Physiological parameter sensing system and method - Patents.com

Abstract

An apparatus for sensing a physiological parameter of a subject, comprising a force sensor having a force sensing surface, the force sensor configured to generate a first signal representative of a force displacement of an organ of the subject, a displacement sensor associated with the force sensor, the displacement sensor having a displacement sensing surface, the displacement sensor configured to generate a second signal representative of a displacement rate of the organ of the subject, a coupler arranged over one of the force sensor and the displacement sensor, the coupler configured to mechanically couple the force sensor and the displacement sensor to the organ, the displacement sensing surface coinciding with or being smaller in size relative to the force sensing surface.

Description

[Technical field]

[0001] The present disclosure relates generally to sensing signals, and more specifically to a sensor assembly for sensing a signal related to at least one physiological parameter of a subject. [Background technology]

[0002] Non-invasive patient or subject monitoring of physiological parameters through the use of sensors is important in the field of medicine. Devices have been developed in which different sensors are combined to obtain multiple signals or data and achieve monitoring of several physiological characteristics of a subject at once. As such devices have been developed in which different sensors are combined, the specific combination of different sensors takes into account the intended purpose, which may be different or inappropriate for different types of physiological monitoring compared to the original intended purpose. For example, when the original intended purpose is to determine the pulse and oxygen saturation in the blood of a subject, a pulse oximeter sensor is capable of detecting the pulse rate and measuring the oxygen level of the blood. However, blood pressure information is omitted from reading as it is beyond the intended purpose, which limits which combination of sensors is needed in the device.

[0003] It is always necessary to optimize the specific combination of the specific sensor that is best suited to detect the relevant signal related to the target organ and / or physiological parameter. A need is indeed felt for a device having at least a force-sensing resistor and a piezoelectric sensor combined together to enable continuous and non-invasive monitoring of mechanical physiological events such as the volumetric changes of blood in the circulation of a subject, blood pressure, and oxygen saturation in the blood. There is also a need to increase the sensitivity and accuracy in detecting physiological parameters, as efficient detection of irregular signals is essential for early diagnosis and treatment. Furthermore, optimizing the configuration of the sensor to improve the contact with the subject also allows better signals to be obtained.

[0004] While various sensors and systems exist for measuring signals when placed around a volume, and in particular for measuring and monitoring physiological parameters of a living subject, it remains a challenge to continually and reliably provide a useful output signal representative of the parameter being measured. Additionally, it is also a challenge for a living subject to comfortably accommodate and do so with a sensor / system that measures a parameter, especially if the subject is required to wear the sensor / system for extended periods of time.

[0005] The discussion of any documents, acts, materials, devices, or implements included in this specification shall not be deemed to be an admission that any or all of that matter formed part of the prior art or was common general knowledge in the art relevant to the present disclosure as it existed prior to the priority date of each of the appended claims. Summary of the Invention [Problem to be solved by the invention]

[0006] It may be advantageous to provide a force sensor that can be first calibrated against a gold standard blood pressure measurement device such as a cuff device or finger device like Biopac. This step allows for an ongoing calibrated value for the measurement of force on the sensor and therefore an ongoing measurement of blood pressure.

[0007] It may be advantageous to include force and optical sensors and / or displacement sensors to provide additional signals related to volumetric changes in blood in the subject's circulation. Having the additional signals provides further accuracy regarding the subject's physiological condition.

[0008] It may be advantageous for the device to have a force-sensing resistor (FSR) along with a piezoelectric sensor such as a displacement sensor. Having different types of sensors together provides important information regarding the physiological parameters of the subject.

[0009] It may be advantageous to operate the piezoelectric sensor to detect body sounds, which may also be advantageously used to monitor the subject's health via sounds produced by normal functioning organs, such as, but not limited to, the lungs (for breathing sounds) and the heart (for monitoring heartbeat sounds) and to determine if sounds heard are irregular.

[0010] It may be advantageous to use a coupler having a maximum planar surface area that is less than the area of ​​the maximum planar surface of the force sensor. This advantage of the planar configuration allows the force sensor and the displacement sensor mechanically coupled to the coupler to ensure mechanical transmission of the force from the subject to the respective sensors. Furthermore, it may be advantageous to configure the sensor assembly to simultaneously generate force-displacement and displacement-rate signals, with the force sensor and the displacement sensor mechanically coupled to the coupler and the coupler mechanically coupled to the subject's surface. These signals are then used to enable continuous and non-invasive monitoring of mechanical physiological events.

[0011] It may be advantageous to arrange the force sensors and displacement sensors concentrically on the operable rear surface of the coupler so that the displacement sensors can effectively detect body sounds produced by the subject's organs.

[0012] It is an object of the present invention to overcome or ameliorate at least one of the disadvantages of the prior art, or to provide a useful alternative. [Means for solving the problem]

[0013] According to a first aspect of the present invention, there is provided an apparatus for sensing a physiological parameter of a subject, the apparatus comprising: a force sensor having a force sensing surface, the force sensor configured to generate a first signal representative of a force displacement of an organ of the subject; a displacement sensor associated with the force sensor, the displacement sensor having a displacement sensing surface and configured to generate a second signal representative of a displacement velocity of the organ of the subject; and a coupler arranged on one of the force sensor and the displacement sensor, the coupler configured to mechanically couple the force sensor and the displacement sensor with the organ, wherein the displacement sensing surface is coincident with or is of a smaller size relative to the force sensing surface.

[0014] Preferably, the force sensor can be first calibrated against a gold standard blood pressure measurement device such as a cuff device or finger device like Biopac. This step allows for ongoing calibrated values ​​for the measurement of force on the sensor and therefore ongoing measurement of blood pressure.

[0015] Preferably, the device may include a force sensor and an optical sensor, the latter used instead of or in addition to the displacement sensor to provide an additional signal related to volumetric changes in the subject's circulating blood.

[0016] Preferably, the first force sensor may measure a signal at the patient's chest and the second force sensor may be the user's finger or wrist. The second force sensor may also be on the upper chest, for example at the suprasternal notch.

[0017] Preferably, the force sensor may include a first force sensing resistor (FSR). The displacement sensor may include a piezoelectric sensor. Operating the displacement sensor may enable detecting body sounds.

[0018] Preferably, the coupler may have a maximum planar surface area that is less than the maximum planar surface area of ​​the force sensor. Further, the maximum planar surface area of ​​the coupler may approximate the maximum planar surface area of ​​the displacement sensor.

[0019] Preferably, the force sensor may be mounted on a displacement sensor.

[0020] Preferably, the force sensor may include a movable front surface coupled to the movable back surface of the coupler and a movable back surface coupled to the movable front surface of the displacement sensor.

[0021] Preferably, the force sensor and the displacement sensor may each have an operable front surface coupled to the operable back surface of the coupler. The force sensor and the displacement sensor may be concentrically arranged on the operable back surface of the coupler. The displacement sensor may be configured such that the second signal is representative of a body sound produced by an organ of the subject.

[0022] Preferably, the device may also include at least one optical sensor configured to generate a third signal representative of a volumetric change in circulating blood of the subject. In such an embodiment, the at least one optical sensor may be configured to be arranged on the subject separately from the force sensor, the displacement sensor, and the coupler. Alternatively, the at least one optical sensor may be fixed adjacent to the force sensor.

[0023] Preferably, the coupler may be shaped to at least partially surround the optical sensor such that the coupler is mechanically decoupled from the optical sensor.

[0024] Preferably, the device may include a plurality of optical sensors operable together to generate a fourth signal representative of blood oxygen saturation level.

[0025] Preferably, the coupler may be configured as a conductive electrode electrically coupled to a processing circuit configured to measure a biopotential when the coupler is arranged with respect to the subject. In such an embodiment, the processing circuit may be configured to measure an electrocardiogram (ECG) of the subject and generate a fourth signal representative of the ECG.

[0026] Preferably, the coupler may include a temperature sensor and is electrically coupled to a processing circuit configured to measure a temperature in response to the coupler being aligned with the subject.

[0027] Preferably, an annular conductive electrode may be configured around the device. The annular conductive electrode may be electrically coupled to a processing circuit configured to measure a biopotential when the coupler is arranged with respect to the subject. In such an embodiment, the processing circuit may be configured to measure an electrocardiogram (ECG) of the subject and generate a fourth signal representative of the ECG.

[0028] Preferably, the device may include a first conductive electrode configured as an annular ring electrically coupled to a processing circuit configured to measure a biopotential when the annular ring is arranged with respect to the subject.

[0029] Preferably, the device may include a second conductive electrode spaced apart and arranged isolated from the first conductive electrode to enable alignment with another portion of the subject, the second conductive electrode being coupled to the processing circuitry to enable measuring additional biopotentials when the first and second conductive electrodes are aligned with the subject.

[0030] Preferably, the device may include a third conductive electrode spaced apart and arranged isolated from the first and second conductive electrodes to allow alignment with respect to another portion of the subject, the third conductive electrode being coupled to the processing circuit to allow measuring additional biopotentials when the first, second and third conductive electrodes are aligned with the subject. The third conductive electrode may be movable relative to the first and second electrodes.

[0031] Preferably, the processing circuitry is configured to measure an electrocardiography (ECG) of the subject in response to any conductive electrodes arranged relative to the subject, and may be configured to generate a fourth signal representative of the ECG.

[0032] Preferably, if a second ECG electrode and a third ECG electrode are incorporated into the device, this may be isolated from the first electrode and may be arranged to hold the second electrode while allowing the subject's hand to complete the ECG circuit, or may be arranged on a second sensor attached to the subject and connected to the processing circuit.

[0033] Preferably, the coupler may include a front surface configured to contact the organ. The front surface may be dome-shaped, or mushroom-shaped, or cone-shaped, or pyramid-shaped. Alternatively, the coupler may be cylindrical or rectangular. The coupler may include at least one of a rigid plastic material, such as an acrylic resin, and a conductive material.

[0034] Preferably, the device may include a second force sensor configured to measure the force applied to the movable back surface of the device. The second force sensor may be calibrated to know the force it produces, allowing the signal from the first force sensor to be quantified, leading to an estimation of blood pressure. The second force sensor may be a force sensing resistor (FSR). The second force sensor may be coupled to the movable back surface of the displacement sensor.

[0035] Preferably, the apparatus may further comprise a fixation device configured to fix the apparatus to an organ of the subject. The fixation device may comprise at least one of: a) a strap, b) a belt, c) an adhesive patch.

[0036] Preferably, the apparatus may further include at least one processor configured to determine a physiological parameter based on the first signal and the second signal. The at least one processor may be configured to calibrate the second signal received from the displacement sensor based on the first signal.

[0037] Preferably, the physiological parameters may include at least one of heart palpitations, blood pressure such as central or peripheral blood pressure, uterine contractions, fetal activity, breathing, body sounds such as heart sounds, opening time of the subject's heart valve, closing time of the subject's heart valve, contraction level of the subject's heart, elasticity of blood vessels, stroke volume of the subject's heart, cardiac output, and blood pulse wave transit time. Preferably, the device further includes a first morphic sensor configured to generate a respiratory signal representative of chest volume changes, the morphic sensor in communication with the plurality of sensors. Preferably, the device further includes a second morphic sensor configured to detect a physiological signal for enabling identification of the subject. Preferably, the first morphic sensor or the second morphic sensor includes an accelerometer for detecting the position and movement of the subject.

[0038] In another aspect, a method of increasing a signal to noise ratio of a signal generated by a sensor assembly is provided, the assembly including a force sensor and a displacement sensor, the method including: arraying the displacement sensor at a position on a subject, the displacement sensor configured to generate a first signal representative of a displacement; arraying a force sensor at the same position on the subject, the force sensor configured to generate a second signal representative of the force displacement; and operating at least one processor coupled to the displacement sensor and the force sensor and configured to process the force signal and the displacement signal.

[0039] Preferably, the processing may include multiplying the first signal and the second signal.

[0040] In another aspect, a method of measuring a physiological parameter of a subject is provided, the method including receiving a first signal from a first force sensor mechanically coupled to a first location of the subject, receiving a second signal from a second force sensor mechanically coupled to a second location of the subject, the second location being separated from the first location, and determining the physiological parameter based on a comparison of the first signal and the second signal.

[0041] Preferably, the first force sensor may measure a signal at the patient's chest and the second force sensor may be the user's finger or wrist. The second force sensor may also be on the upper chest, for example at the suprasternal notch.

[0042] Preferably, the comparison may include a difference between the first and second signals. The comparison may further include a timing between the first and second signals, which timing is equal to a pulse transit time (PTT) from the first location to the second location. PTT is a measurement indicative of blood pressure. It may be appreciated that PTT may be measured at any different predefined locations.

[0043] Preferably, one or more of the first force sensor and the second force sensor may be a force sensing resistor (FSR).

[0044] Preferably, the physiological parameters may include at least one of cardiac parameters such as heart rate, pulse wave transit time, pulse transit time, blood pressure such as central blood pressure or peripheral blood pressure, body sounds such as uterine contractions, fetal activity, breathing, heart sounds, opening time of the subject's heart valves, closing time of the subject's heart valves, contraction level of the subject's heart, stroke volume, cardiac output, and blood pulse wave transit time of the subject.

[0045] Preferably, the first location may be on the subject's upper rib cage, such as at or near the xiphoid process. The second location may be on the subject's lower rib cage. The physiological parameter to be measured may be central blood pressure.

[0046] In another aspect of the invention, the first location may be on the subject's thorax, and the second location may be proximate to one of the subject's femoral and subclavian arteries, or other peripheral arteries, and the physiological parameter to be measured may be peripheral blood pressure in such case.

[0047] In another aspect of the invention, the first and second force sensors may be on one assembly with the rear force sensor separate from the front force sensor. A user's finger may be applied to the coupler to the second force sensor when the assembly is placed on the user's heart. The timing difference of the cardiac signal from the heart to the finger is the pulse transit time.

[0048] Preferably, the method may further include receiving a third signal from a third force sensor mechanically coupled to the subject at a third location separated from the first location and the second location, and determining the physiological parameter based on a comparison of the first signal, the second signal, and the third signal. The third force sensor may be an FSR.

[0049] Preferably, the method may further include mechanically coupling one or more of the first sensor and the second sensor to the subject.

[0050] Preferably, the method may further include using an apparatus having both a force sensor and a displacement sensor, where the signal from the displacement sensor is multiplied with the signal from the force sensor so as to avoid the need to modulate the signal from the displacement sensor.

[0051] According to another aspect, a system for measuring a physiological parameter of a subject is provided, the system including a first force sensor configured to generate a first signal representative of a force displacement at a first location on the subject, a second force sensor configured to generate a second signal representative of the force displacement at a second location on the subject, and at least one processor configured to determine the physiological parameter of the subject based on a comparison between the first signal and the second signal.

