Reliable Stenosis Detection Based on Thrill Waveform Analysis Using Non-Contact Arteriovenous Fistula Imaging.

Hemodialysis therapy is an extracorporeal circulation treatment that serves as a substitute for renal function. In Japan, patients receive this efficient four-hour treatment, three times per week, allowing them to maintain a social life nearly equivalent to that of healthy individuals. Before the treatment, two punctures are performed to establish extracorporeal circulation, and a high blood flow rate is essential to ensure efficient therapy. Specialized blood vessels created through arteriovenous fistula (AVF) surgery are utilized to achieve high blood flow rates. Although the AVF allows safe and efficient dialysis treatment, AVF stenosis leads to a serious problem in dialysis. To early detect this abnormal blood flow, auscultation and palpation methods are widely used in hospitals. However, these methods can only provide qualitative judgment of the AVF condition, so the results cannot be shared among other doctors and staff. Additionally, since the conventional methods require contact with the skin, some issues require consideration regarding infection and low reproducibility. In our previous study, we proposed an alternative method for auscultation using non-contact optical imaging technology. This study aims to construct a reliable AVF stenosis detection method using Thrill waveform analysis based on the developed non-contact device to solve the problem with the contact palpation method. This paper demonstrates the performance validation of the non-contact imaging in the normal AVF group (206 total data, 75 patients, mean age: 69.1 years) and in the treatable stenosis group (107 total data, 17 patients, mean age: 70.1 years). The experimental results of the Mann-Whitney U test showed a significant difference (p=0.0002) between the normal and abnormal groups, which indicated the effectiveness of the proposed method as a new possible alternative to palpation.

Heat Stroke Prevention in Hot Specific Occupational Environment Enhanced by Supervised Machine Learning with Personalized Vital Signs.

Recently, wet-bulb globe temperature (WBGT) has attracted a lot of attention as a useful index for measuring heat strokes even when core body temperature cannot be available for the prevention. However, because the WBGT is only valid in the vicinity of the WBGT meter, the actual ambient heat could be different even in the same room owing to ventilation, clothes, and body size, especially in hot specific occupational environments. To realize reliable heat stroke prevention in hot working places, we proposed a new personalized vital sign index, which is combined with several types of vital data, including the personalized heat strain temperature (pHST) index based on the temperature/humidity measurement to adjust the WBGT at the individual level. In this study, a wearable device was equipped with the proposed pHST meter, a heart rate monitor, and an accelerometer. Additionally, supervised machine learning based on the proposed personalized vital index was introduced to improve the prevention accuracy. Our developed system with the proposed vital sign index achieved a prevention accuracy of 85.2% in a hot occupational experiment in the summer season, where the true positive rate and true negative rate were 96.3% and 83.7%, respectively.

Quantification and Visualization of Reliable Hemodynamics Evaluation Based on Non-Contact Arteriovenous Fistula Measurement.

The condition of arteriovenous fistula (AVF) blood flow is typically checked by using auscultation; however, auscultation should require a qualitative judgment dependent on the skills of doctors, and further attention to contact infection is required. For these reasons, this study developed a non-contact and non-invasive medical device to measure the pulse wave of AVFs by applying optical imaging technology. As a first step toward realization of the quantification judgment based on non-contact AVF measurement, we experimentally validated the developed system, whereby the hemodynamics of 168 subjects were visually and quantitatively evaluated based on clinical tests. Based on the evaluation results, the fundamental statistical characteristics of the non-contact measurement, including the average and median values, and distribution of measured signal-to-noise power ratio, were demonstrated. The clinical test results contributed to the future construction of quantified criteria for the AVF condition with the non-contact measurement.

Systematic Performance Evaluation of a Novel Optimized Differential Localization Method for Capsule Endoscopes.

Capsule endoscopy is a well-established diagnostic tool for the gastrointestinal tract. However, the reliable tracking of capsule endoscopes needs further investigation. Recently, the static magnetic differential method for the localization of capsule endoscopes has shown promising results. This method was experimentally validated by investigating the difference in the measured values of the geomagnetic flux density of a representative sensor pair. In the measurements, it was revealed that misalignment of the sensors and ferromagnetic material near the sensor pair had the most significant impact on the differential approach. Besides, a systematical simulation-based study was conducted. Herein, the position and alignment of all sensors of the localization system were randomly varied. Furthermore, root-mean-squared noise was added to the sensor measurements, and the influence of nearby ferromagnetic material was evaluated. Subsequently, non-idealities were applied simultaneously on the proposed localization system, and the entire system was rotated. The proposed method was significantly better than state-of-the-art geomagnetic compensation methods for the localization of capsule endoscopes with mean position and orientation errors of approximately 2 mm and 1°, respectively.

