Smart Wearable Systems for Health Monitoring

Real-time prognostic biomarkers for predicting in-hospital mortality and cardiac complications in COVID-19 patients

Hospitalized patients with Coronavirus disease 2019 (COVID-19) are highly susceptible to in-hospital mortality and cardiac complications such as atrial arrhythmias (AA). However, the utilization of biomarkers such as potassium, B-type natriuretic peptide, albumin, and others for diagnosis or the prediction of in-hospital mortality and cardiac complications has not been well established. The study aims to investigate whether biomarkers can be utilized to predict mortality and cardiac complications among hospitalized COVID-19 patients. Data were collected from 6,927 hospitalized COVID-19 patients from March 1, 2020, to March 31, 2021 at one quaternary (Henry Ford Health) and five community hospital registries (Trinity Health Systems). A multivariable logistic regression prediction model was derived using a random sample of 70% for derivation and 30% for validation. Serum values, demographic variables, and comorbidities were used as input predictors. The primary outcome was in-hospital mortality, and the secondary outcome was onset of AA. The associations between predictor variables and outcomes are presented as odds ratio (OR) with 95% confidence intervals (CIs). Discrimination was assessed using area under ROC curve (AUC). Calibration was assessed using Brier score. The model predicted in-hospital mortality with an AUC of 90% [95% CI: 88%, 92%]. In addition, potassium showed promise as an independent prognostic biomarker that predicted both in-hospital mortality, with an AUC of 71.51% [95% Cl: 69.51%, 73.50%], and AA with AUC of 63.6% [95% Cl: 58.86%, 68.34%]. Within the test cohort, an increase of 1 mEq/L potassium was associated with an in-hospital mortality risk of 1.40 [95% CI: 1.14, 1.73] and a risk of new onset of AA of 1.55 [95% CI: 1.25, 1.93]. This cross-sectional study suggests that biomarkers can be used as prognostic variables for in-hospital mortality and onset of AA among hospitalized COVID-19 patients.

Mobile Data Gathering and Preliminary Analysis for the Functional Reach Test

The functional reach test (FRT) is a clinical tool used to evaluate dynamic balance and fall risk in older adults and those with certain neurological diseases. It provides crucial information for developing rehabilitation programs to improve balance and reduce fall risk. This paper aims to describe a new tool to gather and analyze the data from inertial sensors to allow automation and increased reliability in the future by removing practitioner bias and facilitating the FRT procedure. A new tool for gathering and analyzing data from inertial sensors has been developed to remove practitioner bias and streamline the FRT procedure. The study involved 54 senior citizens using smartphones with sensors to execute FRT. The methods included using a mobile app to gather data, using sensor-fusion algorithms like the Madgwick algorithm to estimate orientation, and attempting to estimate location by twice integrating accelerometer data. However, accurate position estimation was difficult, highlighting the need for more research and development. The study highlights the benefits and drawbacks of automated balance assessment testing with mobile device sensors, highlighting the potential of technology to enhance conventional health evaluations.

Reversible thermochromic fibers with excellent elasticity and hydrophobicity for wearable temperature sensors

Color-changing fibers, which can intuitively convey information to the human eye, can be used to facilely add functionality to various types of clothing. However, they are often expensive and complex, and can suffer from low durability. Therefore, in this study, we developed highly elastic and hydrophobic thermochromic fibers as wearable temperature sensors using a simple method that does not require an electric current. A thermochromic pigment was embedded inside and outside hydrophobic silica aerogel particles, following which the thermochromic aerogel was fixed to highly elastic spandex fibers using polydimethylsiloxane as a flexible binder. In particular, multi-strand spandex fibers were used instead of single strands, resulting in the thermochromic aerogels penetrating the inside of the strands upon their expansion by solvent swelling. During drying, the thermochromic aerogel adhered more tightly to the fibers by compressing the strands. The thermochromic fiber was purple at room temperature (25 °C), but exhibited a two-stage color change to blue and then white as the temperature increased to 37 °C. In addition, even after 100 cycles of tension-contraction at 200%, the thermochromic aerogel did not detach and was strongly attached to the fiber. Additionally, it was confirmed that color change due to temperature was stable even after exposure to 1 wt% NaCl (artificial sweat) and 0.1 wt% detergent solutions. The developed thermochromic fiber therefore exhibited excellent elasticity and hydrophobicity, and is expected to be widely utilized as an economical wearable temperature sensor as it does not require electrical devices.

Road map for personalized exercise medicine in T2DM

The number of patients with type 2 diabetes mellitus (T2DM) is rising at an alarming rate. Regular physical activity and exercise are cornerstones in the therapy of T2DM. While a one-size-fits-all approach fails to account for many between-subject differences, the use of personalized exercise medicine has the potential of optimizing health outcomes. Here, a road map for personalized exercise therapy targeted at patients with T2DM is presented. It considers secondary complications, glucose management, response heterogeneity, and other relevant factors that might influence the effectiveness of exercise as medicine, taking exercise-medication-diet interactions, as well as feasibility and acceptance into account. Furthermore, the potential of artificial intelligence and machine learning-based applications in assisting sports therapists to find appropriate exercise programs is outlined.

Assessment Scales in Cerebral Palsy: A Comprehensive Review of Tools and Applications

Cerebral palsy (CP) is a complex neurological condition characterized by motor dysfunction affecting millions worldwide. This comprehensive review delves into the critical role of assessment in managing CP. Beginning with exploring its definition and background, we elucidate the diverse objectives of CP assessment, ranging from diagnosis and goal setting to research and epidemiology. We examine standard assessment scales and tools, discuss the challenges inherent in CP assessment, and highlight emerging trends, including integrating technology, personalized medicine, and neuroimaging. The applications of CP assessment in clinical diagnosis, treatment planning, research, and education are underscored. Recommendations for the future encompass standardization, interdisciplinary collaboration, research priorities, and professional training. In conclusion, we emphasize the importance of assessment as a compass guiding the care of individuals with CP, issuing a call to action for improved assessment practices to shape a brighter future for those affected by this condition.

