A flexible multimodal pulse sensor for wearable continuous blood pressure monitoring.

Monitoring of arterial blood pressure via cuffless pulse waveform measurement at the wrist has an important clinical value for the early diagnosis and prevention of cardiovascular disease. However, accurate measurement of the radial pulse waveform is challenging owing to its subtle, wideband, and preload-dependent variation characteristics. Evidence shows that uncertainties or variations of wearing pressure and skin temperature can cause artifact signals in wrist pulse measurements, thus degrading blood pressure estimate accuracy and hindering precise clinical diagnosis. Herein, we report a flexible multisensory pulse sensor utilizing natural piezo-thermic transduction of human skin in conjunction with thin-film thermistors for the accurately measuring radial artery pulse waves with high fidelity and good anti-artifact performance. The flexible pulse sensor achieved a wide pressure measuring range (228.2 kPa), low detection limit (4 Pa), good linearity (R2 = 0.999), low hysteresis (2.45%), fast response (88 ms), and good durability and stability, thereby enabling accurate pulse measurement with high fidelity. The pulse sensor also monolithically integrated the simultaneous detections of skin temperature and wearing pressure for resisting artifact effects in pulse measurements. Through the fusion of multiple features extracted from the pulse waveform, wearing pressure, skin temperature and user's personal physical characteristics using an efficient multilayer perceptron, blood pressure is accurately estimated and good generalizability is achieved.

A new method of continuous blood pressure monitoring using multichannel sensing signals on the wrist.

Hypertension is a worldwide health problem and a primary risk factor for cardiovascular disease. Continuous monitoring of blood pressure has important clinical value for the early diagnosis and prevention of cardiovascular disease. However, existing technologies for wearable continuous blood pressure monitoring are usually inaccurate, rely on subject-specific calibration and have poor generalization across individuals, which limit their practical applications. Here, we report a new blood pressure measurement method and develop an associated wearable device to implement continuous blood pressure monitoring for new subjects. The wearable device detects cardiac output and pulse waveform features through dual photoplethysmography (PPG) sensors worn on the palmar and dorsal sides of the wrist, incorporating custom-made interface sensors to detect the wearing contact pressure and skin temperature. The detected multichannel signals are fused using a machine-learning algorithm to estimate continuous blood pressure in real time. This dual PPG sensing method effectively eliminates the personal differences in PPG signals caused by different people and different wearing conditions. The proposed wearable device enables continuous blood pressure monitoring with good generalizability across individuals and demonstrates promising potential in personal health care applications.

Sex disparity of cerebral white matter hyperintensity in the hypertensive elderly: The Shanghai Changfeng study.

White matter hyperintensity (WMH) is associated with vascular hemodynamic alterations and reflects white matter injury. To date, the sex difference of tract-specific WMH and the relationship between high blood pressure (BP) and tract-specific WMH remain unclear. We recruited 515 subjects from the Shanghai Changfeng study (range 53-89 years, mean age 67.33 years). Systolic and diastolic blood pressure (SBP and DBP) were collected and used to calculate pulse pressure (PP). Magnetic resonance T1 and T2 FLAIR images were acquired to measure WMH and calculate WMH index. The ANCOVA test was performed to test the difference between sexes, and the linear regression model was used to examine the associations between BP and WMH index. Men showed higher WMH index than women in all white matter tracts (p < .001, respectively) except for the bilateral superior longitudinal fasciculus (SLF) and its left temporal part (tSLF). High SBP and PP was associated with a lower WMH index on the left corticospinal tract (CST), SLF, tSLF and right cingulum in hippocampus (p ≤ .001, respectively) in women, while high DBP was associated with a higher WMH index on the bilateral CST (left p < .001; right p = .001), left inferior longitudinal fasciculus (p < .001) and inferior fronto-occipital fasciculus (p = .002) in men. Men tend to have more WMH compared to women. A high SBP/PP relates to a lower WMH burden in women. This suggests that women could benefit from higher blood pressure in older age.

Interface sensors with skin piezo-thermic transduction enable motion artifact removal for wearable physiological monitoring.

Accurate measurements on physiological parameters using wearable monitoring devices during physical exercises are essential for personal healthcare and rehabilitation training, but still challenging owing to various motion artifacts (MA) caused by the interfacial dynamic change between wearable sensors and human skin. Here, we propose an interface sensor to detect noncontact proximity and contact pressure between wearable sensors and human skin. The interface sensor employs natural piezo-thermic transduction of human skin and enables direct interfacial proximity/pressure detection by using simple thin-film thermistors to detect the interfacial thermal field change. We develop a wearable watch-type heart rate (HR) monitor utilizing interface sensors to remove MA for a photoplethysmography (PPG) sensor through adaptive filtering. To validate the method, we conduct experiments for multiple subjects, who carry out HR monitoring using the wearable device while doing various physical exercises. The PPG-based HR estimations are corrected through MA removal using interface sensors and compared with that using conventional accelerometer-based MA removal. The experimental results verify that the interface sensors capture the interfacial dynamic change between the PPG sensor and skin better, and obtain more accurate HR estimations during irregular and muscle strength exercises. Utilizing natural transduction of human skin and simple thermometry, the interface sensor provides an advantageous way to overcome MA for wearable monitoring devices during physical activities and thus broadens wearable monitoring applications.

Incidental Brain Magnetic Resonance Imaging Findings and the Cognitive and Motor Performance in the Elderly: The Shanghai Changfeng Study.

