Wearable wireless continuous vital signs monitoring on the general ward.

PURPOSE OF REVIEW: Wearable wireless sensors for continuous vital signs monitoring (CVSM) offer the potential for early identification of patient deterioration, especially in low-intensity care settings like general wards. This study aims to review advances in wearable CVSM - with a focus on the general ward - highlighting the technological characteristics of CVSM systems, user perspectives and impact on patient outcomes by exploring recent evidence. RECENT FINDINGS: The accuracy of wearable sensors measuring vital signs exhibits variability, especially notable in ambulatory patients within hospital settings, and standard validation protocols are lacking. Usability of CMVS systems is critical for nurses and patients, highlighting the need for easy-to-use wearable sensors, and expansion of the number of measured vital signs. Current software systems lack integration with hospital IT infrastructures and workflow automation. Imperative enhancements involve nurse-friendly, less intrusive alarm strategies, and advanced decision support systems. Despite observed reductions in ICU admissions and Rapid Response Team calls, the impact on patient outcomes lacks robust statistical significance. SUMMARY: Widespread implementation of CVSM systems on the general ward and potentially outside the hospital seems inevitable. Despite the theoretical benefits of CVSM systems in improving clinical outcomes, and supporting nursing care by optimizing clinical workflow efficiency, the demonstrated effects in clinical practice are mixed. This review highlights the existing challenges related to data quality, usability, implementation, integration, interpretation, and user perspectives, as well as the need for robust evidence to support their impact on patient outcomes, workflow and cost-effectiveness.

Rapid and on-site wireless immunoassay of respiratory virus aerosols via hydrogel-modulated resonators.

Rapid and accurate detection of respiratory virus aerosols is highlighted for virus surveillance and infection control. Here, we report a wireless immunoassay technology for fast (within 10 min), on-site (wireless and battery-free), and sensitive (limit of detection down to fg/L) detection of virus antigens in aerosols. The wireless immunoassay leverages the immuno-responsive hydrogel-modulated radio frequency resonant sensor to capture and amplify the recognition of virus antigen, and flexible readout network to transduce the immuno bindings into electrical signals. The wireless immunoassay achieves simultaneous detection of respiratory viruses such as severe acute respiratory syndrome coronavirus 2, influenza A H1N1 virus, and respiratory syncytial virus for community infection surveillance. Direct detection of unpretreated clinical samples further demonstrates high accuracy for diagnosis of respiratory virus infection. This work provides a sensitive and accurate immunoassay technology for on-site virus detection and disease diagnosis compatible with wearable integration.

Lead-free dual-frequency ultrasound implants for wireless, biphasic deep brain stimulation.

Ultrasound-driven bioelectronics could offer a wireless scheme with sustainable power supply; however, current ultrasound implantable systems present critical challenges in biocompatibility and harvesting performance related to lead/lead-free piezoelectric materials and devices. Here, we report a lead-free dual-frequency ultrasound implants for wireless, biphasic deep brain stimulation, which integrates two developed lead-free sandwich porous 1-3-type piezoelectric composite elements with enhanced harvesting performance in a flexible printed circuit board. The implant is ultrasonically powered through a portable external dual-frequency transducer and generates programmable biphasic stimulus pulses in clinically relevant frequencies. Furthermore, we demonstrate ultrasound-driven implants for long-term biosafety therapy in deep brain stimulation through an epileptic rodent model. With biocompatibility and improved electrical performance, the lead-free materials and devices presented here could provide a promising platform for developing implantable ultrasonic electronics in the future.

Design and fabrication of a microstrip triplexer with wide flat channels for multi-band 5G applications.

In this paper, a new microstrip triplexer is designed to work at 2.5 GHz, 4.4 GHz and 6 GHz for mid-band 5G applications. All channels are flat with three low group delays (GDs) of 0.84 ns, 0.75 ns and 0.49 ns, respectively. Compared to the previously reported works, the proposed triplexer has the minimum group delay. The designed triplexer has 18.2%, 13.7%, 23.6% fractional bandwidths (FBW%) at 2.5 GHz, 4.4 GHz and 6 GHz, respectively. The obtained insertion losses (ILs) are low at all channels. These features are obtained without a noticeable increase in the overall size. A novel and simple resonator is used to design the proposed triplexer, which includes two pairs of coupled lines combined with a shunt stub. A perfect mathematical analysis is performed to find the resonator behavior and the layout optimization. The type of shunt stub is determined mathematically. Also, the smallness or largeness of some important physical dimensions is determined using the proposed mathematical analysis. Finally, the designed triplexer is fabricated and measured, where the measurement results verify the simulations.

