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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

Challenges: Wearable Sensors
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Affordable, Sensorized Garments for Kangaroo Mother Care: Promoting Behavior Change and Enabling Data Collection

Conor Walsh, Harvard University (Cambridge, Massachusetts, United States)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Conor Walsh of Harvard University and Elisabeth Salisbury of the University of Massachusetts Medical School in the U.S. will develop a low-cost, wearable, monitoring device to improve kangaroo mother care for newborns in remote settings. Kangaroo mother care is an established childcare method that is particularly valuable for preterm infants. It uses clothing to attach the baby to the caregiver, thereby ensuring continuous skin-to-skin contact to provide warmth. However, too much or too little heat can also be dangerous, but there is currently no way to monitor that. They will develop and test washable, temperature- and stretch-sensitive materials that can attach to existing kangaroo mother care garments to monitor the temperature and breathing rate of the infant. The device will also be able to alert the parent using color or other simple cues when they need to warm or cool the infant or provide stimulation.

Always-on Imperceptible Infant Monitoring (AIIM) in Kangaroo Mother Care

Debra Weese-Mayer, Ann & Robert H Lurie Children's Hospital of Chicago (Chicago, Illinois, United States)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Debra E. Weese-Mayer, Roozbeh Ghaffari, John A. Rogers, Matt Glucksberg, Aaron Hamvas, Mark Fisher, Bill Grobman and Casey Rand of the Ann & Robert H. Lurie Children's Hospital of Chicago and the Center for Bio-Integrated Electronics at the Simpson & Querrey Institute, Northwestern University in the U.S. will develop a skin-like sensor for newborns that improves the value of kangaroo mother care (KMC), which is a method used to maintain skin contact with the mother to keep the baby warm. Kangaroo mother care is particularly useful for premature babies in low-resource settings, but it is difficult to monitor how often it is used once the mothers have gone home. They have developed a wearable, ultrathin sensor adapted to delicate newborn skin by fusing soft, stretchable bioelectronics that can measure multiple physiological parameters such as breathing rate and temperature non-invasively through the skin. The device also emits audio and visual alerts when potentially dangerous values are detected, and can store and transmit data wirelessly for clinical monitoring and analysis. They will adapt the sensor to also detect motion and develop it for use during kangaroo mother care. The device will be tested for usability on a panel of mothers and nurses in a clinic in South Africa, and for accuracy in a U.S. based medical center.

Evaluation of a mHealth System for Tracking Kangaroo Mother Care and Temperature in Southern India

Prem Mony, St. John's Research Institute (Bangalore, Karnataka, India)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Prem Mony of St John's Research Institute in India along with the Indian Institute of Science, Bangalore, will develop a temperature sensor to be worn by caregivers during kangaroo mother care of infants up to four weeks old combined with a mobile device to transmit data for analysis and real-time feedback. Kangaroo mother care involves continuous skin-to-skin contact with the mother to keep the infant warm, and is particularly valuable for protecting preterm infants. However, how long and how often it is actually used in the home, and thus its value, has been difficult to quantify. They will build a mobile phone application and establish a data-monitoring platform that can be combined with their wearable, energy-independent temperature sensor, which has already been tested in India. They will also add visual or audio alerts to remind mothers to use kangaroo mother care, and alert them when the baby's temperature gets too high or too low. Their approach will be tested in a small-scale clinical trial of 30-40 mothers.

Kangagrow

Ratul Narain, BEMPU Technologies (Bengaluru, Karnataka, India)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Ratul Narain of BEMPU Technologies in India will create a sleeve that can be simply attached to slings used for kangaroo mother care, which is a continuous skin-to-skin contact method of care for newborns suited to low-resource settings, to measure and encourage use. Kangaroo mother care is particularly beneficial for preterm and low-weight babies as it maintains their body temperature and thereby avoids hypothermia and promotes weight gain. However, in India, uptake in the home is low, which appears to be due in part to the lack of real-time feedback for mothers showing how it is helping their baby. They will make the attachable sleeve, known as Kangagrow, containing mechanical force gauges and an audio-visual interface displaying a colored flower that gradually blooms during the continual use of kangaroo mother care to demonstrate to the mother and family that their efforts are providing what is essentially 'nourishment' to the baby. It will also contain a safe power source that doesn't require charging over the 30-day neonatal period. They will verify its accuracy in a hospital setting, and perform a multicenter trial of 100 mothers to see whether it promotes newborn weight gain and growth.

Maternal Actigraphy Exploratory Study I (MAES-I)

José Guilherme Cecatti, Universidade Estadual de Campinas (Campinas, São Paulo, Brazil)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

JosÈ Guilherme Cecatti of Cemicamp in Brazil will develop a small watch-like device to measure the sleep patterns and physical activity of pregnant women to help identify very early signs of serious medical conditions such as gestational diabetes and preterm birth so they can be better treated or prevented. Some chronic diseases such as diabetes and cancer are known to be associated with disturbances in sleep and physical activity. They will study whether this is the case also for complications during pregnancy. They will use established actigraphy technology and develop algorithms for measuring activity. The device will be tested in an exploratory study on a cohort of around 400 pregnant women across five centers in Brazil to identify patterns linked with serious medical conditions.

