Stress is an inherent sensation of being unable to handle demands and occurrences. If not properly managed, stress can develop into a chronic condition, leading to the onset of additional chronic health issues like cardiovascular illnesses and diabetes. Various stress meters have been suggested in the past, along with diverse approaches for its estimate. However, in the case of more serious health issues such as hypertension and diabetes, the results can be significantly improved. This study presents the design and implementation of a distributed wearable sensor computing platform with multiple channels. The platform aims to estimate stress levels in diabetes patients by utilizing a fuzzy logic algorithm that is based on the assessment of several physiological indicators. Additionally, a mobile application was created to monitor users' stress levels and integrate data on their blood pressure and blood glucose levels. Validation experiments were performed on patients with chronic diabetes, and the initial findings are presented in the study.

The manuscript presents a novel approach to designing and fabricating a stretchable patch antenna designed for strain sensing and wireless communication of sensing data at the same time. The challenge lies in combining flexible and stretchable textile materials with different physical mor-phologies, which can hinder adhesion among multiple layers when stacked up, resisting the overall stretchability of the antenna. The proposed antenna design overcomes this challenge by incorpo-rating a lattice hinge pattern in the non-stretchable conductive e-textile, transforming it into a stretchable structure. The innovative design includes the longitudinal cuts inserted in both the patch and the ground plane of the antenna, allowing it to stretch along in the perpendicular direction. Implementing the lattice hinge pattern over the conductive layers of the proposed patch antenna in combination with a 2 mm thick Polydimethylsiloxane (PDMS) substrate achieves a maximum of 25% stretchability compared to its counterpart antenna without lattice hinge design. The stretchable textile antenna resonates around a frequency of 2.45 GHz and exhibits a linear resonant frequency shift when strained up to 25%. This characteristic makes it suitable for use as a strain sensor. Ad-ditionally, the lattice hinge design enhances the conformability and flexibility of the antenna compared to a solid patch antenna. The realized antenna gains in the E and H-plane were measured as 2.21 dBi and 2.34 dBi, respectively. Overall, the presented design offers a simple and effective solution for fabricating a stretchable textile patch antenna for normal use or as a sensing element, opening up possibilities for applications in communication and sensing fields.

The COVID-19 pandemic resulted in government restrictions that altered the lifestyle of people worldwide. Studying the impact of these restrictions on exercise behaviors will improve our understanding of environmental factors that influence individuals’ PA. We conducted a retrospective analysis using an index of government pandemic stringency developed by Oxford and a wearable device for runners to compare strictness of lockdowns and exercise habits, using digitally-logged PA data from more than 7,000 runners on a global scale. Additionally, time-of-day of PA globally and levels of PA in 14 countries are compared between the pre-pandemic year of 2019 and the first pandemic year of 2020. We found that during the pandemic the time-of-day that people exercised experienced a major shift, with significantly more activities logged during standard working hours on workdays (p<0.001) and fewer during the same time frame on weekends (p<0.001). Of the countries examined, Italy and Spain had among the most strict lockdowns and suffered the largest decreases in activity counts, whereas France experienced a minimal decrease in activity counts despite enacting a similarly strict lockdown. This study suggests that there are several factors affecting PA, including government policy, workplace policy, and cultural norms.

Freezing of Gait (FOG) is an impairment that affects the majority of patients in the advanced stages of Parkinson’s Disease (PD). FOG can lead to sudden falls and injuries, negatively impacting the quality of life for the patients and their families. Rhythmic Auditory Stimulation (RAS) can be used to help patients recover from FOG and resume normal gait. RAS might be ineffective due to the latency between the start of a FOG event, it’s detection and initialization of RAS. We propose a system capable of both FOG prediction and detection using signals from tri-axial accelerometer sensors that will be useful in initializing RAS with minimal latency. We compared the performance of several time frequency analysis techniques, including moving windows extracted from the signals, handcrafted features, Recurrence Plots (RP), Short Time Fourier Transform (STFT), Discreet Wavelet Transform (DWT) and Pseudo Wigner Ville Distribution (PWVD) with Deep Learning (DL) based Long Short Term Memory (LSTM) and Convolutional Neural Networks (CNN). We also propose three Ensemble Network Architectures that combine all the time frequency representations and DL architectures. Experimental results show that our ensemble architectures significantly improve the performance compared with existing techniques. We also present the results of applying our method trained on publicly available dataset to data collected from patients using wearable sensors in collaboration with A.T. Still University.