[0052] Preferably, the comparison may include a difference between the first and second signals. Further, the comparison may include a timing difference between the first and second signals.

[0053] Preferably, at least one of the first and second force sensors may be a force sensing resistor (FSR).

[0054] Preferably, the physiological parameters may include at least one of cardiac parameters such as heart rate, pulse wave transit time, pulse transit time, blood pressure such as central blood pressure or peripheral blood pressure, body sounds such as uterine contractions, fetal activity, breathing, heart sounds, opening time of the subject's heart valves, closing time of the subject's heart valves, contraction level of the subject's heart, stroke volume, cardiac output, and blood pulse wave transit time of the subject.

[0055] Preferably, the first location may be on the subject's upper rib cage, such as at or near the xiphoid process. The second location may be on the subject's lower rib cage. The physiological parameter to be measured may be central blood pressure.

[0056] In another aspect of the invention, the first location may be on the subject's thorax, and the second location may be proximate to one of the subject's femoral and subclavian arteries, or other peripheral arteries, and the physiological parameter to be measured may be peripheral blood pressure in such case.

[0057] Preferably, the system may further include a third force sensor configured to generate a first signal representative of a force displacement at a third location on the subject separated from the first and second locations. The physiological parameter may then be determined based on a comparison of the first, second, and third signals. The third force sensor may be an FSR.

[0058] Preferably, one or more of the first and second force sensors may be a first force sensor of the apparatus as described above.

[0059] According to another aspect, an apparatus for sensing at least one parameter of a subject is provided, the apparatus including a stretchable sensor member having an impedance that changes with curvature, and a stretchable carrier configured to surround the stretchable sensor member and maintain a contact surface of the stretchable sensor member in proximity to a surface of the subject such that changes in shape, such as radius, of the subject's surface cause the stretchable sensor to bend.

[0060] Preferably, the expandable sensor member may include a force sensing resistor (FSR).

[0061] Preferably, the carrier may be at least one of a fabric carrier and an elastomeric carrier. The carrier may include a strap or an adhesive patch. The carrier may include a garment worn by the subject. The garment may include a shirt, or a vest, or a jacket, or a coat.

[0062] Preferably, the subject's surface may be skin, such as the skin on the subject's rib cage, and the stretchable carrier may be configured to maintain a contact surface in close proximity to the skin such that expansion and contraction of the skin (e.g., expansion and contraction of the rib cage due to breathing) causes the stretchable sensor to flex.

[0063] Preferably, the apparatus may further include at least one processor configured to generate at least one parameter based on the impedance of the stretchable sensor member.

[0064] Preferably, the parameters may include cardiac parameters such as heart rate, blood pressure such as central blood pressure or peripheral blood pressure, or body sounds such as uterine contractions, fetal activity, breathing, heart sounds, opening time of the subject's heart valves, closing time of the subject's heart valves, contraction level of the subject's heart, stroke volume, cardiac output, and / or blood pulse wave transit time of the subject.

[0065] According to another aspect, a method of sensing at least one parameter of a subject is provided, comprising positioning a stretchable sensor as described above at a first location proximate to an organ of the subject, and determining the at least one parameter based on an impedance of the stretchable sensor member.

[0066] According to another aspect, an apparatus for sensing a physiological parameter of a subject is provided, the apparatus including a force sensor configured to generate a first signal representative of a force displacement of an organ of the subject, at least one optical sensor configured to generate a second signal representative of a volumetric change in circulating blood of the subject, and a coupler arranged on the force sensor configured to mechanically couple the force sensor with the organ.

[0067] Preferably, at least one optical sensor of any of the above described embodiments is capable of sensing the resulting signal using at least one wavelength of light.

[0068] According to another aspect, a system for identifying a subject is provided, the system including at least one first force sensor configured to generate a force signal representative of a force and a displacement sensor configured to generate a displacement signal representative of a displacement, the force sensor and the displacement sensor arranged relative to each other to enable positioning at substantially the same position on the subject to enable generating the signal, the system further including at least one processor coupled to the force sensor and the displacement sensor, the at least one processor configured to process the force signal and the displacement signal to determine an identifier of the subject.

[0069] Preferably, the at least one processor may be coupled to the memory and may be further configured to determine an identifier for the subject based on at least one standardized historical signal for the same subject stored in the memory.

[0070] Preferably, the system may also include a photoplethysmography sensor configured to generate a photoplethysmography signal and a pair of electrocardiography electrodes configured to generate an electrocardiography signal, and at least one processor coupled to the photoplethysmography sensor and / or the pair of electrocardiography electrodes configured to process at least one of the force signal and the displacement signal, and at least one of the photoplethysmography and electrocardiography signals to determine an identifier of the subject.

[0071] Preferably, the at least one processor may be configured to determine an identifier for the subject based on a combination of at least two standardized historical signals for the same subject stored in the memory.

[0072] Preferably, each operation of the system may generate one or more of the signals and cause one or more corresponding standardized historical signals to be updated.

[0073] Preferably, use of the system may involve placing the system in contact with the palmar side of a user's finger to enable generation of force and displacement signals. The system may be placed on the tip of the index finger.

[0074] Preferably, in response to the subject adjusting one or more of the contact force and duration exerted by the finger, the processor may be configured to communicate an alarm signal to one or more remotely located devices or systems.

[0075] Preferably, in response to the subject adjusting one or more of the contact force and duration exerted by the finger, the processor may be configured to communicate at least one of the recorded and analyzed signals to one or more remotely located devices or systems.

[0076] Embodiments of the disclosure will now be described, by way of example only, with reference to the accompanying drawings, in which: [Brief description of the drawings]

[0077] [Figure 1a] FIG. 2 is a schematic diagram of a first embodiment of a sensor assembly. [Figure 1b] FIG. 4 is a schematic diagram of a second embodiment of the sensor assembly. [Figure 1c] FIG. 11 is a schematic diagram of a third embodiment of the sensor assembly. [Figure 1d] FIG. 11 is a schematic diagram of a fourth embodiment of the sensor assembly. [Figure 1e] FIG. 13 is a schematic diagram of a fifth embodiment of the sensor assembly. [Figure 1f] FIG. 13 is a schematic diagram of a sixth embodiment of the sensor assembly. [Figure 1g] FIG. 13 is a perspective view of a seventh embodiment of the sensor assembly. [Figure 1h] FIG. 13 is a perspective view of an eighth embodiment of the sensor assembly. [Figure 1i] FIG. 13 is a perspective view of a ninth embodiment of the sensor assembly. [Figure 1j] FIG. 19 is a perspective view of a tenth embodiment of a sensor assembly. [Figure 1k] FIG. 19 is a perspective view of a tenth embodiment of a sensor assembly. [Figure 1l] A perspective view of an eleventh embodiment of a sensor assembly. [Figure 2a] FIG. 2 shows a variation of the coupler of FIGS. [Figure 2b] FIG. 2 shows a variation of the coupler of FIGS. [Figure 2c] FIG. 2 shows a variation of the coupler of FIGS. [Figure 2d] FIG. 2 shows a variation of the coupler of FIGS. [Figure 2e] FIG. 2 shows a variation of the coupler of FIGS. [Figure 2f] FIG. 2 shows a variation of the coupler of FIGS. [Figure 2g] FIG. 2 shows a variation of the coupler of FIGS. [Diagram 3] FIG. 1 shows examples of sensor assemblies in various arrays on a human subject. [Figure 4] FIG. 1 shows examples of sensor assemblies in various arrays on a human subject. [Diagram 5] FIG. 1 shows examples of sensor assemblies in various arrays on a human subject. [Figure 6a] FIG. 1 shows examples of sensor assemblies in various arrays on a human subject. [Figure 6b] FIG. 1 shows examples of sensor assemblies in various arrays on a human subject. [Figure 6c] FIG. 1 shows examples of sensor assemblies in various arrays on a human subject. [Figure 7] FIG. 2 illustrates a signal processing chain for processing signals received from the sensor assembly. [Figure 8] FIG. 8 illustrates an example processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a force signal from the force sensor of the sensor assembly of FIG. 1 or 2. [Figure 9] FIG. 8 illustrates an example processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a force signal from the force sensor of the sensor assembly of FIG. 1 or 2. [Figure 10] FIG. 8 illustrates an example processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a force signal from the force sensor of the sensor assembly of FIG. 1 or 2. [Figure 11] FIG. 8 is a circuit diagram of an example processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a force signal based on characteristics of the force sensor and a second force sensor of the sensor assembly of FIG. 2. [Figure 12]FIG. 8 is a circuit diagram of an example processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a force signal based on characteristics of the force sensor and a second force sensor of the sensor assembly of FIG. 2. [Figure 13] FIG. 8 is a circuit diagram of an example processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a force signal based on characteristics of the force sensor and a second force sensor of the sensor assembly of FIG. 2. [Figure 14] FIG. 8 is a block diagram of an example processing chain implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a conditioned velocity signal from the displacement sensor of the sensor assembly of FIG. 1a or 1b. [Figure 15a] FIG. 8 illustrates a first embodiment of a processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a conditioned velocity signal from the displacement sensor of the sensor assembly of FIG. 1a or 1b. [Figure 15b] FIG. 8 illustrates a second embodiment of a processing circuit implemented by the signal conditioning stage of the signal processing chain of FIG. 7 for generating a conditioned velocity signal from the displacement sensor of the sensor assembly of FIG. 1a or 1b. [Figure 16] FIG. 1 illustrates a signal processing chain for processing signals received from multiple sensor assemblies. [Figure 17] FIG. 4 is a plot showing force versus time recorded by the sensor assembly of FIG. 1a positioned on the sternum of a subject as shown in FIG. 3. [Figure 18] FIG. 4 is a plot showing force versus time recorded by the sensor assembly of FIG. 1a positioned on the sternum of a subject as shown in FIG. 3. [Figure 19] Figure 14 shows a lower plot of the sum of two force signals from the force sensors of the sensor assembly located at the suprasternal notch and apex of the subject, respectively, and an upper plot of the signal acquired using ECG electrodes. [Figure 20]1B is a plot comparing the integral of the force signal derived from the force sensor of the sensor assembly of FIG. 1a and the integral of the displacement rate signal derived from the displacement sensor of the sensor assembly of FIG. 1; [Figure 21] FIG. 2 is a plot comparing electrocardiograms (ECG) with force and displacement signals derived from the sensor assembly of FIG. 1. [Figure 22] 1b is a plot showing a force signal derived from the force sensor of the sensor assembly of FIG. 1a and a respiratory signal derived from the force signal together with an ECG and a respiratory signal derived from the ECG. [Figure 23] 1B is a plot showing force and acceleration signals derived from the sensor assembly of FIG. 1a along with a cardiac sound signal, an ECG, and a photophethysmogram (PPG). [Figure 24] FIG. 1B is a plot showing raw respiration-related data derived from the sensor assembly of Figure 1a. [Figure 25a] Figure 1a is a plot showing data relating to sound and seismic cardiograms as derived from the sensor assembly of Figure 1a. [Figure 25b] FIG. 6B shows two plots, an upper plot showing force and displacement signals, and a lower plot showing red and infrared light signals, as derived from the sensor assembly array of FIG. 6B or 6C. [Figure 26] FIG. 2 is a cross-sectional view of an embodiment of a sensor assembly. [Figure 27] FIG. 27 is a plan surface view of the embodiment of the sensor assembly shown in FIG. [Figure 28] FIG. 27 shows a pair of the sensor assemblies of FIG. 26 arranged on the rib cage of a subject. [Figure 29] Figure 26 is a breath signal derived from the sensor assembly. [Diagram 30] 11 is a cross-sectional view of a further embodiment of a sensor assembly. [Diagram 31] FIG. 11 is a cross-sectional view of another embodiment of a sensor assembly. [Diagram 32]FIG. 1B is a plot of the pulse transit time (PTT) as derived from the sensor assembly of FIG. 1a by a subject at rest. [Diagram 33] Figure 1a is a plot of the PTT as derived from the sensor assembly of Figure 1a after subject exertion. [Diagram 34] Figure 1a is a plot of cardiac activity as derived from the sensor assembly by a subject at rest. [Diagram 35] FIG. 1B is a plot of cardiac activity as derived from the sensor assembly of FIG. 1a after low rate exertion by a subject. [Diagram 36] FIG. 1B is a plot of cardiac activity as derived from the sensor assembly of FIG. 1a following high rate exertion by a subject. [Figure 37] FIG. 13 shows two plots representing sounds recorded by a conventional digital stethoscope and by one of the sensor assemblies shown in the previous figure. [Figure 38A] FIG. 1 is a block diagram illustrating the stages of operating a sensor assembly to detect sound. [Figure 38B] FIG. 11 is another block diagram also illustrating the stages of operating the sensor assembly to detect sound. [Figure 39A] FIG. 1 is a block diagram illustrating a system configured to identify a subject. [Figure 39B] FIG. 2 is another block diagram also illustrating a system configured to identify a subject. [Figure 39C] FIG. 1 illustrates a flow chart for using machine learning to update a comparison signal to identify a subject. [Diagram 40] FIG. 1 is a schematic diagram illustrating the use of a sensor assembly configured to identify a subject. [Figure 41a] FIG. 41 shows plots of force and displacement signals obtained by a subject intermittently exerting a force on a sensor assembly, such as that illustrated in FIG. 40. [Figure 41b]FIG. 41 shows plots of force and displacement signals obtained by a subject intermittently exerting a force on a sensor assembly, such as that illustrated in FIG. 40. [Fig. 41c] FIG. 41 shows plots of force and displacement signals obtained by a subject intermittently exerting a force on a sensor assembly, such as that illustrated in FIG. 40. [Fig. 41d] FIG. 1 is a schematic diagram illustrating a particular configuration for identifying a subject by finger tip. [Figure 41e] FIG. 13 illustrates a method of raising an alarm based on variable pressure, variable time, and a subject exerting intermittent force on the sensor assembly. [Fig.41f] FIG. 13 illustrates an example of the types of signals acquired and physiological parameters transmitted. [Figure 42A] FIG. 1 illustrates three signals obtained from three different subjects intermittently contacting the sensor assembly. [Figure 42B] FIG. 11 is another schematic diagram illustrating a sensor assembly and a multi-color photoplethysmograph / pulse oximeter used on the same side of a finger. [Figure 42C] On the left is a schematic diagram illustrating a sensor assembly used on the top surface of a finger and a multi-color photoplethysmograph / pulse oximeter used on the bottom surface of a finger, and on the right is a front view of Figure 42 (left). [Figure 43a] FIG. 13 shows how a finger is placed against the rear coupler to measure pulse wave transit time from the heart to the tip of the finger. [Figure 43b] FIG. 13 shows how a finger is placed against the rear coupler to measure pulse wave transit time from the heart to the tip of the finger. [Figure 43c] FIG. 13 shows how a finger is placed against the rear coupler to measure pulse wave transit time from the heart to the tip of the finger. [Fig. 43d] FIG. 13 shows how a finger is placed against the rear coupler to measure pulse wave transit time from the heart to the tip of the finger. [Diagram 44]FIG. 43b shows the difference in timing between two pulses resulting from the example in FIG. 43a, giving a direct measurement of pulse wave transit time. [Diagram 45] FIG. 13 shows a comparison of signals on the arm versus chest for both a piezoelectric sensor and a force sensor compared to both, as well as an ecg signal (top) and blood pressure signal (bottom) from a finger. [Figure 46a] FIG. 1 shows two sensors positioned on the chest, one over the apex and the second over the suprasternal notch / aortic arch. [Figure 46b] FIG. 14 shows the resulting signal that allows measurement of the delay between triggering (R-peak on ECG) and apical motility, and also the delay between apical ejection time and aortic arch ejection time. [Figure 47a] 1 shows signals from a piezoelectric sensor, a force sensor, and a finger BP monitor, with various artifacts from breathing and movement present. [Figure 47b] FIG. 13 shows a signal with removed artifacts revealing a similar shape for the signal. [Figure 48a] FIG. 13 shows an embodiment with a dorsal force sensor connected to an outer skin contact force sensor and a piezoelectric sensor. The assembled sensor can be calibrated in grams / Newton. [Figure 48b] FIG. 13 illustrates the difference between the calibrated DC component of force measured by the front FSR and the DC component of force measured by the back FSR, and hence the difference in tissue compliance between the chest and the wrist. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0078] Embodiments of the present disclosure relate to sensing systems and methods for monitoring physiological mechanics from local measurements of the forces and their propagation velocities exerted by organs, muscles, blood flow, and skin surface displacements due to fluid shifts, i.e., digestion, swallowing, breathing, etc.

