A wearable, flexible sensor for real-time, home monitoring of sleep apnea.

A flexible sensor that can be attached to the body to collect vital data wirelessly enables real-time human healthcare management. One potential application for home-use healthcare devices is monitoring of sleep conditions to diagnose sleep apnea syndrome. Such data are not readily gathered using conventional tools, owing to the bulk and cost of instrumentation. In order to monitor respiration at home, it is necessary to improve sensing performance and long-term stability of the sensors without sacrificing wearability and comfortability. To build a platform for wireless home-use respiration monitoring, this study develops a mask-borne flexible humidity sensor using ZnIn2S4 nanosheets as a humidity-sensitive material with high sensitivity and stability for more than 150 h. As proof-of-concept, long-term wireless respiration monitoring is demonstrated during sleep to identify symptoms of sleep apnea in wearers.

All trans retinoic acid alleviates coronary stenosis by regulating smooth muscle cell function in a mouse model of Kawasaki disease.

Coronary artery (CA) stenosis is a detrimental and often life-threatening sequela in Kawasaki disease (KD) patients with coronary artery aneurysm (CAA). Therapeutic strategies for these patients have not yet been established. All-trans-retinoic acid (atRA) is a modulator of smooth muscle cell functions. The purpose of this study was to investigate the effect of atRA on CA stenosis in a mouse model of KD. Lactobacillus casei cell wall extract (LCWE) was intraperitoneally injected into 5-week-old male C57BL/6 J mice to induce CA stenosis. Two weeks later, the mice were orally administered atRA (30 mg/kg) 5 days per week for 14 weeks (LCWE + atRA group, n = 7). Mice in the untreated group (LCWE group, n = 6) received corn oil alone. Control mice were injected with phosphate-buffered saline (PBS, n = 5). Treatment with atRA significantly suppressed CA inflammation (19.3 ± 2.8 vs 4.4 ± 2.8, p < 0.0001) and reduced the incidence of CA stenosis (100% vs 18.5%, p < 0.05). In addition, atRA suppressed the migration of human coronary artery smooth muscle cells (HCASMCs) induced by platelet-derived growth factor subunit B homodimer (PDGF-BB). In conclusion, atRA dramatically alleviated CA stenosis by suppressing SMC migration. Therefore, it is expected to have clinical applications preventing CA stenosis in KD patients with CAA.

Wireless and Flexible Skin Moisture and Temperature Sensor Sheets toward the Study of Thermoregulator Center.

A disorder in the thermoregulator center in a human body leads to some potential diseases such as fever and hyperthyroidism. To predict these diseases early, monitoring the health condition of the human body due to the influence of thermoregulation disorders is important. Although extensive works are performed on sweat-rate detection by constructing microfluidic channels, skin-moisture evaporation before sweating remains unknown. This work proposes a wireless and flexible sensor sheet to investigate the thermoregulatory responses of different people under cold stimulation and exercise by measuring the temperature and moisture variations on the finger skin. An integrated flexible sensor system consists of a ZnIn2 S4 nanosheet-based humidity sensor and carbon nanotube/SnO2 temperature sensor. The results exhibit distinct thermoregulation abilities of five volunteers. Interestingly, the sudden increase in finger moisture that results from the excitation by the sympathetic nerve is observed during the cold-stimulus test. Although further studies are required to predict the potential diseases resulted from thermoregulation disorders in human body, this study provides a possibility of continuous and real-time monitoring of thermoregulatory activities via skin moisture and temperature detection using a flexible sensor sheet.

Application of Genome-Wide DNA Methylation Analysis to Differentiate a Case of Radiation-Induced Glioblastoma From Late-Relapsed Medulloblastoma.

Recurrent medulloblastoma can be difficult to diagnose with conventional diagnostic methods because other lesions mimic tumor relapse, particularly at later stages. We report 2 cases of medulloblastoma, both of which seemed to develop late recurrences. Case 1 was a 6-year-old girl who had a medulloblastoma with focal desmoplasia. She was in complete remission for 9 years after treatment but developed an intradural lesion in her thoracic spine, which was pathologically confirmed as tumor recurrence by biopsy. Case 2 was a 10-year-old girl who had a nonmetastatic medulloblastoma. She developed a left cerebellar mass 5 years after the initial diagnosis; the pathological diagnosis was tumor relapse. We performed t-distributed stochastic neighbor embedding of the methylation data from these cases and reference data. In contrast to the consistency of methylation profiling and copy number abnormalities between primary and recurrent tumors of Case 1, the analysis of the recurrent tumor in Case 2 was distinct from medulloblastomas and clustered with "IDH-wild type glioblastomas," suggesting that the recurrent tumor was a radiation-induced glioblastoma. This report highlights the clinical utility of molecular genetic/epigenetic analysis combined with a standard diagnostic approach to confirm the diagnosis of brain tumor recurrence.

Multimodal Wearable Sensor Sheet for Health-Related Chemical and Physical Monitoring.

Continuous multiple data health monitoring has high potential to detect abnormal conditions or early stages of diseases in the future. To monitor a continuous small vital signal, one of the promising architectures is an attachable flexible multimodal sensor system, which can detect multiple health conditions from the skin surface. Recent breakthroughs have realized continuous sweat chemicals or physical conditions using flexible sensors. However, multimodal sensor integration to monitor chemical and physical information simultaneously and precisely is still a challenge. In this study, we present a multimodal wearable sensor sheet, which allows us to monitor sweat glucose, electrocardiograms, and skin temperature. Furthermore, to prevent the accumulation of glucose on the sensor surface for precise monitoring, a fluidic channel is also integrated to refresh the sweat from the sensor surface, resulting in the precise measurement of chemical substances in real time. This multimodal and flexible sensor platform takes a significant step toward realizing wearable healthcare applications to diagnose the early stages of diseases in advance.

