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Nwokoye II, Triantis IF. A 3 MHz Low-Error Adaptive Howland Current Source for High-Frequency Bioimpedance Applications. SENSORS (BASEL, SWITZERLAND) 2024; 24:4357. [PMID: 39001136 PMCID: PMC11243945 DOI: 10.3390/s24134357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/07/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024]
Abstract
Bioimpedance is a diagnostic sensing method used in medical applications, ranging from body composition assessment to detecting skin cancer. Commonly, discrete-component (and at times integrated) circuit variants of the Howland Current Source (HCS) topology are employed for injection of an AC current. Ideally, its amplitude should remain within 1% of its nominal value across a frequency range, and that nominal value should be programmable. However, the method's applicability and accuracy are hindered due to the current amplitude diminishing at frequencies above 100 kHz, with very few designs accomplishing 1 MHz, and only at a single nominal amplitude. This paper presents the design and implementation of an adaptive current source for bioimpedance applications employing automatic gain control (AGC). The "Adaptive Howland Current Source" (AHCS) was experimentally tested, and the results indicate that the design can achieve less than 1% amplitude error for both 1 mA and 100 µA currents for bandwidths up to 3 MHz. Simulations also indicate that the system can be designed to achieve up to 19% noise reduction relative to the most common HCS design. AHCS addresses the need for high bandwidth AC current sources in bioimpedance spectroscopy, offering automatic output current compensation without constant recalibration. The novel structure of AHCS proves crucial in applications requiring higher β-dispersion frequencies exceeding 1 MHz, where greater penetration depths and better cell status assessment can be achieved, e.g., in the detection of skin or breast cancer.
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Affiliation(s)
| | - Iasonas F. Triantis
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, UK;
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2
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Yu Y, Lowe A, Anand G, Kalra A, Zhang H. The Investigation of Bio-impedance Analysis at a Wrist Phantom with Two Pulsatile Arteries. Cardiovasc Eng Technol 2023; 14:810-826. [PMID: 37848736 DOI: 10.1007/s13239-023-00689-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE Bio-impedance analysis (BIA) has been widely investigated for hemodynamic monitoring. However, previous works rarely modelled two synchronously pulsatile arteries (representing the radial and ulnar arteries) in the wrist/forearm model. This work aims to clarify and quantify the influences of two pulsatile arteries on BIA. METHODS First, two blood-filled arteries were structured in a 3D wrist segment using the finite element method (FEM). Afterwards, an easy-to-produce two-arteries artificial wrist was fabricated with two components: gelatine-based surrounding tissue phantom and saline blood phantom. A syringe driver was utilised to constrict the arteries, and the impedance signals were measured using a Multi-frequency Impedance Analyser (MFIA). RESULTS Both simulation and experimental results demonstrated the non-negligible influences of the ulnar artery on the overall BIA, inducing unwanted resistance changes to the acquired signals from the radial artery. The phantom experiments revealed the summation of the individual resistance changes caused by a single pulsatile artery was approximately equal to the measured resistance change caused by two synchronously pulsatile arteries, confirming the measured impedance signal at the wrist contains the pulsatile information from both arteries. CONCLUSION This work is the first simulation and phantom investigation into two synchronously pulsatile arteries under BIA in the distal forearm, providing a better insight and understanding in the morphology of measured impedance signals. Future research can accordingly select either a small spacing 4-spot electrode configuration for a single artery sensing or a band electrode configuration for overall pulsatile arteries sensing. A more accurate estimation of blood volume change and pulse wave analysis (PWA) could help to develop cuffless blood pressure measurement (BPM).
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Affiliation(s)
- Yang Yu
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, 1010, New Zealand.
| | - Andrew Lowe
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, 1010, New Zealand
| | - Gautam Anand
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, 1010, New Zealand
| | - Anubha Kalra
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, 1010, New Zealand
| | - Huiyang Zhang
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, 1010, New Zealand
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3
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Mohammed H, Chen HB, Li Y, Sabor N, Wang JG, Wang G. Meta-Analysis of Pulse Transition Features in Non-Invasive Blood Pressure Estimation Systems: Bridging Physiology and Engineering Perspectives. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2023; 17:1257-1281. [PMID: 38015673 DOI: 10.1109/tbcas.2023.3334960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
The pulse transition features (PTFs), including pulse arrival time (PAT) and pulse transition time (PTT), hold significant importance in estimating non-invasive blood pressure (NIBP). However, the literature showcases considerable variations in terms of PTFs' correlation with blood pressure (BP), accuracy in NIBP estimation, and the comprehension of the relationship between PTFs and BP. This inconsistency is exemplified by the wide-ranging correlations reported across studies investigating the same feature. Furthermore, investigations comparing PAT and PTT have yielded conflicting outcomes. Additionally, PTFs have been derived from various bio-signals, capturing distinct characteristic points like the pulse's foot and peak. To address these inconsistencies, this study meticulously reviews a selection of such research endeavors while aligning them with the biological intricacies of blood pressure and the human cardiovascular system (CVS). Each study underwent evaluation, considering the specific signal acquisition locale and the corresponding recording procedure. Moreover, a comprehensive meta-analysis was conducted, yielding multiple conclusions that could significantly enhance the design and accuracy of NIBP systems. Grounded in these dual aspects, the study systematically examines PTFs in correlation with the specific study conditions and the underlying factors influencing the CVS. This approach serves as a valuable resource for researchers aiming to optimize the design of BP recording experiments, bio-signal acquisition systems, and the fine-tuning of feature engineering methodologies, ultimately advancing PTF-based NIBP estimation.
