Wireless body sensor networks for health-monitoring applications

This is an author-created, un-copyedited version of an article accepted for publication in Physiological Measurement. The publisher is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at http://dx.doi.org/10.1088/0967-3334/29/11/R01

Low-power Wearable Healthcare Sensors

Advances in technology have produced a range of on-body sensors and smartwatches that can be used to monitor a wearer’s health with the objective to keep the user healthy. However, the real potential of such devices not only lies in monitoring but also in interactive communication with expert-system-based cloud services to offer personalized and real-time healthcare advice that will enable the user to manage their health and, over time, to reduce expensive hospital admissions. To meet this goal, the research challenges for the next generation of wearable healthcare devices include the need to offer a wide range of sensing, computing, communication, and human–computer interaction methods, all within a tiny device with limited resources and electrical power. This Special Issue presents a collection of six papers on a wide range of research developments that highlight the specific challenges in creating the next generation of low-power wearable healthcare sensors

Ultra-low power mixed-signal frontend for wearable EEGs

Electronics circuits are ubiquitous in daily life, aided by advancements in the chip design industry, leading to miniaturised solutions for typical day to day problems. One of the critical healthcare areas helped by this advancement in technology is electroencephalography (EEG). EEG is a non-invasive method of tracking a person's brain waves, and a crucial tool in several healthcare contexts, including epilepsy and sleep disorders. Current ambulatory EEG systems still suffer from limitations that affect their usability. Furthermore, many patients admitted to emergency departments (ED) for a neurological disorder like altered mental status or seizures, would remain undiagnosed hours to days after admission, which leads to an elevated rate of death compared to other conditions. Conducting a thorough EEG monitoring in early-stage could prevent further damage to the brain and avoid high mortality. But lack of portability and ease of access results in a long wait time for the prescribed patients. All real signals are analogue in nature, including brainwaves sensed by EEG systems. For converting the EEG signal into digital for further processing, a truly wearable EEG has to have an analogue mixed-signal front-end (AFE). This research aims to define the specifications for building a custom AFE for the EEG recording and use that to review the suitability of the architectures available in the literature. Another critical task is to provide new architectures that can meet the developed specifications for EEG monitoring and can be used in epilepsy diagnosis, sleep monitoring, drowsiness detection and depression study. The thesis starts with a preview on EEG technology and available methods of brainwaves recording. It further expands to design requirements for the AFE, with a discussion about critical issues that need resolving. Three new continuous-time capacitive feedback chopped amplifier designs are proposed. A novel calibration loop for setting the accurate value for a pseudo-resistor, which is a crucial block in the proposed topology, is also discussed. This pseudoresistor calibration loop achieved the resistor variation of under 8.25%. The thesis also presents a new design of a curvature corrected bandgap, as well as a novel DDA based fourth-order Sallen-Key filter. A modified sensor frontend architecture is then proposed, along with a detailed analysis of its implementation. Measurement results of the AFE are finally presented. The AFE consumed a total power of 3.2A (including ADC, amplifier, filter, and current generation circuitry) with the overall integrated input-referred noise of 0.87V-rms in the frequency band of 0.5-50Hz. Measurement results confirmed that only the proposed AFE achieved all defined specifications for the wearable EEG system with the smallest power consumption than state-of-art architectures that meet few but not all specifications. The AFE also achieved a CMRR of 131.62dB, which is higher than any studied architectures.Open Acces

A Hybrid-Powered Wireless System for Multiple Biopotential Monitoring

Chronic diseases are the top cause of human death in the United States and worldwide. A huge amount of healthcare costs is spent on chronic diseases every year. The high medical cost on these chronic diseases facilitates the transformation from in-hospital to out-of-hospital healthcare. The out-of-hospital scenarios require comfortability and mobility along with quality healthcare. Wearable electronics for well-being management provide good solutions for out-of-hospital healthcare. Long-term health monitoring is a practical and effective way in healthcare to prevent and diagnose chronic diseases. Wearable devices for long-term biopotential monitoring are impressive trends for out-of-hospital health monitoring. The biopotential signals in long-term monitoring provide essential information for various human physiological conditions and are usually used for chronic diseases diagnosis. This study aims to develop a hybrid-powered wireless wearable system for long-term monitoring of multiple biopotentials. For the biopotential monitoring, the non-contact electrodes are deployed in the wireless wearable system to provide high-level comfortability and flexibility for daily use. For providing the hybrid power, an alternative mechanism to harvest human motion energy, triboelectric energy harvesting, has been applied along with the battery to supply energy for long-term monitoring. For power management, an SSHI rectifying strategy associated with triboelectric energy harvester design has been proposed to provide a new perspective on designing TEHs by considering their capacitance concurrently. Multiple biopotentials, including ECG, EMG, and EEG, have been monitored to validate the performance of the wireless wearable system. With the investigations and studies in this project, the wearable system for biopotential monitoring will be more practical and can be applied in the real-life scenarios to increase the economic benefits for the health-related wearable devices