[0079] Some embodiments use force sensors, such as force sensing resistors (FSRs), mechanically coupled to a subject on the thorax or upper abdomen to measure the recoil forces generated by cardiac contraction and blood circulation actions, so-called "force cardiography (FCG)". Thus, embodiments can enable continuous and non-invasive monitoring of the mechanical events of each cardiac cycle of a subject. In particular, by using multiple force sensors mechanically coupled to a subject, typically at the skin, information can be obtained about physiological parameters such as the identity and duration of each phase of the cardiac cycle, cardiac valve opening and closing timing, cardiac contraction level, stroke volume, cardiac output, pulse wave transit time, and central arterial pressure. Furthermore, morphic bands can be combined to determine chest volume changes in a subject. Morphic bands are ones that can be deformed by the monitored body with negligible or no mechanical resistance. As heart failure is a complex and multifaceted disease, it can affect multiple organ systems, including the respiratory system. Additional information from the morphic band allows respiratory signals to be obtained. If the force is calibrated against a known force, a quantified measure of force, and therefore a quantified measure of pressure, can be calculated. Information regarding cardiac disease and / or dysfunction can then be obtained, including, but not limited to, heart failure, mechanical dyssynchrony (e.g., as a result of bundle branch block), valvular disease (e.g., aortic and mitral regurgitation, stenotic heart disease), etc.

[0080] When placed in close proximity to peripheral pulse points or major vessels (i.e. neck pulse, radial pulse, etc.), force sensors can be used to measure forces and their propagation times, and thus the speed of blood movement and flow. Such flows may include venous return as well as changes in hydrostatic pressure due to breathing. Thus, embodiments allow respiration rate to be inferred from force measurements of the peripheral limbs.

[0081] Some embodiments use one or more force sensors (such as FSRs) in combination with a displacement sensor (such as a piezoelectric sensor) that is both mechanically coupled to the subject to simultaneously measure the force displacement of the subject and the speed or velocity of such displacement. Compressive force (DC reference value of the force sensor signal) and dynamic force (AC component of the force sensor signal) can be used to calibrate the displacement velocity signal generated by the displacement sensor, allowing for accurate and continuous direct measurement of the force displacement itself, along with the speed or velocity of the skin displacement. Thus, accurate and continuous measurements of blood pulsation, and therefore heart pulsation, can be obtained from skin movement alone.

[0082] In some embodiments, the force sensor can be first calibrated against a gold standard blood pressure measurement device such as a cuff device or finger device such as Biopac. This step allows for an ongoing calibrated value for the measurement of force on the sensor and therefore an ongoing measurement of blood pressure.

[0083] In another embodiment, the force sensor may have a force sensing surface and the displacement sensor may have a displacement sensing surface. Each of the sensing surfaces is a surface that allows for detection of a signal of a target area or subject. Each surface has a shape and size, and it is advantageous to have a displacement sensor or a piezoelectric sensor displacement sensing surface that has a contour shape and size that matches or is smaller in size than the force sensing surface of the force sensing resistor (FSR) to allow optimal coupling and contact between the sensors. For example, the force sensing resistor may have a circular force sensing surface and the displacement sensor may also have a circular force sensing surface. It can be recognized that the surface that can be planar is not limited to a circle, but can be a surface of any shape that allows the sensor to sense. For example, a possible size measurement of the sensing surfaces of the matching shape can be 10 square millimeters for the force sensing surface and 9 square millimeters for the displacement sensing surface as a means of explaining how the matching sensing surfaces can have a larger or smaller size relative to each other. It can be recognized that the above measurements are mentioned as examples and are not limited to those values, and that the surfaces can be surfaces of different sizes.

[0084] Some embodiments use one or more force sensors (such as FSRs) in combination with one or more optical sensors (such as photoplethysmography (PPG) sensors), both in contact with the subject's skin, to simultaneously measure force displacement of the subject's skin and changes in blood volume or flow in organs or vessels beneath the skin. Further embodiments also include displacement sensors, such as piezoelectric sensors, in combination with the one or more force sensors and optical sensors. Typically, embodiments include an optical sensor that also has an annulus arranged to allow the optical sensor to be placed in contact with the subject's skin.

[0085] While the sensor assemblies described herein have been specifically developed for measuring physiological parameters, such as cardiac and respiratory activity, directly from the skin of a living subject, those skilled in the art will recognize that embodiments of the disclosed force and displacement sensor assemblies may be used through a layer or layers of fabric arranged across the skin, such as clothing or bedding. In some such embodiments, the sensor assembly may be held in place by being incorporated into or attached to an upholstered or otherwise fabric-covered structure, such as a bed mattress, a chair seat, including wheelchairs and vehicle seats, the steering wheels of a vehicle, or a seat belt secured to a vehicle.

[0086] While the sensor assemblies described herein have been specifically developed for measuring physiological parameters, such as, for example, cardiac and respiratory activity, of living subjects, those skilled in the art will recognize that the sensor assemblies of the disclosed subject matter may be used with other objects to which forces are applied by underlying portions of the sensor assembly, and thus the sensor assemblies described herein may be used in industrial applications, such as soft robots or other inanimate objects to which such forces are applied.

[0087] 1a is a cross-sectional view of a first embodiment of a sensor assembly 100 for sensing at least one physiological parameter of a subject. The sensor assembly 100 includes a force sensor 102, a displacement sensor 104, and a mechanical coupler 106. The force sensor 102 and the displacement sensor 104 are arranged on the coupler 106 such that any force applied to a front surface 108 of the coupler is transmitted to both the force sensor 102 and the displacement sensor 104. The coupler 106 may be formed from a conductive material and may be configured to operate as an ECG electrode. It will be appreciated that at least two electrodes are required to form a single lead ECG, one or both of which may be incorporated into an individual sensor assembly.

[0088] The coupler 106 comprises a rigid material, such as a rigid plastic or rubber. In some embodiments, the coupler 106 may comprise an acrylic resin. In other embodiments, the coupler 106 may be partially or entirely conductive. For example, the coupler 106 may comprise partially or entirely a conductive material, such as silver or silver chloride. The front surface 108 of the coupler 106, configured to be placed opposite and preferably in contact with the subject's surface, may be a dome shaped to press into a compliant surface of the subject, such as the skin. Providing a dome shaped front surface 108 helps improve coupling of mechanical displacements from the subject to the force sensor 102 and the displacement sensor 104. Other shapes for the front surface 108 that provide a similar effect include a cone shape, a mushroom shape, and the like.

[0089] Coupler 106 has a generally circular cross-section when viewed in a horizontal plane parallel to the subject-facing horizontal surface of sensor assembly 100. In addition to coupling motion (force and displacement), coupler 106 may be configured as a biopotential electrode and electrically coupled to processing circuitry (not shown) for measuring biopotentials (e.g., electrocardiography (ECG), electromyography (EMG), electroencephalography (EEG), etc.).

[0090] The force sensor 102 is mounted to the backside of the coupler 106 via a force sensor carrier 110 that includes a stretchable medium. The force sensor 102 is mounted to the carrier 110 by adhesive, lamination, or otherwise. An electrical connection to the force sensor 102 is made using two or more electrodes 112 that also act as anchoring points to anchor the force sensor 102 to the sensor carrier 110. The force sensor 102 may be a force sensing resistor (FSR) or a load cell. As described in more detail below, a characteristic of the force sensor 102 changes in response to a force signal applied to the force sensor, the change being indicative of a force displacement of an organ in contact with the front side 108 of the coupler 106. Such a characteristic may be, for example, the impedance or output current or voltage of the force sensor 102. If the force sensor 102 is an FSR, the change in resistance of the force sensor 102 is indicative of a force displacement, and an output voltage may be generated from the force displacement, as described in more detail below.

[0091] In an embodiment, the front surface of the force sensor 102, which faces towards the subject during use, has a surface area of ​​between about 5 square millimeters and 25 square millimeters, for example 7 square millimeters, 15 square millimeters, or 20 square millimeters.

[0092] The force sensor 102 and the displacement sensor 104 are mounted together via an optional rigid bonding layer 114. The rigid bonding layer 114 is provided on a back side of the force sensor 102. The rigid bonding layer 114 may include brass, rigid plastic, or a similar rigid material. In some embodiments, the rigid bonding layer 114 may be a double-sided PCB, with the force sensor 102 mounted on a first surface of the PCB (i.e., the surface that faces the subject during use) and the displacement sensor 104 mounted on an opposite second surface of the PCB.

[0093] In either case, the displacement sensor 104 is mechanically coupled to the backside of the force sensor 102, as shown in Figure 1a. Thus, displacement of the coupler 106 due to movement of an organ in contact with the coupler 106 moves the displacement sensor 104. The displacement sensor 104 generates a velocity signal that represents the speed or velocity of the displacement of the sensor 104. When mechanically coupled to an organ, such as the skin of a subject, this velocity signal is proportional to the displacement velocity of the organ.

[0094] In an embodiment, the front, subject-facing surface of the displacement sensor 104 has a surface area between about 5 square millimeters and 25 square millimeters, for example, 7 square millimeters, 15 square millimeters, or 20 square millimeters.

[0095] Advantageously, the surface areas of force sensor 102 and displacement sensor 104 are substantially matched to ensure uniform transfer of displacement from force sensor 102 to displacement sensor 104. Accordingly, force sensor 102 and displacement sensor 104 are also preferably axially aligned along a central, operational vertical axis of assembly 100 for similar reasons.

[0096] An optional protective cover 116 may be provided around the back surface of the displacement sensor 104. The protective cover 116 may be separated from the back surface by a fluid gap filled with air or other gas, or a vacuum. In doing so, the protective cover 116 protects the displacement sensor 104 from impacts on the operative rear, non-subject-facing side of the assembly 100.

[0097] In addition to the force sensor 102 and the displacement sensor 104, the sensor assembly 100 may optionally include an accelerometer 120. The accelerometer 120 may be configured to measure acceleration in one or more axes. For example, the accelerometer 120 may be configured to measure acceleration in at least an axis perpendicular to a surface of a subject to which the sensor assembly 100 is adhered during use. Preferably, the accelerometer 120 additionally measures acceleration in one or more horizontal planes or axes parallel to a surface of a subject to which the sensor assembly 100 is adhered during use, so as to measure the movement of the sensor assembly in such horizontal planes. The accelerometer 120 may be located anywhere on the sensor assembly 100, provided that a mechanical coupling (direct or indirect) is provided to the coupler 106. For example, the accelerometer 120 may be coupled to the rear of the protective cover 116.

[0098] The housing 118 encapsulates the sensor assembly 100 to protect the elements of the assembly 100 from debris, such as dirt, gravel, water, and / or any other material that may affect the operation of the assembly 100, and to prevent ingress of foreign matter into the assembly 100. The operable front surface 108 of the coupler 106 extends through an opening in the housing 118. Alternatively, the housing 118 includes at least a telescopic portion (not shown) that extends across and conforms to the front surface 108 of the coupler 106, thereby completely encapsulating the force sensor 102, the displacement sensor 104, and the coupler 106.

[0099] During operation, the front surface 108 of the coupler 106 of the sensor assembly 100 is placed in contact with a surface of the subject, such as the subject's skin, and the sensor assembly 100 is secured to the subject by one or more fixation devices, such as a belt, an adhesive patch, or an adhesive tape. Such a tape may be made of the material from which sports tape, also known as kinesiology tape, is made. With the force sensor 102 and displacement sensor 104 mechanically coupled to the coupler 106, and the coupler 106 mechanically coupled to the surface of the subject, the sensor assembly 100 is configured to simultaneously generate force-displacement and displacement velocity signals. The signals are then used to enable continuous and non-invasive monitoring of mechanical physiological events, as described in further detail below.

[0100] Figure 1b is a cross-sectional view of another embodiment of a sensor assembly 200, which is a variation of the sensor assembly 100 shown in Figure 1a. In Figure 1b, like reference numerals refer to like parts unless otherwise indicated with reference to Figure 1a.

[0101] In addition to the elements of the sensor assembly 100, the sensor assembly 200 of FIG. 1b further includes a second force sensor 202 similar to and having similar characteristics as the force sensor 102. The second force sensor 202 is operatively mounted rearward of the displacement sensor 104, for example, to an operable outer surface of the protective cover 116. Similar to the force sensor 102, the second force sensor 202 is configured to generate (actively or passively) a signal representative of a force applied at the second sensor 202. Thus, the second force sensor 202 is used to measure a force applied to an operable rear portion of the assembly 200, for example, due to one or more fixation devices used to apply the sensor assembly 200 to a surface of a subject.