(1) Background: New sensor technologies in wearables and other consumer health devices open up promising opportunities to collect real-world data. As cardiovascular diseases remain reason number one for disease and mortality worldwide, cardiology offers potent monitoring use-cases with patients in their out-of-hospital daily routine. Therefore, the aim of this systematic review is to investigate the status quo of studies monitoring patients with cardiovascular risks and patients suffering from cardiovascular diseases in a telemedical setting using not only a smartphone-based app, but also consumer health devices such as wearables and other sensor-based devices. (2) Methods: A literature search was conducted across five databases and the results were examined according to the study protocols, technical approaches and qualitative and quantitative parameters measured. (3) Results: Out of 166 articles, 8 studies were included in this systematic review. These cover interventional and observational monitoring approaches in the area of cardiovascular diseases, heart failure and atrial fibrillation using various app, wearable and health device combination. (4) Conclusions: Depending on the researcher’s motivation a fusion of apps, patient reported outcome measures and non-invasive sensors can be orchestrated in a meaningful way adding major contributions to monitoring concepts for both, individual patients and larger cohorts.

STRAS (Single access Transluminal Robotic Assistant for Surgeons) is a flexible robotic system based on the Anubis® platform of Karl Storz for application to intra-luminal surgical procedures. It consists of three cable-driven systems, one endoscope serving as guide and two inserted instruments. The flexible and bendable instruments have three degrees of freedom and can be teleoperated by a single user via two specially designed master interfaces. In this research, a pair of specific sensor gloves, which ergonomically fit to the master handles of the system was designed and the forces applied by one expert and one novice user during system-specific task execution in a simulator task (4-step-pick-and-drop) were compared. The results show that user expertise is not only reflected by shorter task execution times but also, more importantly, by specific differences in handgrip force profiles for specific sensor locations on anatomically relevant parts of the fingers and hand controlling the surgical instruments of the robotic master/slave system.

Detection of human movement requires lightweight, flexible systems to detect mechanical parameters (like strain and pressure) not interfering with user activity, and that he/she can wear comfortably. In this work we address such multifaceted challenge with the development of smart garments for lower limb motion detection, like a textile kneepad and anklet in which soft sensors and readout electronics are embedded for detecting movement of the specific joint. Stretchable capacitive sensors with a three-electrode configuration are built combining conductive textiles and elastomeric layers, and distributed at knee and ankle. They show an excellent behavior in the ~30% strain range, hence the correlation between their responses and the optically tracked Euler angles is allowed for basic lower limb movements. Bending during knee flexion/extension is detected, and it is discriminated from any external contact by implementing in real time a low computational algorithm. The smart anklet is designed to address joint motion detection in and off the sagittal plane. In this work, ankle dorsi/plantar flexion, adduction/abduction, and rotation are retrieved. Both smart garments show a high accuracy in movement detection, with a RMSE less than 4° in the worst case.

The design of torsional springs for Series Elastic Actuators (SEAs) is challenging, especially when it comes to balancing good stiffness characteristics and efficient torque robustness. This study focuses on the design of a lightweight, low-cost, and compact torsional spring for use in rotary series elastic actuator (ES-RSEA) of lumbar support exoskeleton. The exoskeleton is used as an assistive device to prevent lower back injuries. The torsion spring was designed following design for manufacturability (DFM) principles, focusing on minimal space and weight. The design process consisted of determining the potential topology and optimizing the selected topology parameters through finite element method (FEM) to reduce equivalent stress. The prototype was made using a waterjet cutting process with low-cost material (AISI-4140-alloy) and tested using a custom-made test rig. The results showed that the torsion spring had a linear torque-displacement relationship with 99% linearity, and the deviation between FEM simulation and experimental measurements was less than 2%. The torsion spring has a maximum torque capacity of 45.7 Nm and a stiffness of 440 Nm/rad. The proposed torsion spring is a promising option for lumbar support exoskeletons and similar applications requiring high stiffness, low weight-to-torque ratio, and cost-effectiveness.

