Structural annotation of unknown molecules in a miniaturized mass spectrometer based on a transformer enabled fragment tree method.

Structural annotation of small molecules in tandem mass spectrometry has always been a central challenge in mass spectrometry analysis, especially using a miniaturized mass spectrometer for on-site testing. Here, we propose the Transformer enabled Fragment Tree (TeFT) method, which combines various types of fragmentation tree models and a deep learning Transformer module. It is aimed to generate the specific structure of molecules de novo solely from mass spectrometry spectra. The evaluation results on different open-source databases indicated that the proposed model achieved remarkable results in that the majority of molecular structures of compounds in the test can be successfully recognized. Also, the TeFT has been validated on a miniaturized mass spectrometer with low-resolution spectra for 16 flavonoid alcohols, achieving complete structure prediction for 8 substances. Finally, TeFT confirmed the structure of the compound contained in a Chinese medicine substance called the Anweiyang capsule. These results indicate that the TeFT method is suitable for annotating fragmentation peaks with clear fragmentation rules, particularly when applied to on-site mass spectrometry with lower mass resolution.

ALTA: a simple nutritional prognostic score for patients with hepatitis B virus-related acute-on-chronic liver failure.

Background: Malnutrition, despite being a common complication, is often neglected in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The objective of this study was to develop a simplified nutritional prognostic score to accurately predict mortality in HBV-ACLF patients. Methods: In this multicenter retrospective study, clinical data from 530 HBV-ACLF patients were used to create a new prognostic score, which was then validated in two external cohorts (n = 229 and 248). Results: Four independent factors were significantly associated with 28-day mortality in HBV-ACLF patients, forming a novel prognostic score (ALTA score = 0.187 × age-0.849 × lymphocyte count-2.033 × total cholesterol-0.148 × albumin-0.971). Notably, the AUROC of ALTA score for 28/90-day mortality (0.950/0.967) were significantly higher than those of three other ACLF prognostic scores (COSSH-ACLF II, 0.864/0.734; MELD, 0.525/0.488; MELD-Na, 0.546/0.517; all P < 0.001), and three known nutritional scores (CONUT, 0.739/0.861; OPNI, 0.279/0.157; NRS-2002, 0.322/0.286; all P < 0.001). The prediction error rates of ALTA score for 28-day mortality were significantly lower than COSSH-ACLF II (7.3%), MELD (14.4%), MELD-Na (12.7%), CONUT (9.0%), OPNI (30.6%), and NRS2002 (34.1%) scores. Further classifying ALTA score into two strata, the hazard ratios of mortality at 28/90 days were notably increased in the high-risk groups compared to the low-risk group (15.959 and 5.740). These results were then validated in two external cohorts. Conclusion: ALTA, as a simplified nutritional prognostic score for HBV-ACLF, demonstrates superiority over the COSSH-ACLF II and other scores in predicting short-term mortality among HBV-ACLF patients. Therefore, it may be used to guide clinical management, particularly in primary care settings.

Fucosyltransferase 8 regulates adult neurogenesis and cognition of mice by modulating the Itga6-PI3K/Akt signaling pathway.

Fucosyltransferase 8 (Fut8) and core fucosylation play critical roles in regulating various biological processes, including immune response, signal transduction, proteasomal degradation, and energy metabolism. However, the function and underlying mechanism of Fut8 and core fucosylation in regulating adult neurogenesis remains unknown. We have shown that Fut8 and core fucosylation display dynamic features during the differentiation of adult neural stem/progenitor cells (aNSPCs) and postnatal brain development. Fut8 depletion reduces the proliferation of aNSPCs and inhibits neuronal differentiation of aNSPCs in vitro and in vivo, respectively. Additionally, Fut8 deficiency impairs learning and memory in mice. Mechanistically, Fut8 directly interacts with integrin α6 (Itga6), an upstream regulator of the PI3k-Akt signaling pathway, and catalyzes core fucosylation of Itga6. Deletion of Fut8 enhances the ubiquitination of Itga6 by promoting the binding of ubiquitin ligase Trim21 to Itga6. Low levels of Itga6 inhibit the activity of the PI3K/Akt signaling pathway. Moreover, the Akt agonist SC79 can rescue neurogenic and behavioral deficits caused by Fut8 deficiency. In summary, our study uncovers an essential function of Fut8 and core fucosylation in regulating adult neurogenesis and sheds light on the underlying mechanisms.

