Medical smart textiles based on fiber optic technology: an overview

Unpacking the packaged optical fiber bio-sensors: understanding the obstacle for biomedical application

A biosensor is a promising alternative tool for the detection of clinically relevant analytes. Optical fiber as a transducer element in biosensors offers low cost, biocompatibility, and lack of electromagnetic interference. Moreover, due to the miniature size of optical fibers, they have the potential to be used in microfluidic chips and in vivo applications. The number of optical fiber biosensors are extensively growing: they have been developed to detect different analytes ranging from small molecules to whole cells. Yet the widespread applications of optical fiber biosensor have been hindered; one of the reasons is the lack of suitable packaging for their real-life application. In order to translate optical fiber biosensors into clinical practice, a proper embedding of biosensors into medical devices or portable chips is often required. A proper packaging approach is frequently as challenging as the sensor architecture itself. Therefore, this review aims to give an unpack different aspects of the integration of optical fiber biosensors into packaging platforms to bring them closer to actual clinical use. Particularly, the paper discusses how optical fiber sensors are integrated into flow cells, organized into microfluidic chips, inserted into catheters, or otherwise encased in medical devices to meet requirements of the prospective applications.

Advancements in optical fiber-based wearable sensors for smart health monitoring

Healthcare system is undergoing a significant transformation from a traditional hospital-centered to an individual-centered one, as a result of escalating chronic diseases, ageing populations, and ever-increasing healthcare costs,. Wearable sensors have become widely used in health monitoring systems since the COVID-19 pandemic. They enable continuous measurement of important health indicators like body temperature, wrist pulse, respiration rate, and non-invasive bio fluids like saliva and perspiration. Over the last few decades, the development has mostly concentrated on electrochemical and electrical wearable sensors. However, due to the drawbacks of such sensors, such as electronic waste, electromagnetic interference, non-electrical security, and poor performance, researchers are exhibiting a strong interest in optical principle-based systems. Fiber-based optical wearables are among the most promising healthcare systems because of advancements in high-sensitivity, durable, multiplexed sensing, and simple integration with flexible materials to improve wearability and simplicity. We present an overview of recent developments in optical fiber-based wearable sensors, focusing on two mechanisms: wavelength interrogation and intensity modulation for the detection of body temperature, pulse rate, respiration rate, body movements, and biomedical noninvasive fluids, with a thorough examination of their benefits and drawbacks. This review also focuses on improving working performance and application techniques for healthcare systems, including the integration of nanomaterials and the usage of the Internet of Things (IoT) with signal processing. Finally, the review concludes with a discussion of the future possibilities and problems for optical fiber-based wearables.

Miniaturized fluorescence pH sensor with assembly free ball lens on a tapered multimode optical fiber

In biochemistry, the absence of a compact, assembly-free pH sensor with high sensitivity and signal-to-noise ratio has been a persistent hurdle in achieving accurate pH measurements in real time, particularly in complex liquid environments. This manuscript introduces what we believe to be a novel solution in the form of a miniaturized pH sensor utilizing an assembly-free ball lens on a tapered multimode optical fiber (TMMF), offering the potential to revolutionize pH sensing in biochemical applications. A multimode optical fiber (MMF) was subjected to tapering processes, leading to the creation of an ultra-thin needle-like structure with a cross-sectional diameter of about 12.5 µm and a taper length of 3 mm. Subsequently, a ball lens possessing a diameter of 20 µm was fabricated at the apex of the taper. The resultant structure was coated utilizing the dip-coating technique, involving a composite mixture of epoxy and pH-sensitive dye, 2',7'-bis(2-carboxyethyl)-5-(and-6)-carboxyfluorescein (BCECF), thereby ensconcing the tapered ball lens with dye molecules for pH sensing. This study encompassed the fabrication and evaluation of six distinct fiber structures, incorporating the cleaved endface, the convex lens, and the ball lens structures to compare light focal lengths and propagation intensities. Computational simulations and numerical analyses were conducted to elucidate the encompassing light focal distances across the full array of lens configurations. The efficacy of the proposed pH sensor was subsequently assessed through its deployment within a complex liquid medium spanning a pH spectrum ranging from 6 to 8. Real-time data acquisition was performed with a fast response time of 0.5 seconds. A comparative analysis with a pH sensor predicated upon a single TMMF embedded with the fluorescent dye underscored the substantial signal enhancement achieved by the proposed system twice the fluorescence signal magnitude. The proposed assembly-free miniaturized pH sensor not only substantiates enhanced signal collection efficiency but also decisively addresses the persistent challenges of poor signal-to-noise ratio encountered within contemporary miniaturized pH probes.

Wearable Sensors for Respiration Monitoring: A Review

This paper provides an overview of flexible and wearable respiration sensors with emphasis on their significance in healthcare applications. The paper classifies these sensors based on their operating frequency distinguishing between high-frequency sensors, which operate above 10 MHz, and low-frequency sensors, which operate below this level. The operating principles of breathing sensors as well as the materials and fabrication techniques employed in their design are addressed. The existing research highlights the need for robust and flexible materials to enable the development of reliable and comfortable sensors. Finally, the paper presents potential research directions and proposes research challenges in the field of flexible and wearable respiration sensors. By identifying emerging trends and gaps in knowledge, this review can encourage further advancements and innovation in the rapidly evolving domain of flexible and wearable sensors.

Wearable Optical Fiber Sensors in Medical Monitoring Applications: A Review

Wearable optical fiber sensors have great potential for development in medical monitoring. With the increasing demand for compactness, comfort, accuracy, and other features in new medical monitoring devices, the development of wearable optical fiber sensors is increasingly meeting these requirements. This paper reviews the latest evolution of wearable optical fiber sensors in the medical field. Three types of wearable optical fiber sensors are analyzed: wearable optical fiber sensors based on Fiber Bragg grating, wearable optical fiber sensors based on light intensity changes, and wearable optical fiber sensors based on Fabry-Perot interferometry. The innovation of wearable optical fiber sensors in respiration and joint monitoring is introduced in detail, and the main principles of three kinds of wearable optical fiber sensors are summarized. In addition, we discuss their advantages, limitations, directions to improve accuracy and the challenges they face. We also look forward to future development prospects, such as the combination of wireless networks which will change how medical services are provided. Wearable optical fiber sensors offer a viable technology for prospective continuous medical surveillance and will change future medical benefits.