Common-Mode Noise Reduction in Noncontact Biopotential Acquisition Circuit Based on Imbalance Cancellation of Electrode-Body Impedance.

Biopotential sensing technology with electrodes has a great future in medical treatment and human-machine interface, whereas comfort and longevity are two significant problems during usage. Noncontact electrode is a promising alternative to achieve more comfortable and long term biopotential signal recordings than contact electrode. However, it could pick up a significantly higher level of common-mode (CM) noise, which is hardly solved with passive filtering. The impedance imbalance at the electrode-body interface is a limiting factor of this problem, which reduces the common mode rejection ratio (CMRR) of the amplifier. In this work, we firstly present two novel CM noise reduction circuit designs. The circuit designs are based on electrode-body impedance imbalance cancellation. We perform circuit analysis and circuit simulations to explain the principles of the two circuits, both of which showed effectiveness in CM noise rejection. Secondly, we proposed a practical approach to detect and monitor the electrode-body impedance imbalance change. Compared with the conventional approach, it has certain advantages in interference immunity, and good linearity for capacitance. Lastly, we show experimental evaluation results on one of the designs we proposed. The results indicated the validity and feasibility of the approach.

Influence of population density, temperature, and absolute humidity on spread and decay durations of COVID-19: A comparative study of scenarios in China, England, Germany, and Japan.

In this study, we analyzed the spread and decay durations of the COVID-19 pandemic in several cities of China, England, Germany, and Japan, where the first wave has undergone decay. Differences in medical and health insurance systems, as well as in regional policies incommoded the comparison of the spread and decay in different cities and countries. The spread and decay durations in the cities of the four studied countries were reordered and calculated based on an asymmetric bell-shaped model. We acquired the values of the ambient temperature, absolute humidity, and population density to perform multivariable analysis. We found a significant correlation (p < 0.05) of the spread and decay durations with population density in the four analyzed countries. Specifically, spread duration showed a high correlation with population density and absolute humidity (p < 0.05), whereas decay duration demonstrated the highest correlation with population density, absolute humidity, and maximum temperature (p < 0.05). The effect of population density was almost nonexistent in China because of the implemented strict lockdown. Our findings will be useful in policy setting and governmental actions in the next pandemic, as well as in the next waves of COVID-19.

Blood pressure estimation system using human body communication-based electrocardiograph and photoplethysmography.

In order to realise low-load cuffless and continuous blood pressure measurement in daily life, the authors developed a blood pressure estimation system combining human body communication-based wearable electrocardiograph and reflectance photoplethysmography. The principle is based on a relationship between the pulse arrive time and the systolic blood pressure. The pulse arrive time is the time period between the R-wave in electrocardiograph and peak of pulse wave. The greatest feature is the use of a human body communication-based electrocardiograph which can provide automatic synchronisation in time between the measured electrocardiograph and pulse wave signals to obtain the pulse arrive time so that no additional synchronisation circuit is required. Using this system, the authors measured the pulse arrive time from the electrocardiograph and pulse wave signals in real time, estimated the systolic blood pressure and compared the result with that measured by a cuff sphygmomanometer. The authors found that the root mean square error of the estimated blood pressure and the actual value measured using the cuff sphygmomanometer was 4.5 mmHg or less, and the correlation coefficient was >0.6 with a P value much <0.05. These results show the validity of the developed system for cuffless and continuous blood pressure estimation.

Metasurface sensing difference in waveforms at the same frequency with reduced power level.