[0102] This measured external force signal can be used to compensate for carrier pressure (i.e., the force applied behind the sensor assembly 200 by the fixation device) and subject surface recovery force (i.e., how the sensed subject surface recovers). For example, knowing the pressure applied from an external carrier or assembly operator allows for artifact removal. For example, a sudden bang or shear of the sensor, i.e., during movement, may change the applied pressure of the force sensor 102, which in turn may increase artifacts in the signal from the force sensor 102. In addition, rhythmic movements caused by an activity such as the subject running may affect the baseline wander and associated artifacts to the signal from the force sensor 102. Such artifacts can be cancelled (either in real time or in post processing) using signals derived from each of the two force sensors 102, 202 and the displacement sensor 104, as described in more detail below.

[0103] 1c and 1d of the drawings, further embodiments of sensor assemblies 100 and 200 are illustrated. Once again, with reference to the previous drawings, like reference numerals refer to like parts unless otherwise indicated.

[0104] In both embodiments, coupler 106 includes a collar 109 that is received within a housing 118 with a dome-shaped surface 108 of coupler 106 protruding through an opening (not shown) in the housing 118. The opening has a diameter smaller than that of collar 109 such that collar 109 assists in holding captive coupler 106 against housing 118 and prevents separation of coupler 106 from housing 118.

[0105] Further, in both embodiments, the diameter of coupler 106 at its base, i.e., that portion of coupler 106 in contact with sensor carrier 110 (referred to as the "base diameter"), is less than the diameter of force sensor 102. However, it is desirable and preferred for coupler 106 to distribute its force across the entire surface area of ​​displacement sensor 104. Thus, the base diameter of coupler 106 approximates the diameter of displacement sensor 104. Typically, the base diameter of coupler 106 is approximately 70%-90% of the diameter of force sensor 102, e.g., about 80%.

[0106] In the embodiment shown in Figure 1d of the drawings, the sensor assembly 200 further includes a back pressure applicator, or coupler, 111. Typically, this coupler 111 is covered by a component, such as a strap, belt, tape, or the like (not shown), by which the sensor assembly 200 is secured to the subject's organ during use. This component applies a displacement force to the force sensor 202 via the coupler 111 and assists in eliminating artifacts recorded by the sensor assembly 200 due to extraneous factors such as movement of the sensor assembly 200 relative to the subject's organ.

[0107] While coupler 111 is shown as a plate-like structure, it will be appreciated that coupler 111 may have any suitable shape, including a dome shape similar to the shape of coupler 106. Additionally, coupler 111 has a diameter that is less than the diameter of force sensor 202, typically approximately 70% to 90% of the diameter of force sensor 202, such as about 80%.

[0108] As noted above, the dome-shaped coupler 106 aids in pressing into a compliant surface of the subject, such as the skin. Thus, providing the coupler 106 with a dome-shaped front surface 108 improves the coupling of mechanical displacement from the subject to the force sensor 102 and the displacement sensor 104.

[0109] The sensor assemblies 100, 200 described above include force and displacement sensors in a "sandwich" arrangement stacked relative to one another. However, embodiments of the present disclosure are not limited to such arrangements. For example, in other embodiments, the force and displacement sensors may be arranged in a planar configuration, e.g., arranged relative to one another, or arranged concentrically (one within the other), either on a common substrate or on different separate substrates. In each embodiment, each force and displacement sensor is preferably mechanically coupled (either directly or indirectly) to a coupler, such as couplers 106, 111 of FIGS. 1a-1d, to ensure mechanical transmission of forces from the subject to each sensor.

[0110] Figure 1e is a plan surface view of an embodiment of a sensor assembly 400, which is a variation of the sensor assemblies 100, 200 shown in Figures 1a-1d. With reference to those figures, in Figure 1e, like reference numerals refer to like parts unless otherwise indicated.

[0111] The sensor assembly 400 includes a coupler 406 arranged to transmit forces to the force sensor 102 and, optionally, to the displacement sensor 104 (neither shown in FIG. 1e). The coupler 406 is configured to at least partially surround at least one optical sensor such that forces acting on the coupler 406 are not transmitted to the optical sensor. In the illustrated embodiment, the optical sensor is in the form of a polychromatic photoplethysmography (PPG) sensor 402 arranged with a cavity 408 defined by the ring-shaped coupler 406. In other embodiments (not illustrated), the PPG sensor is replaced by or arranged in conjunction with a pulse oximeter sensor. In some embodiments, the optical sensor is operatively arranged on the force sensor 102, which defines an aperture (not illustrated) that allows the optical sensor to be electrically coupled to other components of the assembly 400 through the aperture.

[0112] The PPG sensor 402 is arranged in approximate alignment with the operable upper surface of the coupler 406 to allow the PPG sensor 402 to be placed against the skin at the same time that a force is exerted by the skin on the coupler 406. Typically, the coupler 406 is formed from an opaque material to prevent the passage of light through the coupler 406 affecting the reading of the PPG sensor 402. The PPG sensor 402 is configured to sense blood volume biometrics, simultaneously with the operation of the other sensors 102, 104, to derive further information related to the state of the subject's cardiovascular system.

[0113] 1f-1l illustrate alternative embodiments of the sensor assemblies 100, 200 shown in FIGS. 1a-1d, whereby common reference numerals indicate common features. The embodiments illustrated in FIGS. 1f-1l may include electrocardiogram (ECG) electrodes in addition to and electrically isolated from the sensor assemblies 100, 200. In some embodiments, the coupler 106 may include a temperature sensor and may be connected to processing circuitry configured to measure temperature.

[0114] 1f and 1g show an embodiment of the assembly 100, 200 including a first conductive electrode in the form of an annular ring 140 arranged on a side of the sensor assembly 100, 200 arranged to allow contact with a subject. In the illustrated embodiment, the ring 140 is secured to the housing 118 so as to surround a periphery of a base of the sensor assembly 100, 200. The ring 140 is electrically isolated from the housing 118 and configured to form one lead of an ECG circuit. The ring 140 is electrically connected to a processing circuit configured to generate an ECG signal in response to placing the ring 140 on the subject.

[0115] The embodiment shown in Figure 1g also includes a temperature sensor 154 arranged within the electrode ring 140 to enable it to be placed against the subject simultaneously with the ring 140. The temperature sensor 154 is connected to processing circuitry configured to generate a temperature signal in response to placing the sensor 154 against the subject.

[0116] FIG. 1h shows another embodiment of the assembly 100, which includes a second electrode in the form of a gripping portion 150 (arranged at least partially around the side wall of the housing 118). The gripping portion 150 is electrically isolated from the housing and connected to an ECG processing circuit to form an ECG circuit lead. The gripping portion 150 is shaped and arranged to allow the subject to hold the portion 150 and thus contact the second electrode at the same time as arranging the annular ring 140 containing the first electrode against the subject. This arrangement thus allows the subject to form two simultaneous connections with the electrodes 140, 150 to obtain alternative ECG signals that would be obtainable with a single electrode 140 embodiment.

[0117] Fig. 1i illustrates an alternative embodiment of the assembly shown in Fig. 1h. In this embodiment, the second electrode includes a gripping portion 150 and a handle member 160. The handle 160 is electrically connected to the gripping portion 150 to effectively extend the surface area of ​​the additional electrode 150. This arrangement can enhance the ease of holding the assembly 100, 200 on a subject while also forming an electrical connection with the second electrode 150.

[0118] 1j and 1k illustrate another alternative embodiment of the assembly 100, 200, which includes a third electrode in the form of a contact pad 170 arranged on the handle 160 to allow it to be arranged against the subject simultaneously with the first electrode 140. The pad 170 is spaced a defined distance from the annular ring 140 by the handle 160. The pad 170 is electrically isolated from the handle 160 and connected to the ECG processing circuit to form a third load of the ECG circuit. Configuring the assembly 100, 200 in this way allows the first electrode 140 and the third electrode 170 to be arranged against the subject at the same time that the subject contacts the second electrode by gripping either the gripping portion 150 and / or the handle 160 to form a three-electrode system. This may allow to obtain an ECG signal that is an alternative to the signal obtained by the previously described embodiment.

[0119] Fig. 1l is an alternative embodiment to that shown in Figs. 1j and 1k, this embodiment having a third electrode in the form of an adhesive pad 180 configured to be secured to the skin and connected to the housing 118 via a wire 182 to connect to an ECG processing circuit. The wire 182 is isolated from the housing 118 and the gripping portion 150. This embodiment allows for arranging the third electrode 180 to be substantially spaced apart from the first electrode 140 and the second electrode 150 so as to allow for obtaining further alternative ECG signals. This embodiment also allows for the placement of the third electrode 180 within different locations on the subject's body, which may allow for influencing the ECG signal.

[0120] Figures 2a-2g show several variations of the coupler 106 of Figures 1a-1j that may be provided in place of the coupler 106 shown in Figures 1a and 1b. As previously mentioned, like reference numerals refer to like parts unless otherwise specified.

[0121] 2a is a cross-sectional view of a sensor assembly 100 having a mushroom-shaped coupler 201 that, along with a dome-shaped front surface 203, includes a dome-shaped back surface 205 configured to contact a force sensor 102. Providing the dome-shaped back surface 205 reduces the surface area of ​​contact between the coupler 201 and the force sensor 102, thereby increasing the force applied to the sensor per unit area, which in turn increases the sensitivity of the sensor 102 to forces applied to the front surface of the coupler 201.

[0122] FIG. 2b shows an embodiment of a sensor assembly 100 similar to that of FIG. 2a, but including a coupler 111 acting on a force sensor 202 as described above with reference to the sensor assembly 202 of FIG. 1d.

[0123] 2c and 2d provide perspective (closed up) and side views, respectively, of a coupler 204 including a dome-shaped front surface 206, similar to coupler 201 of FIGS. 2a and 2b, as well as a dome-shaped back surface 208 configured for contact with a force sensor 208. Optionally, coupler 204 is held in place relative to housing 118 and force sensor 102 by one or more fasteners 210, such as resilient or elastomeric links. In other embodiments, coupler 204 may be held in place by back pressure on housing 118 and may contact surfaces of the subject and carrier (not shown). As shown in FIG. 2d, providing a dome-shaped back surface 208 reduces the surface area of ​​contact between coupler 204 and force sensor 102, thereby increasing the force applied to the sensor per unit area, which in turn increases the sensitivity of sensor 102 to forces applied to the front surface of coupler 204. As discussed above in connection with coupler 106, it has been discovered that providing a dome-shaped front surface 206 improves the coupling of mechanical displacement from the subject to force sensor 102 and displacement sensor 104. Other shapes for front surface 206 and back surface 208 that provide similar effects include cone shapes, mushroom shapes, and the like.

[0124] 2e and 2f show a further coupler 212, which is a variation of coupler 204. Coupler 212 includes a ball or sphere 214 supported within housing 118 by a lip 216 extending around the circumference of ball 214. Lip 216 may form part of housing 118. Optionally, a seal 218, such as a gasket or O-ring, is provided between ball 214 and lip 216 to prevent the ingress of dirt and other harmful substances.

[0125] 2g shows coupler 220, which is a variation of coupler 212, in which ball 214 is replaced with a double mushroom or waisted coupling member 222. The waisted portion of coupling member 222 may be engaged and held in place within coupler 220 by lip 216, which also prevents separation of coupling member 222 from housing 118.

[0126] Each of the sensor assemblies 100, 200 described above includes a displacement sensor 104. However, it should be noted that embodiments of the present disclosure are not limited to using a combination of force and displacement sensors. For example, various novel techniques are described below for using multiple force sensors positioned at different locations on a subject to detect various physiological parameters. Such techniques do not require simultaneous displacement sensing. Such techniques may use the sensor assemblies 100, 200 described above, or may use a sensor assembly including only a force sensor and a coupler. Such a sensor assembly may include any conceivable coupling arrangement, such as one of the arrangements shown in any one of Figures 1a-2g. For example, embodiments may use a variation of the sensor assembly 100 shown above but omitting the displacement sensor 104.

[0127] 3-6 show various arrangements of a sensor assembly, such as the sensor assembly 100 of FIG. 1a, the sensor assembly 200 of FIG. 1b, or variations thereof, secured to a living human subject 300.

[0128] 3, a single sensor assembly 302 is secured against the xiphoid process using a chest belt 304. The chest belt 304 is configured to apply external pressure from behind the sensor assembly 302 to maintain the sensor assembly 302 at or near the xiphoid process.

[0129] 4, multiple sensor assemblies 402 are secured to the skin of the subject 300 using adhesive patches 404. Like the chest belt 304, each adhesive patch 404 is configured to apply external pressure from behind the sensor assembly 402 to maintain it in a predetermined position on the subject 300, typically against the subject's thorax.

[0130] 5 shows a further arrangement in which multiple sensor assemblies 502 are secured to the chest of the subject 300 by a common adhesive patch 504 configured to apply external pressure from behind the sensor assemblies 502 to maintain them in a predetermined position relative to the subject 300. Additionally or alternatively, the multiple sensor assemblies 502 may be secured to the back of the subject 300 in any suitable manner. By providing multiple sensor assemblies 502 around the subject's torso, a force tomograph of the chest region may be generated from data derived from the sensors of the sensor assemblies 502.

[0131] 6a shows a single sensor assembly 602 secured to a radial or peripheral artery located on a wrist 604 of a subject 300. The sensor assembly 602 may be held in place on the wrist 604 by a wrist strap 606 (or adhesive or other means), which also applies an external force to the rear of the sensor assembly 602 to maintain contact between the assembly 602 and the wrist 606.

[0132] FIG. 6b shows another arrangement in which a single sensor assembly 610 is secured to a finger 612 of the subject 300, typically held in place by a releasable or elastically deformable mechanism such as a strap or sleeve (not illustrated). Showing the assembly 610 secured to the finger 612 is merely exemplary, and it will be appreciated that the assembly 610 can be configured to be secured to other parts of the subject's 300 body. The sensor assembly 610 includes a sensor 100 arranged adjacent to an optical sensor, which in this embodiment is a multi-color PPG sensor 614. In other embodiments (not illustrated), a pulse oximeter sensor is arranged in addition to or instead of the PPG sensor 614. This arrangement allows for simultaneous collection of blood volume signals from separate sensors 100, 614 positioned on the same side of the assembly 610 to sense positions arranged adjacent to one another on the finger.

[0133] FIG. 6c shows a further arrangement in which a single sensor assembly 650 is secured to a finger 612 of the subject 300, typically held in place by a releasable or elastically deformable mechanism such as a strap or sleeve (not illustrated). Showing the assembly 650 secured to the finger 612 is merely exemplary, and it will be appreciated that the assembly 650 can be configured to be secured to other parts of the subject's 300 body. The sensor assembly 650 includes a sensor 100 arranged opposite from an optical sensor, which in this embodiment is a multi-color PPG sensor 614. In other embodiments (not illustrated), a pulse oximeter sensor is arranged in addition to or instead of the PPG sensor 614. This arrangement allows for simultaneous collection of blood volume signals from separate sensors 100, 614 positioned on opposite sides of the finger 612.

