Ultra-Compact Pulse Charger for Lithium Polymer Battery with Simple Built-in Resistance Compensation in Biomedical Applications.

Active implantable medical devices (AIMDs) rely on batteries for uninterrupted operation and patient safety. Therefore, it is critical to ensure battery safety and longevity. To achieve this, constant current/constant voltage (CC/CV) methods have been commonly used and research has been conducted to compensate for the effects of built-in resistance (BIR) of batteries. However, conventional CC/CV methods may pose the risk of lithium plating. Furthermore, conventional compensation methods for BIR require external components, complex algorithms, or large chip sizes, which inhibit the miniaturization and integration of AIMDs. To address this issue, we have developed a pulse charger that utilizes pulse current to ensure battery safety and facilitate easy compensation for BIR. A comparison with previous research on BIR compensation shows that our approach achieves the smallest chip size of 0.0062 mm2 and the lowest system complexity using 1-bit ADC. In addition, we have demonstrated a reduction in charging time by at least 44.4% compared to conventional CC/CV methods, validating the effectiveness of our system's BIR compensation. The compact size and safety features of the proposed charging system make it promising for AIMDs, which have space-constrained environments.

Strain-invariant stretchable radio-frequency electronics.

Wireless modules that provide telecommunications and power-harvesting capabilities enabled by radio-frequency (RF) electronics are vital components of skin-interfaced stretchable electronics1-7. However, recent studies on stretchable RF components have demonstrated that substantial changes in electrical properties, such as a shift in the antenna resonance frequency, occur even under relatively low elastic strains8-15. Such changes lead directly to greatly reduced wireless signal strength or power-transfer efficiency in stretchable systems, particularly in physically dynamic environments such as the surface of the skin. Here we present strain-invariant stretchable RF electronics capable of completely maintaining the original RF properties under various elastic strains using a 'dielectro-elastic' material as the substrate. Dielectro-elastic materials have physically tunable dielectric properties that effectively avert frequency shifts arising in interfacing RF electronics. Compared with conventional stretchable substrate materials, our material has superior electrical, mechanical and thermal properties that are suitable for high-performance stretchable RF electronics. In this paper, we describe the materials, fabrication and design strategies that serve as the foundation for enabling the strain-invariant behaviour of key RF components based on experimental and computational studies. Finally, we present a set of skin-interfaced wireless healthcare monitors based on strain-invariant stretchable RF electronics with a wireless operational distance of up to 30 m under strain.

Efficient Distributed Wireless Power Transfer System for Multiple Wearable Sensors through Textile Coil Array.

When it is necessary to detect various physiological signals of the human body, clothing embroidered with near-field effect patterns can be used as a long-term power supply medium to supply power to long-distance transmitters and receivers to form a wireless power supply system. The proposed system uses an optimized parallel circuit to achieve a power transfer efficiency of more than five times higher than that of the existing series circuit. The power transfer efficiency of simultaneously supplying energy to multiple sensors is increased higher than five times and even more when only one sensor is coupled. When powering eight sensors at the same time, the power transmission efficiency can reach 25.1%. Even when eight sensors powered by the coupled textile coils are reduced to one, the power transfer efficiency of the whole system can reach 13.21%. Additionally, the proposed system is also applicable when the number of sensors ranges from 2 to 12.

Full-duplex enabled wireless power transfer system via textile for miniaturized IMD.

Full-duplex (FD) enabled wireless power transfer (WPT) system via textile for miniaturized IMD is presented. By utilizing the battery-free near-field communication (NFC) method, the system realizes wireless power and data transmission without a bulky battery or energy harvester which can diminish the physical size of implantable medical device (IMD). Moreover, using textile as a medium of power transmission, the system overcomes the drawback and extends the limited effective range of the NFC method. In addition, as realizing simultaneous bidirectional data transmission over a single data channel, IMD has been further miniaturized. The proposed system including an external transmitter and the minimized IMD receiver supports 200 kbps and 50 kbps data rates for FSK downlink and LSK uplink telemetries at the same time with bit error rate (BER) of < 8 × 10 - 5 and < 4 × 10 - 5 , respectively. The measured power transfer efficiency (PTE) and DC-to-DC power delivered to load (PDL) are 5.77% and 64 mW at 0.5/60 cm of vertical/horizontal distance.