The Galvanic Skin Response (GSR, also widely known as electrodermal activity EDA) is one of the signals related to this emotional reaction. Given the sparsity of studies related to and the variety of devices, we experimented at the Human Health Activity Laboratory with 17 healthy subjects. The goal is to know the variability of detection changes in the electrodermal activity among a test group with heterogeneous respondents in response to valence and arousal stimuli, correlating GSR biosignals measured from different body sites. We experiment with the right and left wrist, left fingers, the right foot's inner side using Shimmer3GSR, and Empatica E4 sensors. Results indicate as the most promising homogeneous GSR measure place the left fingers and right foot. Results suggest that due to a significantly strong correlation among the inner side of the right foot and left fingers and moderate correlations with the right and left wrist, the foot is a good place to measure EDA. This paper also contributes knowledge about some wearable sensor technologies available in the market. Shimmer3GSR sensor may be better reliable to homogenous detecting electrodermal activity changes, as these have fewer anomalies among the respondents. However, we found some anomalies in signals from the Empatica E4 sensor, which we discuss in this work.

Motor functions are deteriorated by aging. Some conditions may magnify this deterioration. To examine whether hemodialysis (HD) process would negatively impact gait and balance beyond diabetes condition among mid-age adults (48-64 years) and older adults (65+ years). One hundred and ninety-six subjects (age=66.2±9.1 years, body-mass-index=30.1±6.4 kg/m², female=56%) in 5 groups were recruited: mid-age adults with diabetes undergoing HD (Mid-age HD+, n=38) and without HD (Mid-age HD-, n=40); older adults with diabetes undergoing HD (Older HD+, n=36) and without HD (Older HD-, n=37); and non-diabetic older adults (Older DM-, n=45). Gait parameters (stride velocity, stride length, gait cycle time, and double support) and balance parameters (ankle, hip, and center of mass sways) were quantified using validated wearable platforms. Groups with diabetes had overall poorer gait and balance compared to the non-diabetic group (p<0.050). Among people with diabetes, the HD+ had significantly worsened gait and balance when comparing to the HD- (Cohen’s effect size d=0.63-2.32, p<0.050). Between-group difference was more pronounced among older adults with the largest effect size observed for stride length (d=2.32, p<0.001). Results suggested that deterioration in gait speed among the HD+ was correlated with age (r=-0.440, p<0.001), while this correlation was diminished among the HD-. Interestingly, results also suggested that poor gait in the Older HD- related to poor balance, while no correlation was observed between poor balance and poor gait among the Older HD+. Using objective assessments, results confirmed that the presence of diabetes can deteriorate gait and balance, and this deterioration can be magnified by HD process. Among non-HD people with diabetes, poor static balance described poor gait. However, among people with diabetes undergoing HD, age was a dominate factor describing poor gait irrespective of static balance. Results also suggested feasibility of using wearable platforms to quantify motor performance during routine dialysis clinic visits. These objective assessments may assist in identifying early deterioration in motor function, which in turn may promote timely intervention.

This comprehensive review explores the multifaceted landscape of supercapacitors, highlighting their pivotal role in meeting the global demand for efficient energy storage solutions. Supercapacitors, with their high power density, rapid charge-discharge cycles, and extended cycle life, offer a compelling alternative to conventional batteries and capacitors. The review delves into the fundamental mechanisms of energy storage in supercapacitors, categorizing them into Electrochemical Double-Layer Capacitors (EDLCs), pseudocapacitors, and hybrid capacitors. It discusses significant advancements in supercapacitor technology, including nanostructured materials, flexible and wearable supercapacitors, solid-state supercapacitors, and hybrid supercapacitors, highlighting their potential applications across industries such as transportation, renewable energy, consumer electronics, and industrial power management. Through continued research and development, supercapacitors are poised to play a pivotal role in driving the transition towards a greener and more efficient future.

