U.S. patent application number 16/552215 was filed with the patent office on 2020-10-08 for flexible and stretchable electronic systems for epidermal electronics.
This patent application is currently assigned to The Board of Trustees of the University of Illinois. The applicant listed for this patent is The Board of Trustees of the University of Illinois. Invention is credited to Dae-Hyeong KIM, John A. ROGERS.
Application Number | 20200315488 16/552215 |
Document ID | / |
Family ID | 1000004905666 |
Filed Date | 2020-10-08 |
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United States Patent
Application |
20200315488 |
Kind Code |
A1 |
ROGERS; John A. ; et
al. |
October 8, 2020 |
FLEXIBLE AND STRETCHABLE ELECTRONIC SYSTEMS FOR EPIDERMAL
ELECTRONICS
Abstract
Provided herein are skin-mounted biomedical devices and methods
of making and using biomedical devices for sensing and actuation
applications. For example, flexible and/or stretchable biomedical
devices are provided, including electronic devices useful for
establishing conformal contact with the skin of a subject. Devices
disclosed herein can comprise a plurality of sensing and/or
actuating devices provided as part of a skin-mounted flexible or
stretchable electronic circuit.
Inventors: |
ROGERS; John A.; (Wilmette,
IL) ; KIM; Dae-Hyeong; (Champaign, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
The Board of Trustees of the University of Illinois |
Urbana |
IL |
US |
|
|
Assignee: |
The Board of Trustees of the
University of Illinois
Urbana
IL
|
Family ID: |
1000004905666 |
Appl. No.: |
16/552215 |
Filed: |
August 27, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13492636 |
Jun 8, 2012 |
10441185 |
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16552215 |
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12968637 |
Dec 15, 2010 |
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13492636 |
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61495623 |
Jun 10, 2011 |
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61286921 |
Dec 16, 2009 |
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61313397 |
Mar 12, 2010 |
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61388529 |
Sep 30, 2010 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
H05K 1/189 20130101;
A61B 5/04284 20130101; A61B 5/1104 20130101; H01L 2924/19041
20130101; A61B 2562/0271 20130101; A61B 5/0492 20130101; H01L
2924/0002 20130101; A61B 2562/12 20130101; A61B 2562/066 20130101;
A61N 1/0472 20130101; A61B 2562/164 20130101; H05K 3/323 20130101;
H01L 2924/3025 20130101; H01L 23/3121 20130101; H01L 23/3192
20130101; H01L 29/7869 20130101; A61B 5/1107 20130101; H01L
29/78603 20130101; A61B 5/4875 20130101; A61B 5/04085 20130101;
H01L 2924/3011 20130101; H01L 27/1218 20130101; A61B 5/0422
20130101; H05K 1/0283 20130101; A61B 2562/02 20130101; A61B
2562/0261 20130101; H01L 2924/12044 20130101; H05K 2201/09263
20130101; A61B 5/6867 20130101; A61B 5/0537 20130101; A61B 2562/029
20130101; A61B 5/076 20130101; A61N 1/05 20130101; A61N 1/0587
20130101; H05K 1/147 20130101; A61B 2562/046 20130101; A61B 5/0478
20130101; A61N 1/36 20130101 |
International
Class: |
A61B 5/0408 20060101
A61B005/0408; A61B 5/042 20060101 A61B005/042; H05K 1/18 20060101
H05K001/18; A61B 5/07 20060101 A61B005/07; A61N 1/05 20060101
A61N001/05; A61B 5/00 20060101 A61B005/00; H01L 23/31 20060101
H01L023/31; A61N 1/04 20060101 A61N001/04; H05K 1/02 20060101
H05K001/02; A61B 5/11 20060101 A61B005/11 |
Goverment Interests
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
[0002] This invention was made with United States governmental
support from the U.S. Department of Energy under Award No.
DEFG02-91ER45439, the National Science Foundation under grant
DMI-0328162, the U.S. Department of Energy under Award No.
DE-FG02-07ER46453 and DE-FG02-07ER46471, the U.S. Army Research
Laboratory and the U.S. Army Research Office under contract number
W911 NF-07-1-0618, the National Institute of Neurological Disorders
and Stroke (NINDS) under Award Nos. R01-NS041811-04 and
R01-NS48598-01 and by the DARPA-DSO and the National Institutes of
Health P41 Tissue Engineering Resource Center under award number
P41 EB002520. The U.S. Government has certain rights in the
invention.
Claims
1-89. (canceled)
90. A device for establishing an interface with a skin of a
subject, the device comprising: a flexible substrate having an
effective Young's modulus less than or equal to 10 GPa; a flexible
electronic circuit supported by the flexible substrate, wherein the
flexible electronic circuit comprises a plurality of
electrophysiological sensors connected with filamentary wires; each
of the electrophysiological sensors independently comprising an
inorganic layer, an electrode layer, or both, including one or more
inorganic semiconductor circuit elements or electrodes, or a
combination of inorganic semiconductor circuit elements and
electrodes; and a barrier layer encapsulating at least a portion of
the flexible electronic circuit, the barrier layer being a
multilayer structure comprising a plurality of layers, the barrier
layer providing one or more of an electrical, physical, chemical,
biological, or thermal barrier, wherein the device has a multilayer
geometry including the flexible substrate, the flexible electronic
circuit, and the barrier layer as a series of stacked layers with
the flexible electronic circuit provided between the flexible
substrate and the barrier layer, and wherein the flexible
substrate, barrier layer and the electronic circuit provide a net
bending stiffness allowing conformal contact to be established with
the skin of the subject.
91. The device of claim 90, wherein the barrier layer is patterned
so as to selectively modulate one or more of physical contact,
thermal contact, chemical contact, biological contact, optical
communication, or electrical communication between the flexible
electronic circuit and the skin.
92. The device of claim 90, wherein the barrier layer is patterned
to provide one or more transparent regions, wherein the transparent
regions transmit to or from the flexible electronic circuit
ultraviolet, visible or near-infrared electromagnetic radiation
having a preselected wavelength distribution.
93. The device of claim 90, wherein the barrier layer is patterned
to provide one or more opaque regions that substantially prevent
transmission to or from the flexible electronic circuit of
electromagnetic radiation having a preselected distribution of
wavelengths in the ultraviolet, visible or near-infrared regions of
the electromagnetic spectrum.
94. The device of claim 90, wherein the barrier layer is patterned
to provide one or more permeable regions that are selectively
permeable to one or more target molecules to allow transport of the
target molecules from the skin to the flexible electronic circuit
or from the flexible electronic circuit to the skin.
95. The device of claim 90, wherein the barrier layer is patterned
to provide one or more impermeable regions that are impermeable to
one or more target molecules to prevent transport of the target
molecules from the skin to the flexible electronic circuit or from
the flexible electronic circuit to the skin.
96. The device of claim 90, further comprising a controller in
communication with the flexible electronic circuit, the controller
configured to receive input signals from the flexible electronic
circuit and provide output signals to the flexible electronic
circuit, wherein the controller receives and analyzes input signals
corresponding to one or more measurements from one or more of the
plurality of electrophysiological sensors and generates output
signals that control or provide one or more sensing or actuation
parameters to the flexible electronic circuit.
97. The device of claim 90, wherein the flexible substrate
comprises one or more of a polymer, an inorganic polymer, an
organic polymer, a plastic, an elastomer, a biopolymer, a
thermoset, rubber, fabric, paper, or any combinations thereof.
98. A device for establishing a conformal interface with a skin of
a subject, the device comprising: a flexible substrate; a flexible
electronic circuit supported by the flexible substrate, the
flexible electronic circuit comprising a plurality of hydration
sensors for determining hydration of underlying skin of the
subject, each hydration sensor independently comprising an
inorganic layer, an electrode layer, or both, including one or more
semiconductor circuit elements or electrodes, the plurality of
hydration sensors being connected with filamentary wires; and a
barrier layer encapsulating at least a portion of the flexible
electronic circuit, the barrier layer including a plurality of
layers, the barrier layer providing an electrical, physical,
chemical, biological or thermal barrier, wherein the flexible
substrate, the flexible electronic circuit, and the barrier layer
are provided as a series of stacked layers with the flexible
electronic circuit provided between the flexible substrate and the
barrier layer, and wherein the flexible substrate, barrier layer
and the electronic circuit provide a net bending stiffness allowing
conformal contact to be established with the skin of the
subject.
99. The device of claim 98, wherein the flexible substrate
comprises one or more of a polymer, an inorganic polymer, an
organic polymer, a plastic, an elastomer, a biopolymer, a
thermoset, rubber, fabric, paper, or any combinations thereof.
100. The device of claim 98, wherein the plurality of hydration
sensors include an electrode for determining the impedance of
underlying skin.
101. The device of claim 98, wherein the plurality of hydration
sensors include one or more LEDS and photodiodes for determining
the water absorption of underlying skin.
102. The device of claim 98, wherein the barrier layer is patterned
to provide one or more transparent regions, wherein the transparent
regions transmit to or from the flexible electronic circuit
ultraviolet, visible or near-infrared electromagnetic radiation
having a preselected wavelength distribution.
103. The device of claim 98, wherein the barrier layer is patterned
to provide one or more opaque regions that substantially prevent
transmission to or from the flexible electronic circuit of
electromagnetic radiation having a preselected distribution of
wavelengths in the ultraviolet, visible or near-infrared regions of
the electromagnetic spectrum.
104. The device of claim 98, wherein the barrier layer is patterned
to provide one or more permeable regions that are selectively
permeable to one or more target molecules to allow transport of the
target molecules from the skin to the flexible electronic circuit
or from the flexible electronic circuit to the skin.
105. The device of claim 98, wherein the barrier layer is patterned
to provide one or more impermeable regions that are impermeable to
one or more target molecules to prevent transport of the target
molecules from the skin to the flexible electronic circuit or from
the flexible electronic circuit to the skin.
106. The device of claim 98, further comprising a controller in
communication with the flexible electronic circuit, the controller
configured to receive input signals from the flexible electronic
circuit and provide output signals to the flexible electronic
circuit, wherein the controller receives and analyzes input signals
corresponding to one or more measurements from said one or more
hydration sensors and generates output signals that control or
provide one or more sensing or actuation parameters to the flexible
electronic circuit.
107. A device for establishing a human-to-machine interface with a
skin of a subject, the device comprising: a flexible substrate; a
flexible electronic circuit supported by the flexible substrate,
wherein the flexible electronic circuit comprises a plurality of
electrophysiological sensors; wherein each of said
electrophysiological sensors independently comprises an inorganic
layer, an electrode layer or a combination of these; including one
or more inorganic semiconductor circuit elements or electrodes, or
a combination of inorganic semiconductor circuit elements and
electrodes, wherein the plurality of electrophysiological sensors
are connected with filamentary wires; and a barrier layer
encapsulating at least a portion of the flexible electronic
circuit; wherein said barrier layer is a multilayer structure
comprising a plurality of layers; wherein said barrier layer
provides an electrical, physical, chemical, biological or thermal
barrier; said device having a multilayer geometry wherein said
flexible substrate, said flexible electronic circuit and said
barrier layer are provided as a series of stacked layers wherein
said flexible electronic circuit is provided between said flexible
substrate and said barrier layer; wherein the flexible substrate,
barrier layer and the electronic circuit provide a net bending
stiffness so as to allow for conformal contact to be established
with the skin of the subject.
108. The device of claim 107, wherein at least one of the plurality
of electrophysiological sensors is configured to provide signals
corresponding to muscle activity.
109. The device of claim 107, wherein at least one of the plurality
of electrophysiological sensors is configured to provide signals
corresponding to an acceleration of the skin or a movement of the
skin.
110. The device of claim 107, wherein at least one of the plurality
of electrophysiological sensors is configured to provide signals
corresponding to a change in the concentration of a target molecule
at the skin.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 13/492,636 filed Jun. 8, 2012, which is a
continuation-in-part of U.S. patent application Ser. No. 12/968,637
filed Dec. 15, 2010, which claims the benefit of, and priority to,
U.S. Provisional Patent Application Nos. 61/286,921, 61/313,397 and
61/388,529 filed Dec. 16, 2009, Mar. 12, 2010, and Sep. 30, 2010,
respectively; and this application claims the benefit of U.S.
Provisional Patent Application No. 61/495,623 filed Jun. 10, 2011,
all of which are incorporated by reference to the extent not
inconsistent with the disclosure herein.
BACKGROUND
[0003] Physiological measurement and stimulation techniques that
exploit interfaces to the skin have been of interest for more than
40 years, the former beginning in as early as 1966 with
electromyography of laryngeal muscles. Despite much progress over
this time, nearly all associated device technologies continue to
rely on conceptually old designs. Typically, small numbers of bulk
electrodes are mounted on the skin via adhesive tapes, mechanical
clamps/straps and/or penetrating needles, often mediated by
conductive gels, with terminal connections to separate boxes that
house collections of rigid circuit boards, power supplies and
communication components. These systems have many important
capabilities, but they are poorly suited for practical application
outside of research labs or clinical settings, due to difficulties
in establishing long-lived, robust electrical contacts that do not
irritate the skin, and in achieving integrated systems with overall
sizes, weights and shapes that do not cause discomfort during
prolonged use.
[0004] Recently, a number of patents and publications have
disclosed flexible, resilient and implantable electrode arrays. For
example, U.S. Patent Application Publication US 2007/0043416
discloses an implantable flexible elastic support with a plurality
of electrodes held in contact with a target tissue. Similarly,
International Patent Application Publication WO 98/49936 discloses
a resilient electrode array for sensing signals associated
(mapping) and ablating heart tissue. U.S. Pat. No. 5,678,737
discloses an electrophysiology mapping system for displaying a 3D
model of epicardial and endocardial surfaces with dynamic display
of potential distribution data.
[0005] U.S. Patent Application Publication US 2003/0149456
discloses a multi-electrode cardiac lead adapter which incorporates
a multiplexing circuit allowing for control by a conventional
single lead cardiac pacing pulse generator. Similarly, U.S. Patent
Application Publication US 2006/0173364 discloses a multichannel
electrophysiology acquisition system which utilizes a digital
multiplexing circuit build on a conventional integrated circuit.
U.S. Pat. No. 6,666,821 discloses an implantable sensor array
system with an associated protective member which prevents the
sensors from interacting with the surrounding environment until it
is disabled.
[0006] International Application Publication WO 2009/114689, which
is hereby incorporated by reference in its entirety, discloses
flexible and scalable sensor arrays for recording and modulating
physiologic activity. US Patent Application Publication Nos. US
2008/0157235, US 2008/0108171, US 2010/0002402 and U.S. Pat. No.
7,557,367 issued Jul. 7, 2009, all of which are hereby incorporated
by reference in their entireties, disclose multilayer stretchable,
foldable and printable semiconductor devices.
SUMMARY OF THE INVENTION
[0007] Provided herein are skin-mounted biomedical devices and
methods of making and using biomedical devices for sensing and
actuation applications. For example, flexible and/or stretchable
biomedical devices are provided, including electronic devices
useful for establishing conformal contact with the skin of a
subject. Devices disclosed herein can comprise a plurality of
sensing and/or actuating devices provided as part of a skin-mounted
flexible or stretchable electronic circuit.
[0008] In one aspect, the invention provides devices for
interfacing with a tissue in a biological environment including
conformable devices. Devices of this aspect are useful, for
example, for sensing and/or actuating a tissue in a biological
environment. When placed in a biological environment, devices of an
aspect of the invention optionally establish conformal contact with
a target tissue(s), thereby providing contact useful for sensing or
actuation of the tissue. Further, devices of this aspect optionally
maintain conformal contact and/or electrical contact and/or optical
communication with the surface of a tissue as the tissue moves
and/or as the device is moved across a surface of the tissue.
Devices and related methods provided herein are particularly suited
for long-term mounting to the skin without adverse biological
events typically associated with long-term wear, including undue
surface irritation, cell death. Long-term refers to continuous wear
of the device on the order of days or weeks, including about 7 days
or longer.
[0009] In an embodiment, a device for establishing an interface
with a skin of a subject is provided, the device comprising: (1) a
flexible or stretchable substrate having an average modulus less
than or equal to 1 MPa; (2) a flexible or stretchable electronic
circuit supported by the flexible or stretchable substrate, wherein
the flexible or stretchable electronic circuit comprises a
plurality of sensors, actuators or both sensors and actuators
provided in an array including one or more inorganic semiconductor
circuit elements or electrodes, or a combination of inorganic
semiconductor circuit elements and electrodes; and (3) a barrier
layer encapsulating at least a portion of the flexible or
stretchable electronic circuit, the flexible or stretchable
substrate, or both the flexible or stretchable electronic circuit
and the flexible or stretchable substrate; wherein the flexible or
stretchable substrate, barrier layer and the electronic circuit
provide a net bending stiffness, thickness, effective elastic
modulus, and areal mass density of the device such that the device
establishes conformal contact with the skin of the subject.
[0010] In an aspect, the device is a skin mounted tissue sensor, a
skin mounted tissue actuator, or an array of skin mounted tissue
sensors or skin mounted tissue actuators. In another aspect, the
device does not include an adhesive layer between the skin of the
subject and the flexible or stretchable electronic circuit. In
another aspect, any of the flexible or stretchable electronic
circuits or devices are mounted on the skin without a flexible or
stretchable substrate. In this aspect, the transfer is mediated via
a transfer substrate such as transfer stamp that picks up the
circuit from a donor substrate and transfers the circuit to the
skin. Optionally, a contact layer facilitates transfer from the
transfer substrate to the skin.
[0011] In an embodiment, the device has a modulus and a thickness
within a factor of 2 of a modulus and a thickness of an epidermal
layer of the skin of the subject at the interface, optionally
within a factor of 1.5, optionally within a factor of 1.0,
optionally within a factor of 0.5. In an aspect, the device has an
average modulus less than or equal to 500 kPa, optionally less than
250 kPa. In an aspect, the device has an average modulus less than
or equal to 100 kPa. In an aspect, the device has an average
modulus less than or equal to 50 kPa. In another aspect, the device
has an average modulus selected over the range of 0.5 kPa to 100
kPa, optionally selected over the range of 0.5 kPa to 250 kPa,
optionally selected over the range of 1 kPa to 250 kPa, optionally
over the range of 5 kPa to 500 kPa. In an aspect, the device has an
average modulus equal to or less than 50 times the average modulus
of the skin of the subject at the interface, optionally equal to or
less than 25 times, optionally less than or equal to or less than
15 times.
[0012] In an embodiment, the device has an average thickness less
than or equal to 500 microns, optionally less than or equal to 250
microns, optionally less than or equal to 150 microns. In an
aspect, the device has an average thickness less than or equal to
100 microns. In another aspect, the device has an average thickness
less than or equal to 50 microns. In an aspect, the device has an
average thickness selected over the range of 1 to 500 microns,
optionally 10 to 250 microns, optionally 1 to 150 microns.
[0013] In an embodiment, the device has a net bending stiffness
less than or equal to 1 nN m, optionally less than or equal to 0.5
nN m. In an aspect, the device has a net bending stiffness selected
over the range of 0.1 to 1 nN m, optionally 0.1 to 0.5 nN m,
optionally 0.2 nN m to 1 nNm. In another embodiment, the device has
an areal mass density less than or equal to 10 mg cm.sup.-2,
optionally less than or equal to 5 mg cm.sup.-2, optionally less
than or equal to 1 mg cm.sup.-2. In an aspect, the device has an
areal mass density selected over the range of 0.5 mg cm.sup.-2 to
10 mg cm.sup.-2, optionally 0.5 mg cm.sup.-2 to 5 mg cm.sup.-2.
[0014] In an embodiment, the flexible or stretchable substrate is a
low modulus polymer. In an aspect, the flexible or stretchable
substrate has an average modulus less than or equal to 500 kPa,
optionally less than or equal to 250 kPa, optionally less than or
equal to 150 kPa, optionally less than or equal to 100 kPa,
optionally less than or equal to 50 kPa. In an aspect, the flexible
or stretchable substrate has an average modulus selected over the
range of 1 kPa to 500 kPa, optionally 10 kPa to 500 kPa, optionally
1 kPa to 250 kPa, optionally 25 kPa to 500 kPa, optionally 1 kPa to
150 kPa. In an aspect, the flexible or stretchable substrate is a
low modulus rubber material or a low modulus silicone material. In
an aspect, the flexible or stretchable substrate comprises a low
modulus rubber material or a low modulus silicone material. In an
aspect, the flexible or stretchable substrate is Ecoflex.RTM.
plastic (BASF). In an aspect, the flexible or stretchable substrate
is a bioinert or biocompatible material. In an aspect, the flexible
or stretchable substrate comprises a bioinert or biocompatible
material. In an aspect, the flexible or stretchable substrate
comprises a gas-permeable elastomeric sheet. In an aspect, the
flexible or stretchable substrate is applied to the electronic
circuit after the circuit is mounted to the skin, such as by
application of a sprayable liquid bandage.
[0015] In an embodiment, the flexible or stretchable electronic
circuit comprises one or more electrodes, transistors, inducers,
LEDs, capacitors, oscillators, photodiodes, diodes or any
combinations of these. In an aspect, the flexible or stretchable
electronic circuit comprises one or more amplifiers, strain gauges,
temperature sensors, wireless power coils, solar cells, inductive
coils, high frequency inductors, high frequency capacitors, high
frequency oscillators, high frequency antennae, multiplex circuits,
electrocardiography sensors, electromyography sensors,
electroencephalography sensors, electrophysiological sensors,
thermistors, transistors, diodes, resistors, capacitive sensors,
light emitting diodes, or any combinations of these. In an aspect,
the flexible or stretchable is a hydration sensor that measures
hydration level of a biological tissue, including skin. In an
aspect, the hydration sensor determines hydration level by
measuring impedance of the biological tissue. In an aspect, a map
of hydration levels is provided over a surface area and/or as a
function of depth from the tissue surface.
[0016] In an embodiment, the plurality of sensors, actuators or
both sensors and actuators of the device are provided in an array,
wherein the sensors, actuators, or both are separated by less than
or equal to 2.0 mm, optionally 1.0 mm, optionally 0.75 mm,
optionally 0.5 mm. In an embodiment, the plurality of sensors,
actuators or both sensors and actuators of the device are provided
in an array, wherein the sensors, actuators, or both are separated
by a distance selected over the range of 0.005 mm to 5.0 mm,
optionally 0.1 mm to 2.0 mm, optionally 0.1 to 1.0 mm, optionally
0.1 mm to 0.75 mm, optionally 0.1 to 0.5 mm. In an aspect, the
plurality of sensors, actuators or both sensors and actuators of
the device are provided in an array, wherein the array is a one
dimensional array, optionally a two dimensional array, optionally a
three dimensional array.
[0017] In an embodiment, the flexible or stretchable electronic
circuit has an average thickness less than or equal to 100 microns,
optionally less than or equal to 75 microns, optionally less than
or equal to 50 microns, optionally less than or equal to 25
microns. In an aspect, the flexible or stretchable electronic
circuit has an average thickness less than or equal to 10 microns,
optionally less than or equal to 5 microns.
[0018] In an embodiment, the flexible or stretchable electronic
circuit comprises one or more single crystalline inorganic
semiconductor structures. In an embodiment, the flexible or
stretchable electronic circuit is positioned proximate to a neutral
mechanical plane of the device.
[0019] In an embodiment, the flexible or stretchable electronic
circuit comprises a plurality of stretchable electronic devices or
device components. In an aspect, the flexible or stretchable
electronic circuit comprises one or more electronic devices or
device components having a curved, serpentine, bent, wavy or
buckled geometry. In an aspect, the flexible or stretchable
electronic circuit comprises one or more electronic devices or
device components comprising structures having a curved geometry,
wherein the one or more electronic devices or device components
exhibit one or more curves positioned within a plane parallel to a
receiving surface of the flexible or stretchable substrate
supporting the flexible or stretchable electronic circuit. In an
aspect, the flexible or stretchable electronic circuit comprises
one or more electronic devices or device components having the wavy
geometry comprising structures characterized by a plurality of
maxima and minima, wherein the maxima and minima are positioned
within a plane parallel to a receiving surface of the flexible or
stretchable substrate supporting the flexible or stretchable
electronic circuit.
[0020] In an embodiment, the flexible or stretchable electronic
circuit comprises one or more nanoribbons, micromembranes or
nanomembranes. In an aspect, the nanoribbons, micromembranes or
nanomembranes are provided in a wavy geometry characterized by a
plurality of maxima and minima. In an aspect, adjacent maxima and
minima of the wavy geometry are separated by a distance less than
or equal to 10 microns, optionally less than or equal to 5 microns.
In an aspect, adjacent maxima and minima of the wavy geometry are
separated by a distance selected over the range of 0.1 micron to 10
microns, optionally 1 micron to 8 microns, optionally 1 micron to 5
microns, optionally 2 microns to 10 microns.
[0021] In an embodiment, the wavy geometry is characterized by a
periodic structure. In an aspect, wavy geometry is characterized by
an amplitude of less than 10 microns, optionally less than 8
microns, optionally less than 5 microns. In an aspect, the wavy
geometry is characterized by a periodic structure. In an aspect,
wavy geometry is characterized by an amplitude selected over the
range of 0.1 micron to 10 microns, optionally 1 micron to 10
microns, optionally 1 micron to 8 microns.
[0022] In an embodiment, the wavy geometry is characterized by a
radius of curvature less than or equal to 1 mm, optionally 0.5 mm,
optionally 0.1 mm. In an aspect, the wavy geometry is characterized
by a radius of curvature selected over the range of 0.01 mm to 1
mm, optionally 0.02 mm to 1 mm, optionally 0.1 mm to 1 mm.
[0023] In an embodiment, the wavy geometry is a serpentine
geometry. In an aspect, the serpentine geometry is characterized by
a repeating s-shaped feature.
[0024] In an embodiment, local displacement of the nanoribbons,
micromembranes or nanomembranes within the plane parallel to the
receiving surface of the flexible or stretchable substrate
supporting the flexible or stretchable electronic circuit reduces
an overall state of strain of the device.
[0025] In an embodiment, the nanoribbons, micromembranes or
nanomembranes comprise metallic structures. In an aspect, the
nanoribbons, micromembranes or nanomembranes comprise single
crystalline semiconductor structures. In another aspect, the
nanoribbons, micromembranes or nanomembranes comprise hybrid
structures comprising one or more metallic structures connected to
one or more single crystalline semiconductor structures.
[0026] In an embodiment, the flexible or stretchable electronic
circuit comprises one or more island and bridge structures. In an
aspect, the island structures comprise one or more semiconductor
circuit elements. In an aspect, the island structures correspond to
electrodes. In another aspect, the bridge structures comprise one
or more flexible or stretchable electrical interconnections.
[0027] In an embodiment, the flexible or stretchable electronic
circuit is assembled on the flexible or stretchable substrate or
directly to the biological tissue via contact printing.
[0028] In an embodiment, the device further comprises a transfer
substrate supporting the flexible or stretchable substrate, the
flexible or stretchable electronic circuit, or both the flexible or
stretchable substrate and the flexible or stretchable electronic
circuit. In an aspect, the transfer substrate is in physical
contact with the flexible or stretchable substrate. In an aspect,
the transfer substrate is in physical contact with the flexible or
stretchable electronic circuit. In this aspect, the transfer
substrate functions as a supporting substrate during the transfer
of the flexible or stretchable electronic circuit to the tissue
surface. In an aspect, the transfer substrate is a removable
substrate and the transfer substrate is partially or completely
removed upon providing the device in contact with the skin of the
subject. In an aspect, the transfer substrate is a dissolvable
substrate and wherein the transfer substrate is partially or
completely dissolved after the device is provided in contact with
the skin of the subject. In another aspect, the transfer substrate
is a polymer. In an aspect, the transfer substrate is polyvinyl
acetate.
[0029] In an aspect, the flexible or stretchable substrate, the
electronic circuit and the barrier layer provide a net flexural
rigidity of the device less than or equal to 1.times.10.sup.-4 N m,
optionally 5.times.10.sup.-5 N m, optionally 2.5.times.10.sup.-5 N
m. In an aspect, the flexible or stretchable substrate, the
electronic circuit and the barrier layer provide a net flexural
rigidity of the device selected over the range of 5.times.10.sup.-6
N m to 1.times.10.sup.-4 N m, optionally 1.times.10.sup.-5 N m to
1.times.10.sup.-4 N m.
[0030] In an embodiment, the barrier layer comprises a material
selected from the group consisting of: a polymer, an inorganic
polymer, an organic polymer, an elastomer, a biopolymer, a ceramic,
and any combination of these. In an aspect, the barrier layer
comprises polyvinylpyrrolidone, pyroxylin, nitrocellulose,
poly(methylacrylate-isobutene-monoisopropylmaleate), pyroxylin, an
acrylate polymer, a siloxane polymer, a cyanoacrylate, an
octylcyanoacrylate, an acrylate copolymer, 2-octyl cyanoacrylate,
ethyl cyanoacrylate, n-Butyl cyanoacrylate, an acrylate terpolymer,
polyethylene, polydimethylsiloxane, a liquid bandage composition,
or any combination thereof. In an aspect, the barrier layer
comprises an elastomer. In an aspect, the barrier layer comprises
PDMS, polyimide, SU-8, parylene, parylene C, silicon carbide (SiC),
or Si.sub.3N.sub.4. In an aspect, the barrier layer is a
biocompatible material or a bioinert material. In an aspect, the
barrier layer comprises a biocompatible material or a bioinert
material. In an aspect, any of the barrier layers provided herein
is a cover layer. In an aspect, the barrier layer is applied as a
liquid, wherein upon evaporation of solvent, a polymer layer is
left behind that covers the electronic circuit.
[0031] In an embodiment, a method of interfacing an electronic
device with a skin of a subject is provided, the method comprising:
(1) providing the skin of the subject; (2) providing a conformable
electronic device, the device comprising: (i) a flexible or
stretchable substrate having an average modulus less than or equal
to 1 MPa; (ii) a flexible or stretchable electronic circuit
supported by the flexible or stretchable substrate, wherein the
flexible or stretchable electronic circuit comprises a plurality of
sensors, actuators or both sensors and actuators provided in an
array including one or more inorganic semiconductor circuit
elements or electrodes, or a combination of inorganic semiconductor
circuit elements and electrodes; (iii) a barrier layer
encapsulating at least a portion of the flexible or stretchable
electronic circuit, the flexible or stretchable substrate, or both
the flexible or stretchable electronic circuit and the flexible or
stretchable substrate; and (iv) a transfer substrate supporting the
flexible or stretchable substrate, the flexible or stretchable
electronic circuit, or both the flexible or stretchable substrate
and the flexible or stretchable electronic circuit; (3) contacting
the conformable electronic device to a receiving surface of the
skin of the subject, wherein upon contact the flexible or
stretchable electronic circuit is positioned between the skin and
the a flexible or stretchable substrate; and (4) at least partially
removing the transfer substrate; wherein the flexible or
stretchable substrate, barrier layer and the flexible or
stretchable electronic circuit provide a net bending stiffness of
the conformable electronic device low enough that the conformable
electronic device establishes conformal contact with the skin of
the subject upon at least partial removal of the transfer
substrate, thereby interfacing the conformable electronic device
with the skin of the subject.
[0032] In an embodiment, the step of at least partially removing
the transfer substrate comprises entirely removing the transfer
substrate. In an aspect, the step of at least partially removing
the transfer substrate comprises dissolving the transfer substrate
after the step of contacting the conformable electronic device to a
receiving surface of the skin of the subject.
[0033] In an embodiment, the method further comprises sensing
and/or actuating a tissue of the subject. In an aspect, the tissue
of the subject is skin, heart, muscle or brain tissue of the
subject. In an aspect, impedance of skin is measured, such as by a
plurality of electrodes and impedance is used to determine
hydration.
[0034] In an embodiment, the method further comprises making
electrocardiography measurements, electromyography measurements or
electroencephalography measurements of the subject. In an
embodiment, the method further comprises providing electromagnetic
radiation to the tissue of the subject. In an embodiment, the
method further comprises measuring a temperature of the tissue of
the subject. In an embodiment, the method further comprises
comprising making one or more voltage measurements, current
measurements, impedance measurements, electromagnetic radiation
intensity or power measurements, temperature measurements, pressure
measurements, tissue acceleration measurements, or tissue movement
measurements of the tissue of the subject. In an aspect, any of
those measures provide a distribution over a region or a "map".
Such spatial monitoring is referred herein as "mapping". The
mapping may further by measured as a time course, with the map
changing over time. In this manner, localized regions within a
larger monitoring area can be further studied and examined.
[0035] In an embodiment, the conformal device contacts an area of
the skin of the subject selected from the range of 1000 .mu.m.sup.2
to 1000 cm.sup.2, optionally 5000 .mu.m.sup.2 to 1000 cm.sup.2,
optionally 1000 .mu.m.sup.2 to 500 cm.sup.2, optionally 5000
.mu.m.sup.2 to 500 cm.sup.2.
[0036] In an embodiment, the flexible or stretchable electronic
circuit is positioned proximate to a neutral mechanical plane of
the device. In an embodiment, the substrate, the electronic circuit
and the barrier layer provide a net flexural rigidity of the device
less than or equal to 1.times.10.sup.-4 N m, optionally
5.times.10.sup.-5 N m, optionally 1.times.10.sup.-5 N m.
[0037] In an embodiment, the method further comprises measuring a
temperature of the tissue of the subject. In an aspect, the method
further comprises making one or more voltage measurements, current
measurements, electromagnetic radiation intensity or power
measurements, temperature measurements, pressure measurements,
tissue acceleration measurements, or tissue movement measurements
of the tissue of the subject. In an aspect, the conformal device
contacts an area of the skin of the subject selected from the range
of 1000 .mu.m.sup.2 to 1000 cm.sup.2, optionally 5000 .mu.m.sup.2
to 500 cm.sup.2, optionally 5000 .mu.m.sup.2 to 1000 cm.sup.2,
optionally 1 cm.sup.2 to 100 cm.sup.2.
[0038] In an embodiment, the invention provides a device for
interfacing with a tissue in a biological environment comprising:
(1) a flexible or stretchable substrate; (2) a flexible or
stretchable electronic circuit comprising one or more inorganic
semiconductor circuit elements supported by the flexible or
stretchable substrate; and (3) a barrier layer encapsulating at
least a portion of the flexible or stretchable electronic circuit.
The materials, physical dimensions and mechanical properties of the
device, and components thereof, are selected in some embodiments to
provide device attributes useful for a range of biomedical
applications, including sensing and actuation of tissue. In an
embodiment, for example, the flexible or stretchable substrate, the
flexible or stretchable electronic circuit and the barrier layer
have compositions, physical dimensions and/or geometries providing
a net bending stiffness and/or flexural rigidity of the device low
enough that the device establishes conformal contact with the
tissue in the biological environment. In certain embodiments, the
barrier layer is a moisture barrier, a thermal barrier, an
electromagnetic radiation barrier, an electrical barrier, an
optical barrier, a magnetic barrier, a selectively permeable or
impermeable barrier or any combination of these. In an embodiment,
for example, the substrate is a flexible substrate and the
electronic circuit is a flexible electronic circuit. In an
embodiment, for example, the substrate is a stretchable substrate
and the electronic circuit is a stretchable electronic circuit.