Secure UAV adhoc network with blockchain technology.

Recent advances in aerial robotics and wireless transceivers have generated an enormous interest in networks constituted by multiple compact unmanned aerial vehicles (UAVs). UAV adhoc networks, i.e., aerial networks with dynamic topology and no centralized control, are found suitable for a unique set of applications, yet their operation is vulnerable to cyberattacks. In many applications, such as IoT networks or emergency failover networks, UAVs augment and provide support to the sensor nodes or mobile nodes in the ground network in data acquisition and also improve the overall network performance. In this situation, ensuring the security of the adhoc UAV network and the integrity of data is paramount to accomplishing network mission objectives. In this paper, we propose a novel approach to secure UAV adhoc networks, referred to as the blockchain-assisted security framework (BCSF). We demonstrate that the proposed system provides security without sacrificing the performance of the network through blockchain technology adopted to the priority of the message to be communicated over the adhoc UAV network. Theoretical analysis for computing average latency is performed based on queuing theory models followed by an evaluation of the proposed BCSF approach through simulations that establish the superior performance of the proposed methodology in terms of transaction delay, data secrecy, data recovery, and energy efficiency.

Developing a Novel Prosthetic Hand with Wireless Wearable Sensor Technology Based on User Perspectives: A Pilot Study.

Myoelectric hands are beneficial tools in the daily activities of people with upper-limb deficiencies. Because traditional myoelectric hands rely on detecting muscle activity in residual limbs, they are not suitable for individuals with short stumps or paralyzed limbs. Therefore, we developed a novel electric prosthetic hand that functions without myoelectricity, utilizing wearable wireless sensor technology for control. As a preliminary evaluation, our prototype hand with wireless button sensors was compared with a conventional myoelectric hand (Ottobock). Ten healthy therapists were enrolled in this study. The hands were fixed to their forearms, myoelectric hand muscle activity sensors were attached to the wrist extensor and flexor muscles, and wireless button sensors for the prostheses were attached to each user's trunk. Clinical evaluations were performed using the Simple Test for Evaluating Hand Function and the Action Research Arm Test. The fatigue degree was evaluated using the modified Borg scale before and after the tests. While no statistically significant differences were observed between the two hands across the tests, the change in the Borg scale was notably smaller for our prosthetic hand (p = 0.045). Compared with the Ottobock hand, the proposed hand prosthesis has potential for widespread applications in people with upper-limb deficiencies.

Performance Assessment for the Validation of Wireless Communication Engines in an Innovative Wearable Monitoring Platform.

In today's health-monitoring applications, there is a growing demand for wireless and wearable acquisition platforms capable of simultaneously gathering multiple bio-signals from multiple body areas. These systems require well-structured software architectures, both to keep different wireless sensing nodes synchronized each other and to flush collected data towards an external gateway. This paper presents a quantitative analysis aimed at validating both the wireless synchronization task (implemented with a custom protocol) and the data transmission task (implemented with the BLE protocol) in a prototype wearable monitoring platform. We evaluated seven frequencies for exchanging synchronization packets (10 Hz, 20 Hz, 30 Hz, 40 Hz, 50 Hz, 60 Hz, 70 Hz) as well as two different BLE configurations (with and without the implementation of a dynamic adaptation of the BLE Connection Interval parameter). Additionally, we tested BLE data transmission performance in five different use case scenarios. As a result, we achieved the optimal performance in the synchronization task (1.18 ticks as median synchronization delay with a Min-Max range of 1.60 ticks and an Interquartile range (IQR) of 0.42 ticks) when exploiting a synchronization frequency of 40 Hz and the dynamic adaptation of the Connection Interval. Moreover, BLE data transmission proved to be significantly more efficient with shorter distances between the communicating nodes, growing worse by 30.5% beyond 8 m. In summary, this study suggests the best-performing network configurations to enhance the synchronization task of the prototype platform under analysis, as well as quantitative details on the best placement of data collectors.