A Novel Joint Denoising Method for Hydrophone Signal Based on Improved SGMD and WT.

Underwater acoustic technology as an important means of exploring the oceans is receiving more attention. Denoising for underwater acoustic information in complex marine environments has become a hot research topic. In order to realize the hydrophone signal denoising, this paper proposes a joint denoising method based on improved symplectic geometry modal decomposition (ISGMD) and wavelet threshold (WT). Firstly, the energy contribution (EC) is introduced into the SGMD as an iterative termination condition, which efficiently improves the denoising capability of SGMD and generates a reasonable number of symplectic geometry components (SGCs). Then spectral clustering (SC) is used to accurately aggregate SGCs into information clusters mixed-clusters, and noise clusters. Spectrum entropy (SE) is used to distinguish clusters quickly. Finally, the mixed clusters achieve the signal denoising by wavelet threshold. The useful information is reconstructed to achieve the original signal denoising. In the simulation experiment, the denoising effect of different denoising algorithms in the time domain and frequency domain is compared, and SNR and RMSE are used as evaluation indexes. The results show that the proposed algorithm has better performance. In the experiment of hydrophone, the denoising ability of the proposed algorithm is also verified.

Magnesium Depletion Score and Metabolic Syndrome in US Adults: Analysis of NHANES 2003-2018.

BACKGROUND: The association between magnesium status and metabolic syndrome remains unclear. This study aimed to examine the relationship between the kidney reabsorption-related magnesium depletion score (MDS) and metabolic syndrome among US adults. METHODS: We analyzed data from 15,565 adults participating in the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Metabolic syndrome was defined according to the National Cholesterol Education Program's Adult Treatment Panel III report. The MDS is a scoring system developed to predict the status of magnesium deficiency that fully considers the pathophysiological factors influencing the kidneys' reabsorption capability. Weighted univariate and multivariate logistic regression were used to assess the association between MDS and metabolic syndrome. Restricted cubic spline analysis was conducted to characterize dose-response relationships. Stratified analyses by sociodemographic and lifestyle factors were also performed. RESULTS: In both univariate and multivariate analyses, higher MDS was significantly associated with increased odds of metabolic syndrome. Each unit increase in MDS was associated with approximately a 30% higher risk for metabolic syndrome, even after adjusting for confounding factors (OR 1.31; 95% CI 1.17-1.45). Restricted cubic spline graphs depicted a linear dose-response relationship across the MDS range. This positive correlation remained consistent across various population subgroups and exhibited no significant interaction by age, gender, race, adiposity, smoking status, or alcohol consumption. CONCLUSIONS: Higher urinary magnesium loss as quantified by MDS may be an independent linear risk factor for metabolic syndrome in US adults, irrespective of sociodemographic and behavioral factors. Optimizing magnesium nutritional status could potentially confer benefits to patients with metabolic syndrome.

MgO-modified biochar by modifying hydroxyl and amino groups for selective phosphate removal: Insight into phosphate selectivity adsorption mechanism through experimental and theoretical.

Metal oxides-modified biochars have been widely studied as promising adsorbents for removing phosphate from wastewater discharge. Yet, the low adsorption selectivity towards phosphate severely limits its potential in practical applications. In this study, MgO-modified biochar modified by hydroxyl and amino groups (OH/NH2@MBC) is developed for selective phosphorus recovery from wastewater. As major results, the OH/NH2@MBC exhibits favorable phosphate adsorption performance is superior to that of MBC resin in the presence of co-existing anions (NO3-, Cl-, HCO3- and SO42-) and natural organic matter (humic acid) even actual wastewater, suggesting its superior selectivity towards phosphate. The OH/NH2@MBC shows an excellent phosphate adsorption capacity (43.27 mg/g) and desorption ratio (82.34 %) after five cycles under the condition of anion coexistence (100 mg/L). The experimental and DFT theoretical study reveals that attaching hydroxyl and amino groups onto the MBC surface, which facilitates to inhibiting the side effects of anions (NO3-, Cl-, HCO3-, and SO42-) through Lewis acid-base sites, hydrogen bonds, and metal affinity, and preferentially select adsorption P, contributing greatly to improve phosphate adsorption selectivity. Importantly, the presence of amino and hydroxyl groups can reduce the Fermi level of OH/NH2@MgO(220) and OH/NH2@MgO(200) and improve the adsorption selection for HPO42-. This study provides an effective strategy for enhancing the adsorption selectivity of metal oxides-modified biochars towards phosphate through modifying functional groups.

