Wearable Temperature Sensors Based on Reduced Graphene Oxide Films

With the development of medical technology and increasing demands of healthcare monitoring, wearable temperature sensors have gained widespread attention because of their portability, flexibility, and capability of conducting real-time and continuous signal detection. To achieve excellent thermal sensitivity, high linearity, and a fast response time, the materials of sensors should be chosen carefully. Thus, reduced graphene oxide (rGO) has become one of the most popular materials for temperature sensors due to its exceptional thermal conductivity and sensitive resistance changes in response to different temperatures. Moreover, by using the corresponding preparation methods, rGO can be easily combined with various substrates, which has led to it being extensively applied in the wearable field. This paper reviews the state-of-the-art advances in wearable temperature sensors based on rGO films and summarizes their sensing mechanisms, structure designs, functional material additions, manufacturing processes, and performances. Finally, the possible challenges and prospects of rGO-based wearable temperature sensors are briefly discussed.

Carbon-Based Textile Sensors for Physiological-Signal Monitoring

As the focus on physical health increases, the market demand for flexible wearable sensors increases. Textiles combined with sensitive materials and electronic circuits can form flexible, breathable high-performance sensors for physiological-signal monitoring. Carbon-based materials such as graphene, carbon nanotubes (CNTs), and carbon black (CB) have been widely utilized in the development of flexible wearable sensors due to their high electrical conductivity, low toxicity, low mass density, and easy functionalization. This review provides an overview of recent advancements in carbon-based flexible textile sensors, highlighting the development, properties, and applications of graphene, CNTs, and CB for flexible textile sensors. The physiological signals that can be monitored by carbon-based textile sensors include electrocardiogram (ECG), human body movement, pulse and respiration, body temperature, and tactile perception. We categorize and describe carbon-based textile sensors based on the physiological signals they monitor. Finally, we discuss the current challenges associated with carbon-based textile sensors and explore the future direction of textile sensors for monitoring physiological signals.

Soft Electronics for Health Monitoring Assisted by Machine Learning

Due to the development of the novel materials, the past two decades have witnessed the rapid advances of soft electronics. The soft electronics have huge potential in the physical sign monitoring and health care. One of the important advantages of soft electronics is forming good interface with skin, which can increase the user scale and improve the signal quality. Therefore, it is easy to build the specific dataset, which is important to improve the performance of machine learning algorithm. At the same time, with the assistance of machine learning algorithm, the soft electronics have become more and more intelligent to realize real-time analysis and diagnosis. The soft electronics and machining learning algorithms complement each other very well. It is indubitable that the soft electronics will bring us to a healthier and more intelligent world in the near future. Therefore, in this review, we will give a careful introduction about the new soft material, physiological signal detected by soft devices, and the soft devices assisted by machine learning algorithm. Some soft materials will be discussed such as two-dimensional material, carbon nanotube, nanowire, nanomesh, and hydrogel. Then, soft sensors will be discussed according to the physiological signal types (pulse, respiration, human motion, intraocular pressure, phonation, etc.). After that, the soft electronics assisted by various algorithms will be reviewed, including some classical algorithms and powerful neural network algorithms. Especially, the soft device assisted by neural network will be introduced carefully. Finally, the outlook, challenge, and conclusion of soft system powered by machine learning algorithm will be discussed.

Intelligent and highly sensitive strain sensor based on indium tin oxide micromesh with a high crack density

Cracks play an important role in strain sensors. However, a systematic analysis of how cracks influence the strain sensors has not been proposed. In this work, an intelligent and highly sensitive strain sensor based on indium tin oxide (ITO)/polyurethane (PU) micromesh is realized. The micromesh has good skin compatibility, water vapor permeability, and stability. Due to the color of the ITO/PU micromesh, it can be invisible on the skin. Based on the fragility of ITO, the density and resistance of cracks in the micromesh are greatly improved. Therefore, the ITO/PU micromesh strain sensor (IMSS) has an ultrahigh gauge factor (744.3). In addition, a finite element model based on four resistance layers is proposed to explain the performance of the IMSS and show the importance of high-density cracks. Compared with other strain sensors based on low-density cracks, the IMSS based on high-density cracks has larger sensitivity and better linearity. Physiological signals, such as respiration, pulse, and joint motion, can be monitored using the IMSS self-fixed on the skin. Finally, an invisible and artificial throat has been realized by combining the IMSS with a convolutional neural network algorithm. The artificial throat can translate the throat vibrations of the tester automatically with an accuracy of 86.5%. This work has great potential in health care and language function reconstruction.

