saffari SE, Ning Y, Xie F, Chakraborty B, Volovici V, Vaughan R, Ong MEH, Liu N. AutoScore-Ordinal: an interpretable machine learning framework for generating scoring models for ordinal outcomes. BMC Med Res Methodol 2022; 22:286. [PMID: 36333672 PMCID: PMC9636613 DOI: 10.1186/s12874-022-01770-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
Background Risk prediction models are useful tools in clinical decision-making which help with risk stratification and resource allocations and may lead to a better health care for patients. AutoScore is a machine learning–based automatic clinical score generator for binary outcomes. This study aims to expand the AutoScore framework to provide a tool for interpretable risk prediction for ordinal outcomes. Methods The AutoScore-Ordinal framework is generated using the same 6 modules of the original AutoScore algorithm including variable ranking, variable transformation, score derivation (from proportional odds models), model selection, score fine-tuning, and model evaluation. To illustrate the AutoScore-Ordinal performance, the method was conducted on electronic health records data from the emergency department at Singapore General Hospital over 2008 to 2017. The model was trained on 70% of the data, validated on 10% and tested on the remaining 20%. Results This study included 445,989 inpatient cases, where the distribution of the ordinal outcome was 80.7% alive without 30-day readmission, 12.5% alive with 30-day readmission, and 6.8% died inpatient or by day 30 post discharge. Two point-based risk prediction models were developed using two sets of 8 predictor variables identified by the flexible variable selection procedure. The two models indicated reasonably good performance measured by mean area under the receiver operating characteristic curve (0.758 and 0.793) and generalized c-index (0.737 and 0.760), which were comparable to alternative models. Conclusion AutoScore-Ordinal provides an automated and easy-to-use framework for development and validation of risk prediction models for ordinal outcomes, which can systematically identify potential predictors from high-dimensional data.
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Nair N. Use of machine learning techniques to identify risk factors for RV failure in LVAD patients. Front Cardiovasc Med 2022; 9:848789. [PMID: 36186964 PMCID: PMC9515379 DOI: 10.3389/fcvm.2022.848789] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/25/2022] [Indexed: 11/25/2022] Open
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Cai A, Chen R, Pang C, Liu H, Zhou Y, Chen J, Li L. Machine learning model for predicting 1-year and 3-year all-cause mortality in ischemic heart failure patients. Postgrad Med 2022; 134:810-819. [PMID: 35984114 DOI: 10.1080/00325481.2022.2115735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Machine learning (ML) model has not been developed specifically for ischemic heart failure (HF) patients. Whether the performance of ML model is better than the MAGGIC risk score and NT-proBNP is unknown. The current study was to apply ML algorithm to build risk model for predicting 1-year and 3-year all-cause mortality in ischemic HF patient and to compare the performance of ML model with the MAGGIC risk score and NT-proBNP. METHOD Three ML algorithms without and with feature selection were used for model exploration, and the performance was determined based on the area under the curve (AUC) in five-fold cross-validation. The best performing ML model was selected and compared with the MAGGIC risk score and NT-proBNP. The calibration of ML model was assessed by the Brier score. RESULTS Random forest with feature selection had the highest AUC (0.742 and 95% CI: 0.697-0.787) for predicting 1-year all-cause mortality, and support vector machine without feature selection had the highest AUC (0.732 and 95% CI: 0.694-0.707) for predicting 3-year all-cause mortality. When compared to the MAGGIC risk score and NT-proBNP, ML model had a comparable AUC for predicting 1-year (0.742 vs 0.714 vs 0.694) and 3-year all-cause mortality (0.732 vs 0.712 vs 0.682). The Brier score for predicting 1-year and 3-year all-cause mortality were 0.068 and 0.174, respectively. CONCLUSION ML models predicted prognosis in ischemic HF with good discrimination and well calibration. These models may be used by clinicians as a decision-making tool to estimate the prognosis of ischemic HF patients.