Impacts of a new diagnosis-related group point payment system on children's medical services in China: Length of stay and costs.

BACKGROUND: Paediatric healthcare is always highlighted in medical and health care system reform in China. Zhejiang Province established a new diagnosis-related group (DRG) point payment reform in 2020 to regulate provider behaviours and control medical costs. We conducted this study to evaluate impacts of the DRG point payment policy on provider behaviours and resource usage in children's medical services. METHODS: Data from patients' discharge records from July 2019 to December 2020 in Children's Hospital, Zhejiang University School of Medicine were collected for analysis. We employed the interrupted time series approach to reveal the trend before and after the DRG point payment reform and the difference-in-differences analysis to estimate the independent outcome changes attributed to the reform. RESULTS: We found that the upward trend of length of stay slightly slowed, and the total costs began to decrease at the post-policy stage. Although independent effects of the reform were not presented among the whole sample, the length of stay and hospitalisation costs of moderate-hospital-stay paediatric patients, non-surgical patients, and infant patients were found to decrease rapidly after the reform. CONCLUSION: DRG point payments can changed the provider behaviours and eventually reduce healthcare resource usage in children's medical services.

A Minimized Measurement Scheme for Predicting HbA1c Using Discrete Self-Monitoring Blood Glucose Data Within 4 Weeks for People with Type 2 Diabetes.

Objective: To establish an accurate and robust calculation model for predicting hemoglobin A1c (HbA1c) for people with type 2 diabetes (T2D) by using the fewest discrete blood glucose values according to an irregular data set and propose an appropriate cost-effective and scientific scheme for routine blood glucose monitoring. Methods: By using two data sets obtained from 2017 to 2022, which involved 2432 people with T2D, ∼420,000 irregular blood glucose values, and 10,000 HbA1c values, multiple blood glucose monitoring schemes were designed and compared to find the optimal one. The data were structured and then fitted using a regularized extreme learning machine, and the results were evaluated on the basis of indicators such as mean absolute error (MAE), root mean square error, and the relevance analysis (R) value; the optimal scheme for routine blood glucose monitoring was determined by combining the accuracy and the cost and was compared with previous studies in terms of accuracy and stability. Results: Data fitting results for the chosen scheme: R = 0.8029 (P < 0.001), MAE = 0.3181% (95% confidence interval, 0.2666-0.3695%). Within the last 4 weeks before the prediction of HbA1c, a minimum of only seven fasting and seven postprandial blood glucose values are needed, of which are one fasting and one postprandial blood glucose values per 4 days. Compared with previous studies, the prediction model shows better accuracy and stability (P < 0.05), especially under the great glucose fluctuation group. Conclusion: A minimized calculation model for accurately and robustly predicting HbA1c using discrete self-monitoring of blood glucose data within 4 weeks for people with T2D has been established and provides a new reference for the design of a scheme for blood glucose monitoring. The diabetes care clinic of Peking University First Hospital (Registration Number: ChiCTR2300068139).

Enhancing ion mobility spectrometry performance through a programmable ion swarm shaping method based on Bradbury-Nielsen gates.

The ion gate is a critical element in drift tube ion mobility spectrometry (IMS) as it directly influences the resolving power and sensitivity of the system. However, the conventional Bradbury-Nielsen gate (BNG) often leads to deformation of the ion swarm shape, resulting in reduced resolving power and significant discrimination effects. To address these limitations, we propose a novel method that incorporates a cutting phase following the gate opening. This approach effectively reduces trailing edge deformation, resulting in a maximum resolving power of over 100 and increased signal intensity. Additionally, this method maintains high resolving power even during longer gate opening times. Remarkably, this method not only significantly reduces the mobility discrimination effect but also enables the achievement of reverse discrimination by adjusting the duration of the cutting phase. Consequently, it demonstrates the potential to selectively amplify the peak height of target ions. Our method offers straightforward implementation across all IMS systems utilizing the BNG, thereby significantly improving system performance.

