A distributed, high-channel-count, implanted bidirectional system for restoration of somatosensation and myoelectric control.

Objective. We intend to chronically restore somatosensation and provide high-fidelity myoelectric control for those with limb loss via a novel, distributed, high-channel-count, implanted system.Approach.We have developed the implanted Somatosensory Electrical Neurostimulation and Sensing (iSens®) system to support peripheral nerve stimulation through up to 64, 96, or 128 electrode contacts with myoelectric recording from 16, 8, or 0 bipolar sites, respectively. The rechargeable central device has Bluetooth® wireless telemetry to communicate to external devices and wired connections for up to four implanted satellite stimulation or recording devices. We characterized the stimulation, recording, battery runtime, and wireless performance and completed safety testing to support its use in human trials.Results.The stimulator operates as expected across a range of parameters and can schedule multiple asynchronous, interleaved pulse trains subject to total charge delivery limits. Recorded signals in saline show negligible stimulus artifact when 10 cm from a 1 mA stimulating source. The wireless telemetry range exceeds 1 m (direction and orientation dependent) in a saline torso phantom. The bandwidth supports 100 Hz bidirectional update rates of stimulation commands and data features or streaming select full bandwidth myoelectric signals. Preliminary first-in-human data validates the bench testing result.Significance.We developed, tested, and clinically implemented an advanced, modular, fully implanted peripheral stimulation and sensing system for somatosensory restoration and myoelectric control. The modularity in electrode type and number, including distributed sensing and stimulation, supports a wide variety of applications; iSens® is a flexible platform to bring peripheral neuromodulation applications to clinical reality. ClinicalTrials.gov ID NCT04430218.

Internet of Things-Enabled Patch With Built-in Microsensors and Wireless Chip: Real-Time Remote Monitoring of Patch Treatment.

Purpose: We aimed to design, develop, and evaluate an internet of things-enabled patch (IoT patch) for real-time remote monitoring of adherence (or patch wear time) during patch treatment in child participants in clinical trials. This study provides healthcare providers with a tool for objective, real-time, and remote assessment of adherence and for making required adjustments to treatment plans. Methods: The IoT patch had two temperature microsensors and a wireless chip. One sensor was placed closer to the skin than the other, resulting in a temperature difference depending on whether the patch was worn. When the patch was worn, it measured temperatures every 30 seconds and transmitted temperature data to a cloud server via a mobile application every 15 seconds. The patch was evaluated via 2 experiments with 30 healthy adults and 40 children with amblyopia. Results: Excellent monitoring accuracy was observed in both adults (mean delay of recorded time data, 0.4 minutes) and children (mean, 0.5 minutes). The difference between manually recorded and objectively recorded patch wear times showed good agreement in both groups. Experiment 1 showed accurate monitoring over a wide range of temperatures (from 0 to 30°C). Experiment 2 showed no significant differences in wearability (ease-of-use and comfort scores) between the IoT and conventional patches. Conclusions: The IoT patch offers an accurate, real-time, and remote system to monitor adherence to patch treatment. The patch is comfortable and easy to use. The utilization of an IoT patch may increase adherence to patch treatment based on accurate monitoring. Translational Relevance: Results show that the IoT patch can enable real-time adherence monitoring in clinical trials, improving treatment precision, and patient compliance to enhance outcomes.

Multi-Sensor Origami Platform: A Customizable System for Obtaining Spatiotemporally Precise Functional Readouts in 3D Models.

Bioprinting technology offers unprecedented opportunities to construct in vitro tissue models that recapitulate the 3D morphology and functionality of native tissue. Yet, it remains difficult to obtain adequate functional readouts from such models. In particular, it is challenging to position sensors in desired locations within pre-fabricated 3D bioprinted structures. At the same time, bioprinting tissue directly onto a sensing device is not feasible due to interference with the printer head. As such, a multi-sensing platform inspired by origami that overcomes these challenges by "folding" around a separately fabricated 3D tissue structure is proposed, allowing for the insertion of electrodes into precise locations, which are custom-defined using computer-aided-design software. The multi-sensing origami platform (MSOP) can be connected to a commercial multi-electrode array (MEA) system for data-acquisition and processing. To demonstrate the platform, how integrated 3D MEA electrodes can record neuronal electrical activity in a 3D model of a neurovascular unit is shown. The MSOP also enables a microvascular endothelial network to be cultured separately and integrated with the 3D tissue structure. Accordingly, how impedance-based sensors in the platform can measure endothelial barrier function is shown. It is further demonstrated the device's versatility by using it to measure neuronal activity in brain organoids.

