Unobstructive Heartbeat Monitoring of Sleeping Infants and Young Children Using Sheet-Type PVDF Sensors.

Techniques for noninvasively acquiring the vital information of infants and young children are considered very useful in the fields of healthcare and medical care. An unobstructive measurement method for sleeping infants and young children under the age of 6 years using a sheet-type vital sensor with a polyvinylidene fluoride (PVDF) pressure-sensitive layer is demonstrated. The signal filter conditions to obtain the ballistocardiogram (BCG) and phonocardiogram (PCG) are discussed from the waveform data of infants and young children. The difference in signal processing conditions was caused by the physique of the infants and young children. The peak-to-peak interval (PPI) extracted from the BCG or PCG during sleep showed an extremely high correlation with the R-to-R interval (RRI) extracted from the electrocardiogram (ECG). The vital changes until awakening in infants monitored using a sheet sensor were also investigated. In infants under one year of age that awakened spontaneously, the distinctive vital changes during awakening were observed. Understanding the changes in the heartbeat and respiration signs of infants and young children during sleep is essential for improving the accuracy of abnormality detection by unobstructive sensors.

Printed Directional Bending Sensor with High Sensitivity and Low Hysteresis for Human Motion Detection and Soft Robotic Perception.

We present a high-performance flexible bending strain sensor for directional motion detection of human hands and soft robotic grippers. The sensor was fabricated using a printable porous conductive composite composed of polydimethylsiloxane (PDMS) and carbon black (CB). The utilization of a deep eutectic solvent (DES) in the ink formulation induced a phase segregation between the CB and PDMS and led to a porous structure inside the printed films after being vapored. This simple and spontaneously formed conductive architecture provided superior directional bend-sensing characteristics compared to conventional random composites. The resulting flexible bending sensors displayed high bidirectional sensitivity (gauge factor of 45.6 under compressive bending and 35.2 under tensile bending), negligible hysteresis, good linearity (>0.99), and excellent bending durability (over 10,000 cycles). The multifunctional applications of these sensors, including human motion detection, object-shape monitoring, and robotic perceptions, are demonstrated as a proof-of-concept.

Printed Composite Film with Microporous/Micropyramid Hybrid Conductive Architecture for Multifunctional Flexible Force Sensors.

Porous structures and micropatterning surfaces play a crucial role in the development of highly sensitive force sensors. However, achieving these two conductive architectures typically requires the synthesis of complex materials and expensive manufacturing processes. In this study, we introduce a novel conductive composite film featuring a microporous/micropyramid hybrid conductive architecture, which is achieved through a straightforward process of materials mixing and one-step screen printing. By utilizing a deep eutectic solvent in the ink component, micropores are induced in the printed composite, while the mesh of the screen mask acts as a template, resulting in a micropyramid film surface. We have successfully realized highly sensitive flexible force sensors (0.15 kPa-1) with multifunctional capabilities for perceiving normal force and shear force.

A Printed Flexible Humidity Sensor with High Sensitivity and Fast Response Using a Cellulose Nanofiber/Carbon Black Composite.

In the emerging Internet of Things (IoT) society, there is a significant need for low-cost, high-performance flexible humidity sensors in wearable devices. However, commercially available humidity sensors lack flexibility or require expensive and complex fabrication methods, limiting their application and widespread use. We report a high-performance printed flexible humidity sensor using a cellulose nanofiber/carbon black (CNF/CB) composite. The cellulose nanofiber enables excellent dispersion of carbon black, which facilitates the ink preparation and printing process. At the same time, its hydrophilic and porous nature provides high sensitivity and fast response to humidity. Significant resistance changes of 120% were observed in the sensor at humidity ranging from 30% RH to 90% RH, with a fast response time of 10 s and a recovery time of 6 s. Furthermore, the developed sensor also exhibited high-performance uniformity, response stability, and flexibility. A simple humidity detection device was fabricated and successfully applied to monitor human respiration and noncontact fingertip moisture as a proof-of-concept.

Control of Molecular Orientation in Organic Semiconductors Using Weak Iodine-Iodine Interactions.