A Novel Force-Sensing Smart Textile: Inserting Silicone-Embedded FBG Sensors into a Knitted Undergarment

A number of textile-based fiber optic sensors have recently been proposed for the continuous monitoring of vital signs. However, some of these sensors are likely unsuitable for conducting direct measurements on the torso as they lack elasticity and are inconvenient. This project provides a novel method for creating a force-sensing smart textile by inlaying four silicone-embedded fiber Bragg grating sensors into a knitted undergarment. The applied force was determined within 3 N after transferring the Bragg wavelength. The results show that the sensors embedded in the silicone membranes achieved enhanced sensitivity to force, as well as flexibility and softness. Additionally, by assessing the degree of FBG response to a range of standardized forces, the linearity (R2) between the shift in the Bragg wavelength and force was found to be above 0.95, with an ICC of 0.97, when tested on a soft surface. Furthermore, the real-time data acquisition could facilitate the adjustment and monitoring of force during the fitting processes, such as in bracing treatment for adolescent idiopathic scoliosis patients. Nevertheless, the optimal bracing pressure has not yet been standardized. This proposed method could help orthotists to adjust the tightness of brace straps and the location of padding in a more scientific and straightforward way. The output of this project could be further extended to determine ideal bracing pressure levels.

Plasmonic Perfect Absorber Utilizing Polyhexamethylene Biguanide Polymer for Carbon Dioxide Gas Sensing Application

In this paper a perfect absorber with a photonic crystal cavity (PhC-cavity) is numerically investigated for carbon dioxide (CO₂) gas sensing application. Metallic structures in the form of silver are introduced for harnessing plasmonic effects to achieve perfect absorption. The sensor comprises a PhC-cavity, silver (Ag) stripes, and a host functional material-Polyhexamethylene biguanide polymer-deposited on the surface of the sensor. The PhC-cavity is implemented within the middle of the cell, helping to penetrate the EM waves into the sublayers of the structure. Therefore, corresponding to the concentration of the CO₂ gas, as it increases, the refractive index of the host material decreases, causing a blue shift in the resonant wavelength and vice versa of the device. The sensor is used for the detection of 0-524 parts per million (ppm) concentration of the CO₂ gas, with a maximum sensitivity of 17.32 pm (pico meter)/ppm achieved for a concentration of 366 ppm with a figure of merit (FOM) of 2.9 RIU^-1. The four-layer device presents a straightforward and compact design that can be adopted in various sensing applications by using suitable host functional materials.

Microbial profile of T-shirts after a fitness session of Chinese students

Clothing textiles could protect our human skin against external factors, but the microbial population, including conditional pathogens, in clothing, would cause unpleasant odor, Skin inflammation, and textile deterioration. Several studies have reported that microbiomes on clothes are affected by skin microorganisms of individuals, the local environment and the types of textile fabrics, but little is known about how the textile microbial community is shaped in the Chinese population. In this study, 10 healthy young students were recruited to successfully wear the T-shirts made with 3 different fabrics (polyester, cotton, and blending fabrics of polyester and cotton) during physical exercise. Total deoxyribonucleic acid (DNA) was extracted from 30 T-shirts and 16s rRNA gene amplicon sequencing was applied to estimate the absolute abundances of bacteria in the samples. The main bacteria on wore T-shirts were Staphylococcus (21.66%) Enhydrobacter (13.81%), Pantoea (8.14%), Acinetobacter (7.81%), Pseudomonas (6.18%), Cutibacterium (4.99%). However, no difference of α and β diversity was observed among the three textile fabrics. Further analysis found that Pantoea and Pseudomonas, mainly from the environment, enriched on the polyester, but not on cotton, while Enhydrobacter, from human skin, has the growth advantage on cotton, and the blending fabric in between. Collectively, our study preliminary explored the clothes microbiome in Chinese young students, contributing to helping understand the role of clothing microorganisms on human health.

Fabrication of Conductive Fabrics Based on SWCNTs, MWCNTs and Graphene and Their Applications: A Review

In recent years, the field of conductive fabrics has been challenged by the increasing popularity of these materials in the production of conductive, flexible and lightweight textiles, so-called smart textiles, which make our lives easier. These electronic textiles can be used in a wide range of human applications, from medical devices to consumer products. Recently, several scientific results on smart textiles have been published, focusing on the key factors that affect the performance of smart textiles, such as the type of substrate, the type of conductive materials, and the manufacturing method to use them in the appropriate application. Smart textiles have already been fabricated from various fabrics and different conductive materials, such as metallic nanoparticles, conductive polymers, and carbon-based materials. In this review, we study the fabrication of conductive fabrics based on carbon materials, especially carbon nanotubes and graphene, which represent a growing class of high-performance materials for conductive textiles and provide them with superior electrical, thermal, and mechanical properties. Therefore, this paper comprehensively describes conductive fabrics based on single-walled carbon nanotubes, multi-walled carbon nanotubes, and graphene. The fabrication process, physical properties, and their increasing importance in the field of electronic devices are discussed.

Algoritmically improved microwave radar monitors breathing more acurrate than sensorized belt

This paper describes a novel way to measure, process, analyze, and compare respiratory signals acquired by two types of devices: a wearable sensorized belt and a microwave radar-based sensor. Both devices provide breathing rate readouts. First, the background research is presented. Then, the underlying principles and working parameters of the microwave radar-based sensor, a contactless device for monitoring breathing, are described. The breathing rate measurement protocol is then presented, and the proposed algorithm for octave error elimination is introduced. Details are provided about the data processing phase; specifically, the management of signals acquired from two devices with different working principles and how they are resampled with a common processing sample rate. This is followed by an analysis of respiratory signals experimentally acquired by the belt and microwave radar-based sensors. The analysis outcomes were checked using Levene’s test, the Kruskal–Wallis test, and Dunn’s post hoc test. The findings show that the proposed assessment method is statistically stable. The source of variability lies in the person-triggered breathing patterns rather than the working principles of the devices used. Finally, conclusions are derived, and future work is outlined.

Fiber Bragg Grating-Based Smart Garment for Monitoring Human Body Temperature

Body temperature provides an insight into the physiological state of a person, and body temperature changes reflect much information about human health. In this study, a garment for monitoring human body temperature based on fiber Bragg grating (FBG) sensors is reported. The FBG sensor was encapsulated with a PMMA tube and calibrated in the thermostatic water bath. The results showed that FBG sensors had good vibration resistance, and the wavelength changed about 0–1 pm at a 0.5–80 Hz vibration frequency. The bending path of the optical fiber after integration with clothing is discussed. When the bending radius is equal to or greater than 20 mm, a lower bending loss can be achieved even under the bending and stretching of the human body. The FBG sensor, the optical fiber, and the garment were integrated together using hot melt glue by the electric iron and the hot press machine. Through experiments of monitoring human body temperature, the sensor can reach the human armpit temperature in about 10–15 min with the upper arm close to the torso. Because it is immune to electromagnetic interferences, the smart garment can be used in some special environments such as ultrasonography, magnetic resonance (MR), and aerospace.

