Abstract:Modern auscultation, using digital stethoscopes, provides a better solution than conventional methods in sound recording and visualization. However, current digital stethoscopes are too bulky and nonconformal to the skin for continuous auscultation. Moreover, motion artifacts from the rigidity cause friction noise, leading to inaccurate diagnoses. Here, we report a class of technologies that offers real-time, wireless, continuous auscultation using a soft wearable system as a quantitative disease diagnosis too… Show more
“…More functions provide a broader range of applications for wearable devices. In the latest research, wearable devices are also used in many fields, such as the detection of COVID-19 [ 74 ], automatic real-time detection of diseases, health monitoring [ 75 , 76 ], temperature adjustable clothes [ 77 ] as well as implantable and wearable bioelectronic devices [ 78 ]. Fig.…”
For graphene oxide (GO) composite hydrogels, a two-dimensional GO material is introduced into them, whose special structure is used to improve their properties. GO contains abundant oxygen-containing functional groups, which can improve the mechanical properties of hydrogels and support the application needs. Especially, the unique-conjugated structure of GO can endow or enhance the stimulation response of hydrogels. Therefore, GO composite hydrogels have a great potential in the field of wearable devices. We referred to the works published in recent years, and reviewed from these aspects: (a) structure of GO; (b) factors affecting the mechanical properties of the composite hydrogel, including hydrogen bond, ionic bond, coordination bond and physical crosslinking; (c) stimuli and signals; (d) challenges. Finally, we summarized the research progress of GO composite hydrogels in the field of wearable devices, and put forward some prospects.
“…More functions provide a broader range of applications for wearable devices. In the latest research, wearable devices are also used in many fields, such as the detection of COVID-19 [ 74 ], automatic real-time detection of diseases, health monitoring [ 75 , 76 ], temperature adjustable clothes [ 77 ] as well as implantable and wearable bioelectronic devices [ 78 ]. Fig.…”
For graphene oxide (GO) composite hydrogels, a two-dimensional GO material is introduced into them, whose special structure is used to improve their properties. GO contains abundant oxygen-containing functional groups, which can improve the mechanical properties of hydrogels and support the application needs. Especially, the unique-conjugated structure of GO can endow or enhance the stimulation response of hydrogels. Therefore, GO composite hydrogels have a great potential in the field of wearable devices. We referred to the works published in recent years, and reviewed from these aspects: (a) structure of GO; (b) factors affecting the mechanical properties of the composite hydrogel, including hydrogen bond, ionic bond, coordination bond and physical crosslinking; (c) stimuli and signals; (d) challenges. Finally, we summarized the research progress of GO composite hydrogels in the field of wearable devices, and put forward some prospects.
“…For skin-attachable stethoscopes, noise between the sensor and skin contact can affect diagnostic results. Lee et al [ 56 ] utilized different biocompatible adhesives to optimize motion artifacts and a wavelet denoising algorithm to improve SNR, allowing clinical applications of skin-attachable stethoscopes (Fig. 6 b).…”
Section: Physical Sensormentioning
confidence: 99%
“…Reprint with permission from Ref. [ 56 ]. Copyright 2022 American Association for the Advancement of Science …”
With the growing concern about human health issues, especially during the outbreak of the COVID-19 pandemic, the demand for personalized healthcare regarding disease prevention and recovery is increasing. However, tremendous challenges lie in both limited public medical resources and costly medical diagnosis approaches. Recently, skin-attachable sensors have emerged as promising health monitoring platforms to overcome such difficulties. Owing to the advantages of good comfort and high signal-to-noise ratio, skin-attachable sensors enable household, real-time, and long-term detection of weak physiological signals to efficiently and accurately monitor human motion, heart rate, blood oxygen saturation, respiratory rate, lung and heart sound, glucose, and biomarkers in biomedical applications. To further improve the integration level of biomedical skin-attachable sensors, efforts have been made in combining multiple sensing techniques with elaborate structural designs. This review summarizes the recent advances in different functional skin-attachable sensors, which monitor physical and chemical indicators of the human body. The advantages, shortcomings, and integration strategies of different mechanisms are presented. Specially, we highlight sensors monitoring pulmonary function such as respiratory rate and blood oxygen saturation for their potential usage in the COVID-19 pandemic. Finally, the future development of skin-attachable sensors is envisioned.
“…Wu et al developed an electronic stethoscope and a classification algorithm for cardiopulmonary sounds [ 14 ]. Many wearable stethoscopes for long-term ambulatory respiratory and cardiac health monitoring have been created [ 15 – 17 ]. Moreover, artificial intelligence (AI) algorithms have been increasingly used recently and have been applied in automatic auscultation [ 18 – 21 ].…”
Background
With the spread of COVID-19, telemedicine has played an important role, but tele-auscultation is still unavailable in most countries. This study introduces and tests a tele-auscultation system (Stemoscope) and compares the concordance of the Stemoscope with the traditional stethoscope in the evaluation of heart murmurs.
Methods
A total of 57 patients with murmurs were recruited, and echocardiographs were performed. Three cardiologists were asked to correctly categorize heart sounds (both systolic murmur and diastolic murmur) as normal vs. abnormal with both the Stemoscope and a traditional acoustic stethoscope under different conditions. Firstly, we compared the in-person auscultation agreement between Stemoscope and the conventional acoustic stethoscope. Secondly, we compared tele-auscultation (recorded heart sounds) agreement between Stemoscope and acoustic results. Thirdly, we compared both the Stemoscope tele-auscultation results and traditional acoustic stethoscope in-person auscultation results with echocardiography. Finally, ten other cardiologists were asked to complete a qualitative questionnaire to assess their experience using the Stemoscope.
Results
For murmurs detection, the in-person auscultation agreement between Stemoscope and the acoustic stethoscope was 91% (p = 0.67). The agreement between Stemoscope tele-auscultation and the acoustic stethoscope in-person auscultation was 90% (p = 0.32). When using the echocardiographic findings as the reference, the agreement between Stemoscope (tele-auscultation) and the acoustic stethoscope (in-person auscultation) was 89% vs. 86% (p = 1.00). The system evaluated by ten cardiologists is considered easy to use, and most of them would consider using it in a telemedical setting.
Conclusion
In-person auscultation and tele-auscultation by the Stemoscope are in good agreement with manual acoustic auscultation. The Stemoscope is a helpful heart murmur screening tool at a distance and can be used in telemedicine.
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