Finding the right medication regimen to treat Parkinson’s disease (PD) is a complex healthcare challenge. Wearable health trackers provide detailed information on patients’ symptoms, but this complex data is difficult to turn into useful treatment insights. Now, new research in the INFORMS journal Management Scienceshows that combining wearable health tracker data with state-of-the-art algorithms results in promising treatment strategies that could improve PD patients’ outcomes.
“Our model identified a Parkinson’s disease medication strategy: Frequent dosing of a slow-release medication formulation that would benefit almost all patients,” says Matt Baucum of Florida State University, one of the study authors.
“In fact, our model uses wearable sensors to predict that patients would spend almost twice as long each day (82% longer) with well-managed symptoms under our recommended medication strategy, compared with their existing medication regimens.”
The paper suggests the resulting models can offer novel clinical insights and medication strategies that can potentially democratise access to improved care.
“Our research suggests that combining rich data from wearable health trackers with the pattern-discovery capabilities of machine learning can uncover treatment strategies that otherwise might have gone underutilized,” says Anahita Khojandi, study co-author from the University of Tennessee, Knoxville.
“The algorithms we developed can even be used to predict patients who might benefit from more advanced PD therapies, which really highlights their ability to extract the maximum value from wearable data.”
Baucum and Khojandi, alongside fellow authors Dr Rama Vasudevan of Oak Ridge National Laboratory and Dr Ritesh Ramdhani a neurologist at Hofstra/ Northwell, emphasise that this work is ground-breaking for PD patients who may experience improved symptom control through continuous sensor monitoring and a novel AI approach.
Researchers from Japan have developed a novel wearable chemical sensor capable of measuring the concentration of chloride ions in sweat. The technology, described in the journal ACS Sensors, uses a ‘heat-transfer printing’ technique, the proposed sensor can be applied to the outer surface of common textiles to prevent skin irritation and allergies, and could also be useful in the early detection of heat stroke and dehydration.
Advances in miniaturisation have led to science-fiction like technologies such as wearable sensors which are usually placed directly on the skin. They can monitor important bodily parameters, including heart rate, blood pressure, and muscle activity and are often incorporated into devices such as smart watches.
Some wearable sensors can also detect chemicals in bodily fluids. For instance, sweat biosensors can measure the concentration of ions in sweat, providing information on their levels in blood. However, designing such chemical sensors is more complex than physical sensors. Direct contact between a wearable chemical sensor and skin can cause irritation and allergies. In contrast, if the sensor is fabricated directly on a wearable textile, its accuracy decreases due to surface irregularities.
In a recent study, a research team, led by Associate Professor Isao Shitanda of the Tokyo University of Science (TUS) in Japan, has developed an innovative sweat biosensor that addresses the aforementioned problems. Their technique involves ‘heat-transfer printing’ to fix a thin, flexible chloride ion sensor onto a textile substrate.
“The proposed sensor can be transferred to fibre substrates, and thus can be incorporated into textiles such as T-shirts, wristbands, and insoles,” explains Dr Shitanda. “Further, health indicators such as chloride ion concentration in sweat can be measured by simply wearing them.”
The heat-transfer printing approach offers several advantages. For one thing, the sensor is transferred outside of the piece of clothing, which prevents skin irritation. In addition, the wicking effect of the textile helps spread the sweat evenly between the electrodes of the sensor, creating a stable electrical contact. Moreover, printing the sensor on a flat surface and then transferring it prevents the formation of blurred edges that commonly occur when printing directly onto a textile.
The researchers carefully selected non-allergenic materials and electrochemical mechanisms of the sensor. After developing the sensor, they conducted various experiments using artificial sweat to verify its accuracy in measuring chloride ion concentration. The change in the electromotive force of the sensor was −59.5 mTV/log CCl−. Additionally, it displayed a Nernst response and a linear relationship with the concentration range of chloride ions in human sweat. Moreover, no other ions or substances typically present in sweat were found to interfere with the measurements.
