Wearable Continuous Blood Pressure Monitoring Devices Based on Pulse Wave Transit Time and Pulse Arrival Time: A Review.

Continuous blood pressure (BP) monitoring is of great significance for the real-time monitoring and early prevention of cardiovascular diseases. Recently, wearable BP monitoring devices have made great progress in the development of daily BP monitoring because they adapt to long-term and high-comfort wear requirements. However, the research and development of wearable continuous BP monitoring devices still face great challenges such as obvious motion noise and slow dynamic response speeds. The pulse wave transit time method which is combined with photoplethysmography (PPG) waves and electrocardiogram (ECG) waves for continuous BP monitoring has received wide attention due to its advantages in terms of excellent dynamic response characteristics and high accuracy. Here, we review the recent state-of-art wearable continuous BP monitoring devices and related technology based on the pulse wave transit time; their measuring principles, design methods, preparation processes, and properties are analyzed in detail. In addition, the potential development directions and challenges of wearable continuous BP monitoring devices based on the pulse wave transit time method are discussed.

An Ultra-Sensitive and Multifunctional Electronic Skin with Synergetic Network of Graphene and CNT.

Electronic skin (e-skin) has attracted tremendous interest due to its diverse potential applications, including in physiological signal detection, health monitoring, and artificial throats. However, the major drawbacks of traditional e-skin are the weak adhesion of substrates, incompatibility between sensitivity and stretchability, and its single function. These shortcomings limit the application of e-skin and increase the complexity of its multifunctional integration. Herein, the synergistic network of crosslinked SWCNTs within and between multilayered graphene layers was directly drip coated onto the PU thin film with self-adhesion to fabricate versatile e-skin. The excellent mechanical properties of prepared e-skin arise from the sufficient conductive paths guaranteed by SWCNTs in small and large deformation under various strains. The prepared e-skin exhibits a low detection limit, as small as 0.5% strain, and compatibility between sensitivity and stretchability with a gauge factor (GF) of 964 at a strain of 0-30%, and 2743 at a strain of 30-60%. In physiological signals detection application, the e-skin demonstrates the detection of subtle motions, such as artery pulse and blinking, as well as large body motions, such as knee joint bending, elbow movement, and neck movement. In artificial throat application, the e-skin integrates sound recognition and sound emitting and shows clear and distinct responses between different throat muscle movements and different words for sound signal acquisition and recognition, in conjunction with superior sound emission performance with a sound spectrum response of 71 dB (f = 12.5 kHz). Overall, the presented comprehensive study of novel materials, structures, properties, and mechanisms offers promising potential in physiological signals detection and artificial throat applications.

Two-stage amplification of an ultrasensitive MXene-based intelligent artificial eardrum.

We report an artificial eardrum using an acoustic sensor based on two-dimensional MXene (Ti3C2Tx), which mimics the function of a human eardrum for realizing voice detection and recognition. Using MXene with a large interlayer distance and micropyramid polydimethylsiloxane arrays can enable a two-stage amplification of pressure and acoustic sensing. The MXene artificial eardrum shows an extremely high sensitivity of 62 kPa-1 and a very low detection limit of 0.1 Pa. Notably, benefiting from the ultrasensitive MXene eardrum, the machine-learning algorithm for real-time voice classification can be realized with high accuracy. The 280 voice signals are successfully classified for seven categories, and a high accuracy of 96.4 and 95% can be achieved by the training dataset and the test dataset, respectively. The current results indicate that the MXene artificial intelligent eardrum shows great potential for applications in wearable acoustical health care devices.

Programmable Sensitivity Screening of Strain Sensors by Local Electrical and Mechanical Properties Coupling.

Owing to the canonical trade-off between the gauge factor and the working range, there is an emergent need for strain sensors with customizable sensitivity for various applications of different deformation ranges. However, current optimization strategies typically allow possessing either, not both, high-sensing performance or customizable sensing performance. Here, a laser-programmed heterogeneous strain sensor featured locally coupled electrical and mechanical properties (named an LCoup sensor) is developed to access customized sensor performance. Coupled electromechanical properties enable the applied strain to be mainly experienced by the higher sensitivity regions when stretched. By optimizing the parameters of laser processes, the gauge factor can systematically screen within 2 orders of magnitude (from 7.8 to 266.6) while maintaining good stretchability (50%). To prove the potential in human-machine interaction, the real-time monitoring and recognition of set hand gestures (left-click, right-click, and double-click) are demonstrated, representing the traditional input patterns of the computer mouse. Multiscale programming of material properties can further achieve excellent and tailored device performances, offering more opportunities for the design of a broad range of flexible electronics.

Abnormal nocturnal behavior due to hypoglycemia: A case report.

RATIONALE: Hypoglycemia, which is characterized mainly by palpitations, dizziness, and sweating, is common and easy to identify. However, some other symptoms, such as mental disorder or abnormal behavior, are atypical, which may lead to a misdiagnosis of epilepsy, sleepwalking, infarction, or mental disorder, among others. PATIENT CONCERNS: We report a case of a patient with type 2 diabetes who presented with abnormal nocturnal behavior due to hypoglycemia. DIAGNOSIS: Hypoglycemia was diagnosed based on a blood glucose level of 2.1 mmol/L when the patient turned up disoriented unresponsive, unable to understand what was said to him, and producing nonsensical speech. After the patient ate a piece of chocolate, his consciousness returned to normal and all mental symptoms disappeared. Polysomnography (PSG) was synchronously performed. The results of the PSG did not show any signs of abnormality during nonrapid eye movement (NREM) or rapid eye movement (REM) sleep. INTERVENTIONS: We regulated his dose of insulin. OUTCOMES: No additional episodes occurred during the 3-month follow-up. Therefore, the abnormal nocturnal behavior of this patient was determined to be due to hypoglycemia, while the cause of the hypoglycemia was insulin overuse. LESSONS: For physicians, if the cause of abnormal behavior cannot be detected, hypoglycemia should be suspected. Long-term persistent hypoglycemia may cause brain dysfunction and even result in permanent brain damage.

Fiber optofluidic biosensor for the label-free detection of DNA hybridization and methylation based on an in-line tunable mode coupler.

An optical fiber optofluidic biosensor for the detection of DNA hybridization and methylation has been proposed and experimentally demonstrated. An in-line fiber Michelson interferometer was formed in the photonic crystal fiber. A micrhole in the collapsed region, which combined the tunable mode coupler and optofluidic channel, was fabricated by using femtosecond laser micromachining. The mode field diameter of the guided light is changed with the refractive index in the optofluidic channel, which results in the tunable coupling ratio. Label-free detections of the DNA hybridization and methylation have been experimentally demonstrated. The probe single stranded DNA (ssDNA) was bound with the surface of the optofluidic channel through the Poly-l-lysine layer, and the hybridization between a short 22-mer probe ssDNA and a complementary target ssDNA was carried out and detected by interrogating the fringe visibility of the reflection spectrum. Then, the DNA methylation was also detected through the binding between the methylated DNA and the 5-methylcytosine (5-mC) monoclonal antibody. The experiments results demonstrate that the limit of detection of 5nM is achieved, establishing the tunable mode coupler as a sensitive and versatile biosensor. The sensitive optical fiber optofluidic biosensor possesses high specificity and low temperature cross-sensitivity.