[0039] In an embodiment, the invention provides a device for
interfacing with a tissue in a biological environment, the device
comprising: a flexible or stretchable substrate; a flexible or
stretchable electronic circuit supported by the flexible or
stretchable substrate, wherein the flexible or stretchable
electronic circuit comprises a plurality of sensors, actuators or
both sensors and actuators provided in an array and one or more
inorganic semiconductor circuit elements; a controller in
communication with the flexible or stretchable electronic circuit,
the controller configured to receive input signals from the
flexible or stretchable electronic circuit and provide output
signals to the flexible or stretchable electronic circuit, wherein
the controller receives and analyzes input signals corresponding to
one or more measurements from the sensors and generates output
signals that control or provide one or more sensing or actuation
parameter to the flexible or stretchable electronic circuit; and a
barrier layer encapsulating at least a portion of the flexible or
stretchable electronic circuit; wherein the substrate, the
electronic circuit and the barrier layer provide a net bending
stiffness of the device low enough that the device establishes
conformal contact with the tissue in the biological environment. In
an embodiment, the controller receives input signals corresponding
to measurements by the sensors of tissue properties, such as
composition, structure and physiological properties, and uses the
input signals to control sensing and/or actuation of the tissue,
for example, via a closed-loop feedback algorithm. In an
embodiment, the controller receives input signals corresponding to
measurements by the sensors of tissue properties, such as
composition, structure and physiological properties, as a function
of time and uses the input signals as a function of time to adjust
and/or optimize sensing and/or actuation of the tissue. In an
embodiment, the controller receives input signals corresponding to
measurements by the sensors of tissue properties, such as
composition, structure and physiological properties, and uses the
input signals to control removal of at least a portion of the
tissue, for example, via tissue ablation methods.
[0040] The materials, physical dimensions and mechanical properties
of the device, and components thereof, are selected in some
embodiments to provide complete or partial electronic, optical,
chemical and/or thermal isolation of the device from the tissue
and/or biological environment useful for avoiding damage of the
tissue during use. In an embodiment, for example, the barrier layer
and the flexible or stretchable substrate limit a net leakage
current from the electronic circuit to an amount which does not
adversely affect the tissue. In an embodiment, for example, the
barrier layer and the flexible or stretchable substrate limits heat
transfer from the electronic circuit to the tissue in the
biological environment to an amount that does not adversely affect
the tissue in the biological environment.
[0041] The materials, physical dimensions and mechanical properties
of the device, and components thereof, are selected in some
embodiments to provide access of the device to the tissue and/or
biological environment useful for biomedical applications,
including sensing and/or actuation of tissue. In an embodiment, for
example, the barrier layer is patterned so as to selectively
modulate physical contact, thermal contact, optical communication
or electrical communication between the electronic circuit and the
tissue in the biological environment. In an embodiment, for
example, the barrier layer is patterned so as to provide one or
more permeable regions that are selectively permeable to one or
more target molecules to allow transport of the target molecules
from the biological environment to the electronic circuit or from
the electronic circuit to the biological environment. In an
embodiment, for example, the barrier layer is patterned so as to
provide one or more impermeable regions that are impermeable to one
or more target molecules to prevent transport of the target
molecules from the biological environment to the electronic circuit
or from the electronic circuit to the biological environment. In an
embodiment, for example, the barrier layer is patterned to provide
one or more transparent regions, wherein the transparent regions
transmit to or from the electronic circuit ultraviolet, visible or
near-infrared electromagnetic radiation having a preselected
wavelength distribution. In an embodiment, for example, the barrier
layer is patterned to provide one or more opaque regions that
substantially prevent transmission to or from the electronic
circuit of electromagnetic radiation having a preselected
distribution of wavelengths in the ultraviolet, visible or
near-infrared regions of the electromagnetic spectrum.
[0042] As used in this context, the term "patterned" refers to
selective variation of the physical properties, chemical
composition, physical dimensions and/or geometry of a device or
component thereof, for example via openings, channels, pores,
contact regions, permeable regions, impermeable regions,
transmissive regions, conductive regions and/or opaque regions. In
an embodiment, the barrier layer is patterned to have one or more
contact regions, such as openings or passages allowing physical
contact between components of the electronic circuit (e.g.,
electrodes or sensors) and the tissue. In an embodiment, the
barrier layer is patterned to have one or more transmissive
regions, such as windows allowing optical communication between
components (e.g., sensors, optical sources, LEDs, laser,
photodiodes, etc.) of the electronic circuit and the tissue. In an
embodiment, the barrier layer is patterned to have one or more
chemically permeable regions, such as pores or channels allowing
selective transport of target molecules between with electronic
circuit and the tissue. Patterned in this context may refer to a
device component, such as a barrier layer, that is patterned via a
microprocessing technique such as optical lithography, soft
lithography, etching, e-beam writing and/or laser ablation.
[0043] Devices of the present invention are applicable to a wide
range of tissues and biological environments, including implant
environments and exposed tissue environments, such as skin. In an
embodiment, for example, the biological environment is an in-vivo
biological environment. In an embodiment, for example, the
biological environment comprises a conductive ionic solution, such
as a biological fluid including blood, a component of blood,
pericardial fluid, peritoneal fluid, cerumen, and cerebrospinal
fluid. In an embodiment, for example, the tissue in the biological
environment comprises heart tissue, brain tissue, muscle tissue,
skin, nervous system tissue, epithelial tissue, retina tissue, ear
drum, tumor tissue, digestive system structures, circulatory system
structures and/or vascular tissue. In an embodiment, the device
establishes conformal contact with the tissue in situ when the
device is placed in physical contact with the tissue in the
biological environment, and wherein the conformal contact with the
tissue in the biological environment is maintained as the tissue or
the device moves. In an embodiment, the device is in electrical
contact with the tissue in the biological environment, wherein the
electrical contact with the tissue in the biological environment is
maintained as the tissue or the device moves. In some embodiments,
the device of the invention is applied via establishing physical
contact with the tissue and/or biological environment, for example
by implanting the device or contacting a surface of the tissue with
the device.
[0044] The invention provides devices having physical and chemical
properties useful for a wide range of biomedical applications
including cardiac monitoring, sensing and actuation of brain
tissue, vascular therapies and skin mounted sensing. In an
embodiment, for example, the substrate, the electronic circuit and
the barrier layer provide a net bending stiffness of the device
less than or equal to 1.times.10.sup.8 GPa .mu.m.sup.4, optionally
for some applications less than or equal to 1.times.10.sup.7 GPa
.mu.m.sup.4, and optionally for some applications less than or
equal to 1.times.10.sup.6 GPa .mu.m.sup.4. In an embodiment, for
example, the substrate, the electronic circuit and the barrier
layer provide a net bending stiffness of the device selected over
the range of 1.times.10.sup.8 GPa .mu.m.sup.4-1.times.10.sup.5 GPa
.mu.m.sup.4, and optionally for some applications selected over the
range of 1.times.10.sup.7 GPa .mu.m.sup.4-1.times.10.sup.5 GPa
.mu.m.sup.4, and optionally for some applications selected over the
range of 1.times.10.sup.6 GPa .mu.m.sup.4-1.times.10.sup.5 GPa
.mu.m.sup.4. In an embodiment, for example, the substrate, the
electronic circuit and the barrier layer provide a net flexural
rigidity of the device less than or equal to 1.times.10.sup.-4 Nm,
and optionally for some embodiments less than or equal to
1.times.10.sup.-5 Nm. In an embodiment, for example, the substrate,
the electronic circuit and the barrier layer provide a net flexural
rigidity of the device selected from the range of 1.times.10.sup.-4
Nm to 1.times.10.sup.-7 Nm, and optionally for some applications
device selected from the range of 1.times.10.sup.-5 Nm to
1.times.10.sup.-7 Nm. For certain embodiments, devices of this
aspect have and/or are capable of having a bending radius for all
and/or portions of the device of 100 .mu.m. For example, devices of
this aspect can adopt a radius of curvature of 100 .mu.m without
undergoing damage to the device or device components, such as
mechanical fracture, device failure or interruption of electrical
interconnections.
[0045] The invention includes devices having a multilayer geometry,
including a geometry wherein independently any of the substrate,
electronic circuit and barrier layer components (and/or components
of these) are provided in a series of stacked layers, including
layers and/or thin films that are provided in direct contact with
each other in the series of layers or in a series having one or
more intermediate layers (e.g., adhesive layers, contact layers,
cover layers, spacer layers, NMP layers, etc.) provided between
device layers of the series. The positioning of device components
in multilayer geometries of the present devices may be selected to
provide enhanced mechanical attributes or device functionality. In
an embodiment, for example, the device has a neutral mechanical
plane and at least a portion of the inorganic semiconductor circuit
elements are positioned proximate to the neutral mechanical plane.
In an embodiment, for example, a thickness of the barrier layer and
a thickness of the flexible or stretchable substrate are selected
so as to position at least a portion, or optionally all, of the
inorganic semiconductor circuit elements proximate to the neutral
mechanical plane. In some embodiments, proximate to the neutral
mechanical plane refers to device geometries wherein a device
component, such as an electronic circuit component is positioned
within 10 microns, and optionally for some applications, within 1
micron, to the overall neutral mechanical plane at a specific
position of the device.
[0046] Any of the barrier layers of any of the devices may function
to completely or partially encapsulate one or more other device
components such as flexible or stretchable electronic circuit
components and or the flexible or stretchable substrate. In some
embodiments, the electronic circuit component is completely
encapsulated by, and in physical contact with, the barrier layer
and/or flexible or stretchable substrate. In an embodiment, for
example, the barrier layer and/or flexible or stretchable substrate
encapsulates at least 50% of the electronic circuit component of
the device, optionally at least 90% of the electronic circuit
component of the device, and optionally all of the electronic
circuit component of the device. In an embodiment, the barrier
layer partially or completely encapsulates the flexible or
stretchable substrate. In an embodiment, for example, the barrier
layer encapsulates at least 50% of the flexible or stretchable
substrate of the device, optionally at least 90% of the flexible or
stretchable substrate of the device, and optionally all of the
flexible or stretchable substrate of the device. In an aspect, a
cover layer is provided that is functionally similar to a barrier
layer. Cover layer refers to the aspect where a layer is provided
after any of the devices disclosed herein are applied to the
tissue, such as skin. In an aspect where the application is to skin
having a contact layer, the cover layer effectively encapsulates
the device from the surrounding environment. As necessary or
desired, the cover layer may be periodically reapplied, such as
daily, to facilitate long term use. A plurality of cover layers may
be applied, including cover layers having different compositions
for different functionality. For example, one cover layer may
provide exceptional waterproofing and another exceptional
durability. In this manner, the cover layer may be a composite
cover layer to achieve better functional outcome.
[0047] Selection of the composition and physical properties of the
barrier, contact or cover layer is an important aspect of the
invention for controlling and/or selectively modulating the
interface of the device and the tissue and/or biological
environment. In an embodiment, for example, the barrier, contact or
cover layer has an average thickness over at least a portion of the
electronic circuit less than or equal to 1000 .mu.m, optionally for
some applications less than or equal to 100 .mu.m, optionally for
some applications less than or equal to 10 .mu.m, and optionally
for some embodiments applications less than or equal to 1 .mu.m In
an embodiment, for example, the barrier, contact or cover layer has
a thickness over at least a portion of the electronic circuit
selected over the range of 0.25 .mu.m to 1000 .mu.m, and optionally
for some applications selected over the range of 0.5 .mu.m to 500
.mu.m, and optionally for some applications selected over the range
of 1 .mu.m to 25 .mu.m. In an embodiment, the ratio of the average
thickness of the barrier layer to the average thickness of the
flexible or stretchable substrate is selected over the range of 0.1
to 10, and optionally for some applications 0.5 to 2.
[0048] In some embodiments, the barrier layer comprises a low
modulus material. The invention includes, for example, devices
wherein the barrier layer has an average modulus less than or equal
to 10 GPa, an average modulus less than or equal to 1 GPa
optionally for some embodiments less than or equal to 100 MPa,
optionally for some embodiments less than or equal to 10 MPa, and
optionally for some embodiments less than or equal to 1 MPa. In an
embodiment, for example, the barrier layer has an average modulus
selected over the range of 0.5 KPa to 10 GPa, optionally for some
application selected over the range of 1 KPa to 1 GPa, and
optionally for some application selected over the range of 1 KPa to
100 MPa. In an embodiment, for example, the barrier layer has an
average modulus equal to or less than 50 times the average modulus
of the skin of the subject at the tissue interface. As will be
generally understood by one skilled in the art, use of a barrier
layer with a relatively high modulus (e.g., greater than 1 GPa) in
some embodiments may require a small thickness (e.g., less than 100
microns or optionally less than 10 microns) to provide net device
mechanical properties (e.g., bending stiffness or flexural
rigidity) useful for establishing conformal contact with the
tissue.
[0049] A range of materials are useful for barrier layers of the
devices of the invention. In an embodiment, for example, the
barrier layer comprises a material selected from the group
consisting of: a polymer, an inorganic polymer, an organic polymer,
an elastomer, a biopolymer (e.g., polypeptide, protein,
polynucleotide, oligonucleotide, carbohydrate, etc.), a ceramic,
and any combination of these. Barrier layers of the invention
include composite materials. In an embodiment, for example, the
barrier layer comprises an elastomer. In an embodiment, for
example, the barrier layer comprises PDMS, SU-8, Si.sub.3N.sub.4,
SiO.sub.2, polyurethane, polyimide, parylene, parylene C, silicon
carbide (SiC), BCB, NOA, and any combination of these. In an
embodiment, for example, the barrier layer is a biocompatible
material and/or a bioinert material.
[0050] In an embodiment, for example, the barrier layer is
patterned to have one or more nanostructured or microstructured
optically transmissive regions, optically opaque regions or
selectively permeable regions that are permeable to one or more
target molecules, for example, to provide 1 to 1000 of such
nanostructured or microstructured regions, and optionally 10-50 of
such nanostructured or microstructured regions. As used herein, the
term "microstructured" refers to a structure having at least one
physical dimension selected over the range of 1 micron to 1000
microns, such as one or more lateral dimensions (e.g., length or
width) selected over the range of 1 micron to 1000 microns. The
term "nanostructured" refers to a structure having at least one
physical dimension selected over the range of 10 nanometers to 1000
nanometers, such as one or more lateral dimensions (e.g., length or
width) selected over the range of 10 nanometers to 1000 nanometers.
Microstructured and/or nanostructured regions of the barrier layer
include a variety of structures including channels, pores,
openings, windows, electrodes, permeable regions, recessed
features, relief features (e.g., raised features), transparent
regions, opaque regions and the like. In an embodiment, the
microstructured or nanostructured region(s) of the barrier layer is
one or more openings, pores or channels in the barrier layer so as
to provide physical contact between selected regions of the
electronic circuit and the tissue or biological environment. In an
embodiment, the microstructured or nanostructured region(s) of the
barrier layer is one or more optically transparent windows in the
barrier layer so as to provide optical communication between
selected regions of the electronic circuit and the tissue and/or
biological environment, for example, to allow transmission of
electromagnetic radiation having a preselected wavelength
distribution, such as light in the visible, ultra violet and/or
near infrared regions of the electromagnetic spectrum. In an
embodiment, the microstructured or nanostructured region(s) of the
barrier layer is one or more electrodes in the barrier layer so as
to provide electrical contact between selected regions of the
electronic circuit and the tissue and/or biological
environment.
[0051] In an embodiment, the barrier and/or cover layer comprises a
multilayer structure, for example, comprising 2 to 50 individual
layers and optionally 2-20 individual layers. In some embodiments,
for example, a barrier layer of the invention comprises a sequence
of layers, wherein layers in the sequence are selected from the
group consisting of metal layers, inorganic layers (e.g., inorganic
dielectrics such as oxides, carbides or nitrides, etc.) and polymer
layers. In an embodiment, the layers of the sequence are thin film
layers having thicknesses ranging from 10 nanometers to 10 microns.
This aspect of the invention is beneficial for providing barrier
layers having useful chemical, electronic or thermal properties,
such as providing low leakage currents for long periods of time. In
an embodiment, for example, the barrier layer is a multilayer
structure comprising one or more metal layers separated by one or
more inorganic layers or polymer layers. In an embodiment, for
example, the barrier layer is a multilayer structure comprising one
or more inorganic layers separated by one or more metal layers or
polymer layers. In an embodiment, for example, the barrier layer is
a multilayer structure comprising one or more polymer layers
separated by one or more metal layers or inorganic layers. Use of
polymer layers in barrier or cover layers comprising multilayer
structures is useful in some embodiments for filling in cracks
and/or pinholes in metal and/or inorganic layers and filling in
open areas of the flexible and stretchable electronic circuit,
thereby facilitating long-term use. In an embodiment, a barrier
layer of the invention comprises a multilayer structure having a
total thickness less than 500 microns, optionally for some
applications less than 100 microns, and optionally for some
applications less than 10 microns.
[0052] Selection of the composition and physical properties of the
flexible or stretchable substrate is an important aspect of the
invention for providing useful device properties. In an embodiment,
for example, the flexible or stretchable substrate has an average
thickness less than or equal to 1000 .mu.m, optionally for some
applications less than or equal to 100 .mu.m, and optionally for
some applications less than or equal to 10 .mu.m. In an embodiment,
for example, the flexible or stretchable substrate has an average
thickness selected over the range of 0.25 .mu.m to 1000 .mu.m,
optionally for some embodiments selected over the range of 10 .mu.m
to 500 .mu.m and optionally for some embodiments selected over the
range of 10 .mu.m to 100 .mu.m. Substrates of certain devices of
the invention have a substantially uniform thickness (e.g.,
deviations from an average thickness less than 10% and optionally
less than 5% and optionally less than 1%). Alternatively, the
invention includes substrates having a thickness that varies
selectively along one or more lateral dimension (e.g. length or
width) over the electronic circuit. In some embodiments, for
example, the substrate is thicker in certain regions, such as
regions supporting or in physical contact with components of the
electronic circuit, than in other regions of the substrate that are
not supporting or in physical contact with components of the
electronic circuit. In some embodiments, for example, the substrate
is absent in certain regions, such as regions of the substrate that
are not supporting or in physical contact with components of the
electronic circuit.
[0053] In some embodiments, the device of the invention comprises a
substrate having one or more microstructured and/or nanostructured
features, including recessed features, relief (e.g. raised)
features, openings, passages and/or channels. In an embodiment, at
least a portion of, and optionally all of, the electronic circuit
component of the device is supported by a flexible or stretchable
substrate having a mesh structure. Use of a substrate having a mesh
structure is beneficial in the invention for providing a
structurally supporting layer allowing for efficient handling and
administration of the device, while at the same time providing
mechanical properties (e.g., flexibility, deformability,
bendability, stretchability, etc.) useful for establishing
conformal contact with the target tissue. In an embodiment, for
example, a mesh structure refers to a layer or other structural
component that occupies a portion of, but not all, the foot print
area of the device, for example, occupying a portion of, but not
all of, the area of the device that interfaces the target tissue.
In an embodiment, for example, the foot print area of the device is
an area corresponding to the perimeter of the device that
establishes the interface with a target tissue, and the mesh
structure of the substrate occupies a portion, but not all of the,
foot print area. Mesh structures in some embodiments, occupy 75% or
less than the foot print area and/or tissue interface area of the
device, and optionally 50% or less than the foot print area and/or
tissue interface area; and optionally 25% or less than the foot
print area and/or tissue interface area of the device. In an
embodiment, for example, the substrate has a mesh structure that is
a lattice structure, a perforated structure or a tentacle
structure. In an embodiment, for example, the substrate is a mesh
structure having structural regions at least partially supporting,
or optionally in physical contact with, one or more of the
components of the electronic circuit, such as inorganic
semiconductor components or electrodes, wherein structural regions
of the substrate are separated from each other by voids, cut outs
or other openings where the substrate is not present. In such
embodiments, therefore, the presence of the void regions, cut outs
or other openings provides a mesh structured substrate occupying
less than the foot print area of the device. In an embodiment, for
example, the substrate having a mesh structure is a discontinuous
layer, as opposed to a continuous layer, such as a continuous film
or sheet.
[0054] In an embodiment, for example, the flexible or stretchable
substrate comprises a low modulus material. For example, the
invention includes devices having a flexible or stretchable
substrate with an average modulus less than or equal to 10 GPa,
optionally for some embodiments less than or equal to 100 MPa,
optionally for some embodiments less than or equal to 10 MPa, and
optionally for some embodiments less than or equal to 1 MPa and
optionally less than 0.1 MPa. In an embodiment, for example, the
flexible or stretchable substrate has an average modulus selected
over the range of 0.5 KPa to 5 GPa, optionally for some application
selected over the range of 1K to 1 GPa, and optionally for some
application selected over the range of 1 KPa to 100 MPa. In an
embodiment, for example, the flexible or stretchable substrate has
an average modulus equal to or less than 50 times the average
modulus of the skin of the subject at the tissue interface. As will
be generally understood by one skilled in the art, use of a
flexible or stretchable substrate layer with a relatively high
modulus (e.g., greater than 1 GPa) in some embodiments may require
a small thickness (e.g., less than 100 microns or optionally less
than 10 microns) to provide net device mechanical properties (e.g.,
bending stiffness or flexural rigidity) useful for establishing
conformal contact with the tissue.
[0055] A range of materials are useful for flexible or stretchable
substrates of the devices of the invention. In an embodiment, for
example, the flexible or stretchable substrate comprises a material
selected from the group consisting of: a polymer, an inorganic
polymer, an organic polymer, a biopolymer (e.g., polypeptide,
protein, polynucleotide, oligonucleotide, carbohydrate, etc.), a
plastic, an elastomer, a thermoset, rubber, fabric, paper, a
composite material and any combination of these. In an embodiment,
for example, the flexible or stretchable substrate comprises PDMS,
parylene or polyimide. In an embodiment, for example, the flexible
or stretchable substrate comprises a low modulus rubber or a low
modulus silicone material, such as Ecoflex.RTM.. In an embodiment,
for example, the flexible or stretchable substrate is a
biocompatible material or a bioinert material. In an embodiment,
for example, the flexible or stretchable substrate and the barrier
each comprise the same material, such as the same polymer or
elastomer material
[0056] Flexible or stretchable electronic circuit components of the
invention include a range of electronic devices, or components
thereof, including semiconductor devices, active electronic
devices, passive electronic devices, opto-electronic devices,
optical devices, and electronic device arrays. Electronic circuits
of the invention include, for example, an inorganic semiconductor
component, such as a single crystalline inorganic semiconductor
structure, doped single crystalline inorganic semiconductor
structure, high purity single crystalline inorganic semiconductor
structure. This aspect of the invention is particularly useful for
accessing devices exhibiting very high electronic device
performance, such as devices having transistor components
exhibiting useful field effect mobilities and/or on/off ratios.
[0057] In an embodiment, for example, the flexible or stretchable
electronic circuit comprises one or more flexible or stretchable
inorganic semiconductor structures. In an embodiment, for example,
the flexible or stretchable inorganic semiconductor structures of
the electronic circuit component comprise a single crystalline
inorganic semiconductor, such as single crystalline silicon or a
single crystalline iii-v semiconductor structure. To provide useful
flexibility in some embodiments, the semiconductor structures of
the electronic circuit of the invention are thin semiconductor
structures. In an embodiment, for example, the flexible or
stretchable inorganic semiconductor structures have an average
thickness less than or equal to 500 microns, optionally for some
applications less than or equal to 100 microns, optionally for some
applications less than or equal to 10 microns, optionally for some
applications less than or equal to 1 micron, and optionally for
some applications less than or equal to 500 nanometers. In an
embodiment, for example, the flexible or stretchable inorganic
semiconductor structures have an average thickness selected from
the range of 100 nanometers to 1000 microns, optionally for some
embodiments selected from the range of 500 nm to 500 microns,
optionally for some embodiments selected from the range of 1 micron
to 100 microns. In an embodiment, for example, the flexible or
stretchable inorganic semiconductor structures have an average
thickness selected from the range of 250 nanometers to 100 microns.
In an embodiment, for example, the flexible or stretchable
inorganic semiconductor structures are ultrathin structures. In an
embodiment, for example, each of the flexible or stretchable
inorganic semiconductor structures has a net flexural rigidity less
than or equal to less than or equal to 1.times.10.sup.-4 Nm. In an
embodiment, for example, each of the flexible or stretchable
inorganic semiconductor structures has a net bending stiffness less
than or equal to 1.times.10.sup.8 GPa .mu.m.sup.4, optionally for
some applications less than or equal to 1.times.10.sup.7 GPa
.mu.m.sup.4, and optionally for some applications less than or
equal to 1.times.10.sup.6 GPa .mu.m.sup.4. In an embodiment, for
example, each of the flexible or stretchable inorganic
semiconductor structures is independently a flexible or stretchable
semiconductor nanoribbon, semiconductor membrane, semiconductor
nanowire or any combination of these. In an embodiment, for
example, the flexible or stretchable inorganic semiconductor
structures are assembled on the flexible or stretchable substrate
via a transfer printing technique, such as dry transfer contact
printing and/or transfer printing process using an elastomeric
transfer device.
[0058] In an embodiment, the flexible or stretchable electronic
circuit further comprises one or more additional device components
in physical or electronic contact with the inorganic semiconductor
structures. In an embodiment, for example, the flexible or
stretchable electronic circuit further comprises one or more
flexible or stretchable dielectric structures, wherein at least a
portion of the flexible or stretchable inorganic semiconductor
structures is in physical contact with one or more of the
dielectric structures. A range of dielectric structures are useful
in this aspect of the invention including flexible or stretchable
dielectric structures having a thickness equal to or less than 100
microns. In an embodiment, for example, the flexible or stretchable
electronic circuit further comprises one or more flexible or
stretchable electrodes, wherein at least a portion of the flexible
or stretchable inorganic semiconductor structures or a portion of
the dielectric structures is in electrical contact with one or more
of the electrodes. A range of electrodes are useful in this aspect
of the invention including flexible or stretchable electrodes
having a thickness equal to or less than 500 microns.
[0059] The invention includes devices wherein the flexible or
stretchable electronic circuit comprises a plurality of
electronically interconnected island and bridge structures. This
aspect of the invention is useful for providing highly conformal
and optionally stretchable devices. In an embodiment, for example,
the island structures comprise one or more semiconductors,
including flexible or rigid semiconductor structures and/or
semiconductor electronic devices, semiconductor and dielectric
structures, semiconductor and electrode structures, transistors,
photodiodes, light emitting diodes, lasers, diodes, integrated
circuits, multiplexer circuits, and amplifier circuits. In an
embodiment, for example, the bridge structures comprise one or more
flexible or stretchable electrical interconnections, such as
electrical interconnections having a serpentine, meander, buckled,
or bent geometry. In an embodiment, for example, the flexible or
stretchable electrical interconnections are encapsulated structures
(e.g. encapsulated in polymer or elastomer). In some embodiments,
at least a portion of the island structures comprising
semiconductor structures are in electrical contact with one or more
flexible or stretchable interconnects.
[0060] The invention includes devices wherein the flexible or
stretchable electronic circuit is selected from the group
consisting of: a flexible or stretchable transistor, a flexible or
stretchable diode, a flexible or stretchable amplifier, a flexible
or stretchable multiplexer, a flexible or stretchable light
emitting diode, a flexible or stretchable laser, a flexible or
stretchable photodiode, a flexible or stretchable integrated
circuit and any combination and arrays thereof. In some
embodiments, for example, the flexible or stretchable electronic
circuit is a CMOS integrated circuit or a logic gate circuit. In an
embodiment, the flexible or stretchable electronic circuit further
comprises a plurality of sensing or actuating elements spatially
arranged over the flexible or stretchable substrate, wherein each
sensing or actuating element is in electrical communication with at
least one of the plurality of flexible semiconductor circuit
elements, for example, wherein at least one of the plurality of
sensing or actuating elements is in electrical communication with
the tissue when the device is in conformal contact with the tissue
in the biological environment. In an embodiment, for example, the
actuating elements comprise circuit elements selected from the
group consisting of: electrode elements, electromagnetic radiation
emitting elements, heating elements, ablation elements and any
combination of these. In an embodiment, for example, the flexible
or stretchable electronic circuit includes one or more sensing
electrode elements, chemical or biological sensor elements, pH
sensors, optical sensors, temperature sensors, capacitive sensors,
strain sensors, acceleration sensors, movement sensors,
displacement sensors and any combination of these. In an
embodiment, for example, the flexible or stretchable electronic
circuit comprises one or more sensors using a capacitance type
circuit. In an embodiment, for example, at least a portion of the
sensing or actuating elements is encapsulated by the barrier layer
and/or the flexible or stretchable substrate. In some embodiments,
at least one sensing element is positioned at the surface of the
barrier layer, in electrical communication with a tissue in a
biological environment, optical communication with a tissue in a
biological environment and/or in physical contact with a tissue in
a biological environment.
[0061] In an embodiment, the flexible or stretchable electronic
circuit comprises an active circuit, such as an amplifier circuit,
multiplexing circuit or a logic gate. In an embodiment, for
example, the multiplexing circuit of the flexible or stretchable
electronic device is configured to individually address each of a
plurality of sensing or actuating circuit elements spatially
arranged over the flexible or stretchable substrate, such as a
plurality of electrodes in an array. In an embodiment, the flexible
or stretchable electronic circuit comprises a current limiting
circuit, for example, a current limiting circuit that limits net
leakage current from the electronic device to 10 .mu.A or less,
optionally for some applications 5 .mu.A or less or optionally for
some applications 1 .mu.A or less.
[0062] Devices of this aspect optionally have a neutral mechanical
plane wherein at least a portion of the flexible or stretchable
electronic circuit, or components thereof, are positioned proximate
to the neutral mechanical plane, or wherein optionally all of the
components of the flexible or stretchable electronic circuit are
positioned proximate to the neutral mechanical plane. In some
embodiments, device components, such as flexible semiconductor
circuit components, provided proximate to the neutral mechanical
plane are within 100 microns of the neutral mechanical plane,
optionally for some embodiments within 10 microns of the neutral
mechanical plane, optionally for some embodiments within 5 microns
of the neutral mechanical plane, and optionally for some
embodiments within 1 micron of the neutral mechanical plane.
Thicknesses of the device components, such as the flexible
substrate and the barrier layer are optionally be selected in some
embodiments so as to position the neutral mechanical plane of the
device proximate to one or more flexible semiconductor circuit
elements.
[0063] In an aspect, the invention provides a conformable device
for biomedical sensing applications. In a device of this aspect,
the flexible or stretchable electronic circuit is a stretchable or
flexible electrode array comprising a plurality of individually
addressable electrodes, multiplex circuitry and amplification
circuitry. Devices of this aspect include conformable high density
electrode arrays for making high-speed and high resolution
electrophysiology measurements, for example in cardiac tissue,
brain tissue and skin environments. In an embodiment, the
stretchable or flexible electrode array comprises 2 to 500,000
electrodes, optionally for some applications 2 to 50,000 electrodes
and optionally for some applications 2 to 5,000 electrodes, wherein
the electrodes of the array are each optionally individually
addressable electrodes. In an aspect, the device is for assessing
hydration in a tissue by electrical impedance measurement by the
array of electrodes.
[0064] In an embodiment, for example, the stretchable or flexible
electrode array comprises 20 or more electrode unit cells,
optionally 50 or more electrode unit cells, and optionally 100 or
more electrode unit cells. In an embodiment, for example, adjacent
electrodes of the electrode array are separated from each other by
a distance less than or equal to 50 .mu.m, optionally for some
applications a distance less than or equal to 500 .mu.m, and
optionally for some applications a distance less than or equal to
2000 .mu.m. In an embodiment, for example, the electrode unit cells
of the electrode array are disposed on an area of the flexible or
stretchable substrate ranging from 10 mm.sup.2 to 10000 mm.sup.2,
optionally for some applications 10 mm.sup.2 to 1000 mm.sup.2, and
optionally for some applications 100 mm.sup.2 to 1000 mm.sup.2. In
some embodiments, the density of electrodes in the stretchable or
flexible electrode array is selected over the range of 0.1
electrode mm.sup.-2 to 50 electrodes mm.sup.-2, and optionally for
some application selected over the range of 1 electrode mm.sup.-2
to 20 electrodes mm.sup.-2.
[0065] In an embodiment, for example, the stretchable or flexible
electrode array comprises a plurality of electrode unit cells, for
example, a plurality of electrode unit cells comprising a contact
pad, amplifier and multiplexer, wherein the contact pad provides an
electrical interface to the tissue and is in electrical
communication with the amplifier and multiplexer. In an embodiment,
for example, the amplifier and multiplexer of the unit cell
comprises a plurality of transistors, for example, 2 to 50
transistors, and optionally for some applications 2 to 10
transistors. In an embodiment, for example, each of the unit cells
of the flexible or stretchable electrode array comprises a
multilayer structure comprising one or more semiconductor layers,
one or more dielectric layers and one or more metal layers provided
in a multilayer stacked geometry, for example, a stacked geometry
wherein the semiconductor layers, dielectric layers and metal
layers are provided in series, wherein adjacent layers are in
physical contact with each other or separated by intermediate
layers, such as adhesive, spacer and/or boundary layers. In an
embodiment, for example, the semiconductor layers of the multilayer
structure are positioned proximate to the neutral mechanical plane
of the flexible or stretchable electronic circuit.
[0066] In an aspect, the invention provides a device for optical
applications, including sensing and providing a local source of
electromagnetic radiation at the tissue site. In a device of this
aspect, the flexible or stretchable electronic circuit is a
stretchable or flexible array of light emitting diodes comprising a
plurality of light emitting diodes in electrical communication with
a plurality of stretchable or flexible electrical interconnects.
Devices of this aspect include high density LED arrays, including
implantable LED arrays, stretchable LED arrays and LED arrays for
interfacing with tissue including epithelial tissue. Devices of
this aspect include large area light emitting diode arrays, for
example wherein LEDs of the array are disposed on an area of the
flexible or stretchable substrate ranging from 100 mm.sup.2 to
10,000 mm.sup.2, and optionally for some embodiments ranging from
1000 mm.sup.2 to 10,000 mm.sup.2.