AI Prediction of Brain Signals for Human Gait Using BCI Device and FBG Based Sensorial Platform for Plantar Pressure Measurements

Artificial intelligence (AI) in developing modern solutions for biomedical problems such as the prediction of human gait for human rehabilitation is gaining ground. An attempt was made to use plantar pressure information through fiber Bragg grating (FBG) sensors mounted on an in-sole, in tandem with a brain-computer interface (BCI) device to predict brain signals corresponding to sitting, standing and walking postures of a person. Posture classification was attained with an accuracy range between 87–93% from FBG and BCI signals using machine learning models such as K-nearest neighbor (KNN), logistic regression (LR), support vector machine (SVM), and naïve Bayes (NB). These models were used to identify electrodes responding to sitting, standing and walking activities of four users from a 16 channel BCI device. Six electrode positions based on the 10–20 system for electroencephalography (EEG) were identified as the most sensitive to plantar activities and found to be consistent with clinical investigations of the sensorimotor cortex during foot movement. A prediction of brain EEG corresponding to given FBG data with lowest mean square error (MSE) values (0.065–0.109) was made with the selection of a long-short term memory (LSTM) machine learning model when compared to the recurrent neural network (RNN) and gated recurrent unit (GRU) models.

The Current State of Optical Sensors in Medical Wearables

Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.

AI-enabled photonic smart garment for movement analysis

Smart textiles are novel solutions for remote healthcare monitoring which involve non-invasive sensors-integrated clothing. Polymer optical fiber (POF) sensors have attractive features for smart textile technology, and combined with Artificial Intelligence (AI) algorithms increase the potential of intelligent decision-making. This paper presents the development of a fully portable photonic smart garment with 30 multiplexed POF sensors combined with AI algorithms to evaluate the system ability on the activity classification of multiple subjects. Six daily activities are evaluated: standing, sitting, squatting, up-and-down arms, walking and running. A k-nearest neighbors classifier is employed and results from 10 trials of all volunteers presented an accuracy of 94.00 (0.14)%. To achieve an optimal amount of sensors, the principal component analysis is used for one volunteer and results showed an accuracy of 98.14 (0.31)% using 10 sensors, 1.82% lower than using 30 sensors. Cadence and breathing rate were estimated and compared to the data from an inertial measurement unit located on the garment back and the highest error was 2.22%. Shoulder flexion/extension was also evaluated. The proposed approach presented feasibility for activity recognition and movement-related parameters extraction, leading to a system fully optimized, including the number of sensors and wireless communication, for Healthcare 4.0.

Conception and evaluation of a washable multimodal smart textile

Smart textiles can support people with specific needs and diseases, such as diabetes or heart disease. Currently there are efforts to combine continuous mobile monitoring with other health-related conditions. On this basis, algorithms could be developed that can be used to detect unusual or critical conditions. A study was to investigate whether a previously developed washable Multi-Modal Smart Textile (MMST), based on inexpensive materials, would provide valid and reliable results with regard to the vital parameters of pulse, temperature and mobility. The measurement of the vital parameters was carried out with the developed prototype MMST as well as with validated devices. All electronics including the rechargeable NiMH has been washed more than 30 times with different methods and it remained fully functional. The intraclass correlation coefficients (ICC) for pulse (temperature) measurement ranged between 0.036 and 0.232 (0.077 and 0.817) depending on the activity of the tested individuals (standing, sitting, lying down, moving). Cohen’s Kappa for the detection of the body position was 0.765. For the parameter of pulse, the results indicated an insufficient derivation for both validity and reliability. Due to flaws in the methodology applied, the validly and reliably for the parameter of temperature could not be determined. Valid and reliable results were obtained for the parameter mobility/change of position. If the MMST (after modification of the prototype) achieves reliable results, there are many advantages for people giving and receiving care on a budget price, even in threatening emergency situations.

Optical Fibre Sensor for Capillary Refill Time and Contact Pressure Measurements under the Foot

Capillary refill time (CRT) refers to the time taken for body tissue to regain its colour after an applied blanching pressure is released. Usually, pressure is manually applied and not measured. Upon release of pressure, simple mental counting is typically used to estimate how long it takes for the skin to regain its colour. However, this method is subjective and can provide inaccurate readings due to human error. CRT is often used to assess shock and hydration but also has the potential to assess peripheral arterial disease which can result in tissue breakdown, foot ulcers and ultimately amputation, especially in people with diabetes. The aim of this study was to design an optical fibre sensor to simultaneously detect blood volume changes and the contact pressure applied to the foot. The CRT probe combines two sensors: a plastic optical fibre (POF) based on photoplethysmography (PPG) to measure blood volume changes and a fibre Bragg grating to measure skin contact pressure. The results from 10 healthy volunteers demonstrate that the blanching pressure on the subject’s first metatarsal head of the foot was 100.8 ± 4.8 kPa (mean and standard deviation), the average CRT was 1.37 ± 0.46 s and the time to achieve a stable blood volume was 4.77 ± 1.57 s. For individual volunteers, the fastest CRT measured was 0.82 ± 0.11 and the slowest 1.94 ± 0.49 s. The combined sensor and curve fitting process has the potential to provide increased reliability and accuracy for CRT measurement of the foot in diabetic foot ulcer clinics and in the community.

Fiber‐Shaped Electronic Devices

Textile electronics embedded in clothing represent an exciting new frontier for modern healthcare and communication systems. Fundamental to the development of these textile electronics is the development of the fibers forming the cloths into electronic devices. An electronic fiber must undergo diverse scrutiny for its selection for a multifunctional textile, viz., from the material selection to the device architecture, from the wearability to mechanical stresses, and from the environmental compatibility to the end‐use management. Herein, the performance requirements of fiber‐shaped electronics are reviewed considering the characteristics of single electronic fibers and their assemblies in smart clothing. Broadly, this article includes i) processing strategies of electronic fibers with required properties from precursor to material, ii) the state‐of‐art of current fiber‐shaped electronics emphasizing light‐emitting devices, solar cells, sensors, nanogenerators, supercapacitors storage, and chromatic devices, iii) mechanisms involved in the operation of the above devices, iv) limitations of the current materials and device manufacturing techniques to achieve the target performance, and v) the knowledge gap that must be minimized prior to their deployment. Lessons learned from this review with regard to the challenges and prospects for developing fiber‐shaped electronic components are presented as directions for future research on wearable electronics.