Controlling the molecular orientation of materials is a key issue for improving the performance of organic semiconductor devices. Herein, we demonstrate the structure-property relationships of iodinated and noniodinated molecules based on an asymmetric thienoacene framework. The noniodinated molecule formed an antiparallel slip-stack structure with small orbital overlap between molecules. In contrast, the iodinated molecule formed a head-to-head layered-herringbone structure, and as a result, the transfer integrals became larger and the hole mobility increased significantly compared with the noniodinated material. The iodinated molecule was made into a stable and solution-processable p-type organic semiconductor with a mobility of 2.2 cm2 V-1 s-1, which was 2 orders of magnitude higher than that of the noniodinated molecule. This study reveals that controlling molecular orientations using iodine-iodine interactions is a promising strategy for accelerating the development of organic semiconductor materials.

Printed Soft Sensor with Passivation Layers for the Detection of Object Slippage by a Robotic Gripper.

Tactile sensing, particularly the detection of object slippage, is required for skillful object handling by robotic grippers. The real-time measurement and identification of the dynamic shear forces that result from slippage events are crucial for slip detection and effective object interaction. In this study, a ferroelectric polymer-based printed soft sensor for object slippage detection was developed and fabricated by screen printing. The proposed sensor demonstrated a sensitivity of 8.2 µC·cm-2 and was responsive to shear forces applied in both the parallel and perpendicular directions. An amplifier circuit, based on a printed organic thin-film transistor, was applied and achieved a high sensitivity of 0.1 cm2/V·s. Therefore, this study experimentally demonstrates the effectiveness of the proposed printable high-sensitivity tactile sensor, which could serve as part of a wearable robotic e-skin. The sensor could facilitate the production of a system to detect and prevent the slippage of objects from robotic grippers.

Printed Strain Sensor with High Sensitivity and Wide Working Range Using a Novel Brittle-Stretchable Conductive Network.

There are few reports on resistive strain sensors that exhibit both high sensitivity and a wide working range under stretching. We have newly developed a high-performance strain sensor based on a brittle-stretchable conductive network that consists of both brittle and stretchable conductive layers and is fabricated on a stretchable substrate using the screen-printing method. Adding strain usually generates structural cracks in brittle conductive layers leading to a significant increase in resistance, while a stretchable conductive layer bridges these cracks to maintain the conductive pathways under high-strain conditions. This novel conductive network endows superior electrical-mechanical performance to the strain sensors, which possess high sensitivity (gauge factor > 870) over the entire working range (∼100%). Additionally, the developed sensors showed unique anisotropic bend-sensing characteristics, which could be used to detect the bending directions. This high degree of comprehensive performance results in a strain sensor with the capability for full-range human motion detection and robotic motion sensing.

Fully Printed PEDOT:PSS-based Temperature Sensor with High Humidity Stability for Wireless Healthcare Monitoring.

Facile fabrication and high ambient stability are strongly desired for the practical application of temperautre sensor in real-time wearable healthcare. Herein, a fully printed flexible temperature sensor based on cross-linked poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) was developed. By introducing the crosslinker of (3-glycidyloxypropyl)trimethoxysilane (GOPS) and the fluorinated polymer passivation (CYTOP), significant enhancements in humidity stability and temperature sensitivity of PEDOT:PSS based film were achieved. The prepared sensor exhibited excellent stability in environmental humidity ranged from 30% RH to 80% RH, and high sensitivity of -0.77% °C-1 for temperature sensing between 25 °C and 50 °C. Moreover, a wireless temperature sensing platform was obtained by integrating the printed sensor to a printed flexible hybrid circuit, which performed a stable real-time healthcare monitoring.

A rare case of peliosis hepatis in a patient with chronic renal failure and renal cell carcinoma.