A Wearable Body Condition Sensor System with Wireless Feedback Alarm Functions.

Emerging feedback systems based on tracking body conditions can save human lives. In particular, vulnerable populations such as disabled people, elderly, and infants often require special care. For example, the high global mortality of infants primarily owing to sudden infant death syndrome while sleeping makes request for extraordinary attentions in neonatal intensive care units or daily lives. Here, a versatile laser-induced graphene (LIG)-based integrated flexible sensor system, which can wirelessly monitor the sleeping postures, respiration rate, and diaper moisture with feedback alarm notifications, is reported. A tilt sensor based on confining a liquid metal droplet inside a cavity can track at least 18 slanting orientations. A rapid and scalable laser direct writing method realizes LIG patterning in both the in-plane and out-of-plane configurations as well as the formation of nonstick conductive structures to the liquid metal. By rationally merging the LIG-based tilt, strain, and humidity sensors on a thin flexible film, the multimodal sensor device is applied to a diaper as a real-time feedback tracking system of the sleeping posture, respiration, and wetness toward secure and comfortable lives. User-friendly interfaces, which incorporate alarming functions, provide timely feedback for caregivers tending to vulnerable populations with limited self-care capabilities.

Highly stable Pd/HNb3O8-based flexible humidity sensor for perdurable wireless wearable applications.

Real-time, daily health monitoring can provide large amounts of patient data, which may greatly improve the likelihood of diagnosing health conditions at an early stage. One potential sensor is a flexible humidity sensor to monitor moisture and humidity information such as dehydration. However, achieving a durable functional nanomaterial-based flexible humidity sensor remains a challenge due to partial desorption of water molecules during the recovery process, especially at high humidities. In this work, we demonstrate a highly stable resistive-type Pd/HNb3O8 humidity sensor, which exhibits a perdurable performance for over 100 h of cycle tests under a 90% relative humidity (RH) without significant performance degradation. One notable advantage of the Pd/HNb3O8 humidity sensor is its ability to regulate hydroniums due to the strong reducibility of H atoms dissociated on the Pd surface. This feature realizes a high stability even at a high humidity (99.9% RH). Using this superior performance, the Pd/HNb3O8 humidity sensor realizes wireless monitoring of the changes in the fingertip humidity of an adult under different physiological states, demonstrating a facile and reliable path for dehydration diagnosis.

A novel mouse model of coronary stenosis mimicking Kawasaki disease induced by Lactobacillus casei cell wall extract.

Kawasaki disease (KD), a febrile systemic vasculitis in infants associated with coronary aneurysm, is a major cause of cardiac sequelae such as myocardial infarction (MI) and sudden death. These events are caused by coronary stenosis due to intimal proliferation or thrombotic formation; however, histological evaluation is limited to autopsy cases of human KD. We therefore investigated the histological features of coronary artery (CA) stenosis in mice induced by Lactobacillus casei cell wall extract (LCWE). LCWE-induced coronary inflammation gradually progressed in a time-dependent manner and expanded to all layers of the vessel wall over 28 days. In addition, frequent elastin degradation was observed and abundant α-smooth muscle actin (SMA)-positive vascular smooth muscle cells (VSMCs) infiltrated into the intima. Furthermore, most VSMCs were positive for proliferating cell nuclear antigen (PCNA) following staining, suggesting that VSMCs likely exhibited a proliferative phenotype. In conclusion, we show a novel mouse model of coronary stenosis induced by LCWE that is characterized by coronary stenosis with severe coronary vasculitis and elastin degradation. In addition, VSMC proliferation plays an important role in the formation of coronary stenosis. This model is an appropriate model of KD coronary stenosis.

Decreased CD4 lymphocyte count as a marker predicting high mortality rate in managing ANCA related rapidly progressive glomerulonephritis.

As antineutrophil cytoplasmic antibody positive rapidly progressive glomerulonephritis (ANCA-RPGN) has a high risk of end stage renal failure and is a potentially life threatening disease, early aggressive therapy is recommended. However, aggressive immunosuppressive therapy may lead to immunodeficiency and subsequent mortality in the patients with this disease. Therefore, we need the index of immunodeficiency to cure the disease. To evaluate any risk factors, including therapies, on mortality in ANCA-RPGN, we conducted a retrospective investigation on patient survival in 32 patients with ANCA-RPGN by Kaplan-Meier analysis and the Cox regression model. Fourteen patients were treated with leucocytapheresis (LAP group) and the 18 patients were treated by steroid pulse therapy (steroid pulse group) as initial treatment. The patients were chosen for the different therapies at random. Two patients in the LAP group, and eight patients in the steroid pulse group had died within 6 months. The lymphocyte counts and CD4 cell counts after complete course of therapy were lower in the patients who died than in those who survived in the steroid pulse group. Patient survival was higher in the LAP group than in the steroid pulse group, but did not reach statistical significance. Multivariate Cox regression analysis showed that the factors influencing patient survival were initial serum creatinine, LAP therapy, CD4 cell counts, and lymphocytes at the end of treatment. Age, titer of MPO-ANCA, and percent of glomerular crescents were not found to have an effect on the patient survival. We recommend: that early diagnosis should be established, and immunosuppressive therapy may be done with monitoring of the lymphocyte and CD4 cell count.