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Zhao L, Liang C, Huang Y, Zhou G, Xiao Y, Ji N, Zhang YT, Zhao N. Emerging sensing and modeling technologies for wearable and cuffless blood pressure monitoring. NPJ Digit Med 2023; 6:93. [PMID: 37217650 DOI: 10.1038/s41746-023-00835-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
Cardiovascular diseases (CVDs) are a leading cause of death worldwide. For early diagnosis, intervention and management of CVDs, it is highly desirable to frequently monitor blood pressure (BP), a vital sign closely related to CVDs, during people's daily life, including sleep time. Towards this end, wearable and cuffless BP extraction methods have been extensively researched in recent years as part of the mobile healthcare initiative. This review focuses on the enabling technologies for wearable and cuffless BP monitoring platforms, covering both the emerging flexible sensor designs and BP extraction algorithms. Based on the signal type, the sensing devices are classified into electrical, optical, and mechanical sensors, and the state-of-the-art material choices, fabrication methods, and performances of each type of sensor are briefly reviewed. In the model part of the review, contemporary algorithmic BP estimation methods for beat-to-beat BP measurements and continuous BP waveform extraction are introduced. Mainstream approaches, such as pulse transit time-based analytical models and machine learning methods, are compared in terms of their input modalities, features, implementation algorithms, and performances. The review sheds light on the interdisciplinary research opportunities to combine the latest innovations in the sensor and signal processing research fields to achieve a new generation of cuffless BP measurement devices with improved wearability, reliability, and accuracy.
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Affiliation(s)
- Lei Zhao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Cunman Liang
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yan Huang
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Guodong Zhou
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Yiqun Xiao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Nan Ji
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yuan-Ting Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Ni Zhao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China.
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China.
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5
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Seo S, Jo H, Kim J, Lee B, Bien F. An ultralow power wearable vital sign sensor using an electromagnetically reactive near field. Bioeng Transl Med 2023; 8:e10502. [DOI: 10.1002/btm2.10502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/31/2022] [Accepted: 02/12/2023] [Indexed: 03/01/2023] Open
Affiliation(s)
- Seoktae Seo
- Department of Electrical Engineering Ulsan National Institute of Science and Technology Ulsan Republic of Korea
| | - Hyunkyeong Jo
- Department of Electrical Engineering Ulsan National Institute of Science and Technology Ulsan Republic of Korea
| | - Jungho Kim
- Department of Electrical Engineering Ulsan National Institute of Science and Technology Ulsan Republic of Korea
| | - Bonyoung Lee
- Department of Electrical Engineering Ulsan National Institute of Science and Technology Ulsan Republic of Korea
| | - Franklin Bien
- Department of Electrical Engineering Ulsan National Institute of Science and Technology Ulsan Republic of Korea
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6
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Liu SH, Wu YR, Chen W, Su CH, Chin CL. Using Ballistocardiogram and Impedance Plethysmogram for Minimal Contact Measurement of Blood Pressure Based on a Body Weight-Fat Scale. SENSORS (BASEL, SWITZERLAND) 2023; 23:2318. [PMID: 36850917 PMCID: PMC9966183 DOI: 10.3390/s23042318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Electronic health (eHealth) is a strategy to improve the physical and mental condition of a human, collecting daily physiological data and information from digital apparatuses. Body weight and blood pressure (BP) are the most popular and important physiological data. The goal of this study is to develop a minimal contact BP measurement method based on a commercial body weight-fat scale, capturing biometrics when users stand on it. The pulse transit time (PTT) is extracted from the ballistocardiogram (BCG) and impedance plethysmogram (IPG), measured by four strain gauges and four footpads of a commercial body weight-fat scale. Cuffless BP measurement using the electrocardiogram (ECG) and photoplethysmogram (PPG) serves as the reference method. The BP measured by a commercial BP monitor is considered the ground truth. Twenty subjects participated in this study. By the proposed model, the root-mean-square errors and correlation coefficients (r2s) of estimated systolic blood pressure and diastolic blood pressure are 7.3 ± 2.1 mmHg and 4.5 ± 1.8 mmHg, and 0.570 ± 0.205 and 0.284 ± 0.166, respectively. This accuracy level achieves the C grade of the corresponding IEEE standard. Thus, the proposed method has the potential benefit for eHealth monitoring in daily application.
