Wearable wireless continuous vital signs monitoring on the general ward.

PURPOSE OF REVIEW: Wearable wireless sensors for continuous vital signs monitoring (CVSM) offer the potential for early identification of patient deterioration, especially in low-intensity care settings like general wards. This study aims to review advances in wearable CVSM - with a focus on the general ward - highlighting the technological characteristics of CVSM systems, user perspectives and impact on patient outcomes by exploring recent evidence. RECENT FINDINGS: The accuracy of wearable sensors measuring vital signs exhibits variability, especially notable in ambulatory patients within hospital settings, and standard validation protocols are lacking. Usability of CMVS systems is critical for nurses and patients, highlighting the need for easy-to-use wearable sensors, and expansion of the number of measured vital signs. Current software systems lack integration with hospital IT infrastructures and workflow automation. Imperative enhancements involve nurse-friendly, less intrusive alarm strategies, and advanced decision support systems. Despite observed reductions in ICU admissions and Rapid Response Team calls, the impact on patient outcomes lacks robust statistical significance. SUMMARY: Widespread implementation of CVSM systems on the general ward and potentially outside the hospital seems inevitable. Despite the theoretical benefits of CVSM systems in improving clinical outcomes, and supporting nursing care by optimizing clinical workflow efficiency, the demonstrated effects in clinical practice are mixed. This review highlights the existing challenges related to data quality, usability, implementation, integration, interpretation, and user perspectives, as well as the need for robust evidence to support their impact on patient outcomes, workflow and cost-effectiveness.

Rapid and on-site wireless immunoassay of respiratory virus aerosols via hydrogel-modulated resonators.

Rapid and accurate detection of respiratory virus aerosols is highlighted for virus surveillance and infection control. Here, we report a wireless immunoassay technology for fast (within 10 min), on-site (wireless and battery-free), and sensitive (limit of detection down to fg/L) detection of virus antigens in aerosols. The wireless immunoassay leverages the immuno-responsive hydrogel-modulated radio frequency resonant sensor to capture and amplify the recognition of virus antigen, and flexible readout network to transduce the immuno bindings into electrical signals. The wireless immunoassay achieves simultaneous detection of respiratory viruses such as severe acute respiratory syndrome coronavirus 2, influenza A H1N1 virus, and respiratory syncytial virus for community infection surveillance. Direct detection of unpretreated clinical samples further demonstrates high accuracy for diagnosis of respiratory virus infection. This work provides a sensitive and accurate immunoassay technology for on-site virus detection and disease diagnosis compatible with wearable integration.

Lead-free dual-frequency ultrasound implants for wireless, biphasic deep brain stimulation.

Ultrasound-driven bioelectronics could offer a wireless scheme with sustainable power supply; however, current ultrasound implantable systems present critical challenges in biocompatibility and harvesting performance related to lead/lead-free piezoelectric materials and devices. Here, we report a lead-free dual-frequency ultrasound implants for wireless, biphasic deep brain stimulation, which integrates two developed lead-free sandwich porous 1-3-type piezoelectric composite elements with enhanced harvesting performance in a flexible printed circuit board. The implant is ultrasonically powered through a portable external dual-frequency transducer and generates programmable biphasic stimulus pulses in clinically relevant frequencies. Furthermore, we demonstrate ultrasound-driven implants for long-term biosafety therapy in deep brain stimulation through an epileptic rodent model. With biocompatibility and improved electrical performance, the lead-free materials and devices presented here could provide a promising platform for developing implantable ultrasonic electronics in the future.

Design and fabrication of a microstrip triplexer with wide flat channels for multi-band 5G applications.

In this paper, a new microstrip triplexer is designed to work at 2.5 GHz, 4.4 GHz and 6 GHz for mid-band 5G applications. All channels are flat with three low group delays (GDs) of 0.84 ns, 0.75 ns and 0.49 ns, respectively. Compared to the previously reported works, the proposed triplexer has the minimum group delay. The designed triplexer has 18.2%, 13.7%, 23.6% fractional bandwidths (FBW%) at 2.5 GHz, 4.4 GHz and 6 GHz, respectively. The obtained insertion losses (ILs) are low at all channels. These features are obtained without a noticeable increase in the overall size. A novel and simple resonator is used to design the proposed triplexer, which includes two pairs of coupled lines combined with a shunt stub. A perfect mathematical analysis is performed to find the resonator behavior and the layout optimization. The type of shunt stub is determined mathematically. Also, the smallness or largeness of some important physical dimensions is determined using the proposed mathematical analysis. Finally, the designed triplexer is fabricated and measured, where the measurement results verify the simulations.

