Wearable Loop Sensor for Bilateral Knee Flexion Monitoring.

We have previously reported wearable loop sensors that can accurately monitor knee flexion with unique merits over the state of the art. However, validation to date has been limited to single-leg configurations, discrete flexion angles, and in vitro (phantom-based) experiments. In this work, we take a major step forward to explore the bilateral monitoring of knee flexion angles, in a continuous manner, in vivo. The manuscript provides the theoretical framework of bilateral sensor operation and reports a detailed error analysis that has not been previously reported for wearable loop sensors. This includes the flatness of calibration curves that limits resolution at small angles (such as during walking) as well as the presence of motional electromotive force (EMF) noise at high angular velocities (such as during running). A novel fabrication method for flexible and mechanically robust loops is also introduced. Electromagnetic simulations and phantom-based experimental studies optimize the setup and evaluate feasibility. Proof-of-concept in vivo validation is then conducted for a human subject performing three activities (walking, brisk walking, and running), each lasting 30 s and repeated three times. The results demonstrate a promising root mean square error (RMSE) of less than 3° in most cases.

Real-Time Magnetocardiography with Passive Miniaturized Coil Array in Earth Ambient Field.

We demonstrate a magnetocardiography (MCG) sensor that operates in non-shielded environments, in real-time, and without the need for an accompanying device to identify the cardiac cycles for averaging. We further validate the sensor's performance on human subjects. Our approach integrates seven (7) coils, previously optimized for maximum sensitivity, into a coil array. Based on Faraday's law, magnetic flux from the heart is translated into voltage across the coils. By leveraging digital signal processing (DSP), namely, bandpass filtering and averaging across coils, MCG can be retrieved in real-time. Our coil array can monitor real-time human MCG with clear QRS complexes in non-shielded environments. Intra- and inter-subject variability tests confirm repeatability and accuracy comparable to gold-standard electrocardiography (ECG), viz., a cardiac cycle detection accuracy of >99.13% and averaged R-R interval accuracy of <5.8 ms. Our results confirm the feasibility of real-time R-peak detection using the MCG sensor, as well as the ability to retrieve the full MCG spectrum as based upon the averaging of cycles identified via the MCG sensor itself. This work provides new insights into the development of accessible, miniaturized, safe, and low-cost MCG tools.

High-Contrast Low-Loss Antenna: A Novel Antenna for Efficient Into-Body Radiation.

We present a biocompatible high-contrast low-loss antenna (HCLA) designed for efficient into-body radiation for applications as diverse as medical telemetry, sensing, and imaging. The HCLA is wearable with a compact size of 2.62 cm3 and operates across the 1 to 5 GHz bandwidth. The quasi-bowtie antenna is loaded with a high-contrast (i.e., alternating layers of high and low permittivity materials) and low-loss dielectric to improve directivity and gain into the biological tissues. Measurement results at 2.4 GHz are in good agreement with simulations and show 5.72 dB improvement in transmission loss over the most efficient into-body radiator reported in the past. At the high end of the frequency bandwidth, simulation results for two antennas placed across each other with tissue in between show ~12.5 dB improvement in transmission loss. The HCLA is fabricated with stable, low-loss materials that allow for repeatability and consistency in the fabrication process, thus, addressing limitations of the current state-of-the-art. It is also made from biocompatible materials that enable it to be placed directly on the skin for real-world implementation. In this paper, we discuss the operation principle and design of the HCLA, its transmission performance, radiation patterns, and specific absorption rate.

Wearable Sensors Based on Force-Sensitive Resistors for Touch-Based Collaborative Digital Gaming.

We report new classes of wearable sensors that monitor touch between fully-abled and disabled players in order to empower collaborative digital gaming between the two. Our approach relies on embroidered force-sensitive resistors (FSRs) embedded into armbands, which outperform the state-of-the-art in terms of sensitivity to low applied forces (0 to 5 N). Such low forces are of key significance to this application, given the diverse physical abilities of the players. With a focus on effective gameplay, we further explore the sensor's touch-detection performance, study the effect of the armband fabric selection, and optimize the sensor's placement upon the arm. Our results: (a) demonstrate a 4.4-times improvement in sensitivity to low forces compared to the most sensitive embroidered FSR reported to date, (b) confirm the sensor's ability to empower touch-based collaborative digital gaming for individuals with diverse physical abilities, and (c) provide parametric studies for the future development of diverse sensing solutions and game applications.

Quantifying Cognitive Workload Using a Non-Contact Magnetocardiography (MCG) Wearable Sensor.