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Affiliation(s)
- Anping Cai
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, 510080
| | - Rui Chen
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, 510080
| | - Chengcheng Pang
- Department of Maternal-Fetal Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, 510080
| | - Hui Liu
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, 510080
| | - Yingling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, 510080
| | - Jiyan Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, 510080
| | - Liwen Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, 510080
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Falter M, Scherrenberg M, Driesen K, Pieters Z, Kaihara T, Xu L, Caiani EG, Castiglioni P, Faini A, Parati G, Dendale P. Smartwatch-Based Blood Pressure Measurement Demonstrates Insufficient Accuracy. Front Cardiovasc Med 2022; 9:958212. [PMID: 35898281 PMCID: PMC9309348 DOI: 10.3389/fcvm.2022.958212] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Novel smartwatch-based cuffless blood pressure (BP) measuring devices are coming to market and receive FDA and CE labels. These devices are often insufficiently validated for clinical use. This study aims to investigate a recently CE-cleared smartwatch using cuffless BP measurement in a population with normotensive and hypertensive individuals scheduled for 24-h BP measurement. Methods Patients that were scheduled for 24-h ambulatory blood pressure monitoring (ABPM) were recruited and received an additional Samsung Galaxy Watch Active 2 smartwatch for simultaneous BP measurement on their opposite arm. After calibration, patients were asked to measure as much as possible in a 24-h period. Manual activation of the smartwatch is necessary to measure the BP. Accuracy was calculated using sensitivity, specificity, positive and negative predictive values and ROC curves. Bland-Altman method and Taffé methods were used for bias and precision assessment. BP variability was calculated using average real variability, standard deviation and coefficient of variation. Results Forty patients were included. Bland-Altman and Taffé methods demonstrated a proportional bias, in which low systolic BPs are overestimated, and high BPs are underestimated. Diastolic BPs were all overestimated, with increasing bias toward lower BPs. Sensitivity and specificity for detecting systolic and/or diastolic hypertension were 83 and 41%, respectively. ROC curves demonstrate an area under the curve (AUC) of 0.78 for systolic hypertension and of 0.93 for diastolic hypertension. BP variability was systematically higher in the ABPM measurements compared to the smartwatch measurements. Conclusion This study demonstrates that the BP measurements by the Samsung Galaxy Watch Active 2 show a systematic bias toward a calibration point, overestimating low BPs and underestimating high BPs, when investigated in both normotensive and hypertensive patients. Standards for traditional non-invasive sphygmomanometers are not met, but these standards are not fully applicable to cuffless devices, emphasizing the urgent need for new standards for cuffless devices. The smartwatch-based BP measurement is not yet ready for clinical usage. Future studies are needed to further validate wearable devices, and also to demonstrate new possibilities of non-invasive, high-frequency BP monitoring.
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Affiliation(s)
- Maarten Falter
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Department of Cardiology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Martijn Scherrenberg
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium
| | - Karen Driesen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Zoë Pieters
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Toshiki Kaihara
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Linqi Xu
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- School of Nursing, Jilin University, Changchun, China
| | - Enrico Gianluca Caiani
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
- Institute of Electronics, Computer and Telecommunication Engineering, Consiglio Nazionale delle Ricerche, Milan, Italy
| | | | - Andrea Faini
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital, Milan, Italy
| | - Gianfranco Parati
- Department of Cardiovascular Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Paul Dendale
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
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Shi Z, Meng L, Shi X, Li H, Zhang J, Sun Q, Liu X, Chen J, Liu S. Morphological Engineering of Sensing Materials for Flexible Pressure Sensors and Artificial Intelligence Applications. NANO-MICRO LETTERS 2022; 14:141. [PMID: 35789444 PMCID: PMC9256895 DOI: 10.1007/s40820-022-00874-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/04/2022] [Indexed: 05/05/2023]
Abstract
Various morphological structures in pressure sensors with the resulting advanced sensing properties are reviewed comprehensively. Relevant manufacturing techniques and intelligent applications of pressure sensors are summarized in a complete and interesting way. Future challenges and perspectives of flexible pressure sensors are critically discussed.
