Wireless, intraoral hybrid electronics for real-time quantification of sodium intake toward hypertension management

Edited by John A. Rogers, Northwestern University, Evanston, IL, and approved April 11, 2018 (received for review November 13, 2017)
May 7, 2018
115 (21) 5377-5382

Significance

We introduce a soft, low-profile, intraoral electronics that offers continuous real-time monitoring of sodium intake via long-range wireless telemetry. The stretchable, hybrid electronic system integrates chip-scale components and microstructured sodium sensors with stretchable interconnects, together in an ultrasoft, breathable, microporous membrane. The quantitative computational and experimental studies of antenna performance optimize the wireless electronics, offering consistent functionality with minimal loss during multimodal deformation. Examples of in vivo study with human subjects demonstrate a highly sensitive, real-time quantification of sodium intake.

Abstract

Recent wearable devices offer portable monitoring of biopotentials, heart rate, or physical activity, allowing for active management of human health and wellness. Such systems can be inserted in the oral cavity for measuring food intake in regard to controlling eating behavior, directly related to diseases such as hypertension, diabetes, and obesity. However, existing devices using plastic circuit boards and rigid sensors are not ideal for oral insertion. A user-comfortable system for the oral cavity requires an ultrathin, low-profile, and soft electronic platform along with miniaturized sensors. Here, we introduce a stretchable hybrid electronic system that has an exceptionally small form factor, enabling a long-range wireless monitoring of sodium intake. Computational study of flexible mechanics and soft materials provides fundamental aspects of key design factors for a tissue-friendly configuration, incorporating a stretchable circuit and sensor. Analytical calculation and experimental study enables reliable wireless circuitry that accommodates dynamic mechanical stress. Systematic in vitro modeling characterizes the functionality of a sodium sensor in the electronics. In vivo demonstration with human subjects captures the device feasibility for real-time quantification of sodium intake, which can be used to manage hypertension.

Continue Reading

Acknowledgments

W.-H.Y. acknowledges a research grant from Medarva Foundation, a seed grant from the Institute for Electronics and Nanotechnology, a grant by the Fundamental Research Program (Project PNK5061) of Korea Institute of Materials Science, and startup funding from the Woodruff School of Mechanical Engineering at Georgia Institute of Technology.

Supporting Information

Appendix (PDF)
Movie S1.
Wireless, real-time monitoring of sodium intake with various sodium concentrations.