High Resolution Multi-parametric Diagnostics and Therapy of Atrial Fibrillation: Chasing Arrhythmia Vulnerabilities in the Spatial Domain

After a century of research, atrial fibrillation (AF) remains a challenging disease to study and exceptionally resilient to treatment. Unfortunately, AF is becoming a massive burden on the health care system with an increasing population of susceptible elderly patients and expensive unreliable treatment options. Pharmacological therapies continue to be disappointingly ineffective or are hampered by side effects due to the ubiquitous nature of ion channel targets throughout the body. Ablative therapy for atrial tachyarrhythmias is growing in acceptance. However, ablation procedures can be complex, leading to varying levels of recurrence, and have a number of serious risks. The high recurrence rate could be due to the difficulty of accurately predicting where to draw the ablation lines in order to target the pathophysiology that initiates and maintains the arrhythmia or an inability to distinguish sub-populations of patients who would respond well to such treatments. There are electrical cardioversion options but there is not a practical implanted deployment of this strategy. Under the current bioelectric therapy paradigm there is a trade-off between efficacy and the pain and risk of myocardial damage, all of which are positively correlated with shock strength. Contrary to ventricular fibrillation, pain becomes a significant concern for electrical defibrillation of AF due to the fact that a patient is conscious when experiencing the arrhythmia. Limiting the risk of myocardial injury is key for both forms of fibrillation. In this project we aim to address the limitations of current electrotherapy by diverging from traditional single shock protocols. We seek to further clarify the dynamics of arrhythmia drivers in space and to target therapy in both the temporal and spatial domain; ultimately culminating in the design of physiologically guided applied energy protocols. In an effort to provide further characterization of the organization of AF, we used transillumination optical mapping to evaluate the presence of three-dimensional electrical substrate variations within the transmural wall during acutely induced episodes of AF. The results of this study suggest that transmural propagation may play a role in AF maintenance mechanisms, with a demonstrated range of discordance between the epicardial and endocardial dynamic propagation patterns. After confirming the presence of epi-endo dyssynchrony in multiple animal models, we further investigated the anatomical structure to look for regional trends in transmural fiber orientation that could help explain the spectrum of observed patterns. Simultaneously, we designed and optimized a multi-stage, multi-path defibrillation paradigm that can be tailored to individual AF frequency content in the spatial and temporal domain. These studies continue to drive down the defibrillation threshold of electrotherapies in an attempt to achieve a pain-free AF defibrillation solution. Finally, we designed and characterized a novel platform of stretchable electronics that provide instrumented membranes across the epicardial surface or implanted within the transmural wall to provide physiological feedback during electrotherapy beyond just the electrical state of the tissue. By combining a spatial analysis of the arrhythmia drivers, the energy delivered and the resulting damage, we hope to enhance the biophysical understanding of AF electrical cardioversion and xiii design an ideal targeted energy delivery protocol to improve upon all limitations of current electrotherapy

