Non-Invasive Sensors Integration for NCDs with AIoT Based Telemedicine System.

Thailand's hospitals face overcrowding, particularly with non-communicable disease (NCD) patients, due to a doctor shortage and an aging population. Most literature showed implementation merely on web or mobile application to teleconsult with physicians. Instead, in this work, we developed and implemented a telemedicine health kiosk system embedded with non-invasive biosensors and time-series predictors to improve NCD indicators over an eight-month period. Two cohorts were randomly selected: a control group with usual care and a telemedicine-using group. The telemedicine-using group showed significant improvements in average fasting blood glucose (148 to 130 mg/dL) and systolic blood pressure (152 to 138 mmHg). Data mining with the Apriori algorithm revealed correlations between diseases, occupations, and environmental factors, informing public health policies. Communication between kiosks and servers used LoRa, 5G, and IEEE802.11, which are selected based on the distance and signal availability. The results support telemedicine kiosks as effective for NCD management, significantly improving key NCD indicators, average blood glucose, and blood pressure.

Anomalous Current Steps in 3D Graphene Electrochemical Systems at Room Temperature.

In this work, we report a new phenomenon in electrochemical systems whereby uniform current steps of 1 mA per 0.5 × 0.5 × 0.1 cm3 (width × width × depth) of electrode volume occurred during the electrodeposition of gold and silver nanoparticles onto 3D microporous graphene on nickel layers (GF/Ni) at room temperature. The effect was exhibited only at specific applied electrical potentials. The experiments (magnetic interference, temperature dependence, and surface area dependence) were repeated, and the results were reproducible. Finally, we proposed classical electrochemical theory using the Butler-Volmer equation and quantum theory using the Landauer formalism to describe this new effect. Both theories could be used to explain the experimental results: temperature dependence, surface area dependence, blocking effects, and external magnetic field dependence. In addition, the stepwise current presented in this work facilitates the trapping and supplying of a large amount of electric charge via an inherent magnetic field in a sharp time step (∼1 s). A video clip of the recorded effect can be found at https://youtu.be/pPJh45w1sUQ.

Enhancing modulation performance by design of hybrid plasmonic optical modulator integrating multi-layer graphene and TiO2on silicon waveguides.

A novel way to enhance modulation performance is through the design of a hybrid plasmonic optical modulator that integrates multi-layer graphene and TiO2on silicon waveguides. In this article, a design is presented of a proposed modulator based on the use of the two-dimensional finite difference eigenmode solver, the three-dimensional eigenmode expansion solver, and the CHARGE solver. Leveraging inherent graphene properties and utilizing the subwavelength confinement capabilities of hybrid plasmonic waveguides (HPWs), we achieved a modulator design that is both compact and highly efficient. The electrical bandwidthf3dBis at 460.42 GHz and it reduces energy consumption to 12.17 fJ/bit with a modulator that functions at a wavelength of 1.55µm. According to our simulation results, our innovation was the optimization of the third dielectric layer's thickness, setting the stage to achieve greater modulation depths. This synergy between graphene and HPWs not only augments subwavelength confinement, but also optimizes light-graphene interaction, culminating in a markedly enhanced modulation efficiency. As a result, our modulator presents a high extinction ratio and minimized insertion loss. Furthermore, it exhibits polarization insensitivity and a greater bandwidth. Our work sets a new benchmark in optical communication systems, emphasizing the potential for the next generation of chip-scale with high-efficiency optical modulators that significantly outpace conventional graphene-based designs.

Empowering an Acute Kidney Injury 3D Graphene-Based Sensor Using Extreme Learning Machine.