BACKGROUND: The frequently discovered incidental findings (IFs) from imaging observations are increasing. The IFs show the potential clues of structural abnormalities underlying cognitive decline in elders. Detecting brain IFs and their relationship with cognitive and behavioral functions helps provide the information for clinical strategies. METHODS: Five hundred and seventy-nine participants were recruited in the Shanghai Changfeng Study. All participants performed the demographic, biochemical, and cognitive functions and gait speed assessment and underwent the high-resolution multimodal magnetic resonance imaging scans. We calculated the detection rate of brain IFs. The association between cardiovascular risk factors and IFs and the associations between IFs and cognitive and motor functions were assessed using regression models. The relationships among gray matter volume, cognitive function, and gait speed were assessed with/without adjusting the IFs to evaluate the effects of potential IFs confounders. RESULTS: IFs were found in a total of 578 subjects with a detection rate of 99.8%. Age and blood pressure were the most significant cardiovascular risk factors correlated with IFs. IFs were found to be negatively associated with Montreal Cognitive Assessment, Mini-Mental State Examination, and gait speed. The gray matter volume was found to be positively correlated with the cognitive function without adjusting the white matter hyperintensity but not if adjusted. CONCLUSION: IFs are commonly found in the elderly population and related to brain functions. The adequate intervention of IFs related cardiovascular risk factors that may slow down the progression of brain function decline. We also suggest that IFs should be considered as confounding factors that may affect cognitive issues on the structural neuroimaging researches in aging or diseases.

Skin-inspired quadruple tactile sensors integrated on a robot hand enable object recognition.

Robot hands with tactile perception can improve the safety of object manipulation and also improve the accuracy of object identification. Here, we report the integration of quadruple tactile sensors onto a robot hand to enable precise object recognition through grasping. Our quadruple tactile sensor consists of a skin-inspired multilayer microstructure. It works as thermoreceptor with the ability to perceive thermal conductivity of a material, measure contact pressure, as well as sense object temperature and environment temperature simultaneously and independently. By combining tactile sensing information and machine learning, our smart hand has the capability to precisely recognize different shapes, sizes, and materials in a diverse set of objects. We further apply our smart hand to the task of garbage sorting and demonstrate a classification accuracy of 94% in recognizing seven types of garbage.

Full-scale experimental and numerical study of bioaerosol characteristics against cross-infection in a two-bed hospital ward.

The transmission and deposition of pathogenic bioaerosols and the subsequent contamination of the air and surfaces is well recognized as a potential route of hospital cross-infection. A full-scale experiment using Bacillus subtilis and computational fluid dynamics were utilized to model the bioaerosol characteristics in a two-bed hospital ward with a constant air change rate (12 ACH). The results indicated that the bioaerosol removal efficiency of unilateral downward ventilation was 50% higher than that of bilateral downward ventilation. Additionally, health care workers (HCWs) and nearby patients had lower breathing zone concentrations in the ward with unilateral downward ventilation. Furthermore, a partition played a positive role in protecting patients by reducing the amount of bioaerosol exposure. However, no obvious protective effect was observed with respect to the HCWs. Only 10% of the bioaerosol was deposited on the surfaces in the ward with unilateral downward ventilation, while up to 35% of the bioaerosol was deposited on the surfaces in the ward with bilateral downward ventilation during the 900 s. The main deposition locations of the bioaerosols were near the wall on the same side of the room as the patient's head in all cases. This study could provide scientific evidence for controlling cross-infection in hospital wards, as well as several guidelines for the disinfection of hospital wards.

Temperature and Strain Compensation for Flexible Sensors Based on Thermosensation.

Flexible sensors have wide applications in wearable electronics, health monitoring, humanoid robotics, and smart prosthesis. Problems of temperature drift and bending/stretching strain are challenging and should not be neglected in practical applications of flexible sensors. Here, we report a novel temperature and strain compensation method for thermosensation-based flexible sensors. Thermosensation is human-skin-inspired perception, which inspires diverse flexible sensors (pressure sensor, flow sensor, temperature sensor, material sensor, proximity sensor, etc.) and multisensory electronic skin. Thermosensation-based flexible sensors utilize thin-film sensing thermistors to detect external physical stimuli through perceptions of the conductive and convective heat transfers toward the surroundings, which enables high-density integration of multisensations while minimizing complexity due to the uniform sensing principle of thermistors that have simple structures and easy operations. To overcome the negative effects of temperature drift and bending/stretching strain in these flexible sensors, we propose to monolithically integrate a compensating thermistor that has a similar geometric shape and is of the same material with the sensing thermistor into a Wheatstone-bridge feedback circuit. When the sensing and compensating thermistors meet geometric similarity, the compensations of temperature and strain are self-sustained by a feedback control of a circuit. The effectiveness is validated through theoretical analysis and experiment measurements. As examples, flexible pressure sensor and flexible flow sensor with temperature and strain compensations are demonstrated. Results indicate that the temperature and strain effects can be tremendously eliminated using the proposed compensation method, which is fast, self-sustained, and expedient to realize. The compensation method enriches competences of flexible sensors and demonstrates competitive advantages for diverse flexible and stretching applications of wearable electronics.

A Wearable Sensor Using Structured Silver-Particle Reinforced PDMS for Radial Arterial Pulse Wave Monitoring.

Human pulse signals contain important and useful physiological information for the auxiliary diagnosis of cardiovascular disease. Here, a wearable pulse sensor based on piezo-thermic transduction is reported using a structured silver-particle reinforced polydimethylsiloxane (PDMS) membrane, for monitoring radial arterial pulse waves. The structured silver-particle reinforced PDMS membrane is optimally designed to meet the specific requirements on sensitivity, linearity, and effective preload measuring range for pulse detection by adjusting the air gap volume fraction and silver particle volume fraction of the structured material. The sensor is endowed with high sensitivity, good linearity in preload measuring range, allowing to detect the subtle pulse waveforms of subjects at different ages under different contact pressures, such as superficial (Fu), medium (Zhong) and deep (Chen). The developed pulse device provides a promising approach for homecare pulse monitoring.