Peliosis hepatis (PH) is a rare disease characterized by the presence of sinusoidal dilation and blood-filled cysts throughout the hepatic parenchyma. We report a case of PH in a 49-year-old woman with chronic renal failure (CRF) on hemodialysis and with renal cell carcinoma (RCC). Dynamic contrast-enhanced computed tomography (CT) showed a 35-mm-diameter, hypervascular tumor in the liver and RCC in the right renal cyst. Ultrasound and superparamagnetic iron oxide-enhanced magnetic resonance imaging were also performed; however, the liver tumor could not be distinguished from the metastasis of RCC. Therefore, echo-guided biopsy of the liver tumor using an 18-G Majima needle was performed. Histological evaluation of the specimen showed irregular sinusoidal dilatation and blood-filled cavities without malignant cells. She was ultimately diagnosed with PH. Subsequently, she underwent total right nephrectomy for RCC and was diagnosed with RCC stage 1 (pT1N0M0). A follow-up CT performed 4 months after nephrectomy showed no growth of PH. Although the development of PH in patients with CRF or RCC who do not undergo renal transplantation is extremely rare, it should be considered in the differential diagnosis to distinguish PH from the metastasis of RCC.

Noninvasive Sweat-Lactate Biosensor Emplsoying a Hydrogel-Based Touch Pad.

This study is the first report demonstrating proof-of-concept for a hydrogel-based touch sensor pad used for the non-invasive extraction and detection of sweat components. The sensor device was composed of an electrochemical L-lactate biosensor covered with an agarose gel in a phosphate buffer saline. When human skin contacts the agarose gel, L-lactate in sweat was continuously extracted into the gel, followed by in-situ potentiometric detection without controlled conditions. This novel type of sweat sensor is expected to enable the simple, non-invasive daily periodic monitoring of sweat biomarkers for advanced personal healthcare methods in the future.

A case of pancreatic pseudocysts accompanied by infection, pseudoaneurysm ruptures, and pseudocystocolonic fistulae.

Pancreatic pseudocysts (PPs) can be accompanied by infection, pseudoaneurysm ruptures, and fistulae to other organs, which can be fatal without appropriate treatment. Herein, we present the case of an 82-year-old man with PPs accompanied by infection, pseudoaneurysm rupture, and pseudocystocolonic fistula that were managed via multidisciplinary treatment. Computed tomography (CT) revealed two inflamed PPs, one each in the pancreatic head and tail. He was, therefore, diagnosed with infectious PPs. The pancreatic head PP shrunk on endoscopic nasopancreatic drainage (ENPD), but the pancreatic tail PP did not. Endoscopic ultrasound (EUS)-guided transluminal drainage was performed to treat the pancreatic tail PP; his symptoms improved. However, he vomited blood at 14 day post-drainage. Angiography revealed pseudoaneurysm rupture in a left gastric artery branch. After successful angioembolization, he developed hematochezia 2 days later. We suspected re-bleeding of the pseudoaneurysm. The bleeding stopped spontaneously, but CT and radiography revealed the presence of a pseudocystocolonic fistula. Careful follow-up was performed, and he has not had any symptoms at 9 month post-discharge. We managed PP-related complications via ENPD, EUS-guided transluminal drainage, angioembolization, and careful follow-up. Infection, pseudoaneurysm rupture, and pseudocystocolonic fistula are rare, but can occur simultaneously. Therefore, clinicians should consider these complications when treating patients with PPs.

Clinical outcome of hepatocellular carcinoma can be predicted by the expression of hepatic progenitor cell markers and serum tumour markers.

The high heterogeneity of hepatocellular carcinomas (HCCs) complicates stratification of HCC patients for treatment. Therefore, it is necessary to establish a comprehensive panel of HCC biomarkers related to tumour behaviour and cancer prognosis. Resected HCCs from 251 patients were stained for hepatic progenitor cell (HPC) markers epithelial cell adhesion molecule (EpCAM), neural cell adhesion molecule (NCAM), delta-like 1 homolog (DLK1), and cytokeratin 19 (CK19). Staining patterns were analysed for their prognostic association with relapse-free survival and overall survival. α-Fetoprotein (AFP), lectin-reactive α-fetoprotein (AFP-L3), and des-γ-carboxy prothrombin (DCP) were assessed as indicators of HPC protein expression. Expression pattern of HPC markers correlated with tumour malignancy indicated by high AFP/AFP-L3 serum levels, more frequent vascular invasion, and poorer tumour differentiation. EpCAM expression, DCP ≥300 mAU/ml, age ≥60, and Child-Pugh score grade B or C were independent prognostic factors of poor outcome and were used in a new scoring system for HCC prognosis after operation. Expression of two or more HPC markers was a significant predictor of poor HCC outcome and serum levels of AFP/AFP-L3 correlated with the expression of HPC proteins. Our study paved the way for further elucidation of the association among HPC markers, serum tumour markers, and HCC clinical outcome for precision medicine.