Monitor for Detection of Apnea and Hypothermia in Neonates

Pratyusha Pareddy, Centre for Healthcare Entreprenuership (Hyderbad, Andhra Pradesh, India)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Pratyusha Pareddy and Manoj Sanker of the Centre for Healthcare Entrepreneurship in collaboration with NemoCare Wellness in India will develop a small, battery-operated wearable device for newborns that continuously monitors vital signs in premature babies to alert health workers when a life-threating situation might occur, and provides vibration to stimulate breathing. Premature babies are susceptible to a variety of potentially fatal conditions such as apnea (suspension of breathing) and hypothermia. The lack of sophisticated monitors for these conditions in resource-poor settings means that nurses often have to continually check up to 40 babies, which makes timely detection very challenging. They will design and build a prototype made of soft fabric to fit snugly on the child's foot, and incorporate a photoplethysmography sensor, which measures rate of blood flow, and a thermistor to measure temperature, as well as an audio-visual alarm. A platform will also be developed for wirelessly connecting multiple devices to a hub installed at the nurses' station, which is also fitted with an alarm. They will compare their prototype with currently used monitoring devices in the laboratory, and perform a small-scale field trial to get feedback from health workers and mothers.

NeMo: Empowering Mothers to Identify Neonatal Illness

Soumyadipta Acharya, Johns Hopkins University (Baltimore, Maryland, United States)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Soumyadipta Acharya of Johns Hopkins University in the U.S. will develop a technology they call NeMo (neonatal monitoring), for families in low-resource settings to monitor their newborns at home to help them identify potentially severe illnesses. Infant mortality rates are highest during the first week of life, and in developing countries are largely caused by treatable diseases such as pneumonia or sepsis. To help families detect these conditions they are developing a device that comprises a low-cost, paper sensor that can be placed on the infant's abdomen to measure respiratory rate and temperature, and a smartphone application that uses audio and visual cues to enable a family member to clinically assess the infant. The measurements and assessments together are then used to alert the family to dangerous conditions and connect them with a health worker. They will develop training methods and perform a pilot test of their device in Uganda to analyze usability.

Neo-PATch: Plasma Analyte Transdermal Wearable Sensor for Newborns

Patricia Connolly, University of Strathclyde (Glasgow, United Kingdom)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Patricia Connolly of the University of Strathclyde and colleagues in the United Kingdom will develop a low-cost, wearable skin patch that can continuously monitor metabolite levels in newborns without the need for blood sampling, and can alert mothers and health workers to potential problems via mobile phone. Changes in metabolites such as those of hemoglobin and bilirubin are used to assess many aspects of newborn health, but current methods require invasive blood sampling and access to laboratory analysis, which is often unavailable in low-resource settings. To address this, in consultation with users in Sierra Leone, Vietnam and India, they will develop a flat patch incorporating their new technology, which painlessly enhances the flow of analytes through the skin for detection, and a Bluetooth connector that can communicate levels to a smartphone. The prototype patch will be laboratory tested to refine the design.

Pairing Maternal Wearables with a Holistic Model of Care

Molly Guy, Medtronic Labs (Minneapolis, Minnesota, United States)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Molly Guy and Chemuttaai Lang'at of Medtronic Labs in the U.S. will lead a team seeking to redefine how pregnant women manage hypertension and how clinicians remotely monitor patients' health. Hypertensive disorders of pregnancy have overtaken hemorrhage as a main cause of maternal mortality in some sub-Saharan African settings. Management requires careful monitoring, which is problematic in settings with limited access to care. The team will assess integration of locally-appropriate wearable sensors into their existing hypertension management model of care. The model combines automated blood pressure monitors, mobile devices, and a software application, together allowing for data collection, real-time feedback, SMS messaging, and efficient access to referrals and prescriptions. The team will conduct a six-month pilot of 150 pregnant hypertensive women in Kenya to evaluate usability, feasibility, and desirability of this wearable-enhanced holistic care ecosystem.

Parent-Centric Kangaroo Mother Care Wearable

Yamile Jackson, Nurtured by Design (Sugar Land, Texas, United States)
Nov 1, 2017
Grand Challenges Explorations> Wearable Sensors

Yamile Jackson of Nurtured by Design in the U.S. will develop a digital, wearable wrap with biosensors and a smartphone application to monitor kangaroo mother care - skin-to-skin contact between mother and infant - in low-resource areas, and improve its duration and frequency. The sensors will monitor the infant's temperature, position, and heart rate, and transmit the data to a smartphone provided to the mother, and to the cloud to be monitored by healthcare teams. The application will contain a user-friendly graphical interface and will also provide the mothers with information on the importance of kangaroo mother care and enable them to communicate with other mothers and health workers. They will build and test a prototype at a local research university with the participation of local kangaroo care leaders.

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