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Affiliation(s)
- Zhengya Shi
- School of Materials Science and Engineering, Henan Key Laboratory of Advanced Nylon Materials and Application, Henan Innovation Center for Functional Polymer Membrane Materials, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Lingxian Meng
- School of Materials Science and Engineering, Henan Key Laboratory of Advanced Nylon Materials and Application, Henan Innovation Center for Functional Polymer Membrane Materials, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Xinlei Shi
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 352001, People's Republic of China
| | - Hongpeng Li
- School of Mechanical Engineering, Yangzhou University, Yangzhou, 225127, People's Republic of China
| | - Juzhong Zhang
- School of Materials Science and Engineering, Henan Key Laboratory of Advanced Nylon Materials and Application, Henan Innovation Center for Functional Polymer Membrane Materials, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Qingqing Sun
- School of Materials Science and Engineering, Henan Key Laboratory of Advanced Nylon Materials and Application, Henan Innovation Center for Functional Polymer Membrane Materials, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Xuying Liu
- School of Materials Science and Engineering, Henan Key Laboratory of Advanced Nylon Materials and Application, Henan Innovation Center for Functional Polymer Membrane Materials, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Jinzhou Chen
- School of Materials Science and Engineering, Henan Key Laboratory of Advanced Nylon Materials and Application, Henan Innovation Center for Functional Polymer Membrane Materials, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Shuiren Liu
- School of Materials Science and Engineering, Henan Key Laboratory of Advanced Nylon Materials and Application, Henan Innovation Center for Functional Polymer Membrane Materials, Zhengzhou University, Zhengzhou, 450001, People's Republic of China.
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Rajamani ST, Rajamani K, Kathan A, Schuller BW. Novel Insights on Induced Sparsity in Multi-Time Attention Networks. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2615-2618. [PMID: 36085772 DOI: 10.1109/embc48229.2022.9871801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Current deep learning approaches for dealing with sparse irregularly sampled time-series data do not exploit the extent of sparsity of the input data. Our work is inspired by the sparse and irregularly sampled nature of physiological time series data in electronic health records. We explore the effect of inducing varying degrees of sparsity on the predictive performance of Multi-Time Attention Networks (mTAN) [1]. Our methodology is to induce sparsity by first sub-sampling the time-series before feeding it to the mTAN network. We conduct empirical experiments with sub-sampling ranging from 10 to 90 %. We investigate the performance of our methodology on the Human Activity dataset and Physionet 2012 mortality prediction task. Our results demonstrate that our proposed time-point sub-sampling coupled with mTAN improves the performance by 2 % on the Human Activity dataset with 80 % lesser time-points for training. On the Physionet dataset, our approach achieves comparable performance as baseline with 30 % lesser time-points. Our experiments reveal that time-series data could be further coarsely acquired when used in tandem with state-of-the-art networks capable of handling sparse data (mTAN). This could be of immense help for various applications where data acquisition and labeling is a significant challenge.
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Han F, Wang T, Liu G, Liu H, Xie X, Wei Z, Li J, Jiang C, He Y, Xu F. Materials with Tunable Optical Properties for Wearable Epidermal Sensing in Health Monitoring. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2109055. [PMID: 35258117 DOI: 10.1002/adma.202109055] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/26/2022] [Indexed: 06/14/2023]
Abstract
Advances in wearable epidermal sensors have revolutionized the way that physiological signals are captured and measured for health monitoring. One major challenge is to convert physiological signals to easily readable signals in a convenient way. One possibility for wearable epidermal sensors is based on visible readouts. There are a range of materials whose optical properties can be tuned by parameters such as temperature, pH, light, and electric fields. Herein, this review covers and highlights a set of materials with tunable optical properties and their integration into wearable epidermal sensors for health monitoring. Specifically, the recent progress, fabrication, and applications of these materials for wearable epidermal sensors are summarized and discussed. Finally, the challenges and perspectives for the next generation wearable devices are proposed.
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Affiliation(s)
- Fei Han
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Tiansong Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Guozhen Liu
- School of Life and Health Sciences, The Chinese University of Hong Kong, Shenzhen, 518172, P. R. China
| | - Hao Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Xueyong Xie
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Zhao Wei
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Jing Li
- Department of Burns and Plastic Surgery, Second Affiliated Hospital of Air Force Military Medical University, Xi'an, 710038, P. R. China
| | - Cheng Jiang
- School of Life and Health Sciences, The Chinese University of Hong Kong, Shenzhen, 518172, P. R. China
- Department of Chemistry, University of Oxford, Oxford, OX1 3QZ, UK
| | - Yuan He
- The Second Affiliated Hospital, Xi'an Medical University, Xi'an, 710038, P. R. China
| | - Feng Xu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, P. R. China
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