Hydrogen-Assisted Photoionization and Its Use in Promoting Mass Spectrometry Analysis of VOCs.

As a simple soft ionization method, photoionization (PI) is often coupled with mass spectrometry (MS) for the direct analysis of volatile organic compounds (VOCs). PI enables selective ionization of analytes, but the ion yield is generally not high due to the limited light intensity of the ultraviolet lamp. Here, a hydrogen-assisted photoionization (HAPI) strategy was developed and integrated into a miniature ion trap mass spectrometer. In particular, hydrogen was introduced as a versatile buffer gas to facilitate both photoionization and ion trap operation. This can increase the ion yields by up to 2 orders of magnitude compared to conventional PI-MS, with a low hydrogen consumption (less than 100 µL) for each analysis. The generation of protonated ions indicates a specific photochemical process in HAPI, which has also been studied and initially revealed. The detection of various VOCs and plant volatile gases confirmed the versatility and practicality of the HAPI technology.

Mitochondrial disorders as a mechanism for the development of obese Sarcopenia.

Obese sarcopenia is a severe and prevalent disease in an aging society. Compared to sarcopenia alone, the development and advanced stage of obesity sarcopenia is faster and more severe. Diagnosis of the cause of adipocyte accumulation is also more complicated; however, no effective pharmacological treatment is available. Chronic inflammation is one of the causes of sarcopenia, and obese patients, who are more likely to develop chronic inflammation, may simultaneously suffer from obesity and sarcopenia. Mitochondrial metabolic disorders have been more easily observed in the tissue cells of patients with obesity and sarcopenia. Mitochondrial metabolic disorders include abnormal mtDNA release, mitochondrial autophagy, and dynamic mitochondrial disorders. Therefore, this review will reveal the mechanism of development of obesity myasthenia gravis from the perspective of mitochondria and discuss the currently existing small-molecule drugs.

The association of handgrip strength with all-cause and cardiovascular mortality: results from the National Health and Nutrition Examination Survey database prospective cohort study with propensity score matching.

Objective: To investigate the association between handgrip strength (HGS) with all-cause and cardiovascular disease (CVD) mortality in US adults. Method: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) prospective cohort study (2011-2014) with 10,470 participants. The cox regression analysis, Kaplan-Meier survival curves, fitted curves, ROC curves, and propensity score-matched analysis (PSM) with inverse probability of treatment weighting (IPTW), SMRW (PSM with repeated weights), PA (pairwise algorithm), and OW (overlap weighting) regression analysis were performed to assess the relationship between HGS and all-cause and CVD mortality. Results: The low HGSs (men <37.4 kg, women <24 kg), was found to be associated with higher all-cause and CVD mortality in a reverse J-shaped curve (p < 0.05). Adjusting for multiple covariates including age, BMI, race, education level, marriage status, smoking and alcohol use, and various comorbidities, the hazard ratio (HR) for all-cause mortality in the lowest HGS quintile 1 (Q1) was 3.45 (2.14-5.58) for men and 3.3 (1.88-5.79) for women. For CVD mortality, the HR was 2.99 (1.07-8.37) for men and 10.35 (2.29-46.78) for women. The area under the curve (AUC) for HGS alone as a predictor of all-cause mortality was 0.791 (0.768-0.814) for men and 0.780 (0.752-0.807) for women (p < 0.05), while the AUC for HGS and age was 0.851 (0.830-0.871) for men and 0.848 (0.826-0.869) for women (p < 0.05). For CVD mortality, the AUC for HGS alone was 0.785 (95% CI 0.738-0.833) for men and 0.821 (95% CI 0.777-0.865) for women (p < 0.05), while the AUC for HGS and age as predictors of all-cause mortality was 0.853 (0.861-0.891) for men and 0.859 (0.821-0.896) for women (p < 0.05). The HGS Q1 (men <37.4 kg and women <24 kg) was matched separately for PSM. After univariate, multivariate Cox regression models, PSM, IPTW, SMRW, PA, and OW analyses, women had 2.37-3.12 and 2.92-5.12 HRs with low HGS for all-cause and CVD mortality, while men had 2.21-2.82 and 2.33-2.85 for all-cause and CVD mortality, respectively (p < 0.05). Conclusion: Adults with low HGS exhibited a significantly increased risk of both all-cause and CVD mortality, regardless of gender. Additionally, low HGS served as an independent risk factor and predictor for both all-cause and CVD mortality.