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Affiliation(s)
- Shing-Hong Liu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan
| | - Yan-Rong Wu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan
| | - Wenxi Chen
- Biomedical Information Engineering Laboratory, The University of Aizu, Aizu-Wakamatsu City 965-8580, Japan
| | - Chun-Hung Su
- Institute of Medicine, School of Medicine, Chung-Shan Medical University, Taichung City 40201, Taiwan
- Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung City 40201, Taiwan
| | - Chiun-Li Chin
- Department of Medical Informatics, Chung-Shan Medical University, Taichung City 40201, Taiwan
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7
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Liu SH, Zhang BH, Chen W, Su CH, Chin CL. Cuffless and Touchless Measurement of Blood Pressure from Ballistocardiogram Based on a Body Weight Scale. Nutrients 2022; 14:2552. [PMID: 35745282 PMCID: PMC9229996 DOI: 10.3390/nu14122552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/14/2022] [Accepted: 06/18/2022] [Indexed: 11/16/2022] Open
Abstract
Currently, in terms of reducing the infection risk of the COVID-19 virus spreading all over the world, the development of touchless blood pressure (BP) measurement has potential benefits. The pulse transit time (PTT) has a high relation with BP, which can be measured by electrocardiogram (ECG) and photoplethysmogram (PPG). The ballistocardiogram (BCG) reflects the mechanical vibration (or displacement) caused by the heart contraction/relaxation (or heart beating), which can be measured from multiple degrees of the body. The goal of this study is to develop a cuffless and touchless BP-measurement method based on a commercial weight scale combined with a PPG sensor when measuring body weight. The proposed method was that the PTTBCG-PPGT was extracted from the BCG signal measured by a weight scale, and the PPG signal was measured from the PPG probe placed at the toe. Four PTT models were used to estimate BP. The reference method was the PTTECG-PPGF extracted from the ECG signal and PPG signal measured from the PPG probe placed at the finger. The standard BP was measured by an electronic blood pressure monitor. Twenty subjects were recruited in this study. By the proposed method, the root-mean-square error (ERMS) of estimated systolic blood pressure (SBP) and diastolic blood pressure (DBP) are 6.7 ± 1.60 mmHg and 4.8 ± 1.47 mmHg, respectively. The correlation coefficients, r2, of the proposed model for the SBP and DBP are 0.606 ± 0.142 and 0.284 ± 0.166, respectively. The results show that the proposed method can serve for cuffless and touchless BP measurement.
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Affiliation(s)
- Shing-Hong Liu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan; (S.-H.L.); (B.-H.Z.)
| | - Bing-Hao Zhang
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan; (S.-H.L.); (B.-H.Z.)
| | - Wenxi Chen
- Biomedical Information Engineering Laboratory, The University of Aizu, Aizu-Wakamatsu City 965-8580, Fukushima, Japan;
| | - Chun-Hung Su
- Institute of Medicine, School of Medicine, Chung-Shan Medical University, Taichung City 40201, Taiwan;
- Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung City 40201, Taiwan
| | - Chiun-Li Chin
- Department of Medical Informatics, Chung-Shan Medical University, Taichung City 40201, Taiwan
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8
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Cheng KS, Su YL, Kuo LC, Yang TH, Lee CL, Chen W, Liu SH. Muscle Mass Measurement Using Machine Learning Algorithms with Electrical Impedance Myography. SENSORS (BASEL, SWITZERLAND) 2022; 22:3087. [PMID: 35459072 PMCID: PMC9031580 DOI: 10.3390/s22083087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 02/04/2023]
Abstract
Sarcopenia is a wild chronic disease among elderly people. Although it does not entail a life-threatening risk, it will increase the adverse risk due to the associated unsteady gait, fall, fractures, and functional disability. The import factors in diagnosing sarcopenia are muscle mass and strength. The examination of muscle mass must be carried in the clinic. However, the loss of muscle mass can be improved by rehabilitation that can be performed in non-medical environments. Electronic impedance myography (EIM) can measure some parameters of muscles that have the correlations with muscle mass and strength. The goal of this study is to use machine learning algorithms to estimate the total mass of thigh muscles (MoTM) with the parameters of EIM and body information. We explored the seven major muscles of lower limbs. The feature selection methods, including recursive feature elimination (RFE) and feature combination, were used to select the optimal features based on the ridge regression (RR) and support vector regression (SVR) models. The optimal features were the resistance of rectus femoris normalized by the thigh circumference, phase of tibialis anterior combined with the gender, and body information, height, and weight. There were 96 subjects involved in this study. The performances of estimating the MoTM used the regression coefficient (r2) and root-mean-square error (RMSE), which were 0.800 and 0.929, and 1.432 kg and 0.980 kg for RR and SVR models, respectively. Thus, the proposed method could have the potential to support people examining their muscle mass in non-medical environments.