Developing a Novel Prosthetic Hand with Wireless Wearable Sensor Technology Based on User Perspectives: A Pilot Study.

Myoelectric hands are beneficial tools in the daily activities of people with upper-limb deficiencies. Because traditional myoelectric hands rely on detecting muscle activity in residual limbs, they are not suitable for individuals with short stumps or paralyzed limbs. Therefore, we developed a novel electric prosthetic hand that functions without myoelectricity, utilizing wearable wireless sensor technology for control. As a preliminary evaluation, our prototype hand with wireless button sensors was compared with a conventional myoelectric hand (Ottobock). Ten healthy therapists were enrolled in this study. The hands were fixed to their forearms, myoelectric hand muscle activity sensors were attached to the wrist extensor and flexor muscles, and wireless button sensors for the prostheses were attached to each user's trunk. Clinical evaluations were performed using the Simple Test for Evaluating Hand Function and the Action Research Arm Test. The fatigue degree was evaluated using the modified Borg scale before and after the tests. While no statistically significant differences were observed between the two hands across the tests, the change in the Borg scale was notably smaller for our prosthetic hand (p = 0.045). Compared with the Ottobock hand, the proposed hand prosthesis has potential for widespread applications in people with upper-limb deficiencies.

Performance Assessment for the Validation of Wireless Communication Engines in an Innovative Wearable Monitoring Platform.

In today's health-monitoring applications, there is a growing demand for wireless and wearable acquisition platforms capable of simultaneously gathering multiple bio-signals from multiple body areas. These systems require well-structured software architectures, both to keep different wireless sensing nodes synchronized each other and to flush collected data towards an external gateway. This paper presents a quantitative analysis aimed at validating both the wireless synchronization task (implemented with a custom protocol) and the data transmission task (implemented with the BLE protocol) in a prototype wearable monitoring platform. We evaluated seven frequencies for exchanging synchronization packets (10 Hz, 20 Hz, 30 Hz, 40 Hz, 50 Hz, 60 Hz, 70 Hz) as well as two different BLE configurations (with and without the implementation of a dynamic adaptation of the BLE Connection Interval parameter). Additionally, we tested BLE data transmission performance in five different use case scenarios. As a result, we achieved the optimal performance in the synchronization task (1.18 ticks as median synchronization delay with a Min-Max range of 1.60 ticks and an Interquartile range (IQR) of 0.42 ticks) when exploiting a synchronization frequency of 40 Hz and the dynamic adaptation of the Connection Interval. Moreover, BLE data transmission proved to be significantly more efficient with shorter distances between the communicating nodes, growing worse by 30.5% beyond 8 m. In summary, this study suggests the best-performing network configurations to enhance the synchronization task of the prototype platform under analysis, as well as quantitative details on the best placement of data collectors.

Gait Pattern Analysis: Integration of a Highly Sensitive Flexible Pressure Sensor on a Wireless Instrumented Insole.

Gait phase monitoring wearable sensors play a crucial role in assessing both health and athletic performance, offering valuable insights into an individual's gait pattern. In this study, we introduced a simple and cost-effective capacitive gait sensor manufacturing approach, utilizing a micropatterned polydimethylsiloxane dielectric layer placed between screen-printed silver electrodes. The sensor demonstrated inherent stretchability and durability, even when the electrode was bent at a 45-degree angle, it maintained an electrode resistance of approximately 3 Ω. This feature is particularly advantageous for gait monitoring applications. Furthermore, the fabricated flexible capacitive pressure sensor exhibited higher sensitivity and linearity at both low and high pressure and displayed very good stability. Notably, the sensors demonstrated rapid response and recovery times for both under low and high pressure. To further explore the capabilities of these new sensors, they were successfully tested as insole-type pressure sensors for real-time gait signal monitoring. The sensors displayed a well-balanced combination of sensitivity and response time, making them well-suited for gait analysis. Beyond gait analysis, the proposed sensor holds the potential for a wide range of applications within biomedical, sports, and commercial systems where soft and conformable sensors are preferred.