Review of Wearable Devices and Data Collection Considerations for Connected Health

Wearable sensor technology has gradually extended its usability into a wide range of well-known applications. Wearable sensors can typically assess and quantify the wearer’s physiology and are commonly employed for human activity detection and quantified self-assessment. Wearable sensors are increasingly utilised to monitor patient health, rapidly assist with disease diagnosis, and help predict and often improve patient outcomes. Clinicians use various self-report questionnaires and well-known tests to report patient symptoms and assess their functional ability. These assessments are time consuming and costly and depend on subjective patient recall. Moreover, measurements may not accurately demonstrate the patient’s functional ability whilst at home. Wearable sensors can be used to detect and quantify specific movements in different applications. The volume of data collected by wearable sensors during long-term assessment of ambulatory movement can become immense in tuple size. This paper discusses current techniques used to track and record various human body movements, as well as techniques used to measure activity and sleep from long-term data collected by wearable technology devices.

Nanostructured Surface Finishing and Coatings: Functional Properties and Applications

This review presents current literature on different nanocomposite coatings and surface finishing for textiles, and in particular this study has focused on smart materials, drug-delivery systems, industrial, antifouling and nano/ultrafiltration membrane coatings. Each of these nanostructured coatings shows interesting properties for different fields of application. In this review, particular attention is paid to the synthesis and the consequent physico-chemical characteristics of each coating and, therefore, to the different parameters that influence the substrate deposition process. Several techniques used in the characterization of these surface finishing coatings were also described. In this review the sol-gel method for preparing stimuli-responsive coatings as smart sensor materials is described; polymers and nanoparticles sensitive to pH, temperature, phase, light and biomolecules are also treated; nanomaterials based on phosphorus, borates, hydroxy carbonates and silicones are used and described as flame-retardant coatings; organic/inorganic hybrid sol-gel coatings for industrial applications are illustrated; carbon nanotubes, metallic oxides and polymers are employed for nano/ultrafiltration membranes and antifouling coatings. Research institutes and industries have collaborated in the advancement of nanotechnology by optimizing conversion processes of conventional materials into coatings with new functionalities for intelligent applications.

Soft and Stretchable Optical Waveguide: Light Delivery and Manipulation at Complex Biointerfaces Creating Unique Windows for On-Body Sensing

Over the past few decades, optical waveguides have been increasingly used in wearable/implantable devices for on-body sensing. However, conventional optical waveguides are stiff, rigid, and brittle. A mismatch between conventional optical waveguides and complex biointerfaces makes wearable/implantable devices uncomfortable to wear and potentially unsafe. Soft and stretchable polymer optical waveguides not only inherit many advantages of conventional optical waveguides (e.g., immunity to electromagnetic interference and without electrical hazards) but also provide a new perspective for solving the mismatch between conventional optical waveguides and complex biointerfaces, which is essential for the development of light-based wearable/implantable sensors. In this review, polymer optical waveguides' unique properties, including flexibility, biocompatibility and biodegradability, porosity, and stimulus responsiveness, and their applications in the wearable/implantable field in recent years are summarized. Then, we briefly discuss the current challenges of high optical loss, unstable signal transmission, low manufacturing efficiency, and difficulty in deployment during implantation of flexible polymer optical waveguides, and propose some possible solutions to these problems.

Fiber Optic Sensors for Vital Signs Monitoring. A Review of Its Practicality in the Health Field

Vital signs not only reflect essential functions of the human body but also symptoms of a more serious problem within the anatomy; they are well used for physical monitoring, caloric expenditure, and performance before a possible symptom of a massive failure-a great variety of possibilities that together form a first line of basic diagnosis and follow-up on the health and general condition of a person. This review includes a brief theory about fiber optic sensors' operation and summarizes many research works carried out with them in which their operation and effectiveness are promoted to register some vital sign(s) as a possibility for their use in the medical, health care, and life support fields. The review presents methods and techniques to improve sensitivity in monitoring vital signs, such as the use of doping agents or coatings for optical fiber (OF) that provide stability and resistance to the external factors from which they must be protected in in vivo situations. It has been observed that most of these sensors work with single-mode optical fibers (SMF) in a spectral range of 1550 nm, while only some work in the visible spectrum (Vis); the vast majority, operate through fiber Bragg gratings (FBG), long-period fiber gratings (LPFG), and interferometers. These sensors have brought great advances to the measurement of vital signs, especially with regard to respiratory rate; however, many express the possibility of monitoring other vital signs through mathematical calculations, algorithms, or auxiliary devices. Their advantages due to miniaturization, immunity to electromagnetic interference, and the absence of a power source makes them truly desirable for everyday use at all times.

Sleeve for Knee Angle Monitoring: An IMU-POF Sensor Fusion System

The knee flexion-extension angle is an important variable to be monitored in various clinical scenarios, for example, during physical rehabilitation assessment. The purpose of this work is to develop and validate a sensor fusion system based on a knee sleeve for monitoring of physical therapy. The system consists of merging data from two inertial measurement units (IMUs) and an intensity-variation based Polymer Optical Fiber (POF) curvature sensor using a quaternion-based Multiplicative Extended Kalman Filter (MEKF). The proposed data fusion method is magnetometer-free and deals with sensors' uncertainties through reliability intervals defined during gait. Walking trials were performed by twelve healthy participants using our knee sleeve system and results were validated against a gold standard motion capture system. Additionally, a comparison with other three knee angle estimation methods, which are exclusively based on IMUs, was carried out. The proposed system presented better performance (mean RMSE 3.3 ^°, LFM coefficients, a₁ = 0.99 ± 0.04, a₀ = 0.70 ± 2.29, R² = 0.98 ± 0.01 and ρ_C 0.99) when compared to the other evaluated methods. Experimental results demonstrate the usability and feasibility of our system to estimate knee motion with high accuracy, repeatability, and reproducibility. This wearable system may be suitable for motion assessment in rehabilitation labs in future studies.

Electronic-components less fully textile multiple resonant combiners for body-centric near field communication

Smart and e-textiles have nowadays an important increasing place in the garment industry. The rise of embedded telecommunications, especially smartphones in our pocket, enables us to provide a power source and a wireless link for smart textiles. The main issue is to develop garments able to receive power from smartphones and communicate with them without flexibility and comfort constraints bound to embedded solid-state electronic components. Consequently, this article aims to develop a fully textile NFC combiner to transfer data and power between a smartphone and sensors without any electronic components. It precisely describes textile NFC multiple combiners composed of textile NFC antennas linked by two-wire transmission lines. Also, theoretical analysis, simulations, and experiments have been conducted to adapt the resonant frequency of such structures to the NFC technology (13.56 MHz). Finally, our article generalizes textile NFC combiner resonant frequency equations for multiple combiners with any number of antennas.

Measuring the shape of microbends in optical fibers

We report on the distributed shape measurement of small deformations produced along the length of an optical fiber. The fiber contains multiple waveguiding cores, each inscribed with weak continuous Bragg gratings. The distributed Bragg-reflectivity data for the fiber cores, obtained from the optical backscatter reflectometry, are used to estimate the local curvature and the position of the fiber. We successfully demonstrate the sensing of periodic microdeformations-approximately 1 µm or less in amplitude and a few hundred µm in length. Such microbends are known to cause attenuation in optical fibers, and the approach presented here can enable a detailed measurement of these microbends in applications ranging from telecommunications cable design to biotechnology, robotics, manufacturing, aerospace, and security.