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Affiliation(s)
- Kuo-Sheng Cheng
- Department of Biomedical Engineering, National Cheng Kung University, Tainai 701, Taiwan; (K.-S.C.); (Y.-L.S.); (T.-H.Y.)
| | - Ya-Ling Su
- Department of Biomedical Engineering, National Cheng Kung University, Tainai 701, Taiwan; (K.-S.C.); (Y.-L.S.); (T.-H.Y.)
| | - Li-Chieh Kuo
- Department of Occupational Therapy, National Cheng Kung University, Tainan 701, Taiwan;
| | - Tai-Hua Yang
- Department of Biomedical Engineering, National Cheng Kung University, Tainai 701, Taiwan; (K.-S.C.); (Y.-L.S.); (T.-H.Y.)
| | - Chia-Lin Lee
- Department of Physical Education, National Kaohsiung Normal University, Kaohsiung City 80201, Taiwan;
| | - Wenxi Chen
- Biomedical Information Engineering Laboratory, The University of Aizu, Aizu-Wakamatsu City, Fukushima 965-8580, Japan;
| | - Shing-Hong Liu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung 413310, Taiwan
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Heimark S, Rindal OMH, Seeberg TM, Stepanov A, Boysen ES, Bøtker-Rasmussen KG, Mobæk NK, Søraas CL, Stenehjem AE, Fadl Elmula FEM, Waldum-Grevbo B. Blood pressure altering method affects correlation with pulse arrival time. Blood Press Monit 2022; 27:139-146. [PMID: 34855653 PMCID: PMC8893131 DOI: 10.1097/mbp.0000000000000577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Pulse arrival time (PAT) is a potential main feature in cuff-less blood pressure (BP) monitoring. However, the precise relationship between BP parameters and PAT under varying conditions lacks a complete understanding. We hypothesize that simple test protocols fail to demonstrate the complex relationship between PAT and both SBP and DBP. Therefore, this study aimed to investigate the correlation between PAT and BP during two exercise modalities with differing BP responses using an unobtrusive wearable device. METHODS Seventy-five subjects, of which 43.7% had a prior diagnosis of hypertension, participated in an isometric and dynamic exercise test also including seated periods of rest prior to, in between and after. PAT was measured using a prototype wearable chest belt with a one-channel electrocardiogram and a photo-plethysmography sensor. Reference BP was measured auscultatory. RESULTS Mean individual correlation between PAT and SBP was -0.82 ± 0.14 in the full protocol, -0.79 ± 0.27 during isometric exercise and -0.77 ± 0.19 during dynamic exercise. Corresponding correlation between PAT and DBP was 0.25 ± 0.35, -0.74 ± 0.23 and 0.39 ± 0.41. CONCLUSION The results confirm PAT as a potential main feature to track changes in SBP. The relationship between DBP and PAT varied between exercise modalities, with the sign of the correlation changing from negative to positive between type of exercise modality. Thus, we hypothesize that simple test protocols fail to demonstrate the complex relationship between PAT and BP with emphasis on DBP.
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Affiliation(s)
- Sondre Heimark
- Department of Nephrology, Oslo University Hospital
- Section for Cardiovascular and Renal Research, Oslo University Hospital
- Institute of Clinical Medicine, University of Oslo
| | | | | | | | | | | | | | - Camilla L. Søraas
- Section for Cardiovascular and Renal Research, Oslo University Hospital
- Section for Environmental and Occupational Medicine, Oslo University Hospital
| | | | - Fadl Elmula M. Fadl Elmula
- Section for Cardiovascular and Renal Research, Oslo University Hospital
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
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Learning and non-learning algorithms for cuffless blood pressure measurement: a review. Med Biol Eng Comput 2021; 59:1201-1222. [PMID: 34085135 DOI: 10.1007/s11517-021-02362-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
The machine learning approach has gained a significant attention in the healthcare sector because of the prospect of developing new techniques for medical devices and handling the critical database of chronic diseases. The learning approach has potential to analyze complex medical data, disease diagnosis, and patient monitoring system, and to monitor e-health record. Non-invasive cuffless blood pressure (CLBP) measurement secured a significant position in the patient monitoring system. From a few recent decades, the importance of cuffless technology has been perceived towards continuous monitoring of blood pressure (BP) and supplementary efforts have been made towards its continuous monitoring. However, the optimal method that measures BP unambiguously and continuously has not yet emerged along with issues like calibration time, accuracy and long-term estimation of BP with miniaturizing hardware. The present study provides an insight into several learning algorithms along with their feature selection models. Various challenges and future improvements towards the current state of machine learning in healthcare industries are discussed in the present review. The bottom line of this study is to provide a comprehensive perspective of the machine learning approach of CLBP for the generation of highly precise predictive models for continuous BP measurement.