Postoperative Long-Term Monitoring of Mechanical Characteristics in Reconstructed Soft Tissues Using Biocompatible, Immune-Tolerant, and Wireless Electronic Sutures.

Accurate postoperative assessment of varying mechanical properties is crucial for customizing patient-specific treatments and optimizing rehabilitation strategies following Achilles tendon (AT) rupture and reconstruction surgery. This study introduces a wireless, chip-less, and immune-tolerant in vivo strain-sensing suture designed to continuously monitor mechanical stiffness variations in the reconstructed AT throughout the healing process. This innovative sensing suture integrates a standard medical suturing thread with a wireless fiber strain-sensing system, which incorporates a fiber strain sensor and a double-layered inductive coil for wireless readout. The winding design of Au nanoparticle-based fiber electrodes and a hollow core contribute to the fiber strain sensor's high sensitivity (factor of 6.2 and 15.1 pF for revised sensitivity), negligible hysteresis, and durability over 10,000 stretching cycles. To ensure biocompatibility and immune tolerance during extended in vivo periods, an antibiofouling lubricant layer was applied to the sensing suture. Using this sensing system, we successfully monitored the strain responses of the reconstructed AT in an in vivo porcine model. This facilitated the postoperative assessment of mechanical stiffness variations through a well-established analytical model during the healing period.

Monolithically Defined Wireless Fully Implantable Nervous System Interfaces.

ConspectusEvolution of implantable neural interfaces is critical in addressing the challenges in understanding the fundamental working principles and therapeutic applications for central and peripheral nervous systems. Traditional approaches utilizing hermetically sealed, rigid electronics and detached electrodes face challenges in power supply, encapsulation, channel count, dispersed application location, and modality. Employing thin-film, wirelessly powered devices is promising to expand capabilities. Devices that forego bulky power supplies, favoring a configuration where electronics are integrated directly onto thin films, reduce displacement volumes for seamless, fully implantable interfaces with high energy availability and soft mechanics to conform to the neuronal target. We discuss 3 device architectures: (1) Highly miniaturized devices that merge electronics and neural interfaces into a single, injectable format; (2) Interfaces that consolidate power, computation, and neural connectivity on a thin sheet applied directly to the target area; (3) A spatially dislocated approach where power and computation are situated subdermally, connected via a thin interconnect to the neural interface.Each has advantages and constraints in terms of implantation invasiveness, power capturing efficiency, and directional sensitivity of power delivery. In powering these devices, near-field power delivery emerges as the most implemented technique. Key parameters are size and volume of primary and secondary antennas, which determine coupling efficiency and power delivery. Based on application requirements, ranging from small to large animal models, subjects require system level designs. Material strategies play a crucial role; monolithic designs, with materials like polyimide substrates, enable scalability with high performance. This contrasts with established hermetic encapsulation approaches that use a stainless steel or titanium box with passthroughs that result in large tissue displacements and prohibit intimate integration with target organ systems. Encapsulation, particularly with parylene, enables longevity and effectiveness; more research is needed to enable human lifetime operation. Implant-to-ambient device communication, focusing on strategies compatible with well-established standards and off-the-shelf electronics, is discussed with the goal of enabling seamless system integration, reliability, and scalability. The interface with the central nervous system is explored through various wireless, battery-free devices capable of both stimulation (electrical and optogenetic) and recording (photometric and electrochemical). These devices show advanced capabilities for chronic studies and insights into neural dynamics. In the peripheral nervous system, stimulation devices for applications, such as spinal and muscle stimulation, are discussed. The challenges lie in the mechanical and electrochemical durability. Examples that successfully navigate these challenges offer solutions for chronic studies in this domain. The potential of wireless, fully implantable nervous system interfaces using near field resonant power transfer is characterized by monolithically defined device architecture, providing a significant leap toward seamless access to the central and peripheral nervous systems. New avenues for research and therapeutic applications supporting a multimodal and multisite approach to neuromodulation with a high degree of connectivity and a holistic approach toward deciphering and supplementing the nervous system may enable recovery and treatment of injury and chronic disease.