[0067] In an embodiment of this aspect, the stretchable or flexible
array of light emitting diodes is an island-bridge structure,
wherein the light emitting diodes provide islands of the
island-bridge structure and the stretchable or flexible electrical
interconnects provide bridge structures of the island-bridge
structure. In an embodiment, the electrical interconnects and the
light emitting diodes are entirely encapsulated by the barrier
layer, the flexible or stretchable substrate or both the barrier
layer and the flexible or stretchable substrate. In an embodiment,
for example, the light emitting diodes comprise the one or more
inorganic semiconductor circuit elements of the flexible or
stretchable electronic circuit. In an embodiment, for example, each
of the stretchable or flexible electrical interconnects comprise a
metal film encapsulated in a polymer layer, for example a thin
metal film (e.g., thickness equal to or less than 500 microns)
encapsulated in PDMS. In an embodiment, for example, the metal film
is positioned proximate to the neutral mechanical plane of the
stretchable interconnect. In an embodiment, for example, the device
further comprises additional bridge structures physically
connecting light emitting diodes of the array, wherein the
additional bridge structures comprise a polymer layer. In an
embodiment, for example, at least a portion of the stretchable or
flexible electrical interconnects have a serpentine, bent or
buckled geometry. In an embodiment, electrical interconnects or
electrodes of the invention comprise a conductive metal such as
copper, silver, gold, aluminum and the like, and alloys
thereof.
[0068] In a device of this aspect, the stretchable or flexible
array of light emitting diodes of this aspect comprises a
multilayer structure comprising a plurality of individually
encapsulated LED array layers provided in a multilayer stacked
geometry. In an embodiment, for example, the stretchable or
flexible array of light emitting diodes comprises 2 to 1000
individually encapsulated LED array layers provided in a multilayer
stacked geometry, an optionally 10 to 1000 individually
encapsulated LED array layers provided in a multilayer stacked
geometry. The multilayer geometry of this aspect of the invention
is beneficial for providing high LED densities and fill factors
which maintaining a useful degree of conformability and
stretchability. In an embodiment, for example, the individually
encapsulated LED array layers are combined to provide a density
equal to or greater than 1 LED mm.sup.-2, and optionally equal to
or greater than 100 LEDs mm.sup.-2. In an embodiment, for example,
the individually encapsulated LED array layers provide a density
selected from the range of 1 LEDs mm.sup.-2 to 1000 LEDs mm.sup.-2.
In an embodiment, for example, the individually encapsulated LED
array layers are laterally offset so as to provide a fill factor
greater than or equal to 1.times.10.sup.-6, or optionally provide a
fill factor selected over the range of 1.times.10.sup.-6 to
1.times.10.sup.-3. As used herein, the expression "laterally
offset" refers to a multilayer geometry wherein at least a portion
of the LEDs in different layers of the device are positioned such
that they do not reside on top of each other. As used in this
context, the term "fill factor" refers to the fraction of the area
of the footprint of the device that is occupied by the LED
structures.
[0069] In some embodiments, barrier layers and flexible or
stretchable substrates limit a net leakage current from the
electronic device to an amount which does not adversely affect a
tissue in a biological environment. Barrier layers of the invention
include moisture barriers. In one embodiment, the barrier layer is
configured to limit a net leakage current from the electronic
device to the biological environment to less than 10 .mu.A,
optionally for some applications less than 5 .mu.A and optionally
for some applications less than 1 .mu.A, and optionally for some
applications less than 0.1 .mu.A. In some embodiments, the barrier
layer prevents leakage current from being concentrated to small
areas so to prevent tissue damage caused by current leakage from
the device. In an embodiment, for example, the barrier layer is
configured to limit leakage current from the device to the
biological environment to 0.1 .mu.A/cm.sup.2; less, and for some
applications 0.01 .mu.A/cm.sup.2 or less, and for some applications
0.001 .mu.A/cm.sup.2 or less. In some embodiments, barrier layers
of the invention have an electrical resistivity of 10.sup.14
.OMEGA.m or greater, for example an electrical resistivity selected
over the range of 10.sup.15 to 10.sup.17 .OMEGA.m. In some
embodiments, the barrier layer prevents the rate at which charge is
leaked from the electronic device; for example, one barrier layer
embodiment limits electrical discharge from a device to 10 .mu.C or
less over a period of 1 second. In some embodiments, the barrier
layer limits leakage current or average leakage current from the
device to 10 .mu.A or less or 5 .mu.A or less over a long period of
time, such as 3 hours or more or 5 hours or more.
[0070] In some embodiments, a barrier and/or cover layer is
configured to prevent moisture from reaching the flexible or
stretchable electronic circuit and limit leakage current therefrom,
for example to less than 10 .mu.A optionally for some applications
less than 5 .mu.A and optionally for some applications less than 1
.mu.A. Useful moisture barriers, for example, include those
configured for protecting tissue in contact with electronic device
embodiments from damage due to leakage current. Further, useful
moisture barriers include those configured for protecting
electronic devices from damage due to leakage current.
[0071] In an embodiment, the barrier layer is patterned so as to
selectively modulate physical, thermal, optical, electromagnetic
and/or electrical contact and/or communication between flexible
semiconductor circuit elements and the tissue in the biological
environment. Optionally, a barrier layer comprises multiple layers.
For example, a barrier layer comprises at least one organic polymer
layer and at least one inorganic dielectric layer. In specific
embodiments, the net thickness of a barrier layer comprising
multiple layers is selected over the range of 1 .mu.m to 25 .mu.m
or over the range of 1 .mu.m to 100 .mu.m.
[0072] In some embodiments, the barrier layer includes one or more
via structures. As used herein, a via structure refers to a
recessed region which is at least partially filled with a
conducting material. Via structures are useful in a barrier layer
for providing electrical communication between electronic circuit
components encapsulated by a barrier layer (e.g., semiconductor
device such as a transistor, amplifier or multiplexer) and
electronic circuit components not encapsulated by a barrier layer
and in contact with the tissue or fluid in contact with the tissue
(e.g., an electrode). In a specific embodiment, the barrier layer
comprises multiple layers and includes multiple offset via
structures; for example, one via structure in a lower barrier layer
and one via structure in an upper barrier layer in electrical
communication with the first via structure. In embodiments, barrier
layers including multiple layers with offset via structures are
useful as moisture barriers.
[0073] Depending on the application, the barrier layer can have a
variable thickness; that is, for certain applications, the barrier
layer has a thickness that is spatially variable (i.e., relatively
thicker in some regions and relatively thinner in other regions).
In embodiments where a sensing element does not need to be exposed
and/or in direct contact with or electrical communication with a
tissue in a biological environment, barrier layers of spatially
varying thickness are useful; for example, when a sensing element
is positioned close to the surface (e.g., within 5 .mu.m or less)
of the barrier layer but still encapsulated by the barrier
layer.
[0074] In embodiments, an electronic device of this aspect further
comprises a plurality of actuating elements spatially arranged over
the flexible substrate. Optionally, each actuating element is
positioned in electrical communication with at least one flexible
semiconductor circuit element. Optionally, one or more via
structures are configured to and/or positioned in the barrier layer
to provide electrical communication between an actuating element
and a flexible semiconductor circuit element. In some embodiments,
one or more actuating elements are encapsulated by the barrier
layer. Useful actuating elements include, but are not limited to,
electrode elements, electromagnetic radiation emitting elements,
light emitting diodes, lasers, and heating elements. In some
embodiments, at least one actuating element is positioned at the
surface of the barrier layer, in electrical communication with a
tissue in a biological environment, in optical communication with a
tissue in a biological environment and/or in physical contact with
a tissue in a biological environment. In some embodiments an
actuating element is a sensing element.
[0075] "Spatially arranged over the flexible substrate" as used
herein, refers to a distribution of elements over the surface area
of a flexible substrate such that each element is located at a
different position. Inter element spacing can be uniform or
variable. In some embodiments, the elements are spatially arranged
in a regular array pattern with equal inter element spacing, for
example in a 2D array or 3D array. In some embodiments, the
elements are spatially arranged in a line (e.g., a 1D array).
Useful spatial arrangements include regular and irregular
distributions of elements.
[0076] Modulation of physical, optical, thermal and/or electrical
contact and/or communication is achieved in some embodiments by
selective variation of the physical dimensions (e.g., thickness,
etc.), shape, and/or composition of the barrier layer. In some
embodiments, for example, the physical dimensions and/or shape of
the barrier layer provides a preselected pattern of openings in the
barrier layer that expose preselected circuit elements to the
tissue and/or biological environment, particularly when the device
is provided in conformal contact with the tissue. In some
embodiments, for example, the physical dimensions, shape or
composition of the barrier layer provide a preselected pattern of
electrically conductive and/or optically or electromagnetically
transparent regions of the barrier, particularly when the device is
provided in conformal contact with the tissue. Barrier layers
include, but are not limited to, barrier layers having a plurality
of contact regions that expose a components of the electronic
circuit (e.g., electrodes, sensors, etc.) to the tissue and/or
biological environment. Barrier layers of some embodiments of this
aspect provide patterned physical contact between preselected
circuit elements, such as electrode and/or sensor components, and
the tissue and/or biological environment. Barrier layers include,
but are not limited to, barrier layers having a plurality of
contact regions that electronically couple a preselected subset of
flexible semiconductor circuit elements and the tissue and/or
biological environment. Barrier layers of some embodiments of this
aspect provide patterned electrical contact between preselected
circuit elements, such as electrode and/or sensor components, and
the tissue and/or biological environment. Barrier layers include,
but are not limited to, barrier layers having a plurality of
contact regions that optically couple a preselected subset of
flexible semiconductor circuit elements and the tissue and/or
biological environment. Barrier layers of some embodiments of this
aspect provide patterned optical communication (e.g., a pattern of
optically transmissive regions and optically opaque regions)
between preselected circuit elements, such as optical source (e.g.,
laser, LED, fiber optic, etc.) components and photodetector (e.g.,
photodiode, diode array. etc.) components, and the tissue and/or
biological environment. In an embodiment, for example, at least a
portion of the barrier layer is opaque or substantially blocks
electromagnetic radiation having a preselected range of
wavelengths.
[0077] In an embodiment, a barrier layer limits heat transfer from
the electronic device to the tissue in the biological environment
to an amount that does not adversely affect the tissue. In an
embodiment, the barrier layer, or components thereof, have a
thermal conductivity of 0.3 W/mK or less, 0.1 W/mK or less, 0.01
W/mK or less, 0.001 W/mK or less or selected over the range of
0.001 W/mK to 0.3 W/mK and/or portions having a thermal resistivity
of 3 mK/W or more, 10 mK/W or more, 100 mK/W or more, 1000 mK/W or
more selected over the range of 1 to 1000 mK/W. In an embodiment, a
barrier layer comprises a thermal insulator and/or a heat spreader.
Certain device embodiments further include active cooling
components; for example active cooling components positioned in
thermal communication with the barrier layer and/or in thermal
communication with one or more flexible semiconductor circuit
elements. In some embodiments, the barrier layer comprises active
cooling components, such as thermoelectric cooling devices.
[0078] In an embodiment, a barrier layer includes portions which
are at least partially transparent to electromagnetic radiation. In
an embodiment, a device comprises a barrier layer patterned to
provide one or more transparent regions and one or more
non-transparent regions, wherein the transparent regions transmit
electromagnetic radiation have wavelengths in the ultraviolet,
visible or near-infrared regions of the electromagnetic spectrum
having a preselected wavelength distribution, wherein the
non-transparent regions substantially prevent transmission of
electromagnetic radiation in the in the ultraviolet, visible or
near-infrared regions of the electromagnetic spectrum. In an
embodiment, a barrier layer includes portions which are opaque or
block electromagnetic radiation. In another embodiment, a barrier
layer includes portions which are at least partially transparent to
electromagnetic radiation and portions which are opaque or block
electromagnetic radiation. For example, portions of the barrier
layer can be partially or fully transparent to electromagnetic
radiation of a selected wavelength or over a selected region of the
electromagnetic spectrum. For example, selected over the range of
100 nm to 2000 nm, 1 .mu.m to 2000 .mu.m, 400 nm to 2000 nm or in
the UV, visible, IR, near IR, or microwave portions of the
spectrum. In embodiments, a barrier layer is selectively patterned
to provide one or more transparent regions and one or more opaque
regions. In embodiments, a barrier layer is selectively patterned
to provide one or more optical components or structures, such as
lenses, microlenses, lens arrays, optical filters, reflectors,
reflective coatings, and antireflective coatings.
[0079] Transparent or partially transparent barrier layers are
useful, for example, when an optical sensor, such as a photodiode,
is encapsulated within the barrier layer and/or it is desired to
detect electromagnetic radiation. A transparent or partially
transparent can also be useful, for example, when a source of
electromagnetic radiation, such as a light emitting diode and/or a
laser, is encapsulated within the barrier layer and/or it is
desired to permit electromagnetic radiation to pass through the
barrier layer.
[0080] In an embodiment, a barrier layer includes portions which
serve as an electrical, electrostatic and/or magnetic barrier. In
specific embodiments, a barrier layer blocks electric fields and/or
magnetic fields, for example, blocking fields external to the
electronic circuit from interacting with the electronic circuit or
blocking fields generated by the electronic circuit from
interacting with the tissue and/or biological environment. In
various embodiments of this aspect, the barrier layer comprises a
Faraday cage, an electrical insulator and/or magnetic shielding. In
a specific embodiment, a barrier layer comprises material having an
electrical resistivity of 10.sup.14 .OMEGA.m or larger or selected
over the range of 10.sup.15 to 10.sup.17 .OMEGA.m.
[0081] In an embodiment, a barrier layer is patterned so as to
provide one or more selectively permeable regions that are
selectively permeable to one or more target molecules. In some
embodiments, the barrier layer provides a plurality of spatially
patterned regions which are selectively permeable to one or more
target molecules comprising biomolecules, analytes, liquids or
gases. In another aspect, a barrier layer comprises a plurality of
spatially patterned impermeable regions which are selectively
impermeable to one or more target molecules, such as one or more
biomolecules, analytes, liquids or gases. For example, portions of
the barrier layer can be selectively permeable to one or more
target chemicals, molecules or biomolecules while being impermeable
to other chemicals, molecules or biomolecules, such as solvents or
aqueous solutions. Optionally, the barrier layer is impermeable to
water and salts dissolved therein and is selectively permeable to
one or more proteins, organic compounds or biomolecules (e.g.,
nucleic acids). A selectively permeable barrier layer is useful,
for example, when a chemical or biochemical sensor is encapsulated
within the barrier layer and it is desired to detect and/or collect
a target chemical, molecule or biomolecule. Target molecules useful
in the embodiments of the present devices and methods include, but
are not limited to: polypeptides, polynucleotides, carbohydrates,
proteins, steroids, glycopeptides, lipids, metabolites, drugs or
drug precursors.
[0082] In an embodiment, a device of the present invention further
comprises a controller in communication with the flexible or
stretchable electronic circuit. Controllers of this aspect of the
invention are useful for providing device control, signal
processing and measurement analysis functionality. In an
embodiment, the controller receives input signals from the flexible
or stretchable electronic circuit that serves the basis of
closed-loop control of the electronic device, for example,
providing real-time adjustment of sensing and actuation of the
tissue. In an embodiment, for example, the controller provides
closed-loop control of sensing and/or actuation based on signals
received from the electronic circuit corresponding to measurements
of tissue properties.
[0083] For example, the invention includes a controller configured
to provide an output signal to the flexible or stretchable
electronic circuit, receive an input signal from the flexible or
stretchable electronic circuit, or to provide an output signal to
the flexible or stretchable electronic circuit and receive an input
signal to the flexible or stretchable electronic circuit. As used
in this context, the expression "in communication" refers to a
configuration of devices or device components such that a signal
can be exchanged, and includes one way communication and two way
communication between the controller and the flexible or
stretchable electronic circuit. In an embodiment, for example, the
controller is in electrical communication or wireless communication
with the flexible or stretchable electronic circuit. In an
embodiment, for example, the output signal provides an input to the
flexible or stretchable electronic circuit so as to control
actuation or sensing of the tissue in the biological environment.
In an embodiment, for example, the output signal provides a sensing
or actuation parameter from the controller to the flexible or
stretchable electronic circuit, for example, a parameter relating
to the timing of a measurement or actuation, the magnitude of a
sensing or actuation variable (e.g., voltage, current, power,
intensity, temperature, etc.). In an embodiment, for example, the
input signal provides a measurement parameter from the flexible or
stretchable electronic circuit to the controller, for example a
measurement parameter corresponding to a time, voltage, current,
impedance, intensity, power, or temperature. In an embodiment, for
example, the input signal provides a measurement parameter
corresponding to a plurality of voltage measurements, current
measurements, electromagnetic radiation intensity or power
measurements, temperature measurements, pressure measurements,
tissue acceleration measurements, tissue movement measurements,
target molecule concentration measurements, time measurements,
position measurements, acoustic measurements or any combination of
these. In an embodiment, for example, the controller receives and
analyzes the input signal from the flexible or stretchable
electronic circuit and generates an output signal that controls or
provides a sensing or actuation parameter(s) to the flexible or
stretchable electronic circuit, for example via a closed-loop
control algorithm that adjusts the sensing or actuation
parameter(s) based on one or more tissue measurements. A wide range
of controllers are useful in the present devices and methods,
including a microprocessor, microcontroller, digital signal
processor, computer or fixed logic device. Controllers of this
aspect include implantable controllers, controllers that are
administered to the tissue site along with the flexible or
stretchable electronic circuit and controllers that are ex
vivo.
[0084] In an aspect, a device of the invention further comprises a
transfer substrate supporting the flexible or stretchable
substrate, the flexible or stretchable electronic circuit or both.
Transfer substrates of some devices of the invention function to
facilitate administration of the device to a tissue site, for
example, by providing net mechanical properties and/or physical
dimensions of the device to allow effective handling, transfer
and/or deployment to the tissue interface in a manner that does not
damage or modify the properties of the other components of the
device (e.g., substrate, barrier layer or electronic circuit
components). Transfer layers of some embodiments also function as
sacrificial layers that are at least partially removed upon
administration to the tissue, for example, via dissolution or
delamination (e.g., peel back) processes. In an embodiment, the
invention provides a method of administrating, or otherwise using,
a device of the invention having a transfer layer, the method
further comprising the step of at least partially removing the
transfer substrate, for example, via dissolving the transfer
substrate or separating the transfer substrate from the flexible or
stretchable substrate (e.g., via a delamination process). In a
method of the invention, for example, partial or complete removal
of the transfer substrate results in the device establishing
conformal contact with the tissue in the biological
environment.
[0085] In some embodiments, the transfer substrate is in physical
contact with, and/or optionally bonded to, the flexible or
stretchable substrate. In an embodiment, the transfer substrate is
bound to the flexible or stretchable substrate via one or more
adhesive layers. In an embodiment, the transfer substrate is a
removable substrate, wherein the transfer substrate is partially or
completely removed after the device establishes conformal contact
with the tissue in the biological environment. In an embodiment,
for example, the removable substrate is a dissolvable substrate,
wherein the removable substrate is partially or completely
dissolved after the device is provided in contact with the tissue
in the biological environment, for example via washing or rinsing
with one or more solvents (e.g., water). In an embodiment, for
example, the removable substrate is configured so as to be able to
be separated from the flexible or stretchable substrate after
administration, for example, via a delamination process.
[0086] In some embodiments, the transfer substrate comprises a
bioinert or biocompatible material, for example, to minimize or
avoid inflammation or unwanted immune responses upon administration
of the device to a tissue in a biological environment. In an
embodiment, for example, the transfer substrate is a polymer layer
such as a polyvinyl acetate layer. In an embodiment, for example,
the transfer substrate has a thickness selected from the range of
100 .mu.m to 100 mm. in an embodiment, for example, the transfer
substrate has a composition and physical dimensions that allowed
the device to be handled and/or administered by hand, for example,
during a surgical procedure.
[0087] In an aspect, the invention provides a device for collecting
electrophysiology data from a tissue in a biological environment,
the device comprising: (1) a flexible or stretchable substrate; (2)
a flexible or stretchable electrode array comprising one or more
inorganic semiconductor circuit elements and a plurality of
electrode elements positioned in electrical communication with at
least a portion of the semiconductor circuit elements, wherein the
one or more inorganic semiconductor circuit elements include
multiplex circuitry and amplification circuitry, and wherein the
electrode array is supported by the flexible or stretchable
substrate; (3) a barrier and/or cover layer encapsulating at least
a portion of the flexible or stretchable electrode array to limit a
net leakage current from the flexible or stretchable electrode
array to an amount that does not adversely affect the tissue;
wherein the flexible or stretchable substrate, the flexible or
stretchable electrode array and the barrier layer provide a net
bending stiffness of the device low enough that the device
establishes conformal contact with the tissue in the biological
environment, thereby, positioning at least one of the plurality of
electrode elements in electrical communication with the tissue in
the biological environment. In an embodiment, for example, the
electrode array comprises a plurality of electrode unit cells,
wherein each unit cell comprises a contact pad, amplifier and
multiplexer. In some embodiments, the contact pad provides an
electrical interface to the tissue and is in electrical contact
with the amplifier and multiplexer. In an embodiment, for example,
each of the unit cells of the flexible or stretchable electrode
array comprises a multilayer structure comprising one or more
semiconductor layers, one or more dielectric layers and one or more
metal layers provided in a multilayer stacked geometry. In an
embodiment, for example, the semiconductor layers of the multilayer
structure are positioned proximate to the neutral mechanical plane
of the flexible or stretchable electronic circuit.
[0088] In an aspect, the invention provides a method of collecting
electrophysiology data from a tissue in a biological environment,
the method comprising the steps of: (1) providing a conformable
electronic device comprising: (i) a flexible or stretchable
substrate; (ii) a flexible or stretchable electrode array
comprising one or more inorganic semiconductor circuit elements and
a plurality of electrode elements positioned in electrical
communication with at least a portion of the semiconductor circuit
elements, wherein the one or more inorganic semiconductor circuit
elements include multiplex circuitry and amplification circuitry,
and wherein the electrode array is supported by the flexible or
stretchable substrate; (iii) a barrier and/or cover layer
encapsulating at least a portion of the flexible or stretchable
electrode array to limit a net leakage current from the flexible or
stretchable electrode array to an amount that does not adversely
affect the tissue; wherein the flexible or stretchable substrate,
the flexible or stretchable electrode array and the barrier layer
provide a net bending stiffness of the device low enough that the
device establishes conformal contact with the tissue in the
biological environment; (2) contacting the tissue with the
conformable electronic device, thereby establishing the conformal
contact such that at least one of the plurality of electrode
elements is positioned in electrical communication with the tissue
in the biological environment; and (3) measuring one or more
voltages associated with the tissue in the biological environment
on at least a portion of the plurality of electrode elements. In an
embodiment, for example, the voltages associated with the tissue
have a spatial arrangement corresponding to a spatial arrangement
of the electrode elements. Methods of the invention may include the
steps of administering the conformable device to a subject (e.g., a
patient), and/or removal of the conformable device from the subject
(e.g., a patient). In an embodiment, the step of contacting the
conformable device with the tissue of the subject is carried out by
physically contacting one or more surfaces of the tissue with a
contact surface of the conformable device.
[0089] In an aspect, the invention provides a device for
interfacing with a tissue in a biological environment, the device
comprising: (1) a flexible or stretchable substrate; (2) a
stretchable or flexible array of light emitting diodes comprising a
plurality of light emitting diodes in electrical communication with
a plurality of stretchable or flexible electrical interconnects,
the stretchable or flexible array of light emitting diodes
supported by the flexible or stretchable substrate; and (3) a
barrier layer encapsulating at least a portion of the stretchable
or flexible array of light emitting diodes to limit a net leakage
current from the stretchable or flexible array of light emitting
diodes to the tissue to an amount that does not adversely affect
the tissue; wherein the flexible or stretchable substrate,
stretchable or flexible array of light emitting diodes and the
barrier layer provide a net bending stiffness of the device low
enough that the device establishes conformal contact with the
tissue in the biological environment. In an embodiment, the device
of this aspect is an implantable or skin mounted array of light
emitting diodes. In an embodiment, for example, the stretchable or
flexible array of light emitting diodes comprises a multilayer
structure comprising a plurality of individually encapsulated LED
array layers provided in a multilayer stacked geometry, for
example, wherein 2 to 50 individually encapsulated LED array layers
provided in a multilayer stacked geometry.
[0090] In an embodiment, the invention provides a method of
interfacing an array of light emitting diodes with a tissue of a
subject, the method comprising the steps of: (1) providing a
conformable device for interfacing with a tissue in a biological
environment, the device comprising: (i) a flexible or stretchable
substrate; (ii) a stretchable or flexible array of light emitting
diodes comprising a plurality of light emitting diodes in
electrical communication with a plurality of stretchable or
flexible electrical interconnects, the stretchable or flexible
array of light emitting diodes supported by the flexible or
stretchable substrate; and (iii) a barrier layer encapsulating at
least a portion of the stretchable or flexible array of light
emitting diodes to limit a net leakage current from the stretchable
or flexible array of light emitting diodes to the tissue to an
amount that does not adversely affect the tissue, wherein the
flexible or stretchable substrate, stretchable or flexible array of
light emitting diodes and the barrier layer provide a net bending
stiffness of the device low enough that the device establishes
conformal contact with the tissue in the biological environment;
and (2) contacting the conformable device with the tissue of the
subject, thereby establishing the conformal contact with the tissue
in the biological environment. Methods of the invention may include
the steps of administering the conformable device to a subject
(e.g., a patient), and/or removal of the conformable device from
the subject (e.g., a patient). In an embodiment, the step of
contacting the conformable device with the tissue of the subject is
carried out by physically contacting one or more surfaces of the
tissue with a contact surface of the conformable device.
[0091] The invention provides a range of bioanalytical and
therapeutic methods including diagnostic and therapeutic methods.
As will be appreciated by one of skill in the art, methods of the
invention may utilize any of the device configurations disclosed
herein. Devices of this aspect are useful, for example, for making
electrophysiology measurements of a tissue in a biological
environment. In embodiments, the biological environment is an
in-vivo biological environment. In certain embodiments, the
biological environment comprises an ionic solution, such as saline.
Devices of this aspect are useful for making measurements and/or
actuating tissues including, but not limited to, heart tissue,
brain tissue, muscle tissue, skin, nervous system tissue, vascular
tissue, epithelial tissue, retina tissue, ear drum, tumor tissue,
digestive system structures and any combination of these.
[0092] In an embodiment, the invention provides a method of sensing
or actuating a tissue in a biological environment; the method
comprising: (1) providing a subject having the tissue in the
biological environment; (2) providing a conformable device, the
device comprising: (i) a flexible or stretchable substrate; (ii) a
flexible or stretchable electronic circuit supported by the
flexible or stretchable substrate, wherein the flexible or
stretchable electronic circuit comprises an plurality of sensors,
actuators or both sensors and actuators provided in an array,
wherein said sensors or actuators comprise one or more inorganic
semiconductor circuit elements; and (iii) a barrier layer
encapsulating at least a portion of the flexible or stretchable
electronic circuit; wherein the barrier layer and the flexible or
stretchable substrate limit a net leakage current from the flexible
or stretchable electronic circuit to an amount which does not
adversely affect the tissue or the barrier layer is patterned so as
to selectively modulate physical contact, thermal contact, optical
communication or electrical communication between the flexible or
stretchable electronic circuit and the tissue in the biological
environment; wherein the flexible or stretchable substrate, the
flexible or stretchable electronic circuit and the barrier layer
provide a net bending stiffness of the device low enough that the
conformable device establishes conformal contact with the tissue in
the biological environment; (3) contacting the tissue with the
conformable device, thereby establishing the conformal contact such
that at least a portion of the plurality of sensors, actuators or
both sensors and actuators of the array is provided in physical
contact, electrical communication, optical communication, fluid
communication or thermal communication with the tissue in the
biological environment; and (4) sensing or actuating the tissue in
contact with the conformable device. In an embodiment, for example,
the biological environment is an in-vivo biological environment. In
an embodiment, for example, the tissue in the biological
environment comprises heart tissue, brain tissue, muscle tissue,
skin, nervous system tissue, vascular tissue, epithelial tissue,
retina tissue, ear drum, tumor tissue, a digestive system structure
or any combination of these. In an embodiment, for example, the
step of contacting the tissue with the conformable device
establishes conformal contact between one or more contact surfaces
of the conformable device and an area of the tissue selected from
the range of from 10 mm.sup.2 to 10,000 mm.sup.2. In an embodiment,
for example, the method further comprising the step of moving the
conformable device along a surface of the tissue in the biological
environment.
[0093] In an embodiment, the step of sensing or actuating the
tissue in contact with the conformable device comprises: generating
one or more voltages at a plurality of different regions on a
surface of the tissue; sensing one or more voltages at a plurality
of different regions on a surface of the tissue; or sensing one or
more voltages at a plurality of different regions on a surface of
the tissue and generating one or more voltages at a plurality of
different regions on the surface of the tissue. In a method, for
example for sensing applications, the voltages are selected from
the range of -100 mV to 100 mV, optionally for some applications
from the range of -50 mV to 50 mV, and optionally for some
applications from the range of -20 mV to 20 mV. In a method, for
example for stimulation and actuation applications, the voltages
are selected from the range of -100 V to 100 V, optionally for some
applications from the range of -5 V to 5 V, and optionally for some
applications from the range of -1 V to 1 V.
[0094] In an embodiment, the step of sensing or actuating the
tissue in contact with the conformable device comprises: generating
one or more currents at a plurality of different regions on a
surface of the tissue; sensing one or more currents at a plurality
of different regions on a surface of the tissue; or sensing one or
more currents at a plurality of different regions on a surface of
the tissue and generating one or more currents at a plurality of
different regions on the surface of the tissue.
[0095] In an embodiment, the step of sensing or actuating the
tissue in contact with the conformable device comprises: sensing
electromagnetic radiation at a surface of the tissue; generating
electromagnetic radiation at a surface of the tissue; or sensing
electromagnetic radiation at a surface of the tissue and generating
electromagnetic radiation at the surface of the tissue. In a
method, for example, the electromagnetic radiation has a
distribution of wavelengths in the ultraviolet, visible, near
infrared, microwave and/or radiowave regions of the electromagnetic
spectrum. In a method, for example, the step of sensing or
actuating the tissue in contact with the conformable device
comprises ablating at least a portion of the tissue, such as a
portion of the tissue comprising a lesion or tumor.
[0096] In an embodiment, the step of sensing or actuating the
tissue in contact with the conformable device comprises:
transporting a target molecule from a surface of the tissue to the
flexible or stretchable electronic circuit; transporting a target
molecule from the flexible or stretchable electronic circuit to a
surface of the tissue; or transporting a target molecule from a
surface of the tissue to the flexible or stretchable electronic
circuit and transporting a target molecule from the flexible or
stretchable electronic circuit to a surface of the tissue. In a
methods, for example, the target molecule is selected from the
group consisting of polypeptides, polynucleotides, carbohydrates,
proteins, steroids, glycopeptides, lipids, metabolites and drugs,
including photoactive drugs such as Type 1 or Type 2 phototherapy
agents.
[0097] In an embodiment, the step of sensing or actuating the
tissue in contact with the conformable device comprises: sensing or
changing a temperature of a region of the tissue; sensing or
changing a pressure of a region of the tissue; sensing or changing
a position of the tissue; sensing or generating an electrical field
at a region of the tissue; or sensing or generating a magnetic
field at a region of the tissue.
[0098] In an embodiment, a method of this aspect further comprises
administering to the subject a therapeutic agent, wherein the
therapeutic agent localizes at the tissue, wherein the step of
sensing or actuating the tissue in contact with the conformable
device comprises activating the therapeutic agent at the tissue or
specific region thereof (e.g., a tumor or lesion). Methods and
devices of the invention are capable of a range of activation
techniques, including optical activation, electronic activation,
acoustic activation or thermal activation.
[0099] In an embodiment, the step of sensing or actuating the
tissue in contact with the conformable device comprises measuring
an electrophysiological signal from the tissue, measuring an
intensity of electromagnetic radiation from the tissue, measuring a
change in the concentration of a target molecule at the target
tissue, measuring an acceleration of the tissue, measuring a
movement of the tissue, measuring a position of the tissue or
region thereof or measuring a temperature of the tissue. In a
method, for example, the tissue is heart tissue, and wherein the
step of sensing or actuating the tissue in contact with the
conformable device comprises simultaneously applying multiple
pacing stimuli to the heart tissue, such as applying a plurality of
voltages to different areas of the tissue at the same or different
times. In an embodiment of this aspect, the tissue is epicardium
tissue.
[0100] In an embodiment, the step of contacting the tissue with the
conformable device is carried out via a surgical technique. In a
method, for example, the step of contacting the tissue with the
conformable device is carried out using a catheter. In a method,
for example, the conformable device is collapsed, rolled or wrapped
on itself and inserted into the catheter, and wherein the catheter
is subsequently positioned at the tissue and the conformable device
is released from the catheter, thereby delivering the conformable
device to a surface of the tissue. In a method, for example, the
conformable device changes conformation upon release from the
catheter so as to establish conformal contact with one or more
surfaces of the tissue, for example by unrolling or unwrapping.
[0101] In an embodiment, a method of the invention comprises a
diagnostic or therapeutic procedure, for example a surgical
diagnostic or therapeutic procedure. In a method, for example, the
diagnostic or therapeutic procedure is selected from the group
consisting of anatomic mapping, physiologic mapping and
resynchronization therapy. In a method, for example, the diagnostic
or therapeutic procedure comprises measuring cardiac contractility,
myocardial wall displacement, myocardial wall stress, myocardial
movement or ischemic changes. In a method, for example, the
diagnostic or therapeutic procedure comprises cardiac mapping or
cardiac resynchronization therapy. In a method, for example, the
diagnostic or therapeutic procedure comprises cardiac ablation
therapy.
[0102] In an embodiment, for example, the flexible or stretchable
electronic circuit comprises a plurality of sensors for
determination and/or discrimination of tissue properties and one or
more actuators that is an ablation source for ablating one or more
regions of the tissue. In a method, for example, the sensors for
determination and/or discrimination of tissue properties
distinguish one or more components of the tissue selected from the
group consisting of a lesion, a tumor, epicardial muscle,
myocardial tissue, epicardial fat, a coronary artery, and a nerve.
In a method, for example, the ablation source selectively ablates
the lesion or tumor component of the tissue.
[0103] In another embodiment, any of the devices and methods
disclosed herein relate to a skin-mounted device that does not, at
least initially, have a flexible or stretchable substrate. Instead,
the substrate may functionally correspond to a transfer substrate
that picks up the flexible or stretchable electronic circuit,
applies it to the skin, and the transfer substrate removed with the
flexible or stretchable electronic circuit left connected to the
skin, including in conformal contact. Optionally, a contact layer
is applied to the skin to facilitate receipt, placement, and
long-term use of the device connected to the skin. Removal of the
transfer substrate or stamp leaves behind a free-standing flexible
or stretchable electronic circuit in conformal contact without a
flexible or stretchable substrate (other than the skin and
optionally contact layer). The exposed surface of the flexible or
stretchable electronic circuit is covered with a cover layer, such
as by application of a polymer layer by a liquid bandage
application. Repeated cover layer application ensures the device is
adequately protected from the surrounding environment. In this
manner, long-term and comfortable wearability is achieved. Such
long-term function may be described quantitatively in terms of
continued conformal contact maintained, such as over at least 90%
or 95%, continued sensor or actuator functionality, and lack of
unduly adverse biological response.