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11
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Anand G, Yu Y, Lowe A, Kalra A. Bioimpedance analysis as a tool for hemodynamic monitoring: overview, methods and challenges. Physiol Meas 2021; 42. [PMID: 33607637 DOI: 10.1088/1361-6579/abe80e] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 02/19/2021] [Indexed: 12/14/2022]
Abstract
Recent advances in hemodynamic monitoring have seen the advent of non-invasive methods which offer ease of application and improve patient comfort. Bioimpedance Analysis or BIA is one of the currently employed non-invasive techniques for hemodynamic monitoring. Impedance Cardiography (ICG), one of the implementations of BIA, is widely used as a non-invasive procedure for estimating hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Even though BIA is not a new diagnostic technique, it has failed to gain consensus as a reliable measure of hemodynamic parameters. Several devices have emerged for estimating CO using ICG which are based on evolving methodologies and techniques to calculate SV. However, the calculations are generally dependent on the electrode configurations (whole body, segmental or localised) as well as the accuracy of different techniques in tracking blood flow changes. Blood volume changes, concentration of red blood cells, pulsatile velocity profile and ambient temperature contribute to the overall conductivity of blood and hence its impedance response during flow. There is a growing interest in investigating limbs for localised BIA to estimate hemodynamic parameters such as pulse wave velocity. As such, this paper summarises the current state of hemodynamic monitoring through BIA in terms of different configurations and devices in the market. The conductivity of blood flow has been emphasized with contributions from both volume and velocity changes during flow. Recommendations for using BIA in hemodynamic monitoring have been mentioned highlighting the suitable range of frequencies (1 kHz-1 MHz) as well as safety considerations for a BIA setup. Finally, current challenges in using BIA such as geometry assumption and inaccuracies have been discussed while mentioning potential advantages of a multi-frequency analysis to cover all the major contributors to blood's impedance response during flow.
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Affiliation(s)
- Gautam Anand
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Yang Yu
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Andrew Lowe
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Anubha Kalra
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
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12
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Bio-Impedance Measurement Optimization for High-Resolution Carotid Pulse Sensing. SENSORS 2021; 21:s21051600. [PMID: 33668822 PMCID: PMC7956181 DOI: 10.3390/s21051600] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 11/24/2022]
Abstract
Continuous hemodynamic monitoring is important for long-term cardiovascular healthcare, especially in hypertension. The impedance plethysmography (IPG) based carotid pulse sensing is a non-invasive diagnosis technique for measuring pulse signals and further evaluating the arterial conditions of the patient such as continuous blood pressure (BP) monitoring. To reach the high-resolution IPG-based carotid pulse detection for cardiovascular applications, this study provides an optimized measurement parameter in response to obvious pulsation from the carotid artery. The influence of the frequency of excitation current, electrode cross-sectional area, electrode arrangements, and physiological site of carotid arteries on IPG measurement resolution was thoroughly investigated for optimized parameters. In this study, the IPG system was implemented and installed on the subject’s neck above the carotid artery to evaluate the measurement parameters. The measurement results within 6 subjects obtained the arterial impedance variation of 2137 mΩ using the optimized measurement conditions, including excitation frequency of 50 kHz, a smaller area of 2 cm2, electrode spacing of 4 cm and 1.7 cm for excitation and sensing functions, and location on the left side of the neck. The significance of this study demonstrates an optimized measurement methodology of IPG-based carotid pulse sensing that greatly improves the measurement quality in cardiovascular monitoring.
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13
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Girčys R, Kazanavičius E, Maskeliūnas R, Damaševičius R, Woźniak M. Wearable system for real-time monitoring of hemodynamic parameters: Implementation and evaluation. Biomed Signal Process Control 2020. [DOI: 10.1016/j.bspc.2020.101873] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Multimodal Photoplethysmography-Based Approaches for Improved Detection of Hypertension. J Clin Med 2020; 9:jcm9041203. [PMID: 32331360 PMCID: PMC7230564 DOI: 10.3390/jcm9041203] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022] Open
Abstract
Elevated blood pressure (BP) is a major cause of death, yet hypertension commonly goes undetected. Owing to its nature, it is typically asymptomatic until later in its progression when the vessel or organ structure has already been compromised. Therefore, noninvasive and continuous BP measurement methods are needed to ensure appropriate diagnosis and early management before hypertension leads to irreversible complications. Photoplethysmography (PPG) is a noninvasive technology with waveform morphologies similar to that of arterial BP waveforms, therefore attracting interest regarding its usability in BP estimation. In recent years, wearable devices incorporating PPG sensors have been proposed to improve the early diagnosis and management of hypertension. Additionally, the need for improved accuracy and convenience has led to the development of devices that incorporate multiple different biosignals with PPG. Through the addition of modalities such as an electrocardiogram, a final measure of the pulse wave velocity is derived, which has been proved to be inversely correlated to BP and to yield accurate estimations. This paper reviews and summarizes recent studies within the period 2010–2019 that combined PPG with other biosignals and offers perspectives on the strengths and weaknesses of current developments to guide future advancements in BP measurement. Our literature review reveals promising measurement accuracies and we comment on the effective combinations of modalities and success of this technology.
