Symposium N
Progress in Wearable/Wireless and Implantable Body Sensor Networks for Healthcare Applications

Session N-1 - Advances in Sensing Devices for Biomedical Monitoring

N-1:IL01  A Multisensor Platform for Metabolomics
D.R.S. CUMMMING, M. AL-RAWHANI, B.C. CHEAH, C. MARTIN, School of Engineering, Rankine Building, University of Glasgow, Glasgow, UK; M.P. BARRETT, A.I. MACDONALD, Institute of Infection, Immunity and Inflammation, Sir Graeme Davies Building, University of Glasgow, Glasgow, UK

Stratified medicine relies on fast and accurate diagnostic tools. Increasingly attention is turning to the use of panels of multiple markers to provide precise diagnosis. Metabolomic markers are therefore becoming more important in many clinical applications. We describe the development of a single chip microelectronic platform that exploits the potential for making large numbers of sensors on a single chip. Using ion sensitive and photo-sensitive devices we show that chips can be used to measure enzyme kinetics that are central to metabolomic pathways. In so doing we prepare the way for a new range of diagnostic tools with widespread application.


N-1:IL02  Carbon-ceramic Micro Electrodes for Pace Makers and Similar Biomedical Applications
G. BLUGAN¹, F. DALCANALE¹, J. GROSSENBACHER², H. TEVAEARAI³, J. BRUGGER², T. GRAULE¹, J. KUEBLER¹, ¹Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for High Performance Ceramics, Duebendorf, Switzerland; ²EPFL, Microsystems Laboratory LMIS1, Lausanne,  Switzerland; ³Bern University Hospital, Department of Cardiovascular Surgery, Bern, Switzerland

Conductive carbon-ceramic based electrodes have been specifically developed for use as more bio-compatible implantable electrodes compared to the state of the art metallic electrodes. The goal being to reduce fibrotic reactions as experienced by today's platinum based pace making electrodes. Starting from a low-viscosity organosilicon polymer (e.g. SiC, SiCN), additional carbon was added as a liquid precursor or in the form of carbon nanotubes to produce conductive ceramic composites. The use of these liquid polymer derived ceramic materials allows the forming of electrodes with complex geometries using MEMS technologies. The bio-compatibility of the electrodes was characterized with both invitro and invivo testing. The carbon-ceramic composite electrodes were found to have similar bio-compatibility to today's non-conductive bioceramic materials. The electrical conductivity was sufficient to stimulate isolated muscles cells as well as rat leg muscles, and allowed pacing of perfused rats' hearts. These electrodes may also be suitable for other biological and clinical applications including brain tissue simulation.


N-1:IL03  Tailoring Surfaces' Properties to Produce Materials for Sensitive Signalling of Binding Events
S.E.J. BELL, School of Chemistry and Chem. Eng., Queen's University, Belfast, UK

Raman spectroscopy has many of the desirable features for chemical sensing, in particular the molecular specificity of the signals. Unfortunately, Raman’s low scattering probability makes it unsuitable for low concentration measurements. However, if the targets adsorb to the surface of nanostructured metal surfaces (principally Ag or Au) the scattering is strongly enhanced and low concentration measurements are possible, even with inexpensive hand-held devices. Huge effort has been put into optimising the enhancing media but for sensing applications the main reason why targets are not detected is that they do not approach the enhancing surface. We are interested both in understanding why some targets spontaneously absorb and also in developing approaches to promoting adsorption of problematic targets by modifying the chemistry of the enhancing surfaces. This is primarily through the preparation of self-assembled monolayers of various functionalised alkane and alkyl thiols, either as single components or more powerfully, as mixed monolayers. The success of this approach will he illustrated by examples of biomolecules, therapeutic drugs and drugs of abuse and will include the use of polymer-based enhancing materials which combine tailored surfaces with low cost and long shelf life.


N-1:L04  Wearable Healthcare Devices based on Flexible Electronic Skins
HYUNHYUB KO¹, HEON SANG LEE², MIN PARK³, GEON-WOONG LEE⁴, ¹School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, Rep.of Korea; ²Department of Chemical Engineering, Dong-A University, Busan, Rep.of Korea; ³Photo-Electronic Hybrids Research Center, Korea Institute of Science and Technology, Seoul, Rep.of Korea; ⁴Nano Carbon Materials Research Group, Korea Electrotechnology Research Institute, Changwon, Rep.of Korea