A Soft Collaborative Robot for Contact-based Intuitive Human Drag Teaching.

Soft material-based robots, known for their safety and compliance, are expected to play an irreplaceable role in human-robot collaboration. However, this expectation is far from real industrial applications due to their complex programmability and poor motion precision, brought by the super elasticity and large hysteresis of soft materials. Here, a soft collaborative robot (Soft Co-bot) with intuitive and easy programming by contact-based drag teaching, and also with exceptional motion repeatability (< 0.30% of body length) and ultra-low hysteresis (< 2.0%) is reported. Such an unprecedented capability is achieved by a biomimetic antagonistic design within a pneumatic soft robot, in which cables are threaded to servo motors through tension sensors to form a self-sensing system, thus providing both precise actuation and dragging-aware collaboration. Hence, the Soft Co-bots can be first taught by human drag and then precisely repeat various tasks on their own, such as electronics assembling, machine tool installation, etc. The proposed Soft Co-bots exhibit a high potential for safe and intuitive human-robot collaboration in unstructured environments, promoting the immediate practical application of soft robots.

Earthworm-Inspired Soft Skin Crawling Robot.

Earthworms are fascinating animals capable of crawling and burrowing through various terrains using peristaltic motion and the directional friction response of their epidermis. Anisotropic anchoring governed by tiny appendages on their skin called setae is known to enhance the earthworm's locomotion. A multi-material fabrication technique is employed to produce soft skins with bristles inspired by the earthworm epidermis and their setae. The effect of bristles arranged in triangular and square grids at two spatial densities on the locomotion capability of a simple soft crawling robot comprised of an extending soft actuator covered by the soft skin is investigated experimentally. The results suggest that the presence of bristles results in a rostral to caudal friction ratio of µR/µC > 1 with some variations across bristle arrangements and applied elongations. Doubling the number of bristles increases the robot's speed by a factor of 1.78 for the triangular grid while it is less pronounced for the rectangular grid with a small factor of 1.06. Additionally, it is observed that increasing the actuation stroke for the skin with the high-density triangular grid, from 15% to 30%, elevates the speed from 0.5 to 0.9 mm s-1, but further increases in stroke to 45% may compromise the durability of the actuators with less gains in speed (1 mm s-1). Finally, it is demonstrated that a crawling robot equipped with soft skin can traverse both a linear and a curved channel.

A Dynamic Ultrasound Phantom with Tissue-Mimicking Mechanical and Acoustic Properties.

Tissue-mimicking phantoms are valuable tools that aid in improving the equipment and training available to medical professionals. However, current phantoms possess limited utility due to their inability to precisely simulate multiple physical properties simultaneously, which is crucial for achieving a system understanding of dynamic human tissues. In this work, novel materials design and fabrication processes to produce various tissue-mimicking materials (TMMs) for skin, adipose, muscle, and soft tissue at a human scale are developed. Target properties (Young's modulus, density, speed of sound, and acoustic attenuation) are first defined for each TMM based on literature. Each TMM recipe is developed, associated mechanical and acoustic properties are characterized, and the TMMs are confirmed to have comparable mechanical and acoustic properties with the corresponding human tissues. Furthermore, a novel sacrificial core to fabricate a hollow, ellipsoid-shaped bladder phantom complete with inlet and outlet tubes, which allow liquids to flow through and expand this phantom, is adopted. This dynamic bladder phantom with realistic mechanical and acoustic properties to human tissues in combination with the developed skin, soft tissue, and subcutaneous adipose tissue TMMs, culminates in a human scale torso tank and electro-mechanical system that can be systematically utilized for characterizing various medical imaging devices.

Design and Development of Transient Sensing Devices for Healthcare Applications.