Temperature Self-Compensating Intelligent Wireless Measuring Contact Lens for Quantitative Intraocular Pressure Monitoring.

Flexible bioelectronic devices that can perform real-time and accurate intraocular pressure (IOP) monitoring in both clinical and home settings hold significant implications for the diagnosis and treatment of glaucoma, yet they face challenges due to the open physiological environment of the ocular. Herein, we develop an intelligent wireless measuring contact lens (WMCL) incorporating a dual inductor-capacitor-resistor (LCR) resonant system to achieve temperature self-compensation for quantitative IOP monitoring in different application environments. The WMCL utilizes a compact circuitry design, which enables the integration of low-frequency and high-frequency resonators within a single layer of a sensing circuit without causing visual impairment. Mechanically guided microscale 3D encapsulation strategy combined with flexible circuit printing techniques achieves the surface-adaptive fabrication of the WMCL. The specific design of frequency separation imparts distinct temperature response characteristics to the dual resonators, and the linear combination of the dual resonators can eliminate the impact of temperature variations on measurement accuracy. The WMCL demonstrates outstanding sensitivity and linearity in monitoring the IOP of porcine eyes in vitro while maintaining satisfactory measurement accuracy even with internal temperature variations exceeding 10 °C. Overcoming the impact of temperature variations on IOP monitoring from the system level, the WMCL showcases immense potential as the next generation of all-weather IOP monitoring devices.

Design of a mid-field wireless power transmission system for deep-tissue implants.

BACKGROUND: Implantable medical devices are being valued as one of the developments of wireless biomedical technology. OBJECTIVE: This paper presents a mid-field wireless power transmission (WPT) system, which is designed for implantable applications and operates at the 2.40-2.48 GHz band of Industrial, Scientific, and Medical (ISM). METHODS: A new compact transmitter structure is proposed, and a small 4-C planar ring antenna is designed as the receiving element. A measurement setup is fulfilled on porcine tissues to verify the power transmission system. RESULTS: The experimental results show that the operating bandwidth is 2.2-2.62 GHz and the transmission coefficient can reach -26.32 dB at a distance of 50 mm. The effects of tissue differences, placement depth, and different transmission distances were also measured. The displacement and deflection tolerances between the transmitter and the implant receiver also have good performance. In the safety standard of specific absorption rate, for the 1 W output power from the mid-field transmitter, the receiving power of the implantable antenna at the mid-field distance can reach 79.6 mW. CONCLUSION: With measurements of different implantation and transmission distance on pork, the mid-field power transmission efficiency is proven and shows the high performance of the system.

Implantable bioelectronic systems for early detection of kidney transplant rejection.

Early-stage organ transplant rejection can be difficult to detect. Percutaneous biopsies occur infrequently and are risky, and measuring biomarker levels in blood can lead to false-negative and -positive outcomes. We developed an implantable bioelectronic system capable of continuous, real-time, long-term monitoring of the local temperature and thermal conductivity of a kidney for detecting inflammatory processes associated with graft rejection, as demonstrated in rat models. The system detects ultradian rhythms, disruption of the circadian cycle, and/or a rise in kidney temperature. These provide warning signs of acute kidney transplant rejection that precede changes in blood serum creatinine/urea nitrogen by 2 to 3 weeks and approximately 3 days for cases of discontinued and absent administration of immunosuppressive therapy, respectively.

Sub-1.4 cm3 capsule for detecting labile inflammatory biomarkers in situ.