Intelligent and Multifunctional Graphene Nanomesh Electronic Skin with High Comfort

As the aging population increases in many countries, electronic skin (e-skin) for health monitoring has been attracting much attention. However, to realize the industrialization of e-skin, two factors must be optimized. The first is to achieve high comfort, which can significantly improve the user experience. The second is to make the e-skin intelligent, so it can detect and analyze physiological signals at the same time. In this article, intelligent and multifunctional e-skin consisting of laser-scribed graphene and polyurethane (PU) nanomesh is realized with high comfort. The e-skin can be used as a strain sensor with large measurement range (>60%), good sensitivity (GF≈40), high linearity range (60%), and excellent stability (>1000 cycles). By analyzing the morphology of e-skin, a parallel networks model is proposed to express the mechanism of the strain sensor. In addition, laser scribing is also applied to etch the insulating PU, which greatly decreases the impedance in detecting electrophysiology signals. Finally, the e-skin is applied to monitor the electrocardiogram, electroencephalogram (EEG), and electrooculogram signals. A time- and frequency-domain concatenated convolution neural network is built to analyze the EEG signal detected using the e-skin on the forehead and classify the attention level of testers.

Multifunctional Graphene Microstructures Inspired by Honeycomb for Ultrahigh Performance Electromagnetic Interference Shielding and Wearable Applications

High-performance electromagnetic interference (EMI) shielding materials with ultralow density, excellent flexibility, and good mechanical properties are highly desirable for aerospace and wearable electronics. Herein, honeycomb porous graphene (HPG) fabricated by laser scribing technology is reported for EMI shielding and wearable applications. Due to the honeycomb structure, the HPG exhibits an EMI shielding effectiveness (SE) up to 45 dB at a thickness of 48.3 μm. The single-piece HPG exhibits an ultrahigh absolute shielding effectiveness (SSE/t) of 240 123 dB cm²/g with an ultralow density of 0.0388 g/cm³, which is significantly superior to the reported materials such as carbon-based, MXene, and metal materials. Furthermore, MXene and AgNWs are employed to cover the honeycomb holes of the HPG to enhance surface reflection; thus, the SSE/t of the HPG/AgNWs composite membrane can reach up to 292 754 dB cm²/g. More importantly, the HPG exhibits excellent mechanical stability and durability in cyclic stretching and bending, which can be used to monitor weak physiological signals such as pulse, respiration, and laryngeal movement of humans. Therefore, the lightweight and flexible HPG exhibits excellent EMI shielding performance and mechanical properties, along with its low cost and ease of mass production, which is promising for practical applications in EMI shielding and wearable electronics.

Mutations in chronic myelomonocytic leukemia and their prognostic relevance

Chronic myelomonocytic leukemia (CMML) is a hematologic malignancy that overlaps with myeloproliferative neoplasms (MPN) and myelodysplastic syndromes (MDS) and tends to transform into acute myeloid leukemia (AML). Among cases of CMML, > 90% have gene mutations, primarily involving TET2 (~ 60%), ASXL1 (~ 40%), SRSF2 (~ 50%), and the RAS pathways (~ 30%). These gene mutations are associated with both the clinical phenotypes and the prognosis of CMML, special CMML variants and pre-phases of CMML. Cytogenetic abnormalities and the size of genome are also associated with prognosis. Meanwhile, cases with ASXL1, DNMT3A, NRAS, SETBP1, CBL and RUNX1 mutations may have inferior prognoses, but only ASXL1 mutations were confirmed to be independent predictors of the patient outcome and were included in three prognostic models. Novel treatment targets related to the various gene mutations are emerging. Therefore, this review provides new insights to explore the correlations among gene mutations, clinical phenotypes, prognosis, and novel drugs in CMML.