A Microlens Array Grating for Miniature Multi-Channel Spectrometers.

Most existing multi-channel spectrometers are constructed by physically stacking single-channel spectrometers, resulting in their large size, high weight, and limited number of channels. Therefore, their miniaturization is urgently needed. In this paper, a microlens array grating is designed for miniature multi-channel spectrometers. A transmissive element integrating microlens arrays and gratings, the MLAG, enables simultaneous focusing and dispersion. Using soft lithography, the MLAG was fabricated with a deviation of less than 2.2%. The dimensions are 10 mm × 10 mm × 4 mm with over 2000 available units. The MLAG spectrometer operates in the 400-700 nm wavelength range with a resolution of 6 nm. Additionally, the designed MLAG multi-channel spectrometer is experimentally verified to have independently valid cells that can be used in multichannel spectrometers. The wavelength position repeatability deviation of each cell is about 0.5 nm, and the repeatability of displacement measurements by the chromatic confocal sensor with the designed MLAG multi-channel spectrometer is less than 0.5 µm.

The relationship between sarcopenia and mortality in Chinese community-dwelling adults: a 7-year cohort study with propensity score matching and Mendelian randomization.

Background: Sarcopenia has been linked to adverse health outcomes, including an increased risk of mortality. This study aimed to assess the 7-year mortality risk of sarcopenia in a community-based population in China and explore the causal relationship between components of sarcopenia and any death. Methods: Data were sourced from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2018. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Logistic regression, Kaplan-Meier (KM) survival analysis, and propensity score matching with inverse probability of treatment weighting were used. Mendelian randomization (MR) analyses, conducted using European population data, were utilized to assess causality between sarcopenia and any death. Results: The study included 9,006 participants: 3,892 had no sarcopenia, 3,570 had possible sarcopenia, 1,125 had sarcopenia, and 419 had severe sarcopenia. Over 7 years of follow-up, there were 871 deaths, including 196 with sarcopenia and 133 with severe sarcopenia. The KM curves showed that sarcopenia had a higher risk of mortality. Compared to those of no sarcopenia, the odds ratios (ORs) of sarcopenia for 7-year mortality were 1.41 (95% CI, 1.06-1.87) after adjusting for confounding variables (p < 0.05). The ORs of severe sarcopenia were 2.11 (95% CI, 1.51-2.95). Propensity score matching analysis and inverse probability of treatment weighting analysis confirmed these findings. The adjusted ORs of sarcopenia and 7-year mortality were 2.94 (95% CI, 1.6-5.39) in the 45-60 age group, 1.72 (95% CI, 1.11-2.68) in the 60-80 age group, and 5.03 (95% CI, 0.48-52.65) in the ≥80 age group. The ORs of severe sarcopenia and 7-year mortality were 6.92 (95% CI, 1.95-24.5) in the 45-60 age group, 2.59 (95% CI, 1.61-4.17) in the 60-80 age group, and 12.52 (95% CI, 1.18-133.18) in the ≥80 age group. The MR analyses, leveraging the inverse variance weighted (IVW) method, unveiled substantial causal links between low hand grip strength in individuals aged 60 and older, the usual walking pace, and mortality risk. Conclusion: This study underscores the significant impact of sarcopenia and its components on mortality risk within the Chinese population. Particularly, low hand grip strength and usual walking pace emerged as noteworthy contributors to mortality risk.

Atmospheric mercury in a developed region of eastern China: Interannual variation and gas-particle partitioning.