Low-complexity ultrasound systems are increasingly desired for wearable point-of-care ultra-sound and massive-channel ultrasound for 3-D matrix imaging. However, the system complexity is closely associated with the imaging capabilities, remaining as a challenge. To resolve this limitation, this study revisits the general structures of analog and digital beamformers and in-troduces a hybrid approach to implement efficient ultrasound systems. The suggested hybrid beamforming takes two stages, where the first analog stage partially beamforms M-channel RF signals to N sum-out data (M-to-N beamforming), and the second digital stage beamforms N partial sums to single final beamformed data (N-to-1 beamforming). Our approach was systematically designed and implemented, which was demonstrated with a customized 64-channel 1-D phased array using a tissue mimicking phantom. The demonstrated results indicate that the analog-digital hybrid beamforming can be applied to any kind of arrays for sophisticated 3-D imaging and tiny wearable ultrasound applications.

Tracking the kinematics of human movement usually requires the use of equipment that constrains the user within a room (e.g., optical motion capture systems), or requires the use of a conspicuous body-worn measurement system (e.g., inertial measurement units (IMUs) attached to each body segment). This paper presents a novel Lie group constrained extended Kalman filter to estimate lower limb kinematics using IMU and inter-IMU distance measurements in a reduced sensor count configuration. The algorithm iterates through the prediction (kinematic equations), measurement (pelvis height assumption/inter-IMU distance measurements, zero velocity update for feet/ankles, flat-floor assumption for feet/ankles, and covariance limiter), and constraint update (formulation of hinged knee joints and ball-and-socket hip joints). The knee and hip joint angle root-mean-square errors in the sagittal plane for straight walking were 7.6±2.6∘ and 6.6±2.7∘, respectively, while the correlation coefficients were 0.95±0.03 and 0.87±0.16, respectively. Furthermore, experiments using simulated inter-IMU distance measurements show that performance improved substantially for dynamic movements, even at large noise levels (σ=0.2 m). However, further validation is recommended with actual distance measurement sensors, such as ultra-wideband ranging sensors.

In this paper, we present the design, manufacturing and characterization of a soft textile-based clutch (TBC) that switches between locking and unlocking of its linear displacement by exploiting vacuum stimulation. The applied vacuum locks the relative sliding motion between two elaborated textile webbings covered by an elastic silicone rubber bag. Based on different fabrication techniques, such as silicone casting on textile, melt embossing for direct fabrication of miniature patterns on textile and sewing, we developed three groups of TBC samples based on friction and interlocking principles and we compared their performance in blocking configuration. The clutch with interlocking mechanism presented the highest withstanding force (150 N) respect to the one (54 N) recorded for the friction-based clutch. The simple and compact structure of the proposed clutch, together with the intrinsic adaptability of fabric with other clothing and soft materials, make it a proper solution for applications in soft wearable robotics and generally as locking and variable stiffness solution for soft robotic applications.

Sustainable urban drainage systems (SuDS) such as swales are designed to collect, store and infiltrate a large amount of surface runoff water during heavy rainfall. Stormwater is known to transport pollutants, such as particle-bound Potential Toxic Elements (PTE), which are known to often accumulate in the topsoil. A portable XRF instrument (pXRF) is used to provide in situ spatial characterization of soil pollutants, specifically lead (Pb), zink (Zn) and copper (Cu). The method uses pXRF measurements of PTE along profiles with set intervals (1 meter) to cover the swale with cross-sections, across the inlet, the deepest point and the outlet. Soil samples are collected, and the In-Situ measurements are verified by the results from laboratory analyses. Stormwater is here shown to be the transporting media for the pollutants, so it is of importance to investigate areas most prone to flooding and infiltration. This quick scan method is time and cost-efficient, easy to execute and the results are comparable to any known (inter)national threshold criteria for polluted soils. The results are of great importance for all stakeholders in cities that are involved in climate adaptation and implementing green infrastructure in urban areas. However, too little is still known about the long-term functioning of the soil-based SuDS facilities.

Wearable devices have become ubiquitous, collecting rich temporal data that offers valuable insights into human activities, health monitoring, and behavior analysis. Leveraging this data, researchers have developed innovative approaches to classify and predict time-based patterns and events in human life. Time-based techniques allow the capture of intricate temporal dependencies, which is the nature of the data coming from wearable devices. This paper focuses on predicting well-being factors, such as stress, anxiety, positive and negative affect, on the Tesserae dataset collected from office workers. We examine the performance of different methodologies, including deep learning architectures, LSTM, ensemble techniques, Random Forest (RF) and XGBoost and compare their performances for time-based and non-time-based versions. In time-based versions, we investigate the effect of previous records of well-being factors on the upcoming ones. The overall results show that time-based LSTM performs the best among conventional (non-time-based) RF, XGBoost, and LSTM. The performance even increases when we consider a more extended previous period, in this case, 3 past-days rather than 1 past-day to predict the next day. Furthermore, we explore the corresponding biomarkers for each well-being factor using feature ranking. The obtained rankings are compatible with the psychological literature. In this work, we validated them based on device measurements rather than subjective survey responses.