A Printed Organic Circuit System for Wearable Amperometric Electrochemical Sensors.

Wearable sensor device technologies, which enable continuous monitoring of biological information from the human body, are promising in the fields of sports, healthcare, and medical applications. Further thinness, light weight, flexibility and low-cost are significant requirements for making the devices attachable onto human tissues or clothes like a patch. Here we demonstrate a flexible and printed circuit system consisting of an enzyme-based amperometric sensor, feedback control and amplification circuits based on organic thin-film transistors. The feedback control and amplification circuits based on pseudo-CMOS inverters were successfuly integrated by printing methods on a plastic film. This simple system worked very well like a potentiostat for electrochemical measurements, and enabled the quantitative and real-time measurement of lactate concentration with high sensitivity of 1 V/mM and a short response time of a hundred seconds.

Morphological Behavior of Printed Silver Electrodes with Protective Self-Assembled Monolayers for Electrochemical Migration.

We evaluated the electrochemical behaviors and reliability of printed silver (Ag) electrodes prepared from nanoparticle inks with the use of protective self-assembled monolayers (SAMs) under electronic bias conditions. The printed Ag electrodes were fabricated by inkjet printing on a hydrophobic substrate. The SAMs, which acted as barriers to moisture, were prepared by immersing the substrate in a pentafluorobenzenethiol solution at ambient temperature (25 °C). We investigated the electrochemical migration phenomenon using the water drop method, and the results showed that the formation of dendrites connecting the cathode and the anode, which can affect the electrochemical reliability of an electric device, was suppressed in the presence of the SAMs. The time before short circuit occurred was found to depend on the spacing between the electrodes, i.e., 130 s, when the distance between the electrodes was 200 µm in the presence of an SAM. We demonstrated that Ag electrodes treated using the procedure described in this work suppress the occurrence of electrical short circuits caused by Ag dendrite formation and thus their electrochemical properties are substantially improved.

Author Correction: Fully Printed Wearable Vital Sensor for Human Pulse Rate Monitoring using Ferroelectric Polymer.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Fully Printed Wearable Vital Sensor for Human Pulse Rate Monitoring using Ferroelectric Polymer.

The ability to monitor subtle changes in vital and arterial signals using flexible devices attached to the human skin can be valuable for the detection of various health conditions such as cardiovascular disease. Conventional Si device technologies are being utilised in traditional clinical systems; however, its fabrication is not easy owing to the difficulties in adapting to conventional processes. Here, we present the development of a fully printed, wearable, ferroelectric-polymer vital sensor for monitoring the human pulse wave/rate on the skin. This vital sensor is compact, thin, sufficiently flexible, and conforms to the skin while providing high pressure sensitivity, fast response time, superior operational stability, and excellent mechanical fatigue properties. Moreover, the vital sensor is connected to a communication amplifier circuit for monitoring the pulse waves with a wireless sensing system. This sensor system can realise the development of new healthcare devices for wearable sensor applications.

A Printed Organic Amplification System for Wearable Potentiometric Electrochemical Sensors.

Electrochemical sensor systems with integrated amplifier circuits play an important role in measuring physiological signals via in situ human perspiration analysis. Signal processing circuitry based on organic thin-film transistors (OTFTs) have significant potential in realizing wearable sensor devices due to their superior mechanical flexibility and biocompatibility. Here, we demonstrate a novel potentiometric electrochemical sensing system comprised of a potassium ion (K+) sensor and amplifier circuits employing OTFT-based pseudo-CMOS inverters, which have a highly controllable switching voltage and closed-loop gain. The ion concentration sensitivity of the fabricated K+ sensor was 34 mV/dec, which was amplified to 160 mV/dec (by a factor of 4.6) with high linearity. The developed system is expected to help further the realization of ultra-thin and flexible wearable sensor devices for healthcare applications.