We numerically demonstrate a new type of waveform-selective metasurface that senses the difference in incoming waveforms or pulse widths at the same frequency. Importantly, the proposed structure contains precise rectifier circuits that, compared to ordinary schottky diodes used within old types of structures, rectify induced electric charges at a markedly reduced input power level depending on several design parameters but mostly on the gain of operational amplifiers. As a result, a waveform-selective absorbing mechanism related to this turn-on voltage appears even with a limited signal strength that is comparable to realistic wireless signal levels. In addition, the proposed structure exhibits a noticeably wide dynamic range from [Formula: see text] 30 to 6 dBm, compared to a conventional structure that operated only around 0 dBm. Thus, our study opens up the door to apply the concept of waveform selectivity to a more practical field of wireless communications to control different small signals at the same frequency.

Regulated expression of the HNK-1 carbohydrate is essential for medaka (Oryzias latipes) embryogenesis.

Carbohydrates are known to play essential roles in various biological processes including development. However, it remains largely unknown which carbohydrate structure takes part in each biological event. Here, we examined the roles of the human natural killer-1 (HNK-1) carbohydrate in medaka embryogenesis. We first cloned two medaka glucuronyltransferases, GlcAT-P and GlcAT-S, key enzymes for HNK-1 biosynthesis. Overexpression of these glucuronyltransferases affected morphogenetic processes. In addition, loss-of-function experiments revealed that GlcAT-P is physiologically indispensable for head morphogenesis and GlcAT-P depletion also led to markedly increased apoptosis. However, even when the apoptosis was blocked, abnormal head morphogenesis caused by GlcAT-P depletion was still observed, indicating that apoptosis was not the main cause of the abnormality. Moreover, in situ hybridization analyses indicated that GlcAT-P depletion resulted in the abnormal formation of the nervous system but not in cell specification. These results suggest that tight regulation of HNK-1 expression is essential for proper morphogenesis of medaka embryos.

Common-mode noise cancellation circuit for wearable ECG.

Wearable electrocardiogram (ECG) is attracting much attention for monitoring heart diseases in healthcare and medical applications. However, an imbalance usually exists between the contact resistances of sensing electrodes, so that a common mode noise caused by external electromagnetic field can be converted into the ECG detection circuit as a differential mode interference voltage. In this study, after explaining the mechanism of how the common mode noise is converted to a differential mode interference voltage, the authors propose a circuit with cadmium sulphide photo-resistors for cancelling the imbalance between the contact resistances and confirm its validity by simulation experiment. As a result, the authors found that the interference voltage generated at the wearable ECG can be effectively reduced to a sufficient small level.

Motion artefact removals for wearable ECG using stationary wavelet transform.

Wearable Electrocardiogram (ECG) is attracting much attention in daily healthcare applications. From the viewpoint of long-term use, it is desired that the electrodes are non-contact with the human body. In this study, the authors propose an algorithm using the stationary wavelet transform (SWT) to remove motion artefact superimposed on ECG signal when using non-contact capacitively coupling electrodes. The authors evaluate the effect on motion artefact removal of this algorithm by applying it to various ECG signals with motion artefacts superimposed. As a result, the correlation coefficients of ECG signals with respect to the clean ones have been improved from 0.71 to 0.88 on median before and after motion artefact removal, which demonstrates the validity of the proposed SWT-based algorithm.

Performance of human body communication-based wearable ECG with capacitive coupling electrodes.

Wearable electrocardiogram (ECG) is attracting much attention in daily healthcare applications, and human body communication (HBC) technology provides an evident advantage in making the sensing electrodes of ECG also working for transmission through the human body. In view of actual usage in daily life, however, non-contact electrodes to the human body are desirable. In this Letter, the authors discussed the ECG circuit structure in the HBC-based wearable ECG for removing the common mode noise when employing non-contact capacitive coupling electrodes. Through the comparison of experimental results, they have shown that the authors' proposed circuit structure with the third electrode directly connected to signal ground can provide an effect on common mode noise reduction similar to the usual drive-right-leg circuit, and a sufficiently good acquisition performance of ECG signals.

An EM imaging-based localization method with sparse reconstruction for implant devices.

To localize implant devices accurately, it is efficient to estimate a human internal structure with incident electromagnetic waves based on an electromagnetic (EM) imaging technique. In order to realize high resolution in such a localization system, it has been pointed out that huge number of measurement points should be required. To solve this problem, we investigated the possibility to apply the sparse reconstruction to the EM imaging-based localization in order to reduce the measurement points without any deterioration in the estimation accuracy. Moreover, we evaluated the estimation accuracy of our location estimation method with the sparse reconstruction by computer simulations. From the results, it is revealed that the sparse reconstruction is acceptable to the EM imaging-based localization, and the proposed method can estimate the location of an implant device with the accuracy of 1cm under a high signal-to-noise power ratio (SNR) condition.