A Conformal Tri-Band Antenna for Flexible Devices and Body-Centric Wireless Communications

A conformal tri-band antenna tailored for flexible devices and body-centric wireless communications operating at the key frequency bands is proposed. The antenna is printed on a thin Rogers RT 5880 substrate, merely 0.254 mm thick, with an overall geometrical dimension of 15 × 20 × 0.254 mm3. This inventive design features a truncated corner monopole accompanied by branched stubs fed by a coplanar waveguide. The stubs, varying in length, serve as quarter-wavelength monopoles, facilitating multi-band functionality at 2.45, 3.5, and 5.8 GHz. Given the antenna's intended applications in flexible devices and body-centric networks, the conformability of the proposed design is investigated. Furthermore, an in-depth analysis of the Specific Absorption Rate (SAR) is conducted using a four-layered human tissue model. Notably, the SAR values for the proposed geometry at 2.45, 3.5, and 5.8 GHz stand at 1.48, 1.26, and 1.1 W/kg for 1 g of tissue, and 1.52, 1.41, and 0.62 W/kg for 10 g of tissue, respectively. Remarkably, these values comfortably adhere to both FCC and European Union standards, as they remain substantially beneath the threshold values of 1.6 W/kg and 2 W/kg for 1 g and 10 g tissues, respectively. The radiation characteristics and performance of the antenna in flat and different bending configurations validate the suitability of the antenna for flexible devices and body-centric wireless communications.

Stretchable Sensors: Novel Human Motion Monitoring Wearables

A human body monitoring system remains a significant focus, and to address the challenges in wearable sensors, a nanotechnology-enhanced strategy is proposed for designing stretchable metal-organic polymer nanocomposites. The nanocomposite comprises reduced graphene oxide (rGO) and in-situ generated silver nanoparticles (AgNPs) within elastic electrospun polystyrene-butadiene-polystyrene (SBS) fibers. The resulting Sandwich Structure Piezoresistive Woven Nanofabric (SSPWN) is a tactile-sensitive wearable sensor with remarkable performance. It exhibits a rapid response time (less than three milliseconds) and high reproducible stability over 5500 cycles. The nanocomposite also demonstrates exceptional thermal stability due to effective connections between rGO and AgNPs, making it suitable for wearable electronic applications. Furthermore, the SSPWN is successfully applied to human motion monitoring, including various areas of the hand and RGB sensing shoes for foot motion monitoring. This nanotechnology-enhanced strategy shows promising potential for intelligent healthcare, health monitoring, gait detection, and analysis, offering exciting prospects for future wearable electronic products.

Green Nanomaterials for Smart Textiles Dedicated to Environmental and Biomedical Applications

Smart textiles recently reaped significant attention owing to their potential applications in various fields, such as environmental and biomedical monitoring. Integrating green nanomaterials into smart textiles can enhance their functionality and sustainability. This review will outline recent advancements in smart textiles incorporating green nanomaterials for environmental and biomedical applications. The article highlights green nanomaterials' synthesis, characterization, and applications in smart textile development. We discuss the challenges and limitations of using green nanomaterials in smart textiles and future perspectives for developing environmentally friendly and biocompatible smart textiles.

Intraoperative Beat-to-Beat Pulse Transit Time (PTT) Monitoring via Non-Invasive Piezoelectric/Piezocapacitive Peripheral Sensors Can Predict Changes in Invasively Acquired Blood Pressure in High-Risk Surgical Patients

BACKGROUND

Non-invasive tracking of beat-to-beat pulse transit time (PTT) via piezoelectric/piezocapacitive sensors (PES/PCS) may expand perioperative hemodynamic monitoring. This study evaluated the ability for PTT via PES/PCS to correlate with systolic, diastolic, and mean invasive blood pressure (SBP_IBP, DBP_IBP, and MAP_IBP, respectively) and to detect SBP_IBP fluctuations.

METHODS

PES/PCS and IBP measurements were performed in 20 patients undergoing abdominal, urological, and cardiac surgery. A Pearson's correlation analysis (r) between 1/PTT and IBP was performed. The predictive ability of 1/PTT with changes in SBP_IBP was determined by area under the curve (reported as AUC, sensitivity, specificity).

RESULTS

Significant correlations between 1/PTT and SBP_IBP were found for PES (r = 0.64) and PCS (r = 0.55) (p < 0.01), as well as MAP_IBP/DBP_IBP for PES (r = 0.6/0.55) and PCS (r = 0.5/0.45) (p < 0.05). A 7% decrease in 1/PTT_PES predicted a 30% SBP_IBP decrease (0.82, 0.76, 0.76), while a 5.6% increase predicted a 30% SBP_IBP increase (0.75, 0.7, 0.68). A 6.6% decrease in 1/PTT_PCS detected a 30% SBP_IBP decrease (0.81, 0.72, 0.8), while a 4.8% 1/PTT_PCS increase detected a 30% SBP_IBP increase (0.73, 0.64, 0.68).

CONCLUSIONS

Non-invasive beat-to-beat PTT via PES/PCS demonstrated significant correlations with IBP and detected significant changes in SBP_IBP. Thus, PES/PCS as a novel sensor technology may augment intraoperative hemodynamic monitoring during major surgery.