Gait Pattern Analysis: Integration of a Highly Sensitive Flexible Pressure Sensor on a Wireless Instrumented Insole.

Gait phase monitoring wearable sensors play a crucial role in assessing both health and athletic performance, offering valuable insights into an individual's gait pattern. In this study, we introduced a simple and cost-effective capacitive gait sensor manufacturing approach, utilizing a micropatterned polydimethylsiloxane dielectric layer placed between screen-printed silver electrodes. The sensor demonstrated inherent stretchability and durability, even when the electrode was bent at a 45-degree angle, it maintained an electrode resistance of approximately 3 Ω. This feature is particularly advantageous for gait monitoring applications. Furthermore, the fabricated flexible capacitive pressure sensor exhibited higher sensitivity and linearity at both low and high pressure and displayed very good stability. Notably, the sensors demonstrated rapid response and recovery times for both under low and high pressure. To further explore the capabilities of these new sensors, they were successfully tested as insole-type pressure sensors for real-time gait signal monitoring. The sensors displayed a well-balanced combination of sensitivity and response time, making them well-suited for gait analysis. Beyond gait analysis, the proposed sensor holds the potential for a wide range of applications within biomedical, sports, and commercial systems where soft and conformable sensors are preferred.

Postoperative Long-Term Monitoring of Mechanical Characteristics in Reconstructed Soft Tissues Using Biocompatible, Immune-Tolerant, and Wireless Electronic Sutures.

Accurate postoperative assessment of varying mechanical properties is crucial for customizing patient-specific treatments and optimizing rehabilitation strategies following Achilles tendon (AT) rupture and reconstruction surgery. This study introduces a wireless, chip-less, and immune-tolerant in vivo strain-sensing suture designed to continuously monitor mechanical stiffness variations in the reconstructed AT throughout the healing process. This innovative sensing suture integrates a standard medical suturing thread with a wireless fiber strain-sensing system, which incorporates a fiber strain sensor and a double-layered inductive coil for wireless readout. The winding design of Au nanoparticle-based fiber electrodes and a hollow core contribute to the fiber strain sensor's high sensitivity (factor of 6.2 and 15.1 pF for revised sensitivity), negligible hysteresis, and durability over 10,000 stretching cycles. To ensure biocompatibility and immune tolerance during extended in vivo periods, an antibiofouling lubricant layer was applied to the sensing suture. Using this sensing system, we successfully monitored the strain responses of the reconstructed AT in an in vivo porcine model. This facilitated the postoperative assessment of mechanical stiffness variations through a well-established analytical model during the healing period.

Monolithically Defined Wireless Fully Implantable Nervous System Interfaces.

ConspectusEvolution of implantable neural interfaces is critical in addressing the challenges in understanding the fundamental working principles and therapeutic applications for central and peripheral nervous systems. Traditional approaches utilizing hermetically sealed, rigid electronics and detached electrodes face challenges in power supply, encapsulation, channel count, dispersed application location, and modality. Employing thin-film, wirelessly powered devices is promising to expand capabilities. Devices that forego bulky power supplies, favoring a configuration where electronics are integrated directly onto thin films, reduce displacement volumes for seamless, fully implantable interfaces with high energy availability and soft mechanics to conform to the neuronal target. We discuss 3 device architectures: (1) Highly miniaturized devices that merge electronics and neural interfaces into a single, injectable format; (2) Interfaces that consolidate power, computation, and neural connectivity on a thin sheet applied directly to the target area; (3) A spatially dislocated approach where power and computation are situated subdermally, connected via a thin interconnect to the neural interface.Each has advantages and constraints in terms of implantation invasiveness, power capturing efficiency, and directional sensitivity of power delivery. In powering these devices, near-field power delivery emerges as the most implemented technique. Key parameters are size and volume of primary and secondary antennas, which determine coupling efficiency and power delivery. Based on application requirements, ranging from small to large animal models, subjects require system level designs. Material strategies play a crucial role; monolithic designs, with materials like polyimide substrates, enable scalability with high performance. This contrasts with established hermetic encapsulation approaches that use a stainless steel or titanium box with passthroughs that result in large tissue displacements and prohibit intimate integration with target organ systems. Encapsulation, particularly with parylene, enables longevity and effectiveness; more research is needed to enable human lifetime operation. Implant-to-ambient device communication, focusing on strategies compatible with well-established standards and off-the-shelf electronics, is discussed with the goal of enabling seamless system integration, reliability, and scalability. The interface with the central nervous system is explored through various wireless, battery-free devices capable of both stimulation (electrical and optogenetic) and recording (photometric and electrochemical). These devices show advanced capabilities for chronic studies and insights into neural dynamics. In the peripheral nervous system, stimulation devices for applications, such as spinal and muscle stimulation, are discussed. The challenges lie in the mechanical and electrochemical durability. Examples that successfully navigate these challenges offer solutions for chronic studies in this domain. The potential of wireless, fully implantable nervous system interfaces using near field resonant power transfer is characterized by monolithically defined device architecture, providing a significant leap toward seamless access to the central and peripheral nervous systems. New avenues for research and therapeutic applications supporting a multimodal and multisite approach to neuromodulation with a high degree of connectivity and a holistic approach toward deciphering and supplementing the nervous system may enable recovery and treatment of injury and chronic disease.