References

1
MM Rodgers, VM Pai, RS Conroy, Recent advances in wearable sensors for health monitoring. IEEE Sens J 15, 3119–3126 (2015).
2
R Herbert, J-H Kim, YS Kim, HM Lee, W-H Yeo, Soft material-enabled, flexible hybrid electronics for medicine, healthcare, and human-machine interfaces. Materials (Basel) 11, E187 (2018).
3
Y Hattori, et al., Multifunctional skin-like electronics for quantitative, clinical monitoring of cutaneous wound healing. Adv Healthc Mater 3, 1597–1607 (2014).
4
H Lee, et al., Wearable/disposable sweat-based glucose monitoring device with multistage transdermal drug delivery module. Sci Adv 3, e1601314 (2017).
5
S Jung, et al., Wearable fall detector using integrated sensors and energy devices. Sci Rep 5, 17081 (2015).
6
J Kim, et al., Stretchable silicon nanoribbon electronics for skin prosthesis. Nat Commun 5, 5747 (2014).
7
MS Mannoor, et al., Graphene-based wireless bacteria detection on tooth enamel. Nat Commun 3, 763 (2012).
8
J Kim, et al., Non-invasive mouthguard biosensor for continuous salivary monitoring of metabolites. Analyst (Lond) 139, 1632–1636 (2014).
9
S Mishra, et al., Recent advances in salivary cancer diagnostics enabled by biosensors and bioelectronics. Biosens Bioelectron 81, 181–197 (2016).
10
; World Health Organization Diet, Nutrition and the Prevention of Chronic Diseases (World Health Org, Geneva, 2003).
11
HR Pohl, JS Wheeler, HE Murray, Sodium and potassium in health and disease. Interrelations Between Essential Metal Ions and Human Diseases, eds A Sigel, H Sigel, RKO Sigel (Springer, Dordrecht, The Netherlands), pp. 29–47 (2013).
12
J Perucca, N Bouby, P Valeix, L Bankir, Sex difference in urine concentration across differing ages, sodium intake, and level of kidney disease. Am J Physiol Regul Integr Comp Physiol 292, R700–R705 (2007).
13
NR Cook, et al., Long term effects of dietary sodium reduction on cardiovascular disease outcomes: Observational follow-up of the trials of hypertension prevention (TOHP). BMJ 334, 885–888 (2007).
14
S Tsugane, Salt, salted food intake, and risk of gastric cancer: Epidemiologic evidence. Cancer Sci 96, 1–6 (2005).
15
A Prentice, Diet, nutrition and the prevention of osteoporosis. Public Health Nutr 7, 227–243 (2004).
16
J Powles, et al., Global, regional and national sodium intakes in 1990 and 2010: A systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE) 3, e003733 (2013).
17
T Nwankwo, SS Yoon, V Burt, Q Gu, Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief, pp. 1–8 (2013).
18
; World Health Organization, World Health Report (World Health Org, Geneva). (2002).
19
T Arakawa, et al., Mouthguard biosensor with telemetry system for monitoring of saliva glucose: A novel cavitas sensor. Biosens Bioelectron 84, 106–111 (2016).
20
H Park, et al., A wireless magnetoresistive sensing system for an intraoral tongue-computer interface. IEEE Trans Biomed Circuits Syst 6, 571–585 (2012).
21
S Xu, et al., Soft microfluidic assemblies of sensors, circuits, and radios for the skin. Science 344, 70–74 (2014).
22
JW Lee, et al., Soft, thin skin-mounted power management systems and their use in wireless thermography. Proc Natl Acad Sci USA 113, 6131–6136 (2016).
23
J Kim, et al., Battery-free, stretchable optoelectronic systems for wireless optical characterization of the skin. Sci Adv 2, e1600418 (2016).
24
JJS Norton, et al., Soft, curved electrode systems capable of integration on the auricle as a persistent brain-computer interface. Proc Natl Acad Sci USA 112, 3920–3925 (2015).
25
Y Lee, et al., Soft electronics enabled ergonomic human-computer interaction for swallowing training. Sci Rep 7, 46697 (2017).
26
W-H Yeo, et al., Multifunctional epidermal electronics printed directly onto the skin. Adv Mater 25, 2773–2778 (2013).
27
DM Pozar Microwave Engineering (Wiley, 4th Ed, Hoboken, NJ, 2012).
28
WL Stutzman, GA Thiele Antenna Theory and Design (Wiley, Hoboken, NJ, 2012).
29
HA Wheeler, Transmission-line properties of a strip on a dielectric sheet on a plane. IEEE Trans Microw Theory Tech 25, 631–647 (1977).
30
MM Shafiei, M Moghavvemi, WNL Wan Mahadi, The parametric study and fine-tuning of bow-tie slot antenna with loaded stub. PLoS One 12, e0169033 (2017).
31
MJ Birch, PD Srodon, Biomechanical properties of the human soft palate. Cleft Palate Craniofac J 46, 268–274 (2009).
32
G Park, et al., Immunologic and tissue biocompatibility of flexible/stretchable electronics and optoelectronics. Adv Healthc Mater 3, 515–525 (2014).
33
LM Anovitz, DR Cole, Characterization and analysis of porosity and pore structures. Rev Mineral Geochem 80, 61–164 (2015).
34
N Roy, et al., Significant characteristics of medical-grade polymer sheets and their efficiency in protecting hydrogel wound dressings: A soft polymeric biomaterial. Int J Polym Mater Polym Biomater 61, 72–88 (2012).
35
CKM Ng, KN Yu, Proliferation of epithelial cells on PDMS substrates with micropillars fabricated with different curvature characteristics. Biointerphases 7, 21 (2012).
36
A Cadogan, Z Gao, A Lewenstam, A Ivaska, D Diamond, All-solid-state sodium-selective electrode based on a calixarene ionophore in a poly(vinyl chloride) membrane with a polypyrrole solid contact. Anal Chem 64, 2496–2501 (1992).
37
; World Health Organization Guidelines for Drinking-Water Quality. Vol. 2, Health Criteria and Other Supporting Information (World Health Org, Geneva, 1996).
38
A Ascherio, et al., Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation 98, 1198–1204 (1998).
39
KL Penniston, SY Nakada, RP Holmes, DG Assimos, Quantitative assessment of citric acid in lemon juice, lime juice, and commercially-available fruit juice products. J Endourol 22, 567–570 (2008).
40
S McGuire, U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, January 2011. Adv Nutr 2, 293–294 (2011).
41
WM Edgar, Saliva: Its secretion, composition and functions. Br Dent J 172, 305–312 (1992).
42
R Herbert, et al., Soft material-enabled, flexible hybrid electronics for medicine, healthcare, and human-machine interfaces. Materials 11, 187 (2018).