[0104] In another embodiment, provided herein is a device for
establishing an interface with a skin of a subject, the device
comprising a flexible or stretchable electronic circuit comprising
an array of sensors, actuators, or sensors and actuators, wherein
elements of the array are interconnected by serpentine
interconnects, the flexible or stretchable electronic circuit
configured for conformal contact with the skin of a subject. A
contact layer is positioned between the flexible or stretchable
electronic circuit and the skin to provide conformal contact
between the flexible or stretchable electronic circuit and the
skin. A cover layer covers the flexible or stretchable electronic
circuit when the device is in conformal contact with skin. In an
aspect, the cover layer and contact layer is a polymer layer from a
spray liquid bandage. In an aspect, the device has a plurality of
cover layers, such as from between 2 and 10, or about 4. In an
aspect, the cover layers are applied at different time points, such
as on the order of every few hours or about every day.
[0105] In an embodiment, the contact layer is a polymer layer
formed from a spray bandage applied to the skin and the cover layer
is a polymer layer formed from a spray bandage applied to the
flexible or stretchable electronic circuit in conformal contact
with the skin. In this manner, the device is for long-term
monitoring, wherein the sensors measure and transmit information
about a physical parameter of the skin over a maximum time period
that is at least seven days.
[0106] Also provided are related methods of interfacing an
electronic device with a skin of a subject by applying a liquid
bandage on the skin to form a contact layer on the skin and
contacting a conformable electronic device with the contact layer
on the skin to establish conformal contact between the conformable
electronic device and the underlying skin. In an embodiment, the
conformable electronic device comprises a plurality of sensors
interconnected by serpentine interconnects. A liquid bandage is
applied over the conformable electronic device in conformal contact
with the skin to provide a cover layer. Any of the methods
disclosed herein further comprise wirelessly transmitting data from
the plurality of sensors to a receiver. Any of the devices and
methods are for an interfacing duration that is at least seven days
without substantial degradation of conformal contact, conformal
electronic device performance, or adverse biological response of
the skin underlying the conformal electronic device. In this
context "adverse biological response" refers to unduly large
responses attributed to the device including user-selected
percentage of cell death or turnover compared to normal without the
device, rash, itchiness, or other dermatological response.
[0107] Without wishing to be bound by any particular theory, there
can be discussion herein of beliefs or understandings of underlying
principles relating to the invention. It is recognized that
regardless of the ultimate correctness of any mechanistic
explanation or hypothesis, an embodiment of the invention can
nonetheless be operative and useful.
BRIEF DESCRIPTION OF THE DRAWINGS
[0108] FIGS. 1A-1E provide schematic illustrations and images
corresponding to steps for fabricating a device.
[0109] FIGS. 2A and 2B provide designs of multiplexing circuits for
conformable devices; FIGS. 2C-2F provide data showing electrical
properties of conformable devices; FIG. 2G shows an image of a
conformable device submerged in saline solution and FIG. 2H shows a
sine wave response before and after saline immersion.
[0110] FIGS. 3A-3C show photographs of a conformable device in
vivo. FIG. 3C also provides a spatial map of electrophysiology data
measured by a conformable device showing individual layers of a
multilayer device geometry.
[0111] FIGS. 4A-4F provide representative electrophysiology data
recorded by a conformable device in vivo.
[0112] FIGS. 5A-5D provide schematic illustration corresponding to
steps for fabricating conformable devices.
[0113] FIG. 6 provides a magnified photograph showing a conformable
device in a flexed configuration.
[0114] FIG. 7 shows the physical layout of a single unit cell of a
conformable device embodiment.
[0115] FIG. 8 shows processing steps for forming the unit cell of
FIG. 7.
[0116] FIG. 9 shows an optical microscope image of a single unit
cell of a conformable device embodiment.
[0117] FIG. 10A shows a flow diagram for wiring a conformable
device to an external circuit. FIGS. 10B and 10C show photographs
of a flexible device and external wiring components.
[0118] FIGS. 11A and 11B show images of the acquisition system.
[0119] FIG. 12 provides data showing a measured signal to noise
ratio dependence on multiplexing frequency.
[0120] FIGS. 13A and 13B respectively show a schematic diagram of
wrapping a conformable device on a curved surface and a cross
sectional view of a conformable device embodiment.
[0121] FIGS. 14A and 14B show sine wave measurements on conformable
devices before and after immersion in a saline solution at
frequencies of 4 and 40 Hz, respectively.
[0122] FIGS. 15A and 15B show images of an animal experiment where
a conformable device is place on the surface of cardiac tissue.
[0123] FIG. 16 shows a color map illustrating the average amplitude
of electrophysiology data measured over a cardiac activation
cycle.
[0124] FIGS. 17A and 17B show isochronal activation maps without
and with external pacing, respectively. The relative pacing
electrode is indicated by an asterisk.
[0125] FIG. 18 shows representative voltage data for cardiac
electrophysiology measurements at four points in time during a
cardiac activation cycle.
[0126] FIG. 19 shows the design of an adapter circuit board
embodiment for connecting a conformable device to external
circuitry through a 40 pin ribbon cable.
[0127] FIG. 20 shows the design of an interface circuit board
embodiment.
[0128] FIG. 21 shows an image obtained from an animal
experiment.
[0129] FIG. 22 shows a frame from an electrophysiology data map
movie for an unpaced heart.
[0130] FIG. 23 shows a frame from an electrophysiology data map
movie for a paced heart.
[0131] FIG. 24 shows a frame from an electrophysiology data map
movie for a paced heart.
[0132] FIG. 25A shows a cross sectional image of a single layer
barrier layer embodiment. FIG. 25B shows a cross sectional image of
a dual layer barrier layer embodiment.
[0133] FIG. 26A provides a schematic illustration of a cross
sectional view of a conformal electronic device embodiment. FIG.
26B provides a schematic illustration of a cross sectional view of
a conformal electronic device having a barrier layer comprising a
multilayer structure.
[0134] FIGS. 27A-27G. Device layouts of .mu.-ILED arrays and their
responses to uniaxial and balloon-shape biaxial stretching. FIG.
27A. Optical image of a 6.times.6 array of .mu.-ILEDs (100
.mu.m.times.100 .mu.m, and 2.5 .mu.m thick, in an interconnected
array with a pitch of .about.830 .mu.m) with non-coplanar
serpentine bridges on a thin (.about.400 .mu.m) PDMS substrate
(left frame). Schematic illustration (right) and corresponding
photograph (inset) of a representative device, with encapsulation.
FIG. 27B. Optical images of a stretchable 6.times.6 array of
.mu.-ILEDs, showing uniform emission characteristics under
different uniaxial applied strains (top left: 0%, bottom left: 48%
along horizontal direction, top right: 0%, bottom right: 46% along
diagonal direction). FIG. 27C. Current-voltage (I-V)
characteristics of this array measured in the strained
configurations shown in FIG. 27B (left) and voltage at 20 .mu.A
current for different cycles of stretching to 75% along the
horizontal direction (right). FIG. 27D. Tilted (left) view optical
images of a stretchable array (6.times.6) of .mu.-ILEDs on a thin
(.about.500 .mu.m) PDMS membrane in a flat configuration (top) and
in a hemispherical, balloon state (bottom) induced by pneumatic
pressure. FIG. 27E. The magnified view of FIG. 27D from the top.
The yellow dashed boxes highlight the dimensional changes
associated with the biaxial strain. FIG. 27F. I-V characteristics
of the array in its flat and inflated state. FIG. 27G. Distribution
of meridional and circumferential strains determined by 3D-FEM.
[0135] FIGS. 28A-28F. Responses of .mu.-ILED arrays to twisting and
stretching on sharp tips. FIG. 28A. Optical images of an array of
.mu.-ILEDs (3.times.8) on a band of PDMS twisted to different
angles (0.degree. (flat), 360.degree., and 720.degree. from top to
bottom), collected with (left) and without (right) external
illumination. FIG. 28B. SEM image of the array when twisted to
360.degree.. The serpentine interconnects move out of the plane
(red box) to accommodate the induced strains. FIG. 28C. I-V
characteristics of the array twisted by various amounts (0 (flat),
360 and 720.degree.). FIG. 28D. Distributions of axial (left),
width (center) and shear (right) strain determined by 3D-FEM for
twisting to 720.degree.. FIG. 28E. Optical images of an array of
.mu.-ILEDs (6.times.6), tightly stretched on the sharp tip of a
pencil, collected with (left) and without (right) external
illumination. The white arrows indicate the direction of
stretching. The inset image was obtained without external
illumination. FIG. 28F. I-V characteristics of the array in FIG.
28E, before (initial), during (deformed) and after (released)
deformation. The inset provides a graph of the voltage needed to
generate a current of 20 .mu.A, measured after different numbers of
cycles of deformation.
[0136] FIGS. 29A-29G. Multilayer laminated configurations of arrays
of .mu.-ILEDs for high effective area coverage and integration on
various unusual substrates. FIG. 29A. Schematic, exploded view
illustration for a stacked device formed by multilayer lamination.
FIG. 29B. Optical images of a four layer stack of 4.times.4 arrays
with layer-to-layer offsets designed to minimize overlap of
interconnect lines with positions of the .mu.-ILEDs. The images
show emission with different numbers of layers in operation (1st
layer on, 1st and 2nd layers on, 1st, 2nd and 3rd layers on, and
1st, 2nd, 3rd and 4th layers on). FIG. 29C. Optical images of a two
layer stack of 8.times.8 arrays, with different layers in
operation. The inset shows the device in a bent state (bending
radius .about.2 mm) with both layers on. FIG. 29D. Optical image of
an array of .mu.-ILEDs (8.times.8) on a piece of paper, in a folded
state (bending radius .about.400 .mu.m) during operation. The inset
shows the device in its flat state. FIG. 29E. Image of a 6.times.6
array on a sheet of aluminum foil under crumpled state. The inset
shows the device in its flat state. FIG. 29F. Images of a thin
(.about.8 .mu.m), narrow (820 .mu.m) strip of .mu.-ILEDs
(1.times.8) with serpentine interconnects on a rigid plastic tube
(diameter .about.2.0 mm, left). Inset shows the magnified view of a
single pixel. FIG. 29G. A thin strip LED device consisting of an
isolated .mu.-ILED with straight interconnects wrapped around a
glass tube (diameter .about.5.0 mm, right).
[0137] FIG. 30A. Schematic exploded view illustration of an array
of .mu.-ILEDs (5.times.5) on a thin PET film (50 .mu.m thick)
coated with an adhesive. Layers of PDMS on the top and bottom
provide a soft, elastomeric encapsulation that offers
biocompatibility and an excellent barrier to biofluids and
surrounding tissue. FIG. 30B. Image of an animal model with this
array implanted under the skin, and on top of the muscle tissue.
The inset shows the device before implantation.
[0138] FIGS. 31A-31B. Schematic illustration of epitaxial layer
(FIG. 31A) and fabrication processes for .mu.-ILEDs arrays on a
carrier glass substrate after transfer printing (FIG. 31B).
[0139] FIG. 32A. Schematic illustration (left frame) and
corresponding microscope (top right frame) and SEM (bottom right
frame) images of a 6.times.6 .mu.-ILEDs on a handle glass substrate
coated with layers of polymers (epoxy/PI/PMMA). FIG. 32B. Schematic
illustration (left frame) and corresponding microscope (top right
frame) and optical (bottom right frame) images of a 6.times.6
.mu.-ILEDs array which is picked up with a PDMS stamp for transfer
printing. A shadow mask for selective deposition of Cr/SiO2
(thickness: 3 nm/30 nm) covers the retrieved array on a soft
elastomeric PDMS stamp. FIG. 32C. Schematic illustration of
transfer printing to a pre-strained thin (thickness: .about.400
.mu.m) PDMS substrate (left frame) and microscope (top right frame)
and SEM (bottom right frame) images of the transferred .mu.-ILEDs
array on a prestrained thin PDMS substrate. Prestrain value was
.about.20%.
[0140] FIG. 33A. Schematic illustration of top encapsulation layers
indicating some of the key dimensions. FIG. 33B. Schematic
illustration of the cross sectional structure at an island, with
approximate thicknesses for each layer. The inset corresponds to an
SEM image of a .mu.-ILEDs array after transfer printing to a thin
PDMS substrate with prestrain of .about.20%. FIG. 33C. Schematic
illustration of the cross sectional structure at metal
interconnection bridges, with approximate thicknesses of each
layer.
[0141] FIG. 34A. Tilted view SEM images of adjacent .mu.-ILEDs
(yellow dashed boxes) before (left, formed with .about.20%
pre-strain) and after (right) stretching along the horizontal
direction (red arrows). FIG. 34B. Strain distributions determined
by 3D-FEM for the cases corresponding to frames in FIG. 34A. The
black outlines indicate the positions of the devices and the
serpentines before relaxing the pre-strain.
[0142] FIG. 35A. Optical microscope images of two pixels in a
.mu.-ILEDs array with a serpentine bridge design before (left
frame) and after (right frame) external stretching along the
horizontal direction. The upper and lower images show optical
micrographs in emission light off (upper) and on (lower) states.
The distance between adjacent pixels appears in the lower images
and used for calculation of applied strains. The lower images were
obtained without external illumination. FIG. 35B. Optical
micrograph images of two pixels in a .mu.-ILEDs array before (left
frame) and after (right frame) external stretching along the
diagonal direction. FIG. 35C. FEM simulation under external
stretching along the diagonal direction (left frame), and strain
contours in the GaAs active island (top right frame) and the metal
bridge (bottom right frame).
[0143] FIG. 36. Optical images of a 6.times.6 .mu.-ILEDs array with
a serpentine mesh design with external illumination under the same
strain circumstances as FIG. 27B.
[0144] FIG. 37A. Optical image of an 8.times.8 .mu.-ILEDs array on
a thin PDMS substrate in its on state, which is under the same kind
of deformed condition as bottom left frame of FIG. 27D. FIG. 37B.
Top view optical images of same array as FIG. 27D in its `flat`
(left frame) and `inflated` state (right frame) without external
illumination. FIG. 37C. Spatial distribution of FEM results of the
right frame of FIG. 27D and analytical solutions calculated from
Equations (S1) and (S2).
[0145] FIG. 38A. Schematic illustrations of a 3.times.8 .mu.-ILEDs
array integrated on a thin PDMS substrate with detailed dimensions
(upper frame: registrations of the .mu.-ILEDs on a PDMS donor
substrate, lower frame: entire view of the printed 3.times.8
.mu.-ILEDs array). The inset on top represents an optical
microscope image of this .mu.-ILEDs array on a handle glass
substrate before transfer printing. FIG. 38B. Magnified view of the
SEM image in FIG. 28B. The white dotted rectangle highlights the
non-coplanar bridge structures. FIG. 38C. Voltage at 20 .mu.A
current for each twisting cycle of 360.degree..
[0146] FIG. 39. FEM strain contours of axial (top), width (center),
and shear (bottom) strains for 360.degree. twisted PDMS
substrate.
[0147] FIGS. 40A-40B. Fatigue test result of a 6.times.6 .mu.-ILEDs
array as shown in FIG. 28E. FIG. 40A. Plot of I-V characteristics
of a 6.times.6 .mu.-ILEDs array as a function of deformation
cycles. FIG. 40B. Plot of voltage needed to generate a current of
20 .mu.A measured after deformation cycles up to 1000 times. Each
deformed state is approximately same as shown in FIG. 28E.
[0148] FIG. 41A. Schematic illustration of stacked devices
describing states of FIG. 29B. FIG. 41B. Optical images of stacked
devices as shown in FIG. 29B, collected without external
illumination.
[0149] FIG. 42A. The strain distribution of the two-layer system in
the stacked array bent to a radius of curvature 2 mm, as shown in
FIG. 29C. The black dashed rectangles demonstrate the positions of
.mu.-ILEDs. FIG. 42B. The strain distribution in GaAs layers in the
.mu.-ILEDs island.
[0150] FIG. 43A. Optical image of a 6.times.6 .mu.-ILEDs array with
serpentine metal interconnects, integrated on fabrics, in its bent
and on state (bending radius .about.4.0 mm). The inset shows the
device in its flat and off state. FIG. 43B. Plot of I-V
characteristics of this array in its bent state. Inset provides a
graph of the voltage needed to generate a current of 20 .mu.A,
measured after different numbers of cycles of bending deformation.
FIG. 43C. Optical image of an 8.times.8 .mu.-ILEDs array with a
human pattern, integrated on a fallen leaf, in its bent and on
state. The inset image was collected with external illumination.
FIG. 43D. Plot of I-V characteristics in the bent state as shown in
FIG. 43C. FIG. 43E. Optical image of a .mu.-ILEDs array integrated
on a paper in its folded and on state. FIG. 43F. Optical image of
the same .mu.-ILEDs array as shown in FIG. 29E in its mildly
crumbled state. Inset represents microscope image of adjacent four
pixels in their on states.
[0151] FIG. 44A. Plot of I-V characteristics of a 6.times.6
.mu.-ILEDs array integrated on paper in its flat (FIG. 29D inset)
and folded (FIG. 29D) state. FIG. 44B. Plot of I-V characteristics
of a 6.times.6 .mu.-ILEDs array integrated on aluminum foil in its
flat (FIG. 29E inset) and crumbled (the center frame of FIG. 29E)
state. FIG. 44C. Fatigue tests of arrays of 6.times.6 .mu.-ILEDs as
shown in FIG. 43E. Plot of I-V characteristics of a .mu.-ILEDs
array integrated on paper as a function of deformation cycles (left
frame). Plot of voltage needed to generate a current of 20 .mu.A
measured after deformation cycles up to 1000 times (right frame).
FIG. 44D. Fatigue tests of arrays of 6.times.6 .mu.-ILEDs as shown
in FIG. 43F. Plot of I-V characteristics of a .mu.-ILEDs array
integrated on aluminum foil as a function of deformation cycles
(left frame). Plot of voltage needed to generate a current of 20
.mu.A measured after deformation cycles up to 1000 times (right
frame).
[0152] FIGS. 45A-45D. SEM images of various substrate such as
fabrics (FIG. 45A), Al foils (FIG. 45B), paper (FIG. 45C), and
fallen leaves (FIG. 45D) before (left frame) and after (right
frame) coating of thin layer of PDMS.
[0153] FIG. 46. Schematic illustration of the encapsulation of an
implantable array of .mu.-ILEDs as described in FIGS. 30A and
30B.
[0154] FIG. 47A. Result of Luminance (L)-Current (I)-Voltage (V)
measurement of an individual pixel with and without applied ohmic
contacts. FIG. 47B. Applied voltage to generate a current of 20
.mu.A, measured after different operation time. The inset provides
I-V characteristics with different operation time.
[0155] FIG. 48A. Schematic illustration of analytical model for the
inflation and printing-down of PDMS film. FIG. 48B. FEM contours of
meridional (upper left) and circumferential (lower left) strains of
the inflated state and its comparison with analytical solutions
calculated from Equations (S1) and (S2). FIG. 48C. FEM contours of
meridional (upper left) and circumferential (lower left) strains of
the as-printed state and its comparison with analytical solutions
Equations (S3) and (S4) (right frame).
[0156] FIG. 49. Schematic illustration of the cross section of
.mu.-ILEDs on a substrate.
[0157] FIG. 50A. Four frames of the electrode array transfer
printed onto thin, low modulus ecoflex. On skin (left top),
partially peeled off state (right top), magnified view of each top
frame (bottom). Blue dotted boxes correspond to the magnified
images at the bottom frame. The modulus and thickness of ecoflex
substrate is .about.50 kPa and .about.30 um, respectively. The
electrode array is facing down to skin, sandwiched by the skin and
ecoflex substrate. FIG. 50B. Schematic view of application
procedures of skin patch to the skin. The electrode array is
transfer printed onto ecoflex, coated on the PVA film, and water
dissolvable and biocompatible film. The transferred electrode array
is positioned onto the right location of skin. Some water can be
applied to the backside of PVA film to dissolve it away. Thin, low
modulus skin patch conforms very well to skin, like a tattoo. FIG.
50C. Deformed images of skin patch on skin to four different
directions and their magnified views. The highly conformal skin
patch follows the wrinkles on skin very well. FIG. 50D. Electrode
array transfer printed at the backside of the commercial temporary
tattoo. It is applied to the skin. Instead of ecoflex thin film, a
temporary tattoo can be used for the purpose of camouflage or
cover-up. FIG. 50E. A schematic diagram illustrating a
cross-sectional view of a skin-mounted conformal device of the
invention having a polyimide encapsulating barrier layer.
[0158] FIG. 51A. Mechanically optimized fully serpentine electrode
array (left). The right frame shows the stress-strain relationship
from which the modulus in the plot was calculated. The optimized
design shows comparable modulus with the bare skin. FIG. 51B.
Debonding experiment results under tension (left) and compression
(right). As the modulus and thickness decrease, the debonding
happens at larger strain. FIG. 51C. Cross-sectional image (X-ray)
of skin electronic devices located on the pig skin.
[0159] FIG. 52A. Serpentine shape active EMG/EKG sensor. Left top
frame shows source, drain and gate of nmos transistor and silicon
drain to gate feedback resistor. Inset shows conventional shape
active EMG/EKG sensor. Left bottom image shows the final device
image for serpentine shape device and its magnified view (inset).
Right top and bottom frame shows transfer and IV curve for the
transistor. FIG. 52B. Circuit diagram for active EMG/EKG sensor and
the frequency response of active sensor (common source amplifier).
FIG. 52C. Microscope image of temperature sensor using platinum
resistor and gold serpentine wires. Right frame shows the
calibration curve, showing different resistances of temperature
sensor at different temperatures. FIG. 52D. Microscope image of
strain gauge using conductive PDMS (CPDMS). Right frame shows the
calibration curve of the strain gauge. FIG. 52E. Microscope images
of proximity sensor using forward and reverse biased LED array.
Forward biased LED array radiates light and reverse biased LED
array detects the reflected light from the object. As the distance
between the object and LED array decreases, the reflectance
increases and thereby the photocurrent increases, as shown in the
right frame. FIG. 52F. A single LED pixel powered by wireless power
transmission coil. Right frame shows the IV curve of LED pixel.
FIG. 52G. Microscope image of PN diodes (left) and it S21 value
measured at different frequencies in radio frequency range. FIG.
52H. Microscope image of inductor and capacitor pair (left top).
Right top plot shows S21 value of capacitor at various RF
frequencies and left bottom plot shows S21 and S11 values of
inductor at RF frequencies. Right bottom plot shows the estimated
oscillation frequencies for different capacitors.
[0160] FIG. 53A. Passive electrode array on forehead for undeformed
(left top) and deformed (right top and bottom) state. Left bottom
image shows the partially peeled off state. FIG. 53B. EEG
measurement results for Stroop test. When the target letter matches
with the highlighted letter (congruent case) the response speed is
faster than unmatched (incongruent case) case. FIG. 53C. EEG
measurement results for eye open and eye close case. Left plot
shows raw EEG and right plot shows results after Fourier
transformation.
[0161] FIG. 54A. EKG measurement result measured with active EKG
sensor (left) and magnified view of single heartbeat (right). FIG.
54B. EMG measurement result from a right leg during walking (from 0
sec to 10 sec) and standing (from 10 sec to 20 sec) measured with
active EMG sensor (left) and conventional passive EMG sensor with
conductive gel (right). FIG. 54C. Magnified view of EMG signal of
FIG. 54B. FIG. 54D. Corresponding spectrogram for each electrode.
FIG. 54E. EMG measurement result from neck for four different
words, "up", "down", "left" and "right". FIG. 54F. Corresponding
spectrogram for four words. FIG. 54G. Video game control using
recorded EMG signal.
[0162] FIG. 55 is block diagram of a system for a wide range of
biological sensing and therapeutic treatment applications.
[0163] FIG. 56 is a diagram depicting the collapsible nature of a
flexible high-density micro-array device that can be deployed to a
tissue site.
[0164] FIG. 57 is a diagram depicting insertion of the array device
into a sheath for introduction into a patient.
[0165] FIG. 58 is a diagram depicting deployment of the array
device from a sheath to a tissue surface.
[0166] FIG. 59 is a diagram of the array device deployed on the
surface of the heart.
[0167] FIGS. 60 and 61 are diagrams showing connection of the array
device to an implantable electronics unit.
[0168] FIG. 62 is a diagram showing a specific example of elements
on the array device.
[0169] FIG. 63 is a timing diagram showing examples of stimulation
timing schemes to groups of elements on the array device.
[0170] FIG. 64 is a flow chart of a continuously adjustable
stimulation process using the array device.
[0171] FIG. 65 is a diagram showing a configuration of the array
device suitable for providing mechanical support to a portion of
the heart.
[0172] FIG. 66 is a block diagram showing the array device used in
a cardiac mapping and ablation system configuration.
[0173] FIGS. 67A and 67B are diagrams showing photos of actual
deployment of the array device on the surface of a heart. FIG. 67C
is a diagram depicting the mapping data that can be obtained from
the array device in the environment shown in FIGS. 67A and 67B.
[0174] FIG. 68 illustrates an example of the array device 100.
[0175] FIG. 69 is a schematic diagram that illustrates how unit
cells connect to other unit cells to create a multiplexed signal
output, for example for sensing from one of the elements 110 that
is configured to operate as a sensor electrode.
[0176] FIG. 70 is similar to FIG. 69, but adds stimulation control
capability. In this example, the stimulation input lines STIM0,
STIM1, etc., are provided.
[0177] FIG. 71 illustrates a schematic diagram that is similar to
FIG. 70, but uses independent stimulation row select signals.
[0178] FIG. 72 shows an example transistor level schematic for an
element 110 in a sensing configuration. There is a constant current
source 112, a current mirror 114 and a multiplexer 116.
[0179] FIG. 73 shows an example transistor level layout for an
element 110 with stimulation control according to that described
above in connection with FIG. 70.
[0180] FIG. 74 shows an example transistor level layout for an
element 110 with row independent selectable stimulation control
according to that described above in connection with FIG. 71.
[0181] FIG. 75A. Image of a multifunctional, `skin-like` electronic
system that serves as a demonstration platform for
electrophysiological and temperature sensors, strain gauges, LEDs,
wireless power coils, RF inductors, capacitors, diodes and
oscillators, and a wireless transmit/receive antenna. Mounting this
device on a sacrificial, water-soluble film of PVA, placing the
entire structure against the skin, with electronics facing down,
dissolving the PVA and then drying to remove the remaining water
leaves the device conformally attached to the skin, in an overall
procedure similar to that used for a temporary transfer tattoo. The
elastic moduli, thickness and other physical properties of the
device match the epidermis; we refer to the technology as an
epidermal electronic system (EES). Adequate adhesion is possible
through van der Waals forces alone, in a format that imposes
negligible mass or mechanical loading effects on the skin; (FIG.
75B) EES partially (top frame) and fully (bottom frame) peeled away
from the skin. The inset shows a representative cross-sectional
illustration of the structure, with the neutral mechanical plane
(NMP) defined by a red dashed line; (FIG. 75C) Multifunctional EES
on skin: undeformed (first frame), compressed (middle frame) and
stretched (right frame); (FIG. 75D) A commercial temporary transfer
tattoo provides an alternative to PE/PVA for the substrate; in this
case, the system includes an adhesive to improve bonding to the
skin. Images of the backside of a tattoo (first frame), electronics
integrated onto this surface (second frame) and attached to skin
with electronics facing down in undeformed (third frame) and
compressed (fourth frame) states.
[0182] FIG. 76A. Plots of critical tensile (left frame) and
compressive (right frame) strains for delamination of a test
structure consisting of films of PDMS on substrates of PE, designed
to model the EES/skin system. Data for formulations of PDMS with
two different moduli are shown (red: 19 kPa; blue: 145 kPa). The
results indicate that the critical strains increase as the PDMS
thickness and modulus decrease, consistent with modeling results
(lines). FIG. 76B. Optical micrograph of an EES with filamentary
serpentine (FS) design (left frame). The plot in the right frame
shows the stress-strain data from uniaxial tensile measurements on
an FS-EES, for two orthogonal directions. Data collected from a
sample of pig skin are also presented. The FS-EES has modulus
comparable to or less than the skin, over the range of strains
shown here. The dashed lines correspond to calculations by finite
element modeling. FIG. 76C. Contour plots of strain distributions
computed by FEM, for 30% tensile strains along x (left) and y
(right). The results indicate maximum principle strains of less
than 0.2% in the FS structures. FIG. 76D. Skin of the forehead
before (top left frame) and after integration of a representative
FS-EES, at various magnifications and states of deformation. The
dashed blue boxes in the right frames highlight the outer boundary
of the device. The red arrows indicate the direction of compressive
strains, generated by contraction of facial muscles. The red dashed
box in the upper right frame corresponds to the field of view of
the image in the lower left. FIG. 76E. Confocal microscope image
(top view) of the contacting interface between an FS-EES and a
sample of pig skin. The FS structure and the skin are dyed with red
and blue fluorophores, respectively. FIG. 76F. Cross-sectional
confocal images, at locations corresponding to the numbered, white
dashed lines shown in the top view frame above. The results
indicate intimate, conformal contact, to within the resolution of
the microscope. FIG. 76G. Mechanics analysis of the condition for
conformal contact as a function of tattoo-skin adhesion and skin
roughness.
[0183] FIG. 77A. Optical micrographs of an active
electrophysiological (EP) sensor with local amplification, as part
of an FS-EES. The left frame shows the source, drain and gate of a
silicon MOSFET and a silicon feedback resistor before connection to
sensor electrodes, all in FS layouts. The right image shows the
final device, after metallization for the interconnects and sensor
electrodes, with magnified view (inset). FIG. 77B. Circuit diagram
for the amplified EP sensor shown above (left frame). The right
frame shows measured and simulated frequency response for different
input capacitance (C.sub.IN=.infin., 1 .mu.F, 220 pF). FIG. 77C.
Optical micrograph of a temperature sensor that uses a platinum
resistor with FS interconnects (left frame) and a strain gauge that
uses electrically conductive silicone (CPDMS; right frame). FIG.
77D. Image of an array of microscale AlInGaP LEDs and
photodetectors, in an interconnected array integrated on skin,
under compressive deformation, (left frame) and of a FS silicon
solar cell (right frame). FIG. 77E. Image of a FS wireless coil,
connected to a microscale AlGaN LED, powered by inductive coupling
to a separate transmission coil (not in the field of view). The
right frame shows electromagnetic simulations of the behavior of
the FS coil. FIG. 77F. Optical micrograph of an interconnected pair
of FS inductors and capacitors designed for RF operation (left top
frame). The plot in the upper right shows the value of S21 measured
on a set of FS capacitors as a function of frequency. The plot in
the lower left frame shows the frequency dependence of S21 and S11
for an FS inductor. The graph on the bottom right shows resonant
frequencies for LC oscillators built with different FS capacitors.
FIG. 77G. Image of a silicon RF diode (left frame) and the
frequency dependence of S11 and S21 (right frame).
[0184] FIG. 78A. ECG signals measured with an EES integrated on the
chest using an active EP sensor (left frame), and magnified view of
data corresponding to a single heartbeat (right frame). FIG. 78B.
The left frame shows the results of EMG measurement using a similar
device, mounted on the right leg during simulated walking (from 0
sec to 10 s) and standing (from 10 s to 20 s). The right frame
shows similar data recorded using a conventional EMG sensor based
on a tin electrode coupled to the skin with a conductive gel and
affixed using adhesive tape. FIG. 78C. Frequency spectral (i.e.
spectrogram) representation of the data in FIG. 78B, for each
electrode type. FIG. 78D. EMG spectrograms measured using an EES
mounted on the neck during vocalization of four different words:
"up", "down", "left" and "right". FIG. 78E. Simulated video game
control using pattern recognition algorithms applied to EMG data
recorded with an EES on the neck. The yellow arrows indicate the
direction of motion of the player icon from an initial position
(red) to a final one (green). FIG. 78F. The left frame shows
discrete Fourier transform (DFT) coefficient associated with EES
recordings of EEG from the forehead, showing expected alpha rhythms
at .about.10 Hz when the eyes are closed. (See below for DFT
definition.) The center frame shows a spectrogram representation of
the alpha rhythm measurement. The first and next 10 seconds
correspond to periods when the eyes were closed and open,
respectively. The right frame shows results that demonstrate
expected Stroop effects in data measured with the same type of EES
used for the alpha rhythms.
[0185] FIG. 79A. Stress-strain curve for a 30 .quadrature.m thick
free-standing PE film. The Young's modulus is 60 kPa. FIG. 79B.
Stress-strain curve for PVA. The Young's modulus is 1.9 GPa. FIG.
79C. Stress-strain curve for 30:1 and 50:1 PDMS, with Young's
moduli of 145 kPa and 19 kPa respectively. FIG. 79D. Schematic
illustration for a device island with size L.sub.d and a serpentine
span L. FIG. 79E. Top view and cross-sectional schematic
illustrations of an island-plus-serpentine sample. FIG. 79F.
Contour plot of strain in an island-plus-serpentine sample after
stretching by 30%, computed using FEM.
[0186] FIG. 80A. Excitation and emission spectrum of fluorescent
dyes used for confocal microscopy. Alexa Fluor 488 is used to stain
PE substrate and Alexa Fluor 647 is used to stain polyimide, which
is patterned into the layout of electrodes. Pig skin is stained by
FM 1-43, which labels cell membrane. FIG. 80B. Top and
cross-sectional view of bare pig skin. FIG. 80C. Top and
cross-sectional view of EES with island mounted on pig skin.
[0187] FIG. 81A. Transfer curve and (FIG. 81B) IV curve of an Si
MOSFET in FS geometry. FIG. 81C. Calibration curve of a temperature
sensor. FIG. 81D. Percentage change in resistance of the strain
gauge as a function of uniaxial tensile strain. Gauge factors for
the longitudinal and transverse strain gauges are 1.3 and 0.5
respectively. FIG. 81E. Proximity sensor and optical measurement
system on skin using a combined LED-photodetector array with
forward and reverse biases before (top frame) and after (bottom
frame) deforming the skin with (left frame) and without (right
frame) external illumination. FIG. 81F. Current-voltage
characteristics of a single LED. FIG. 81G. Measured photocurrent
from reverse biased diodes at different distances between the
sensor and the external object. FIG. 81H. Current and power of a FS
Si photovoltaic cell at different voltages. FIG. 81I. Images of an
LC (inductor-capacitor) oscillator at 0% (left frame) and
.about.12% (right frame) tensile strain. FIG. 81J. S21 of an LC
oscillator as a function of frequency. The resonant frequency
changes from 1.08 GHz (0% strain) to 1.38 GHz (.about.12% strain)
due to tensile deformation.
[0188] FIG. 82 provides a magnified view of the EMG signal of FIG.
78B. Red and blue plots correspond to raw and high pass filtered
data, respectively.