This study reports on the application of an extreme learning machine (ELM) in near-real-time kidney monitoring via urine neutrophil gelatinase-associated lipocalin (NGAL) detection with a 3D graphene electrode. This integration marks the first instance of combining a graphene-based electrode with machine learning to enhance the NGAL detection accuracy, building on our group's 2020 research. The methodology involves two key components: a graphene electrode functionalized with a lipocalin-2 antibody for NGAL detection and the ELM application for improved prediction accuracy by using urine analysis data. The results show a significant 15% increase in the area under the curve (AUC) for NGAL determination, with error reduction from ±6 to 0.54 ng/mL within a linear range of 2.7-140 ng/mL. The ELM also lowered the detection limit from 14.8 to 0.89 ng/mL and increased accuracy, precision, sensitivity, specificity, and F1 score for AKI prediction by 8.89, 30.69, 6.78, 9.94, and 19.07%, respectively. These findings underscore the efficacy of simple neural networks in enhancing graphene-based electrochemical sensors for AKI biomarkers. ELM was chosen for its optimal performance-resource balance, with a comparative analysis of ELM, support vector machines, multilayer perceptron, and random forest algorithms also included. This research suggests the potential for miniaturizing AI-enhanced sensors for practical applications.

Electrical performance enhancement of a triboelectric nanogenerator based on epoxy resin/BaTiO3by Al nanopowder addition for low power electronic devices.

Triboelectric nanogenerators (TENGs) are crucial for applications such as smart sensors and bio-electronics. In the current work, we aimed for improved performance of TENGs with incorporation of BaTiO3powder, which is known for its strong ferroelectric properties, combining it with epoxy resin to improve the flexibility of our devices. We observed that our TENGs can operate for over 24 000 cycles with no degradation of function. Additionally, we improved the electrical performance of the TENGs by incorporating various aluminum concentrations that change the electronic properties in the form of mixed epoxy resin, BaTiO3, and Al nanopowders. To identify the optimum conditions for the best performance, we analyzed the electrical characteristics and material properties by employing scanning electron microscopy, energy dispersive x-ray spectroscopy, and x-ray diffractometry characterization techniques. Our findings suggest that this innovative combination of materials and optimization techniques can significantly improve the performance of TENGs, making them ideal for practical applications in various fields, such as low-power electronics, environmental monitoring and healthcare. Moreover, these enhanced TENGs can serve as sustainable and dependable energy sources for various applications.

Nanoflowers on Microporous Graphene Electrodes as a Highly Sensitive and Low-Cost As(III) Electrochemical Sensor for Water Quality Monitoring.

In this work, we report a low-cost and highly sensitive electrochemical sensor for detecting As(III) in water. The sensor uses a 3D microporous graphene electrode with nanoflowers, which enriches the reactive surface area and thus enhances its sensitivity. The detection range achieved was 1-50 ppb, meeting the US-EPA cutoff criteria of 10 ppb. The sensor works by trapping As(III) ions using the interlayer dipole between Ni and graphene, reducing As(III), and transferring electrons to the nanoflowers. The nanoflowers then exchange charges with the graphene layer, producing a measurable current. Interference by other ions, such as Pb(II) and Cd(II), was found to be negligible. The proposed method has potential for use as a portable field sensor for monitoring water quality to control hazardous As(III) in human life.

Optimization of the Chronic Kidney Disease-Peritoneal Dialysis App to Improve Care for Patients on Peritoneal Dialysis in Northeast Thailand: User-Centered Design Study.