Anisotropic Elastomer Ionomer Composite-Based Strain Sensors: Achieving High Sensitivity and Wide Detection for Human Motion Detection and Wireless Transmission.

Anisotropic strain sensors capable of multidirectional sensing are crucial for advanced sensor applications in human motion detection. However, current anisotropic sensors encounter challenges in achieving a balance among high sensitivity, substantial stretchability, and a wide linear detection range. To address these challenges, a facile freeze-casting strategy was employed to construct oriented filler networks composed of carbon nanotubes and conductive carbon black within a brominated butyl rubber ionomer (iBIIR) matrix. The resulting anisotropic sensor based on the iBIIR composites exhibited distinct gauge factors (GF) in the parallel and vertical directions (GF∥ = 4.91, while GF⊥ = 2.24) and a broad linear detection range over a strain range of 190%. This feature enables the sensor to detect various human activities, including uniaxial pulse, finder bending, elbow bending, and cervical spine movements. Moreover, the ion-cross-linking network within the iBIIR, coupled with strong π-cation interactions between the fillers and iBIIR macromolecules, imparted high strength (12.3 MPa, nearly twice that of pure iBIIR) and an ultrahigh elongation at break (>1800%) to the composites. Furthermore, the sensor exhibited exceptional antibacterial effectiveness, surpassing 99% against both Escherichia coli and Staphylococcus aureus. Notably, the sensor was capable of wireless sensing. It is anticipated that anisotropic sensors will have extensive application prospects in flexible wearable devices.

Wireless Flexible System for Highly Sensitive Ammonia Detection Based on Polyaniline/Carbon Nanotubes.

Ammonia (NH3) is a harmful atmospheric pollutant and an important indicator of environment, health, and food safety conditions. Wearable devices with flexible gas sensors offer convenient real-time NH3 monitoring capabilities. A flexible ammonia gas sensing system to support the internet of things (IoT) is proposed. The flexible gas sensor in this system utilizes polyaniline (PANI) with multiwall carbon nanotubes (MWCNTs) decoration as a sensitive material, coated on a silver interdigital electrode on a polyethylene terephthalate (PET) substrate. Gas sensors are combined with other electronic components to form a flexible electronic system. The IoT functionality of the system comes from a microcontroller with Wi-Fi capability. The flexible gas sensor demonstrates commendable sensitivity, selectivity, humidity resistance, and long lifespan. The experimental data procured from the sensor reveal a remarkably low detection threshold of 0.3 ppm, aligning well with the required specifications for monitoring ammonia concentrations in exhaled breath gas, which typically range from 0.425 to 1.8 ppm. Furthermore, the sensor demonstrates a negligible reaction to the presence of interfering gases, such as ethanol, acetone, and methanol, thereby ensuring high selectivity for ammonia detection. In addition to these attributes, the sensor maintains consistent stability across a range of environmental conditions, including varying humidity levels, repeated bending cycles, and diverse angles of orientation. A portable, stable, and effective flexible IoT system solution for real-time ammonia sensing is demonstrated by collecting data at the edge end, processing the data in the cloud, and displaying the data at the user end.