[0189] FIG. 83A. Images of an active EES-based EMG sensor on the
neck without (left frame) and with (right frame) skin deformation.
FIG. 83B. Raw recordings from neck using a similar sensor for
different words. "Go" (top frame), "Stop" (middle frame) and
"Great" (bottom frame).
[0190] FIG. 84 provides a plot showing an EES EMG measurement from
the neck for four different words, "up", "down", "left" and
"right". Red and blue plots correspond to raw and high pass
filtered data, respectively.
[0191] FIG. 85 provides spectrograms of EES EMG measurements from
the neck for four different words, "Go" (top frame), "Stop" (middle
frame) and "Great" (bottom frame).
[0192] FIG. 86 provides plots showing averaged classification
accuracy versus the number of reference feature vectors available
for classifying each direction. Shaded areas indicate one standard
deviation of the data.
[0193] FIG. 87A. Recorded EEG data using passive EES sensor while
eyes closed (top frame) and eyes open (bottom frame). FIG. 87B.
Experiment setup for Stroop test. When the target letter matches
with its color (congruent case) the response speed is faster than
the unmatched (incongruent) case.
[0194] FIG. 88A. Conformal contact requirement for filamentary
serpentine EES with devices of different thickness and modulus.
FIG. 88B. The contact pressure between the filamentary serpentine
EES and skin of different roughnesses.
[0195] FIG. 89 provides a schematic cross-sectional view of EES at
the interface between skin and PE (top) and local stress
distribution along the FS-EES/skin interface (bottom).
[0196] FIG. 90 provides an image of an FS-EES EP sensor on PE/PVA
substrate.
[0197] FIG. 91 provides fatigue test results for an FS-EES device
under repetitive 20% tensile stretching.
[0198] FIG. 92. Principle of hydration sensor based on impedance
measurement.
[0199] FIGS. 93A-93B. Schematic of the differential hydration
sensor, (FIG. 93A) sensor layout and (FIG. 93B) equivalent
model.
[0200] FIG. 94. Schematic of the hydration mapping sensor.
[0201] FIGS. 95A-95J. Fabrication process of hydration sensors:
(FIG. 95A) spin-coating of sacrificial PMMA layer and the polyimide
supporting layer; (FIG. 95B) deposition and patterning of gold to
form serpentine interconnections; (FIG. 95C) spin-coating of
additional polyimide layer and opening of vias; (FIG. 95D)
deposition and patterning of gold to form electrodes; (FIG. 95E)
spin-coating and patterning of photoresist as a mask to define the
outline of the device; (FIG. 95F) Removal of PMMA layer and release
of the device; (FIG. 95G) Device pickup from Si wafer through PVA
tape; (FIG. 95H) Deposition of Ti/SiO.sub.2 layer; (FIG. 95I)
Transfer printing of the device to a silicone substrate; (FIG. 95J)
Removal of PVA tape in water.
[0202] FIGS. 96A-96D. Images of differential hydration sensors:
(FIG. 96A) a fabricated differential hydration sensor on solaris
substrate; (FIG. 96B) bending and twisting of the hydration sensor;
(FIG. 96C) hydration sensor connected with releasable cable bonded
with ACF cable; (FIG. 96D) hydration sensor on skin.
[0203] FIGS. 97A-97D. Images of hydration mapping and depth
profiling sensors: (FIG. 97A) a fabricated hydration mapping sensor
on solaris substrate; (FIG. 97B) sensors attached to a glass tube;
(FIG. 97C) Sensor on skin; (FIG. 97D) microchamber and sensors used
to assess the effective measurement depth of electrodes.
[0204] FIG. 98. Experimental setup for differential hydration
sensor.
[0205] FIG. 99. Experimental setup for 8.times.8 hydration depth
profiling and mapping sensors.
[0206] FIG. 100. Setup for in-vitro characterization of depth
profiling device.
[0207] FIGS. 101A-101B. The relation between the hydration levels
with the impedance. (FIG. 101A) Before and (FIG. 101B) after
calibration.
[0208] FIGS. 102A-102D. Impedance variation by repeatedly attached
the hydration sensor onto the skin at a stable hydration level:
Impedance (FIG. 102A) amplitude and (FIG. 102B) phase of channel 4
and impedance (FIG. 102C) amplitude and (FIG. 102D) phase of
channel 5.
[0209] FIG. 103. Stability of the hydration sensor as compared with
the moisture meter.
[0210] FIGS. 104A-104D. Sensor response to hydration changes at
various frequencies (channel 3 and channel 6): (FIG. 104A)
impedance amplitude and (FIG. 104B) phase changes of channel 3 at
varying hydration levels; (FIG. 104C) impedance amplitude and (FIG.
104D) phase changes of channel 4 at varying hydration levels.
[0211] FIGS. 105A-105D. Sensor response to hydration changes at
various frequencies (channel 4 and channel 5): (FIG. 105A)
impedance amplitude and (FIG. 105B) phase changes of channel 4 at
varying hydration levels; (FIG. 105C) impedance amplitude and (FIG.
105D) phase changes of channel 5 at varying hydration levels.
[0212] FIG. 106. Hydration measured by the differential epidermal
sensor as compared with the moisture meter.
[0213] FIGS. 107A-107D. Impedance of electrodes with spacing
ranging from 60 to 200 .mu.m at measurement frequencies of (FIG.
107A) 15 kHz, (FIG. 107B) 250 KHz, (FIG. 107C) 500 kHz, and (FIG.
107D) 1.25 MHz.
[0214] FIGS. 108A-108C. Impedance of hydration sensor for
depth-profile mapping at 15 kHz at hydration levels of (FIG. 108A)
64, (FIG. 108B) 117, and (FIG. 108C) 96.
[0215] FIG. 109. Impedance of hydration sensor with different
electrode spacing at 15 kHz at various hydration levels.
[0216] FIGS. 110A-110C. Impedance amplitude and phase of hydration
mapping sensor at 1.25 MHz at hydration levels of (FIG. 110A) 40,
(FIG. 110B) 114, and (FIG. 110C) 77.
[0217] FIGS. 111A-111B. Time course of (FIG. 111A) electrode
impedance and (FIG. 111B) calibrated hydration levels of one
electrode in the hydration mapping sensor before and after
application of lotion at 1.25 MHz.
[0218] FIGS. 112A-112D. Schematic illustrations of fabrication
processes for multifunctional electronics and direct mounting of
the electronics onto skin. FIG. 112A. Fabricate the multifunctional
electronics composed of EP-, strain, and temperature sensors on a
Si, handling wafer. FIG. 112B. Release the completed device in
acetone through dissolving a sacrificial photoresist and pick up
the device using a elastomeric stamp. FIG. 112C. Transfer the
electronics on the stamp onto the skin using a thin, sprayed glue
layer. FIG. 112D. Cover the electronics on the skin with a
spray-on-bandage. After covering electronics with the bandage, the
skin deformation is tested, which shows unnoticeable constraints in
motion.
[0219] FIGS. 113A-113D. Long-term wearability of an electronic
device on skin with a spray bandage. FIG. 113A. Characteristics of
spray bandage; an optical image of spray-on-bandage on a glass
slide, AFM study of the surface, and the height information from
surface profilometer. FIG. 113B. Cross-sectional, schematic
illustration of the characteristics of the spray-on-bandage when it
covers the electronic device on skin (not in scale). FIG. 113C.
Demonstration of long-term wearability of a skin-like device on a
subject's forearm and chest for a week. FIG. 113D. Comparison of
adhesion force of various materials on skin (forearm) with a fixed
area of 9 cm.sup.2. Error bar represents the standard deviation
(n=3).
[0220] FIGS. 114A-1140. FEM and experimental study of
conformability of skin-like electronics on skin. FIG. 114A. FEM
study of mechanical stability with 10 .mu.m-FS electrodes. FIG.
114B. Scaling law between the width of FS electrode and adhesion
force for conformal contact. FIG. 114C. SEM study of conformal
mounting of various electrode designs on the skin replicas. Inset
of the bottom 10 .mu.m-FS image shows a zoomed-out view. In the SEM
images, electrodes were colorized as gold color for
ease-of-viewing. FIG. 114D. The comparison of skin-electrode
impedance between the skin-like electronics and the conventional
gel-based electrodes. Illustrations compare the conformal
lamination of electrodes.
[0221] FIGS. 115A-115D. Utilization of a releasable, skin-like
connector with a commercial wireless data acquisition system for
recording signals on skin. FIG. 115A. Wireless DAQ system including
a transmitter, a wireless receiver, and a laptop with data
recording software. FIG. 115B. A releasable connector on a
stretchable, skin-like membrane. FIG. 115C. The skin-like
electronics sensor in conjunction with the epidermal pad. The inset
shows the magnified view of the epidermal pad (scale bar: 1 mm).
FIG. 115D. Physically mounted releasable connector on the
electronic sensor on skin for data acquisition with the wireless
DAQ system.
[0222] FIGS. 116A-116D. Demonstration of multifunctional skin-like
electronics with long-term EP measurement. FIG. 116A.
Multifunctional electronic device that incorporates 10 .mu.m-FS EP
sensor, Pt temperature sensor, and silicone nanomembrane strain
sensor. The sensing components are placed in neutral mechanical
plane. FIG. 116B. Demonstration of multi-modal measurements of EMG,
strain, and temperature signals on a subject's forearm. FIG. 116C.
Long-term (a week) measurement of ECG and EMG signals on a
subject's chest and forearm, respectively. FIG. 116D. Skin
irritation test of wearing the skin-like electronics for a
week.
DETAILED DESCRIPTION OF THE INVENTION
[0223] In general the terms and phrases used herein have their
art-recognized meaning, which can be found by reference to standard
texts, journal references and contexts known to those skilled in
the art. The following definitions are provided to clarify their
specific use in the context of the invention.
[0224] The terms "flexible" and "bendable" are used synonymously in
the present description and refer to the ability of a material,
structure, device or device component to be deformed into a curved
or bent shape without undergoing a transformation that introduces
significant strain, such as strain characterizing the failure point
of a material, structure, device or device component. In an
exemplary embodiment, a flexible material, structure, device or
device component may be deformed into a curved shape without
introducing strain larger than or equal to 5%, for some
applications larger than or equal to 1%, and for yet other
applications larger than or equal to 0.5% in strain-sensitive
regions. A used herein, some, but not necessarily all, flexible
structures are also stretchable. A variety of properties provide
flexible structures (e.g., device components) of the invention,
including materials properties such as a low modulus, bending
stiffness and flexural rigidity; physical dimensions such as small
average thickness (e.g., less than 100 microns, optionally less
than 10 microns and optionally less than 1 micron) and device
geometries such as thin film and mesh geometries.
[0225] "Stretchable" refers to the ability of a material,
structure, device or device component to be strained without
undergoing fracture. In an exemplary embodiment, a stretchable
material, structure, device or device component may undergo strain
larger than 0.5% without fracturing, for some applications strain
larger than 1% without fracturing and for yet other applications
strain larger than 3% without fracturing. A used herein, many
stretchable structures are also flexible. Some stretchable
structures (e.g., device components) are engineered to be able to
undergo compression, elongation and/or twisting so as to be able to
deform without fracturing. Stretchable structures include thin film
structures comprising stretchable materials, such as elastomers;
bent structures capable of elongation, compression and/or twisting
motion; and structures having an island--bridge geometry.
Stretchable device components include structures having stretchable
interconnects, such as stretchable electrical interconnects.
[0226] "Functional layer" refers to a device-containing layer that
imparts some functionality to the device. For example, the
functional layer may be a thin film such as a semiconductor layer.
Alternatively, the functional layer may comprise multiple layers,
such as multiple semiconductor layers separated by support layers.
The functional layer may comprise a plurality of patterned
elements, such as interconnects running between device-receiving
pads or islands. The functional layer may be heterogeneous or may
have one or more properties that are inhomogeneous. "Inhomogeneous
property" refers to a physical parameter that can spatially vary,
thereby effecting the position of the neutral mechanical surface
(NMS) within the multilayer device.
[0227] "Semiconductor" refers to any material that is an insulator
at a low temperature, but which has an appreciable electrical
conductivity at a temperatures of about 300 Kelvin. In the present
description, use of the term semiconductor is intended to be
consistent with use of this term in the art of microelectronics and
electronic devices. Useful semiconductors include those comprising
element semiconductors, such as silicon, germanium and diamond, and
compound semiconductors, such as group IV compound semiconductors
such as SiC and SiGe, group III-V semiconductors such as AlSb,
AlAs, Aln, AlP, BN, GaSb, GaAs, GaN, GaP, InSb, InAs, InN, and InP,
group III-V ternary semiconductors alloys such as
Al.sub.xGa.sub.1-xAs, group II-VI semiconductors such as CsSe, CdS,
CdTe, ZnO, ZnSe, ZnS, and ZnTe, group I-VII semiconductors CuCl,
group IV-VI semiconductors such as PbS, PbTe and SnS, layer
semiconductors such as PbI.sub.2, MoS.sub.2 and GaSe, oxide
semiconductors such as CuO and Cu.sub.2O. The term semiconductor
includes intrinsic semiconductors and extrinsic semiconductors that
are doped with one or more selected materials, including
semiconductor having p-type doping materials and n-type doping
materials, to provide beneficial electronic properties useful for a
given application or device. The term semiconductor includes
composite materials comprising a mixture of semiconductors and/or
dopants. Specific semiconductor materials useful for in some
embodiments include, but are not limited to, Si, Ge, SiC, AlP,
AlAs, AlSb, GaN, GaP, GaAs, GaSb, InP, InAs, GaSb, InP, InAs, InSb,
ZnO, ZnSe, ZnTe, CdS, CdSe, ZnSe, ZnTe, CdS, CdSe, CdTe, HgS, PbS,
PbSe, PbTe, AlGaAs, AlInAs, AlInP, GaAsP, GaInAs, GaInP, AlGaAsSb,
AlGaInP, and GaInAsP. Porous silicon semiconductor materials are
useful for applications of aspects described herein in the field of
sensors and light emitting materials, such as light emitting diodes
(LEDs) and solid state lasers. Impurities of semiconductor
materials are atoms, elements, ions and/or molecules other than the
semiconductor material(s) themselves or any dopants provided to the
semiconductor material. Impurities are undesirable materials
present in semiconductor materials which may negatively impact the
electronic properties of semiconductor materials, and include but
are not limited to oxygen, carbon, and metals including heavy
metals. Heavy metal impurities include, but are not limited to, the
group of elements between copper and lead on the periodic table,
calcium, sodium, and all ions, compounds and/or complexes
thereof.
[0228] "Semiconductor element", "semiconductor structure" and
"semiconductor circuit element" are used synonymously in the
present description and broadly refer to any semiconductor
material, composition or structure, and expressly includes high
quality single crystalline and polycrystalline semiconductors,
semiconductor materials fabricated via high temperature processing,
doped semiconductor materials, organic and inorganic semiconductors
and composite semiconductor materials and structures having one or
more additional semiconductor components and/or non-semiconductor
components, such as dielectric layers or materials, electrodes
and/or conducting layers or materials.
[0229] "Coincident" refers to refers to the relative position of
two or more objects, planes or surfaces, for example a surface such
as a NMS or NMP that is positioned within or is adjacent to a
layer, such as a functional layer, substrate layer, or other layer.
In an embodiment, a NMS or NMP is positioned to correspond to the
most strain-sensitive layer or material within the layer.
[0230] "Proximate" refers to the relative position of two or more
objects, planes or surfaces, for example a NMS or NMP that closely
follows the position of a layer, such as a functional layer,
substrate layer, or other layer while still providing desired
flexibility or stretchability without an adverse impact on the
strain-sensitive material physical properties. In general, a layer
having a high strain sensitivity, and consequently being prone to
being the first layer to fracture, is located in the functional
layer, such as a functional layer containing a relatively brittle
semiconductor or other strain-sensitive device element. A NMS or
NMP that is proximate to a layer need not be constrained within
that layer, but may be positioned proximate or sufficiently near to
provide a functional benefit of reducing the strain on the
strain-sensitive device element when the device is folded.
[0231] "Electronic device" is used broadly herein to refer to
devices such as integrated circuits, imagers or other
optoelectronic devices. Electronic device may also refer to a
component of an electronic device such as passive or active
components such as a semiconductor, interconnect, contact pad,
transistors, diodes, LEDs, circuits, etc. Devices disclosed herein
may relate to the following fields: collecting optics, diffusing
optics, displays, pick and place assembly, vertical cavity
surface-emitting lasers (VCSELS) and arrays thereof, LEDs and
arrays thereof, transparent electronics, photovoltaic arrays, solar
cells and arrays thereof, flexible electronics, micromanipulation,
plastic electronics, displays, pick and place assembly, transfer
printing, LEDs, transparent electronics, stretchable electronics,
and flexible electronics.
[0232] A "component" is used broadly to refer to a material or
individual component used in a device. An "interconnect" is one
example of a component and refers to an electrically conducting
material capable of establishing an electrical connection with a
component or between components. In particular, an interconnect may
establish electrical contact between components that are separate
and/or can move with respect to each other. Depending on the
desired device specifications, operation, and application, an
interconnect is made from a suitable material. For applications
where a high conductivity is required, typical interconnect metals
may be used, including but not limited to copper, silver, gold,
aluminum and the like, and alloys. Suitable conductive materials
further include semiconductors, such as silicon and GaAs and other
conducting materials such as indium tin oxide.
[0233] An interconnect that is "stretchable" or "flexible" is used
herein to broadly refer to an interconnect capable of undergoing a
variety of forces and strains such as stretching, bending and/or
compression in one or more directions without adversely impacting
electrical connection to, or electrical conduction from, a device
component. Accordingly, a stretchable interconnect may be formed of
a relatively brittle material, such as GaAs, yet remain capable of
continued function even when exposed to a significant deformatory
force (e.g., stretching, bending, compression) due to the
interconnect's geometrical configuration. In an exemplary
embodiment, a stretchable interconnect may undergo strain larger
than 1%, optionally 10% or optionally 30% or optionally up to 100%
without fracturing. In an example, the strain is generated by
stretching an underlying elastomeric substrate to which at least a
portion of the interconnect is bonded. For certain embodiments,
flexible or stretchable interconnects include interconnects having
wavy, meandering or serpentine shapes.
[0234] A "device component" is used to broadly refer to an
individual component within an electrical, optical, mechanical or
thermal device. Components include, but are not limited to, a
photodiode, LED, TFT, electrode, semiconductor, other
light-collecting/detecting components, transistor, integrated
circuit, contact pad capable of receiving a device component, thin
film devices, circuit elements, control elements, microprocessors,
transducers and combinations thereof. A device component can be
connected to one or more contact pads as known in the art, such as
metal evaporation, wire bonding, application of solids or
conductive pastes, for example. Electrical device generally refers
to a device incorporating a plurality of device components, and
includes large area electronics, printed wire boards, integrated
circuits, device components arrays, biological and/or chemical
sensors, physical sensors (e.g., temperature, light, radiation,
etc.), solar cell or photovoltaic arrays, display arrays, optical
collectors, systems and displays.
[0235] "Sensing element" and "sensor" are used synonymously and
refers to a device component useful as a sensor and/or useful for
detecting the presence, absence, amount, magnitude or intensity of
a physical property, object, radiation and/or chemical. Sensors in
some embodiments function to transduce a biological signal into an
electrical signal, optical signal, wireless signal, acoustic
signal, etc. Useful sensing elements include, but are not limited
to electrode elements, chemical or biological sensor elements, pH
sensors, optical sensors, photodiodes, temperature sensors,
capacitive sensors strain sensors, acceleration sensors, movement
sensors, displacement sensors, pressure sensors, acoustic sensors
or combinations of these.
[0236] "Actuating element" and "actuator" are used synonymously and
refers to a device component useful for interacting with,
stimulating, controlling, or otherwise affecting an external
structure, material or fluid, for example a biological tissue.
Useful actuating elements include, but are not limited to,
electrode elements, electromagnetic radiation emitting elements,
light emitting diodes, lasers and heating elements. Actuating
elements include electrodes for providing a voltage or current to a
tissue. Actuating elements include sources of electromagnetic
radiation for providing electromagnetic radiation to a tissue.
Actuating elements include ablation sources for ablating tissue.
Actuating elements include thermal sources for heating tissue.
Actuating elements include displacement sources for displacing or
otherwise moving a tissue.
[0237] "Island" or "device island" refers to a relatively rigid
device element or component of an electronic device comprising
multiple semiconductor elements or active semiconductor structures.
"Bridge" or "bridge structure" refers to stretchable or flexible
structures interconnecting two or more device islands or one device
island to another device component. Specific bridge structures
include flexible semiconductor interconnects.
[0238] "Barrier layer" refers to a device component spatially
separating two or more other device components or spatially
separating a device component from a structure, material or fluid
external to the device. In one embodiment, a barrier layer
encapsulates one or more device components. In embodiments, a
barrier layer separates one or more device components from an
aqueous solution, a biological tissue and/or a biological
environment. In some embodiments, a barrier layer is a passive
device component. In some embodiments, a barrier layer is a
functional, but non-active, device component. In a specific
embodiment, a barrier layer is a moisture barrier. As used herein,
the term "moisture barrier" refers to a barrier layer which
provides protection to other device components from bodily fluids,
ionic solutions, water or other solvents. In one embodiment, a
moisture barrier provides protection to an external structure,
material or fluid, for example, by preventing leakage current from
escaping an encapsulated device component and reaching the external
structure, material or fluid. In a specific embodiment, a barrier
layer is a thermal barrier. As used herein, the term "thermal
barrier" refers to a barrier layer which acts as a thermal
insulator, preventing, reducing or otherwise limiting the transfer
of heat from one device component to another or from a device
component to an external structure, fluid or material. Useful
thermal barriers include those comprising materials having a
thermal conductivity of 0.3 W/mK or less, such as selected over the
range of 0.001 to 0.3 W/mK. In some embodiments, a thermal barrier
comprises active cooling components, such as components known in
the art of thermal management, such as thermoelectric cooling
devices and systems. Thermal barriers also include those barriers
comprising thermal management structures, such as structures useful
for transporting heat away from a portion of a device or tissue; in
these and other embodiments, a thermal barrier comprises thermally
conductive material, for example material having a high thermal
conductivity, such as a thermal conductivity characteristic of a
metal.
[0239] "Leakage current" or "leakage" refers to electric current
which flows from an electronic device along an unintended path.
Under certain conditions, leakage of sufficient current from an
electronic device can damage the device and/or components thereof.
In certain circumstances, leakage current can also or alternatively
damage the material into which it flows.
[0240] "Active circuit" and "active circuitry" refers to one or
more device components configured for performing a specific
function. Useful active circuits include, but are not limited to,
amplifier circuits, multiplexing circuits, logic circuits, CMOS
circuits, processors, and current limiting circuits. Useful active
circuit elements include, but are not limited to, transistor
elements and diode elements.
[0241] "Selectively permeable" refers to a property of a material
to allow certain substances to pass through the material while
preventing other substances from being passed through. In one
embodiment, a selectively permeable material allows one or more
target chemicals, molecules and/or biomolecules to be passed
through the material while preventing water, ionic solutions,
bodily fluids, salts, proteins and other substances from being
passed through the material. In an embodiment, the barrier layer of
a device has spatially patterned permeable regions, impermeable
regions or a combination of both permeable regions and impermeable
regions.
[0242] "Substrate" refers to a material having a surface that is
capable of supporting a structure, including an electronic device
or electronic device component. An structure that is "bonded" to
the substrate refers to a portion of the structure in physical
contact with the substrate and unable to substantially move
relative to the substrate surface to which it is bonded. Unbonded
portions, in contrast, are capable of substantial movement relative
to the substrate.
[0243] A "NMS adjusting layer" refers to a layer whose primary
function is adjusting the position of the NMS in the device. For
example, the NMS adjusting layer may be an encapsulating layer or
an add layer such as an elastomeric material.
[0244] In the context of this description, a "bent configuration"
refers to a structure having a curved conformation resulting from
the application of a force. Bent structures may have one or more
folded regions, convex regions, concave regions, and any
combinations thereof. Useful bent structures, for example, may be
provided in a coiled conformation, a wrinkled conformation, a
buckled conformation and/or a wavy (i.e., wave-shaped)
configuration. Bent structures, such as stretchable bent
interconnects, may be bonded to a flexible substrate, such as a
polymer and/or elastic substrate, in a conformation wherein the
bent structure is under strain. In some embodiments, the bent
structure, such as a bent ribbon structure, is under a strain equal
to or less than 30%, optionally a strain equal to or less than 10%,
optionally a strain equal to or less than 5% and optionally a
strain equal to or less than 1% in embodiments preferred for some
applications. In some embodiments, the bent structure, such as a
bent ribbon structure, is under a strain selected from the range of
0.5% to 30%, optionally a strain selected from the range of 0.5% to
10%, and optionally a strain selected from the range of 0.5% to 5%.
Alternatively, the stretchable bent interconnects may be bonded to
a substrate that is a substrate of a device component, including a
substrate that is itself not flexible. The substrate itself may be
planar, substantially planar, curved, have sharp edges, or any
combination thereof. Stretchable bent interconnects are available
for transferring to any one or more of these complex substrate
surface shapes.
[0245] "Thermal contact" refers to the ability of two or more
materials and/or structures that are capable of substantial heat
transfer from the higher temperature material to the lower
temperature material, such as by conduction. Thermal communication
refers to a configuration of two or more components such that heat
can be directly or indirectly transferred from one component to
another. In some embodiments, components in thermal communication
are in direct thermal communication wherein heat is directly
transferred from one component to another. In some embodiments,
components in thermal communication are in indirect thermal
communication wherein heat is indirectly transferred from one
component to another via one or more intermediate structures
separating the components.
[0246] "Fluid communication" refers to the configuration of two or
more components such that a fluid (e.g., a gas or a liquid) is
capable of transport, flowing and/or diffusing from one component
to another component. Elements may be in fluid communication via
one or more additional elements such as tubes, containment
structures, channels, valves, pumps or any combinations of these.
In some embodiments, components in fluid communication are in
direct fluid communication wherein fluid is capable of transport
directly from one component to another. In some embodiments,
components in fluid communication are in indirect fluid
communication wherein fluid is capable of transport indirectly from
one component to another via one or more intermediate structures
separating the components.
[0247] "Electrical contact" refers to the ability of two or more
materials and/or structures that are capable of transferring charge
between them, such as in the form of the transfer of electrons or
ions. Electrical communication refers to a configuration of two or
more components such that an electronic signal or charge carrier
can be directly or indirectly transferred from one component to
another. As used herein, electrical communication includes one way
and two way electrical communication. In some embodiments,
components in electrical communication are in direct electrical
communication wherein an electronic signal or charge carrier is
directly transferred from one component to another. In some
embodiments, components in electrical communication are in indirect
electrical communication wherein an electronic signal or charge
carrier is indirectly transferred from one component to another via
one or more intermediate structures, such as circuit elements,
separating the components.
[0248] "Optical communication refers to a configuration of two or
more components such that electromagnetic radiation can be directly
or indirectly transferred from one component to another. As used
herein, optical communication includes one way and two way optical
communication. In some embodiments, components in optical
communication are in direct optical communication wherein
electromagnetic radiation is directly transferred from one
component to another. In some embodiments, components in optical
communication are in indirect optical communication wherein an
electromagnetic radiation is indirectly transferred from one
component to another via one or more intermediate structures, such
as reflectors, lenses, or prisms, separating the components.
[0249] "Ultrathin" refers to devices of thin geometries that
exhibit extreme levels of bendability. In an embodiment, ultrathin
refers to circuits having a thickness less than 1 .mu.m, less than
600 nm or less than 500 nm. In an embodiment, a multilayer device
that is ultrathin has a thickness less than 200 .mu.m, less than 50
.mu.m, or less than 10 .mu.m.
[0250] "Thin layer" refers to a material that at least partially
covers an underlying substrate, wherein the thickness is less than
or equal to 300 .mu.m, less than or equal to 200 .mu.m, or less
than or equal to 50 .mu.m. Alternatively, the layer is described in
terms of a functional parameter, such as a thickness that is
sufficient to isolate or substantially reduce the strain on the
electronic device, and more particularly a functional layer in the
electronic device that is sensitive to strain.
[0251] "Dielectric" refers to a non-conducting or insulating
material. In an embodiment, an inorganic dielectric comprises a
dielectric material substantially free of carbon. Specific examples
of inorganic dielectric materials include, but are not limited to,
silicon nitride and silicon dioxide.
[0252] "Polymer" refers to a macromolecule composed of repeating
structural units connected by covalent chemical bonds or the
polymerization product of one or more monomers, often characterized
by a high molecular weight. The term polymer includes homopolymers,
or polymers consisting essentially of a single repeating monomer
subunit. The term polymer also includes copolymers, or polymers
consisting essentially of two or more monomer subunits, such as
random, block, alternating, segmented, graft, tapered and other
copolymers. Useful polymers include organic polymers or inorganic
polymers and may be in amorphous, semi-amorphous, crystalline or
partially crystalline states. Cross linked polymers having linked
monomer chains are particularly useful for some applications.
Polymers useable in the methods, devices and device components
include, but are not limited to, plastics, elastomers,
thermoplastic elastomers, elastoplastics, thermostats,
thermoplastics and acrylates. Exemplary polymers include, but are
not limited to, acetal polymers, biodegradable polymers, cellulosic
polymers, fluoropolymers, nylons, polyacrylonitrile polymers,
polyamide-imide polymers, polyimides, polyarylates,
polybenzimidazole, polybutylene, polycarbonate, polyesters,
polyetherimide, polyethylene, polyethylene copolymers and modified
polyethylenes, polyketones, poly(methyl methacrylate,
polymethylpentene, polyphenylene oxides and polyphenylene sulfides,
polyphthalamide, polypropylene, polyurethanes, styrenic resins,
sulfone based resins, vinyl-based resins, rubber (including natural
rubber, styrene-butadiene, polybutadiene, neoprene,
ethylene-propylene, butyl, nitrile, silicones), acrylic, nylon,
polycarbonate, polyester, polyethylene, polypropylene, polystyrene,
polyvinyl chloride, polyolefin or any combinations of these.
[0253] "Elastomer" refers to a polymeric material which can be
stretched or deformed and return to its original shape without
substantial permanent deformation. Elastomers commonly undergo
substantially elastic deformations. Useful elastomers include those
comprising polymers, copolymers, composite materials or mixtures of
polymers and copolymers. Elastomeric layer refers to a layer
comprising at least one elastomer. Elastomeric layers may also
include dopants and other non-elastomeric materials. Useful
elastomers useful include, but are not limited to, thermoplastic
elastomers, styrenic materials, olefenic materials, polyolefin,
polyurethane thermoplastic elastomers, polyamides, synthetic
rubbers, PDMS, polybutadiene, polyisobutylene,
poly(styrene-butadiene-styrene), polyurethanes, polychloroprene and
silicones. In some embodiments, an elastomeric stamp comprises an
elastomer. Exemplary elastomers include, but are not limited to
silicon containing polymers such as polysiloxanes including
poly(dimethyl siloxane) (i.e. PDMS and h-PDMS), poly(methyl
siloxane), partially alkylated poly(methyl siloxane), poly(alkyl
methyl siloxane) and poly(phenyl methyl siloxane), silicon modified
elastomers, thermoplastic elastomers, styrenic materials, olefenic
materials, polyolefin, polyurethane thermoplastic elastomers,
polyamides, synthetic rubbers, polyisobutylene,
poly(styrene-butadiene-styrene), polyurethanes, polychloroprene and
silicones. In an embodiment, a flexible polymer is a flexible
elastomer.
[0254] "Elastomeric stamp" or "elastomeric transfer device" are
used interchangeably and refer to an elastomeric material having a
surface that can receive as well as transfer a component, such as
an electronic device or component thereof. Exemplary elastomeric
transfer devices include stamps, molds and masks. The transfer
device affects and/or facilitates feature transfer from a donor
material to a receiver material. Stamps and transfer device may be
used for assembling components via transfer printing, such as dry
contact transfer printing.
[0255] "Conformal contact" refers to contact established between a
device and a receiving surface, which may for example be a target
tissue in a biological environment. In one aspect, conformal
contact involves a macroscopic adaptation of one or more surfaces
(e.g., contact surfaces) of an implantable device to the overall
shape of a tissue surface. In another aspect, conformal contact
involves a microscopic adaptation of one or more surfaces (e.g.,
contact surfaces) of an implantable device to a tissue surface
resulting in an intimate contact substantially free of voids. In an
embodiment, conformal contact involves adaptation of a contact
surface(s) of the implantable device to a receiving surface(s) of a
tissue such that intimate contact is achieved, for example, wherein
less than 20% of the surface area of a contact surface of the
implantable device does not physically contact the receiving
surface, or optionally less than 10% of a contact surface of the
implantable device does not physically contact the receiving
surface, or optionally less than 5% of a contact surface of the
implantable device does not physically contact the receiving
surface. Conformal contact includes large area conformal contact,
for example, wherein conformal contact between a tissue and device
component is over an area greater than or equal to 1000 mm.sup.2,
and optionally greater than or equal to 10,000 mm.sup.2.
[0256] "Conformable" refers to a device, material or substrate
which has a bending stiffness sufficiently low to allow the device,
material or substrate to adopt a desired contour profile, for
example a contour profile allowing for conformal contact with a
surface having a pattern of relief or recessed features. In certain
embodiments, a desired contour profile is that of a tissue in a
biological environment, for example heart tissue.
[0257] "Low modulus" refers to materials having a Young's modulus
less than or equal to 10 MPa, less than or equal to 5 MPa, or
optionally less than or equal to 1 MPa and optionally for some
applications less than or equal to 0.1 MPa.
[0258] "Young's modulus" and "modulus" are used interchangeably and
refer to a mechanical property of a material, device or layer which
refers to the ratio of stress to strain for a given substance.
Young's modulus may be provided by the expression;
E = ( stress ) ( strain ) = ( L 0 .DELTA. L ) ( F A ) , ( I )
##EQU00001##
where E is Young's modulus, L.sub.0 is the equilibrium length,
.DELTA.L is the length change under the applied stress, F is the
force applied and A is the area over which the force is applied.
Young's modulus may also be expressed in terms of Lame constants
via the equation:
E = .mu. ( 3 .lamda. + 2 .mu. ) .lamda. + .mu. , ( II )
##EQU00002##
where .lamda. and .mu. are Lame constants. High Young's modulus (or
"high modulus") and low Young's modulus (or "low modulus") are
relative descriptors of the magnitude of Young's modulus in a given
material, layer or device. In some embodiments, a high Young's
modulus is larger than a low Young's modulus, preferably 10 times
larger for some applications, more preferably 100 times larger for
other applications and even more preferably 1000 times larger for
yet other applications. "Inhomogeneous Young's modulus" refers to a
material having a Young's modulus that spatially varies (e.g.,
changes with surface location). A material having an inhomogeneous
Young's modulus may optionally be described in terms of a "bulk" or
"average" Young's modulus for the entire layer of material.