A Software-Defined Radio Receiver for Wireless Recording From Freely Behaving Animals.

To eliminate tethering effects on the small animals' behavior during electrophysiology experiments, such as neural interfacing, a robust and wideband wireless data link is needed for communicating with the implanted sensing elements without blind spots. We present a software-defined radio (SDR) based scalable data acquisition system, which can be programmed to provide coverage over standard-sized or customized experimental arenas. The incoming RF signal with the highest power among SDRs is selected in real-time to prevent data loss in the presence of spatial and angular misalignments between the transmitter (Tx) and receiver (Rx) antennas. A 32-channel wireless neural recording system-on-a-chip (SoC), known as WINeRS-8, is embedded in a headstage and transmits digitalized raw neural signals, which are sampled at 25 kHz/ch, at 9 Mbps via on-off keying (OOK) of a 434 MHz RF carrier. Measurement results show that the dual-SDR Rx system reduces the packet loss down to 0.12%, on average, by eliminating the blind spots caused by the moving Tx directionality. The system operation is verified in vivo on a freely behaving rat and compared with a commercial hardwired system.

Integration of bulk materials with two-dimensional materials for physical coupling and applications.

Hybrid heterostructures are essential for functional device systems. The advent of 2D materials has broadened the material set beyond conventional 3D material-based heterostructures. It has triggered the fundamental investigation and use in applications of new coupling phenomena between 3D bulk materials and 2D atomic layers that have unique van der Waals features. Here we review the state-of-the-art fabrication of 2D and 3D heterostructures, present a critical survey of unique phenomena arising from forming 3D/2D interfaces, and introduce their applications. We also discuss potential directions for research based on these new coupled architectures.

A mm-Sized Free-Floating Wirelessly Powered Implantable Optical Stimulation Device.

This paper presents a mm-sized, free-floating, wirelessly powered, implantable optical stimulation (FF-WIOS) device for untethered optogenetic neuromodulation. A resonator-based three-coil inductive link creates a homogeneous magnetic field that continuously delivers sufficient power (>2.7 mW) at an optimal carrier frequency of 60 MHz to the FF-WIOS in the near field without surpassing the specific absorption rate limit, regardless of the position of the FF-WIOS in a large brain area. Forward data telemetry carries stimulation parameters by on-off-keying the power carrier at a data rate of 50 kb/s to selectively activate a 4 × 4 µLED array. Load-shift-keying back telemetry controls the wireless power transmission by reporting the FF-WIOS received power level in a closed-loop power control mechanism. LEDs typically require high instantaneous power to emit sufficient light for optical stimulation. Thus, a switched-capacitor-based stimulation architecture is used as an energy storage buffer with one off-chip capacitor to receive charge directly from the inductive link and deliver it to the selected µLED at the onset of stimulation. The FF-WIOS system-on-a-chip prototype, fabricated in a 0.35-µm standard CMOS process, charges a 10-µF capacitor up to 5 V with 37% efficiency and passes instantaneous current spikes up to 10 mA in the selected µLED, creating a bright exponentially decaying flash with minimal wasted power. An in vivo experiment was conducted to verify the efficacy of the FF-WIOS by observing light-evoked local field potentials and immunostained tissue response from the primary visual cortex (V1) of two anesthetized rats.

An Inductively-Powered Wireless Neural Recording and Stimulation System for Freely-Behaving Animals.

An inductively-powered wireless integrated neural recording and stimulation (WINeRS-8) system-on-a-chip (SoC) that is compatible with the EnerCage-HC2 for wireless/battery-less operation has been presented for neuroscience experiments on freely behaving animals. WINeRS-8 includes a 32-ch recording analog front end, a 4-ch current-controlled stimulator, and a 434 MHz on - off keying data link to an external software- defined radio wideband receiver (Rx). The headstage also has a bluetooth low energy link for controlling the SoC. WINeRS-8/EnerCage-HC2 systems form a bidirectional wireless and battery-less neural interface within a standard homecage, which can support longitudinal experiments in an enriched environment. Both systems were verified in vivo on rat animal model, and the recorded signals were compared with hardwired and battery-powered recording results. Realtime stimulation and recording verified the system's potential for bidirectional neural interfacing within the homecage, while continuously delivering 35 mW to the hybrid WINeRS-8 headstage over an unlimited period.