Wireless Gold/Boron-Nitrogen-Codoped Graphene-Based Antenna Immunosensor for the Rapid Detection of Neuron-Specific Enolase.

Tumor-marker immunosensors for rapid on-site detection have not yet been developed because of immunoreaction bottlenecks, such as shortening the reaction time and facilitating incubation. In this study, a gold-boron-nitrogen-codoped graphene (Au-BNG)-based immunosensor antenna was constructed for the rapid detection of neuron-specific enolase (NSE). A Au-BNG radiation electrode with dual functions of antibody protein fixation and signal transmission was developed for the first time. A radiation sample cell was constructed by embedding a radiation electrode into the groove of a poly(dimethylsiloxane) dielectric substrate. The constructed sense antenna achieves accurate detection of NSE with a range from 50 fg mL-1 to 40,000 pg mL-1 and a limit of detection of 10.99 fg mL-1, demonstrating excellent selectivity, stability, and reliability. The tumor-marker detection meter can provide NSE detection results as rapidly as within 2 min by using the new strategy of the microwave self-incubation of tumor markers. This antenna immunosensor is suitable for rapid detection in outpatient clinics and can be developed into household tumor-marker detectors, which would be significant in the early detection, long-term monitoring, and efficacy evaluation of tumors.

Temperature Self-Compensating Intelligent Wireless Measuring Contact Lens for Quantitative Intraocular Pressure Monitoring.

Flexible bioelectronic devices that can perform real-time and accurate intraocular pressure (IOP) monitoring in both clinical and home settings hold significant implications for the diagnosis and treatment of glaucoma, yet they face challenges due to the open physiological environment of the ocular. Herein, we develop an intelligent wireless measuring contact lens (WMCL) incorporating a dual inductor-capacitor-resistor (LCR) resonant system to achieve temperature self-compensation for quantitative IOP monitoring in different application environments. The WMCL utilizes a compact circuitry design, which enables the integration of low-frequency and high-frequency resonators within a single layer of a sensing circuit without causing visual impairment. Mechanically guided microscale 3D encapsulation strategy combined with flexible circuit printing techniques achieves the surface-adaptive fabrication of the WMCL. The specific design of frequency separation imparts distinct temperature response characteristics to the dual resonators, and the linear combination of the dual resonators can eliminate the impact of temperature variations on measurement accuracy. The WMCL demonstrates outstanding sensitivity and linearity in monitoring the IOP of porcine eyes in vitro while maintaining satisfactory measurement accuracy even with internal temperature variations exceeding 10 °C. Overcoming the impact of temperature variations on IOP monitoring from the system level, the WMCL showcases immense potential as the next generation of all-weather IOP monitoring devices.

Bioresorbable, wireless, passive sensors for continuous pH measurements and early detection of gastric leakage.

Continuous monitoring of biomarkers at locations adjacent to targeted internal organs can provide actionable information about postoperative status beyond conventional diagnostic methods. As an example, changes in pH in the intra-abdominal space after gastric surgeries can serve as direct indicators of potentially life-threatening leakage events, in contrast to symptomatic reactions that may delay treatment. Here, we report a bioresorbable, wireless, passive sensor that addresses this clinical need, designed to locally monitor pH for early detection of gastric leakage. A pH-responsive hydrogel serves as a transducer that couples to a mechanically optimized inductor-capacitor circuit for wireless readout. This platform enables real-time monitoring of pH with fast response time (within 1 hour) over a clinically relevant period (up to 7 days) and timely detection of simulated gastric leaks in animal models. These concepts have broad potential applications for temporary sensing of relevant biomarkers during critical risk periods following diverse types of surgeries.

A multi-objective optimized OLSR routing protocol.