[0259] "Bending stiffness" is a mechanical property of a material,
device or layer describing the resistance of the material, device
or layer to an applied bending moment. Generally, bending stiffness
is defined as the product of the modulus and area moment of inertia
of the material, device or layer. A material having an
inhomogeneous bending stiffness may optionally be described in
terms of a "bulk" or "average" bending stiffness for the entire
layer of material.
[0260] "Adversely affect" in the context of a tissue and/or
biological environment, refers to a stimulus, such as voltage,
current, temperature, electric field, electromagnetic radiation or
combination thereof, capable of damaging, disrupting, reducing
viability and/or killing cells of the tissue in the biological
environment. As will be understood by a skilled artisan, conditions
that adversely affect a tissue in a biological environment depend
on the specific type and composition of the tissue and biological
environment of the tissue. In an embodiment, for example, a barrier
layer limits the leakage current from the electronic device to the
tissue to a specific amount, such as a value equal to or less than
0.1 .mu.A/cm.sup.2, optionally for some applications equal to or
less than 0.01 .mu.A/cm.sup.2; and optionally for some applications
equal to or less than 0.001 .mu.A/cm.sup.2, so as to not adversely
affect the tissue. In an embodiment, for example, a barrier layer
limits the thermal transfer from the electronic device to the
tissue so as to provide in situ increase in temperature of the
tissue equal to or less than 0.5, optionally 1, optionally 2, or
optionally 5 degrees Celsius so as to not adversely affect the
tissue.
[0261] "Encapsulate" refers to the orientation of one structure
such that it is at least partially, and in some cases completely,
surrounded by one or more other structures. "Partially
encapsulated" refers to the orientation of one structure such that
it is partially surrounded by one or more other structures.
"Completely encapsulated" refers to the orientation of one
structure such that it is completely surrounded by one or more
other structures. The invention includes implantable devices having
partially or completely encapsulated electronic devices, device
components and/or inorganic semiconductor components and/or
electrodes.
[0262] "Biocompatible" refers to a material that does not elicit an
immunological rejection or detrimental effect when it is disposed
within an in-vivo biological environment. For example, a biological
marker indicative of an immune response changes less than 10%, or
less than 20%, or less than 25%, or less than 40%, or less than 50%
from a baseline value when a biocompatible material is implanted
into a human or animal.
[0263] "Bioinert" refers to a material that does not elicit an
immune response from a human or animal when it is disposed within
an in-vivo biological environment. For example, a biological marker
indicative of an immune response remains substantially constant
(plus or minus 5% of a baseline value) when a bioinert material is
implanted into a human or animal.
[0264] As used herein, "liquid bandage" refers to a mixture of
chemicals that are capable of creating a tissue adhesive such as a
polymeric layer that binds to skin, including a polymer that is
dissolved in a solvent. A number of liquid bandages are
commercially available including Dermabond, Band-Aid, PeriAcryl,
GluStitch, Xoin, Gesika, VetGlu, 3M Vetbond, LiquiVet, Indermil,
LiquiBand, Histoacryl, New-Skin and Nexcare and compositions
related thereto. A thin film of polymer is formed after application
when the carrier of the polymer evaporates after application. A
liquid bandage is used interchangeably with the term spray bandage.
A spray bandage provides an easy means for liquid application
without having to physically spread liquid over the area by hand.
The liquid or spray bandage may be used to make a contact layer.
The liquid or spray bandage may be used to make a cover layer. As
desired, multiple layers are made by repeated application,
including by liquid or spray bandages of different
compositions.
[0265] Described herein are conformable electrophysiology data
acquisition devices and methods for acquiring electrophysiology
data at high-speed and high-resolution. The conformable devices
disclosed herein include devices incorporating a moisture barrier;
moisture barriers, for example, are useful for preventing
conductive solutions from penetrating into electronic devices and
thereby producing leakage current from components thereof. The
conformable devices disclosed herein include devices useful for
diagnosing and treating medical conditions in real time and with
high spatial precision. The disclosed devices and methods also
include those suited for monitoring electrical, optical, thermal
and tissue characteristics of tissues in-vivo as they undergo
motion, for example the tissue of a beating heart. The disclosed
devices and methods further include those especially suited for
monitoring electrical characteristics of tissues having nonplanar
surfaces.
[0266] The invention may be further understood by the following
non-limiting examples.
Example 1: High-Speed, High-Resolution Cardiac Electrophysiology
In-Vivo Using Conformal Electronics
[0267] Mapping cardiac arrhythmias with standard, clinical
electrophysiology (EP) devices can be a tedious, lengthy process,
particularly over the epicardial surface. Probes with small numbers
(4-10) of widely spaced (2-5 mm) passive electrodes sequentially
record electrical activity from small areas of heart muscle as they
are moved manually, point to point, across regions of interest.
Because each electrode requires a separate connection to external
processors, spatial resolution and mapping speed are limited by
practical constraints on the number and configuration of electrodes
and wires that can fit in the device. This example describes a high
resolution, high speed system that eliminates these constraints.
The device uses fully integrated, conformal electronic circuits
(built with >2,000 single crystal silicon nanoribbon
transistors) to simultaneously record from 288 multiplexed (16:1)
channels, each with its own on-board amplifier. The low bending
stiffness of the device allows it to adhere to the dynamic, three
dimensional (3D) surface of the beating heart via physical
lamination, without pins or adhesives. This integrated system maps
activity at high spatial (sub-mm) and temporal (sub-ms) resolutions
over large areas in a single pass, without human intervention. This
functionality is demonstrated by mapping the spread of ventricular
depolarization from spontaneous and paced activation wavefronts
in-vivo in a porcine animal model, thereby introducing a platform
for a new generation of intelligent, implantable medical
devices.
[0268] Sudden cardiac arrest is the leading cause of death in
developed countries. Many patients at risk for arrhythmic death
have advanced structural heart disease, and preexisting non-lethal
ventricular arrhythmias. In these and other cases, cardiac
electrophysiologic (EP) studies are used to aid diagnosis and guide
therapy. Conventional devices for this purpose use sparse arrays of
electrodes that probe potentials at the surface of cardiac tissue.
During mapping, sensors are continuously maneuvered to record from
discrete sites on the heart. These sequential local recordings are
"stitched" together with software to render a complete
representation of cardiac electrical activity over a region of
interest. The iterative nature of this approach prolongs EP
procedures and impedes real time mapping of transient abnormal
rhythms. Despite explosive growth and innovation in the broader
electronics industry, the key limitation of EP devices is that they
have retained the simple electronics-tissue interface of their
earliest predecessors of .about.40 years ago. Sensing and
stimulating electrodes are purely passive metallic contacts
individually wired to separate, remote processing units that use
traditional semiconductor wafer-based electronics. Rapid, high
resolution EP mapping might be most effectively accomplished by
embedding modern silicon-based integrated circuit (IC) technology
directly at the tissue-electrode interface. Unfortunately the
planar shapes and rigid, brittle mechanical properties associated
with conventional ICs strictly preclude their non-destructive,
intimate integration with the curvilinear, soft surfaces of
biological tissues.
[0269] Recent advances in material science provide a solution to
this problem through scalable routes to ICs that offer the
performance of similarly designed devices on semiconductor wafers,
but with the mechanical properties of thin sheets of plastic or
rubber. This technology relies on established, inorganic
semiconductors (e.g. Si) configured into structural forms that
provide the desired mechanical properties. For example, single
crystal silicon in the form of nanoscale ribbons, membranes or
wires are flexible by virtue of their small thicknesses. Multilayer
circuit structures that exploit such materials in neutral
mechanical plane designs can accommodate bending to radii of
curvature of .about.50 .mu.m without fracture or degradation in
their electrical properties. These and related strategies enable
high-performance, active electrode arrays that can stretch, fold,
and conform to complex, 3D dynamic surfaces, such as the epicardial
surface of the beating heart. The ability to incorporate active,
powered components on flexible substrates, including amplifiers and
transistor-based multiplexing circuitry, enables a high density of
active electrodes on an EP device, without the need for a
connecting wire between each element, or for an implanted or
external control unit. Below, this example further describes the
successful implementation of a system of this type, at levels of
integration (i.e. >2000 transistors) that significantly exceed
previous reports of active biomedical or other classes of flexible
devices, and in clinically relevant modes of use (i.e. high speed,
high resolution EP mapping in-vivo) that provide clear advantages
over existing technologies. The results are important not only to
cardiac EP applications but more generally to new classes of active
electronic systems that can be integrated intimately with the human
body for diagnostic or therapeutic benefit.
[0270] FIGS. 1A-1E show a set of images and illustrations that
detail the fabrication sequence at a single unit cell (FIGS.
1A-1D), and a completed device (FIG. 1E). Each cell consists of a
contact pad that serves as an electrical interface to the tissue
and an associated amplifier and multiplexer. The device includes an
18 by 16 array of such amplified electrodes to provide a total of
288 measurement points, spaced by 800 .mu.m and covering a total
area of 14.4 mm by 12.8 mm. See FIGS. 1A-1E. Each unit cell
comprises 7 transistors for a total of 2016, representing the
highest level of integration achieved in any non-display flexible
electronic system. With integrated multiplexing circuitry, only 36
wires are required to connect all 288 measurement points to
external data acquisition and control units.
[0271] The fabrication involves formation of transistors and
interconnects in four metal layers. In the first step, transfer
printing delivers to a flexible plastic substrate (polyimide;
.about.25 .mu.m) an organized collection of single crystalline,
semiconductor grade silicon nanomembranes (260 nm) with patterned
regions of doping for ohmic contacts (FIG. 1A). Plasma enhanced
chemical vapor deposition of SiO2 (.about.100 nm) at reduced
temperatures yields a gate dielectric through which source/drain
contact openings are formed by photolithography and etching in
buffered oxide etchant. Electron beam evaporation, photolithography
and wet etching define the first layer of metal interconnect,
including source, drain and gate contacts, as shown in FIG. 1B.
Similarly fabricated second and third metal layers form the column
and row addressing electrodes (FIGS. 1C-1D) where a thin layer of
spin cast polyimide (1.4 .mu.m) with etched via holes provides the
interlayer dielectric between the first and second metal layers, a
trilayer organic/inorganic stack (polyimide/Si.sub.3N.sub.4/epoxy;
1.4 .mu.m/80 nm/9 .mu.m) and a single layer of epoxy (9 .mu.m)
forms a similar interlayer for the second and third and third and
fourth metal layers, respectively. Details appear in FIGS. 5A-5D,
6, 7, 8 and 9, described below. These different layers locate the
circuit at the neutral mechanical plane and ensure reliable
operation when immersed in saline solution, as described
subsequently. The top metal layer defines surface electrodes (Au
pads, 250.times.250 .mu.m) that contact the cardiac tissue and
connect to the underlying circuits through via holes. These
electrodes, which we refer to as inputs, have impedances of 100
KOhm+10% at 1 KHz, as measured using a similarly designed passive
electrode array immersed in normal saline (0.9%) solution. The
entire device connects to a data acquisition system through an
anisotropic conductive film (ACF) connector with 36 contacts. See
the methods and FIGS. 10A-10C for details of the fabrication
procedures, and dimensions of devices.
[0272] The right frames of FIG. 1C and FIG. 2A provide annotated
images and circuit diagrams, respectively, of the amplifier and the
multiplexing transistor. The amplifier uses a source-follower
configuration with significant current gain. The multiplexing
transistor enables readout of all inputs via programmed, sequential
addressing of each row of electrodes, thereby providing a 16.times.
reduction in the required number of output wires compared to a
non-multiplexed electrode array. The schematic in FIG. 2B
illustrates how the unit cell in FIG. 2A can be connected to other
unit cells to create the multiplexed signal output. During
multiplexed sampling, one row of electrodes is selected at a time
by driving one of the row select signals, such as R.sub.0
(highlighted in blue in FIG. 2B), high and all of the others low
(R.sub.1 . . . R.sub.n, where R.sub.1 is highlighted in green).
This allows the unit cells in that row to drive the column output
lines (C.sub.0 . . . C.sub.n, where C.sub.0 is highlighted in red),
which are connected to a high-speed analog to digital converter
(see FIGS. 11A-11B, National Instruments, USA). Row select signals
are rapidly cycled to sample all electrodes on the array. FIG. 2C
presents electrical characteristics of a representative
multiplexing transistor. The transistor exhibits an on/off ratio
and electron mobility of .about.10.sup.5 and .about.490
cm.sup.2/Vs, respectively. The high mobility, compared to organics
or other materials for flexible electronics, enables the amplifier
to have a high bandwidth, as shown in FIG. 2D, and the multiplexer
to switch quickly, as shown in FIG. 2E, even for the relatively
coarse dimensions of the devices reported here (i.e. channel
lengths of .about.40 .mu.m). FIG. 2D shows the measured and
simulated bandwidth of a single amplifier with the multiplexing
disabled. The amplifier shows performance properties consistent
with design targets and simulations, i.e. -3 db cutoff frequency of
.about.200 kHz. Simulations were obtained using commercial software
(Cadence, Cadence Design Systems, USA). See methods for more
details about the simulations. As shown in FIG. 2E, the multiplexer
switching time was about 5 .mu.s. The switching time was limited,
however, by the slew rate of the external row select signals
provided to the array, as shown in blue and green. FIG. 2F shows
the percentage of the final voltage value attained during the
allotted settling time, averaged across all of the electrodes, for
increasing multiplexing frequency. These results demonstrate that
multiplexing rates up to 200 kHz are possible, yielding sampling
rates up to 12.5 kHz per electrode. FIG. 12 further shows that the
signal to noise ratio (SNR) for the system remains constant up to
200 kHz multiplexing frequency. If the slew rate of the row select
signals is increased, the multiplexing rate can be further
increased. In experiments described below, the 16 row select
signals were cycled at 10 kHz, yielding a sampling rate of 625 Hz
per active electrode, with all 16 electrodes in a given row thus
sampled simultaneously. The multiplexed analog signals were
synchronously sampled at 50 kHz, 5 times oversampling per switch
interval, to improve the signal-to-noise ratio. Data were acquired,
demultiplexed, stored, and displayed using custom MATLAB software
(The MathWorks.TM., Natick, Mass.).
[0273] In addition to the electrical properties, mechanical
flexibility and capacity to operate while immersed in a saline
environment are critically important for this application.
Analytical mechanics modeling elucidates the bend-induced strains
in all layers of the devices used in animal experiments. The
thicknesses of the layers of epoxy and the substrate were chosen to
place the active circuit components near the neutral mechanical
plane. As a result, for bend radii of .about.5 cm, typical of those
encountered in human cardiac EP studies, maximum strains in the Si
and SiO.sub.2 are calculated to be 0.001% and 0.0001%,
respectively. These values are orders of magnitude below the
fracture strains for our devices, and they are also significantly
less than those expected to alter their electrical performance.
Another feature of the device design is that the bending stiffness
of the circuit is sufficiently low to allow conformal wrapping on
the moist surface of the cardiac tissue. These mechanics can also
be modeled by comparing the system energy for a circuit in a flat
configuration to one in a wrapped state (see FIGS. 13A-13B). The
result is that wrapping is energetically favored when
.gamma.>B/2R.sup.2, where .gamma. is the adhesion energy between
the circuit and the tissue, R is the radius of curvature, and B is
the bending stiffness of the circuit. Using R.about.2.5 cm and a
computed value of B, one finds that wrapping is the preferred
configuration for cases where .gamma.>34.7 mJ/m.sup.2. The
reported value of adhesion energy between two wet surfaces is
.about.75-150 mJ/m.sup.2. Based upon these models and measurements
from the fabricated devices, the conclusion is that the circuits
will naturally wrap around the cardiac tissue without any separate
mechanism to ensure adhesion. The partially wet surface of the
tissue, in-vivo, facilitates this outcome. To accommodate this
aspect and to enable device use in realistic clinical settings, the
circuit must provide sustained operation when immersed in the
body's fluids. It was found that the inorganic/organic
encapsulation scheme described previously serves as an effective
water barrier for this purpose. FIG. 2G shows a circuit immersed in
a saline bath, to test for leakage currents by creating a
conduction path from the device to a separate ground electrode in
the bath. A cutoff value of 10 .mu.A was selected, consistent with
the International Electrotechnical Commission standards for medical
electronic equipment (IEC 60601-1). Roughly 75% of the fabricated
devices passed this test. Randomly selected samples were tested for
long term reliability in the saline bath and found to operate for
greater than 3 hours while maintaining a leakage current less than
10 .mu.A. FIG. 2H presents 20 Hz sine wave response before and
after saline immersion for 10 minutes, verifying negligible changes
in circuit properties. 4 Hz and 40 Hz results are also displayed in
FIGS. 14A-14B.
[0274] In-vivo experiments were performed in normal 80-90 pound
male Yorkshire pigs. The heart was surgically exposed via a median
sternotomy and a subsequent pericardiotomy. The flexible EP circuit
was then placed on the epicardial surface while under direct
visualization (FIG. 3A). See methodology details in FIGS. 15A-15B
and FIG. 21. The device remained adhered to the curvilinear surface
of the heart, even during vigorous cardiac motion. FIG. 3B shows
motion snapshots at various stages of the cardiac cycle; the blue
lines highlight the dynamic variations in the surface shape
associated with maintaining conformal contact. Given the average
heart rate of .about.77 beats per minute (BPM) during in-vivo
experiments and a recording duration of .about.137 minutes, the
device provided reliable data over the course of >10,000 bending
cycles during the experiments. Unipolar voltage data were recorded
from all 288 electrode elements using the sampling and multiplexing
strategy described above. Baseline electrogram data were collected
in sinus rhythm with the array in multiple positions and
orientations on the epicardial surface. Data were also recorded
while pacing the heart from multiple locations relative to the
array via a standard, non-steerable decapolar electrode EP catheter
(Boston Scientific, San Jose, Calif.) held in contact with the
epicardial surface. FIG. 3C shows the array positioned over the
left anterior descending (LAD) coronary artery, with the pacing
catheter positioned just inferior to the array. The color coded map
in this frame shows a visual representation of the data collected
from the device, using procedures described below.
[0275] Data from all channels were filtered and processed using
custom MATLAB software to determine the relative activation time at
each contact by comparing the time of the maximum negative slope
(dV/dt) of the unipolar electrogram to the maximum negative slope
of the average electrogram of all 288 channels. These activation
times were then used to generate isochronal maps showing
propagation of paced and unpaced cardiac depolarization wavefronts
spreading across the array for a variety of recording sites and
pacing conditions (see FIG. 22 for more details). Sample voltage
trace data from a single channel without remote pacing are shown in
FIG. 4A. The inset at right highlights the very low noise level of
the recording. The signal to noise ratio (SNR) is approximately 50.
Note that negative is plotted up by convention. FIG. 4B shows
voltage data for all channels taken at 4 points in time. FIG. 22
shows some of the voltage data presented in FIG. 4B. FIG. 16
illustrates the uniformity of all of the electrodes by plotting the
average peak amplitude of the cardiac activation. FIG. 17A shows an
isochronal activation map made from this voltage data, illustrating
the natural activation pattern of the heart. Data from 5 of the 18
columns have been removed due to failures in the metal
interconnections. All of the remaining channels and all rows
functioned properly. FIG. 4C shows an average voltage trace
collected from all of the electrodes. Dashed lines have been
plotted on the trace to illustrate the instant in time that each
frame in FIG. 4B was taken. Sample voltage trace data from a single
channel with remote pacing are shown in FIG. 4D. FIGS. 4E and 17B
show isochronal maps generated by pacing from three different
locations relative to the array. Based on relative activation
times, conduction velocity across the array (transverse to fiber
axis) was 0.9 mm/msec (FIG. 4E); the velocity in the longitudinal
direction (approximately parallel to the orientation of the LAD)
was faster by a factor of 3 (FIG. 17B). These results are
consistent with anisotropic conduction properties measured in
previous studies. FIG. 18 shows the same paced voltage data as in
the right panel of FIG. 4E for all channels taken at 4 instants in
time. FIG. 23 and FIG. 24 show sample voltage data used to generate
the isochronal map in the left and right panels of FIG. 4E,
respectively. FIG. 4F shows sample distance vs. activation plots
for selected rows of the electrode array following the arrows in
FIG. 4E.
[0276] Collectively, these results represent mapping of electrical
activity in the heart at unprecedented rates and levels of spatial
and temporal resolution. This approach of conformal, integrated
circuits for a new form of biointerfaced electronics provides a
fundamentally new way to measure electrical processes in or on the
body, with many clinically important implications. Specifically for
the system introduced here, the high temporal and spatial
resolution should improve accuracy and reduce mapping time for many
cardiac arrhythmias. The more general benefit of these
technologies, in the broadest sense, is the capacity to integrate
the full power of silicon-based electronics technology for multiple
modalities of sensing and energy delivery on a single conformable
device. For example, multi-site cardiac pacing with closed-loop
feedback of local ventricular contractility or cardiac output
measurements via distributed arrays of active sensory and
stimulation electrodes could form the basis of an entirely new
class of assistive synchronization devices in cardiology.
Furthermore, the mechanical properties of the circuits permit
packaging in catheter-based delivery systems, with the ability to
deploy on and conform to large, irregular curvilinear surfaces of
the body. Pursuing these and related ideas using the materials and
electronics strategies reported here has great potential to yield
technologies with important benefits to human health.
[0277] Methods.
[0278] Circuit design. Each unit cell incorporates an nMOS based
source-follower amplifier configuration. This circuit provides
significant current gain to enable fast switching of the
multiplexers by supplying the current needed to charge the
parasitic output capacitances. These parasitics come from several
sources, including the inactive multiplexing transistors in a given
column, the .about.2 foot long cables that connect the electrode
array to the interface circuit board, the circuit board itself and
the input capacitance of its buffer amplifiers.
[0279] Circuit fabrication. The fabrication starts with the
preparation of the polyimide substrate (25 .mu.m; Kapton, Dupont,
USA). For ease of handling, a sheet of this material was attached
to a glass slide coated with a thin layer of poly(dimethylsiloxane)
as a soft adhesive. Separately doped silicon nanoribbons were
prepared through a high temperature diffusion process using a
p-type silicon-on-insulator (SOI) wafer (Si(260 nm)/SiO.sub.2(1000
nm)/Si; SOITEC, France) and phosphorous spin-on-dopant (SOD) (P509,
Filmtronics, USA). A 300 nm thick layer of SiO.sub.2 deposited by
plasma enhanced chemical vapor deposition (PECVD) served as the
diffusion barrier mask. Doping regions were defined through
conventional photolithography and CF.sub.4/O.sub.2 reactive ion
etching (RIE). The diffusion was performed at 950-1000.degree. C.
in a rapid thermal annealing (RTA) system. A series of wet etching
steps with HF and piranha solution (H.sub.2O.sub.2 and
H.sub.2SO.sub.4 mixture) removed the SOD and SiO.sub.2.
[0280] Doped nanomembranes derived by patterned etching of the top
silicon layer of the SOI wafer were transfer printed onto the
polyimide substrate using a thin, spin cast layer of a precursor to
polyimide as an adhesive. To prepare the structures for transfer,
the buried SiO.sub.2 layer was etched away with concentrated HF
solution to yield freestanding nanomembranes. The polyimide
precursor was cured at 300.degree. C. for 1 h immediately after
printing. Further isolation of the active Si components, such as
source, drain and channel regions, was accomplished by
photolithography and reactive ion etching with SF.sub.6. A thin
gate oxide of SiO.sub.2 (.about.100 nm) was then deposited by
PECVD. The source/drain contact regions were opened with buffered
oxide etchant through a photolithographically patterned mask. The
gate electrodes and metal interconnects were deposited by electron
evaporation of Cr/Au (.about.5 nm/.about.145 nm) and patterned
through wet etching. Each unit cell contains 7 transistors,
interconnected by wiring as described in the main text. Isolation
of the metal layers was accomplished with a polyimide interlayer
dielectric with thickness of 1.4 .mu.m. Connections between layers
were established through holes defined by patterned reactive ion
etching with O.sub.2. A stack of organic/inorganic insulation
layers followed by encapsulation with a photocurable epoxy (SU8,
Microchem Corp) formed a water-tight seal, as described above. The
flexible heat seal connector was used to connect the electrodes
with the data acquisition system. After aligning the connector to
gold pads at the periphery of the circuit, the application of heat
(.about.170.degree. C.) and pressure (applied with clips) for 15
min. formed low resistance and strong connection between the
conductive film and the electrode array. The other side of flexible
conductive film was connected to an adapter circuit board. The
design of this adapter board is shown in FIG. 19.
[0281] Acquisition system. The adapter circuit board was connected
via a standard 40 pin ribbon cable to the main interface circuit
board shown in FIG. 20. This custom circuit board provided the row
select signals from to the electrode array and provided buffering
of the analog output signals from the array. The buffering was
accomplished by TLC2274 op-amps (Texas Instruments). This stage of
buffering further reduced the output impedance to allow for longer
cable runs and improved switching speed. The outputs of this
circuit board were connected to National Instruments PXI-6281 and
USB-6259 high-speed M Series multifunction data acquisition (DAQ)
modules via standard BNC cables. The National Instruments DAQ
modules were used to generate the row select signals and to sample
the multiplexed analog output signals from the electrode array. In
total, 18 analog input channels were used.
[0282] Circuit Simulation. Simulations were performed using
Cadence's "spectreS" simulator. The "NCSU_TechLib_ami06" tech
library was used for all of the transistors.
[0283] Animal experiments. The array was placed on the heart of an
adult pig and conformed to the epicardial surface, including
epicardial coronary vessels (FIGS. 3A-3C). Initially, the array was
positioned between the epicardium and parietal pericardium, where
it was demonstrated to slide easily across the surface of the
heart. Subsequently, the parietal pericardium was removed, and the
array was left to stay in position via surface tension alone.
[0284] Supplementary Methods.
[0285] Nearly all of the materials and methods relied on
specialized setups specifically designed for this project,
including many of the planar processing steps and transfer printing
processes, the encapsulation strategies, the circuit designs and
acquisition system, the methods for interconnection and readout and
the mechanics analysis. The following describes additional details
on certain aspects.
[0286] Fabrication sequence. The steps, outlined above, were
implemented using a mask set illustrated in FIGS. 5A-5D and FIG. 6.
In FIGS. 5A-5D, the green boxes correspond to the isolated silicon
active regions that are connected by pink color first metal layer.
After spin coating of PI interlayer dielectric and following dry
etching for via, first metal layers are connected to yellow color
second metal layer through purple color first via, which finishes
the device fabrication process, as shown in FIGS. 5A-5D.
[0287] Since the measurement environment is wet and contains large
amount of ions due to the saline solution, a multilayer insulation
strategy is required to prevent the leakage current that may cause
electrical shock to the test animal. The inorganic/organic
multilayer and additional thick organic insulation layer were used
for this passivation, as shown in FIGS. 7 and 8. FIG. 7 shows the
overall design and FIG. 8 describes step by step encapsulation
process. Another aspect of the encapsulation design is the
misaligned via structure, between via 2 and via 3. By the
intentional misalignment of the vias, the first via can be
completely covered by the final epoxy layer.
[0288] Interconnection scheme. After the device fabrication, the
flexible sensor can be interconnected to the circuit board through
a flexible ACF film. For this connection, heat and pressure should
be applied. After alignment between ACF film and the sample,
clipping with conventional metal clips provide enough pressure for
the connection. To prevent mechanical failure in samples during
clipping and to spread pressure over the whole connection area, a
piece of PDMS and glass can be added, as shown in FIG. 10A. After
clipping, heating at 180.degree. C. for 15 min. results in a good
connection between the metal and ACF film. The image before and
after the heal seal connection is shown in FIGS. 10B and 10C.
[0289] Data processing. Data from all channels were high pass
filtered at 1 Hz and 20 times up-sampled to 12.5 kHz sampling rate
before processing. After up-sampling the data were smoothed and
demeaned to remove the DC bias. An average signal was constructed
and the derivative was taken to identify the relative activation
times using an automatic peak search algorithm.
[0290] Mechanics of the circuit wrapping on a curved surface. For a
thin film of length L and bending stiffness B wrapping on a
cylinder of radius R, as shown in FIG. 13A, the total energy of the
wrapped state is composed of two parts, the bending energy in the
thin film U.sub.b and the adhesion energy U.sub.a between the thin
film and the cylinder. The bending energy in the thin film is
1 2 U b = 1 2 B .kappa. 2 L = B 2 R 2 L . ( III ) ##EQU00003##
[0291] The adhesion energy is
1/2U.sub.a=-.gamma.L,
[0292] where .gamma. is the adhesion energy (per unit area) between
the thin film and the cylinder. If U.sub.b+U.sub.a<0 (the
unwrapped state has energy of 0), the wrapped state is
energetically favorable, and thus the thin film wraps around the
cylinder. This gives
.gamma. > B 2 R 2 . ( V ) ##EQU00004##
[0293] The cross sectional layout of the circuit, which will be
used to determine the bending stiffness B, is shown in FIG. 13B.
The top SU8 layer has a thickness h.sub.1=18 .mu.m, Young's modulus
E.sub.SU8=5.6 GPa and Poisson's ratio V.sub.SU8=0.22. The bottom PI
layer has a thickness h.sub.2=25 .mu.m, Young's modulus
E.sub.PI=3.4 GPa and Poisson's ratio V.sub.PI=0.34. The middle
layer, of thickness .about.5 .mu.m, is composed of several
different components. The material and thickness of each component
is shown in FIG. 13B, and their Young's moduli are: E.sub.Si=150
GPa, E.sub.SiO2=72 GPa, E.sub.Au=78 GPa, E.sub.Si3N4=194 GPa. Since
each of these components only occupies a small portion of each
layer of material, the position of the mechanical neutral axis can
be approximately obtained as (within a few percent error)
y 0 = 1 2 E _ PI h 2 2 + E _ SU 8 h 1 ( 2 h 2 + h 1 ) E _ PI h 2 +
E _ SU 8 h 1 , ( VI ) ##EQU00005##
where .sub.PI=E.sub.PI/(1-v.sub.PI.sup.2) and
.sub.SU8=E.sub.SU8/(1-v.sub.SU8.sup.2) are the plain strain moduli
of PI and SU8, respectively. The bending stiffness of the circuit
is
B= .sub.PIh.sub.2(1/2h.sub.2.sup.2-h.sub.2y.sub.0+y.sub.0.sup.2)+
.sub.SU8h.sub.1[1/3h.sub.1.sup.2+h.sub.1(h.sub.2-y.sub.0)+(h.sub.2-y.sub.-
0).sup.2]. (VII)
[0294] The strain at a point of coordinate y is given by
= y - y 0 R b , ( VIII ) ##EQU00006##
where Rb is the bending radius of curvature of the circuit. The
position of the mechanical neutral axis is calculated as
y.sub.0=26.5 .mu.m. With the bending stiffness given by Eq. (VII),
Eq. (VIII) gives .gamma.>8.7 mJ/m.sup.2. For a bending radius
R.sub.b=5 cm, the maximum strain in the Si is and SiO.sub.2 is
.about.0.001% and .about.0.0001%, respectively; the strains in the
four Au layers are .about.0.001%, 0.004%, 0.03% and 0.05%,
respectively.
[0295] FIGS. 1A-1E. Schematic illustration and images corresponding
to steps for fabricating active, conformal electronics for cardiac
electrophysiology mapping, and photograph of a completed device.
FIG. 1A. Schematic illustration (left) and optical micrograph
(right) of a collection of doped silicon nanomembranes at a unit
cell. FIG. 1B. Configuration after fabrication of the source, drain
and gate contacts, with suitable interconnects and row electrodes
for multiplexed addressing. FIG. 1C. Configuration after
fabrication of the second metal layer, including the column output
electrodes. Annotations in the image on the right indicate the
multiplexing transistor and the various components of the
amplifier. FIG. 1D. Final layout after deposition of encapsulation
layers and fabrication of the contact electrode that provides the
interface to the cardiac tissue. FIG. 1E. Photograph of a completed
device, in a slightly bent state. The inset at the bottom provides
a magnified view of a pair of unit cells.
[0296] FIGS. 2A-2H. Design and electrical properties of an active,
flexible device for cardiac electrophysiology mapping. FIG. 2A.
Circuit diagram for a unit cell, with annotations corresponding to
those in FIG. 1C. FIG. 2B. Circuit diagram of four unit cells,
indicating the scheme for multiplexed addressing. FIG. 2C.
Current-voltage characteristics of a representative multiplexing
transistor. FIG. 2D. Frequency response of a representative
amplifier. FIG. 2E. Representative multiplexer switching response,
showing the row select signals, column output and simulated column
output. The response time is limited by the external row select
signal slew rate. FIG. 2F. Average percentage settled to final
value for increasing single electrode sampling rate, indicating the
maximum useable multiplexing rate is approximately 200 kHz. FIG.
2G. Photograph of a completed device with ACF interconnect,
immersed in a saline solution. FIG. 2H. Sine wave response (at 20
Hz) before and after saline immersion for 10 minutes.
[0297] FIGS. 3A-3C. Photographs of a flexible EP mapping device in
use on a porcine animal model. FIG. 3A. Photograph of flexible
device conforming to the cardiac tissue via surface tension. The
inset provides a magnified image at a different viewing angle. FIG.
3B. Sequence of movie frames collected at different times during
the contraction cycle of the heart, illustrating the ability of the
device to bend in a way that maintains intimate, conformal contact
with the tissue during cardiac rhythm. Blue lines pasted on image
highlights the degree of bending along the device. A conventional
pacing electrode is indicated in the left frame (white arrow). FIG.
3C. Photograph of a device on the left anterior descending (LAD)
coronary artery, with overlaid color map of the relative time of
depolarization from paced activation. The white arrow in the lower
left indicates the source of the pacing and the red colors in the
activation map indicate the areas of earliest response.
[0298] FIGS. 4A-4F. Representative data recorded from a porcine
animal model using a flexible EP mapping device. FIG. 4A.
Representative single voltage trace without external pacing.
(Inset) Magnified view of the system noise. The black arrow
indicates the source of the inset data. The signal to noise ratio
(SNR) of the recorded signal was approximately 50. FIG. 4B.
Representative voltage data for all electrodes at 4 points in time
showing un-paced cardiac wave front propagation. Voltage is plotted
using the colour scale in the right corner. FIG. 4C. Average
voltage from all electrodes illustrating the point in time that
each frame in FIG. 4B was taken. The colour of the dotted lines
corresponds to the colour of the time label in FIG. 4B. FIG. 4D.
Representative single voltage trace with external pacing from a
standard clinical electrode. The black arrow and box highlight the
pacing artifact. Note that negative is plotted up by convention in
FIGS. 4A, 4C and 4D. FIG. 4E. Color map of relative activation
times for two different external pacing sites. The activation times
are plotted using the color bar shown at the right. Asterisks (*)
indicate the relative location of the external pacing electrode.
The scale bar illustrates the spacing between electrode locations.