Wireless opto-electro neural interface for experiments with small freely behaving animals.

OBJECTIVE: We have developed a wireless opto-electro interface (WOENI) device, which combines electrocorticogram (ECoG) recording and optical stimulation for bi-directional neuromodulation on small, freely behaving animals, such as rodents. APPROACH: The device is comprised of two components, a detachable headstage and an implantable polyimide-based substrate. The headstage establishes a bluetooth low energy (BLE) bi-directional data communication with an external custom-designed USB dongle for receiving user commands and optogenetic stimulation patterns, and sending digitalized ECoG data. MAIN RESULTS: The functionality and stability of the device were evaluated in vivo on freely behaving rats. When the animal received optical stimulation on the primary visual cortex (V1) and visual stimulation via eyes, spontaneous changes in ECoG signals were recorded from both left and right V1 during four consecutive experiments with 7 d intervals over a time span of 21 d following device implantation. Immunostained tissue analyses showed results consistent with ECoG analyses, validating the efficacy of optical stimulation to upregulate the activity of cortical neurons expressing ChR2. SIGNIFICANCE: The proposed WOENI device is potentially a versatile tool in the studies that involve long-term optogenetic neuromodulation.

An Implantable Peripheral Nerve Recording and Stimulation System for Experiments on Freely Moving Animal Subjects.

A new study with rat sciatic nerve model for peripheral nerve interfacing is presented using a fully-implanted inductively-powered recording and stimulation system in a wirelessly-powered standard homecage that allows animal subjects move freely within the homecage. The Wireless Implantable Neural Recording and Stimulation (WINeRS) system offers 32-channel peripheral nerve recording and 4-channel current-controlled stimulation capabilities in a 3 × 1.5 × 0.5 cm3 package. A bi-directional data link is established by on-off keying pulse-position modulation (OOK-PPM) in near field for narrow-band downlink and 433 MHz OOK for wideband uplink. An external wideband receiver is designed by adopting a commercial software defined radio (SDR) for a robust wideband data acquisition on a PC. The WINeRS-8 prototypes in two forms of battery-powered headstage and wirelessly-powered implant are validated in vivo, and compared with a commercial system. In the animal study, evoked compound action potentials were recorded to verify the stimulation and recording capabilities of the WINeRS-8 system with 32-ch penetrating and 4-ch cuff electrodes on the sciatic nerve of awake freely-behaving rats. Compared to the conventional battery-powered system, WINeRS can be used in closed-loop recording and stimulation experiments over extended periods without adding the burden of carrying batteries on the animal subject or interrupting the experiment.

Optimal Design of a Resonance-Based Voltage Boosting Rectifier for Wireless Power Transmission.

This paper presents the design procedure for a new multi-cycle resonance-based voltage boosting rectifier (MCRR) capable of delivering a desired amount of power to the load (PDL) at a designated high voltage (HV) through a loosely-coupled inductive link. This is achieved by shorting the receiver (Rx) LC-tank for several cycles to harvest and accumulate the wireless energy in the RX inductor before boosting the voltage by breaking the loop and transferring the energy to the load in a quarter cycle. By optimizing the geometries of the transmitter (Tx) and Rx coils and the number of cycles, N, for energy harvesting, through an iterative design procedure, the MCRR can achieve the highest PDL under a given set of design constraints. Governing equations in the MCRR operation are derived to identify key specifications and the design guidelines. Using an exemplary set of specs, the optimized MCRR was able to generate 20.9 VDC across a 100 kΩ load from a 1.8 Vp, 6.78 MHz sinusoid input in the ISM-band at a Tx/Rx coil separation of 1.3 cm, power transfer efficiency (PTE) of 2.2%, and N = 9 cycles. At the same coil distance and loading, coils optimized for a conventional half-wave rectifier (CHWR) were able to reach only 13.6 VDC from the same source.

Distributed Coordination for Optimal Energy Generation and Distribution in Cyber-Physical Energy Networks.