In the human fingertips, the fingerprint patterns and interlocked epidermal-dermal microridges play a critical role in the spatio-temporal perception of various static and dynamic tactile signals. Inspired by the structure and functions of the human fingertip, here we introduce highly-sensitive, multifunctional, and stretchable e-skins based on interlocked design of micro- and nanostructured hybrid materials. We show that piezoresistive e-skins based on the interlocked microdome arrays possess highly direction-sensitive sensitive detection capability of various mechanical stimuli including normal, shear, stretching, bending, and twisting forces. We also introduce fingerprint-like patterns and interlocked microstructures in ferroelectric films, which can detect and discriminate static and dynamic pressure, vibration, and temperature with high sensitivities. Finally, we show that the multifunctional e-skins attached on the human skin can distinguish various mechanical stimuli applied in different directions, monitor different intensities and directions of air flows, sensitively monitor human breathing flows and voice vibrations, simultaneously monitor pulse pressure and temperature of artery vessels, and precisely detect acoustic sounds.

 
Session N-2 - Smart Fabrics and Wearable Patches

N-2:IL01  The Development of Screen, Inkjet and Dispenser Printing Techniques for Smart Fabric Applications
R. TORAH, Y. WEI, Y. LI, K. YANG, M. DE VOS, S. BEEBY, J. TUDOR, Department of Electronics and Computer Science, University of Southampton, Southampton, UK

The University of Southampton has developed a range of printing, processing and bespoke electrically functional inks for printing directly on to fabrics to create smart fabrics. Using screen, inkjet and dispenser printing it is possible to print complex multi-layer electrically functional structures on the surface of a range of fabrics. These next generation smart textiles allow designers more freedom to place functionality anywhere on a garment or application where fabric is used. Fabric is used extensively in the fashion, workwear, military, medical, advertising, automotive and architectural industries. These new printable materials allow these industries to integrate interactivity in their fabrics such as lighting, touch, proximity and motion sensing, heating, colour change and bio-potential monitoring. The devices are constructed in a planar method with each layer being printed and cured directly on the fabric before subsequent layers are processed. This presentation will discuss the development of these materials as part of the EU funded FP7 projects ‘Microflex’ and ‘CREATIF’ and how their results can be integrated within the existing fabric industries. Examples will include a printed heater, electroluminescent watch display, antennas, motion sensing and micropumps.


N-2:IL02  Sensing Garments for Body Segments Reconstruction and Motion Capture
A. TOGNETTI, Research Center "E. Piaggio" and Information Engineering Department, University of Pisa, Italy

Human motion capture is a fundamental topic for a wide range of applications such as rehabilitation, sport medicine and virtual training. The development of wearable sensing systems that enable a reliable measurement of human motion is still an open issue. In this context, e-textile solutions have been developed and their application in ambulatory human motion detection has been demonstrated. Textile based solutions have several advantages if compared with conventional sensors: low cost, lightweight, flexibility and possibility to be adapted to different body structures. Textile sensors enable the design of sensing garments by applying sensor strips to specific locations on normal cloth. Despite these attracting characteristics, textile sensors application is still reduced mainly due the low reliability that limits their use to the reconstruction of wide and slow movements. Recently, we have developed a new generation textile-based goniometers obtained by coupling two layers of knitted piezoresistive fabrics through an electrically insulating stratum. If compared with previously developed textile solutions, textile goniometers provide a reliable measurement of the angle between connected body segments and represent an important step forward in wearable human motion detection.


Session N-3 - Wearable and Implantable Sensor Integrationù

N-3:IL01  Smart Eyeglasses, E-textiles, and the Future of Wearable Computing
O. AMFT, University of Passau, Passau, Germany

Where a decade a ago mostly visions and bulky carry-on devices existed, today several wearable computing products could be found.  For example, activity trackers are already selling in convenience stores. The development does neither mean that the core innovations of the wearable computing vision are realised, nor that there will be any successful wearable device beyond those activity trackers.  The product announcements and explorations, such as Google Glass, have identified key challenges that are urging further research investments. The lessons to learn from those recent developments are discussed here, leading to an approach towards multi-function materials and wearable devices. Two projects are described that implement a multi-function approach. In the SimpleSkin project, a generic fabric is developed to realise different sensor functions, controlled via software apps in a Garment OS. The same fabric material is used in smart eyeglasses to realise temple-integrated electrodes. Whereas SimpleSkin aims at skin-attached wearables, the smart eyeglasses developed here closely resemble regular glasses and thus could become publicly accepted wearable accessories. Moving towards wearable technology that is truly embedded into everyday life opens a series of new health support applications that are sketched here, based on the concept of smart eyeglasses.