With the ever-growing requirements in the healthcare sector aimed at personalized diagnostics and treatment, continuous and real-time monitoring of relevant parameters is gaining significant traction. In many applications, health status monitoring may be carried out by dedicated wearable or implantable sensing devices only within a defined period and followed by sensor removal without additional risks for the patient. At the same time, disposal of the increasing number of conventional portable electronic devices with short life cycles raises serious environmental concerns due to the dangerous accumulation of electronic and chemical waste. An attractive solution to address these complex and contradictory demands is offered by biodegradable sensing devices. Such devices may be able to perform required tests within a programmed period and then disappear by safe resorption in the body or harmless degradation in the environment. This work critically assesses the design and development concepts related to biodegradable and bioresorbable sensors for healthcare applications. Different aspects are comprehensively addressed, from fundamental material properties and sensing principles to application-tailored designs, fabrication techniques, and device implementations. The emerging approaches spanning the last 5 years are emphasized and a broad insight into the most important challenges and future perspectives of biodegradable sensors in healthcare are provided.

In Vivo Intelligent Fluorescence Endo-Microscopy by Varifocal Meta-Device and Deep Learning.

Endo-microscopy is crucial for real-time 3D visualization of internal tissues and subcellular structures. Conventional methods rely on axial movement of optical components for precise focus adjustment, limiting miniaturization and complicating procedures. Meta-device, composed of artificial nanostructures, is an emerging optical flat device that can freely manipulate the phase and amplitude of light. Here, an intelligent fluorescence endo-microscope is developed based on varifocal meta-lens and deep learning (DL). The breakthrough enables in vivo 3D imaging of mouse brains, where varifocal meta-lens focal length adjusts through relative rotation angle. The system offers key advantages such as invariant magnification, a large field-of-view, and optical sectioning at a maximum focal length tuning range of ≈2 mm with 3 µm lateral resolution. Using a DL network, image acquisition time and system complexity are significantly reduced, and in vivo high-resolution brain images of detailed vessels and surrounding perivascular space are clearly observed within 0.1 s (≈50 times faster). The approach will benefit various surgical procedures, such as gastrointestinal biopsies, neural imaging, brain surgery, etc.

Design and Synthesis of Transferrable Macro-Sized Continuous Free-Standing Metal-Organic Framework Films for Biosensor Device.

Metal organic framework (MOF) films have attracted abundant attention due to their unique characters compared with MOF particles. But the high-temperature reaction and solvent corrosion limit the preparation of MOF films on fragile substrates, hindering further applications. Fabricating macro-sized continuous free-standing MOF films and transferring them onto fragile substrates are a promising alternative but still challenging. Here, a universal strategy to prepare transferrable macro-sized continuous free-standing MOF films with the assistance of oxide nanomembranes prepared by atomic layer deposition and studied the growth mechanism is developed. The oxide nanomembranes serve not only as reactant, but also as interfacial layer to maintain the integrality of the free-standing structure as the stacked MOF particles are supported by the oxide nanomembrane. The centimeter-scale free-standing MOF films can be transferred onto fragile substrates, and all in one device for glucose sensing is assembled. Due to the strong adsorption toward glucose molecules, the obtained devices exhibit outstanding performance in terms of high sensitivity, low limit of detection, and long durability. This work opens a new window toward the preparation of MOF films and MOF film-based biosensor chip for advantageous applications in post-Moore law period.

Multistrand Twisted Triboelectric Kevlar Yarns for Harvesting High Impact Energy, Body Injury Location and Levels Evaluation.

Developing ultrahigh-strength fabric-based triboelectric nanogenerators for harvesting high-impact energy and sensing biomechanical signals is still a great challenge. Here, the constraints are addressed by design of a multistrand twisted triboelectric Kevlar (MTTK) yarn using conductive and non-conductive Kevlar fibers. Manufactured using a multistrand twisting process, the MTTK yarn offers superior tensile strength (372 MPa), compared to current triboelectric yarns. In addition, a self-powered impact sensing fabric patch (SP-ISFP) comprising signal acquisition, processing, communication circuit, and MTTK yarns is integrated. The SP-ISFP features withstanding impact (4 GPa) and a sensitivity and response time under the high impact condition (59.68 V GPa-1; 0.4 s). Furthermore, a multi-channel smart bulletproof vest is developed by the array of 36 SP-ISFPs, enabling the reconstruction of impact mapping and assessment of body injury location and levels by real-time data acquisition. Their potential to reduce body injuries, professional security, and construct a multi-point personal vital signs dynamic monitoring platform holds great promise.

