Emerging Modalities and Implantable Technologies for Neuromodulation.

Techniques for neuromodulation serve as effective routes to care of patients with many types of challenging conditions. Continued progress in this field of medicine will require (1) improvements in our understanding of the mechanisms of neural control over organ function and (2) advances in technologies for precisely modulating these functions in a programmable manner. This review presents recent research on devices that are relevant to both of these goals, with an emphasis on multimodal operation, miniaturized dimensions, biocompatible designs, advanced neural interface schemes, and battery-free, wireless capabilities. A future that involves recording and modulating neural activity with such systems, including those that exploit closed-loop strategies and/or bioresorbable designs, seems increasingly within reach.

Materials for flexible bioelectronic systems as chronic neural interfaces.

Engineered systems that can serve as chronically stable, high-performance electronic recording and stimulation interfaces to the brain and other parts of the nervous system, with cellular-level resolution across macroscopic areas, are of broad interest to the neuroscience and biomedical communities. Challenges remain in the development of biocompatible materials and the design of flexible implants for these purposes, where ulimate goals are for performance attributes approaching those of conventional wafer-based technologies and for operational timescales reaching the human lifespan. This Review summarizes recent advances in this field, with emphasis on active and passive constituent materials, design architectures and integration methods that support necessary levels of biocompatibility, electronic functionality, long-term stable operation in biofluids and reliability for use in vivo. Bioelectronic systems that enable multiplexed electrophysiological mapping across large areas at high spatiotemporal resolution are surveyed, with a particular focus on those with proven chronic stability in live animal models and scalability to thousands of channels over human-brain-scale dimensions. Research in materials science will continue to underpin progress in this field of study.

Submillimeter-scale multimaterial terrestrial robots.

Robots with submillimeter dimensions are of interest for applications that range from tools for minimally invasive surgical procedures in clinical medicine to vehicles for manipulating cells/tissues in biology research. The limited classes of structures and materials that can be used in such robots, however, create challenges in achieving desired performance parameters and modes of operation. Here, we introduce approaches in manufacturing and actuation that address these constraints to enable untethered, terrestrial robots with complex, three-dimensional (3D) geometries and heterogeneous material construction. The manufacturing procedure exploits controlled mechanical buckling to create 3D multimaterial structures in layouts that range from arrays of filaments and origami constructs to biomimetic configurations and others. A balance of forces associated with a one-way shape memory alloy and the elastic resilience of an encapsulating shell provides the basis for reversible deformations of these structures. Modes of locomotion and manipulation span from bending, twisting, and expansion upon global heating to linear/curvilinear crawling, walking, turning, and jumping upon laser-induced local thermal actuation. Photonic structures such as retroreflectors and colorimetric sensing materials support simple forms of wireless monitoring and localization. These collective advances in materials, manufacturing, actuation, and sensing add to a growing body of capabilities in this emerging field of technology.

Recent Advances in Materials, Devices, and Systems for Neural Interfaces.

Technologies capable of establishing intimate, long-lived optical/electrical interfaces to neural systems will play critical roles in neuroscience research and in the development of nonpharmacological treatments for neurological disorders. The development of high-density interfaces to 3D populations of neurons across entire tissue systems in living animals, including human subjects, represents a grand challenge for the field, where advanced biocompatible materials and engineered structures for electrodes and light emitters will be essential. This review summarizes recent progress in these directions, with an emphasis on the most promising demonstrated concepts, materials, devices, and systems. The article begins with an overview of electrode materials with enhanced electrical and/or mechanical performance, in forms ranging from planar films, to micro/nanostructured surfaces, to 3D porous frameworks and soft composites. Subsequent sections highlight integration with active materials and components for multiplexed addressing, local amplification, wireless data transmission, and power harvesting, with multimodal operation in soft, shape-conformal systems. These advances establish the foundations for scalable architectures in optical/electrical neural interfaces of the future, where a blurring of the lines between biotic and abiotic systems will catalyze profound progress in neuroscience research and in human health/well-being.

Ultrathin Trilayer Assemblies as Long-Lived Barriers against Water and Ion Penetration in Flexible Bioelectronic Systems.

Biomedical implants that incorporate active electronics and offer the ability to operate in a safe, stable fashion for long periods of time must incorporate defect-free layers as barriers to biofluid penetration. This paper reports an engineered material approach to this challenge that combines ultrathin, physically transferred films of silicon dioxide (t-SiO2) thermally grown on silicon wafers, with layers of hafnium oxide (HfO2) formed by atomic layer deposition and coatings of parylene (Parylene C) created by chemical vapor deposition, as a dual-sided encapsulation structure for flexible bioelectronic systems. Accelerated aging tests on passive/active components in platforms that incorporate active, silicon-based transistors suggest that this trilayer construct can serve as a robust, long-lived, defect-free barrier to phosphate-buffered saline (PBS) solution at a physiological pH of 7.4. Reactive diffusion modeling and systematic immersion experiments highlight fundamental aspects of water diffusion and hydrolysis behaviors, with results that suggest lifetimes of many decades at physiological conditions. A combination of ion-diffusion tests under continuous electrical bias, measurements of elemental concentration profiles, and temperature-dependent simulations reveals that this encapsulation strategy can also block transport of ions that would otherwise degrade the performance of the underlying electronics. These findings suggest broad utility of this trilayer assembly as a reliable encapsulation strategy for the most demanding applications in chronic biomedical implants and high-performance flexible bioelectronic systems.

Patients' attitudes towards online dental information and a web-based virtual reality program for clinical dentistry: a pilot investigation in China.

OBJECTIVES: This research investigated (1) the attitudes of dental patients toward searching online for dental information and (2) patients attitudes and expectations towards a web-based 3D virtual reality program for clinical dentistry. METHODS: A questionnaire survey was conducted in six clinics across two cities in China. Dental patients visiting the six clinics were invited to participate in the study. All subjects browsed a webpage containing the 3D virtual reality dental program. The new media was supplemented as a consultive system for patients into the traditional pattern of seeking dental care procedure. Subjects then completed a questionnaire detailing their attitudes toward their experience with the software. The questionnaire responses were then collected and analyzed. RESULTS: 45% of respondents reported having searched information online before receiving dental care. Respondents held different attitudes towards the online dental information, with a majority reporting a reliance on it but with reservations. Over 50% of respondents held positive attitudes to the web-based virtual reality dental information program, while 21% reported negative views toward the new method. Most respondents reported that the web-based virtual reality program was superior to traditional static web pages, but only as a supplementary material. Respondents also indicated that internet speed may likely be a major determinant to their future usage of such a system. CONCLUSIONS: These findings indicate that a considerable portion of respondents conduct their own internet searches for related dental information before seeking professional advice on dental care. Most of the respondents reported positive attitudes towards a web-based virtual reality program for clinical dentistry. However, the current speed of internet connections in China is a major area of concern for the future application and uptake of web-based virtual reality dental software.