N-3:IL02  Advances in Bioelectronics for Retinal Prosthesis
W. MOKWA, Institute of Materials in Electrical Engineering I, RWTH Aachen University, Aachen, Germany

The mostly cause of blindness in the developed countries is a degeneration of the retina. For more than 50 years researchers worldwide have been working on a technical approach to restore vision. The first ideas were based on electrical stimulation of the optical cortex. In the last 25 years stimulation of retinal nerve cells has been successfully studied. Two companies have already commercialized their developments. The US-firm Second Sight is following the epiretinal approach. Stimulation electrodes are placed inside the eye onto the retina. The system has got the CE-Certification in 2011 and the FDA-approval in 2013. Up to now it has been implanted in more than 150 patients. The Retina Implant AG in Germany is following the subretinal approach. Stimulation electrodes are placed behind the retina at the position of the degenerated rods and cons. This system got the CE-Certification in 2013. Both systems have several drawbacks. A cable through the sclera is connecting the inner electrode part to the electronics outside. The side of view is restricted to only about 9°. Furthermore the number of electrodes is very restricted in the epiretinal system. This paper wants to give an overview about existing approaches and will present new approaches that might overcome these drawbacks.


N-3:IL03  Implantable Brain Pressure Sensors: State-of-the-art
S. LEONHARDT, Philips Chair or Medical Information Technology, RWTH Aachen University, Aachen, Germany

The unobtrusive measurement of intracranial pressure (ICP) have attracted great interest in recent years, as implantable sensors have become more and more available. ICP is a critical parameter that is frequently measured in case of traumatic brain injury (TBI) or in case of a chronic liquor disbalance leading to hydrocephalus. Classically, an increased ICP is treated by either an extraventricular drainage system (only suitable in an ICU environment) or an implantable pressure relief valve system (so called "shunt"). Implantable brain pressure sensors may be used to continuously measure ICP leading to better diagnosis. Also, such sensors may allow better control of future shunts. For example, instead of using absolute ICP measurements sensible to sensor drift, a proper analysis of brains pressure waves may be the right way to control future mechatronic shunt systems.


Session N-4 - Low Power Electronics, Energy Harvesting, Sensor Network Architecture

N-4:IL01  Energy Harvesting for Wearable Sensors
Z. LUO, J. SHI, S.P. BEEBY, Department of Electronics and Computer Science, University of Southampton, Southampton, UK

Ferroelectrets are porous polymer based materials that contain numerous voids which are electrically charged during poling. Being an electret material, the charge is held within the ferroelectret forming permanent electric fields across the voids. Under a mechanical force, e.g. compressive, these voids deform getting smaller and the macroscopic polarisation is increased producing a quasi-piezoelectric effect. The low Young's modulus of the polymer together with the presence of a large number of voids means these materials are highly compliant and exhibit piezoelectric coefficients far in excess of conventional ferroelectric polymers such as PVDF. This mechanically compliant nature makes this material attractive for use in human based sensing and energy harvesting applications. This work presents an investigation into the use of a commercially available porous polyolefin material manufactured by Emfit as an energy harvester. Its energy harvesting properties are explored and its potential for use is demonstrated in a shoe based self-powered sensor. The performance of PDMS based ferroelectrets fabricated with a specifically engineered void geometry fabricated using 3D printed and micromachined moulds will also be presented.


N-4:IL03  Smart Implants for Monitoring Surgical Site Infection
GUANG-ZHONG YANG, Hamlyn Centre, Imperial College London, UK

Surgical Site Infections (SSIs), catheter related sepsis, wound dehiscence and gastrointestinal anastomotic leakage are recognised complications following surgical interventions or invasive monitoring of critically ill surgical patients. Early detection of SSIs is critical to patient management to ensure prompt instigation of appropriate therapy and to avoid the associated mortality. The purpose of this talk is to present some of the latest advances in both wearable and implantable technologies for early detection and continuous monitoring of surgical site infections. It will address key technical issues related to sensor design, miniaturisation, and self-calibration, as well as low-power on-node processing, inferencing, and clinical decision support. Potential clinical impact in terms of improving surgical workflows, support safe discharge and home/community-based recovery, reduce unplanned readmissions, and influence the future of healthcare policy will be discussed.