BACKGROUND: The prevalence of peritoneal dialysis (PD) in Thailand is increasing rapidly in part because of Thailand's Peritoneal Dialysis First policy. PD is a home-based renal replacement therapy in which patients with chronic kidney disease perform up to 4 exchanges of dialysate fluid per day in the peritoneal cavity. Overhydration is one of the most common complications in patients on PD and is associated with increased morbidity and mortality. To monitor hydration status, patients collect hydration metrics, including body weight, blood pressure, urine output, and ultrafiltration volume, from each dialysis cycle and enter this information into a PD logbook. This information is reviewed bimonthly at PD clinic appointments. The chronic kidney disease-PD (CKD-PD) app with near-field communication (NFC) and optical character recognition (OCR) was developed to automate hydration metric collection. The information was displayed in the app for self-monitoring and uploaded to a database for real-time monitoring by the PD clinic staff. Early detection and treatment of overhydration could potentially reduce the morbidity and mortality related to overhydration. OBJECTIVE: This study aims to identify usability issues and technology adoption barriers for the CKD-PD app with NFC and OCR and a monitoring system and to use this information to make rapid cycle improvements. METHODS: A multidisciplinary team of nephrologists, PD clinic nurses, computer programmers, and engineers trained and observed 2 groups of 5 participants in the use of the CKD-PD app with NFC and OCR and a monitoring system. The participants were observed using technology in their homes in 3 phases. The data collected included the Unified Theory of Acceptance and Use of Technology questionnaire, think-aloud observation, user ratings, completion of hydration metrics, and upload of hydration metrics to the central database. These results were used by the team between phases to improve the functionality and usefulness of the app. RESULTS: The CKD-PD app with NFC and OCR and a monitoring system underwent 3 rapid improvement cycles. Issues were identified regarding the usability of the NFC and OCR data collection, app stability, user interface, hydration metric calculation, and display. NFC and OCR improved hydration metric capture; however, issues remained with their usability. App stability and user interface issues were corrected, and hydration metrics were successfully uploaded by the end of phase 3. Participants' scores on technology adoption decreased but were still high, and there was enthusiasm for the self-monitoring and clinical communication features. CONCLUSIONS: Our rapid cycle process improvement methodology identified and resolved key barriers and usability issues for the CKD-PD app with NFC and OCR and a monitoring system. We believe that this methodology can be accomplished with limited training in data collection, statistical analysis, and funding.

Non-invasively accuracy enhanced blood glucose sensor using shallow dense neural networks with NIR monitoring and medical features.

Non-invasive and accurate method for continuous blood glucose monitoring, the self-testing of blood glucose is in quest for better diagnosis, control and the management of diabetes mellitus (DM). Therefore, this study reports a multiple photonic band near-infrared (mbNIR) sensor augmented with personalized medical features (PMF) in Shallow Dense Neural Networks (SDNN) for the precise, inexpensive and pain free blood glucose determination. Datasets collected from 401 blood samples were randomized and trained with ten-fold validation. Additionally, a cohort of 234 individuals not included in the model training set were investigated to evaluate the performance of the model. The model achieved the accuracy of 97.8% along with 96.0% precision, 94.8% sensitivity and 98.7% specificity for DM classification based on a diagnosis threshold of 126 mg/dL for diabetes in fasting blood glucose. For non-invasive real-time blood glucose monitoring, the model exhibited ± 15% error with 95% confidence interval and the detection limit of 60-400 mg/dL, as validated with the standard hexokinase enzymatic method for glucose estimation. In conclusion, this proposed mbNIR based SDNN model with PMF is highly accurate and computationally cheaper compared to similar previous works using complex neural network. Some groups proposed using complicated mixed types of sensors to improve noninvasive glucose prediction accuracy; however, the accuracy gain over the complexity and costs of the systems harvested is still in questioned (Geng et al. in Sci Rep 7:12650, 2017). None of previous works report on accuracy enhancement of NIR/NN using PMF. Therefore, the proposed SDNN over PMF/mbNIR is an extremely promising candidate for the non-invasive real-time blood glucose monitoring with less complexity and pain-free.

Highly-Sensitive Surface-Enhanced Raman Spectroscopy (SERS)-based Chemical Sensor using 3D Graphene Foam Decorated with Silver Nanoparticles as SERS substrate.

In this work, a novel platform for surface-enhanced Raman spectroscopy (SERS)-based chemical sensors utilizing three-dimensional microporous graphene foam (GF) decorated with silver nanoparticles (AgNPs) is developed and applied for methylene blue (MB) detection. The results demonstrate that silver nanoparticles significantly enhance cascaded amplification of SERS effect on multilayer graphene foam (GF). The enhancement factor of AgNPs/GF sensor is found to be four orders of magnitude larger than that of AgNPs/Si substrate. In addition, the sensitivity of the sensor could be tuned by controlling the size of silver nanoparticles. The highest SERS enhancement factor of ∼ 5 × 10(4) is achieved at the optimal nanoparticle size of 50 nm. Moreover, the sensor is capable of detecting MB over broad concentration ranges from 1 nM to 100 µM. Therefore, AgNPs/GF is a highly promising SERS substrate for detection of chemical substances with ultra-low concentrations.