Substrate-Free Multilayer Graphene Electronic Skin for Intelligent Diagnosis

Current wearable sensors are fabricated with substrates, which limits the comfort, flexibility, stretchability, and induces interface mismatch. In addition, the substrate prevents the evaporation of sweat and is harmful to skin health. In this work, we have enabled the substrate-free laser scribed graphene (SFG) electronic skin (e-skin) with multifunctions. Compared with the e-skin with the substrate, the SFG has good gas permeability, low impedance, and flexibility. Only assisted using water, the SFG can be transferred to almost any objects including silicon and human skin and it can even be suspended. Many through-holes like stomas in leaf can be formed in the SFG, which make it breathable. After designing the pattern, the gauge factor (GF) of graphene electronic skin (GES) can be designed as the strain sensor. Physiological signals such as respiration, human motion, and electrocardiogram (ECG) can be detected. Moreover, the suspended SFG detect vibrations with high sensitivity. Due to the substrate-free structure, the impedance between SFG e-skin and the human body decreases greatly. Finally, an ECG detecting system has been designed based on the GES, which can monitor the body condition in real time. To analyze the ECG signals automatically, a convolutional neural network (CNN) was built and trained successfully. This work has high potential in the field of health telemonitoring.

Graphene-Based Thermoacoustic Sound Source

Thermoacoustic (TA) effect has been discovered for more than 130 years. However, limited by the material characteristics, the performance of a TA sound source could not be compared with magnetoelectric and piezoelectric loudspeakers. Recently, graphene, a two-dimensional material with the lowest heat capacity per unit area, was discovered to have a good TA performance. Compared with a traditional sound source, graphene TA sound sources (GTASSs) have many advantages, such as small volume, no diaphragm vibration, wide frequency range, high transparency, good flexibility, and high sound pressure level (SPL). Therefore, graphene has a great potential as a next-generation sound source. Photoacoustic (PA) imaging can also be applied to the diagnosis and treatment of diseases using the photothermo-acoustic (PTA) effect. Therefore, in this review, we will introduce the history of TA devices. Then, the theory and simulation model of TA will be analyzed in detail. After that, we will talk about the graphene synthesis method. To improve the performance of GTASSs, many strategies such as lowering the thickness and using porous or suspended structures will be introduced. With a good PTA effect and large specific area, graphene PA imaging and drug delivery is a promising prospect in cancer treatment. Finally, the challenges and prospects of GTASSs will be discussed.

Graphene-based wearable sensors

The human body is a "delicate machine" full of sensors such as the fingers, nose, and mouth. In addition, numerous physiological signals are being created every moment, which can reflect the condition of the body. The quality and the quantity of the physiological signals are important for diagnoses and the execution of therapies. Due to the incompact interface between the sensors and the skin, the signals obtained by commercial rigid sensors do not bond well with the body; this decreases the quality of the signal. To increase the quantity of the data, it is important to detect physiological signals in real time during daily life. In recent years, there has been an obvious trend of applying graphene devices with excellent performance (flexibility, biocompatibility, and electronic characters) in wearable systems. In this review, we will first provide an introduction about the different methods of synthesis of graphene, and then techniques for graphene patterning will be outlined. Moreover, wearable graphene sensors to detect mechanical, electrophysiological, fluid, and gas signals will be introduced. Finally, the challenges and prospects of wearable graphene devices will be discussed. Wearable graphene sensors can improve the quality and quantity of the physiological signals and have great potential for health-care and telemedicine in the future.

Influenza a virus and Streptococcus pneumonia coinfection potentially promotes bacterial colonization and enhances B lymphocyte depression and reduction