Intelligent Technical Textiles Based on Fiber Bragg Gratings for Strain Monitoring

In this paper, the concept design of intelligent technical textile blocks implemented with optical fibers that include fiber Bragg gratings for strain and temperature sensing is briefly introduced. In addition to the main design of the system, a design of measurement blocks with integrated fiber Bragg grating elements for strain measurement is also presented. In the basic measurement, the created textile block was tested for deformation sensitivity when a load was applied. Moreover, a unique robust and low profile connector was designed, created and verified. The fibers are terminated with GRIN lenses, allowing easy manipulation and completion of the connector in the field, with an average insertion loss of 5.5 dB.

Human Vital Signs Detection Methods and Potential Using Radars: A Review

Continuous monitoring of vital signs, such as respiration and heartbeat, plays a crucial role in early detection and even prediction of conditions that may affect the wellbeing of the patient. Sensing vital signs can be categorized into: contact-based techniques and contactless based techniques. Conventional clinical methods of detecting these vital signs require the use of contact sensors, which may not be practical for long duration monitoring and less convenient for repeatable measurements. On the other hand, wireless vital signs detection using radars has the distinct advantage of not requiring the attachment of electrodes to the subject's body and hence not constraining the movement of the person and eliminating the possibility of skin irritation. In addition, it removes the need for wires and limitation of access to patients, especially for children and the elderly. This paper presents a thorough review on the traditional methods of monitoring cardio-pulmonary rates as well as the potential of replacing these systems with radar-based techniques. The paper also highlights the challenges that radar-based vital signs monitoring methods need to overcome to gain acceptance in the healthcare field. A proof-of-concept of a radar-based vital sign detection system is presented together with promising measurement results.

Application Challenges in Fiber and Textile Electronics

Modern electronic devices are moving toward miniaturization and integration with an emerging focus on wearable electronics. Due to their close contact with the human body, wearable electronics have new requirements including low weight, small size, and flexibility. Conventional 3D and 2D electronic devices fail to efficiently meet these requirements due to their rigidity and bulkiness. Hence, a new family of 1D fiber-shaped electronic devices including energy-harvesting devices, energy-storage devices, light-emitting devices, and sensing devices has risen to the challenge due to their small diameter, lightweight, flexibility, and weavability into soft textile electronics. The application challenges faced by fiber and textile electronics from single fiber-shaped devices to continuously scalable fabrication, to encapsulation and testing, and to application mode exploration, are discussed. The evolutionary trends of fiber and textile electronics are then summarized. Finally, future directions required to boost their commercialization are highlighted.

Demonstrating the Use of Optical Fibres in Biomedical Sensing: A Collaborative Approach for Engagement and Education

This paper demonstrates how research at the intersection of physics, engineering, biology and medicine can be presented in an interactive and educational way to a non-scientific audience. Interdisciplinary research with a focus on prevalent diseases provides a relatable context that can be used to engage with the public. Respiratory diseases are significant contributors to avoidable morbidity and mortality and have a growing social and economic impact. With the aim of improving lung disease understanding, new techniques in fibre-based optical endomicroscopy have been recently developed. Here, we present a novel engagement activity that resembles a bench-to-bedside pathway. The activity comprises an inexpensive educational tool (<$70) adapted from a clinical optical endomicroscopy system and tutorials that cover state-of-the-art research. The activity was co-created by high school science teachers and researchers in a collaborative way that can be implemented into any engagement development process.

A Machine-Learning-Based Approach to Solve Both Contact Location and Force in Soft Material Tactile Sensors

This study addresses a design and calibration methodology based on numerical finite element method (FEM) modeling for the development of a soft tactile sensor able to simultaneously solve the magnitude and the application location of a normal load exerted onto its surface. The sensor entails the integration of a Bragg grating fiber optic sensor in a Dragon Skin 10 polymer brick (110 mm length, 24 mm width). The soft polymer mediates the transmission of the applied load to the buried fiber Bragg gratings (FBGs), and we also investigated the effect of sensor thickness on receptive field and sensitivity, both with the developed model and experimentally. Force-controlled indentations of the sensor (up to 2.5 N) were carried out through a cylindrical probe applied along the direction of the optical fiber (over an ∼90 mm span in length). A finite element model of the sensor was built and experimentally validated for 1 and 6 mm thicknesses of the soft polymeric encapsulation material, considering that the latter thickness resulted from numerical simulations as leading to optimal cross talk and sensitivity, given the chosen soft material. The FEM model was also used to train a neural network so as to obtain the inverse sensor function. Using four FBG transducers embedded in the 6-mm-thick soft polymer, the proposed machine learning approach managed to accurately detect both load magnitude (R = 0.97) and location (R = 0.99) over the whole experimental range. The proposed system could be used for developing tactile sensors that can be effectively used for a broad range of applications.

Multifunctional Textile Platform for Fiber Optic Wearable Temperature-Monitoring Application

Wearable sensing technologies have been developed rapidly in the last decades for physiological and biomechanical signal monitoring. Much attention has been paid to functions of wearable applications, but comfort parameters have been overlooked. This research presents a developed fabric temperature sensor by adopting fiber Bragg grating (FBG) sensors and processing via a textile platform. This FBG-based quasi-distributed sensing system demonstrated a sensitivity of 10.61 ± 0.08 pm/°C with high stability in various temperature environments. No obvious wavelength shift occurred under the curvatures varying from 0 to 50.48 m⁻¹ and in different integration methods with textiles. The temperature distribution monitored by the developed textile sensor in a complex environment with multiple heat sources was deduced using MATLAB to present a real-time dynamic temperature distribution in the wearing environment. This novel fabric temperature sensor shows high sensitivity, stability, and usability with comfort textile properties that are of great potential in wearable applications.

Wearable textile based on silver plated knitted sensor for respiratory rate monitoring

Wearable systems are gaining broad acceptance for monitoring physiological parameters in several medical applications. Among a number of approaches, smart textiles have attracted interest because they are comfortable and do not impair patients' movements. In this article, we aim at developing a smart textile for respiratory monitoring based on a piezoresistive sensing element. Firstly, the calibration curve of the system and its hysteresis have been investigated. Then, the proposed system has been assessed on 6 healthy subjects. The volunteers were invited to wear the system to monitor their breathing rate. The results of the calibration show a good mean sensitivity (i.e., approximately 0.11V·%^-1); although the hysteresis is not negligible, the system can follow the cycles also at high rates (up to 36 cycle·min^-1). The feasibility assessment on 6 volunteers (two trials for each one) shows that the proposed system can estimate with good accuracy the breathing rate. Indeed, the results obtained by the proposed system were compared with the ones collected with a spirometer, used as reference. Considering all the experiments, a mean percentage error was approximately 2%. In conclusion, the proposed system has several valuable features (e.g., the sensing element is lightweight, the sensitivity is high, and it is possible to develop comfortable smart textile); in addition, the promising performances considering both metrological properties and assessment on volunteers foster future tests focused on: i) the possibility of developing and system embedding several sensing elements, and ii) to develop a wireless acquisition system, to allow comfortable and long-term acquisition in both patients and during sport activities.