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15
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Wang TW, Lin SF. Wearable Piezoelectric-Based System for Continuous Beat-to-Beat Blood Pressure Measurement. SENSORS (BASEL, SWITZERLAND) 2020; 20:E851. [PMID: 32033495 PMCID: PMC7038670 DOI: 10.3390/s20030851] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/02/2020] [Accepted: 02/04/2020] [Indexed: 02/01/2023]
Abstract
Non-invasive continuous blood pressure measurement is an emerging issue that potentially can be applied to cardiovascular disease monitoring and prediction. Recently, many groups have proposed the pulse transition time (PTT) method to estimate blood pressure for long-term monitoring. However, the PTT-based methods for blood pressure estimation are limited by non-specific estimation models and require multiple calibrations. This study aims to develop a low-cost wearable piezoelectric-based system for continuous beat-to-beat blood pressure measurement. The pressure change in the radial artery was extracted by systolic and diastolic feature points in pressure pulse wave (PPW) and the pressure sensitivity of the sensor. The proposed system showed a reliable accuracy of systolic blood pressure (SBP) (mean absolute error (MAE) ± standard deviation (SD) 1.52 ± 0.30 mmHg) and diastolic blood pressure (DBP, MAE ± SD 1.83 ± 0.50), and its performance agreed with standard criteria of MAE within 5 mmHg and SD within ±8 mmHg. In conclusion, this study successfully developed a low-cost, high-accuracy piezoelectric-based system for continuous beat-to-beat SBP and DBP measurement without multiple calibrations and complex regression analysis. The system is potentially suitable for continuous, long-term blood pressure-monitoring applications.
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Affiliation(s)
- Ting-Wei Wang
- Department of Electrical and Computer Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu 30010, Taiwan;
| | - Shien-Fong Lin
- Department of Electrical and Computer Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu 30010, Taiwan;
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu 30010, Taiwan
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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16
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Hashim ZQ, Constantinou L, Triantis IF. Modelling Dynamically Re-Sizeable Electrodes (DRE) for Targeted Transcutaneous Measurements in Impedance Plethysmography. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2020; 14:104-112. [PMID: 31831436 DOI: 10.1109/tbcas.2019.2959437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Impedance plethysmography of extremities typically involves band electrodes around limbs to monitor changes in blood volume. This often causes monitored blood variations to only generate minuscule impedance values relative to the measured baseline, attributed to the tissue surrounding the artery or vein of interest. Smaller, ECG type electrodes can provide a larger signal, however their output is very easily affected by the placement of the electrodes relative to the targeted vasculature. This paper presents a novel method to adjust the active surface of electrodes, introducing Dynamically Re-sizeable Electrodes (DRE), to only target the exact area of interest, forming localised electrodes, without having to manually re-position them. Elongated rectangular electrodes were partitioned into smaller electrode segments, interconnected through custom circuitry. For the development and assessment of the DRE system, work was carried out both experimentally in-vitro on gelatine phantoms using custom switching circuits and through finite element modelling (FEM) simulations in COMSOL. A scanning sequence made use of DRE in single segment variable tetra-pole (SSVT) mode proved capable to identify the transcutaneous location of the blood vessel of interest and the specific electrode segments located in its vicinity. Impedance measurements were then taken using these segments connected to form localised electrodes only placed over the targeted vessel. The resulting localised electrodes exhibited up to [Formula: see text] increased sensitivity to blood variations relative to larger electrodes.
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17
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Zambrana-Vinaroz D, Vicente-Samper JM, G Juan C, Esteve-Sala V, Sabater-Navarro JM. Non-Invasive Device for Blood Pressure Wave Acquisition by Means of Mechanical Transducer. SENSORS 2019; 19:s19194311. [PMID: 31590351 PMCID: PMC6806211 DOI: 10.3390/s19194311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 11/29/2022]
Abstract
Blood pressure wave monitoring provides interesting information about the patient’s cardiovascular function. For this reason, this article proposes a non-invasive device capable of capturing the vibrations (pressure waves) produced by the carotid artery by means of a pressure sensor encapsulated in a closed dome filled with air. When the device is placed onto the outer skin of the carotid area, the vibrations of the artery will exert a deformation in the dome, which, in turn, will lead to a pressure increase in its inner air. Then, the sensor inside the dome captures this pressure increase. By combining the blood pressure wave obtained with this device together with the ECG signal, it is possible to help the screening of the cardiovascular system, obtaining parameters such as heart rate variability (HRV) and pulse transit time (PTT). The results show how the pressure wave has been successfully obtained in the carotid artery area, discerning the characteristic points of this signal. The features of this device compare well with previous works by other authors. The main advantages of the proposed device are the reduced size, the cuffless condition, and the potential to be a continuous ambulatory device. These features could be exploited in ambulatory tests.