Information & Authors

Information

Published in

The cover image for PNAS Vol.115; No.21
Proceedings of the National Academy of Sciences
Vol. 115 | No. 21
May 22, 2018
PubMed: 29735689

Classifications

Submission history

Published online: May 7, 2018
Published in issue: May 22, 2018

Keywords

  1. wireless intraoral system
  2. stretchable hybrid electronics
  3. sodium intake quantification
  4. hypertension management

Acknowledgments

W.-H.Y. acknowledges a research grant from Medarva Foundation, a seed grant from the Institute for Electronics and Nanotechnology, a grant by the Fundamental Research Program (Project PNK5061) of Korea Institute of Materials Science, and startup funding from the Woodruff School of Mechanical Engineering at Georgia Institute of Technology.

Notes

This article is a PNAS Direct Submission.

Authors

Affiliations

Yongkuk Lee
George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332;
Connor Howe
Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284;
Saswat Mishra
George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332;
Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284;
Musa Mahmood
George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332;
Matthew Piper
Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284;
Youngbin Kim
Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284;
Katie Tieu
Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284;
Department of Chemical and Biomolecular Engineering, Chonnam National University, 59626 Jeonnam, South Korea;
James P. Coffey
Department of Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298;
Mahdis Shayan
Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15261;
Youngjae Chun
Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15261;
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15261;
Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298;
George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332;
Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332;
Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, Atlanta, GA 30332;
Center for Flexible Electronics, Georgia Institute of Technology, Atlanta, GA 30332

Notes

1
To whom correspondence should be addressed. Email: [email protected].
Author contributions: Y.L., J.P.C., R.M.C., and W.-H.Y. designed research; Y.L., C.H., S.M., D.S.L., M.M., M.P., Y.K., K.T., J.P.C., M.S., Y.C., and W.-H.Y. performed research; Y.L., C.H., S.M., D.S.L., M.M., M.P., Y.K., K.T., H.-S.B., M.S., Y.C., R.M.C., and W.-H.Y. analyzed data; and Y.L., C.H., H.-S.B., Y.C., R.M.C., and W.-H.Y. wrote the paper.

Competing Interests

Conflict of interest statement: R.M.C. and W.-H.Y. are inventors on Patent Application US 2017/0087363A1 that covers “Wireless implantable taste system.” The other authors declare that they have no competing financial interests.

Metrics & Citations

Metrics

Note: The article usage is presented with a three- to four-day delay and will update daily once available. Due to ths delay, usage data will not appear immediately following publication. Citation information is sourced from Crossref Cited-by service.


Citation statements

Altmetrics

Citations

Export the article citation data by selecting a format from the list below and clicking Export.

Cited by

    Loading...

    View Options

    View options

    PDF format

    Download this article as a PDF file

    DOWNLOAD PDF

    Login options

    Check if you have access through your login credentials or your institution to get full access on this article.

    Personal login Institutional Login

    Recommend to a librarian

    Recommend PNAS to a Librarian

    Purchase options

    Purchase this article to access the full text.

    Single Article Purchase

    Wireless, intraoral hybrid electronics for real-time quantification of sodium intake toward hypertension management
    Proceedings of the National Academy of Sciences
    • Vol. 115
    • No. 21
    • pp. 5301-E4952

    Figures

    Tables

    Media

    Share

    Share

    Share article link

    Share on social media