Quantifying cognitive workload, i.e., the level of mental effort put forth by an individual in response to a cognitive task, is relevant for healthcare, training and gaming applications. However, there is currently no technology available that can readily and reliably quantify the cognitive workload of an individual in a real-world environment at a seamless way and affordable price. In this work, we overcome these limitations and demonstrate the feasibility of a magnetocardiography (MCG) sensor to reliably classify high vs. low cognitive workload while being non-contact, fully passive and low-cost, with the potential to have a wearable form factor. The operating principle relies on measuring the naturally emanated magnetic fields from the heart and subsequently analyzing the heart rate variability (HRV) matrix in three time-domain parameters: standard deviation of RR intervals (SDRR); root mean square of successive differences between heartbeats (RMSSD); and mean values of adjacent R-peaks in the cardiac signals (MeanRR). A total of 13 participants were recruited, two of whom were excluded due to low signal quality. The results show that SDRR and RMSSD achieve a 100% success rate in classifying high vs. low cognitive workload, while MeanRR achieves a 91% success rate. Tests for the same individual yield an intra-subject classification accuracy of 100% for all three HRV parameters. Future studies should leverage machine learning and advanced digital signal processing to achieve automated classification of cognitive workload and reliable operation in a natural environment.

Quarter-Wave Plates to Improve Rotational Misalignment Robustness in Medical Telemetry.

A major challenge in developing robust wireless links to implanted/ingestible antennas is the potential for rotational misalignment. In this paper, we present an artificially anisotropic quarter-wave plate (QWP) capable of developing a circularly polarized wave from a linearly polarized wave. Without loss of generality, our QWP is composed of plastic and hydrogel, while the linearly polarized wave is developed by a bio-matched antenna-a high gain, broadband antenna with a dielectric engineered to match to biological tissues. Using a basic implanted patch antenna, we demonstrate a 1.00 dB (1.26) variance in transmission coefficient over a 90° variance, with a remarkable average measured transmission coefficient of -34.4 dB (3.63 × 10-4 ) at 2.4 GHz. Without the QWP, the rotational variance is 12.52 dB (17.9). Notably, the QWP increases the maximum input power to comply with specific absorption rate limitations. In our case, this allows for -15.0 dBm (31.6 µW) of power to be received by the implant, which is comparable to the -15.7 dBm (26.9 µW) received without the QWP. Additionally, we demonstrate that with the QWP, the standard deviation from the mean transmission for rotational misalignments remains below 3 dB (2.00) from 2 to 3.62 GHz, resulting in a simulated 57.7% fractional bandwidth. © 2021 Bioelectromagnetics Society.

A Novel Method of Transmission Enhancement and Misalignment Mitigation between Implant and External Antennas for Efficient Biopotential Sensing.

The idea of passive biosensing through inductive coupling between antennas has been of recent interest. Passive sensing systems have the advantages of flexibility, wearability, and unobtrusiveness. However, it is difficult to build such systems having good transmission performance. Moreover, their near-field coupling makes them sensitive to misalignment and movements. In this work, to enhance transmission between two antennas, we investigate the effect of superstrates and metamaterials and propose the idea of dielectric fill in between the antenna and the superstrate. Preliminary studies show that the proposed method can increase transmission between a pair of antennas significantly. Specifically, transmission increase of ≈5 dB in free space and ≈8 dB in lossy media have been observed. Next, an analysis on a representative passive neurosensing system with realistic biological tissues shows very low transmission loss, as well as considerably better performance than the state-of-the-art systems. Apart from transmission enhancement, the proposed technique can significantly mitigate performance degradation due to misalignment of the external antenna, which is confirmed through suitable sensitivity analysis. Overall, the proposed idea can have fascinating prospects in the field of biopotential sensing for different biomedical applications.

Wireless Wearables and Implants: A Dosimetry Review.

Wireless wearable and implantable devices are continuing to grow in popularity, and as this growth occurs, so too does the need to consider the safety of such devices. Wearable and implantable devices require the transmitting and receiving of electromagnetic waves near and through the body, which at high enough exposure levels may damage proximate tissues. The specific absorption rate (SAR) is the quantity commonly used to enumerate exposure levels, and various national and international organizations have defined regulations limiting exposure to ensure safe operation. In this paper, we comprehensively review dosimetric studies reported in the literature up to the year 2019 for wearables and implants. We discuss antenna designs for wearables and implants as they relate to SAR values and field and thermal distributions in tissue, present designs that have made steps to reduce SAR, and then review SAR considerations as they relate to applied devices. As compared with previous review papers, this paper is the first review to focus on dosimetry aspects relative to wearable and implantable devices. Bioelectromagnetics. 2020;41:3-20 © 2019 The Authors. Bioelectromagnetics published by Wiley Periodicals, Inc.