Soft Robots with Plant-Inspired Gravitropism Based on Fluidic Liquid Metal.

Plants can autonomously adjust their growth direction based on the gravitropic response to maximize energy acquisition, despite lacking nerves and muscles. Endowing soft robots with gravitropism may facilitate the development of self-regulating systems free of electronics, but remains elusive. Herein, acceleration-regulated soft actuators are described that can respond to the gravitational field by leveraging the unique fluidity of liquid metal in its self-limiting oxide skin. The soft actuator is obtained by magnetic printing of the fluidic liquid metal heater circuit on a thermoresponsive liquid crystal elastomer. The Joule heat of the liquid metal circuit with gravity-regulated resistance can be programmed by changing the actuator's pose to induce the flow of liquid metal. The actuator can autonomously adjust its bending degree by the dynamic interaction between its thermomechanical response and gravity. A gravity-interactive soft gripper is also created with controllable grasping and releasing by rotating the actuator. Moreover, it is demonstrated that self-regulated oscillation motion can be achieved by interfacing the actuator with a monostable tape spring, allowing the electronics-free control of a bionic walker. This work paves the avenue for the development of liquid metal-based reconfigurable electronics and electronics-free soft robots that can perceive gravity or acceleration.

A Bioinspired and Cost-Effective Device for Minimally Invasive Blood Sampling.

Conventional venipuncture is invasive and challenging in low and middle-income countries. Conversely, point-of-care devices paired with fingersticks, although less invasive, suffer from high variability and low blood volume collection. Recently approved microsampling devices address some of these issues but remain cost-prohibitive for resource-limited settings. In this work, a cost-effective microsampling device is described for the collection of liquid blood with minimal invasiveness and sufficient volume retrieval for laboratory analyses or immediate point-of-care testing. Inspired by the anatomy of sanguivorous leeches, the single-use device features a storage compartment for blood collection and a microneedle patch hidden within a suction cup. Finite Element Method simulations, corroborated by mechanical analyses, guide the material selection for device fabrication and design optimization. In piglets, the device successfully collects ≈195 µL of blood with minimal invasiveness. Additionally, a tailor-made lid and adapter enable safe fluid transportation and integration with commercially available point-of-care systems for on-site analyses, respectively. Taken together, the proposed platform holds significant promise for enhancing healthcare in the pediatric population by improving patient compliance and reducing the risk of needlestick injuries through concealed microneedles. Most importantly, given its cost-effective fabrication, the open-source microsampling device may have a meaningful impact in resource-limited healthcare settings.

A Review of Recent Advancements in Sensor-Integrated Medical Tools.

A medical tool is a general instrument intended for use in the prevention, diagnosis, and treatment of diseases in humans or other animals. Nowadays, sensors are widely employed in medical tools to analyze or quantify disease-related parameters for the diagnosis and monitoring of patients' diseases. Recent explosive advancements in sensor technologies have extended the integration and application of sensors in medical tools by providing more versatile in vivo sensing capabilities. These unique sensing capabilities, especially for medical tools for surgery or medical treatment, are getting more attention owing to the rapid growth of minimally invasive surgery. In this review, recent advancements in sensor-integrated medical tools are presented, and their necessity, use, and examples are comprehensively introduced. Specifically, medical tools often utilized for medical surgery or treatment, for example, medical needles, catheters, robotic surgery, sutures, endoscopes, and tubes, are covered, and in-depth discussions about the working mechanism used for each sensor-integrated medical tool are provided.

Using high-resolution imaging to study the impact of the Kalogon wheelchair cushion on blood flow in the gluteal area.