The data from the activation map at the locations marked by lines
i-iii are plotted below in FIG. 4F. FIG. 4F. Distance vs.
activation delay plots for selected rows of the electrode array
following the arrows in FIG. 4E.
[0299] FIGS. 5A-5D. Schematic illustration corresponding to steps
for fabricating active, conformal electronics for cardiac
electrophysiology mapping. Nine unit cells are shown to illustrate
their interconnection at each metal level.
[0300] FIG. 6. Magnified view of a completed device, in a slightly
bent state to illustrate detail.
[0301] FIG. 7. Physical layout of a single unit cell showing the
additional insulation layers added to prevent leakage current in
saline solution.
[0302] FIG. 8. Sequential process of trilayer organic/inorganic
stack fabrication.
[0303] FIG. 9. Optical microscope image of a single unit cell with
completed insulation layers.
[0304] FIG. 10A. Schematic diagram of ACF connection process. Image
of flexible electrode array, ACF film and the circuit board before
(FIG. 10B) and after (FIG. 10C) heat seal connection.
[0305] FIGS. 11A-11B. Image of acquisition system during the animal
experiment: (FIG. 11A) front view, (FIG. 11B) side view.
[0306] FIG. 12. Signal to noise ratio dependence on multiplexing
frequency for a 20 Hz test signal.
[0307] FIGS. 13A-13B. Schematic diagram of wrapping model (FIG.
13A) and cross-sectional view of sensor (FIG. 13B).
[0308] FIGS. 14A-14B. Sine wave measurement before and after
immersion into the saline solution: 4 Hz (FIG. 14A) and 40 Hz (FIG.
14B).
[0309] FIGS. 15A-15B. Image of experiment with porcine animal model
(FIG. 15A) and photograph of flexible device conforming to the
cardiac tissue via surface tension (FIG. 15B).
[0310] FIG. 16. Colour map illustrating the amplitude uniformity of
all of the channels by plotting the average peak amplitude of the
cardiac activation cycle.
[0311] FIGS. 17A-17B. Isochronal activation map without (FIG. 17A)
and with (FIG. 17B) pacing. The relative pacing electrode location
is indicated by an asterisk (*).
[0312] FIG. 18. Representative voltage data for all electrodes at 4
points in time showing paced cardiac wave front propagation. The
relative pacing electrode location is indicated by an asterisk (*).
Voltage is plotted using the colour scale in the right corner. The
bottom frame shows the average voltage from all electrodes. The
dashed colour lines illustrate the points in time that each frame
was taken. Note that negative is plotted up by convention.
[0313] FIG. 19. Design of the adapter circuit board which adapts
the ACF ribbon to a 40 pin connector.
[0314] FIG. 20. Design of the main interface circuit board which
connects the 40 pin ribbon cable to the acquisition system.
[0315] FIG. 21. Animal experiment.
[0316] FIG. 22. Unpaced voltage data from all electrodes
illustrating the natural activation pattern of the heart. The
bottom frame shows an average ECG signal composed of all of the
above channels along with a guide bar to show the current position
in the voltage trace. Four frames from this movie are presented in
FIG. 4B.
[0317] FIG. 23. Voltage data from all electrodes illustrating the
paced activation pattern of the heart. The asterisk (*) indicates
the relative position of the pacing electrode. The bottom frame
shows an average ECG signal composed of all of the above channels
along with a guide bar to show the current position in the voltage
trace. Data from this interval in the recording were processed to
create the isochronal map shown in the left frame of FIG. 4E.
[0318] FIG. 24. Voltage data from all electrodes illustrating the
paced activation pattern of the heart. The asterisk (*) indicates
the relative position of the pacing electrode. The bottom frame
shows an average ECG signal composed of all of the above channels
along with a guide bar to show the current position in the voltage
trace. Data from this interval in the recording were processed to
create the isochronal map shown in the right frame of FIG. 4E. Four
frames from this movie are presented in FIG. 18.
Example 2: Multilayer Encapsulation for Enhanced Moisture
Barrier
[0319] One advantage achieved by encapsulation is prevention of
leakage current from electronic circuitry to a surrounding
conductive solution, such as saline solution, while the contact
type metal electrode that is connected to the gate of load
transistor is exposed to the surface to make a conformal and
intimate contact to the curvilinear, soft cardiac tissue. This
example describes a multilayer encapsulation structure to enhance
prevention of leakage current.
[0320] Multiple Layer Structure with Mis-aligned Via Structure. The
encapsulation can be a single polymer layer or in can be a
multilayer structure. If a single polymer layer (e.g., .about.20
.mu.m) is used, pinholes can form following a dry etching process
for via interconnect due to incomplete masking. Such pinholes can
be prevented, for example, if a photo-definable thick polymer, such
as SU8, is used, since the etching process is not needed. For a one
layer structure, a mis-aligned via structure is not typically use.
Use of a single via structure for some device applications may
increase the chance of leakage through the contact region where the
metal electrode and the gate of the transistor are connected.
Therefore, even though a very thick polymer layer is used, this
contact region may not be thoroughly protected with a single
polymer layer/via structure. FIG. 25A illustrates a single
encapsulation layer with an electrode element connected to the gate
of a transistor with a single via structure.
[0321] To solve this problem, a multilayer encapsulation with a
mis-aligned via structure can be used, as illustrated in FIG. 25B.
In this structure, the contact region is encapsulated with another
layer of polymer, leading to a reduced chance of leakage. For
example, instead of thick one polymer layer (.about.20 .mu.m), two
layers of polymer (.about.10 .mu.m each) can be used and the second
layer can fill the first via and protect the contact region between
the electrode and load transistor.
[0322] Even with the two layer structure described above, however,
it is possible that delamination between two layers, especially
between a metal and a polymer layer, can induce leakage current to
flow along the interface between these two layers. To minimize this
possibility, multiple mis-aligned via structure can be used. For
example, three 7 .mu.m polymer layers or four 5 .mu.m polymer
layers can be used. For any multilayer structure such as these, all
vias for each layer should be misaligned.
[0323] Thickness of Encapsulation Layer (Neutral Mechanical Plane
(NMP) Design. Thicker encapsulation layers generally provide better
leakage prevention. However, a deformable (e.g., flexible,
bendable) system needs to consider the induced strain during
deformation. To reduce unwanted mechanical fracture of inorganic
materials, such as silicon, the device layer should be located near
the neutral mechanical plane. Therefore, the top encapsulation
layer thickness can be determined depending on the substrate
thickness and material property, such as modulus.
[0324] Material of Encapsulant--Inorganic/Organic multilayer. To
enhance flexibility, a thinner substrate is used in some
embodiments; to place the device layer at the NMP, and optionally a
thinner encapsulation layer is also used. However, the thinner the
polymer layer, the higher the risk for pinholes or defects and,
therefore, the potential for increased leakage current. In
addition, since the micro structure certain polymers is composed of
fibers, the penetration of ionic fluid through gaps between each
polymer fiber, in the case of a thin polymer layer, can result in
increased leakage current. To prevent this kind of leakage, while
maintaining thin thickness, very thin (.about.50 nm) inorganic
layers, such as silicon nitride, can be inserted between each
organic layer. This inorganic/organic multilayer effectively
prevents the leakage current caused by ionic fluid penetrating
through the organic polymer layers.
[0325] A further method for reducing pinholes or defects in an
organic or polymer material includes reflowing during curing of the
polymer.
[0326] Table 1 summarizes encapsulation considerations for some
embodiments.
TABLE-US-00001 TABLE 1 Factor Exemplary Configuration or
Considerations Electrical leakage <10 .mu.A Total encapsulant
thickness Encapsulation thickness/substrate thickness: 0.5~2 (0.5~2
thickness ratio in the case of the same material with the
substrate.) (If different material, modulus of both materials may
be considered to locate NMP near device layers.) Substrate
thickness Active electronics: 5 .mu.m~30 .mu.m Passive electronics:
1 .mu.m~30 .mu.m Bending stiffness <108 GPa .mu.m.sup.4 Number
of misaligned vias >1 Organic/inorganic thickness Organic: 1
.mu.m~20 .mu.m, Inorganic: 10 nm~500nm Modulus of organic material
0.5 MPa~5 GPa
[0327] Flexible vs. Stretchable. The above descriptions of this
example are generally useful for flexible systems, though they can
also apply to stretchable systems. An alternative approach for
stretchable systems utilizes, for example, island and bridge
structures, such as serpentine bridges. The encapsulation, however,
should be similar, since the encapsulation layer for an island
should parallel the flexible system. One additional aspect of the
stretchable system is the passivation of a serpentine bridge
sidewall. After dry etching to make a serpentine structure, for
example, the sidewalls of serpentine metal interconnects are
exposed. Even with a small amount of delamination between
multilayers of a serpentine bridge during stretching deformation,
large leakage currents can be generated from the metal
interconnects. To prevent leakage, the margin from the edge of the
metal interconnect can be increased. Additionally, the side wall
can be passivated with another layer of polymer after etching.
Example 3: Schematic of a Conformal Electronic Device for Sensing
or Actuation
[0328] FIG. 26A provides a schematic illustration of a cross
sectional view of a conformal electronic device embodiment for
sensing or actuation of a tissue in a biological environment.
Conformable device 100 optionally comprises flexible or stretchable
substrate 110 supporting a flexible or stretchable electronic
circuit comprising plurality of inorganic semiconductor circuit
elements 120, such as electronic device components including
sensors, actuators, electrode arrays, LED arrays, optical sources,
integrated circuits, multiplexing circuits and/or amplifiers.
Barrier layer 130 encapsulating at least a portion of the flexible
or stretchable electronic circuit may provide a moisture barrier, a
thermal barrier, an electromagnetic barrier, an electrical barrier,
a magnetic barrier, a selectively permeable or impermeable barrier
or any combination of these. In some embodiments, the flexible
substrate, the flexible or stretchable electronic circuit and the
barrier layer provide a net bending stiffness or flexural rigidity
of the device low enough that the device establishes conformal
contact with the tissue in the biological environment. In some
embodiments, conformal contact is established between external
surface 135 of the device 100 and a tissue in a biological
environment.
[0329] Optionally, the conformal device 100 further comprises a
controller 155 in communication with the flexible or stretchable
electronic circuit comprising plurality of inorganic semiconductor
circuit elements 120, for example one way or two way communication
as shown by the arrows indicated in FIGS. 26A and 26B. In an
embodiment, controller 155 is provided in electrical communication
or wireless communication, and optionally is positioned away from
the tissue interface. In some embodiments, controller 155 is
configured to receive input signals 156 from the electronic circuit
that correspond to measurements of one or more sensed parameters,
such as time information, tissue properties (e.g., position,
composition, movement, electronic, chemical, optical, temperature,
etc.), or other properties of the biological environment. Input
signals 156 may represent raw data or processed data, optionally in
the form of a measurement. In some embodiments, controller 155 is
configured to provide output signals 157 to the electronic circuit
that correspond to one or more control parameters, such as control
signals for controlling the sensing and or actuation of the tissue,
including one or more time parameter, electronic parameter, optical
parameter, etc. In an embodiment, controller 155 is a processor
that receives and analyzes input signals 156 and generates output
signals 157 based at least in part on the input signals 156. In an
embodiment, controller uses input signals 156 and output signals
157 to provide close-loop control of sensing or actuation of the
tissue.
[0330] In some embodiments, the physical dimensions and material
properties of flexible substrate 110 and barrier layer 130 are
selected such that the semiconductor circuit elements 120 of the
flexible or stretchable electronic circuit are provide proximate to
the neutral mechanical plane of the device (illustrated by thick
dotted line, drawing element 150). Optionally, device 100 further
comprises one or more additional electronic device components 140
not encapsulated by barrier layer 130, optionally provided in
physical and/or electrical contact with the target tissue in the
biological environment. Additional electronic device components 140
useful in some embodiments, include sensors and actuators such as
electrodes, voltage sensing or actuating elements, current sensing
or actuating elements, optical sensors or actuators, temperature
sensors or actuators, pH sensors, chemical or biological sensors,
capacitive sensors, electrode elements, photodiodes, thermistors
strain sensors, acceleration sensors, movement sensors, and
displacement sensors or actuators.
[0331] FIG. 26B provides a schematic illustration of a cross
sectional view of a conformal electronic device having a barrier
layer comprising a multilayer structure. As shown in FIG. 26B,
barrier layer 130 comprises a sequence of individual layers
130a-130e. In some embodiments, individual layers 130a-130e
comprise a sequence of layer selected from the group consisting of
polymer layers, inorganic layers (e.g., inorganic dielectric
materials such as an oxide, carbide or nitride, etc.) and metal
layers. In some embodiments, individual layers 130a-130e comprise a
sequence of thin film structures, for example, thin film structures
fabricated by deposition (e.g., evaporative, sputtering, etc.) or
coating techniques. In some embodiments, individual layers
130a-130e comprise a sequence of thin film structures including at
least one metal thin film and at least one dielectric thin film,
and optionally at least one polymer thin film.
[0332] Alternatively, the circuit 120 may be free-standing without
substrate 110 when applied to the biological tissue. The
configuration of the circuit and transfer printing methods
facilitate the placement of such free-standing structures on
biological tissue, including skin. Optionally, a contact layer is
provided on the skin surface to facilitate placement and transfer
of the electronic circuit from the transfer substrate to the skin
and barrier layers 130 that are cover layers applied to the circuit
after the circuit is mounted on the skin. The cover layer(s) 130
may be polymer layers applied via a spray liquid bandage.
Example 4: Waterproof AlInGaP Optoelectronics with Application
Examples in Biomedicine and Robotics
[0333] This example explores new areas and implements mechanically
optimized layouts to achieve arrays of inorganic LEDs and PDs in
systems that can accommodate extreme modes of mechanical
deformation, for integration on substrates of diverse materials and
formats. Additionally, materials and design strategies allow
operation even upon complete immersion in saline solutions,
biofluids, solutions of relevance to clinical medicine and soapy
water, thereby opening new and unconventional opportunities for
seamless integration of opotelectronics with biomedical and robotic
systems. Thin implantable sheets (i.e. LED tattoos provide an
example). Specifically, this example describes advances, in the
following order: (1) experimental and theoretical aspects of
mechanical designs that enable freely deformable, interconnected
collections of LEDs and PDs on soft, elastomeric membranes, bands
and coatings, (2) strategies for achieving high effective fill
factors in these systems, using laminated multilayer constructs,
(3) device examples on diverse substrates and in varied geometrical
forms, (4) low modulus, biocompatible encapsulation materials that
preserve key mechanical properties and, at the same time, enable
robust operation when integrated on or implanted in living systems,
(5) flexible optoelectronic components for biomedicine, with in
vivo demonstrations on animal models.
[0334] For active materials, thin epitaxial semiconductor layers
grown on GaAs wafers are prepared, and then vertically etched to
define lateral dimensions of devices built with them. Release from
the wafer via selective elimination of an underlying layer of AlAs,
followed by transfer printing accomplishes integration on
substrates of interest. The fabrication scheme described here uses
a dual transfer process that involves first printing the
semiconductor materials to a temporary substrate (glass plate
coated with a trilayer of epoxy/polyimide
(PI)/poly(methylmethacrylate) (PMMA)) for forming contacts,
interconnections and structural bridges, and encapsulation layers.
Dissolving the PMMA releases fully formed, interconnected
collections of devices. A second transfer printing step achieves
integration on elastomeric sheets (e.g. poly(dimethylsiloxane),
PDMS) or other substrates coated with thin layers of PDMS, with
strong bonding only at the locations of the devices. For all
examples described in this example, the LEDs (referred to herein as
.mu.-ILEDs to highlight the small sizes and the distinction over
organic devices), and the PDs (i.e. .mu.-IPDs) have lateral
dimensions of 100.times.100 .mu.m and thicknesses of 2.5 .mu.m,
corresponding to volumes that are orders of magnitude smaller than
those of commercially available devices. The thin geometries are
important because they allow the use of thin film metallization for
interconnect and optimized mechanical designs, described next.
Details of the processing and layouts appear in FIGS. 33A-33C,
34A-34B and 35A-35C.
[0335] FIGS. 27A and 36 present optical images, schematic
illustrations, scanning electron microscope (SEM) images, and
finite element modeling of the mechanics of arrays of .mu.-ILEDs
connected by serpentine shaped ribbons that serve as either
structural bridges or electrical interconnects, transferred to a
thin, pre-strained sheet of PDMS (.about.400 .mu.m thick). Here,
and as described below, the devices are connected in series (FIG.
32A), such that all of them turn on and off together; a single
failed device leads to failure of the entire array. The
interconnects consist of thin films of metal with photodefined
layers of epoxy on top and bottom to locate the metal at the
neutral mechanical plane. The bridges are similar, but without the
metal. Detailed geometries appear in FIGS. 33A-33C. Releasing the
pre-strain yields non-coplanar layouts in the serpentines via a
controlled, non-linear buckling response, as shown in the left
frame of FIG. 27A (.about.20% pre-strain). The right frame and
inset of FIG. 27A present a schematic illustration and magnified
optical image of a representative .mu.-ILED, respectively. These
design choices are informed by careful studies of the mechanics
through three dimensional finite element modeling (3D-FEM) of the
complete systems; they represent highly optimized versions of those
used for silicon circuits and .mu.-ILEDs. The results enable stable
and robust operation during large scale uniaxial, biaxial, shear
and other mixed modes of deformation, as described in the
following.
[0336] FIGS. 34A and 35A show tilted view scanning electron
microscope (SEM) images and corresponding optical microscope images
of adjacent .mu.-ILEDs and non-coplanar serpentine interconnects
formed with .about.20% biaxial pre-strain before (left) and after
(right) uniaxial stretching (.about.60%), respectively. The
separations between adjacent pixels change by an amount expected
from the pre-strain and the applied strain, where a combination of
in- and out-of-plane conformational changes in the serpentines
accommodate the resulting deformations in a way that avoids any
significant strains at the positions of the .mu.-ILEDs. In
particular, 3D-FEM modeling results (FIG. 34B) reveal peak strains
in the metal interconnect and the .mu.-ILEDs that are >300 times
smaller than the applied strain (FIG. 35C shows similar results for
.about.59% stretching along the diagonal direction, corresponding
to FIG. 35B). FIGS. 27B and 36 present two dimensional, in-plane
stretching of a 6.times.6 array of .mu.-ILEDs along horizontal
(left) and diagonal (right) directions. The uniform and constant
operating characteristics of all devices are clearly apparent in
the dark and bright (without and with external illumination) images
of FIG. 27B and FIG. 36 as well as in the current-voltage (I-V)
characteristics (left frame of FIG. 27C). The applied strains,
calculated from the separations of inner edges of adjacent pixels
before and after stretching, reach .about.48% and .about.46% along
the horizontal and diagonal directions, respectively. The I-V
characteristics are invariant even after 100000 cycles of 75%
stretching along the horizontal direction (right frame of FIG.
27C).
[0337] Uniaxial stretching and compressing are among the simplest
modes of deformation. Others of interest include biaxial, shear and
related. The results of FIGS. 27D-27G and 37A-37C demonstrate the
ability of the reported designs to allow these sorts of motions,
through large strains induced by pneumatic pressure, achieved by
inflation of a thin (500 .mu.m) membrane of PDMS that supports an
array similar to that of FIG. 27B. Injecting air through a syringe
in a specially designed cylinder that serves as a mount for the
device deforms the initially flat array (top frame of FIG. 27D)
into a balloon shape (bottom frame of FIG. 27D). FIG. 27E shows
four pixels in the `flat` (top) and `inflated` states (bottom)
during operation, with external illumination. The area expansion
induced in this manner can reach .about.85% without any device
failures. The I-V characteristics also show no appreciable
differences between the flat and inflated states (FIG. 27F). 3D-FEM
is used to model the inflation induced deformation of a circular
elastomeric membrane, with the same thickness (500 .mu.m) and
diameter (20 mm) as in experiment, but without a mounted .mu.-ILED
array. As illustrated in FIGS. 27G and 37C, both the
circumferential and meridional strains reach .about.37.3% when
inflated to a height of 8.3 mm, the same as in the bottom frame of
FIG. 27D. Measured displacements of devices in the system of the
bottom frame of FIG. 27E indicate strains of .about.36%, which are
comparable to values calculated by 3D-FEM. This observation
suggests an important conclusion: with the designs reported here,
the arrays provide negligible mechanical loading of the soft,
elastomeric membrane support, consistent with the very low
effective modulus provided by the optimized, non-coplanar
serpentines.
[0338] Corkscrew twisting (FIG. 28A) provides another well-defined
mode of deformation that is of interest. Here, large shear strains
occur in addition to stretching/compressing in the axial and width
directions. The device test structure in this case consists of a
3.times.8 array of .mu.-ILEDs transferred to a band of PDMS without
pre-strain (see FIG. 38A for details). Optical images of flat,
360.degree., and 720.degree. twisting deformations with (left) and
without (right) external illumination (FIG. 28A) reveal uniform and
invariant emission. These strains lead to out-of-plane motions of
the serpentines, as shown in FIGS. 28B and 34B. The .mu.-ILEDs
remain attached to the PDMS substrate due to their strong bonding.
Electrical measurements indicate similar I-V characteristics with
different twisting angles (FIG. 28C) and at different stages of
fatigue tests, as shown in FIG. 38C. FIG. 28D presents
distributions of various strain components, evaluated at the
surface of a band of PDMS with thickness 0.7 mm by 3D-FEM: axial
stretching (left frame), width stretching (middle frame) and shear
(right frame). (For 360.degree. twisting, see FIG. 39). The results
demonstrate that the PDMS surface undergoes both extreme
axial/width stretching and shear deformations, with shear
dominating, and reaching values of .about.40% for the 720.degree.
twist. As for the case of FIGS. 27D and 27G, the distributions of
strain for the bare PDMS substrate can provide reasonably good
estimates for the system. These controlled uniaxial (FIG. 27B),
biaxial (FIG. 27D) and twisting (FIG. 28A) modes suggest an ability
to accommodate arbitrary deformations. As two examples, FIGS. 28E
and 28F show cases of stretching onto the sharp tip of a pencil and
wrapped onto a cotton swab. The array of 6.times.6 .mu.-ILEDs
pulled onto the pencil (red arrows indicate stretching directions)
experiences local, peak strains of up to .about.100%, estimated
from distances between adjacent devices in this region. Similar but
milder and more spatially distributed deformations occur on the
cotton swab, with an 8.times.8 array. In both cases, observation
and measurement indicate invariant characteristics, without
failures, even in fatigue tests.
[0339] A feature of the layouts that enable these responses is the
relatively small area coverage of active devices, such that the
serpentine structures can absorb most of the motions associated
with applied strain. An associated disadvantage, for certain
applications, is that only a small part of the overall system emits
light. This limitation can be circumvented with layouts that
consist of multilayer stacks of devices, in laminated
configurations, with suitable spatial offsets between layers. The
exploded view schematic illustration in FIG. 29A shows this concept
with four layers. FIGS. 41A-41B provide details. Integration is
accomplished with thin coatings of PDMS (.about.300 .mu.m) that
serve simultaneously as elastomeric interlayer dielectrics,
encapsulants and adhesives. Here, each layer consists of a
substrate of PDMS (300 .mu.m thick) and an array of LEDs (total
thickness with interconnect, .about.8 .mu.m). The total thickness
of the four layer system, including interlayers of PDMS, is
.about.1.3 mm. Optical images of emission from a four layer system
appear in FIG. 29B (with external illumination) and FIG. 41B
(without external illumination). FIG. 29C shows a two layer case,
where each layer lights up in a different pattern. The inset on the
right illustrates the same system in a bent state (bending radius=2
mm), where the maximum strain in top and bottom GaAs layers is only
0.006% and 0.007%, respectively as shown by 3D-FEM simulation
(FIGS. 42A-42B). The PDMS interlayers restrict the motion of the
serpentines, but by an amount that reduces only slightly the
overall deformability. The extent of free movement can be maximized
by minimizing the modulus of the encapsulant. Here, PDMS was mixed
in a ratio to yield a Young's modulus of .about.0.1 MPa, to retain
nearly .about.90% of the stretchability of the unencapsulated
case.
[0340] The favorable mechanical characteristics enable integration
onto a variety of substrates that are incompatible with
conventional optoelectronics. As demonstrations, .mu.-ILED devices
were built on swatches of fabric (FIG. 43A), tree leaves (FIG.
43C), sheets of paper (FIG. 29D), and pieces of aluminum foil (FIG.
29E). In all cases, transfer printing successfully delivers the
devices to these substrates with thin (.about.50 .mu.m) coatings of
PDMS that serve as planarizing and strain isolating layers, and as
adhesives. Bending and folding tests for each case indicate robust
operation under deformed states. The smallest bending radii
explored experimentally were 4 mm, 2.5 mm, and 400 .mu.m for the
fabric, leaf, and paper, respectively. Theoretical modeling, using
Young's moduli and thicknesses 1.2 MPa, 800 .mu.m, 23.5 MPa, 500
.mu.m, 600 MPa and 200 .mu.m for the fabric, leaf and paper,
respectively, shows that the fabric, leaf and paper can be
completely folded, in the sense that the strain in the GaAs remains
much smaller than its failure strain (.about.1%) even when the bend
radius equals the substrate thickness. Without the strain isolation
provided by the PDMS, the fabric can still be folded, but the leaf
and paper can only be bent to minimal radii of 1.3 mm and 3.5 mm,
respectively. This result occurs because the Young's modulus of
PDMS (0.4 MPa) is much smaller than those of leaf and paper (i.e.,
strain isolation), while the Young's moduli of PDMS and fabric are
more similar. Random wrinkling, including multi-directional folding
with inward and outward bending can be accommodated, as is apparent
in the devices on paper and aluminum foil (.about.30 .mu.m). In
images of the latter case (FIG. 29E), the number density of
wrinkles reaches .about.200 per cm.sup.2 with approximate radii of
curvature as small as 150 .mu.m (See FIGS. 43A-43F, 44A-44D and
45A-45D for additional images, plots of I-V characteristics,
results of fatigue tests, and surface topography of these
substrates).
[0341] FIGS. 29F and 29G present images of an array of .mu.-ILEDs
(1.times.8) with serpentine metal bridges and a single .mu.-ILED
device with long (1.25 cm.times.185 .mu.m) metal interconnects,
both on flexible, thin (.about.8 .mu.m) ribbons mounted onto
cylindrical supports. Alternatively, for longer term implantable
applications, subdermal .mu.-ILEDs can overcome scattering
limitations and bring in-vivo illumination to deep layers of
tissue. This approach could yield capabilities complementary to
those of fiber-optic probe-based medical spectroscopic methods, by
enabling real-time evaluation of deep-tissue pathology while
allowing precise delivery of radiation in programmable arrays. Such
devices can be formed in geometries of strips or threads, or of
sheets. As an example of the latter, the left frame of FIGS. 30A
and 46 show a schematic exploded view and an illustration of
fabrication procedures, respectively, for a 5.times.5 array of
.mu.-ILEDs on a thin sheet of polyethylene terephthalate (PET;
Grafix DURA-RAR, 50 .mu.m thickness) film coated with an adhesive
layer (epoxy) and encapsulated on top and bottom with PDMS. Thin
(.about.500 .mu.m) ceramic insulated gold wires that connect to
metal pads at the periphery of the array provide access to external
power supplies. FIG. 30B presents a picture of an animal model with
the device implanted subdermally in direct contact with the
underlying musculature (See methods section for details). The inset
shows the same device before implantation. For continuous operation
at the current levels reported here, peak increases in temperature
at the tissue of a couple of degrees C. are estimated. Short pulsed
mode operation could further minimize the possibility of adverse
thermal effects and also, at the same time, allow the use of
phase-sensitive detection techniques for increasingly sophisticated
diagnostics, imaging and physiological monitoring.
[0342] In summary, the advances described here in mechanics, high
fill factor multilayer layouts and biocompatible designs provide
important, unusual capabilities in inorganic optoelectronics, as
demonstrated by successful integration onto various classes of
substrate and by use in representative devices for biomedical and
robotics applications.
[0343] Methods. Delineating Epitaxial Semiconductor Material for
.mu.-ILEDs and .mu.-IPDs. For fabrication of the .mu.-ILEDs and
.mu.-IPDs, the process began with epitaxial films that included a
quantum well structure (4.times.(6-nm-thick
Al.sub.0.25Ga.sub.0.25In.sub.0.5P barriers/6-nm-thick
In.sub.0.56Ga.sub.0.44P wells)/6-nm-thick
Al.sub.0.25Ga.sub.0.25In.sub.0.5P barriers) and an underlying
sacrificial layer of Al.sub.0.96G.sub.0.04As on a GaAs wafer.
Details appear in FIG. 31A. Inductively coupled plasma reactive ion
etching (ICP-RIE; Unaxis SLR 770 system) with Cl.sub.2/H.sub.2
through a hard mask of SiO.sub.2 formed trenches down to the
Al.sub.0.96G.sub.0.04As, to delineate active materials in 6.times.6
or 8.times.8 or 3.times.8 or 1.times.4 arrays of squares with sizes
of 100 .mu.m.times.100 .mu.m. Next, photolithography defined
photoresist structures at the four corners of each square to hold
the epitaxial layers to the underlying GaAs wafer during removal of
the Al.sub.0.96G.sub.0.04As with diluted hydrofluoric (HF,
Transene, USA) acid (deionized water (DI): 49% HF acid=1:100).
[0344] Fabricating Arrays of .mu.-ILEDs and .mu.-IPDs in Mesh
Designs with Serpentine Interconnects on Glass Substrates. The
released squares of epitaxial material formed according to
procedures described above were transfer printed onto a glass
substrate coated with layers of a photodefinable epoxy (SU8-2;
Microchem.; 1.2 .mu.m thick), polyimide (PI; Sigma-Aldrich; 1.2
.mu.m thick), and poly(methylmethacrylate) (PMMA A2; Microchem.;
100 nm thick) from top to bottom. Next, another layer of epoxy
(SU8-2, 2.0 .mu.m) was spin-cast and then removed everywhere except
from the sidewalls of the squares by reactive ion etching (RIE;
PlasmaTherm 790 Series) to reduce the possibility of partial
removal of the bottom n-GaAs layer during the 1st step of an
etching process (1st step:
H.sub.3PO.sub.4:H.sub.2O.sub.2:DI=1:13:12 for 25 seconds/2nd step:
HCl:DI=2:1 for 15 seconds/3rd step:
H.sub.3PO.sub.4:H.sub.2O.sub.2:DI=1:13:12 for 24 seconds) that
exposed the bottom n-GaAs layer for n-contacts. Next, another layer
of epoxy (1.2 .mu.m thick) spin-cast and photopatterned to expose
only certain regions of the top p-GaAs and bottom n-GaAs, provided
access for metal contacts (non-Ohmic contacts) and interconnect
lines (Cr/Au, 30 nm/300 nm) deposited by electron beam evaporation
and patterned by photolithography and etching. These lines
connected devices in a given row in series, and adjacent rows in
parallel. A final layer of spin cast epoxy (2.5 .mu.m) placed the
devices and metal interconnects near the neutral mechanical plane.
Next, the underlying polymer layers (epoxy/PI/PMMA) were removed in
regions not protected by a masking layer of SiO2 (150 nm thick) by
RIE (oxygen plasma, 20 sccm, 150 mtorr, 150 W, 40 min). Wet etching
the remaining SiO2 with buffered oxide etchant exposed the metal
pads for electrical probing, thereby completing the processing of
arrays of .mu.-ILEDs (and/or .mu.-IPDs) with serpentine
interconnects.
[0345] Transfer Printing of Stretchable Arrays of Devices to
Substrates of Interest. Dissolving the PMMA layer of the structure
described above with acetone at 75.degree. C. for 10 minutes
released the interconnected array of devices from the glass
substrate. Lifting the array onto a flat elastomeric stamp and then
evaporating layers of Cr/SiO.sub.2 (3 nm/30 nm) selectively onto
the backsides of the devices enabled strong adhesion to sheets or
strips of PDMS or to other substrates coated with PDMS. For the
PDMS balloon of FIG. 27D, prestrain was applied by partially
inflating the balloon, followed by transfer printing the .mu.-ILEDs
and then releasing (deflating) the balloon. For small substrates,
roller printing techniques were used. See below for details.
[0346] Stretching Tests and Electrical Characterization. Stretching
tests were performed using custom assemblies of manually controlled
mechanical stages, capable of applying strains along x, y, and
diagonal directions. For fatigue testing, one cycle corresponds to
deformation to a certain level and then return to the undeformed
state. Each fatigue test was performed up to 1000 cycles to levels
of strains similar to those shown in the various figures.
Electrical measurements were conducted using a probe station
(4155C; Agilent), by directly contacting metal pads while
stretched, bent, or twisted. The measurement was performed using a
lead-out conductor line, bonded to metal pads of the arrays of
.mu.-ILEDs. Typical voltage scan ranges for measurement of the
6.times.6, 8.times.8, and 3.times.8 arrays was 0.about.60 V,
0.about.80V, and 0.about.90V, respectively.
[0347] Animal Experiments. All procedures were performed under
approved animal protocols. A female Balb/c mouse was anesthetized
with an intraperitoneal injection of a mix of ketamine/xylazine.
The depth of anesthesia was monitored by palpebral and withdrawal
reflexes to confirm that the animal had reached "stage 3" of
anesthesia. Once the animal was lightly anesthetized, the back was
shaved and cleaned at the incision site with 70% ethanol, followed
by a betadine surgical scrub. Previous implants were removed from
the mouse and the animal was euthanized according to approved
protocols. For the implants, the incision was performed on the
dorsal side of the mouse and the suturing was carried out across
the dermal layers (outer layers and subcutaneous tissues) above the
muscle tissue.
[0348] Photographs. Images in FIGS. 27A and 29E were combined
images to eliminate out-focused regions. Tens of pictures were
captured at different focal depths using a Canon 1Ds Mark III with
a Canon MP-E 1-5.times. Macro lens, and those captured pictures are
merged in the software "helicon focus" to create completely focused
image from several partially focused images.
[0349] Figure Captions. FIGS. 27A-27G. Device layouts of .mu.-ILED
arrays and their responses to uniaxial and balloon-shape biaxial
stretching. FIG. 27A. Optical image of a 6.times.6 array of
.mu.-ILEDs (100 .mu.m.times.100 .mu.m, and 2.5 .mu.m thick, in an
interconnected array with a pitch of .about.830 .mu.m) with
non-coplanar serpentine bridges on a thin (.about.400 .mu.m) PDMS
substrate (left frame). Schematic illustration (right) and
corresponding photograph (inset) of a representative device, with
encapsulation. FIG. 27B. Optical images of a stretchable 6.times.6
array of .mu.-ILEDs, showing uniform emission characteristics under
different uniaxial applied strains (top left: 0%, bottom left: 48%
along horizontal direction, top right: 0%, bottom right: 46% along
diagonal direction). FIG. 27C. Current-voltage (I-V)
characteristics of this array measured in the strained
configurations shown in b (left) and voltage at 20 .mu.A current
for different cycles of stretching to 75% along the horizontal
direction (right). FIG. 27D. Tilted (left) view optical images of a
stretchable array (6.times.6) of .mu.-ILEDs on a thin (.about.500
.mu.m) PDMS membrane in a flat configuration (top) and in a
hemispherical, balloon state (bottom) induced by pneumatic
pressure. FIG. 27E. The magnified view of FIG. 27D from the top.