Wearable ECG Based on Impulse-Radio-Type Human Body Communication.

Human body communication (HBC) provides a promising physical layer for wireless body area networks (BANs) in healthcare and medical applications, because of its low propagation loss and high security characteristics. In this study, we have developed a wearable electrocardiogram (ECG) which employs impulse radio (IR)-type HBC technology for transmitting vital signals on the human body in a wearable BAN scenario. The HBC-based wearable ECG has two excellent features. First, the wideband performance of the IR scheme contributed to very low radiation power so that the transceiver is easy to satisfy the extremely weak radio laws, which does not need a license. This feature can provide big convenience in the use and spread of the wearable ECG. Second, the realization of common use of sensing and transmitting electrodes based on time sharing and capacitive coupling largely simplified the HBC-based ECG structure and contributed to its miniaturization. To verify the validity of the HBC-based ECG, we evaluated its communication performance and ECG acquisition performance. The measured bit error rate, smaller than 10 -3 at 1.25 Mb/s, showed a good physical layer communication performance, and the acquired ECG waveform and various heart-rate variability parameters in time and frequency domains exhibited good agreement with a commercially available radio-frequency ECG and a Holter ECG. These results sufficiently showed the validity and feasibility of the HBC-based ECG for healthcare applications. This should be the first time to have realized a real-time ECG transmission by using the HBC technology.

Performance comparison between UWB-IR and MB-OFDM with transmit diversity in implant communications.

An ultra wideband (UWB) technology is a potential candidate for implant body area networks (BANs), where wireless communications are established between inside and outside of a human body. The UWB can accomplish higher data rate than the other frequency band for the implant communication. However, due to its high frequencies, the UWB signals suffer from quite large attenuation in the implant communication link, which makes it difficult to achieve reliable communications. For achieving reliable communication, it is well known that a spatial diversity technique is efficient without any frequency extension. In our previous works, we developed a transmit polarization diversity antenna for the UWB implant communication. However, optimal UWB modulation scheme for transmit diversity were rarely discussed. In this paper, in order to investigate the optimal UWB modulation schemes for implant communication with transmit diversity, we compare the communication performances of UWB-impulse radio (UWB-IR) and multiband-orthogonal frequency division multiplexing (MB-OFDM). For this purpose, we first analyze the propagation characteristics in the implant UWB channel, which ranges from 3.4 GHz to 4.8 GHz, using a finite difference time domain (FDTD) numerical analysis technique. Then, we evaluate and discuss the communication performances of both modulation schemes for the transmit polarization diversity from the viewpoint of the BER and the required transmit power.

Waveform selectivity at the same frequency.

Electromagnetic properties depend on the composition of materials, i.e. either angstrom scales of molecules or, for metamaterials, subwavelength periodic structures. Each material behaves differently in accordance with the frequency of an incoming electromagnetic wave due to the frequency dispersion or the resonance of the periodic structures. This indicates that if the frequency is fixed, the material always responds in the same manner unless it has nonlinearity. However, such nonlinearity is controlled by the magnitude of the incoming wave or other bias. Therefore, it is difficult to distinguish different incoming waves at the same frequency. Here we present a new concept of circuit-based metasurfaces to selectively absorb or transmit specific types of waveforms even at the same frequency. The metasurfaces, integrated with schottky diodes as well as either capacitors or inductors, selectively absorb short or long pulses, respectively. The two types of circuit elements are then combined to absorb or transmit specific waveforms in between. This waveform selectivity gives us another degree of freedom to control electromagnetic waves in various fields including wireless communications, as our simulation reveals that the metasurfaces are capable of varying bit error rates in response to different waveforms.

Performance evaluation on FPGA-implemented UWB-IR receiver for in-body to out-of-body communication systems.