Transient molecules in the gastrointestinal tract such as nitric oxide and hydrogen sulfide are key signals and mediators of inflammation. Owing to their highly reactive nature and extremely short lifetime in the body, these molecules are difficult to detect. Here we develop a miniaturized device that integrates genetically engineered probiotic biosensors with a custom-designed photodetector and readout chip to track these molecules in the gastrointestinal tract. Leveraging the molecular specificity of living sensors1, we genetically encoded bacteria to respond to inflammation-associated molecules by producing luminescence. Low-power electronic readout circuits2 integrated into the device convert the light emitted by the encapsulated bacteria to a wireless signal. We demonstrate in vivo biosensor monitoring in the gastrointestinal tract of small and large animal models and the integration of all components into a sub-1.4 cm3 form factor that is compatible with ingestion and capable of supporting wireless communication. With this device, diseases such as inflammatory bowel disease could be diagnosed earlier than is currently possible, and disease progression could be more accurately tracked. The wireless detection of short-lived, disease-associated molecules with our device could also support timely communication between patients and caregivers, as well as remote personalized care.

Neural Network Based IRSs-UEs Association and IRSs Optimal Placement in Multi IRSs Aided Wireless System.

Implementing intelligent reflecting surfaces (IRSs), in high frequency based beyond 5G networks, has become a necessity to overcome the harsh blockage issues that exist in these bands. IRSs can supply user equipment (UEs) with multi alternative virtual line of sight (LOS) links, hence enhancing the spectral efficiency (SE) of the system. As a result of deploying multi IRSs as communication assistants, the step of IRSs-UEs association is required to optimally assign each UE to its best IRS; consideration of the interference between different links is needed, to maximize the system performance. However, this process will be a time and power consuming problem, if conventional schemes, which exhaustively search all possible association patterns to find the optimum one for communication, is adapted. Although iterative search based schemes can reduce this complexity, they still need feedback signaling in real time. Hence, they will be inefficient in terms of power consumption and delay. Moreover, optimal placement of the multi-IRSs in the network, to enlarge the system performance, is still an open issue and needs to be studied. Consequently, in this paper, to handle the IRSs-UEs association problem, we propose a neural network (NN) based scheme using a multi-IRSs aided multi input multi output (MIMO) system. In this system, the estimated angles of arrival (AoAs) of UEs are used as input features for the NN, which is trained to associate each UE to its best IRS based on this information; then, within each IRS, passive beamforming is performed. Adapting this NN in online mode guarantees obtaining better performance while relaxing the complexity of association and increasing response time, giving a performance comparable to the exhaustive and iterative search based schemes. The proposed NN based scheme determines the association pattern without searching or feedback signals. Moreover, the proposed approach maintains the system SE nearly similar to the optimum performance obtained by the conventional scheme. Secondly, a criterion is suggested for optimal deployment of multi IRSs in the network, depending on maximizing the average summation UEs signal-to-interference-plus-noise ratio (SINR). Numerical results prove that this strategy outperforms a reference one, which aims to guarantee certain performance by maximizing minimum UE SINR. In contrast the proposed strategy achieves better system and per UE spectral efficiency.

Research on Coverage Optimization in a WSN Based on an Improved COOT Bird Algorithm.

To address the problems of uneven distribution and low coverage of wireless sensor network (WSN) nodes in random deployment, a node coverage optimization strategy with an improved COOT bird algorithm (COOTCLCO) is proposed. Firstly, the chaotic tent map is used to initialize the population, increase the diversity of the population, and lay the foundation for the global search for the optimal solutions. Secondly, the Lévy flight strategy is used to perturb the individual positions to improve the search range of the population. Thirdly, Cauchy mutation and an opposition-based learning strategy are fused to perturb the optimal solutions to generate new solutions and enhance the ability of the algorithm to jump out of the local optimum. Finally, the COOTCLCO algorithm is applied to WSN coverage optimization problems. Simulation results show that COOTCLCO has a faster convergence speed and better search accuracy than several other typical algorithms on 23 benchmark test functions; meanwhile, the coverage rate of the COOTCLCO algorithm is increased by 9.654%, 13.888%, 6.188%, 5.39%, 1.31%, and 2.012% compared to particle swarm optimization (PSO), butterfly optimization algorithm (BOA), seagull optimization algorithm (SOA), whale optimization algorithm (WOA), Harris hawks optimization (HHO), and bald eagle search (BES), respectively. This means that in terms of coverage optimization effect, COOTCLCO can obtain a higher coverage rate compared to these algorithms. The experimental results demonstrate that COOTCLCO can effectively improve the coverage rate of sensor nodes and improve the distribution of nodes in WSN coverage optimization problems.