Influenza has frequently been epidemic in recent years. However, the mechanisms of severe pneumonia with postinfluenza Streptococcus pneumoniae (SP) secondary infection have not been fully understood. In this study, we explored the mechanisms of pneumonia in postinfluenza A virus (IAV) infection via a mouse model. Mice were intranasally inoculated with SP three days after IAV inoculation. We then collected samples at three time points to dynamically observe the pathological progression. In IAV infection alone, lymphocyte infiltration and widened alveolar intervals were observed. In the blood, levels of the CD19+, CD19+CD21+ and CD19+CD79β+B lymphocyte subpopulations were reduced, and IFN-γ and IL-10 were elevated. Slight atrophy was seen in the spleen, which was due to splenic B lymphocyteinitiated apoptosis through the mitochondrial pathway. When SP infection occurred after IAV infection, the pulmonary inflammation was significantly aggravated; a fair number of lymphocytes and neutrophils infiltrated simultaneously with exfoliated bronchial epithelial cells, vascular endothelial cells, widened alveolar septum and hemorrhaging. Increasing edema fluid and bacteria accumulated in the alveolar cavity. Decreased CD19+, CD19+CD21+ and CD19+CD79β+B lymphocyte subpopulations and increased interferon gamma (IFN-γ) or interleukin 10 (IL-10) were more prominent compared to those with viral infection alone. Spleen atrophy resulting from coinfection was more obvious because of massive splenic B lymphocyte apoptosis through the mitochondrial pathway compared to viral infection alone. This study shows that although inflammation caused by SP infection alone was temporary, preceding IAV infection provided favorable conditions for SP colonization and multiplication by destroying lung structure and suppressing humoral immunity. Synergistic IAV-SP coinfection is likely to facilitate more SP colonization and promote B lymphocyte-suppression and reduction. Eventually, the pneumonia worsened.

Multifunctional Mechanical Sensors for Versatile Physiological Signal Detection

Recently, flexible and wearable mechanical sensors have attracted great attention because of their potential applications in monitoring various physiological signals. However, conventional mechanical sensors rarely have both pressure and strain sensing abilities that can meet the demands of both subtle and large human motion detection. Besides, the mechanical sensors with tunable sensitivity or measuring range are also essential for their practical applications. Herein, the graphene ink dip-coating method with merits of time saving, low cost, and large scale was used to fabricate the foam-structured graphene sensors with both pressure and strain sensing performance. Because of high elasticity of styrene butadiene rubber (SBR) substrates and stacked graphene flakes, the tunable mechanical sensors exhibit a high gauge factor (GF) and large measuring range for specific human motion detection. The pressure sensor shows a GF of 2.02 kPa^-1 with a pressure range up to 172 kPa, and the strain sensor displays a GF of 250 with a strain range up to 86%. On the one hand, various detections of subtle vital signals with small strain change were demonstrated by the pressure sensor because of its flexibility and high sensitivity. On another hand, the strain sensor with large strain change shows excellent ability to detect various large human motions including the bending of neck, finger, wrist, and knee. Interestingly, both the pressure sensor and strain sensor exhibit great capability for recognizing 26 letters written by hand. The working mechanism based on the contact area variation was also investigated by the morphology evolution and resistance model. We suppose that the foam-structured graphene mechanical sensors would be promising in wearable electronics for human healthcare and activity monitoring in the future.

Multilayer Graphene Epidermal Electronic Skin

Due to its excellent flexibility, graphene has an important application prospect in epidermal electronic sensors. However, there are drawbacks in current devices, such as sensitivity, range, lamination, and artistry. In this work, we have demonstrated a multilayer graphene epidermal electronic skin based on laser scribing graphene, whose patterns are programmable. A process has been developed to remove the unreduced graphene oxide. This method makes the epidermal electronic skin not only transferable to butterflies, human bodies, and any other objects inseparably and elegantly, merely with the assistance of water, but also have better sensitivity and stability. Therefore, pattern electronic skin could attach to every object like artwork. When packed in Ecoflex, electronic skin exhibits excellent performance, including ultrahigh sensitivity (gauge factor up to 673), large strain range (as high as 10%), and long-term stability. Therefore, many subtle physiological signals can be detected based on epidermal electronic skin with a single graphene line. Electronic skin with multiple graphene lines is employed to detect large-range human motion. To provide a deeper understanding of the resistance variation mechanism, a physical model is established to explain the relationship between the crack directions and electrical characteristics. These results show that graphene epidermal electronic skin has huge potential in health care and intelligent systems.