This paper proposes three coordination laws for optimal energy generation and distribution in energy network, which is composed of physical flow layer and cyber communication layer. The physical energy flows through the physical layer; but all the energies are coordinated to generate and flow by distributed coordination algorithms on the basis of communication information. First, distributed energy generation and energy distribution laws are proposed in a decoupled manner without considering the interactive characteristics between the energy generation and energy distribution. Second, a joint coordination law to treat the energy generation and energy distribution in a coupled manner taking account of the interactive characteristics is designed. Third, to handle over- or less-energy generation cases, an energy distribution law for networks with batteries is designed. The coordination laws proposed in this paper are fully distributed in the sense that they are decided optimally only using relative information among neighboring nodes. Through numerical simulations, the validity of the proposed distributed coordination laws is illustrated.

An Adaptive Averaging Low Noise Front-End for Central and Peripheral Nerve Recording.

An adaptive averaging low noise analog front-end (AFE) is presented for central and peripheral nerve recording applications. The proposed topology allows users to trade off, on the fly, between input referred noise and the number of channels via averaging. The new low noise amplifier (LNA) utilizes a complementary doubled input transconductance (g m ) topology to effectively increase the noise efficiency factor (NEF) without chopping or use of a costly BiCMOS process. It addresses a disadvantage of the doubled-g m technique by a high input impedance DC-coupled LNA and saves on-chip space for higher density by eliminating AC-coupling capacitors. The proposed technique is particularly suitable for ultra-low noise multichannel recording from the peripheral nervous system (PNS) with channel selection analog multiplexer, where input signal is in tens of µV. A 32-ch proof-of-concept-prototype AFE was fabricated in a 5M2P 130-nm standard CMOS process, occupying 2.4 × 2.5 mm2 together with its control block. The prototype LNA consumes 11 µW from a 1 V supply, providing 3.0 µVrms input referred noise with 61 ΜΩ input impedance, which are desirable for high SNR, to be further improved by the adaptive averaging technique.

The Clinical Significance of Lumbosacral Transitional Vertebrae on the Surgical Outcomes of Lumbar Discectomy: A Retrospective Cohort Study of Young Adults.

OBJECTIVE: To evaluate whether the presence of lumbosacral transitional vertebrae (LSTV) affects the clinical outcomes of microdiscectomy (MD) in young adults with lumbar disc herniation. METHODS: We retrospectively included 398 patients who were followed-up for at least 2 years after MD for lumbar disc herniation at L4/5 (disc above the LSTV). The patients were divided into 2 groups. Group A was made up of 31 patients in whom LSTV was detected. Group B, in contrast, was made up of 35 patients in whom LSTV was not detected. The LSTV were classified using plain radiographs and three-dimensional computed tomography by Castellvi et al. The primary outcome measure was pain intensity at each follow-up visit assessed with visual analog scale for back and leg. Secondary outcome measures included the Oswestry Disability Index, a 12-item short-form health survey for quality of life, complications, and recurrence rate. RESULTS: After surgery, the visual analog scale scores for the back and leg decreased significantly in both groups. However, the back pain intensity in group A worsened at 12 and 24 months postoperatively. The Oswestry Disability Index scores and 12-item short-form health survey (both mental and physical) worsened at 12 and 24 months postoperatively in group A. Two cases of reherniation (6.5 %) were observed in group A, who required reoperation. CONCLUSIONS: LSTV can limit a patient's clinical improvement after MD with regard to pain intensity and recurrence. Caution must be taken when a patient is scheduled to undergo surgery.

A Multi-Cycle Q-Modulation for Dynamic Optimization of Inductive Links.

This paper presents a new method, called multi-cycle Q-modulation, which can be used in wireless power transmission (WPT) to modulate the quality factor (Q) of the receiver (Rx) coil and dynamically optimize the load impedance to maximize the power transfer efficiency (PTE) in two-coil links. A key advantage of the proposed method is that it can be easily implemented using off-the-shelf components without requiring fast switching at or above the carrier frequency, which is more suitable for integrated circuit design. Moreover, the proposed technique does not need any sophisticated synchronization between the power carrier and Q-modulation switching pulses. The multi-cycle Q-modulation is analyzed theoretically by a lumped circuit model, and verified in simulation and measurement using an off-the-shelf prototype. Automatic resonance tuning (ART) in the Rx, combined with multi-cycle Q-modulation helped maximizing PTE of the inductive link dynamically in the presence of environmental and loading variations, which can otherwise significantly degrade the PTE in multi-coil settings. In the prototype conventional 2-coil link, the proposed method increased the power amplifier (PA) plus inductive link efficiency from 4.8% to 16.5% at (RL = 1 kΩ, d23 = 3 cm), and from 23% to 28.2% at (RL = 100 Ω, d23 = 3 cm) after 11% change in the resonance capacitance, while delivering 168.1 mW to the load (PDL).