Remote control of the heart and beyond.

A resorbable closed-loop sensor-actuator implant can temporarily control heart rate.

TBISTAT: An open-source, wireless portable, electrochemical impedance spectroscopy capable potentiostat for the point-of-care detection of S100B in plasma samples.

Point-of-Care (POC) testing for biomarker detection demands techniques that are easy to use, readily available, low-cost, and with rapid response times. This paper describes the development of a fully open-source, modular, wireless, battery-powered, smartphone-controlled, low-cost potentiostat capable of conducting electrochemical impedance spectroscopy for the electrochemical detection of the S100B protein captured in an ANTI-S100B functionalized thin-film gold interdigitated electrode platform to support traumatic brain injury diagnosis and treatment. EIS results from the developed potentiostat were validated with a commercial benchtop potentiostat by comparing impedance magnitude and phase values along the EIS frequency range. In addition, an experimental design was performed for detecting S100B in spiked human plasma samples with S100B concentrations of clinical utility, and a calibration curve was found for quantifying S100B detection. No statistically significant differences were found between EIS results from the developed potentiostat and the commercial potentiostat. Statistically significant differences in the changes in charge transfer resistance signal between each tested S100B concentration (p < 0.05) were found, with a limit of detection of 35.73 pg/mL. The modularity of the proposed potentiostat allows easier component changes according to the application demands in power, frequency excitation ranges, wireless communication protocol, signal amplification and transduction, precision, and sampling frequency of ADC, among others, when compared to state-of-the-art open-source EIS potentiostats. In addition, the use of minimal, easy acquirable open-source hardware and software, high-level filtering, accurate ADC, Fast Fourier Transform with low spectral leakage, wireless communication, and the simple user interface provides a framework for facilitating EIS analysis and developing new affordable instrumentation for POC biosensors integrated systems.

Improvement of DBR routing protocol in underwater wireless sensor networks using fuzzy logic and bloom filter.

Routing protocols for underwater wireless sensor networks (UWSN) and underwater Internet of Things (IoT_UWSN) networks have expanded significantly. DBR routing protocol is one of the most critical routing protocols in UWSNs. In this routing protocol, the energy consumption of the nodes, the rate of loss of sent packets, and the rate of drop of routing packets due to node shutdown have created significant challenges. For this purpose, in a new scenario called FB-DBR, clustering is performed, and fuzzy logic and bloom filter are used in each cluster's new routing protocol in underwater wireless sensor networks. Due to the fuzzy nature of the parameters used in DBR, better results are obtained and bloom filters are used in routing tables to compensate for the deceleration. as the average number of accesses to routing table entries, dead nodes, Number of Packets Sent to Base Station (BS), Number of Packets Received at BS, Packet Dropped, and Remaining Energy has improved significantly.

Algorithm for wireless sensor networks in ginseng field in precision agriculture.

In the research on energy-efficient networking methods for precision agriculture, a hot topic is the energy issue of sensing nodes for individual wireless sensor networks. The sensing nodes of the wireless sensor network should be enabled to provide better services with limited energy to support wide-range and multi-scenario acquisition and transmission of three-dimensional crop information. Further, the life cycle of the sensing nodes should be maximized under limited energy. The transmission direction and node power consumption are considered, and the forward and high-energy nodes are selected as the preferred cluster heads or data-forwarding nodes. Taking the cropland cultivation of ginseng as the background, we put forward a particle swarm optimization-based networking algorithm for wireless sensor networks with excellent performance. This algorithm can be used for precision agriculture and achieve optimal equipment configuration in a network under limited energy, while ensuring reliable communication in the network. The node scale is configured as 50 to 300 nodes in the range of 500 × 500 m2, and simulated testing is conducted with the LEACH, BCDCP, and ECHERP routing protocols. Compared with the existing LEACH, BCDCP, and ECHERP routing protocols, the proposed networking method can achieve the network lifetime prolongation and mitigate the decreased degree and decreasing trend of the distance between the sensing nodes and center nodes of the sensor network, which results in a longer network life cycle and stronger environment suitability. It is an effective method that improves the sensing node lifetime for a wireless sensor network applied to cropland cultivation of ginseng.