Effect of double platinum agents, combination of miriplatin-transarterial oily chemoembolization and cisplatin-hepatic arterial infusion chemotherapy, in patients with hepatocellular carcinoma: Report of two cases.

Hepatocellular carcinoma (HCC) is one of the most common cancers and the third highest cause of cancer-associated mortality worldwide. The treatment of HCC is complicated by its variable biological behavior and the frequent coexistence of chronic liver disease, particularly cirrhosis. To date, multiple treatment modalities have been developed according to the stage of the tumor and the hepatic functional reserve, including transarterial treatments such as transarterial chemoembolization, transarterial oily chemoembolization (TOCE), and hepatic arterial infusion chemotherapy (HAIC). We conducted a phase I and II study of the combination therapy with double platinum agents, miriplatin and cisplatin, and confirmed its safety and efficacy. Here, we describe two cases of unresectable HCC who were successfully treated by miriplatin-TOCE/cisplatin-HAIC combination therapy, resulting in complete responses with no significant adverse events. This report will provide that the combination therapy can be the therapeutic option for HCC patients in the advanced stage.

Asymmetric Alkylthienyl Thienoacenes Derived from Anthra[2,3-b]thieno[2,3-d]thiophene for Solution-Processable Organic Semiconductors.

Anthra[2,3-b]thieno[2,3-d]thiophene (ATT), which is readily accessed from thieno[3,2-b]thiophene and 2,3-naphthalenedicarboxylic anhydride, allows for selective substitution at the terminal thiophene ring, thereby providing asymmetric monoalkyl and monoalkylthienyl thienoacenes. Alkyl-substituted ATT (CnATT, n = 6, 8, 10, 12) has characteristics of a p-type field-effect transistor (FET), with mobility on the order of 0.01 cm2 V-1 s-1, which is the same as ATT. Conversely, alkylthienyl-substituted ATT (CnTATT, n = 6, 8, 10, 12) exhibits FET mobility of 0.15-1.9 cm2 V-1 s-1, which is up to 2 orders of magnitude greater than that of ATT and CnATT. Moreover, CnTATT forms crystalline thin films both by spin coating and drop casting, and C8TATT in particular exhibits a mobility of up to 1.6 cm2 V-1 s-1 in the drop-cast film. X-ray diffraction patterns of CnTATT thin films indicate that the molecules become oriented edge-on at the substrate surface with a highly ordered structure in the in-plane direction. Accordingly, CnTATT serves as a solution-processable p-type organic field-effect transistor, where the additional thiophene ring contributes significantly to the highly ordered thin-film structure and the high carrier mobility.

Tumor markers for early diagnosis for brain metastasis of hepatocellular carcinoma: A case series and literature review for effective loco-regional treatment.

Intrahepatic lesions of hepatocellular carcinoma (HCC) have been controlled by significant advances in treatment using loco-regional therapies, including, surgery, ablative therapy, catheter-based chemotherapy, and embolization. Consequently, the number of patients with extrahepatic metastatic lesions has increased. Their prognosis remains poor with approximately <1 y of survival from the time of diagnosis. A molecularly targeted drug, sorafenib, have been used to treat extrahepatic lesions and shown the prolonged survival time. However, the therapeutic benefit for the brain metastasis remains unclear, since it causes intratumor bleeding leading to the severe brain damage. No guidelines for the brain metastasis of HCC have been developed to date due to the shortage of the experiences and evidences. Therefore, the development of standard therapy for brain metastasis following the early diagnosis is essential by accumulating the information of clinical courses and evidences. For this purpose, we reviewed cases of HCC brain metastasis reported to date and analyzed additional 8 cases from our hospital, reviewing 592 advanced HCC cases to estimate the possible metastatic lesions in the brain. With careful review of cases and literature, we suggest that the cases with lung metastasis with increase tendency of tumor markers within recent 3-6 months have higher risks of brain metastasis. Therefore, they should be carefully followed by imaging modalities. In addition, the loco-regional treatment, including surgical resection and radiation therapy should be performed for better prognosis by preventing re-bleeding from the tumors.