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Affiliation(s)
- David Zambrana-Vinaroz
- Neuroengineering research group, Miguel Hernández University of Elche, 03202 Elche, Spain.
| | | | - Carlos G Juan
- Neuroengineering research group, Miguel Hernández University of Elche, 03202 Elche, Spain.
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18
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Using the Characteristics of Pulse Waveform to Enhance the Accuracy of Blood Pressure Measurement by a Multi-Dimension Regression Model. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9142922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
With the advancement of wearable technology, many physiological monitoring instruments are gradually being converted into wearable devices. However, as a consumer product, the blood pressure monitor is still a cuff-type device, which does perform a beat-by-beat continuous blood pressure measurement. Consequently, the cuffless blood pressure measurement device was developed and it is based on the pulse transit time (PTT), although its accuracy remains inadequate. According to the cardiac hemodynamic theorem, blood pressure relates to the arterial characteristics and the contours of the pulse wave include some characteristics of the artery. Therefore, the purpose of this study was to use the contour characteristics of the pulses measured by photoplethysmography (PPG) to estimate the blood pressure using a linear multi-dimension regression model. Ten subjects participated in the experiment, and the blood pressure levels of the subjects were elevated by exercise. The results showed that the mean and standard deviation (mean ± SD) of the root mean square error of the estimated systolic and diastolic pressures within the best five parameters were 6.9 ± 2.81 mmHg and 4.0 ± 0.65 mmHg, respectively. Compared to the results that used one parameter, the PTT, for estimating the systolic and diastolic pressures, 8.2 ± 2.1 mmHg and 4.5 ± 0.79 mmHg, respectively, our results were better.
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19
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Lazazzera R, Belhaj Y, Carrault G. A New Wearable Device for Blood Pressure Estimation Using Photoplethysmogram. SENSORS (BASEL, SWITZERLAND) 2019; 19:E2557. [PMID: 31167514 PMCID: PMC6603632 DOI: 10.3390/s19112557] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/17/2019] [Accepted: 05/29/2019] [Indexed: 12/22/2022]
Abstract
We present a novel smartwatch, CareUp ® , for estimating the Blood Pressure (BP) in real time. It consists of two pulse oximeters: one placed on the back and one on the front of the device. Placing the index finger on the front oximeter starts the acquisition of two photoplethysmograms (PPG); the signals are then filtered and cross-correlated to obtain a Time Delay between them, called Pulse Transit Time (PTT). The Heart Rate (HR) (estimated from the finger PPG) and the PTT are then input in a linear model to give an estimation of the Systolic and Diastolic BP. The performance of the smartwatch in measuring BP have been validated in the Institut Coeur Paris Centre Turin (ICPC), using a sphygmomanometer, on 44 subjects. During the validation, the measures of the CareUp ® were compared to those of two oscillometry-based devices already available on the market: Thuasne ® and Magnien ® . The results showed an accuracy comparable to the oscillometry-based devices and they almost agreed with the American Association for the Advancement of Medical Instrumentation standard for non-automated sphygmomanometers. The integration of the BP estimation algorithm in the smartwatch makes the CareUp ® an easy-to-use, wearable device for monitoring the BP in real time.
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Affiliation(s)
- Remo Lazazzera
- Laboratoire Traitement du Signal et de l'Image, Université de Rennes 1, Rennes F35000, France.
- Institut National de la Santé et de la Recherche Médicale, U1099, Rennes F35000, France.
- Farasha Labs, Paris 75000, France.
| | | | - Guy Carrault
- Laboratoire Traitement du Signal et de l'Image, Université de Rennes 1, Rennes F35000, France.
- Institut National de la Santé et de la Recherche Médicale, U1099, Rennes F35000, France.
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20
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Photoplethysmography-Based Continuous Systolic Blood Pressure Estimation Method for Low Processing Power Wearable Devices. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9112236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Regardless of age, it is always important to detect deviations in long-term blood pressure from normal levels. Continuous monitoring of blood pressure throughout the day is even more important for elderly people with cardiovascular diseases or a high risk of stroke. The traditional cuff-based method for blood pressure measurements is not suitable for continuous real-time applications and is very uncomfortable. To address this problem, continuous blood pressure measurement methods based on photoplethysmogram (PPG) have been developed. However, these methods use specialized high-performance hardware and sensors, which are not available for common users. This paper proposes the continuous systolic blood pressure (SBP) estimation method based on PPG pulse wave steepness for low processing power wearable devices and evaluates its suitability using the commercially available CMS50FW Pulse Oximeter. The SBP estimation is done based on the PPG pulse wave steepness (rising edge angle) because it is highly correlated with systolic blood pressure. The SBP estimation based on this single feature allows us to significantly reduce the amount of data processed and avoid errors, due to PPG pulse wave amplitude changes resulting from physiological or external factors. The experimental evaluation shows that the proposed SBP estimation method allows the use of off-the-shelf wearable PPG measurement devices with a low sampling rate (up to 60 Hz) and low resolution (up to 8-bit) for precise SBP measurements (mean difference MD = −0.043 and standard deviation SD = 6.79). In contrast, the known methods for continuous SBP estimation are based on equipment with a much higher sampling rate and better resolution characteristics.