AIM OF THE STUDY: This study investigated how the air-bladder offloading mode of the Orbiter by Kalogon wheelchair cushion (Orbiter) affected blood flow in the gluteal region of non-disabled subjects. The hypothesis was that the cushion's offloading mode would improve blood flow, resulting in reduced reactive hyperemia when compared to the static setting, or Loaded Control (LC). Furthermore, the study proposed a technique using a high-resolution image laser speckle contrast system to measure blood flow in the gluteal area. METHODS: Two procedures were carried out, one with the participant sitting on a cushion in LC, and the second, the cushion was set to offloading mode. Blood flow was measured through data imaging after each procedure. Three trials were performed, starting and ending in different cushion bladders. Customized algorithms were used to select regions of interest on the images for calculations. The Wilcoxon Signed-Rank Test was conducted to compare the offloads and loaded control values of each region of interest. Results were considered significant at α = 0.05. RESULTS: Ten healthy, non-disabled adults participated in the study, seven females and three males. There were no significant differences among the participants. However, results showed that seven subjects tended to decrease reactive hyperemia in the offload sequence of trial when the last two bladders offloaded were the sacrum followed by the right ischial tuberosity. CONCLUSIONS: The high-resolution imager showed that the Orbiter Offloads helped reduce reactive hyperemia in seven subjects, potentially improving blood flow. More research is necessary to comprehend the mechanisms of these effects fully.

Development of ergo-refined operator's workplace and biophysically actual cost-benefit analysis of riding type self-propelled machines with special reference for female operators.

BACKGROUND: Female agricultural workers contribute to 37% of the total agricultural workforce in India, however, most self-propelled machinery is designed for male agricultural workers. OBJECTIVE: The primary objective was to determine the impact of the ergo-refined operator's workplace on various aspects of operator performance and comfort, including actuating force, posture, and physiological parameters. METHODS: Experiments were carried out in real field conditions using a full factorial randomized design. Twelve female operators participated in the study, and measurements were taken for control lever actuating force, operator posture, heart rate, and other relevant parameters. RESULTS: The ergo-refined operator's workplace intervention resulted in significant reductions in actuating force for various control levers, angles of joints, working heart rate (WHR), oxygen consumption rate (OCR), muscle load, and whole-body vibration (WBV) acceleration. These reductions were observed under different operating conditions. CONCLUSION: The findings suggest that the ergo-refined operator's workplace is effective in enhancing operator comfort and reducing physical strain during the operation of riding type self-propelled machines. It contributes to improved safety, comfort, and operational efficiency for operators working in field conditions. ANOVA and MANOVA analyses confirmed the positive impact of operating conditions and engine speed on the measured parameters when using the ergo-refined operator's workplace.

Absorbing Material of Button Antenna with Directional Radiation of High Gain for P2V Communication.

Vehicular communication systems can be used to enhance the safety level of road users by exchanging safety/warning messages. In this paper, an absorbing material on a button antenna is proposed for pedestrian-to-vehicle (P2V) communication, which provides safety service to road workers on the highway or in a road environment. The button antenna is small in size and is easy to carry for carriers. This antenna is fabricated and tested in an anechoic chamber; it can achieve a maximum gain of 5.5 dBi and an absorption of 92% at 7.6 GHz. The maximum distance of measurement between the absorbing material of the button antenna and the test antenna is less than 150 m. The advantage of the button antenna is that the absorption surface is used in the radiation layer of the antenna so that the antenna can improve the radiation direction and gain. The absorption unit size is 15 × 15 × 5 mm3.

Hollow silicon microneedles, fabricated using combined wet and dry etching techniques, for transdermal delivery and diagnostics.

Microneedle-based technologies are the subject of intense research and commercial interest for applications in transdermal delivery and diagnostics, primarily because of their minimally invasive and painless nature, which in turn could lead to increased patient compliance and self-administration. In this paper, a process for the fabrication of arrays of hollow silicon microneedles is described. This method uses just two bulk silicon etches - a front-side wet etch to define the 500 µm tall octagonal needle structure itself, and a rear-side dry etch to create a 50 µm diameter bore through the needle. This reduces the number of etches and process complexity over the approaches described elsewhere. Ex-vivo human skin and a customised applicator were used to demonstrate biomechanical reliability and the feasibility of using these microneedles for both transdermal delivery and diagnostics. Microneedle arrays show no damage even when applied to skin up to 40 times, are capable of delivering several mL of fluid at flowrates of 30 µL/min, and of withdrawing 1 µL of interstitial fluid using capillary action.