People with diabetic foot frequently exhibit poor gait and balance. However, there is no review to inform digital biomarkers of poor gait and balance related to diabetic foot, measurable by wearables outside traditional gait laboratories. Such information could assist in designing remote patient monitoring platform to track changes in gait and balance dysfunction among people with diabetic foot for timely referral and intervention. Accordingly, we conducted a web-based review using PubMed. Our search was limited to human subjects and English-written papers published in peer-reviewed journals. We identified 20 papers in this review. We found preliminary evidence of digital biomarkers of gait and balance dysfunction in people with diabetic foot, measured by wearables, such as slow gait speed, large gait variability, unstable gait initiation, and large body sway. However, due to heterogeneities in included papers in terms of study design, movement tasks, and small sample size, more studies are recommended to confirm this preliminary evidence. Additionally, based on our review, we recommend establishing appropriate strategies to successfully implement wearable-based assessment into clinical practice for diabetic foot care.

Several studies have analyzed human gait data obtained from inertial gyroscope and accelerometer sensors mounted on different parts of the body. In this article, we take a step further in gait analysis and provide a methodology for predicting the movements of the missing parts of the legs. In particular, we propose a method, called GaIn, to control non-invasive, robotic, prosthetic legs. GaIn can infer the movements of both missing shanks and feet for humans suffering from double trans-femoral amputation using biologically inspired recurrent neural networks. Predictions are performed for casual walking related activities such as walking, taking stairs, and running based on thigh movement. In our experimental tests, GaIn achieved a 4.55 degree prediction error for shank movements on average. However, a patient's intention to stand up and sit down cannot be inferred from thigh movements. In fact, intention causes thigh movements while the shanks and feet remain roughly still. The GaIn system can be triggered by thigh muscle activities measured with electromyography (EMG) sensors to make robotic prosthetic legs perform standing up and sitting down actions. The GaIn system has low prediction latency and is fast and computationally inexpensive to be deployed on mobile platforms and portable devices.

Heart failure (HF) is a growing issue in developed countries and most patients present with a reduced ejection fraction. This condition significantly impairs quality of life and represents a threat not only for patients, but also for the entire healthcare system due to its high management cost. In the last decade, new medical treatments and devices have been developed to reduce HF hospitalizations and improve prognosis, while reducing the overall mortality rate. Medical therapy does not achieve the same results in all patients and, whenever it fails, technology comes in handy: novel devices for the management of HF have reduced symptoms. They have also improved the treatment of fluid retention and life threatening arrhythmias. The present review article gives to the readers a comprehensive overview of the most recent and important findings that need to be considered in HF with reduced ejection fraction patients. Both novel medical treatments and devices have been presented and discussed.

The fundamental question in the field of sensor research is new directions of scientific fields, which play a vital role in the progress of science and technology. This study confronts this question here by developing a bibliometric analysis, which endeavors to explain the evolution of sensor research and new technologies that are critical to science and society. The database of Scopus concerning scientific documents and patents is used for statistical and computational analyses in these topics. Results suggest that emerging technological trajectories in sensors are wireless sensor networks, wearable sensors and biosensors. Main characteristics of these growing research fields and technologies in sensors are described for fruitful implications of research and innovation policy directed to science advances and technological change in society.

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one’s health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex; 2) The data, when communicated, are vulnerable to security and privacy issues; 3) The communication of the continuously collected data is not only costly but also energy hungry; 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks.This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a serviceoriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection. The book chapter ends with experiments and results showing how fog computing could lessen the obstacles of existing cloud-driven medical IoT solutions and enhance the overall performance of the system in terms of computing intelligence, transmission, storage, configurable, and security. The case studies on various types of physiological data shows that the proposed Fog architecture could be used for signal enhancement, processing and analysis of various types of bio-signals.