Atmospheric mercury plays a crucial role in the biogeochemical cycle of mercury. This study conducted an intensive measurement of atmospheric mercury from 2015 to 2018 at a regional site in eastern China. During this period, the concentration of particle-bound mercury (PBM) decreased by 13%, which was much lower than those of gaseous elemenral mercury (GEM, 30%) and reactive gaseous mercury (GOM, 62%). The gradual decrease in the correlation between PBM and CO, K, and Pb indicates that the influence of primary emissions on PBM concentration was weakening. Moreover, the value of the partitioning coefficient (Kp) increased gradually from 0.05 ± 0.076 m3/µg in 2015 to 0.16 ± 0.37 m3/µg in 2018, indicating that GOM was increasingly inclined to adsorb onto particulate matter. Excluding the influence of meteorological conditions and the primary emissions, the change in aerosol composition is designated as the main trigger factor for the increasing gas-particle partitioning of reactive mercury (RM). The increasing ratio of Cl-, NO3-, and organics (Org) in the chemical composition of particle matters (PM2.5), as well as the decrease in the proportion of SO42-, NH4+, and K+, are conducive to the adsorption of GOM onto particles, forming PBM, which led to an increase of Kp and a lag of PBM reduction compared to GEM and GOM under the continuous control measures of anthropogenic mercury emissions. The evolution of aerosol compositions in recent years affects the migration and transformation of atmospheric mercury, which in turn can affect the biogeochemical cycle of mercury.

Mixed mode of artificial liver support in patients with acute-on-chronic liver failure: a retrospective cohort study.

BACKGROUND AND AIMS: Different modes of artificial liver support (ALS) therapy can improve the survival of patients with acute-on-chronic liver failure (ACLF). This study aimed to compare the effects of mixed using different modes of ALS (MALS) and single using one mode of ALS (SALS) on 28- and 90-day survival rates of ACLF. METHODS: Clinical data and survival times of patients with ACLF treated for ALS between January 1, 2018 and December 30, 2021 were retrospectively collected. Cox regression analysis was performed to identify risk factors of 28- and 90-day mortalities. RESULTS: Of the 462 eligible ACLF patients, 388 belonged to the SALS group (76.3% male, 74.2% cirrhosis) and 74 to the MALS group (86.5% male, 71.6% cirrhosis). Comparison of 28-day and 90-day crude mortality between the SALS and MALS groups showed no significant differences (28-day: 20.4% vs. 14.9%, p = 0.27; 90-day: 44.6% vs. 52.7%, p = 0.20). After adjusting for confounders, the 28-day mortality (adjusted hazard ratio [aHR]: 0.32, 95% confidence interval [CI] 0.16-0.65) and 90-day mortality (aHR: 0.65, 95% CI 0.44-0.95) in the MALS group were significantly lower than those in the SALS group. These associations were consistently observed across pre-specified subgroups according to age, sex, etiology, and Child-Pugh grade. However, positive interactions between MALS and 90-day mortality were found between MALS and 90-day mortality in those with MELD score ≥ 22 and international normalized ratio ≥ 1.9 (p for interaction < 0.05). CONCLUSION: MALS therapy significantly decreased 28- and 90-day mortalities of ACLF than SALS did, especially in advanced stages.

Improved Artificial Potential Field Algorithm Assisted by Multisource Data for AUV Path Planning.

With the development of ocean exploration technology, the exploration of the ocean has become a hot research field involving the use of autonomous underwater vehicles (AUVs). In complex underwater environments, the fast, safe, and smooth arrival of target points is key for AUVs to conduct underwater exploration missions. Most path-planning algorithms combine deep reinforcement learning (DRL) and path-planning algorithms to achieve obstacle avoidance and path shortening. In this paper, we propose a method to improve the local minimum in the artificial potential field (APF) to make AUVs out of the local minimum by constructing a traction force. The improved artificial potential field (IAPF) method is combined with DRL for path planning while optimizing the reward function in the DRL algorithm and using the generated path to optimize the future path. By comparing our results with the experimental data of various algorithms, we found that the proposed method has positive effects and advantages in path planning. It is an efficient and safe path-planning method with obvious potential in underwater navigation devices.

Health Monitoring via Heart, Breath, and Korotkoff Sounds by Wearable Piezoelectret Patches.