Lastly, the team tested the sensor on a volunteer who exercised on a static bicycle for 30 minutes, by measuring their perspiration rate, chloride ion levels in blood, and saliva osmolality every five minutes to compare with the data previously gathered by the sensor. The proposed wearable sensor could reliably measure the concentration of chloride ions in sweat.
The sensor can also transmit data wirelessly, making real-time health monitoring easier. “Since chloride is the most abundant electrolyte in human sweat, measuring its concentration provides an excellent indicator of the body’s electrolyte balance and a useful tool for the diagnosis and prevention of heat stroke,” remarks Dr Shitanda.
This research thus demonstrates the potential of using wearable ion sensors for the real-time monitoring of sweat biomarkers, facilitating personalised healthcare development and athlete training management.
A research team has developed a smart wearable sensor that can conduct real-time, point-of-care assessment of chronic wounds wirelessly via an app. The world-first sensor technology can detect temperature, pH, bacteria type and inflammatory factors specific to chronic wounds within 15 minutes, enabling fast and accurate wound assessment.
More patients are suffering from non-healing wounds such as diabetic foot and chronic venous leg ulcers due to ageing and diabets, with an estimated 2% of the world’s population suffering from chronic wounds. Pain, stress and even amputation can result. Timely care and proper treatment of chronic wounds are needed to speed up wound recovery, but requires multiple clinical visits for lengthy wound assessment and treatment. This new technology can alleviate these problems.
The development of the technology was outlined in the journal Science Advances.
Currently, clinical assessments of wounds rely on visual inspection, or collecting and sending wound fluid for lab tests for biomarkers. This process usually takes about one to two days and may impede medical interventions. Though flexible sensors designed for wound care have been developed, they can only probe a limited set of markers such as acidity, temperature, oxygen, uric acid, and impedance to diagnose wound inflammation.
VeCare is a response to these problems, a point-of-care wound assessment platform consisting of an innovative wound sensing bandage, an electronic chip and a mobile app. The bandage consists of a wound contact layer, a breathable outer barrier, a microfluidic wound fluid collector and a flexible immunosensor. VeCare is the first wound assessment platform that can detect bacteria type and probe inflammatory factors, in addition to measuring acidity and temperature, within a single 15-minute test. The microfluidic wound collector boosts delivery to the immunosensor for analysis.
In addition, the reusable integrated chip transmits data to an app for convenient, real-time wound assessment and analysis onsite.
The VeCare platform and mobile app enable doctors to monitor the condition of patients’ chronic wounds remotely, and complements the patient’s existing medical treatment while facilitating timely medical intervention for wound healing processes.
“Point-of-care devices coupled with telehealth or digital health capability can play a significant role in transforming the healthcare industry and our society, which is catalysed by the COVID-19 pandemic requirements for safe distancing. Our smart bandage technology is the first of its kind designed for chronic wound management to give patients the freedom to perform the test and monitor their wound conditions at home,” said research leader Professor Lim Chwee Teck from the National University of Singapore’s (NUS) Department of Biomedical Engineering.
A small clinical test of VeCare was conducted on patients with chronic venous leg ulcers, successfully demonstrating the platform’s effectiveness. “The VeCare platform is easily scalable and customisable to accommodate different panels of biomarkers to monitor various types of wounds. The aim is to have an effective and easy to use diagnostic and prognostic tool for precise and data-driven clinical management of patients,” commented Prof Lim.
Next steps include a larger randomised trial and scaling up production to bring the device to market.
Researchers have created biocompatible generators which harvest body motion to produce electrical impulses for medical applications such as wound healing.
Piezoelectric materials such as ceramics and crystals can generate an electrical charge when mechanically stressed, and are used in many devices such as ultrasound transducers, vibration sensors, and cell phones. In medicine, electrostimulation using piezoelectric devices has been shown to be beneficial for accelerating wound and bone fracture healing, maintaining muscle tone in stroke victims, and chronic pain reduction. However, lack of biocompatibility has stalled progress in the field.