Session N-5 - Materials Chemistry/Biology and Rapid Prototyping/3D Printing Additive Fabrication Technologies

N-5:IL01  From Finger Prick Sampling to On-body and Ultimately Implantable Chem/Bio-sensors: The Key Role of Active Fluidics in Realising the Long-term Functional Platforms of the Future
L. FLOREA, D. BRUEN, W. FRANCIS, A. DUNNE, S. COLEMAN, A. BENAZOUZ, D. DIAMOND, INSIGHT Centre for Data Analytics, National Centre for Sensor Research, Dublin City University, Dublin, Ireland

Despite the wide range of applications and tremendous potential of implantable sensors targeting chemo/bio-markers, bringing actual practical devices fully to market continues to be inhibited by significant technological barriers associated with long-term reliability, which is a key requirement for implants. This is so, even with devices that appear to be well engineered, focused on apparently fairly solid markets, and based on well-established sensing principles. Wearable chem/bio-sensors offer an interesting approach, intermediate between the long-term vision of implantable devices, and the single use-disposable devices that are the current dominant use model. For example, wearable patch-type devices employing minimally invasive sampling of interstitial fluid for continuous glucose monitoring target a use period of up to two weeks. In this paper, I will examine the issues that currently limit the applicability of chemo/bio-sensors in wearable and implantable scenarios, and present ways through which the effective autonomous lifetime of these more complex sensors might be extended from the current norm of (at most) several days, towards much longer periods (ideally years).


N-5:IL02  Soft Composite Materials in Bioengineering for Hard Problems in Biomedicine
JAE-WOONG JEONG, Department of Electrical, Computer, and Energy Engineering, University of Colorado, Boulder, CO, USA

Conventional medical devices interfaced with our body are rigid and bulky. Biological organs and systems, by contrast, are soft, elastic and curved. The recent research and development have established the composite materials and manufacturing foundations for a new class of soft electronics and optoelectronic devices that overcome this fundamental mismatch in mechanics and form. These technologies enable intimate, non-invasive integration of sensors and actuators, directly with biological organs, in ways that are impossible with conventional, rigid, planar device technologies. This talk will introduce recent advances in soft composite materials and electronics that can be applied for advanced healthcare and neuroscience research. The talk will mainly focus on our research on 1) skin electronics that can be integrated with the skin in a way that yields intimate, conformal contact at the electronics-skin interface, and 2) soft wireless optofluidic neural systems for optogenetics and in vivo pharmacology. Potential applications of soft composite materials and electronics will be also discussed.


N-5:IL03  Multimaterial and Multiscale Biofabrication Process for the Future Development of Patient Specific Tissues
G. VOZZI^1,2, F. MONTEMURRO², C. DE MARIA², ¹Dipartimento di Ingegneria dell'Informazione, University di Pisa, Pisa, Italy;  ²Research Center "E. Piaggio", University of Pisa, Pisa, Italy

Tissue engineering aims at producing patient-specific biological substitutes in an attempt to repair, replace and regenerate damaged tissues or organs in order to improve the current state of clinical treatments. A three-dimensional substrate, the scaffold, is a key aspect to promote cell organization to form a tissue. Recently, rapid prototyping (RP) technologies have been successfully used to fabricate complex scaffolds, thanks to the ability to create highly reproducible architecture and compositional variation across the entire structure, due to their precise controlled computer driven fabrication. In fact a tissue is a 3D complex structure that it is composed not only of different materials with different mechanical and biochemical properties but also by different cells, that are organized in order to active their cell activities and in particular cell cross-talking. The future of development of patient specific tissues is the use of novel biofabrication platforms able to process at the same time several materials (cells, biopolymers, biomolecules, etc.) with different extrusion heads and with different resolution( from nano to milli scale) to mimic the real and functional 3D structure of human tissue.

 
Session N-6 -  Applications in Healthcare and Personal Health Monitoring

N-6:IL01  The Role of Wearable Monitor for Healthcare
TOSHIYO TAMURA, Waseda University, Tokyo, Japan

Wearable monitor for healthcare was proposed in the late 1990s. Physiological monitoring in daily life has considerable potential for preventing and predicting diseases, without significant discomfort or inconvenience to the user. Over the past 25 years, wearable monitoring systems have been developed for health monitoring in daily life. In this presentation we will 1) review the devices used in wearable monitoring, including home use and clinical practice; 2) consider the evidence for their benefit in terms of healthcare outcomes; and 3) discuss long-term data collection and analysis using Big Data techniques. Furthermore, issues relating to the popularization of these devices are discussed, including regulation and business models. There are many promising devices available for wearable healthcare monitoring, and we propose ideas to popularize these devices.