Wearable Fiber Optic Technology Based on Smart Textile: A Review

Emerging smart textiles have enriched a variety of wearable technologies, including fiber optic technology. Optic fibers are widely applied in communication, sensing, and healthcare, and smart textiles enable fiber optic technology to be worn close to soft and curved human body parts for personalized functions. This review briefly introduces wearable fiber optic applications with various functions, including fashion and esthetics, vital signal monitoring, and disease treatment. The main working principles of side emission, wavelength modulation, and intensity modulation are summarized. In addition, textile fabrication techniques, including weaving and knitting, are discussed and illustrated as combination methods of embedding fiber optic technology into textile fabric. In conclusion, the combination of optical fibers and textiles has drawn considerable interest and developed rapidly. This work provides an overview of textile-based wearable fiber optic technology and discusses potential textile fabrication techniques for further improvement of wearable fiber optic applications.

Soft and Stretchable Polymeric Optical Waveguide-Based Sensors for Wearable and Biomedical Applications

The past decades have witnessed the rapid development in soft, stretchable, and biocompatible devices for applications in biomedical monitoring, personal healthcare, and human-machine interfaces. In particular, the design of soft devices in optics has attracted tremendous interests attributed to their distinct advantages such as inherent electrical safety, high stability in long-term operation, potential to be miniaturized, and free of electromagnetic interferences. As the alternatives to conventional rigid optical waveguides, considerable efforts have been made to develop light-guiding devices by using various transparent and elastic polymers, which offer desired physiomechanical properties and enable wearable/implantable applications in optical sensing, diagnostics, and therapy. Here, we review recent progress in soft and stretchable optical waveguides and sensors, including advanced structural design, fabrication strategies, and functionalities. Furthermore, the potential applications of those optical devices for various wearable and biomedical applications are discussed. It is expected that the newly emerged soft and stretchable optical technologies will provide a safe and reliable alternative to next-generation, smart wearables and healthcare devices.

Fabrics and Garments as Sensors: A Research Update

Properties critical to the structure of apparel and apparel fabrics (thermal and moisture transfer, elasticity, and flexural rigidity), those related to performance (durability to abrasion, cleaning, and storage), and environmental effects have not been consistently addressed in the research on fabric sensors designed to interact with the human body. These fabric properties need to be acceptable for functionalized fabrics to be effectively used in apparel. Measures of performance such as electrical conductivity, impedance, and/or capacitance have been quantified. That the apparel/human body system involves continuous transient conditions needs to be taken into account when considering performance. This review highlights gaps concerning fabric-related aspects for functionalized apparel and includes information on increasing the inclusion of such aspects. A multidisciplinary approach including experts in chemistry, electronics, textiles, and standard test methods, and the intended end use is key to widespread development and adoption.

Polymer Optical Fiber Sensors in Healthcare Applications: A Comprehensive Review

Advances in medicine and improvements in life quality has led to an increase in the life expectancy of the general population. An ageing world population have placed demands on the use of assistive technology and, in particular, towards novel healthcare devices and sensors. Besides the electromagnetic field immunity, polymer optical fiber (POF) sensors have additional advantages due to their material features such as high flexibility, lower Young’s modulus (enabling high sensitivity for mechanical parameters), higher elastic limits, and impact resistance. Such advantages are well-aligned with the instrumentation requirements of many healthcare devices and in movement analysis. Aiming at these advantages, this review paper presents the state-of-the-art developments of POF sensors for healthcare applications. A plethora of healthcare applications are discussed, which include movement analysis, physiological parameters monitoring, instrumented insoles, as well as instrumentation of healthcare robotic devices such as exoskeletons, smart walkers, actuators, prostheses, and orthosis. This review paper shows the feasibility of using POF sensors in healthcare applications and, due to the aforementioned advantages, it is possible to envisage a further widespread use of such sensors in this research field in the next few years.

Tactile Sensing and Control of Robotic Manipulator Integrating Fiber Bragg Grating Strain-Sensor

Tactile sensing is an instrumental modality of robotic manipulation, as it provides information that is not accessible via remote sensors such as cameras or lidars. Touch is particularly crucial in unstructured environments, where the robot's internal representation of manipulated objects is uncertain. In this study we present the sensorization of an existing artificial hand, with the aim to achieve fine control of robotic limbs and perception of object's physical properties. Tactile feedback is conveyed by means of a soft sensor integrated at the fingertip of a robotic hand. The sensor consists of an optical fiber, housing Fiber Bragg Gratings (FBGs) transducers, embedded into a soft polymeric material integrated on a rigid hand. Through several tasks involving grasps of different objects in various conditions, the ability of the system to acquire information is assessed. Results show that a classifier based on the sensor outputs of the robotic hand is capable of accurately detecting both size and rigidity of the operated objects (99.36 and 100% accuracy, respectively). Furthermore, the outputs provide evidence of the ability to grab fragile objects without breakage or slippage e and to perform dynamic manipulative tasks, that involve the adaptation of fingers position based on the grasped objects' condition.

Multifunctional Smart Optical Fibers: Materials, Fabrication, and Sensing Applications

This paper presents a review of the development of optical fibers made of multiple materials, particularly including silica glass, soft glass, polymers, hydrogels, biomaterials, Polydimethylsiloxane (PDMS), and Polyperfluoro-Butenylvinyleth (CYTOP). The properties of the materials are discussed according to their various applications. Typical fabrication techniques for specialty optical fibers based on these materials are introduced, which are mainly focused on extrusion, drilling, and stacking methods depending on the materials’ thermal properties. Microstructures render multiple functions of optical fibers and bring more flexibility in fiber design and device fabrication. In particular, micro-structured optical fibers made from different types of materials are reviewed. The sensing capability of optical fibers enables smart monitoring. Widely used techniques to develop fiber sensors, i.e., fiber Bragg grating and interferometry, are discussed in terms of sensing principles and fabrication methods. Lastly, sensing applications in oil/gas, optofluidics, and particularly healthcare monitoring using specialty optical fibers are demonstrated. In comparison with conventional silica-glass single-mode fiber, state-of-the-art specialty optical fibers provide promising prospects in sensing applications due to flexible choices in materials and microstructures.

