A Textile Sleeve for Monitoring Oxygen Saturation Using Multichannel Optical Fibre Photoplethysmography

Skin sensing and wearable technology as tools to measure atopic dermatitis severity

Wearable medical technology encompasses a range of electronic devices that act as biosensors. Atopic dermatitis (AD) is the commonest inflammatory skin disease and represents an important area of need in which to leverage the power of wearable biosensor technology, especially as the impact of COVID-19 increases the likelihood of virtual consultations becoming an integrated part of clinical practice. The aim of this review is to systematically define the published evidence for the utility of wearable biosensors in assessment and management of atopic dermatitis (AD). A systematic literature search was conducted for publications from 1995 onwards for 'sensor' OR 'sensing' OR 'biosensor' OR 'biomarker'. Results were combined ('AND') with a search for 'wearable' OR 'actigraphy' OR 'Internet of things' OR 'microneedle' OR 'patch' OR 'e-textile' OR 'smart textile' and atopic dermatitis (MESH terms). Fifty seven abstracts were identified from the database search of which 39 were selected for detailed review. Broadly, wearable sensing systems in atopic dermatitis were split into three categories: wearable biosensor modules (actigraphy and smartwatches), clothing and integrated fabrics placed onto the epidermis and intradermal or subcutaneous sensors. The best evidence for correlation with AD disease severity was with actigraphy measurements of itch. However, newer approaches including sensing skin barrier function, inflammation and small molecule analysis as well as employing artificial intelligence offer more potential for advanced disease monitoring. Skin diseases, specifically AD, stand to benefit greatly from wearable technology, because of the ease of direct contact to the skin, the high prevalence of the disease and the large unmet need for better disease control in this group. However, important emphasis must be placed on validating the correlation of data from such technology with patient-reported outcomes. Wearable biosensors offer a huge potential to deliver better diagnostics, monitoring and treatment outcomes for patients.

A Guide to Measuring Heart and Respiratory Rates Based on Off-the-Shelf Photoplethysmographic Hardware and Open-Source Software

The remote monitoring of vital signs via wearable devices holds significant potential for alleviating the strain on hospital resources and elder-care facilities. Among the various techniques available, photoplethysmography stands out as particularly promising for assessing vital signs such as heart rate, respiratory rate, oxygen saturation, and blood pressure. Despite the efficacy of this method, many commercially available wearables, bearing Conformité Européenne marks and the approval of the Food and Drug Administration, are often integrated within proprietary, closed data ecosystems and are very expensive. In an effort to democratize access to affordable wearable devices, our research endeavored to develop an open-source photoplethysmographic sensor utilizing off-the-shelf hardware and open-source software components. The primary aim of this investigation was to ascertain whether the combination of off-the-shelf hardware components and open-source software yielded vital-sign measurements (specifically heart rate and respiratory rate) comparable to those obtained from more expensive, commercially endorsed medical devices. Conducted as a prospective, single-center study, the research involved the assessment of fifteen participants for three minutes in four distinct positions, supine, seated, standing, and walking in place. The sensor consisted of four PulseSensors measuring photoplethysmographic signals with green light in reflection mode. Subsequent signal processing utilized various open-source Python packages. The heart rate assessment involved the comparison of three distinct methodologies, while the respiratory rate analysis entailed the evaluation of fifteen different algorithmic combinations. For one-minute average heart rates' determination, the Neurokit process pipeline achieved the best results in a seated position with a Spearman's coefficient of 0.9 and a mean difference of 0.59 BPM. For the respiratory rate, the combined utilization of Neurokit and Charlton algorithms yielded the most favorable outcomes with a Spearman's coefficient of 0.82 and a mean difference of 1.90 BrPM. This research found that off-the-shelf components are able to produce comparable results for heart and respiratory rates to those of commercial and approved medical wearables.

A Review of Wearable Optical Fiber Sensors for Rehabilitation Monitoring

As the global aging population increases, the demand for rehabilitation of elderly hand conditions has attracted increased attention in the field of wearable sensors. Owing to their distinctive anti-electromagnetic interference properties, high sensitivity, and excellent biocompatibility, optical fiber sensors exhibit substantial potential for applications in monitoring finger movements, physiological parameters, and tactile responses during rehabilitation. This review provides a brief introduction to the principles and technologies of various fiber sensors, including the Fiber Bragg Grating sensor, self-luminescent stretchable optical fiber sensor, and optic fiber Fabry-Perot sensor. In addition, specific applications are discussed within the rehabilitation field. Furthermore, challenges inherent to current optical fiber sensing technology, such as enhancing the sensitivity and flexibility of the sensors, reducing their cost, and refining system integration, are also addressed. Due to technological developments and greater efforts by researchers, it is likely that wearable optical fiber sensors will become commercially available and extensively utilized for rehabilitation.

Cardiorespiratory Sensors and Their Implications for Out-of-Hospital Cardiac Arrest Detection: A Systematic Review