Now bioengineers at the University of Wisconsin’s Department of Materials Science and Engineering, led by Professor Xudong Wang, have developed implantable piezoelectric therapeutic devices. These thin, flexible devices make use of the piezoelectric properties of non-rigid, nontoxic biological materials such as silk, collagen, and amino acids. The team came up with a method for self-assembly of small patch-like constructs that use the amino acid lysine as the piezoelectric generator. The self-assembly process incorporates a biocompatible polymer shell that surrounds the lysine as the polymer/lysine solution evaporates. Chemical interactions between the inner layer of lysine and the polymer coating orient the lysine into the crystal structure necessary for it to produce electric current when flexed.
“This work is an outstanding example of using the chemical properties of the materials to create a self-assembling product,” explained David Rampulla, director of the Division of Discovery Science and Technology at the National Institute of Biomedical Imaging and Bioengineering. “The process used is rapid and inexpensive, making production of such wafers for therapeutic applications feasible. That the wafers are biodegradable opens the possibility for creating electrotherapies that could be used to accelerate healing of an injured bone or muscle, for example, and then degrade and disappear from the body.”
In one of a number of tests, wafers were placed in the leg and chest of rats, movements of which compressed the piezoelectric wafers enough to create an electrical output. Blood tests performed after the transplanted wafer dissolved showed normal levels of blood cells and other metabolites, indicating no harmful effects from the dissolved device.
Prof Wang emphasises the simplicity of the elegant work. “We believe the technology opens a vast array of possibilities including real-time sensing, accelerated healing of wounds and other types of injuries, and electrical stimulation to treat pain and other neurological disorders. Importantly, our rapid self-assembling technology dramatically reduces the cost of such devices, which has the potential to greatly expand the use of this very promising form of medical intervention.”
Apple has released a list of its products that it advises should be kept a “safe distance” away from sensitive medical devices such as pacemakers and implanted defibrillators. These products are iPhone 12 models, Apple Watch and MacBook Pro.
A number of consumer-electronic devices contain components, such as magnets, which are known to interfere with medical devices. A number of other manufacturers, for example Samsung and Huawei, have issued similar guidance for some of their products.
Heart health is a promoted feature of some Apple products; certain Apple Watches can make electrocardiogram tests and display the results to the user, as well as recording the data for later medical examination. A number of studies have shown that Apple watches can detect cardiovascular problems such as atrial fibrillation with a fairly high degree of sensitivity. However, the current notice warns of the risks posed by components in some products.
“Under certain conditions, magnets and electromagnetic fields might interfere with medical devices,” Apple wrote, noting “implanted pacemakers and defibrillators might contain sensors that respond to magnets and radios when in close contact”.
Implanted defibrillators send electrical pulses to regulate abnormal heart rhythms. Apple said the listed products should be kept more than 15cm away from medical devices, double that if they are wirelessly charging.
The support page that listed the devices, had said earlier this month that iPhone 12 models were “not expected to pose a greater risk of magnetic interference to medical devices” than other iPhones.
However, the website MacRumours, which first noted the list, pointed to research suggesting that the iPhone 12 could interfere with implanted devices.
A study published June 2 in the Journal of the American Heart Association found that “Apple’s iPhone 12 Pro Max MagSafe technology can cause magnet interference”, and so had the potential “to inhibit life-saving therapy”.
The researchers acknowledged the study’s small scale as a limitation, though in a press release lead investigator Dr Michael Wu wrote that they were surprised by the strength of the magnets in the iPhone 12.
“In general, a magnet can change a pacemaker’s timing or deactivate a defibrillator’s life-saving functions, and this research indicates the urgency for everyone to be aware that electronic devices with magnets can interfere with cardiac implantable electronic devices.”
However Marie Moe, a computer security consultant for Mnemonic, told the BBC she was not worried.
“These Apple gadgets are generally not emitting large magnetic fields, unlike heavy machinery, big concert speakers or welding equipment that anyone with a pacemaker should be more concerned about getting in close proximity to,” she said. She is a pacemaker user herself and studies their use.
Ms Moe added that magnets as strong as those in the iPhone 12 could only put the pacemaker into “a kind of safety mode where the pacing is constant”, which would revert back once the device was removed.
