Pregnancy health in POWERMOM participants living in rural versus urban zip codes.

BACKGROUND: Pregnant women living in rural locations in the USA have higher rates of maternal and infant mortality compared to their urban counterparts. One factor contributing to this disparity may be lack of representation of rural women in traditional clinical research studies of pregnancy. Barriers to participation often include transportation to research facilities, which are typically located in urban centers, childcare, and inability to participate during nonwork hours. METHODS: POWERMOM is a digital research app which allows participants to share both survey and sensor data during their pregnancy. Through non-targeted, national outreach a study population of 3612 participants (591 from rural zip codes and 3021 from urban zip codes) have been enrolled so far in the study, beginning on March 16, 2017, through September 20, 2019. RESULTS: On average rural participants in our study were younger, had higher pre-pregnancy weights, were less racially diverse, and were more likely to plan a home birth compared to the urban participants. Both groups showed similar engagement in terms of week of pregnancy when they joined, percentage of surveys completed, and completion of the outcome survey after they delivered their baby. However, rural participants shared less HealthKit or sensor data compared to urban participants. DISCUSSION: Our study demonstrated the feasibility and effectiveness of enrolling pregnant women living in rural zip codes using a digital research study embedded within a popular pregnancy app. Future efforts to conduct remote digital research studies could help fill representation and knowledge gaps related to pregnant women.

Inter- and intraindividual variability in daily resting heart rate and its associations with age, sex, sleep, BMI, and time of year: Retrospective, longitudinal cohort study of 92,457 adults.

BACKGROUND: Heart rate is routinely measured as part of the clinical examination but is rarely acted upon unless it is well outside a population-based normal range. With wearable sensor technologies, heart rate can now be continuously measured, making it possible to accurately identify an individual's "normal" heart rate and potentially important variations in it over time. Our objective is to describe inter- and intra-individual variability in resting heart rate (RHR) collected over the course of two years using a wearable device, studying the variations of resting heart rate as a function of time of year, as well as individuals characteristics like age, sex, average sleep duration, and body mass index (BMI). METHODS AND FINDINGS: Our retrospective, longitudinal cohort study includes 92,457 de-identified individuals from the United States (all 50 states), who consistently-over at least 35 weeks in the period from March 2016 to February 2018, for at least 2 days per week, and at least 20 hours per day-wore a heart rate wrist-worn tracker. In this study, we report daily RHR and its association with age, BMI, sex, and sleep duration, and its variation over time. Individual daily RHR was available for a median of 320 days, providing nearly 33 million daily RHR values. We also explored the range in daily RHR variability between individuals, and the long- and short-term changes in the trajectory of an individual's daily RHR. Mean daily RHR was 65 beats per minute (bpm), with a range of 40 to 109 bpm among all individuals. The mean RHR differed significantly by age, sex, BMI, and average sleep duration. Time of year variations were also noted, with a minimum in July and maximum in January. For most subjects, RHR remained relatively stable over the short term, but 20% experienced at least 1 week in which their RHR fluctuated by 10 bpm or more. CONCLUSIONS: Individuals have a daily RHR that is normal for them but can differ from another individual's normal by as much as 70 bpm. Within individuals, RHR was much more consistent over time, with a small but significant seasonal trend, and detectable discrete and infrequent episodes outside their norms.

Usability of a Wrist-Worn Smartwatch in a Direct-to-Participant Randomized Pragmatic Clinical Trial.

BACKGROUND: The availability of a wide range of innovative wearable sensor technologies today allows for the ability to capture and collect potentially important health-related data in ways not previously possible. These sensors can be adopted in digitalized clinical trials, i.e., clinical trials conducted outside the clinic to capture data about study participants in their day-to-day life. However, having participants activate, charge, and wear the digital sensors for long hours may prove to be a significant obstacle to the success of these trials. OBJECTIVE: This study explores a broad question of wrist-wearable sensor effectiveness in terms of data collection as well as data that are analyzable per individual. The individuals who had already consented to be part of an asymptomatic atrial fibrillation screening trial were directly sent a wrist-wearable activity and heart rate tracker device to be activated and used in a home-based setting. METHODS: A total of 230 participants with a median age of 71 years were asked to wear the wristband as frequently as possible, night and day, for at least a 4-month monitoring period, especially to track heart rhythm during sleep. RESULTS: Of the individuals who received the device, 43% never transmitted any data. Those who used the device wore it a median of ∼15 weeks (IQR 2-24) and for 5.3 days (IQR 3.2-6.5) per week. For rhythm detection purposes, only 5.6% of all recorded data from individuals were analyzable (with beat-to-beat intervals reported). CONCLUSIONS: This study provides some important learnings. It showed that in an older population, despite initial enthusiasm to receive a consumer-quality wrist-based fitness device, a large proportion of individuals never activated the device. However, it also found that for a majority of participants it was possible to successfully collect wearable sensor data without clinical oversight inside a home environment, and that once used, ongoing wear time was high. This suggests that a critical barrier to overcome when incorporating a wearable device into clinical research is making its initiation of use as easy as possible for the participant.