Modeling Fabric Movement for Future E-Textile Sensors.

Studies with e-textile sensors embedded in garments are typically performed on static and controlled phantom models that do not reflect the dynamic nature of wearables. Instead, our objective was to understand the noise e-textile sensors would experience during real-world scenarios. Three types of sleeves, made of loose, tight, and stretchy fabrics, were applied to a phantom arm, and the corresponding fabric movement was measured in three dimensions using physical markers and image-processing software. Our results showed that the stretchy fabrics allowed for the most consistent and predictable clothing-movement (average displacement of up to -2.3 ± 0.1 cm), followed by tight fabrics (up to -4.7 ± 0.2 cm), and loose fabrics (up to -3.6 ± 1.0 cm). In addition, the results demonstrated better performance of higher elasticity (average displacement of up to -2.3 ± 0.1 cm) over lower elasticity (average displacement of up to -3.8 ± 0.3 cm) stretchy fabrics. For a case study with an e-textile sensor that relies on wearable loops to monitor joint flexion, our modeling indicated errors as high as 65.7° for stretchy fabric with higher elasticity. The results from this study can (a) help quantify errors of e-textile sensors operating "in-the-wild," (b) inform decisions regarding the optimal type of clothing-material used, and (c) ultimately empower studies on noise calibration for diverse e-textile sensing applications.

Stray energy transfer during endoscopy.

INTRODUCTION: Endoscopy is the standard tool for the evaluation and treatment of gastrointestinal disorders. While the risk of complication is low, the use of energy devices can increase complications by 100-fold. The mechanism of increased injury and presence of stray energy is unknown. The purpose of the study was to determine if stray energy transfer occurs during endoscopy and if so, to define strategies to minimize the risk of energy complications. METHODS AND PROCEDURES: A gastroscope was introduced into the stomach of an anesthetized pig. A monopolar generator delivered energy for 5 s to a snare without contacting tissue or the endoscope itself. The endoscope tip orientation, energy device type, power level, energy mode, and generator type were varied to mimic in vivo use. The primary outcome (stray current) was quantified as the change in tissue temperature (°C) from baseline at the tissue closest to the tip of the endoscope. Data were reported as mean ± standard deviation. RESULTS: Using the 60 W coag mode while changing the orientation of the endoscope tip, tissue temperature increased by 12.1 ± 3.5 °C nearest the camera lens (p < 0.001 vs. all others), 2.1 ± 0.8 °C nearest the light lens, and 1.7 ± 0.4 °C nearest the working channel. Measuring temperature at the camera lens, reducing power to 30 W (9.5 ± 0.8 °C) and 15 W (8.0 ± 0.8 °C) decreased stray energy transfer (p = 0.04 and p = 0.002, respectively) as did utilizing the low-voltage cut mode (6.6 ± 0.5 °C, p < 0.001). An impedance-monitoring generator significantly decreased the energy transfer compared to a standard generator (1.5 ± 3.5 °C vs. 9.5 ± 0.8 °C, p < 0.001). CONCLUSION: Stray energy is transferred within the endoscope during the activation of common energy devices. This could result in post-polypectomy syndrome, bleeding, or perforation outside of the endoscopist's view. Decreasing the power, utilizing low-voltage modes and/or an impedance-monitoring generator can decrease the risk of complication.

Enhanced Microwave Hyperthermia of Cancer Cells with Fullerene.

Hyperthermia generated with various energy sources including microwave has been widely studied for cancer treatment. However, the potential damage due to nontargeted heating of normal tissue is a major hurdle to its widespread application. Fullerene is a potential agent for improving cancer therapy with microwave hyperthermia but is limited by its poor solubility in water for biomedical applications. Here we report a combination therapy for enhanced cancer cell destruction by combining microwave heating with C60-PCNPs consisting of fullerene (C60) encapsulated in Pluronic F127-chitosan nanoparticles (PCNPs) with high water solubility. A cell culture dish integrated with an antenna was fabricated to generate microwave (2.7 GHz) for heating PC-3 human prostate cancer cells either with or without the C60-PCNPs. The cell viability data show that the C60-PCNPs alone have minimal cytotoxicity. The combination of microwave heating and C60-PCNPs is significantly more effective than the microwave heating alone in killing the cancer cells (7.5 versus 42.2% cell survival). Moreover, the combination of microwave heating and C60-PCNPs is significantly more destructive to the cancer cells than the combination of simple water-bath heating (with a similar thermal history to microwave heating) and C60-PCNPs (7.5 versus 32.5% survival) because the C60 in the many nanoparticles taken up by the cells can absorb the microwave energy and convert it into heat to enhance heating inside the cells under microwave irradiation. These data suggest the great potential of targeted heating via fullerene for enhanced cancer treatment by microwave hyperthermia.