[0134] FIG. 7 is a block diagram illustrating an example signal processing chain 700 for processing signals and / or variations in parameters of the force sensor 102, the displacement sensor 104, the second force sensor 202, and the optional accelerometer 120 generated from a living subject. In the following examples, the force sensor 102 and the second force sensor 202 are described below as force sensing resistors (FSRs), FSR1 and FSR2, whose resistances are proportional to the force applied to them. However, the embodiments are not limited to the use of FSRs as force sensors, and it will be recognized that other load cells or force sensors may be used in place of the FSRs without departing from the scope of the present disclosure. Equally, in the following examples, the displacement sensor 104 is described as a piezoelectric sensor, PZT, which in some examples generates a voltage in response to a change in displacement. However, also, the embodiments are not limited to the use of piezoelectric sensors as the displacement sensor 104. Other exemplary displacement sensors include, but are not limited to, resistive sensors, inductive sensors, capacitive sensors, eddy current sensors, ultrasonic sensors, magnetoresistive sensors, and optical encoder displacement sensors.

[0135] Because some embodiments of the present disclosure require only the force sensor 102 and one or more of the displacement sensor 104, the second force sensor 202, and the accelerometer 120 for operation, the displacement sensor 104, the second force sensor 202, and the accelerometer 120 are shown in dashed lines in FIG. 7.

[0136] The signal processing chain 700 includes a signal conditioning stage 702, an analog-to-digital conversion stage 704, and a filtering stage to generate representations of one or more physiological parameters, including, but not limited to, respiration, exhalation pulse, force parameters, velocity parameters, heart sounds, and blood pressure.

[0137] During the signal conditioning stage 702, the resistance FSR1 of the force sensor 102 is converted into an output voltage Vn, either by hardware (processing circuitry) or by software in post-processing.

[0138] Exemplary hardware for performing such a conversion is shown in Figures 8-10. With reference to Figure 8, the resistance FSR1 of the force sensor 102 forms one tail of a voltage divider 802, the output of which is provided to the input of a non-inverting amplifier 804 to produce an output voltage Vn proportional to the resistance FSR1 of the force sensor 102. In another embodiment, with reference to Figure 9, the change in the resistance FSR1 of the force sensor 102 is converted using a trans-impedance amplifier 902, with the resistance FSR1 configured as a variable input impedance of the amplifier 902. In a further embodiment, as shown in Figure 10, the force sensor 102 is integrated into a current mirror 1002, with the resistance FSR1 of the force sensor 102 configured as a bias resistor of the current mirror 1002.

[0139] As explained above, the second force sensor 202 can be used to calibrate a variable force applied to the rear (non-subject-facing) side of the sensor assembly 200 by any immobilization device or the subject himself / herself. Referring again to Figure 7, signal conditioning circuitry is implemented during signal conditioning 702 to further bias the resistance of the force sensor 102 based on the resistance FSR2 of the second force sensor 202. Figures 11-13 each illustrate an example of a suitable hardware layout for such functionality.

[0140] FIG. 11 is a variation of the trans-impedance amplifier arrangement of FIG. 9 with a bias voltage V2 coupled to the non-inverting input of amplifier 1102, the bias voltage V2 being variable by a current sink through a resistance FSR2 of the second force sensor 202.

[0141] Figure 12 shows a further variation of the arrangement of Figure 9 including a trans-impedance stage 1202 with a further stage 1204 configured to inject into the inverting input of stage 1202 a current proportional to the resistance FSR2 of the second force sensor 202, thus reducing the output voltage Vn as the resistance FSR2 increases. The values ​​of DC voltage V1 and passive resistors R1 and R2 in both Figures 11 and 12 are set according to the power supply used and the desired dynamic range of the output voltage Vn.

[0142] 13 shows a further variant in which the resistance FSR2 of the second force sensor 202 is placed in the feedback loop of a trans-impedance stage 1302. The gain of the stage 1302 is proportional to the resistance FSR2 and thus to the pressure applied to the rear surface of the sensor assembly 200. The resistance R1 is also set according to the power supply used and the desired dynamic range of the output voltage Vn.

[0143] It will be appreciated that any of the above hardware solutions may alternatively be implemented in software, either in real time or after recording of signals from two or more of the sensors 102, 104, 202.

[0144] It will also be appreciated that in addition to calibrating the first sensor 102, the signal derived from the first sensor 102 can be used to determine body compliance, for example, to distinguish between tissues (such as fat / muscle percentages), etc. Such measurements can be used to determine the amount of fat under the subject's skin.

[0145] As described above, in some embodiments, the displacement sensor 104 includes a piezoelectric sensor configured to generate a current in response to a change in displacement. In such cases, the DC offset and AC voltage swing of the signal output from the displacement sensor 104 may need to be adjusted or calibrated. To do so, the signal conditioning stage 702 conditions the signal output from the displacement sensor 104 by implementing processing circuitry, such as the processing circuitry shown in Figures 14, 15a, and 15b.

[0146] 14, a displacement sensor 104 (PZT: piezoelectric sensor) can be polarized using a current source 1402 (which can be digitally controlled) to adjust the AC voltage amplitude due to changes in displacement. A subsequent voltage amplifier 1404 is provided for adjustment of the DC offset.

[0147] Figure 15a shows an exemplary implementation of signal conditioning 702 for the displacement sensor 104. As in Figure 14, a current is injected into the displacement sensor 104 and the resulting high pass filtered signal V1 is provided to a voltage amplifier stage 1502 to adjust for a DC offset. It will be noted that the feedback resistance R7 and the input impedance R3 of the non-inverting input of the amplifier stage 1502 are chosen to match the impedance of the displacement sensor 104 (PZT).

[0148] 15b illustrates another exemplary implementation of a signal conditioning circuit 1502 for a displacement sensor 104. Referring to FIG. 15a of the drawings, like reference numerals refer to like parts unless otherwise indicated. This signal conditioning circuit 1502 exposes Miller's theorem, which increases the input impedance (RIN) seen by the displacement sensor 104 based on the following equation:

number

[0149] This improves the overall low frequency response of the signal conditioning circuit 1502 by reducing the high pass cutoff frequency, which is set to reduce phase shifts that may be introduced by the high pass response even at the lowest frequencies of interest, which are at the lower end of the respiratory signal band, to aid in comparison with the signal from the force sensor 102. In some applications, the cutoff frequency will be set in the range of about 0.01 to 0.05 Hertz.

[0150] To be able to use different displacement sensors 104 without the need for bespoke circuitry, the signal conditioning circuit 1502 may be tunable based on the particular capacitance of the selected displacement sensor 104. Surface mounted device (SMD) resistors in a bootstrap configuration may be used to employ smaller resistance values ​​that reduce the cost of the circuit 1502. By way of illustration, a 100 mega ohm resistor R1, a 100 ohm resistor R3, and a 100 kilo ohm trimmer R2 are used in the circuit 1502 such that when R2 is set to 0 (to provide a cutoff frequency of 0.05 Hertz for a displacement sensor 104 capacitance of 30 nanofarads), an impedance RIN of 100 mega ohms is "seen" by the displacement sensor 104. RIN is increased to 1011 by increasing the trimmer resistance by adjusting R2.

[0151] 7, during the signal conditioning stage 702, a conditioned force signal Vn representative of the force applied to the coupler 106 and a conditioned displacement signal Vd representative of the displacement velocity at the coupler 106 are generated. Optionally, an acceleration signal Va representative of the acceleration at the coupler 106 may also be generated. Those analog signals are then converted by an analogue-to-digital conversion (ADC) stage 704 into digital representations of the force F, the displacement velocity V, and the acceleration A, respectively, using one or more ADCs 708. In some embodiments, a single ADC 708 may be provided and the signal conditioned signals Vn, Vd, Va are provided to the ADC via a multiplexer (not shown). In other embodiments, the conditioned signals Vn, Vd, Va may be provided to separate ADCs 708 as shown in FIG. 7.

[0152] The digital signals F, V, A are then provided to a digital filter stage 706, which is configured to implement one or more filters 710, 712, 714, 716 to filter the force signal F, the velocity signal V, and the (optional) acceleration signal A to generate one or more outputs representative of the subject's physiological parameters. Such parameters are specific to the location on a living subject where the assembly 100, 200 is located during the measurement. For example, when positioned at a location on the subject's thorax, as shown in Figs. 3-5, the digital filter stage 706 is operable to extract data related to cardiac activity (e.g., seismocardiography, heart sounds, etc.) in addition to respiration and pulse cardiography. With the assembly 100, 200 positioned on the wrist, the digital filter stage 706 may only be able to extract data related to respiration and blood pulse.

[0153] A respiratory signal 720 from the subject is extracted by low pass filtering the force signal F using a low pass filter 710. The low pass filter 710 may have a low pass threshold of, for example, about 0.5 Hertz.

[0154] A pulse signal is generated from the force signal by band-pass filtering the force signal F with a band-pass filter 712. The band-pass filter may have, for example, a passband from about 0.5 Hertz to about 8 Hertz.

[0155] Force and velocity parameters specific to the organ of the living subject being monitored are extracted from each of the signals F, V by band-pass filtering the force signal F and the velocity signal V, respectively, with a further band-pass filter 714. For cardiac force and velocity parameters, for example, the band-pass filter 714 may have a passband of about 8 Hz to about 40 Hz.

[0156] For specific applications, i.e., wheezing, crackling, and snoring sounds, body sounds can also be extracted from the force signal F and velocity signal V using band pass filters 716 with lower thresholds of about 20 Hertz, about 30 Hertz, about 40 Hertz, or about 50 Hertz in combination with an upper threshold, usually about 150 Hertz, reaching about 5000 Hertz. Acoustic analysis of wheezing is clinically important since it is a sound produced by airflow through abnormally narrow or compressed airways. Timely identification and intervention of early asthma onset from wheezing may reduce the risk of long-term morbidity. Early detection and early treatment of those sounds is expected to reduce the prevalence of symptoms and improve health-related quality of life. Acoustic analysis and timing of crackles are also important as they may enable clinicians to identify whether a patient or subject has severe airway obstruction (early inspiratory / expiratory crackles), restrictive lung disease such as pulmonary fibrosis, interstitial pulmonary edema (late inspiratory crackles), and left ventricular failure (inspiratory crackles). Acoustic analysis of those snoring sounds is clinically important in examining the sleep characteristics of subjects and can detect respiratory diseases and other abnormalities. Primary applications may include, but are not limited to, prediction of the outcome of surgical procedures, evaluation of snoring before and after therapeutic interventions, and important differentiation of primary obstructive sleep apnea (OSA). They may be utilized to study snoring in pediatric patients as well as in adult patients. Early identification of those sounds allows clinicians to identify abnormalities early as early diagnosis and treatment allows patients to reduce the risk of cardiovascular disease. A further advantage of early treatment may be to save or avoid later more costly treatment, such as using a ventricular assist device that may need to be implanted due to severe heart failure that may result from OSA. In some embodiments, the band pass filter 716 may have a pass band of about 40 Hertz, about 300 Hertz, or even about 5000 Hertz.Depending on the location of the sensor assemblies 100, 200, the body sounds may include one or more of heart sounds (e.g., blood rush, valve movement), bowel sounds (e.g., gas displacement), breathing, snoring, swallowing, and fetal sounds (including fetal movement, fetal heart sounds, fetal breathing, fetal gas displacement, etc.), muscle contractions around the airways such as the trachea.

[0157] Size reduction in the airway may also be monitored by monitoring changes in sounds emanating from the neck region. For example, wheezing or higher sounds or vibrations in the neck may indicate hypopnea (partial reduction in breath), apnea, or asthma conditions, as well as other pulmonary and respiratory conditions. Body sounds may also be extracted from signals received from the accelerometer 120, as discussed below with reference to FIG. 23. Body sounds may be generated based on a combination of two or more of the force signal F, the velocity signal V, and the acceleration signal A.

[0158] The extracted body sounds may be output to one or more speakers or a headset to be heard by a clinician. Thus, the sensor assembly 100, 200 may function as a digital stethoscope providing a high resolution digital representation of the body sounds. Such extracted body sounds may be modulated and / or shifted in frequency to be more easily heard by the human ear. For example, the extracted body sounds may be shifted in frequency to the center of the human hearing range.

[0159] It will be noted that the various filters 710, 712, 714, 716 of the digital filter stage 706 are provided only as examples of filters that may be implemented to extract information from the force signal F and the velocity signal V. Depending on the physiological parameter to be extracted and the location of the assembly 100, 200 on the subject, one or more of the filters 710, 712, 714, 716, 718 may be omitted or other filters may be added.

[0160] When multiple sensor assemblies are provided at different locations on the subject, each of the force, velocity, and acceleration signals generated from such assemblies may be filtered in a manner similar to that described above with reference to Figure 7. For example, as shown in Figure 16, where like reference numbers refer to like parts, digital force signals F1-FN, velocity signals V1-VN, and acceleration signals A1-AN may be provided from N sensor assemblies 1602, 1604, respectively, to a digital filter stage 1606. For simplicity, the sensor assemblies 1602, 1604 include signal conditioning and A / D conversion circuitry for generating the force, velocity, and acceleration signals.

[0161] In addition to filtering the individual force and velocity signals from one or more of the sensor assemblies 1602, 1604, the digital filter bank 1606 is also configured to combine the force and / or velocity signals from two or more of the sensor assemblies 1602, 1604, either before or after filtering. For example, the filter bank 1606 may include a band pass filter and combine module 1608 configured to combine force signals F1, FN from two of the sensor assemblies 1602, 1604 positioned at different locations on the subject to generate a blood pressure signal 1610. The signals F1, FN may be band pass filtered before being combined, or the signals may be combined and a band pass filter applied to the combined signal to generate the blood pressure signal 1610.

[0162] Filter bank 1606 may be configured to combine any combination of received signals, before or after filtering, in any manner without departing from the scope of this disclosure.

[0163] In view of the above, Figures 17-25 graphically illustrate various signals extracted by exemplary sensor assemblies 100, 200 fixed at various locations on a human subject.