Micromotor-based on-off fluorescence detection of sarin and soman simulants.

Self-propelled micromotor-based fluorescent "On-Off" detection of nerve agents is described. The motion-based assay utilizes Si/Pt Janus micromotors coated with fluoresceinamine toward real-time "on-the-fly" field detection of sarin and soman simulants.

Micromotors to capture and destroy anthrax simulant spores.

Towards addressing the need for detecting and eliminating biothreats, we describe a micromotor-based approach for screening, capturing, isolating and destroying anthrax simulant spores in a simple and rapid manner with minimal sample processing. The B. globilli antibody-functionalized micromotors can recognize, capture and transport B. globigii spores in environmental matrices, while showing non-interactions with excess of non-target bacteria. Efficient destruction of the anthrax simulant spores is demonstrated via the micromotor-induced mixing of a mild oxidizing solution. The new micromotor-based approach paves a way to dynamic multifunctional systems that rapidly recognize, isolate, capture and destroy biological threats.

Self-propelled activated carbon Janus micromotors for efficient water purification.

Self-propelled activated carbon-based Janus particle micromotors that display efficient locomotion in environmental matrices and offer effective 'on-the-fly' removal of wide range of organic and inorganic pollutants are described. The new bubble-propelled activated carbon Janus micromotors rely on the asymmetric deposition of a catalytic Pt patch on the surface of activated carbon microspheres. The rough surface of the activated carbon microsphere substrate results in a microporous Pt structure to provide a highly catalytic layer, which leads to an effective bubble evolution and propulsion at remarkable speeds of over 500 µm/s. Such coupling of the high adsorption capacity of carbon nanoadsorbents with the rapid movement of these catalytic Janus micromotors, along with the corresponding fluid dynamics and mixing, results in a highly efficient moving adsorption platform and a greatly accelerated water purification. The adsorption kinetics and adsorption isotherms have been investigated. The remarkable decontamination efficiency of self-propelled activated carbon-based Janus micromotors is illustrated towards the rapid removal of heavy metals, nitroaromatic explosives, organophosphorous nerve agents and azo-dye compounds, indicating considerable promise for diverse environmental, defense, and public health applications.

Turning erythrocytes into functional micromotors.

Attempts to apply artificial nano/micromotors for diverse biomedical applications have inspired a variety of strategies for designing motors with diverse propulsion mechanisms and functions. However, existing artificial motors are made exclusively of synthetic materials, which are subject to serious immune attack and clearance upon entering the bloodstream. Herein we report an elegant approach that turns natural red blood cells (RBCs) into functional micromotors with the aid of ultrasound propulsion and magnetic guidance. Iron oxide nanoparticles are loaded into the RBCs, where their asymmetric distribution within the cells results in a net magnetization, thus enabling magnetic alignment and guidance under acoustic propulsion. The RBC motors display efficient guided and prolonged propulsion in various biological fluids, including undiluted whole blood. The stability and functionality of the RBC motors, as well as the tolerability of regular RBCs to the ultrasound operation, are carefully examined. Since the RBC motors preserve the biological and structural features of regular RBCs, these motors possess a wide range of antigenic, transport, and mechanical properties that common synthetic motors cannot achieve and thus hold considerable promise for a number of practical biomedical uses.

Ultrasound-propelled nanoporous gold wire for efficient drug loading and release.

Ultrasound (US)-powered nanowire motors based on nanoporous gold segment are developed for increasing the drug loading capacity. The new highly porous nanomotors are characterized with a tunable pore size, high surface area, and high capacity for the drug payload. These nanowire motors are prepared by template membrane deposition of a silver-gold alloy segment followed by dealloying the silver component. The drug doxorubicin (DOX) is loaded within the nanopores via electrostatic interactions with an anionic polymeric coating. The nanoporous gold structure also facilitates the near-infrared (NIR) light controlled release of the drug through photothermal effects. Ultrasound-driven transport of the loaded drug toward cancer cells followed by NIR-light triggered release is illustrated. The incorporation of the nanoporous gold segment leads to a nearly 20-fold increase in the active surface area compared to common gold nanowire motors. It is envisioned that such US-powered nanomotors could provide a new approach to rapidly and efficiently deliver large therapeutic payloads in a target-specific manner.

Bubble-propelled micromotors for enhanced transport of passive tracers.

Fluid convection and mixing induced by bubble-propelled tubular microengines are characterized using passive microsphere tracers. Enhanced transport of the passive tracers by bubble-propelled micromotors, indicated by their mean squared displacement (MSD), is dramatically larger than that observed in the presence of catalytic nanowires and Janus particle motors. Bubble generation is shown to play a dominant role in the effective fluid transport observed in the presence of tubular microengines. These findings further support the potential of using bubble-propelled microengines for mixing reagents and accelerating reaction rates. The study offers useful insights toward understanding the role of the motion of multiple micromotors, bubble generation, and additional factors (e.g., motor density and fuel concentration) upon the observed motor-induced fluid transport.