Stiffness-Independent Highly Efficient On-Chip Extraction of Cell-Laden Hydrogel Microcapsules from Oil Emulsion into Aqueous Solution by Dielectrophoresis.

A dielectrophoresis (DEP)-based method achieves highly efficient on-chip extraction of cell-laden microcapsules of any stiffness from oil into aqueous solution. The hydrogel microcapsules can be extracted into the aqueous solution by DEP and interfacial tension forces with no trapped oil, while the encapsulated cells are free from electrical damage due to the Faraday cage effect.

Implantable and ingestible medical devices with wireless telemetry functionalities: a review of current status and challenges.

Wireless medical telemetry permits the measurement of physiological signals at a distance through wireless technologies. One of the latest applications is in the field of implantable and ingestible medical devices (IIMDs) with integrated antennas for wireless radiofrequency (RF) communication (telemetry) with exterior monitoring/control equipment. Implantable medical devices (MDs) perform an expanding variety of diagnostic and therapeutic functions, while ingestible MDs receive significant attention in gastrointestinal endoscopy. Design of such wireless IIMD telemetry systems is highly intriguing and deals with issues related to: operation frequency selection, electronics and powering, antenna design and performance, and modeling of the wireless channel. In this paper, we attempt to comparatively review the current status and challenges of IIMDs with wireless telemetry functionalities. Full solutions of commercial IIMDs are also recorded. The objective is to provide a comprehensive reference for scientists and developers in the field, while indicating directions for future research.

Characterizing the dispersion behavior of poly-atomic magnetic metamaterials.

The propagation of magnetoinductive (MI) waves across magnetic metamaterials known as magnetoinductive waveguides (MIWs) has been an area of interest for many applications due to the flexible design and low-loss performance in challenging radio-frequency (RF) environments. Thus far, the dispersion behavior of MIWs has been limited to mono- and diatomic geometries. In this work, we present a recursive method to generate the dispersion equation for a general poly-atomic MIW. This recursive method greatly simplifies the ability to create closed-form dispersion equations for unique poly-atomic MIW geometries versus the previous method. To demonstrate, four MIW geometries that have been selected for their unique symmetries are analyzed using the recursive method. Using applicable simplifications brought on by the geometric symmetries, a closed-form dispersion equation is reported for each case. The equations are then validated numerically and show excellent agreement in all four cases. This work simultaneously aids in the further development of MIW theory and offers new avenues for MIW design in the presented dispersion equations.

Numerical assessment of the performance of a scalp-implantable antenna: effects of head anatomy and dielectric parameters.

We numerically assess the effects of head properties (anatomy and dielectric parameters) on the performance of a scalp-implantable antenna for telemetry in the Medical Implant Communications Service band (402.0-405.0 MHz). Safety issues and performance (resonance, radiation) are analyzed for an experimentally validated implantable antenna (volume of 203.6 mm(3) ), considering five head models (3- and 5-layer spherical, 6-, 10-, and 13-tissue anatomical) and seven scenarios (variations ± 20% in the reference permittivity and conductivity values). Simulations are carried out at 403.5 MHz using the finite-difference time-domain method. Anatomy of the head model around the implantation site is found to mainly affect antenna performance, whereas overall tissue anatomy and dielectric parameters are less significant. Compared to the reference dielectric parameter scenario within the 3-layer spherical head, maximum variations of -19.9%, +3.7%, -55.1%, and -39.2% are computed in the maximum allowable net input power imposed by the IEEE Std C95.1-1999 and Std C95.1-2005 safety guidelines, return loss, and maximum far-field gain, respectively. Compliance with the recent IEEE Std C95.1-2005 is found to be almost insensitive to head properties, in contrast with IEEE Std C95.1-1999. Taking tissue property uncertainties into account is highlighted as crucial for implantable antenna design and performance assessment. Bioelectromagnetics 34:167-179, 2013. © 2012 Wiley Periodicals, Inc.

A Stretchable, Conductive Thread-Based Sensor Towards Wearable Monitoring of Muscle Atrophy.