An Inductively-Powered Wireless Neural Recording System with a Charge Sampling Analog Front-End.

An inductively-powered wireless integrated neural recording system (WINeR-7) is presented for wireless and battery less neural recording from freely-behaving animal subjects inside a wirelessly-powered standard homecage. The WINeR-7 system employs a novel wide-swing dual slope charge sampling (DSCS) analog front-end (AFE) architecture, which performs amplification, filtering, sampling, and analog-to-time conversion (ATC) with minimal interference and small amount of power. The output of the DSCS-AFE produces a pseudo-digital pulse width modulated (PWM) signal. A circular shift register (CSR) time division multiplexes (TDM) the PWM pulses to create a TDM-PWM signal, which is fed into an on-chip 915 MHz transmitter (Tx). The AFE and Tx are supplied at 1.8 V and 4.2 V, respectively, by a power management block, which includes a high efficiency active rectifier and automatic resonance tuning (ART), operating at 13.56 MHz. The 8-ch system-on-a-chip (SoC) was fabricated in a 0.35-µm CMOS process, occupying 5.0 × 2.5 mm2 and consumed 51.4 mW. For each channel, the sampling rate is 21.48 kHz and the power consumption is 19.3 µW. In vivo experiments were conducted on freely behaving rats in an energized homecage by continuously delivering 51.4 mW to the WINeR-7 system in a closed-loop fashion and recording local field potentials (LFP).

Three-Phase Time-Multiplexed Planar Power Transmission to Distributed Implants.

A platform has been presented for wireless powering of receivers (Rx's) that are arbitrarily distributed over a large area. A potential application could be powering of small Rx implants, distributed over large areas of the brain. The transmitter (Tx) consists of three overlapping layers of hexagonal planar spiral coils (hex-PSC) that are horizontally shifted to provide the strongest and most homogeneous electromagnetic flux coverage. The three-layer hex-PSC array is driven by a three-phase time-division-multiplexed power Tx that takes the advantage of the carrier phase shift, coil geometries, and Rx time constant to homogeneously power the arbitrarily distributed Rx's regardless of their misalignments. The functionality of the proposed three-phase power transmission concept has been verified in a detailed scaled-up high-frequency structure simulator Advanced Design System simulation model and measurement setup, and compared with a conventional Tx. The new Tx delivers 5.4 mW to each Rx and achieves, on average, 5.8% power transfer efficiency to the Rx at the worst case 90° angular misalignment, compared with 1.4% by the conventional Tx.

Radiologic Findings and Risk Factors of Adjacent Segment Degeneration after Anterior Cervical Discectomy and Fusion : A Retrospective Matched Cohort Study with 3-Year Follow-Up Using MRI.

OBJECTIVE: The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). METHODS: A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. RESULTS: Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. CONCLUSION: The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.

Comparison of Outcomes of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Microdiscectomy for Young Adults: A Retrospective Matched Cohort Study.

OBJECTIVE: There have been only a few studies on surgical treatment of lumbar disc herniation (LDH) in young adults. In addition, previous studies do not provide detailed information on the surgical outcomes for young adults with LDH. The purpose of this study was to compare the outcome of transforaminal percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy for active, young adults (age 20-25 years). METHODS: We performed retrospective chart and radiography. The patients were divided into 2 groups according to the surgical methods. Group A included the patients who underwent transforaminal PELD, and Group B included the patients who underwent open lumbar microdiscectomy for LDH at L4/5. After we matched for several factors, 32 young patients in group A and 34 young patients in group B were analyzed. We compared the outcomes between the 2 groups in terms of clinical, radiologic, perioperative outcomes, and surgery-related complications. RESULTS: The clinical results for leg pain and radiologic results for decompression were the same in both groups. Most of complications in the PELD group occurred in the early phase. The recurrence rate and operation failure rate was no difference between the groups. The PELD brought significant advantages in the following areas: back pain, operation time, blood loss, hospital stay, and return-to-work. CONCLUSIONS: Although a learning curve is needed in order to become familiar with PELD, PELD seemed to be a good choice for disc herniation in the lumbar spine for active, young adults.