Structural Brain Network Reorganization in Patients with Neuropsychiatric Systemic Lupus Erythematosus

BACKGROUND AND PURPOSE

Patients with neuropsychiatric systemic lupus erythematosus have worse outcomes compared with those with systemic lupus erythematosus. A better understanding of the mechanisms of neuropsychiatric systemic lupus erythematosus could potentially improve diagnosis and management. The goal of this study was to investigate the differences in the structural brain network of patients with neuropsychiatric systemic lupus erythematosus compared with patients with systemic lupus erythematosus by using brain connectivity analysis.

MATERIALS AND METHODS

We recruited 20 subjects for each patient cohort and age-matched healthy controls. The topology and efficiency of the network and the characteristics of various brain hubs were investigated by using brain connectivity analysis of diffusion MR imaging data.

RESULTS

There were more extensive reorganizations in the structural brain network of patients with neuropsychiatric systemic lupus erythematosus than in patients with systemic lupus erythematosus. For example, the network of the former had significantly decreased clustering coefficient and local efficiency. They also had significantly lower nodal efficiency in the superior temporal gyrus (P = .046) and middle temporal gyrus (P = .041).

CONCLUSIONS

Our results hint at a plausible relationship between the neuropsychiatric symptoms and reorganization of the structural brain network of patients with systemic lupus erythematosus. Brain connectivity analysis may be a potential tool to subtype these patients.

Associations of serotonin receptor gene HTR3A, HTR3B, and HTR3A haplotypes with bipolar disorder in Chinese patients

Single nucleotide polymorphisms (SNPs) in HTR3A and HTR3B have been reported to be associated with bipolar disorder in European and Japanese populations. We explored the roles of 21 tag SNPs in HTR3A and HTR3B in susceptibility to bipolar disorder in a Chinese cohort. Twenty-one Tag SNPs were genotyped in a study consisting of 130 patients with bipolar disorder, who visited Shandong Mental Health Center between June 2013 and May 2014, and 109 healthy individuals as controls. All of the tag SNPs were genotyped using Sequenom MassArray matrix-assisted laser desorption/ionization time of flight spectrometry. Plink 1.07, Haploview 4.2, and SPSS 20.0 were used for the analysis of the genotypes and the associations of the haplotypes with bipolar disorder. Association analyses of tag SNPs detected significant associations with the A allele in HTR3A rs1176719 (P = 0.030) and the C allele in HTR3A rs1176713 (P = 0.048). Haplotype-based association analyses indicated a statistically significant (P = 0.035) five-SNP haplotype (rs1062613:C, rs11604247:C, rs1176722:G, rs2276302:A, rs1176719:G) of linkage disequilibrium in block 3. Analysis of our small Chinese sample revealed a significant association of HTR3A with bipolar disorder, but yielded no evidence of an association between HTR3B and bipolar disorder. Furthermore, evidence for an association was found for a haplotype of HTR3A. Studies with larger Chinese samples are needed to verify our findings.

[The effects of Xuezhikang on serum lipid profile, thromboxane A2 and prostacyclin in patients with hyperlipidemia]

OBJECTIVE

To study the effects of Xuezhikang on lipid profile, thromboxane (TX) A(2), prostacyclin (PGI(2)) in patients with hyperlipidemia.

METHODS

91 patients with hyperlipidemia were randomly divided into a treatment group (n = 47, Xuezhikang 1.2 g/d Bid, p.o) and control group (n = 44, gemfibrozil 1.2 g/d Bid, p.o). serum lipids, TXB(2) and 6-Keto-PGF(1alpha) were determined before and 8 weeks after the treatment.