Out-of-hospital cardiac arrest (OHCA) is a major health problem, with a poor survival rate of 2-11%. For the roughly 75% of OHCAs that are unwitnessed, survival is approximately 2-4.4%, as there are no bystanders present to provide life-saving interventions and alert Emergency Medical Services. Sensor technologies may reduce the number of unwitnessed OHCAs through automated detection of OHCA-associated physiological changes. However, no technologies are widely available for OHCA detection. This review identifies research and commercial technologies developed for cardiopulmonary monitoring that may be best suited for use in the context of OHCA, and provides recommendations for technology development, testing, and implementation. We conducted a systematic review of published studies along with a search of grey literature to identify technologies that were able to provide cardiopulmonary monitoring, and could be used to detect OHCA. We searched MEDLINE, EMBASE, Web of Science, and Engineering Village using MeSH keywords. Following inclusion, we summarized trends and findings from included studies. Our searches retrieved 6945 unique publications between January, 1950 and May, 2023. 90 studies met the inclusion criteria. In addition, our grey literature search identified 26 commercial technologies. Among included technologies, 52% utilized electrocardiography (ECG) and 40% utilized photoplethysmography (PPG) sensors. Most wearable devices were multi-modal (59%), utilizing more than one sensor simultaneously. Most included devices were wearable technologies (84%), with chest patches (22%), wrist-worn devices (18%), and garments (14%) being the most prevalent. ECG and PPG sensors are heavily utilized in devices for cardiopulmonary monitoring that could be adapted to OHCA detection. Developers seeking to rapidly develop methods for OHCA detection should focus on using ECG- and/or PPG-based multimodal systems as these are most prevalent in existing devices. However, novel sensor technology development could overcome limitations in existing sensors and could serve as potential additions to or replacements for ECG- and PPG-based devices.

State-of-the-Art Light to Digital Converter Circuits Applicable in Non-Invasive Health Monitoring Devices to Combat COVID-19 and Other Respiratory Illnesses: A Review

In the past few years, a tremendous advancement in the outcome of biomedical circuits and systems has been reported. Unfortunately, at the time of the sudden outbreak of COVID-19, the electronic engineering researchers felt dearth on their side to combat the pandemic, as no such immediate cutting-edge solutions were ready to recognize the virus with some standard and smart electronic devices. Likely, in this paper, a detailed comparative and comprehensive study on circuit architectures of the biomedical devices is presented. Mostly, this study relates the industry standard circuit schemes applicable in non-invasive health monitoring to combat respiratory illnesses. The trending circuit architectural schemes casted-off to tapeout non-invasive health-care devices available in the past literature are meticulously and broadly discussed in this study. Further, the comprehensive comparison of the state of art of the device performance in terms of supply voltage, chip area, sensitivity, dynamic range, etc. is also shown in this paper. The inclusive design processes of the health monitoring devices from Lab to Industry is thoroughly discussed for the readers. The authors think, that this critical review summarising all the trending and most cited health-care devices in a single paper will alternately help the industrialists to adapt and modify the circuit architectures of the health monitoring devices more precisely and straightforwardly. Finally, the demand for health monitoring devices particularly responsible to detect respiratory illnesses, measuring blood pressure and heart-rate is growing widely in the market after the the incident of COVID-19 and other respiratory diseases.

A Three-Dimensional-Printed Recyclable, Flexible, and Wearable Device for Visualized UV, Temperature, and Sweat pH Sensing

Wearable devices are now recognized as a powerful tool to collect physiological and environmental information in a smart, noninvasive, and real-time manner. Despite the rapid progress of wearable devices especially wearable electronic devices, there are still several challenges that limit their further development, for example, a complicated electrical signal acquisition and processing process to eliminate the interference from the surrounding signals, bulky power supply, inevitable e-waste, and environmental pollution. Herein, we report a 3D-printed recyclable, flexible, and wearable device for visualized UV, temperature, and sweat pH sensing. Compared with wearable electronic devices, our visualized wearable device senses environmental (UV light, ambient temperature), biophysical (skin temperature), and biochemical (sweat pH) signals via stimuli-responsive color change, which does not require complicated electronic circuit design/assembly, time-consuming data processing and additional power source. In addition, this visualized wearable device is fabricated via a 3D support bath printing technology by printing UV-, temperature-, and sweat pH-sensing inks containing photochromic, thermochromic, and pH-chromic materials, respectively, into/onto sustainable starch solution, resulting in a multi-functional, recyclable, and flexible sensing device with high reproducibility. Our results reveal that UV light intensities under sunlight (0-2500 μW/cm2), ambient, and skin temperatures (0-38 °C) as well as sweat pH (4.0-7.0) can be successfully monitored.

Remote Cardiac Rhythm Monitoring in the Era of Smart Wearables: Present Assets and Future Perspectives

Remote monitoring and control of heart function are of primary importance for patient evaluation and management, especially in the modern era of precision medicine and personalized approach. Breaking technological developments have brought to the frontline a variety of smart wearable devices, such as smartwatches, chest patches/straps, or sensors integrated into clothing and footwear, which allow continuous and real-time recording of heart rate, facilitating the detection of cardiac arrhythmias. However, there is great diversity and significant differences in the type and quality of the information they provide, thus impairing their integration into daily clinical practice and the relevant familiarization of practicing physicians. This review will summarize the different types and dominant functions of cardiac smart wearables available in the market. Furthermore, we report the devices certified by official American and/or European authorities and the respective sources of evidence. Finally, we comment pertinent limitations and caveats as well as the potential answers that flow from the latest technological achievements and future perspectives.

PPG EduKit: An Adjustable Photoplethysmography Evaluation System for Educational Activities

The grown interest in healthcare applications has made biomedical engineering one of the fastest growing disciplines in recent years. Photoplethysmography (PPG) has gained popularity in recent years due to its versatility for noninvasive monitoring of vital signs such as heart rate, respiratory rate, blood oxygen saturation and blood pressure. In this work, an adjustable PPG-based educational device called PPG EduKit, which aims to facilitate the learning of the PPG technology for a wide range of engineering and medical disciplines is proposed. Through the use of this educational platform, the PPG signal can be understood, modified and implemented along with the extraction of its relevant physiological information from a didactic, intuitive and practical way. The PPG Edukit is evaluated for the extraction of physiological parameters such as heart rate and blood oxygen level, demonstrating how its features contribute to engineering and medical students to assimilate technical concepts in electrical circuits, biomedical instrumentation, and human physiology.

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.