N-6:L02  Monitoring of Firefighter’s Physiological Parameters by using Advanced Wired Textiles
G. TARTARE, H.N.M. NGO, L. KOEHL, X. ZENG, GEMTEX, Roubaix, France

Firefighting is a high-risk occupation in extreme conditions which sometimes requires external awareness to assist fighters whose physiological parameters drop dramatically. It is of the highest importance to monitor their physiological states by analyzing in real time a selection of relevant parameters. Textile is an appropriate medium between human being and its environment since it can fit body shape as a second skin would do and be in close contact to particular areas of interest for capturing physiological signals. For this purpose we created a smart garment that can continuously collect key health trackers from some sensors cleverly implanted in the textile at the right position under a controlled pressure. We designed a comfortable knitted textile structure which fits body morphology to ensure robust contact and uses conductive yarns to connect sensors and microcontroller. From sensors data, after pre-processing treatment and merging, a local decision support system that relates fatigue state and couple of physiological parameters is proposed and then sent through the air. Further, this high level of information could be transmitted to the command center and offer a better protection for firefighters.


N-6:L03  Simplified 3d Mapping System for Biofied Building using Microsoft Kinect V2 mounted on a Mobile Robot following People
M. DESTRAC, A. MITA, Department of System Design Engineering, Keio University, Yokohama, Japan

These days many people live alone especially elderly. To help them, many systems have been researched and made to improve daily life comfort. While many involve embedded sensor in the house, a Biofied Building aims to improve the life of resident by using sensor agent robot as an intermediate between the people and the environment. The robot, ebioNα collect data by following people using its main sensor, a Microsoft Kinect V2. To get data from the environment, we made a 3d map using Kinect depth and color cameras. Thus a simple following and mapping algorithm were made. The first sub-system was on a “following system” which is able to follow people with fluid movements maintaining a constant distance. This system was tested to be able to follow recognized people across an office space with corridors 70cm wide. The second sub-system was on a “3d Mapping System” storing the layout of ebioNα working space. In addition to the mapping, the locations of ebioNα and the user were stored. These systems aim to be simple to reduce processing requirements. As a result, this research made possible to implement Biofied Building researches out of laboratory environment. As a next step, we would like to add additional sub-systems, in particular one which uses the 3d map.


N-6:L05  Extraction of Stair Walking Parameters in Living Space by using Kinect v2
AMI OGAWA, A. YOROZU, A. MITA, M. TAKAHASHI, Graduate School of Science and Technology, Keio University, Kanagawa, Japan; T. BOCK, Chair of Building Realization and Robotics, Technical University of Munich, Germany

These days many problems caused by the increase of people in need of nursing care have been concerned in the aging society. To solve these problems, expanding the healthy life expectancy is important. Thus, we have been suggesting the “Watching System” which can monitor the resident’s daily life. This system aims to monitor changes of resident’s behaviors as unusual signs to prevent related accidents or diseases. As a part of the system, we focused on walking. The fact that the ability of walking precedes the others is reported, so analyzing the walking is effective to know the aging level. Especially for stair walking, higher ability is needed than level walking, so the decline of walking ability will appear in stair walking earlier. Therefore, we focused on the stair walking in this study. In the previous researches, sensors such as markers or electrodes are mainly used to get the walking information. Since our system is intended to be used in living space, putting sensors on a subject’s body is unacceptable. Thus we used Kinect v2 to acquire the coordinate points of human joints without restraining subjects in this study. We only used depth data considering the privacy protection. We conducted the accuracy verification experiment to evaluate our system.


N-6:IL06  Smart Wearable Systems for Enhanced Monitoring and Mobility
R.A. SHOURESHI, New York Institute of Technology, New York, USA; J.-R. RIZZO, T.E. HUDSON, Department of Physical Medicine & Rehabilitation; and Department of Neurology, NYU School of Medicine, New York, NY, USA; Tactile Navigation Tools, LLC, New York, NY, USA

The percentage of people over age 65 will shift from 12% to 20% nationwide while the average life expectancy for men and women of all races continues to rise, introducing a national and global concern for health related expenses. In particular, diminished stability leading to an increased risk of falling is on the forefront of medical expense projections. The World Health Organization (WHO) estimates there are 285 million suffering from visual impairment (39 million blind, 246 million low vision) worldwide. When adding the aging population with concomitant increases in life expectancy and the climbing rates of vision pathology, the numbers are even more dramatic. Blindness and low vision result in a host of social, emotional and health problems, often due to antecedent difficulties with mobility. This paper presents two smart wearable systems designed to enhance the mobility and monitoring of elderly and those with impaired vision. By using advances in sensors, actuators, and micro-electronics, these wearable systems acquire large amount of data, and with high speed data processing and pattern recognition, provide feedback signals to those wearing them. These systems are self-contained and operate with an easily accessible battery power. Details of the design and analysis of these smart wearable systems are presented.