RESULTS

(1) After 8 weeks of treatment, the level of serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) decreased by 21.6% (P < 0.01) and 33.3% (P < 0. 01) in the Xuezikang group and by 20.4% (P < 0.01) and 24.8% (P < 0.01) in the gemfibrozil group respectively. Serum high density lipoprotein cholesterol (HDL-C) level elevated by 33.7% in the Xuezhikang group (P < 0.01) and 26.9% in the gemfibrozil group (P < 0.01). The effect of Xuezhikang was the same as gemfibrozil. There was no statistically significant difference between the effects of these two drugs. Triglyceride (TG) level decreased by 23.3% in the Xuezhikang group (P < 0.01) and 40.3% in the gemfibrozil group (P < 0.01). TG lowering effect of gemfibrozil was superior to that of Xuezhikang (P < 0.05). (2) The level of lipoprotein (a) [LP (a)] in the plasma decreased by 28.2% (P < 0.01) in the Xuezhikang group and by 4.9% (P > 0.05) in the gemfibrozil group. LP (a) lowering effect of Xuezhikang was superior to that of gemfibrozil (P < 0.01). (3)The Level of thromboxane (TX) B(2) in the plasma decreased by 34.2% in the Xuezhikang group (P < 0.01) and by 8.4% in the gemfibrozil group (P < 0.01). TXB(2) lowering effect of Xuezhikang was superior to that of gemfibrozil (P < 0.01). The level of 6-KetO-PGF(1alpha) in the plasma elevated by 65.4% in the Xuezhikang group (P < 0.01) and by 11.7% in the gemfibrozil group (P < 0.01); the effect of Xuezhikang was superior to that of gemfibrozil (P < 0.01).

CONCLUSION

Xuezhikang could markedly decrease the level of TC and LDL-C and elevate that of HDL-C in patients with hyperlipidemia and the effects of Xuezhikang were the same as those of gemfibrozil. TG lowering effect of gemfibrozil was superior to that of Xuezhikang, but Xuezhikang could markedly decrease the level of Lp (a) and regluate the balance between TXA(2) and PGI(2), its effect being superior to that of gemfibrozil.

A double-stranded RNA element from a hypovirulent strain of Rhizoctonia solani occurs in DNA form and is genetically related to the pentafunctional AROM protein of the shikimate pathway

M2 is a double-stranded RNA (dsRNA) element occurring in the hypovirulent isolate Rhs 1A1 of the plant pathogenic basidiomycete Rhizoctonia solani. Rhs 1A1 originated as a sector of the virulent field isolate Rhs 1AP, which contains no detectable amount of the M2 dsRNA. The complete sequence (3,570 bp) of the M2 dsRNA has been determined. A 6.9-kbp segment of total DNA from either Rhs 1A1 or Rhs 1AP hybridizes with an M2-specific cDNA probe. The sequences of M2 dsRNA and of PCR products generated from Rhs 1A1 total DNA were found to be identical. Thus this report describes a fungal host containing full-length DNA copies of a dsRNA element. A major portion of the M2 dsRNA is located in the cytoplasm, whereas a smaller amount is found in mitochondria. Based on either the universal or the mitochondrial genetic code of filamentous fungi, one strand of M2 encodes a putative protein of 754 amino acids. The resulting polypeptide has all four motifs of a dsRNA viral RNA-dependent RNA polymerase (RDRP) and is phylogenetically related to the RDRP of a mitochondrial dsRNA associated with hypovirulence in strain NB631 of Cryphonectria parasitica, incitant of chestnut blight. This polypeptide also has significant sequence similarity with two domains of a pentafunctional polypeptide, which catalyzes the five central steps of the shikimate pathway in yeast and filamentous fungi.

State of hepatitis B virus DNA in leucocytes of hepatitis B patients

Hepatitis B virus (HBV) DNA in leucocytes from 50 hepatitis patients with various patterns of HBV serological markers and serum HBV DNA and 13 normal controls were examined by Southern blot hybridization with 32P-labeled 3.2 Kb HBV DNA. A free form of HBV DNA was observed in leucocytes of 8 patients, 7 of whom were positive for serum HBeAg, and in 6 patients an integrated form of HBV DNA was identified. HBV DNA was not identified in leucocytes from 13 normal controls. The free form of HBV DNA in leucocytes existed as a heterogeneous smear from 2.0 to 3.2 Kb, similar to the pattern in liver and hepatocellular carcinoma cells but different from serum HBV DNA in which the 3.2 Kb band was absent. The banding pattern of the integrated form of HBV DNA in leucocytes varied among different patients. During preparation of white blood cells and purification of HBV DNA probes, it was important to remove plasma contamination and traces of pBR322, respectively. The presence of extrachromosomal DNA sequences partially homologous to pBR322 could cause false results. The presence of a free and integrated form of HBV DNA in leucocytes is important for explaining the biology of HBV, the harbouring and replication sites of extrahepatic origin, the mechanism of recurrent infection, and the rationale of the treatment of hepatitis B.