Intelligent Biosignal Processing in Wearable and Implantable Sensors

This reprint provides a collection of papers illustrating the state-of-the-art of smart processing of data coming from wearable, implantable or portable sensors. Each paper presents the design, databases used, methodological background, obtained results, and their interpretation for biomedical applications. Revealing examples are brain–machine interfaces for medical rehabilitation, the evaluation of sympathetic nerve activity, a novel automated diagnostic tool based on ECG data to diagnose COVID-19, machine learning-based hypertension risk assessment by means of photoplethysmography and electrocardiography signals, Parkinsonian gait assessment using machine learning tools, thorough analysis of compressive sensing of ECG signals, development of a nanotechnology application for decoding vagus-nerve activity, detection of liver dysfunction using a wearable electronic nose system, prosthetic hand control using surface electromyography, epileptic seizure detection using a CNN, and premature ventricular contraction detection using deep metric learning. Thus, this reprint presents significant clinical applications as well as valuable new research issues, providing current illustrations of this new field of research by addressing the promises, challenges, and hurdles associated with the synergy of biosignal processing and AI through 16 different pertinent studies. Covering a wide range of research and application areas, this book is an excellent resource for researchers, physicians, academics, and PhD or master students working on (bio)signal and image processing, AI, biomaterials, biomechanics, and biotechnology with applications in medicine

DICOM for EIT

With EIT starting to be used in routine clinical practice [1], it important that the clinically relevant information is portable between hospital data management systems. DICOM formats are widely used clinically and cover many imaging modalities, though not specifically EIT. We describe how existing DICOM specifications, can be repurposed as an interim solution, and basis from which a consensus EIT DICOM ‘Supplement’ (an extension to the standard) can be writte

Ultra low power wearable sleep diagnostic systems

Sleep disorders are studied using sleep study systems called Polysomnography that records several biophysical parameters during sleep. However, these are bulky and are typically located in a medical facility where patient monitoring is costly and quite inefficient. Home-based portable systems solve these problems to an extent but they record only a minimal number of channels due to limited battery life. To surmount this, wearable sleep system are desired which need to be unobtrusive and have long battery life. In this thesis, a novel sleep system architecture is presented that enables the design of an ultra low power sleep diagnostic system. This architecture is capable of extending the recording time to 120 hours in a wearable system which is an order of magnitude improvement over commercial wearable systems that record for about 12 hours. This architecture has in effect reduced the average power consumption of 5-6 mW per channel to less than 500 uW per channel. This has been achieved by eliminating sampled data architecture, reducing the wireless transmission rate and by moving the sleep scoring to the sensors. Further, ultra low power instrumentation amplifiers have been designed to operate in weak inversion region to support this architecture. A 40 dB chopper-stabilised low power instrumentation amplifiers to process EEG were designed and tested to operate from 1.0 V consuming just 3.1 uW for peak mode operation with DC servo loop. A 50 dB non-EEG amplifier continuous-time bandpass amplifier with a consumption of 400 nW was also fabricated and tested. Both the amplifiers achieved a high CMRR and impedance that are critical for wearable systems. Combining these amplifiers with the novel architecture enables the design of an ultra low power sleep recording system. This reduces the size of the battery required and hence enables a truly wearable system.Open Acces

Wearable sensor for continuous monitoring of physiological parameters

Providing high quality health care to a mass population is becoming one of the great endeavors of modern society. In order to do so, there is a urge to embrace the use of new technologies that can provide comfort while ensuring the safety and reliability of traditional methods. The system hereby proposed ought to be capable of monitoring a person's vital signs therefore being very flexible regarding its application scenarios. It can be used not only in emergency wards and screening diseases but also in a home environment to monitor elderly people or young children. Furthermore, it is not exclusive to monitoring and preventing diseases, it can also be an instrument that aids sports training at high intensity levels. This product can measure a patient's heart rate and oxygen saturation levels ensuring comfort and easy usage. Another advantage when compared to traditional machines used to fit the same purpose is the fact that it is much cheaper, takes up less space and it encompasses two functional- ities that are otherwise measured with different machines. This system has two major components, an ESP32 microprocessor and a MAX30100 Pho- toPletysmoGraphy (PPG) sensor. The ESP32 module was chosen due to its computing capacity (dual-core 32-bit processor), having a WiFi module built in with full TCP/IP stack and having 3 pre-defined sleep modes to reduce power consumption. The MAX30100 sensor was picked because it is a compact and small module with simple usage. Furthermore, the goal of this disser- tation is to build this system to be energy efficient, maximizing its battery life while not compro- mising its logical correctness. The configuration chosen that produced steady results whilst consuming lowest energy possi- ble was: 37 mA of current for the IR LED, sampling frequency of 50 Hz and pulse width of 200 μs

Estimation of thorax shape for forward modelling in lungs EIT

The thorax models for pre-term babies are developed based on the CT scans from new-borns and their effect on image reconstruction is evaluated in comparison with other available models