Jo Whitmore, senior cardiac nurse at the British Heart Foundation, agreed that devices kept at a safe distance were not cause for concern. “It’s perfectly OK to use a smartphone when you have a pacemaker, and they’re designed to return to normal settings once the magnet is moved away,” she said.
She added that patients should check the device instructions or talk to the manufacturer if they are concerned, and they could also contact their doctor or pacing clinic.
A team from the National University of Singapore (NUS) has devised an innovative way to charge wearable devices such as medical monitors — by transmitting power through the body to other devices.
Advancements in wearable technology are reshaping the way we live, work and play, and also how healthcare is delivered and received. Wearable devices include wristbands, smartwatches, wearable mobile sensors, and other mobile hub medical devices that collect a large range of data from blood sugar and exercise routines to sleep and mood.
Such devices can help patients and providers manage chronic conditions such as diabetes, heart conditions, and chronic pain. According to the Pew Research Center, 60% of US adults reported tracking their weight, diet, or exercise routine; 33% of US adults track health symptoms or indicators such as blood pressure, blood sugar, or sleep patterns; and 8% of adults specifically use medical devices, such as glucose meters.
One major obstacle of using wearables is keeping these devices properly and conveniently powered. The more wearable devices are worn, the more often there is the need to charge multiple batteries. Many users find it cumbersome to charge numerous devices every day, and inconvenient service disruptions occur when batteries run out.
A research team, led by Associate Professor Jerald Yoo from the Department of Electrical and Computer Engineering and the N.1 Institute for Health at NUS, has come up with an innovative solution to these problems. Their technology utilises the human body as a medium for power transmission, enabling a single device, such as a mobile phone placed in the pocket, to wirelessly power other wearable devices on a user’s body. The team’s novel system has an added advantage – it can harvest unused energy from electronics in a typical home or office environment to power the wearables.
Their achievement was first published in the journal Nature Electronics on 10 June 2021. It is the first of its kind to be established among existing literature on electronic wearables.
Power transmission through the body
To extend the battery life of wearable devices, power transmission and energy harvesting approaches are required. However, current approaches for powering up body area wearables are hampered by short distances, intervening obstacles and unstable power delivery. As such, none of the current methods are suitable for the sustainable provision of power to wearables placed around the entire human body.
The NUS approach turned the obstacle of the human body into an advantage by designing a receiver and transmitter system that uses the human body as a medium for power transmission and energy harvesting. Each receiver and transmitter contains a chip that is used as a springboard to extend coverage over the entire body.
The power transmitter need only be on a single power source, such as a smart watch, while multiple power receivers can be placed anywhere on the person’s body. The system then harnesses energy from the source to power multiple wearables on the user’s body via a process termed as body-coupled power transmission. In this way, only one device needs to be charged, and the rest of the wearable devices can be powered from that source. The team’s experiments showed that a single, fully-charged power source to power up to 10 wearable devices on the body, for a duration of over 10 hours.
The researchers also found that typical office and home environments have parasitic electromagnetic (EM) waves that people are constantly exposed to from sources such as running computers. To tap this energy, their novel receiver scavenges the EM waves from the environment, and through a process referred to as body-coupled powering, the human body is able to harvest this energy to power the wearable devices.
Smaller wearables without batteries
On the benefits of his team’s method, Assoc Prof Yoo said, “Batteries are among the most expensive components in wearable devices, and they add bulk to the design. Our unique system has the potential to omit the need for batteries, thereby enabling manufacturers to miniaturise the gadgets while reducing production cost significantly. More excitingly, without the constraints of batteries, our development can enable the next generation wearable applications, such as ECG patches, gaming accessories, and remote diagnostics.”
The NUS team will continue to improve the efficiency of their transmitter/receiver system, so that hopefully any given power-transmitting device such as a smartphone can extend the battery life of other wearable technologies, some of which, like medical monitors, can be quite important.
Journal reference: Li, J., et al. (2021) Body-coupled power transmission and energy harvesting. Nature Electronics. doi.org/10.1038/s41928-021-00592-y.