OBJECTIVE: We present the first wearable sensor designed for frequent monitoring of muscle atrophy and validate performance upon canonical phantoms. METHODS: Our approach relies on Faraday's law of induction and exploits the dependence of magnetic flux density on cross-sectional area. We employ wrap-around transmit and receive coils that stretch to fit changing limb sizes using conductive threads (e-threads) in a novel zig zag pattern. Changes in the loop size result in changes in the magnitude and phase of the transmission coefficient between loops. RESULTS: Simulation and in vitro measurement results are in excellent agreement. As a proof-of-concept, a cylindrical calf model for an average-sized subject is considered. The frequency of 60 MHz is selected via simulation for optimal limb size resolution in magnitude and phase while remaining in the inductive mode of operation. We can monitor muscle volume loss of up to 51%, with an approximate resolution of 0.17 dB and 1.58° per 1% volume loss. In terms of muscle circumference, we achieve resolution of 0.75 dB and 6.7° per centimeter. Thus, we can monitor small-scale changes in overall limb size. CONCLUSION: This is the first known approach for monitoring muscle atrophy with a sensor designed to be worn. Additionally, this work brings forward innovations in creating stretchable electronics from e-threads (as opposed to inks, liquid metal, or polymer). SIGNIFICANCE: The proposed sensor will provide improved monitoring for patients suffering from muscle atrophy. The stretching mechanism can be seamlessly integrated into garments which creates unprecedented opportunities for future wearable devices.

Development of a Coherent Model for Radiometric Core Body Temperature Sensing.

This paper examines the utility of a wideband, physics-based model to determine human core body or brain temperature via microwave radiometry. Pennes's bioheat equation is applied to a six-layer human head model to generate the expected layered temperature profile during the development of a fever. The resulting temperature profile is fed into the forward electromagnetic (EM) model to determine the emitted brightness temperature at various points in time. To accurately retrieve physical temperature via radiometry, the utilized model must incorporate population variation statistics and cover a wide frequency band. The effect of human population variation on emitted brightness temperature is studied by varying the relevant thermal and EM parameters, and brightness temperature emissions are simulated from 0.1 MHz to 10 GHz. A Monte Carlo simulation combined with literature-derived statistical distributions for the thermal and EM parameters is performed to analyze population-level variation in resulting brightness temperature. Variation in thermal parameters affects the offset of the resulting brightness temperature signature, while EM parameter variation shifts the key maxima and minima of the signature. The layering of high and low permittivity layers creates these key maxima and minima via wave interference. This study is one of the first to apply a coherent model to and the first to examine the effect of population-representative variable distributions on radiometry for core temperature measurement. These results better inform the development of an on-body radiometer useful for core body temperature measurement across the human population.

A Core Body Temperature Retrieval Method for Microwave Radiometry when Tissue Permittivity is Unknown.

This paper presents a novel method for core temperature retrieval using microwave radiometry when complex permittivity and heat transfer parameters of the tissue layers of the human subject are unknown. Previous works present methods for core temperature retrieval, but these methods do not account for population variation in the relevant electromagnetic and thermal parameters, which can increase measurement error beyond the clinically acceptable limit of 0.5°C. Pennes' bioheat model of a six-tissue-layer human head model combined with a coherent electromagnetic model simulate experimental data. To retrieve core temperature, nonlinear least squares optimization is then used to minimize the difference between the simulated experimental data and an exponential model for physical temperature and the coherent electromagnetic model. By using 20 frequencies spanning from 1-5 GHz, core temperature is retrieved while accounting for population variation in the permittivity and thermal parameters. A Monte Carlo simulation in which the thermal parameters and permittivity vary according to literature-derived, population-representative distributions and the core body temperature varies from 18-46°C is used to assess the utility of the retrieval method. Different antenna patterns are tested to explore the effect on retrieval accuracy. The retrieval method has a retrieval error of <0.1°C when only the thermal parameters are unknown and a retrieval error of <0.5°C when the thermal parameters and permittivity are unknown, which is within the clinically acceptable error range of 0.5°C. These results help progress the field of medical microwave radiometry toward being a clinically viable noninvasive measurement that is accurate when measuring all patients.

Toward Non-Invasive Core Body Temperature Sensing.

This paper aims to explore the potential of a novel radiometry technique that leverages bio-matched antennas (BMAs), broadband measurements, and forward modeling of layered tissues for non-invasive and accurate core temperature monitoring. Our approach relies on the observation that electromagnetic waves penetrate to different depths depending on their frequency and dielectric properties of the medium and adapts radiative transfer models that have been successfully implemented in the past for layered geophysical media. Preliminary modeling and experimental results confirm feasibility.