The rapid development of mobile communication devices has brought challenges to wireless networks, where data packets are able to organize and maintain local area networks more freely without the constraints of wired devices. Scholars have developed diverse network protocols on how to ensure data transmission while maintaining its self-organizational nature. However, it is difficult for traditional network protocols to meet the needs of increasingly complex networks. In order to solve the problem that the better node set may not be selected when selecting the node set responsible for forwarding in the traditional OLSR protocol, a multi-objective optimized OLSR algorithm is proposed in this paper, which incorporating a new MPR mechanism and an improved NSGA-II algorithm. In the process of route discovery, the intermediate nodes responsible for forwarding packets are determined by the new MPR mechanism, and then the main parameters in the OLSR protocol are provided by the multi-objective optimization algorithm. Matlab was used to build a self-organizing network in this study. In addition, the conventional OLSR protocol, NSGA-II algorithm and multi-objective simulated annealing algorithm are selected to compare with the proposed algorithm. Simulation results show that the proposed algorithm can effectively reduce packet loss and end-to-end delay while obtaining better results in HV and Spacing, two multi-objective optimization result evaluation metrics.

Wireless rotating bipolar electrochemiluminescence for enzymatic detection.

New dynamic, wireless and cost-effective analytical devices are developing rapidly in biochemical analysis. Here, we report on a remotely-controlled rotating electrochemiluminescence (ECL) sensing system for enzymatic detection of a model analyte, glucose, on both polarized sides of an iron wire acting as a bipolar electrode. The iron wire is controlled by double contactless mode, involving remote electric field polarization, and magnetic field-induced rotational motion. The former triggers the interfacial polarization of both extremities of the wire by bipolar electrochemistry, which generates ECL emission of the luminol derivative (L-012) with the enzymatically produced hydrogen peroxide in presence of glucose, at both anodic and cathodic poles, simultaneously. The latter generates a convective flow, leading to an increase in mass transfer and amplifying the corresponding ECL signals. Quantitative glucose detection in human serum samples is achieved. The ECL signals were found to be a linear function of the glucose concentration within the range of 10-1000 µM and with a limit of detection of 10 µM. The dynamic bipolar ECL system simultaneously generates light emissions at both anodic and cathodic poles for glucose detection, which can be further applied to biosensing and imaging in autonomous devices.

[Development of Wireless Wearable Sleep Monitoring System Based on EEG Signal].

A wireless wearable sleep monitoring system based on EEG signals is developed. The collected EEG signals are wirelessly sent to the PC or mobile phone Bluetooth APP for real-time display. The system is small in size, low in power consumption, and light in weight. It can be worn on the patient's forehead and is comfortable. It can be applied to home sleep monitoring scenarios and has good application value. The key performance indicators of the system are compared with the industry-related medical device measurement standards, and the measurement results are better than the special standards.

A novel and effective method for solving the router nodes placement in wireless mesh networks using reinforcement learning.

Router nodes placement (RNP) is an important issue in the design and implementation of wireless mesh networks (WMN). This is known as an P-hard problem, which cannot be solved using conventional algorithms. Consequently, approximate optimization strategies are commonly used to solve this problem. With heavy node density and wide-area WMNs, solving the RNP problem using approximation algorithms often faces many difficulties, therefore, a more effective solution is necessary. This motivated us to conduct this work. We propose a new method for solving the RNP problem using reinforcement learning (RL). The RNP problem is modeled as an RL model with environment, agent, action, and reward are equivalent to the network system, routers, coordinate adjustment, and connectivity of the RNP problem, respectively. To the best of our knowledge, this is the first study that applies RL to solve the RNP problem. The experimental results showed that the proposed method increased the network connectivity by up to 22.73% compared to the most recent methods.

Power-integrated, wireless neural recording systems on the cranium using a direct printing method for deep-brain analysis.

Conventional power-integrated wireless neural recording devices suffer from bulky, rigid batteries in head-mounted configurations, hindering the precise interpretation of the subject's natural behaviors. These power sources also pose risks of material leakage and overheating. We present the direct printing of a power-integrated wireless neural recording system that seamlessly conforms to the cranium. A quasi-solid-state Zn-ion microbattery was 3D-printed as a built-in power source geometrically synchronized to the shape of a mouse skull. Soft deep-brain neural probes, interconnections, and auxiliary electronics were also printed using liquid metals on the cranium with high resolutions. In vivo studies using mice demonstrated the reliability and biocompatibility of this wireless neural recording system, enabling the monitoring of neural activities across extensive brain regions without notable heat generation. This all-printed neural interface system revolutionizes brain research, providing bio-conformable, customizable configurations for improved data quality and naturalistic experimentation.