In order to design an optimized transceiver structure of ultra wideband (UWB) transmission in in-body to out-of-body communications, it is necessary to make the transceiver structure be easily adjustable in order to realize a good communication performance in an experimental environment. For this purpose, we first implement our develop UWB-impulse radio (IR) receiver structure for the in-body to out-of-body communication in a field programmable gate array (FPGA) board, and evaluate the fundamental communication performance of the FPGA-implemented UWB-IR receiver by a biological-equivalent liquid phantom experiment. The FPGA configuration results indicate that our FPGA realization of the UWB-IR receiver has accomplished good communication performance with few FPGA slices. Moreover, the evaluation results in the liquid phantom experiment show that the FPGA-implemented UWB-IR receiver can achieve a bit error rate (BER) of 10(-3) up to a communication distance of 70 mm with ensuring a high data rate of 2 Mbps.

Novel joint TOA/RSSI-based WCE location tracking method without prior knowledge of biological human body tissues.

This paper proposes a novel joint time of arrival (TOA)/received signal strength indicator (RSSI)-based wireless capsule endoscope (WCE) location tracking method without prior knowledge of biological human tissues. Generally, TOA-based localization can achieve much higher localization accuracy than other radio frequency-based localization techniques, whereas wireless signals transmitted from a WCE pass through various kinds of human body tissues, as a result, the propagation velocity inside a human body should be different from one in free space. Because the variation of propagation velocity is mainly affected by the relative permittivity of human body tissues, instead of pre-measurement for the relative permittivity in advance, we simultaneously estimate not only the WCE location but also the relative permittivity information. For this purpose, this paper first derives the relative permittivity estimation model with measured RSSI information. Then, we pay attention to a particle filter algorithm with the TOA-based localization and the RSSI-based relative permittivity estimation. Our computer simulation results demonstrates that the proposed tracking methods with the particle filter can accomplish an excellent localization accuracy of around 2 mm without prior information of the relative permittivity of the human body tissues.

System development and performance evaluation on detection schemes for UWB-IR implant communications.

Ultra wideband-impulse radio (UWB-IR) transmission is one of promising transmission technologies in implant body area networks (BANs). Although some studies have investigated the channel model and communication architecture in implant BANs, no study quantitatively shows the feasibility of UWB-IR communication in the human body with actual developed transceivers at a high data rate. In this paper, we focus on experimental evaluation of the correlation detection (coherent detection) and the energy detection (non-coherent detection) for UWB-IR transmission with multi-pulse position modulation (MPPM). For this purpose, we develop a UWB-IR communication system with MPPM scheme, and experimentally evaluate the transmission performance of the developed systems with the two different detection schemes. In addition to the experimental evaluation, we also theoretically analyze the bit error rate (BER) performance by using Gaussian approximation. From the experimental results, the developed system has achieved a BER of 10(-2) at the propagation loss of 75 dB with a data rate of 2 Mbps in the correlation detection. This result shows the feasibility of reliable UWB-IR communication in actual implant BANs.

Essential role of beta-1,4-galactosyltransferase 2 during medaka (Oryzias latipes) gastrulation.

Glycans are known to play important roles in vertebrate development; however, it is difficult to analyze in mammals because it takes place in utero. Therefore, we used medaka (Oryzias latipes) to clarify the roles of glycans during vertebrate development. beta-1,4-Galactosyltransferase is one of the key enzymes in the biosynthesis of the lactosamine structures that are commonly found on glycoproteins and glycolipids. Here, we show the essential role of beta4GalT2 during medaka development. Depletion of beta4GalT2 by morpholino antisense oligonucleotide injection resulted in significant morphological defects, such as shortening of the anterior-posterior axis, cyclopia, impaired somite segmentation, and head hypoplasia. In situ hybridization analyses revealed that the loss of beta4GalT2 led to defective anterior-posterior axis elongation during gastrulation without affecting organizer formation. Furthermore, a cell tracing experiment demonstrated that beta4GalT2 knockdown mainly affects mediolateral cell intercalation, which contributes to anterior-posterior axis elongation. A cell transplantation experiment indicated that glycans are produced by beta4GalT2 cell-autonomously during gastrulation. beta4GalT2 depletion also led to enhanced apoptosis; however, this does not account for the phenotypic abnormalities, as blockade of apoptosis failed to compensate for the beta4GalT2 depletion. Our data suggest that beta4GalT2 activity is cell-autonomously required in cells undergoing mediolateral cell intercalation, which drives extension movements during medaka gastrulation.