[0164] FIG. 17 graphically illustrates an extracted force signal 1702 obtained from the sensor assembly 300 of FIG. 3 positioned on the sternum of a subject 300 and secured by a belt 304 at the xiphoid process. A corresponding ECG signal 1704 measured at the same time is also shown for comparison. It can be seen that various cardiac parameters can be identified in the force signal 1702, including, but not limited to, the P-wave component 1706, the QRS complex 1708, and the T-wave component 1710. Thus, the sensor assembly 300 can be used in the diagnosis of diseases such as arrhythmias (e.g., atrial fibrillation). Additional parameters can also be extracted from this force signal 1702, including the duration of each phase of the cardiac cycle, cardiac valve opening time 1712 and cardiac valve closing time 1714, cardiac contraction level, stroke volume, cardiac output, and pulse wave transit time.

[0165] 18 graphically illustrates an extracted force signal 1802 obtained from a sensor assembly similar to that shown in FIG. 3, but positioned in a similar location at or near the xiphoid process, with an adhesive patch instead of belt 304. Also shown for comparison is a corresponding ECG signal 1804. As in FIG. 17, it can be seen that the force signal 1802 provides various cardiac indications corresponding to those of the ECG signal 1804.

[0166] FIG. 19 graphically illustrates a combined signal 1902 that is an algebraic sum of the force signals generated by the force sensors of the sensor assemblies 402 shown in FIG. 4, one of which is placed on the upper rib cage at or near the suprasternal notch and the other of which is placed on the lower rib cage at or near the apex. A corresponding ECG signal 1904 obtained by using the coupler 106 is configured as a conductive dome such that the ECG electrodes are also provided for reference. The resulting combined signal 1902 represents an estimate of the central arterial pressure through the heart, from which various parameters can be estimated, including the peak reflected wave P1 and the peak emitted wave P2. It will thus be appreciated that differential measurements of force and / or velocity using the sensor assemblies described herein allow for the determination of not only the central arterial pressure, but also the blood pressure gradient between various portions of the subject. For example, force and / or velocity measurements using two or more sensor assemblies at the suprasternal notch and femoral artery (or subclavian artery or other peripheral artery) can be compared to determine peripheral blood pressure.

[0167] FIG. 20 graphically illustrates a force signal 2002 generated from the force sensor 102 (FSR) of the sensor assembly 100 positioned at or near the xiphoid process as shown in FIG. 3, and an integral signal 2004 of the displacement velocity signal generated from the displacement sensor 104 (PZT) of the sensor assembly 100. This figure illustrates the substantial similarity of the integral 2004 of the velocity signal and the force signal 2002, where velocity is the first derivative of the force displacement. It can therefore be seen that the force signal 2002 can be used to calibrate the velocity signal 2004 either prior to operation of the sensor or in real time during monitoring to account for sensor drift, particularly when using piezoelectric sensors. It can also be seen from FIG. 20 that P-waves are visible in both the force signal 2002 and the integral signal 2004, highlighted by respective circles 2006, 2008 in the plot. Additionally, a diploic ridge can also be seen in both signals 2002, 2004, highlighted by long arrows 2010, 2012 in each plot in FIG.

[0168] FIG. 21 graphically illustrates a force signal 2102 generated from a force sensor (FSR) and a displacement velocity signal 2104 generated from a displacement sensor (PZT) of the sensor assembly 602 positioned on the wrist 604 of the subject 300 at or near the radial artery as shown in FIG. 6. A corresponding ECG signal 2106 is also shown for comparison. The circles in each of the plots highlight the measured P-waves visible in each signal 2102, 2104, 2106. The long arrows identify the dicrotic ridges in each of the force signal 2102 and velocity signal 2104. It can be seen from FIG. 20 that P-waves are visible from the signals received from the force signal 2102 and velocity signal 2104 measured at the wrist 604.

[0169] FIG. 22 graphically illustrates the extraction of respiratory signals 2102, 2104 from respective force signal 2106 and ECG signal 2108 by low pass filtering, for example using the low pass filter described above with reference to FIG. 7.

[0170] As mentioned above, the sensor assembly 100, 200 may be provided with one or more accelerometers configured to measure the acceleration of the sensor assembly 100, 200. FIG. 23 graphically illustrates an acceleration signal 2302 derived from the accelerometer 120 of the sensor assembly 100 positioned at or near the xiphoid process as shown in FIG. 3, and a force signal 2304 derived from the force sensor 102 of the sensor assembly 100. For comparison, recorded cardiac sounds 2306, photoplethysmogram (PPG) 2308, and ECG 2310 signals are also shown. From this figure, it can be seen that the signal 2302 received at the accelerometer 120 has similar characteristics to the recorded cardiac sound signal 2306, which has similar characteristics. It can therefore be seen that the accelerometer 2302 can be used to generate a sound signal representative of a body sound, as described above with reference to FIG. 7.

[0171] Figure 24 graphically illustrates raw data extracted from the sensor assembly 100 of Figure 1a. In Figure 24, an ECG signal 2402 is provided for reference, trace 2404 shows five respiratory cycles as recorded by the displacement sensor 104, and trace 2406 shows five respiratory cycles as recorded by the force sensor 102.

[0172] Similar to FIG. 23, FIG. 25a graphically illustrates sound and seismocardiogram data extracted from the sensor assembly 100 of FIG. 1a. In FIG. 25, trace 2502 represents raw data from the force sensor 102 after respiratory artifacts have been filtered from the signal, and trace 2504 represents raw data from the displacement sensor 104 after removal of the respiratory artifacts. Trace 2506 is a seismocardiogram extracted from the displacement sensor 104 using the signal conditioning circuit of FIG. 7. Trace 2508 is a sound plot extracted from the displacement sensor 104. Trace 2510 is an ECG signal provided for comparison purposes. Thus, with appropriate signal conditioning, a signal representative of body sounds and providing a seismocardiogram can be extracted from the displacement sensor 104 without the need for an ECG device. Thus, a subject wearing the sensor assembly 100, 200 can be monitored while performing an activity and does not need to wait for the completion of the activity in order to have an ECG device attached to the subject's body.

[0173] FIG. 25b shows two plots derived from the sensor assembly 400 shown in FIG. 1e or from the sensor array 610, 650 shown in FIG. 6b or 6c. The top plot 2520 shows the force and displacement signals derived from the force sensor 102, in this scenario an FSR, and the displacement sensor 104, in this scenario a piezoelectric sensor, actuated by the finger 612 of the subject 300. The bottom plot 2522 shows the red and infrared optical signals derived from the optical sensor, in this scenario a PPG sensor 402, 614, positioned against the finger 612. It will be appreciated that there is a direct correlation between the optical data of the bottom plot 2522 and the displacement data derived from the displacement sensor 104 of the top plot 2520.

[0174] The optical signal represented by plot 2522 may be used to calculate blood oxygen saturation at the location of the PPG sensor 402, 614. Alternatively, the PPG sensor 402, 614 may be used in suitable locations at one or both of the force sensor 102 and displacement sensor 104 to enable heart rate tracing. In this example, the rear FSR signal is not shown, only red and infrared light signals are shown as these have been found to enhance accurate calculation of blood oxygen saturation.

[0175] 26 and 27 are cross-sectional and planar surface views, respectively, of a sensor assembly 2300, which includes a stretchable sensor 2302 at least partially encapsulated within a stretchable carrier layer 2304. Similar to the force sensor 102 of the assembly 100 of FIG. 1a, the force sensor 2302 can be an FSR whose impedance changes upon bending or distortion of the stretchable sensor 2302. The stretchable carrier 2304 is capable of bending, thereby allowing the sensor 2302 to conform to the curvature of the surface of the subject to which the sensor 2302 is applied.

[0176] The stretchable carrier layer 2304 is preferably made of a material that is stretchable but not capable of stretching substantially in a direction perpendicular to the surface of the subject to which the layer 2304 may conform. Thus, the carrier layer 2304 may bend and, accordingly, the stretchable sensor 2302, leading to a change in the resistance of the stretchable sensor 2302 (at the FSR) or otherwise leading to a change in the properties of the stretchable sensor 2302. The sensor assembly 2300 further includes a fixation device 2306 for maintaining the sensor assembly 2300 in position relative to the subject. For example, the fixation device 230 is an anchoring point for attaching the sensor assembly 2300 to a carrier, such as a garment worn by the subject. The garment may be a shirt, strap, belt, vest, or the like. Equally, the sensor assembly 2300 may be worn in a pocket of a garment without the fixation device 2306. Any of the conditioning or signal processing modules or circuits described above with respect to the sensor assemblies 100, 200 can equally be used to condition or generate a signal from the stretchable sensor 2302.

[0177] In use, the sensor assembly 2300 is positioned at a fixed location on a surface of the subject 2500 having a radius of curvature that is variable over time. For example, as shown in Fig. 28, the sensor assembly 2300 is fixed to the rib cage of the subject 2500. Expansion of the rib cage during breathing causes the stretchable sensor 2302 to bend, thus changing the properties (resistance or other) of the stretchable sensor 2302.

[0178] FIG. 29 graphically illustrates a clear periodic breath signal generated from the stretchable sensor 2302 of the sensor assembly 2300 integrated into the seam of a shirt worn by a subject 2500 as shown in FIG. 28.

[0179] 30 shows a schematic cross-sectional view of a sensor assembly 2700 that is a variation of the sensor assembly 2300, with reference to FIGS. 26 and 27, where like reference numerals refer to like parts unless otherwise indicated. The sensor assembly 2700 further includes a stretchable displacement sensor 2702 configured to generate a velocity signal representative of a rate or speed of displacement of the sensor 2702. The displacement sensor 2702 is coupled to a backside of the stretchable carrier layer 2304. The displacement sensor 2702 is optionally at least partially encapsulated within an additional stretchable carrier layer 2704. In an embodiment, the displacement sensor 2702 is a piezoelectric sensor.

[0180] FIG. 31 shows a schematic cross-sectional view of a sensor assembly 2800, which is a variation of the sensor assembly 2700, with reference to FIG. 30, where like reference numerals refer to like parts unless otherwise indicated. The sensor assembly 2800 additionally includes a second force sensor 2802, similar to the force sensor 202 of the assembly 200 shown in FIG. 1b, mounted on the displacement sensor 2702. The second force sensor 2802 is optionally at least partially encapsulated within a stretchable carrier layer 2704, similar to the stretchable carrier layer 2304 of the sensor assembly 2700. Like the force sensor 202, the force sensor 2802 changes in resistance when an external pressure is applied to the assembly 2800. Thus, such externally applied forces (and associated artifacts) can be taken into account and the stretchable sensor 2302 calibrated accordingly.

[0181] The operation of the sensor assemblies 2700, 2800 is similar to that of the respective sensor assemblies 100, 200 and therefore will not be described in detail again here.

[0182] 32 and 33 illustrate that the sensor assemblies 100, 200 can be used to measure pulse transit time (PTT) and the variation in PTT as a subject's blood pressure increases.

[0183] The sensor assemblies 100, 200 are positioned on the chest wall of a healthy subject and on the subject's right common iliac artery. Trace 3202 represents the pulse rate detected by the displacement sensor 104 after removal of the respiratory artifact at the iliac crest, and trace 3204 represents the pulse rate detected by the displacement sensor 104 after removal of the respiratory artifact at the subject's chest wall proximate the apex of the subject's heart.

[0184] In FIG. 32, traces 3202 and 3204 are measured before the subject begins exercise, and more specifically, push-ups. It will be noted that before the subject begins exercise, the iliac apical lag was approximately 146 milliseconds based on a healthy subject's resting blood pressure of 123 / 68. FIG. 33 shows that the PTT lag is substantially reduced after exercise, and that the subject's blood pressure increases to 144 / 79. After exercise, the iliac apical lag is reduced to approximately 59 milliseconds. This proves that the sensor assembly 100, 200 can be used to detect PTT and that the sensor assembly 100, 200 is attached to the subject.

[0185] Figures 34-36 illustrate the use of the sensor assemblies 100, 200 to measure cardiac activity, and more specifically, cardiac stroke volume during exercise by a healthy subject. Figure 34 shows various parameters by a healthy subject at rest. Figure 35 shows those parameters by a subject beginning weightlifting at a low rate for the first time, and Figure 36 shows the same parameters by a subject beginning weightlifting at a high rate for the second time.

[0186] In this test, the sensor assembly 100, 200 is attached to the subject's chest wall. The subject is then required to lift weights at two different rates to achieve two different effort levels. In these figures, trace 3402 represents a low frequency force cardiogram (FCG) as measured by the force sensor 102 of the sensor assembly 100, 200. Trace 3404 represents a high frequency FCG as measured by the force sensor 102 of the sensor assembly 100, 200. Trace 3406 represents respiratory effort as measured by the displacement sensor 104 of the sensor assembly 100, 200. Trace 3408 represents a standard ECG and is provided for comparison purposes.

[0187] The results clearly demonstrate a consistent increase in amplitude in both the low-frequency FCG and the high-frequency FCG proportional to the subject's cardiac effort level. In particular, with respect to FCG values ​​measured before exercise, the amplitude of the low-frequency FCG doubles in response to low-rate weightlifting and triples in response to high-rate weightlifting. Conversely, the high-frequency FCG, known to be highly correlated with the seismocardiogram as extracted by the displacement sensor 104, increases approximately 1.5-fold in response to low-rate weightlifting and nearly doubles in response to high-rate weightlifting. The results demonstrate that the two FCG components carry different information regarding cardiac mechanics and that the low-frequency FCG is more correlated with stroke volume than the high-frequency FCG.

[0188] FIG. 37 shows two plots 3702, 3704. The first plot 3702 represents sounds recorded by a conventional Littman electronic (digital) stethoscope, and the second plot 3704 represents sounds recorded by a sensor assembly 100, 200, each of which is placed on the subject's chest. The second plot 3704 is the result of a scalar multiplication of the signals generated by the force sensor 102, 202 and the displacement sensor 104, resulting in a signal that minimizes or avoids additional modulation entirely. "S1" and "S2" identify portions of the signals 3702, 3704 that are indicative of typical heart sounds. The first heart sound, commonly referred to as S1, or "lub", is caused by disturbances resulting from the closure of the mitral and tricuspid valves at the beginning of systole. The second heart sound, commonly called S2, or the "dub," is caused by the closure of the aortic and pulmonary valves, marking the end of systole.

[0189] 38A and 38B are block diagrams illustrating the use of sensor assemblies 100, 200 to detect sound. Although only assembly 100 is shown in this drawing, it will be appreciated that assembly 200 may also be used as illustrated.

[0190] FIG. 38A, likewise FIG. 38B, illustrates two method branches 3802, 3804, each of which employs band pass filtering only in steps 3806 and 3808. It will be appreciated that other filters, such as higher order filtering, are suitable and within the scope of the present disclosure to enable sound extraction by the assemblies 100, 200. As shown in step 3810, the force and displacement signals generated by the sensors 110, 104 may be processed, such as filtered and normalized, scalar multiplied, etc., to enhance sound intelligibility or otherwise increase the signal-to-noise ratio. In step 3812, the sound output may be modulated, such as amplitude modulated, using a user-defined tone as a carrier that is perceptible up to the bandwidth of human hearing, such as 200 Hertz, to enable auscultation in environments with high levels of background noise.