Contact-Based Methods for Measuring Respiratory Rate

There is an ever-growing demand for measuring respiratory variables during a variety of applications, including monitoring in clinical and occupational settings, and during sporting activities and exercise. Special attention is devoted to the monitoring of respiratory rate because it is a vital sign, which responds to a variety of stressors. There are different methods for measuring respiratory rate, which can be classed as contact-based or contactless. The present paper provides an overview of the currently available contact-based methods for measuring respiratory rate. For these methods, the sensing element (or part of the instrument containing it) is attached to the subject's body. Methods based upon the recording of respiratory airflow, sounds, air temperature, air humidity, air components, chest wall movements, and modulation of the cardiac activity are presented. Working principles, metrological characteristics, and applications in the respiratory monitoring field are presented to explore potential development and applicability for each method.

Ultrasound Sensors for Diaphragm Motion Tracking: An Application in Non-Invasive Respiratory Monitoring

This paper introduces a novel respiratory detection system based on diaphragm wall motion tracking using an embedded ultrasound sensory system. We assess the utility and accuracy of this method in evaluating the function of the diaphragm and its contribution to respiratory workload. The developed system is able to monitor the diaphragm wall activity when the sensor is placed in the zone of apposition (ZOA). This system allows for direct measurements with only one ultrasound PZT5 piezo transducer. The system generates pulsed ultrasound waves at 2.2 MHz and amplifies reflected echoes. An added benefit of this system is that due to its design, the respiratory signal is less subject to motion artefacts. Promising results were obtained from six subjects performing six tests per subject with an average respiration detection sensitivity and specificity of 84% and 93%, respectively. Measurements were compared to a gold standard commercial spirometer. In this study, we also compared our measurements to other conventional methods such as inertial and photoplethysmography (PPG) sensors.

Ex vivo animal-model assessment of a non-invasive system for loss of resistance detection during epidural blockade

During recent decades epidural analgesia has gained widespread recognition in many applications. In this complex procedure, anaesthetist uses a specific needle to inject anesthetic into the epidural space. It is crucial the appropriate insertion of the needle through inhomogeneous tissues placed between the skin and the epidural space to minimize anesthetic-related complications (e.g., nausea, headache, and dural puncture). Usually, anaesthetists perform the procedure without any supporting tools, and stop pushing the syringe when they sense a loss of resistance (LOR). This phenomenon is caused by the physical properties of the epidural space: the needle breaks the ligamentum flavum and reaches the epidural space, in this stage the anaesthetist perceives a LOR because the epidural space is much softer than the ligamentum flavum. To support the clinician in this maneuver we designed a non-invasive system able to detect the LOR by measuring the pressure exerted on the syringe plunger to push the needle up to the epidural space. In a previous work we described the system and its assessment during in vitro tests. This work aims at assessing the feasibility of the system for LOR detection on a more realistic model (ex vivo pig model). The system was assessed by analyzing: its ability to hold a constant value (saturation condition) during the insertion of the needle, and its ability to detect the entrance within the epidural space by a decrease of the system's output. Lastly, the anaesthetist was asked to assess how the ex vivo procedure mimics a clinical scenario. The system reached the saturation condition during the needle insertion; this feature is critical to avoid false positive during the procedure. However, it was not easy to detect the entrance within the epidural space due to its small volume in the animal model. Lastly, the practitioner found real the model, and performed the procedures in a conventional manner because the system did not influence his actions.

Smart textile for respiratory monitoring and thoraco-abdominal motion pattern evaluation

The use of wearable systems for monitoring vital parameters has gained wide popularity in several medical fields. The focus of the present study is the experimental assessment of a smart textile based on 12 fiber Bragg grating sensors for breathing monitoring and thoraco-abdominal motion pattern analysis. The feasibility of the smart textile for monitoring several temporal respiratory parameters (ie, breath-by-breath respiratory period, breathing frequency, duration of inspiratory and expiratory phases), volume variations of the whole chest wall and of its compartments is performed on 8 healthy male volunteers. Values gathered by the textile are compared to the data obtained by a motion analysis system, used as the reference instrument. Good agreement between the 2 systems on both respiratory period (bias of 0.01 seconds), breathing frequency (bias of -0.02 breaths/min) and tidal volume (bias of 0.09 L) values is demonstrated. Smart textile shows good performance in the monitoring of thoraco-abdominal pattern and its variation, as well.

A Wearable System for Real-Time Continuous Monitoring of Physical Activity

Over the last decades, wearable systems have gained interest for monitoring of physiological variables, promoting health, and improving exercise adherence in different populations ranging from elite athletes to patients. In this paper, we present a wearable system for the continuous real-time monitoring of respiratory frequency (f_R), heart rate (HR), and movement cadence during physical activity. The system has been experimentally tested in the laboratory (by simulating the breathing pattern with a mechanical ventilator) and by collecting data from one healthy volunteer. Results show the feasibility of the proposed device for real-time continuous monitoring of f_R, HR, and movement cadence both in resting condition and during activity. Finally, different synchronization techniques have been investigated to enable simultaneous data collection from different wearable modules.

Automatic Detection of Seismocardiogram Sensor Misplacement for Robust Pre-Ejection Period Estimation in Unsupervised Settings

Seismocardiography (SCG), the measurement of the local chest vibrations due to the movements of blood and the heart, is a non-invasive technique for assessing myocardial contractility via the pre-ejection period (PEP). Recently, SCG-based extraction of PEP has been shown to be an effective means of classifying decompensated from compensated heart failure patients, and thus can be potentially used for monitoring such patients at home. Accurate extraction of PEP from SCG signals hinges on lab-based population data (i.e., regression curves) linking particular time-domain features of the SCG signal to corresponding features from reference standard bulky instruments such as impedance cardiography (ICG). Such regression curves, in the case of SCG, have always been estimated based on the "ideal" positioning of the SCG sensor on the chest. However, in settings such as the home where users may position the SCG measurement hardware on the chest without supervision, it is likely that the sensor will not always be placed exactly on this "ideal" location on the sternum, but rather on other positions on the chest as well. In this study, we show for the first time that the regression curve for estimating PEP from SCG signals differs significantly as the position of the sensor changes. We further devise a method to automatically detect when the sensor is placed in any position other than the desired one in order to avoid inaccurate systolic time interval estimation. Our classification algorithm for this purpose resulted in 0.83 precision and 0.82 recall when classifying whether the sensor is placed in the desired position or not. The classifier was tested with heartbeats taken both at rest, and also during exercise recovery to ensure that waveform changes due to positioning could be accurately discriminated from those due to physiological effects.