Real-time monitoring of vital sounds from cardiovascular and respiratory systems via wearable devices together with modern data analysis schemes have the potential to reveal a variety of health conditions. Here, a flexible piezoelectret sensing system is developed to examine audio physiological signals in an unobtrusive manner, including heart, Korotkoff, and breath sounds. A customized electromagnetic shielding structure is designed for precision and high-fidelity measurements and several unique physiological sound patterns related to clinical applications are collected and analyzed. At the left chest location for the heart sounds, the S1 and S2 segments related to cardiac systole and diastole conditions, respectively, are successfully extracted and analyzed with good consistency from those of a commercial medical device. At the upper arm location, recorded Korotkoff sounds are used to characterize the systolic and diastolic blood pressure without a doctor or prior calibration. An Omron blood pressure monitor is used to validate these results. The breath sound detections from the lung/ trachea region are achieved a signal-to-noise ration comparable to those of a medical recorder, BIOPAC, with pattern classification capabilities for the diagnosis of viable respiratory diseases. Finally, a 6×6 sensor array is used to record heart sounds at different locations of the chest area simultaneously, including the Aortic, Pulmonic, Erb's point, Tricuspid, and Mitral regions in the form of mixed data resulting from the physiological activities of four heart valves. These signals are then separated by the independent component analysis algorithm and individual heart sound components from specific heart valves can reveal their instantaneous behaviors for the accurate diagnosis of heart diseases. The combination of these demonstrations illustrate a new class of wearable healthcare detection system for potentially advanced diagnostic schemes.

Wearable Photoelectric Fingertip Force Sensing System Based on Blood Volume Changes without Sensory Interference.

Monitoring the force of fingertip manipulation without disturbing the natural sense of touch is crucial for digitizing the skills of experienced craftsmen. However, conventional force sensors need to be put between the skin and the objects, which affects the natural sense of the skin. Here, we proposed a fingertip force sensing method based on changes of blood volume and designed a wearable photoelectric fingertip force sensing system (PFFS) for digitalization of traditional Chinese medicine (TCM) pulse diagnosis. The PFFS does not interfere with the fingertips' tactile sense while detecting fingertip force. This PFFS detects the change of blood volume in fingertip by photoelectric plethysmography and can obtain the change of output current under different fingertip forces. We also studied the effect of various factors on PFFS output signals, including emission lights of different wavelengths, ambient temperature, and the user's heartbeat artifact. We further established the relationship between the change of blood volume and fingertip force by combining experimental and theoretical methods. Moreover, we demonstrated the feasibility of the PFFS to detect fingertip forces under commonly used conditions in TCM pulse diagnosis without sensory interference. This PFFS also shows promise for perceiving the viscosity of objects and recognizing gestures in human-computer interaction. This work paves the way for the digitalization of fingertip forces during TCM pulse diagnosis and other fingertip forces under natural conditions.

Evaluating the Clinical Accuracy of a Non-invasive Single-Fasting-Calibration Glucometer in Patients with Diabetes: A Multicentre Study.

INTRODUCTION: The aim of this study was to evaluate the stability and accuracy of glucose measurements determined using the metabolic heat conformation (MHC)-based non-invasive glucometer in a multicentre, self-controlled clinical trial. This device is the first to obtain a medical device registration certificate awarded by the National Medical Products Administration of China (NMPA). METHODS: The multicentre clinical study was conducted at three sites and enrolled 200 subjects whose glucose was measured with a non-invasive glucometer (the Contour Plus blood glucose monitoring system) and by venous plasma glucose (VPG) measurements, in a fasted state and at 2 and 4 h after meals. RESULTS: Based on both the non-invasive and VPG measurements, 93.9% (95% confidence interval 91.7-95.6%) of the blood glucose (BG) values fell within consensus error grid (CEG) zones A + B. The measurements obtained in a fasted state and at 2 h after meals were more accurate, with 99.0% and 97.0% of the BG values, respectively, falling within zones A + B. Compared to those subjects who received insulin, the proportion of values in zones A + B and the correlation coefficients were 3.1% and 0.0596 higher, respectively. The accuracy of the non-invasive glucometer was influenced by the level of insulin resistance calculated by the homeostatic model assessment method, which had a correlation coefficient with the mean absolute relative difference of - 0.1588 (P = 0.0001). CONCLUSION: The MHC-based non-invasive glucometer assessed in the present study demonstrates generally high stability and accuracy in the glucose monitoring of people with diabetes. The calculation model needs to be further explored and optimised for patients with different diabetes subtypes, levels of insulin resistance and insulin secretion capacity. CLINICAL TRIAL REGISTRY NUMBER: ChiCTR1900020523.