[0191] 39A and 39B are block diagrams of a system 3900 configured to enable subject identification. The system 3900 is illustrated including the assembly 200. In other embodiments, the system 3900 additionally or instead includes the assembly 100. The system 3900 is configured to receive raw signals generated by the force sensors 102, 202 and the displacement sensor 104 of the assemblies 100, 200 in response to a subject (human) contacting the coupler 106, and process those signals to identify the subject. FIG. 39C illustrates a flow chart for the use of machine learning to update the comparison signal to identify the subject. The process may begin by acquiring signals / data, and the data may be divided into predetermined proportions for use in training and testing. In this particular embodiment, 80% of the acquired data may be assigned to the machine to be trained, which may be training data. The other 20% of the acquired data may be assigned to the machine to be tested, which may be testing data. It may be appreciated that the predetermined proportions for training and testing may be variable. The training data may be formed into a trained model by classifying the following parameters of continuous or discrete variables. The trained model may then be turned into a test model, where another proportion of the test data is used for the test model. The suitability of the test model may be evaluated against the performance of the classification model by using a confusion matrix. The matrix compares the actual target values ​​with the target values ​​predicted by the machine learning model. The error of the model may be performed by using RMSE or root mean square calculations in predicting quantitative data.

[0192] It will be appreciated that identification of a particular human may be achieved by a processor identifying one or more unique physiological signals, or unique portions of signals, such as those generated in response to the human activating the sensor assembly 100, 200. An example of a related ECG-based approach is disclosed in "Individual identification via electrocardiogram analysis" by Antonio Fratini, Mario Sansone, Paolo Bifulco, and Mario Cesarelli in Biomedical Engineering Online (Fratini et al. BioMedEng OnLine(2015) 14:78, DOI 10.1186 / s12938-015-0072-y), published Aug. 14, 2015.

[0193] The unique physiological signal, or an aspect of the signal, may be stored in memory. The signal may be generated in response to a user contacting the sensor assembly 100, 200 of the system 3900, or may be acquired by an alternative system or device. The temporal, frequency, and morphological characteristics of the signal generated in response to the subject manipulating the assembly 100, 200 may be compared by the processor to samples stored in memory to allow identification of the subject. This may involve determining the identifier based on at least one standardized historical signal for the same subject stored in memory. In some examples, the system 3900 includes at least one of a photoplethysmography sensor configured to generate a photoplethysmography signal and a pair of electrocardiography electrodes configured to generate an electrocardiography signal. In such examples, determining the identifier of the subject may be based on a combination of at least two standardized historical signals for the same subject stored in memory. The Morphic Dot worn or attached to the user may communicate with the Morphic Band and force sensors in the device. The Morphic Dot may require the user's finger to contact in order for the user's vitals to be obtained in case of a sudden event, and the Morphic Dot may also advantageously include an accelerometer to determine the user's location and / or movement when in use. This location information is particularly important for elderly patients, and the information may mean whether the subject may have a sudden fall or whether the subject is in a lying position to rest. In case of sudden fall detection, the Morphic Dot may communicate or sound an alarm to a caregiver or person responsible for the patient or subject. This alarm may be a sound from the user's finger contacting the Morphic Dot in case the sudden fall caused the user to lose consciousness, or may be a sound without the user's finger contacting the Morphic Dot.This is advantageous as if the subject is alone or lacking attention when this event occurs, someone will be alerted and can quickly attend to the subject's care as soon as possible.

[0194] Operating the system 3900 may involve a human manually applying a coded pattern of touch or force to the assembly 100, 200, such as variable pressure and / or duration of contact within a defined period of time, as described in further detail below. The coded pattern may be stored in memory as a specially configured password or other authentication code to enable or cause further actions, such as access to a digital or physical environment. For example, the processor may be configured to identify a particular pattern and emit an emergency alarm beacon. In some embodiments, as shown in FIG. 39, the system 3900 is configured as a "closed loop" to provide feedback to the user by means of a coded vibration, such as may be induced in the sensor assembly 100, 200 by operating the displacement sensor 104, which in this embodiment is a piezoelectric element. This feedback is typically configured to allow the user to sense that the coded pattern has been recognized and that further actions have been authorized.

[0195] 40 illustrates an embodiment of a sensor assembly 100, 200 configured to identify a subject and cause the generation of a signal using the assembly 100, 200 arranged at or near the subject's fingertip 4002. The subject may be identified in response to identifying a single unique aspect or a combination of unique aspects of the generated signal, such as particular peaks and troughs.

[0196] 40 may operate by placing the assembly 100, 200 in contact with the volar side of a finger 4004, causing the assembly 100, 200 to generate a signal and, as a result, identify the subject. This embodiment typically includes a sensor assembly 100, 200 connected to a battery (not illustrated) and a computer module (not illustrated) configured to process the signal, store the signal, and transmit the signal either to another computing device, such as a PC, smartphone, or hub, or to a remotely hosted server (a "cloud computer"), such as via Bluetooth or Wi-Fi wireless communication protocols, for comparison to a database of signals.

[0197] In some embodiments, the assemblies 100, 200 may be incorporated into a device or structure, such as the keys of a keyboard, or the screen of a smartphone, or an area of ​​furniture, and / or may be disposed on a subject. This may allow for digitally authenticating actions such as securely turning on or off a powered device, such as a vehicle, computer, or cell phone, or granting access to a building or area. This approach may also authenticate access to digital systems that require a level of security beyond or in place of traditional manual or biometric authentication, such as passwords, text codes, fingerprints, eye scans, or facial recognition methods.

[0198] Operating the embodiment of the assembly 100, 200 shown in Fig. 40 may involve the subject manually adjusting one or more of the pressure / force exerted on the assembly 100, 200, the duration of contact with the assembly 100, 200, or an intermittent contact effected with the assembly 100, 200, such as a specific pulse of contact within a defined period of time. When operated in this manner, this embodiment of the assembly 100, 200 is configured to detect one or more defined patterns of force and, as a result, perform further actions, which may allow for an additional level of security. For example, this approach may authorize the sending of an alarm signal to another electronic device or system following an event such as a fall or an adverse change in health status.

[0199] 40 may involve a subject manually contacting coupler 106 with the palmar side of a finger to cause a resultant force and / or displacement signal to be generated, or an analysis of the signal, such as heart rate, respiration rate, or blood pressure, to be recorded, which is transmitted to another device or system. For example, in some embodiments, data may be transmitted to an individual or group remote to the subject to prompt action to address adverse changes in health status.

[0200] 41a-41c illustrate plots of force signals 4102, 4104 and displacement signals 4106 obtained from an embodiment of the assembly 100, 200 illustrated in Fig. 40 as described above and operated upon by a subject intermittently contacting the assembly 100, 200 to generate a pulse signal. The signals 4102, 4104, 4106, alone or in combination, may be unique or may define a unique aspect and therefore may be capable of being processed to identify the subject.

[0201] Fig. 42A illustrates three plots of signals 4202, 4204, 4206 obtained from the embodiment of the assembly 100, 200 illustrated in Fig. 40 as described above and operated by three different subjects intermittently contacting the assembly 100, 200 to generate three pulse signals. Each subject results in the generation of a unique signal plot that can be processed to allow the subject to be identified, as shown in Fig. 42A. For example, a particular subject may produce variations in either the beat width, presence, and timing of the dicrotic crest, and the amplitude of the signal peaks.

[0202] FIG. 42B illustrates another arrangement in which a single sensor assembly 610 is secured to a subject's finger 612, typically held in place by a releasable or elastically deformable mechanism, such as a strap or sleeve (not illustrated). It will be appreciated that showing the assembly 610 secured to the finger 612 is merely exemplary, and that the assembly 610 can be configured to be secured to other parts of the subject's 300 body. The sensor assembly 610 includes a sensor 100 arranged adjacent to an optical sensor, which in this embodiment is a multi-color PPG sensor 614. In other embodiments (not illustrated), a pulse oximeter sensor is arranged in addition to or instead of the PPG sensor 614. This arrangement allows for simultaneous collection of blood volume signals from separate sensors 100, 614 positioned on the same side of the assembly 610 to sense positions arranged adjacent to one another on the finger. FIG. 42C illustrates a further arrangement in which a single sensor assembly 650 is secured to a subject's finger 612, typically held in place by a releasable or elastically deformable mechanism such as a strap or sleeve (not illustrated). It will be appreciated that showing the assembly 650 secured to the finger 612 is merely exemplary, and that the assembly 650 can be configured to be secured to other parts of the subject's 300 body. The sensor assembly 650 includes a sensor 100 positioned opposite from an optical sensor, which in this embodiment is a multi-color PPG sensor 614. In other embodiments (not illustrated), a pulse oximeter sensor is arranged in addition to or instead of the PPG sensor 614. This arrangement allows for simultaneous collection of blood volume signals from separate sensors 100, 614 positioned on opposite sides of the finger 612.

[0203] Figures 43a-43d show various ways of placing a finger on the rear coupler to measure the pulse wave transit time from the heart to the tip of the finger. When the resulting pulse signal / pressure wave from the finger is compared to a front force sensor positioned over the heart, the difference in timing between the signals is the pulse wave transit time for the cardiogenic signal from the user's heart to the finger. The speed at which this arterial pressure wave travels (or its timing for a fixed distance) is directly proportional to blood pressure.

[0204] Figure 43a shows a finger 113 in the form of an auxiliary pressure dome applied to the rear coupler 111 per the assembly in Figure 1d. The pulse response can be detected by the rear force sensor 202, which has a cut gap 4302 that can be created simply allowing the rear force sensor to be mounted to a flap or door. The front sensor assembly in Figure 1c senses signals from the skin surface 4301 above the heart.

[0205] FIG. 43b shows two separate sensor assemblies according to FIG. 1b, one positioned on the chest 4301 and one positioned on a finger 113.

[0206] FIG. 43c shows an alternative arrangement in which the embodiment for the finger 113 does not include a back force sensor according to FIG. 1c.

[0207] FIG. 43 d shows an alternative arrangement in which the sensor assembly on the finger 113 is just a front force sensor assembly 4303 and does not include the displacement sensors 114 , 104 , 116 .

[0208] FIG. 44 shows various signals recorded simultaneously from the embodiment in FIG. 43a including ECG 4404, displacement sensor 4405, frontal force sensor 4406, force sensor from the finger and gold standard blood pressure signal from finger 4407. The difference in timing between the two pulses allows measurement of the pulse transit time 4401. In this case both force sensors are on one device with the frontal force sensor on the chest and the finger is placed on the back force sensor disconnected from the front sensor. This embodiment measures the pulse transit time 4401 from the chest to the tip of the finger. The time measured from the electrocardiograph to the peripheral site is called the pulse arrival time (PAT) and includes the cardiac pre-ejection period (PEP) 4403, so PAT is the R wave to the secondary site with the pulse wave and PTT is per pulse wave, the difference PAT-PTT=PEP.

[0209] Figure 45a shows a comparison of the signals for the arm versus the chest for both the piezoelectric sensor 4504 and the force sensor 4505. They are compared to both the ECG signal (4503) and the blood pressure signal from the finger (4506). The timing of the signals indicative of PAT for both the chest 4501 and arm 4502 signals is highlighted.

[0210] Fig. 46a shows two sensors positioned on the chest, one on the apex 4601 and the second on the suprasternal notch / aortic arch 4602. Fig. 46b shows various signals recorded simultaneously from the embodiment in Fig. 46a including ECG 4603, displacement sensor 4604, frontal force sensor 4605, and gold standard blood pressure signal from finger 4606, allowing measurement of the delay between triggering (R-peak relative to ECG) and apical motility 4607, and also measuring the delay between apex and aortic arch ejection time 4608. The resulting PAT gives a measure of central blood pressure.

[0211] Figure 47a shows signals from a piezoelectric sensor 4702, a force sensor 4703, and a finger BP monitor 4704. Various artifacts from breathing 4705 and movement 4706 are present. Figure 47b shows artifact-removed signals 4707, 4708, 4709, revealing a similar shape to the signals. If the piezoelectric and force sensor signals are calibrated to a single heartbeat from the finger blood pressure monitor (both systolic and diastolic components) 4710, the piezoelectric or force sensors can be used for ongoing measurement of blood pressure.

[0212] Fig. 48a shows an embodiment with a back force sensor 4801 connected to an outer skin 4806 that contacts a force sensor 4803 and a piezoelectric sensor 4802. The assembled sensor can be calibrated in grams / newtons via FSR measurement, applying a calibrated mass and / or a developing calibrated force. To calibrate the piezoelectric sensor, the net force can be used. The back FSR can be used to allow a higher gain to be recorded, as the large DC component is analogously removed.

[0213] The difference between the calibrated DC component of force measured by the front FSR 4804 and the DC component of force measured by the back FSR 4805 gives an indication of body area / tissue compliance. Figure 48b shows this difference in compliance 4809`` between the chest 4807 and wrist 4808.

[0214] One or more of the sensor assemblies described herein may be integrated in any combination into a medical device for monitoring in situ of a subject in various situations. For example, a sensor assembly may be mounted on or onto a mattress, a chair or seat, a car seat belt or steering wheel, a collar, a strap, an attached patch, an animal harness or an ear tag, and configured to monitor one of many physiological parameters of the subject (such as any of those described above). In addition, the sensor assembly may be configured to detect and monitor the movement and position of the subject relative to the sensor assembly on the seat, bed, or mattress. Such monitoring may be advantageous in preventing bed sores (where the sensor assembly / assemblies are integrated into a mattress, etc.).

[0215] It will be appreciated that embodiments of the present disclosure may be used to diagnose and monitor a number of human and animal diseases and conditions that can be diagnosed and monitored by measuring skin forces, displacements, and / or accelerations. Non-limiting examples of cardiac conditions and diseases include innocent murmurs, sclerosis, hypertension, angina pectoris, myocardial infarction, ventricular aneurysm, mitral valve prolapse (MVP), isolated click murmur, mitral regurgitation, mitral stenosis (MS), tricuspid regurgitation (TR), mitral regurgitation, aortic regurgitation, aortic stenosis, hypertrophic obstructive cardiomyopathy, cardiomyopathy, pericarditis, pulmonary hypertension, atrial septal defect, ventricular septal defect, patent ductus arteriosus, pulmonary stenosis, aortic stenosis, tetralogy of Fallot, coronary artery disease, heart failure, cardiac dyssynchrony, systolic heart failure, diastolic heart failure, pulmonary thromboembolism, cor pulmonale, or arteriosclerosis, and the like.