Design and preliminary assessment of a smart textile for respiratory monitoring based on an array of Fiber Bragg Gratings

Comfortable and easy to wear smart textiles have gained popularity for continuous respiratory monitoring. Among different emerging technologies, smart textiles based on fiber optic sensors (FOSs) have several advantages, like Magnetic Resonance (MR)-compatibility and good metrological properties. In this paper we report on the development and assessment of an MR-compatible smart textiles based on FOSs for respiratory monitoring. The system consists of six fiber Bragg grating (FBG) sensors glued on the textile to monitor six compartments of the chest wall (i.e., right and left upper thorax, right and left abdominal rib cage, and right and left abdomen). This solution allows monitoring both global respiratory parameters and each compartment volume change. The system converts thoracic movements into strain measured by the FBGs. The positioning of the FBGs was optimized by experiments performed using an optoelectronic system. The feasibility of the smart textile was assessed on 6 healthy volunteers. Experimental data were compared to the ones estimated by an optoelectronic plethysmography used as reference. Promising results were obtained on both breathing period (maximum percentage error is 1.14%), inspiratory and expiratory period, as well as on total volume change (mean percentage difference between the two systems was ~14%). The Bland-Altman analysis shows a satisfactory accuracy for the parameters under investigation. The proposed system is safe and non-invasive, MR-compatible, and allows monitoring compartmental volumes.

A Phonocardiographic-Based Fiber-Optic Sensor and Adaptive Filtering System for Noninvasive Continuous Fetal Heart Rate Monitoring

This paper focuses on the design, realization, and verification of a novel phonocardiographic- based fiber-optic sensor and adaptive signal processing system for noninvasive continuous fetal heart rate (fHR) monitoring. Our proposed system utilizes two Mach-Zehnder interferometeric sensors. Based on the analysis of real measurement data, we developed a simplified dynamic model for the generation and distribution of heart sounds throughout the human body. Building on this signal model, we then designed, implemented, and verified our adaptive signal processing system by implementing two stochastic gradient-based algorithms: the Least Mean Square Algorithm (LMS), and the Normalized Least Mean Square (NLMS) Algorithm. With this system we were able to extract the fHR information from high quality fetal phonocardiograms (fPCGs), filtered from abdominal maternal phonocardiograms (mPCGs) by performing fPCG signal peak detection. Common signal processing methods such as linear filtering, signal subtraction, and others could not be used for this purpose as fPCG and mPCG signals share overlapping frequency spectra. The performance of the adaptive system was evaluated by using both qualitative (gynecological studies) and quantitative measures such as: Signal-to-Noise Ratio—SNR, Root Mean Square Error—RMSE, Sensitivity—S+, and Positive Predictive Value—PPV.

Fiber Optic Force Sensors for MRI-Guided Interventions and Rehabilitation: A Review

Magnetic Resonance Imaging (MRI) provides both anatomical imaging with excellent soft tissue contrast and functional MRI imaging (fMRI) of physiological parameters. The last two decades have witnessed the manifestation of increased interest in MRI-guided minimally invasive intervention procedures and fMRI for rehabilitation and neuroscience research. Accompanying the aspiration to utilize MRI to provide imaging feedback during interventions and brain activity for neuroscience study, there is an accumulated effort to utilize force sensors compatible with the MRI environment to meet the growing demand of these procedures, with the goal of enhanced interventional safety and accuracy, improved efficacy and rehabilitation outcome. This paper summarizes the fundamental principles, the state of the art development and challenges of fiber optic force sensors for MRI-guided interventions and rehabilitation. It provides an overview of MRI-compatible fiber optic force sensors based on different sensing principles, including light intensity modulation, wavelength modulation, and phase modulation. Extensive design prototypes are reviewed to illustrate the detailed implementation of these principles. Advantages and disadvantages of the sensor designs are compared and analyzed. A perspective on the future development of fiber optic sensors is also presented which may have additional broad clinical applications. Future surgical interventions or rehabilitation will rely on intelligent force sensors to provide situational awareness to augment or complement human perception in these procedures.

Translational bioinformatics in the era of real-time biomedical, health care and wellness data streams

Monitoring and modeling biomedical, health care and wellness data from individuals and converging data on a population scale have tremendous potential to improve understanding of the transition to the healthy state of human physiology to disease setting. Wellness monitoring devices and companion software applications capable of generating alerts and sharing data with health care providers or social networks are now available. The accessibility and clinical utility of such data for disease or wellness research are currently limited. Designing methods for streaming data capture, real-time data aggregation, machine learning, predictive analytics and visualization solutions to integrate wellness or health monitoring data elements with the electronic medical records (EMRs) maintained by health care providers permits better utilization. Integration of population-scale biomedical, health care and wellness data would help to stratify patients for active health management and to understand clinically asymptomatic patients and underlying illness trajectories. In this article, we discuss various health-monitoring devices, their ability to capture the unique state of health represented in a patient and their application in individualized diagnostics, prognosis, clinical or wellness intervention. We also discuss examples of translational bioinformatics approaches to integrating patient-generated data with existing EMRs, personal health records, patient portals and clinical data repositories. Briefly, translational bioinformatics methods, tools and resources are at the center of these advances in implementing real-time biomedical and health care analytics in the clinical setting. Furthermore, these advances are poised to play a significant role in clinical decision-making and implementation of data-driven medicine and wellness care.

Optical measurement of breathing: algorithm volume calibration and preliminary validation on healthy trained subjects

The use of optical technologies may be beneficial when measuring breathing biomechanics. The purpose of this study was twofold: i) to enhance the optoelectronic plethysmography (OEP) algorithm performance for the volume estimation by the use of a novel volume calibration procedure and ii) to compare the OEP volumes gained by a commercial optoelectronic system against actual respiratory volumes measured by a breath-by-breath gas analyzer (BbB). The OEP volume algorithm calibration was performed by the use of a novel volume calibration procedure based on both a calibrator device that delivered known volumes changes and one ad-hoc designed software for the static and dynamic calibration analysis. OEP algorithm threshold, accuracy, repeatability and the volume algorithm calibration were investigated. Tidal volume (VT) measurements performed simultaneously by the calibrated OEP algorithm and BbB analyzer were compared. VT measured simultaneously by OEP and BbB was collected during submaximal exercise tests in five trained healthy participants in two conditions (with hunched shoulders and in normal shoulder position). The two methods were compared by linear regression and Bland-Altman analysis in both positions. The average difference between methods and the discrepancy were calculated. The OEP-BbB correlation was high in both positions, R2=0.92 and R2=0.97 for hunch and normal one, respectively. Bland-Altman analysis demonstrated that OEP algorithm systematic difference was lower than 100mL. The limits of agreement assessed in both positions are comparable. The difference between measurements suggesting that OEP may be a useful tool to analyze chest wall volume changes and breathing mechanics during intense exercise.