MXene-Sponge Based High-Performance Piezoresistive Sensor for Wearable Biomonitoring and Real-Time Tactile Sensing.

Electrode microfabrication technologies such as lithography and deposition have been widely applied in wearable electronics to boost interfacial coupling efficiency and device performance. However, a majority of these approaches are restricted by expensive and complicated processing techniques, as well as waste discharge. Here, helium plasma irradiation is employed to yield a molybdenum microstructured electrode, which is constructed into a flexible piezoresistive pressure sensor based on a Ti3 C2 Tx nanosheet-immersed polyurethane sponge. This electrode engineering strategy enables the smooth transition between sponge deformation and MXene interlamellar displacement, giving rise to high sensitivity (1.52 kPa-1 ) and good linearity (r2  = 0.9985) in a wide sensing range (0-100 kPa) with a response time of 226 ms for pressure detection. In addition, both the experimental characterization and finite element simulation confirm that the hierarchical structures modulated by pore size, plasma bias, and MXene concentration play a crucial role in improving the sensing performance. Furthermore, the as-developed flexible pressure sensor is demonstrated to measure human radial pulse, detect finger tapping, foot stomping, and perform object identification, revealing great feasibility in wearable biomonitoring and health assessment.

Efficient power macromodeling approach for heterogeneously stacked 3d ICs using Bio-geography based optimization.

Low-power consumption has been always a crucial design constraint for an efficient intellectual property based three-dimensional multi-core system that cannot be ignored easily. As the complexity increases due to the number of cores/stacks/ layers in 3D digital systems, the challenges to handle power can be more difficult at a high abstraction level. Therefore, the low-power approach gives designers an opportunity to estimate and optimize the power consumption in the early stages of design phases. The accurate power estimation through the macro-modeling approach at high-level reduces the risk of redesign cycle and turn-around time. In this research, we have presented an improved statistical macro-modeling approach that estimates power through statistical characteristics of randomly generated input patterns by using Biogeography Based Optimization. These input patterns propagate signals into an IP-based 3D digital test system. In experiments, the test system is based on four 8 to 32- bits heterogeneous cores. The response of the power is monitored by applying the well-known Monte Carlo Simulation technique. The entire power estimation method is performed in two major steps. First, the average power is estimated for an IP-based individual core. Second, the average power for bus-based Through-Silicon-Via is estimated. Finally, the cores and B-TSVs are integrated together to construct a 3D system. Then the average power for complete test systems is estimated. The experimental results of the statistical power macro-model are compared with the commercial Electronic Design Automation power simulator at the operating frequency of 100 MHz. The average percentage error of the test system is calculated as 8.65%. For the validation of these results, the statistical error analysis is additionally performed and reveals that our proposed macro-model is accurate in terms of percentage of error with a feasible amount of time.

Development and in-vitro characterization of a novel fetal vesicoamniotic shunt - The Vortex shunt.

OBJECTIVES: To develop and test a novel vesicoamniotic shunt (VAS) to treat fetal lower urinary tract obstruction (LUTO), decrease dislodgement and optimize shunt deployment in-vitro. METHODS: Vesicoamniotic shunt design objectives included: (1) robust and atraumatic fixation elements, (2) kink resistant conduit to adjust to fetal movement and growth, (3) one-way pressure valve to facilitate bladder cycling, and (4) echogenic deployment visualization aids. The force to dislodge the novel Vortex shunt was compared with existing commercially available shunts in a bench-top porcine bladder model. Sonographic echogenicity was evaluated with ultrasound-guided deployment, and the shunt valve pressure measured. RESULTS: A prototype novel Vortex shunt was developed using braided nitinol "umbrella-type" ends with a kink-resistant stem incorporating an internal one-way valve. The peak force required to dislodge the Vortex shunt was significantly higher than commercially available shunts (p < 0.01). Shunt deployment in the bench-top model was easily confirmed with ultrasound guidance and the brisk decompression of the inflated porcine bladder thereafter. In-vitro valve gauge pressure testing mirrored bladder pressures in human LUTO cases. CONCLUSION: In-vitro testing shows that the Vortex shunt may improve deployment, sonographic visualization, kink resistance, and dynamic size adjustment. Validation in preclinical animal models are warranted and currently underway.