[0216] Pulmonary diseases and conditions of the lungs, including pulmonary congestion, may also be diagnosed. Examples of the present disclosure may also be used to diagnose and monitor sleep disorders, such as sleep apnea, for example, by placing one or more sensor assemblies as described herein at or near the trachea or at other locations around the subject's neck. In addition to breathing, the sensor assemblies may optionally be configured to monitor snoring, swallowing, muscle contractions around the airway (e.g., trachea), and size reduction in the airway.

[0217] Arterial and / or venous conditions (calcification, collapse, etc.) may be diagnosed and monitored by placing one or more sensor assemblies described herein on a subject at or near the arteries or veins to be monitored. In some embodiments, for example, sensor assemblies may be positioned bilaterally on the left and right arteries of either both arms or both legs, or one arm and one leg, and a comparison may be made between the left and right arteries on different limbs to determine the status of one or the other (or both) of the arteries.

[0218] In any of the embodiments described above, the sensor assembly may be integrated into a wearable device for short-term or long-term use and force, velocity, and / or acceleration measurements may be collected and stored so that conditions and diseases can be monitored in real time or over time, for example via remote medical consultation.

[0219] The sensor assemblies described herein may also be used to monitor uterine contractions during pregnancy. A pregnant subject may wear one or more sensor assemblies at locations on the skin proximate to the uterus, where contractions cause force displacements on the skin and corresponding signals are derived from the force and displacement sensors and optional accelerometers of the sensor assemblies.

[0220] The sensor assemblies described herein may be used to measure, diagnose, and monitor a human or animal subject, as well as to monitor fetal activity in such a subject. For example, one or more sensor assemblies, such as sensor assemblies 100, 200, may be positioned at locations around the abdomen to monitor fetal movement, respiratory, and cardiac signals within the animal or human subject in a manner similar to that described above with reference to the human or animal subject itself. By comparing the fetal signal (e.g., movement and / or heart rate) with other sensors positioned to measure the maternal signal, changes in the fetal signal may be correlated to changes in the maternal signal (e.g., blood pressure for a mother at risk for pre-eclampsia).

[0221] In the embodiments described herein, and with particular reference to Figures 3-5, the sensor assembly is secured to the front of the torso. For example, Figure 4 shows the sensor assembly positioned in a frontal auscultation position. It will be appreciated that one or more sensor assemblies may be secured to the rear of the torso of an animal subject or human subject in a standard auscultation position, such as on the rear of the torso, without departing from the scope of the present disclosure.

[0222] It should be understood, particularly by those skilled in the art, that various operations described herein, particularly in connection with the drawings, may be implemented by other circuits or other hardware components. The order in which each operation of a given method is performed may be changed, various elements of the systems illustrated herein may be added, reordered, omitted, modified, etc. The present disclosure encompasses all such modifications and alterations, and therefore the above description is intended to be regarded in an illustrative and not a limiting sense.

[0223] Similarly, although the disclosure refers to particular embodiments, certain modifications and variations can be made to those embodiments without departing from the scope and breadth of the disclosure. Moreover, any benefits, advantages, or solutions to problems described herein with respect to particular embodiments are not intended to be construed as critical, required, or essential features or elements.

[0224] Similar further example embodiments will be apparent to those of ordinary skill in the art with the benefit of this disclosure, and such examples should be considered as encompassed herein.

[0225] For many applications, embodiments may be implemented on a DSP (digital signal processor), an ASIC (application specific integrated circuit), or an FPGA (field programmable gate array). Thus, the code may include conventional program code or microcode, or code for setting up or controlling, for example, an ASIC or an FPGA. The code may also include code for dynamically configuring a reconfigurable device, such as a reprogrammable logic gate array. Similarly, the code may include code for a hardware description language, such as Verilog® or VHDL (Very high speed integrated circuit Hardware Description Language). Those skilled in the art will recognize that code may be distributed among multiple coupled components in communication with each other. Where appropriate, embodiments may also be implemented using code running on a field (re)programmable analog array or similar device to configure analog hardware.

[0226] As used herein, the term module shall be used to refer to a functional unit or functional block, and it will be noted that a functional unit or functional block may be implemented at least in part by dedicated hardware components, such as custom-defined circuits, and / or at least in part by one or more software processors or suitable code running on a suitable general-purpose processor or otherwise. A module may itself contain other modules or functional units. A module may be provided by multiple components or sub-modules that are not necessarily collocated, provided on different integrated circuits, and / or running on different processors.

[0227] It will be appreciated by those skilled in the art that numerous variations and / or modifications may be made to the above-described embodiments without departing from the broad overall scope of the present disclosure, and the present embodiments are therefore to be considered in all respects as illustrative and not restrictive.

Claims

1. 1. An apparatus for sensing a physiological parameter of a subject, comprising: a force sensor having a force sensing surface, the force sensor being configured to generate a first signal representative of a force displacement of an organ of the subject; a displacement sensor associated with the force sensor, the displacement sensor having a displacement sensing surface and configured to generate a second signal representative of a displacement velocity of the organ of the subject; a coupler arranged on one of the force sensor and the displacement sensor, the coupler being configured to mechanically couple the force sensor and the displacement sensor to the organ; Equipped with the displacement sensing surface is coincident with or smaller in size relative to the force sensing surface; The device, wherein the coupler is configured as a first conductive electrode and is electrically coupled to a processing circuit configured to measure a biopotential when the coupler is arranged with respect to the subject.

2. The apparatus of claim 1 , wherein the force sensor includes a first force sensing resistor (FSR).

3. The apparatus of claim 1 , wherein the displacement sensor comprises a piezoelectric sensor.

4. The apparatus of claim 1 , wherein the coupler has a maximum planar surface area that is less than a maximum planar surface area of ​​the force sensor.

5. The apparatus of claim 4 , wherein the maximum planar surface area of ​​the coupler approximates a maximum planar surface area of ​​the displacement sensor.

6. 6. The apparatus of claim 5, wherein the force sensor is mounted to the displacement sensor, the force sensor including an operable front surface coupled to the operable back surface of the coupler and an operable back surface coupled to the operable front surface of the displacement sensor.

7. 5. The apparatus of claim 4, wherein the force sensor and the displacement sensor each have an operable front surface coupled to an operable back surface of the coupler, the force sensor and the displacement sensor being arranged concentrically on the operable back surface of the coupler.

8. The apparatus of claim 1 , wherein the displacement sensor is configured such that the second signal is representative of a body sound produced by the organ of the subject.

9. 10. The apparatus of claim 1, further comprising at least one optical sensor configured to generate a third signal representative of a volumetric change in circulating blood of the subject.

10. 10. The apparatus of claim 9, wherein the at least one optical sensor is configured to be arranged on the subject separately from the force sensor, the displacement sensor, and the coupler.

11. The apparatus of claim 9 , wherein the at least one optical sensor is fixed adjacent to the force sensor.

12. The apparatus of claim 10 , wherein the coupler is shaped to at least partially surround the optical sensor such that the coupler is mechanically decoupled from the optical sensor.

13. 10. The apparatus of claim 9, comprising a plurality of said optical sensors operable together to generate a fourth signal representative of a blood oxygen saturation level.

14. 10. The device of claim 1, wherein the coupler includes a temperature sensor and is electrically coupled to a processing circuit configured to measure a temperature in response to the coupler being aligned with the subject.

15. 10. The device of claim 1, wherein the first conductive electrode is configured as an annular ring, the annular ring being electrically coupled to a processing circuit configured to measure a biopotential when the annular ring is arranged with respect to the subject.

16. 2. The device of claim 1, comprising a second conductive electrode spaced apart and arranged isolated from the first conductive electrode to enable alignment with another portion of the subject, the second conductive electrode being coupled to the processing circuit to enable measuring additional biopotentials when the first conductive electrode and the second conductive electrode are aligned with the subject.

17. 17. The device of claim 16, comprising a third conductive electrode spaced apart and arranged isolated from the first and second conductive electrodes to enable alignment with another portion of the subject, the third conductive electrode coupled to the processing circuit to enable measuring additional biopotentials when the first, second, and third conductive electrodes are aligned with the subject, the third conductive electrode being movable relative to the first and second electrodes.

18. 2. The apparatus of claim 1, wherein the processing circuitry is configured to measure an electrocardiography (ECG) of the subject in response to any conductive electrodes arranged on the subject and configured to generate a fourth signal representative of the ECG.

19. The device of claim 1 , further comprising a second force sensor configured to measure a force applied to a movable backside of the device.

20. 1. An apparatus for sensing a physiological parameter of a subject, comprising: a force sensor configured to generate a first signal representative of a force displacement of an organ of the subject; at least one optical sensor configured to generate a second signal representative of a volumetric change in circulating blood of the subject; a coupler arranged on the force sensor configured to mechanically couple the force sensor with the organ; a second force sensor configured to measure a force applied to a movable backside of the device, the second force sensor being a force sensing resistor (FSR); An apparatus comprising:

21. 21. The apparatus of claim 20, wherein the at least one optical sensor detects the resulting signal using at least one wavelength of light.

22. 22. The apparatus of claim 21, wherein the second force sensor is coupled to an operable backside of the displacement sensor.

23. 21. The apparatus of claim 20, further comprising at least one processor configured to determine the physiological parameter based on the first signal and the second signal.

24. 24. The apparatus of claim 23, wherein the at least one processor is configured to calibrate the second signal received from the displacement sensor or the optical sensor based on the first signal.

25. 2. The apparatus of claim 1, wherein the physiological parameters include at least one of heart palpitations, blood pressure, uterine contractions, fetal activity, respiration, opening time of the subject's heart valves, closing time of the subject's heart valves, contractility level of the subject's heart, stiffness of the subject's blood vessels, stroke volume of the heart, cardiac output, and blood pulse wave transit time of the subject.

26. 26. The apparatus of claim 25, wherein the physiological parameter is blood pressure, and the parameter to be measured includes at least one of central blood pressure and peripheral blood pressure.

27. 1. A method for increasing a signal-to-noise ratio of a signal generated by a sensor assembly, the assembly including a force sensor and a displacement sensor, comprising: arranging the displacement sensors at locations on the subject, the displacement sensors configured to generate a first signal representative of displacement; arranging the force sensors at identical locations on the subject, the force sensors configured to generate a second signal representative of a force displacement; operating at least one processor coupled to the displacement sensor and the force sensor and configured to process force and displacement signals; The method includes:

28. 28. The method of claim 27, wherein the processing step comprises multiplying the first signal and the second signal.

29. 1. A method for measuring a physiological parameter of a subject, comprising: receiving a first signal from a first force sensor mechanically coupled to a first location on the subject; receiving a second signal from a second force sensor mechanically coupled to a second location on the subject, the second location being decoupled from the first location; determining the physiological parameter based on a comparison of the first signal and the second signal; The method includes:

30. 30. The method of claim 29, wherein the comparison comprises a difference between the first and second signals comprising a pulse transit time, one or more of the first and second force sensors are force sensing resistors (FSRs), the physiological parameter comprises at least one of blood pressure, uterine contractions, and fetal activity, the physiological parameter is blood pressure, and the method comprises measuring at least one of central blood pressure and peripheral blood pressure.

31. 31. The method of claim 30, wherein the first location is on the subject's upper thorax and the second location is on the subject's lower thorax, and the physiological parameter to be measured is central blood pressure.

32. 31. The method of claim 30, wherein the first location is on the subject's thorax and the second location is proximate one of the subject's femoral artery and subclavian artery, and the physiological parameter to be measured is peripheral blood pressure.

33. 1. An apparatus for sensing at least one parameter of a subject, comprising: a stretchable sensor member having an impedance that changes with bending; a stretchable carrier surrounding the stretchable sensor member and configured to maintain a contact surface of the stretchable sensor member in close proximity to the subject's surface such that changes in the shape of the subject's surface cause the stretchable sensor member to bend; An apparatus comprising:

34. 34. The apparatus of claim 33, wherein the stretchable sensor member comprises a force sensing resistor (FSR), the carrier is at least one of a fabric carrier and an elastomeric carrier, the carrier comprises at least one of a strap and an adhesive patch, and the carrier comprises clothing worn by the subject, the clothing comprising at least one of a shirt, a chest band, a wrist band, a vest, a jacket, and a coat.

35. 35. The apparatus of claim 34, wherein the surface of the subject is the subject's thorax, the stretchable carrier is configured to maintain the contact surface in close proximity to the skin such that expansion and contraction of the thorax due to breathing causes the stretchable sensor to bend, and the apparatus further comprises at least one processor configured to generate the at least one parameter based on the impedance of the stretchable sensor member, the at least one parameter being respiratory.

36. The apparatus comprises: positioning the stretchable sensor at a first location adjacent to an organ of a subject; determining the at least one parameter based on an impedance of the extendable sensor member; 36. The apparatus of claim 35, adapted to

37. 1. A system for identifying a subject, comprising: at least one first force sensor configured to generate a force signal representative of the force; a displacement sensor configured to generate a displacement signal representative of the displacement; wherein the force sensor and the displacement sensor are mutually arranged to enable positioning at substantially the same position on a subject to enable generating the signal; The system further comprises: at least one processor coupled to the force sensor and the displacement sensor; the at least one processor configured to process the force signal and the displacement signal to determine an identifier of the subject; The system is arranged to contact a volar side of a finger of the user to enable generation of the force signal and the displacement signal, and the subject is identified by the processor.

38. The at least one processor is coupled to a memory and configured to determine the identifier of the subject based on at least one standardized historical signal for a same subject stored in the memory, and further includes at least one of a photoplethysmography sensor configured to generate a photoplethysmography signal and a pair of electrocardiography electrodes configured to generate an electrocardiography signal; 38. The system of claim 37, wherein the at least one processor is coupled to a pair of photoplethysmography sensors and / or electrocardiography electrodes configured to process at least one of the force and displacement signals and at least one of the photoplethysmography and electrocardiography signals to determine the identifier of the subject, and the at least one processor is configured to determine the identifier of the subject based on a combination of at least two standardized historical signals for the same subject stored in the memory, and each operation of the system to generate one or more of the signals causes the one or more corresponding standardized historical signals to be updated.

39. 38. The system of claim 37, wherein the system is arranged on a tip of an index finger, and wherein in response to the subject adjusting one or more of a contact force and duration exerted by the finger, the processor is configured to communicate an alarm signal to one or more remotely located devices or systems, and in response to the subject adjusting one or more of a contact force and duration exerted by the finger, the processor is configured to communicate at least one of a recorded signal and an analyzed signal to one or more remotely located devices or systems.

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