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21
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14.85 µW Analog Front-End for Photoplethysmography Acquisition with 142-dBΩ Gain and 64.2-pA rms Noise. SENSORS 2019; 19:s19030512. [PMID: 30691150 PMCID: PMC6387274 DOI: 10.3390/s19030512] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 11/17/2022]
Abstract
A low-power, high-gain, and low-noise analog front-end (AFE) for wearable photoplethysmography (PPG) acquisition systems is designed and fabricated in a 0.35 μm CMOS process. A high transimpedance gain of 142 dBΩ and a low input-referred noise of only 64.2 pArms was achieved. A Sub-Hz filter was integrated using a pseudo resistor, resulting in a small silicon area. To mitigate the saturation problem caused by background light (BGL), a BGL cancellation loop and a new simple automatic gain control block are used to enhance the dynamic range and improve the linearity of the AFE. The measurement results show that a DC photocurrent component up-to-10 μA can be rejected and the PPG output swing can reach 1.42 Vpp at THD < 1%. The chip consumes a total power of 14.85 μW using a single 3.3-V power supply. In this work, the small area and efficiently integrated blocks were used to implement the PPG AFE and the silicon area is minimized to 0.8 mm × 0.8 mm.
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22
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Liu ZD, Liu JK, Wen B, He QY, Li Y, Miao F. Cuffless Blood Pressure Estimation Using Pressure Pulse Wave Signals. SENSORS 2018; 18:s18124227. [PMID: 30513838 PMCID: PMC6308537 DOI: 10.3390/s18124227] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 11/16/2022]
Abstract
Pulse transit time (PTT) has received considerable attention for noninvasive cuffless blood pressure measurement. However, this approach is inconvenient to deploy in wearable devices because two sensors are required for collecting two-channel physiological signals, such as electrocardiogram and pulse wave signals. In this study, we investigated the pressure pulse wave (PPW) signals collected from one piezoelectric-induced sensor located at a single site for cuffless blood pressure estimation. Twenty-one features were extracted from PPW that collected from the radial artery, and then a linear regression method was used to develop blood pressure estimation models by using the extracted PPW features. Sixty-five middle-aged and elderly participants were recruited to evaluate the performance of the constructed blood pressure estimation models, with oscillometric technique-based blood pressure as a reference. The experimental results indicated that the mean ± standard deviation errors for the estimated systolic blood pressure and diastolic blood pressure were 0.70 ± 7.78 mmHg and 0.83 ± 5.45 mmHg, which achieved a decrease of 1.33 ± 0.37 mmHg in systolic blood pressure and 1.14 ± 0.20 mmHg in diastolic blood pressure, compared with the conventional PTT-based method. The proposed model also demonstrated a high level of robustness in a maximum 60-day follow-up study. These results indicated that PPW obtained from the piezoelectric sensor has great feasibility for cuffless blood pressure estimation, and could serve as a promising method in home healthcare settings.
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Affiliation(s)
- Zeng-Ding Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Ji-Kui Liu
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Bo Wen
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Qing-Yun He
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
| | - Ye Li
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
- Key Laboratory for Health Informatics of the Chinese Academy of Sciences (HICAS), Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China.
| | - Fen Miao
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
- Key Laboratory for Health Informatics of the Chinese Academy of Sciences (HICAS), Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China.
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23
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Xu XY, Yan B, Lian X. Wearable glove sensor for non-invasive organophosphorus pesticide detection based on a double-signal fluorescence strategy. NANOSCALE 2018; 10:13722-13729. [PMID: 29989624 DOI: 10.1039/c8nr03352h] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A wearable glove-based sensor has been developed for non-invasive organophosphorus pesticide (OP) monitoring via the fluorescent detection technology. The new "lab-on-a-glove" device integrates a flexible host material (CMC aerogel) and two fluorescent centers (EuMOFs for red and nanosized CDs for blue emissons). After characterizing the performance and stability of the sensor, qualitative and quantitative OP detections are successfully conducted on the surfaces of different agricultural products using swipe collection. The real-time detection system offers considerable advantages such as rapid response (30 s) due to the porous structures of CMC aerogel and MOFs, detection with the naked eye (the red to blue emission transition corresponds to an increase in the OP concentration) and high sensitivity (R2 = 0.99529, LOD = 89 nM) owing to the double-signal sensing strategy in which EuMOFs are the working fluorescence center and CDs are the reference fluorescence center. Compared with other OP detection methods, our strategy of using wearable device with the ratiometric fluorescence method leads to a convenient and reliable detection process for OP analysis. Also, considering its cost advantage, the glove-based sensor holds promise for practical applications in food safety and security.
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Affiliation(s)
- Xiao-Yu Xu
- School of Chemical Science and Engineering, Tongji University, Siping Road 1239, Shanghai 200092, P. R. China.
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