The yellow dashed boxes highlight the dimensional changes
associated with the biaxial strain. FIG. 27F. I-V characteristics
of the array in its flat and inflated state. FIG. 27G. Distribution
of meridional and circumferential strains determined by 3D-FEM.
[0350] FIGS. 28A-28F. Responses of .mu.-ILED arrays to twisting and
stretching on sharp tips. FIG. 28A. Optical images of an array of
.mu.-ILEDs (3.times.8) on a band of PDMS twisted to different
angles (0.degree. (flat), 360.degree., and 720.degree. from top to
bottom), collected with (left) and without (right) external
illumination. FIG. 28B. SEM image of the array when twisted to
360.degree.. The serpentine interconnects move out of the plane
(red box) to accommodate the induced strains. FIG. 28C. I-V
characteristics of the array twisted by various amounts (0 (flat),
360 and 720.degree.). FIG. 28D. Distributions of axial (left),
width (center) and shear (right) strain determined by 3D-FEM for
twisting to 720.degree.. FIG. 28E. Optical images of an array of
.mu.-ILEDs (6.times.6), tightly stretched on the sharp tip of a
pencil, collected with (left) and without (right) external
illumination. The white arrows indicate the direction of
stretching. FIG. 28F. Optical images of a stretchable 8.times.8
array wrapped and stretched downward on the head of a cotton swab.
The inset image was obtained without external illumination. FIG.
28G. I-V characteristics of the array in FIG. 28E, before
(initial), during (deformed) and after (released) deformation. The
inset provides a graph of the voltage needed to generate a current
of 20 .mu.A, measured after different numbers of cycles of
deformation.
[0351] FIGS. 29A-29G. Multilayer laminated configurations of arrays
of .mu.-ILEDs for high effective area coverage and integration on
various unusual substrates. FIG. 29A. Schematic, exploded view
illustration for a stacked device formed by multilayer lamination.
FIG. 29B. Optical images of a four layer stack of 4.times.4 arrays
with layer-to-layer offsets designed to minimize overlap of
interconnect lines with positions of the .mu.-ILEDs. The images
show emission with different numbers of layers in operation (1st
layer on, 1st and 2nd layers on, 1st, 2nd and 3rd layers on, and
1st, 2nd, 3rd and 4th layers on). FIG. 29C. Optical images of a two
layer stack of 8.times.8 arrays, with different layers in
operation. The inset shows the device in a bent state (bending
radius .about.2 mm) with both layers on. FIG. 29D. Optical image of
an array of .mu.-ILEDs (8.times.8) on a piece of paper, in a folded
state (bending radius .about.400 .mu.m) during operation. The inset
shows the device in its flat state. FIG. 29E. Image of a 6.times.6
array on a sheet of aluminum foil under crumpled state. The inset
shows the device in its flat state. FIG. 29F. Images of a thin
(.about.8 .mu.m), narrow (820 .mu.m) strip of .mu.-ILEDs
(1.times.8) with serpentine interconnects on a rigid plastic tube
(diameter .about.2.0 mm, left). Inset shows the magnified view of a
single pixel. FIG. 29G. A thin strip LED device consisting of an
isolated .mu.-ILED with straight interconnects wrapped around a
glass tube (diameter .about.5.0 mm, right). The insets provide a
magnified view. FIG. 291. Image of a 1.times.8 array with
serpentine metal bridges on a .about.700 .mu.m diameter fiber,
wrapped around a glass tube (diameter .about.1.4 mm, left frame)
and, in a knotted state (inset), respectively, resting on coins
(pennies) to set the scale.
[0352] FIG. 30A. Schematic exploded view illustration of an array
of .mu.-ILEDs (5.times.5) on a thin PET film (50 .mu.m thick)
coated with an adhesive. Layers of PDMS on the top and bottom
provide a soft, elastomeric encapsulation that offers
biocompatibility and an excellent barrier to biofluids and
surrounding tissue. FIG. 30B. Image of an animal model with this
array implanted under the skin, and on top of the muscle tissue.
The inset shows the device before implantation. Contact Scheme.
Here, simple metal (Cr/Au) to doped GaAs contacts are used instead
of ohmic contacts. For improved electrical characteristics,
conventional ohmic contacts of metal interconnects to GaAs can be
implemented. To form the ohmic contact, a series of metal stacks
followed by appropriate annealing (n ohmic contact metals: Pd/Ge/Au
followed by anneal at 175.degree. C. for 1 hour, p ohmic contact
metal: Pt/Ti/Pt/Au in this paper) can be used, which results in
lower take-off voltage can be obtained as shown in FIG. 47A.
[0353] Long-term operation. Long-term operation was tested using
two LED devices, connected in series, on a thin slab of PDMS was
performed under the constant current mode (0.75 mA). Both devices
showed robust and reliable performance during the continuous
operation for 100 hours without affecting I-V characteristics as
shown in FIG. 47B.
[0354] FEM Simulation of Balloon Deformation. FIG. 48A illustrates
the mechanics model for inflating and transfer printing onto the
PDMS balloon of FIGS. 27A-27G. The initially flat, circular thin
film (initial state, upper left frame of FIG. 38A) of radius r is
fixed at its outer boundary, and is inflated by air to a spherical
cap of height h (inflated state, right frame of FIG. 48A). The
radius of the sphere is R=(h.sup.2+r.sup.2)/(2h). The spherical cap
is pressed down and flattened during transfer printing, as shown in
the lower left frame of FIG. 48A (as-print state). The deformation
is uniform along the meridional direction during inflation, while
all material points move vertically downward during printing.
Therefore, for a point of distance x.sub.0 to the film center at
the initial state, its position changes to x.sub.1 in the inflated
state with an arc distance s.sub.1 to the film center, and then
changes to x.sub.2 in the state during printing, where
s.sub.1=(R.sub.x0/r) arcsin(r/R) and x.sub.1=x.sub.2=R
sin[(x.sub.0/r) sin.sup.-1(r/R)]. These give the meridional and
circumferential strains of the inflated state as:
.theta.1 = R r arcsin r R - 1 , ( S1 ) .phi.1 = R x 0 sin ( x 0 r
arcsin r R ) - 1. ( S2 ) ##EQU00007##
The meridional and circumferential strains at the state during
printing are given by:
.theta. 2 = R r cos ( x 0 r sin - 1 r R ) sin - 1 r R - 1 , ( S 3 )
.PHI. 2 = R x 0 sin ( x 0 r sin - 1 r R ) - 1. ( S4 )
##EQU00008##
Finite element method (FEM) was used to study this process in order
to validate the analytical model above. The contours of meridional
and circumferential strains of the inflated state appear in the
upper and lower left frames of FIG. 48B, respectively. The results
are compared with analytical solutions, Equations (S1) and (S2), in
the right frame of FIG. 48B, and show good agreement. Therefore,
the analytical formulae, Equations (S1) and (S2), can be used to
predict the PDMS strain under different inflation, and further to
estimate the strain in devices on the balloon surface. FIG. 48C
shows the contours of meridional (upper left frame) and
circumferential (lower left frame) strains of the asprint state,
and the comparison with analytical solutions from Equations (S3)
and (S4) (right frame). The analytical solutions, once again, agree
well with FEM simulations without any parameter fitting.
[0355] Bending of LEDs on Various Substrates. The LED, as
illustrated in FIG. 49, consists of multiple layers with
thicknesses h.sub.1=3.5 .mu.m, h.sub.2=2.5 .mu.m, h.sub.3=1.2 .mu.m
and h.sub.4=1.2 .mu.m, and Young's moduli are E.sub.SU8=5.6 GPa,
E.sub.GaAs=85.5 GPa and E.sub.PI=3.2 GPa. These layers are modeled
as a composite beam with equivalent tensile and bending
stiffnesses. The PDMS strain isolation layer has thickness
h.sub.5=50 um and Young's modulus E.sub.PDMS=0.4 MPa. The Young's
modulus E.sub.sub and thickness H of the substrate are 1.2 MPa and
0.8 mm for the fabric, 23.5 MPa and 0.5 mm for the fallen leaf, and
600 MPa and 0.2 mm for the paper. The strain isolation model then
gives very small maximum strains in GaAs, 0.043%, 0.082% and 0.23%
for the completely folded fabric, leaf and paper, respectively. The
minimal bend radii are the same as the corresponding substrate
thicknesses H, i.e., 800 .mu.m, 500 .mu.m and 200 .mu.m for the
fabric, leaf and paper, respectively. For the Al foil substrate,
the minimum bend radius is obtained as 139 .mu.m when the strain in
GaAs reaches 1%.
[0356] Without the PDMS strain isolation layer, the LED and
substrate are modeled as a composite beam. The position of neutral
axis (measured from the top surface) is given by:
y 0 = { E SU 8 [ ( h 1 + h 3 ) 2 + 2 h 2 h 3 ] + E PI h 4 ( 2 h 1 +
2 h 2 + 2 h 3 + h 4 ) + E GaAs h 2 ( 2 h 1 + h 2 ) + E sub H ( 2 h
1 + 2 h 2 + 2 h 3 + 2 h 4 + H ) } 2 [ E SU 8 ( h 1 + h 3 ) + E GaAs
h 2 + E PI h 4 + E sub H ] . ##EQU00009##
The maximum strain in GaAs is
GaAs = 1 R b max ( y 0 - h 1 , h 1 + h 2 - y 0 ) , ##EQU00010##
where R.sub.b is the bending radius. Therefore, the minimum bending
radius of LED array on the substrate is
R b = 1 failure min ( y 0 - h 1 , h 1 + h 2 - y 0 ) ,
##EQU00011##
where .epsilon..sub.failure=1% is the failure strain of GaAs. For
the fabric substrate, the maximum strain in GaAs is only 0.34% even
when it is completely folded, which gives the minimum bending
radius the same as the thickness 0.8 mm. For the fallen leaf and
the paper, the minimum bending radii are 1.3 mm and 3.5 mm.
[0357] Figure Captions. FIGS. 33A-33C. Schematic illustration of
epitaxial layer (FIG. 33A) and fabrication processes for .mu.-ILEDs
arrays on a carrier glass substrate after transfer printing (FIG.
33B).
[0358] FIG. 32A. Schematic illustration (left frame) and
corresponding microscope (top right frame) and SEM (bottom right
frame) images of a 6.times.6 .mu.-ILEDs on a handle glass substrate
coated with layers of polymers (epoxy/PI/PMMA). FIG. 32B. Schematic
illustration (left frame) and corresponding microscope (top right
frame) and optical (bottom right frame) images of a 6.times.6
.mu.-ILEDs array which is picked up with a PDMS stamp for transfer
printing. A shadow mask for selective deposition of Cr/SiO.sub.2
(thickness: 3 nm/30 nm) covers the retrieved array on a soft
elastomeric PDMS stamp. FIG. 32C. Schematic illustration of
transfer printing to a pre-strained thin (thickness: .about.400
.mu.m) PDMS substrate (left frame) and microscope (top right frame)
and SEM (bottom right frame) images of the transferred .mu.-ILEDs
array on a prestrained thin PDMS substrate. Prestrain value was
.about.20%.
[0359] FIG. 33A. Schematic illustration of top encapsulation layers
indicating some of the key dimensions. FIG. 33B. Schematic
illustration of the cross sectional structure at an island, with
approximate thicknesses for each layer. The inset corresponds to an
SEM image of a .mu.-ILEDs array after transfer printing to a thin
PDMS substrate with prestrain of .about.20%. FIG. 33C. Schematic
illustration of the cross sectional structure at metal
interconnection bridges, with approximate thicknesses of each
layer.
[0360] FIG. 34A. Tilted view SEM images of adjacent .mu.-ILEDs
(yellow dashed boxes) before (left, formed with .about.20%
pre-strain) and after (right) stretching along the horizontal
direction (red arrows). FIG. 34B. Strain distributions determined
by 3D-FEM for the cases corresponding to frames in FIG. 34A. The
black outlines indicate the positions of the devices and the
serpentines before relaxing the pre-strain.
[0361] FIG. 35A. Optical microscope images of two pixels in a
.mu.-ILEDs array with a serpentine bridge design before (left
frame) and after (right frame) external stretching along the
horizontal direction. The upper and lower images show optical
micrographs in emission light off (upper) and on (lower) states.
The distance between adjacent pixels appears in the lower images
and used for calculation of applied strains. The lower images were
obtained without external illumination. FIG. 35B. Optical
micrograph images of two pixels in a .mu.-ILEDs array before (left
frame) and after (right frame) external stretching along the
diagonal direction. FIG. 35C. FEM simulation under external
stretching along the diagonal direction (left frame), and strain
contours in the GaAs active island (top right frame) and the metal
bridge (bottom right frame).
[0362] FIG. 36. Optical images of a 6.times.6 .mu.-ILEDs array with
a serpentine mesh design with external illumination under the same
strain circumstances as FIG. 27B.
[0363] FIG. 37A. Optical image of an 8.times.8 .mu.-ILEDs array on
a thin PDMS substrate in its on state, which is under the same kind
of deformed condition as bottom left frame of FIG. 27D. FIG. 37B.
Top view optical images of same array as FIG. 27D in its `flat`
(left frame) and `inflated` state (right frame) without external
illumination. FIG. 37C. Spatial distribution of FEM results of the
right frame of FIG. 27D and analytical solutions calculated from
Equations (S1) and (S2).
[0364] FIG. 38A. Schematic illustrations of a 3.times.8 .mu.-ILEDs
array integrated on a thin PDMS substrate with detailed dimensions
(upper frame: registrations of the .mu.-ILEDs on a PDMS donor
substrate, lower frame: entire view of the printed 3.times.8
.mu.-ILEDs array). The inset on top represents an optical
microscope image of this .mu.-ILEDs array on a handle glass
substrate before transfer printing. FIG. 38B. Magnified view of the
SEM image in FIG. 28B. The white dotted rectangle highlights the
non-coplanar bridge structures. FIG. 38C. Voltage at 20 .mu.A
current for each twisting cycle of 360.degree..
[0365] FIG. 39. FEM strain contours of axial (top), width (center),
and shear (bottom) strains for 360.degree. twisted PDMS
substrate.
[0366] FIGS. 40A-40B. Fatigue test result of a 6.times.6 .mu.-ILEDs
array as shown in FIG. 28E. FIG. 40A. Plot of I-V characteristics
of a 6.times.6 .mu.-ILEDs array as a function of deformation
cycles. FIG. 40B. Plot of voltage needed to generate a current of
20 .mu.A measured after deformation cycles up to 1000 times. Each
deformed state is approximately same as shown in FIG. 28E.
[0367] FIG. 41A. Schematic illustration of stacked devices
describing states of FIG. 29B. FIG. 41B. Optical images of stacked
devices as shown in FIG. 29B, collected without external
illumination.
[0368] FIG. 42A. The strain distribution of the two-layer system in
the stacked array bent to a radius of curvature 2 mm, as shown in
FIG. 29C. The black dashed rectangles demonstrate the positions of
.mu.-ILEDs. FIG. 42B. The strain distribution in GaAs layers in the
.mu.-ILEDs island.
[0369] FIG. 43A. Optical image of a 6.times.6 .mu.-ILEDs array with
serpentine metal interconnects, integrated on fabrics, in its bent
and on state (bending radius .about.4.0 mm). The inset shows the
device in its flat and off state. FIG. 43B. Plot of I-V
characteristics of this array in its bent state. Inset provides a
graph of the voltage needed to generate a current of 20 .mu.A,
measured after different numbers of cycles of bending deformation.
FIG. 43C. Optical image of an 8.times.8 .mu.-ILEDs array with a
human pattern, integrated on a fallen leaf, in its bent and on
state. The inset image was collected with external illumination.
FIG. 43D. Plot of I-V characteristics in the bent state as shown in
FIG. 43C. FIG. 43E. Optical image of a .mu.-ILEDs array integrated
on a paper in its folded and on state. FIG. 43F. Optical image of
the same .mu.-ILEDs array as shown in FIG. 29E in its mildly
crumbled state. Inset represents microscope image of adjacent four
pixels in their on states.
[0370] FIG. 44A. Plot of I-V characteristics of a 6.times.6
.mu.-ILEDs array integrated on paper in its flat (FIG. 29D inset)
and folded (FIG. 29D) state. FIG. 44B. Plot of I-V characteristics
of a 6.times.6 .mu.-ILEDs array integrated on aluminum foil in its
flat (FIG. 29E inset) and crumbled (the center frame of FIG. 29E)
state. FIG. 44C. Fatigue tests of arrays of 6.times.6 .mu.-ILEDs as
shown in FIG. 43E. Plot of I-V characteristics of a .mu.-ILEDs
array integrated on paper as a function of deformation cycles (left
frame). Plot of voltage needed to generate a current of 20 .mu.A
measured after deformation cycles up to 1000 times (right frame).
FIG. 44D. Fatigue tests of arrays of 6.times.6 .mu.-ILEDs as shown
in FIG. 43F. Plot of I-V characteristics of a .mu.-ILEDs array
integrated on aluminum foil as a function of deformation cycles
(left frame). Plot of voltage needed to generate a current of 20
.mu.A measured after deformation cycles up to 1000 times (right
frame).
[0371] FIGS. 45A-45D. SEM images of various substrate such as
fabrics (FIG. 45A), Al foils (FIG. 45B), paper (FIG. 45C), and
fallen leaves (FIG. 45D) before (left frame) and after (right
frame) coating of thin layer of PDMS.
[0372] FIG. 46. Schematic illustration of the encapsulation of an
implantable array of .mu.-ILEDs as described in FIGS. 30A and
30B.
[0373] FIG. 47A. Result of Luminance (L)-Current (I)-Voltage (V)
measurement of an individual pixel with and without applied ohmic
contacts. FIG. 47B. Applied voltage to generate a current of 20
.mu.A, measured after different operation time. The inset provides
I-V characteristics with different operation time.
[0374] FIG. 48A. Schematic illustration of analytical model for the
inflation and printing-down of PDMS film. FIG. 48B. FEM contours of
meridional (upper left) and circumferential (lower left) strains of
the inflated state and its comparison with analytical solutions
calculated from Equations (S1) and (S2). FIG. 48C. FEM contours of
meridional (upper left) and circumferential (lower left) strains of
the as-printed state and its comparison with analytical solutions
Equations (S3) and (S4) (right frame).
[0375] FIG. 49. Schematic illustration of the cross section of
.mu.-ILEDs on a substrate.
Example 5: System for Biological Sensing and Stimulating
Applications Using High Density Array Devices
[0376] The capacity to intimately integrate the full power of
modern semiconductor technology with the soft, fluid-bathed,
curvilinear and moving surfaces of an animal, e.g., a human, has
major implications for human health, for diagnostic, therapeutic
and surgical applications. In general, current forms of high
performance electronic devices are built on the hard, rigid and
brittle surfaces of semiconductor wafers, in formats that are
inherently incompatible with establishing intimate, large area
interfaces with a biological tissue. Electronic platforms that are
flexible and stretchable have the potential to avoid these
limitations. An example of a flexible high-density active electrode
array fabricated particularly for biological applications is
disclosed in commonly assigned International Patent Application
Publication No. WO 2009/114689, published on Sep. 17, 2009, and
entitled "Flexible and Scalable Sensor Arrays for Recording and
Modulating Physiologic Activity," the entirety of which is
incorporated herein by reference.
[0377] One example of a biological therapeutic application is
cardiac resynchronization therapy (CRT). CRT refers to the
simultaneous application of multiple pacing stimuli to different
areas of a failing heart in order to improve cardiac function. In
patients with heart failure due to myocardial infarction or other
causes, the ability of the ventricle to pump blood is compromised
by dyssynchronous activity in various walls of the ventricle. By
promoting more organized mechanical contraction via two or more
electrical stimuli that are carefully timed and positioned on or in
the heart, more synchronous and thus more efficient ventricular
function can be restored. Unlike basic pacemaker therapy, in which
a single electrical stimulus is applied to the ventricle for each
heartbeat purely to treat abnormally slow heart rhythms, CRT is
designed to effectively replace the electrical system of the
failing heart and improve the organization of ventricular
contraction at all heart rates.
[0378] Another application is to map conditions across the surface
of a biological tissue, e.g., the heart, to determine an
appropriate stimulation scheme to be applied, e.g., pacing or
ablating. Cardiac mapping is useful to isolate failing areas and to
use that information to determine where to focus treatment, such as
ablation treatment. There are numerous biological sensing and
stimulating applications that would benefit from a highly flexible
and yet miniaturized device that supports an array of elements
useful for sensing a variety of conditions from the tissue and/or
for applying different types of energy to the tissue.
[0379] In an embodiment, the invention provides a thin and highly
flexible device having an array of elements that can be used for
sensing or stimulating is used as a platform from which numerous
biological sensing, mapping and stimulating applications are
provided. There are numerous applications described herein that
exploit the spatial arrangement of elements on the device, and in
so doing, provide a mechanism to deliver treatments that would not
otherwise be possible without more invasive procedures, such as
surgery.
[0380] Referring first to FIG. 55, a system 10 is shown that is
designed for biological sensing and therapeutic treatment
applications. The system 10 comprises a flexible high-density
micro-array device (array device) 100 that connects or interfaces
with a control system 200. The array device 100 is configured to be
placed in operational contact or communication with a biological
tissue shown at reference numeral 20 for monitoring and/or
therapeutic treatment of the biological tissue. Examples of
biological tissue for which the array device 100 may be used
include heart tissue, brain or other nervous system organs,
muscles, retinas, ear drums, circulatory system structures, tumor
tissues, and digestive system structures.
[0381] Examples of specific structures and fabrication techniques
for the array device 100 are described in the aforementioned
co-pending application. FIGS. 68-74, described hereinafter,
illustrate additional electrical circuit configurations for the
array device 100. The array device 100 comprises an array of
elements 110 that may be sensors and/or effectors on a thin and
highly flexible substrate 115. The array device 100 is fabricated
using silicon-based circuit fabrication techniques. It is highly
flexible and stretchable and well suited to flex with the natural
movement of a biological tissue.
[0382] The elements 110 on the array device 100 may serve as
sensors and/or effectors. As used herein, an effector is any device
that takes a signal and introduces an intervention to modulate
biological (e.g., brain or heart) activity. Examples of effectors
include electrical stimulators, photo/light-emitters (e.g., for
activating brain tissues impregnated with a light responsive
compound), chemical releasing/infusion devices, devices that change
temperature, pressure, and/or acceleration, and devices that
introduce electrical, magnetic or other fields, etc. Illumination
sources such as a light source or other source that can activate
tissue for diagnostic or monitoring purposes may also be used. For
example, such illumination sources may be used to activate brain
tissue to interrogate its function but not necessarily to modulate
its activity.
[0383] Similarly, a sensor is any element that can be used to
transduce a biological signal into an electrical or other signal.
Examples of sensors include: electrical contacts for recording
electrophysiological signals, optical detectors for recording light
correlates of biological activity, chemical sensors for detecting
changes in chemical concentrations or PH (e.g., chloride,
neurotransmitters, lactate, glucose, other metabolites,
neuro-active compounds, medications, biological substances such as
tumor-secreted factors, etc.), devices for measuring temperature,
force, acceleration, movement, pressure, etc.
[0384] A sensor may also include functionality of the effector as
defined above.
[0385] The control system 200 interfaces with the electrode array
device 100 through one or more direct wired connections, or
optionally though a wireless connection. The control system 200
comprises a signal analysis subsystem 300 and a treatment
application subsystem 400. One or both of these subsystems may be
employed for a particular application. Some of the functions of
these subsystems may be incorporated on-board the array device 100.
The signal analysis subsystem analyzes signals obtained from
individual elements 110 of the array device 100 for those elements
configured as sensor elements. An example of an application of the
signal analysis subsystem is to analyze local ventricular
contraction parameters derived from sensor elements 110 in the form
of strain gauge micro-sensors. The treatment application subsystem
400 takes input from the signal analysis subsystem or some other
source in order to determine parameters for a therapy to be
applied, via the array device 100, or some other device. For
example, the treatment application subsystem 400 may determine
pacing parameters to be employed when the array device 100 is
configured to apply multiple spatially diverse pacing stimuli.
These are only examples of the possible functions of the signal
analysis subsystem 300 and treatment application subsystem 400.
Other examples are described hereinafter. In addition, while signal
analysis subsystem 300 and therapy application subsystem 400 are
shown as separate blocks, they be implemented within a single
block, i.e., by a microprocessor, microcontroller, digital signal
processor, or other programmable or fixed logic device.
[0386] Turning to FIG. 56, a diagram is provided to show that the
array device 100 can be collapsed (wrapped or rolled on itself) for
introduction into a body of an animal for deployment at the
biological tissue site of interest. To this end, as shown in FIG.
57, the array device 100, when collapsed, rolled or wrapped on
itself, may be inserted into a catheter or other introducer sheath
device 30 for guidance and delivery to the biological tissue
site.
[0387] Example Application: Cardiac Resynchronization
[0388] One application described herein relates to cardiac
resynchronization.
[0389] Referring to FIGS. 58 and 59, an example application is
shown in which the array device 100 is introduced inside the
pericardium of the heart of an animal using the introducer sheath
30. Once the introducer sheath 30 reaches into the pericardium, the
array device 100 is allowed to unroll or unwrap by being pushed
outward from the sheath 30, such as by a guide wire, in order to
make contact with an area of the heart of interest as shown in FIG.
59. Suitable electrical (and/or physical) contact between the array
elements 110 of the array device and the heart tissue is enhanced
by the pericardial fluid around the surface of the heart inside the
pericardial sac.
[0390] Thus, FIGS. 58 and 59 show that the array device 100 is a
thin, ultra-flexible device platform supporting an array of active
electronics that can be introduced into or around the heart via
standard catheter delivery techniques in a traditional
electrophysiology laboratory. It is collapsed (e.g., retracted,
rolling, or folded), moved to within or around the heart and
related structures (with the assistance of a combination of fluid
and air injected in the pericardial space), and re-deployed at a
separate location.
[0391] In one form, the device 100 is initially introduced into the
body on a biodegradable backing platform (e.g. silk). This
biodegradable platform will provide additional support for
implantation and initial manipulation, then dissolve and facilitate
close adherence of the device 100 to cardiac and heart-related
tissues.
[0392] In an alternative form, the array device 100 may be directly
placed on the epicardium via surgical techniques.
[0393] Turning to FIGS. 60 and 61, an example of a closed-loop
application of the array device 100 is now described. In this
example, the array device 100 is secured to the epicardium and
connected to an implantable electronics unit 500 within which the
control system 200 resides. The electronics unit 500 connects to
the array device via a tunneled lead 510 and also connects to
transvenous right atrial and right ventricular pacing electrodes
530 and 535 via leads 520 and 525.
[0394] In the configuration shown in FIG. 61, pacing stimuli can be
delivered in a programmable fashion with high spatial and temporal
adaptability that is well suited for cardiac resynchronization
therapy (CRT). As explained herein, CRT involves the simultaneous
application of multiple pacing stimuli to different areas of the
heart. Since the array device 100 has numerous spatially arranged
elements 110, which can be configured as active effector elements,
the array device 100 is well suited to provide a fully implantable
system that is capable of delivering CRT.
[0395] In particular, the array device 100 provides for the ability
to pace the heart from essentially any location, sequence of
locations, or combination of locations on the ventricles. This
allows for customization and optimization of pacing for each
individual patient, with the goal of increasing both the number of
patients for whom CRT will be indicated and the proportion of
patients that experience a positive response.
[0396] FIGS. 62 and 63 illustrate the flexibility in spatially
controlling pacing stimuli to the heart. FIG. 62 is a simplified
diagram of the active area of the array device, showing effector
elements 110 of the array device 100 arranged in rows A-D and
columns 1-4. FIG. 63 illustrates a variety of spatial and timing
schemes that may be employed with respect to the effector elements
on the array device. In addition to the schemes depicted in FIG.
63, individual effector elements 110 may be addressed for
delivering a stimulus at a particular time instant. Thus, there are
numerous spatial and timing schemes that can be employed in
connection with the array device 100 for delivering pacing stimuli
to the heart. Furthermore, the array device 100 makes feasible a
multitude of additional applications and advantages over existing
resynchronization devices and systems. Incorporation of sensors
such as strain gauges at select array elements 110 can provide
information on local ventricular contraction parameters that enable
a closed-loop system in which the control system 200 can adjust and
optimize pacing parameters in real-time. Such a system may be
crucial in improving the response rate to resynchronization
therapy, as current optimization techniques focus on adjusting
parameters at one point in time and maintaining those parameters as
the "permanent" settings.
[0397] Further still, using appropriate sensors (described above)
for the elements of the array device 100, the array device 100 may
be employed with integrated active circuitry for measuring cardiac
contractility, myocardial wall displacement, myocardial wall
stress, and movement in real-time, with high spatial and temporal
resolution. Similarly, the array device 100 may be employed with
integrated active circuitry for modulating, that is, actively
controlling, cardiac contractility, myocardial wall displacement,
myocardial wall stress, and movement in real-time, with high
spatial and temporal resolution, through appropriate stimuli. As
described above, the array device 100 may be employed with
integrated active circuitry for measuring and improving myocardial
contractile function in a real-time, closed-loop system.
[0398] FIG. 64 illustrates a flow chart for a continuously
adjustable stimulation process 600 that may be performed by the
control system 200. At 610, local ventricular contraction is sensed
from suitably configured sensor elements on the array device 100.
At 620, the contraction data obtained from the sensor elements on
the array device 100 is analyzed to continuously characterize
(e.g., on a beat-by-beat basis) the ventricular contraction
behavior of the heart. At 630, pacing parameters associated with
CRT or other pacing schemes for pacing stimuli delivered via
effector elements of the array device 100 (or via other pacing
electrodes positioned in or on the heart) are continuously adjusted
based on the ventricular contraction behavior of the heart.
[0399] Some real-time adjustment in heart rate and atrioventricular
timing can be effected by incorporation of various activity sensors
in current devices. However, these changes are based on preset
algorithms rather than concurrently measured individual patient
data. It is likely that ideal atrioventricular and interventricular
timing varies significantly with changing hemodynamic conditions.
Consequently, the ability to integrate instantaneous feedback on a
beat-by-beat basis may improve a patient's response to CRT.
[0400] In addition, an implanted electrode array can be used to
record information about spontaneous arrhythmias that may develop.
Heart failure with diminished left ventricular ejection fraction
(EF) is associated with an increased risk of sudden cardiac death,
and large randomized trials have demonstrated mortality benefit
from prophylactic ICD implant in patients both with and without
prior myocardial infarction (MI). As such, many patients for whom
CRT is indicated also qualify for implantable
cardioverter-defibrillator (ICD) implantation. A significant
portion of patients with an ICD will eventually develop a
life-threatening tachyarrhythmia that will require an ICD shock; a
subgroup of those patients may have multiple episodes requiring
multiple shocks, a painful and psychologically stressful therapy.
Catheter ablation procedures for eliminating ventricular
tachycardia are becoming increasingly common to prevent further
arrhythmias and ICD shocks in such patients, and localization of
the clinically important arrhythmia can at times be difficult. The
more extensive and detailed spatial information recorded by an
implanted array of electrodes during an arrhythmia prior to
hospitalization, compared with the limited information recorded by
the two or three leads in conventional devices, will help in
planning a more efficient and effective ablation procedure. It will
also provide more data with which to compare arrhythmias induced
during an EP study, facilitating more rapid identification of those
arrhythmias that are clinically relevant.
[0401] Another scheme that may be employed with the use of the
device 100 is to electrically silence regions of the heart that are
responsible for generating life threatening arrhythmias through
timed depolarization. Using correctly timed stimulations from the
array device 100 to the heart, arrhythmogenic foci or areas of
myocardium can be maintained in a constant state of depolarization,
and thus be unable to participate in arrhythmogenesis. The array
device 100 can be configured, functionally, in size, to act on
regions of the heart (e.g. the entirety of a myocardial infarction)
that are too large to be treated with conventional ablation
techniques. Similar concepts may apply to treatment of epilepsy,
with brain stimulation to prevent the development of seizure
activity. A different but related technique is use of the array
device 100 for "electrical silencing" through stimulation of neural
inputs to the heart, i.e., the sympathetic trunk or ganglionated
plexi that innervate the heart. A closed-loop mechanism may be
employed to modify the spatial and temporal pattern of stimulation
in real-time based on the effectiveness of arrhythmia
suppression.
[0402] It is possible that the array device 100, once implanted,
could additionally provide mechanical support to the failing heart.
Passive constraint of the ventricles against chronic dilation via
an implanted synthetic mesh-like device was previously studied in
randomized trials of the CorCap.TM. Cardiac Support Device (CSD)
(Acorn Cardiovascular, Inc., St. Paul, Minn.).
[0403] FIG. 65 illustrates a configuration of the array device 100
that may be suitable to provide mechanical support to a failing
heart. The array device 100, equipped to operate as both a pacing
device and a recording device, can provide active, mechanical
systolic support analogous to cardiomyoplasty. The array device 100
is constructed of a size suitable to be wrapped around a region of
the heart to provide passive mechanical support for facilitating
ventricular diastole or active mechanical support to augment
systolic function.
[0404] The device serves as a flexible, active, multi-scale array
with adjustable spatial and temporal resolution capable of
high-density recording and stimulation from the epicardium or
endocardium. The pacing configurations and schemes that are
available through the use of the array device 100 are numerous,
from single-site pacing to multiple-site pacing. In addition, the
array device 100 can be used in a system to treat arrhythmias that
cannot be safely or effectively ablated. Moreover, the array device
100 can be used to detect the early stages of a cardiac event and
to treat it with a suitable stimulation scheme to stop it.
[0405] Example Application: Anatomic and Physiologic Mapping and
Ablation
[0406] Anatomic and physiologic mapping of the surface of a
biological tissue has important applications. For example, mapping
the epicardial surface via percutaneous pericardial puncture, as
first demonstrated in patients with Chagas' disease and ventricular
tachycardia (VT), has proven useful in ablation of VT circuits with
crucial portions of the reentrant circuits located in subepicardial
muscle. Surgical data suggests that at least 15% of post-myocardial
infarction VT is dependent on such subepicardial circuits, a
proportion that is likely much higher in patients with non-ischemic
cardiomyopathy and VT.
[0407] One advantage to the aforementioned percutaneous procedure
is the ability to access the epicardium without the need for
surgical exposure. However, the lack of surgical exposure creates
several obstacles, including inability to easily visualize the
location and course of epicardial coronary arteries and the phrenic
nerve, as well as difficulties distinguishing epicardial fat from
scarred myocardium. The appearance of multi-component and late
electrograms has been primarily used to distinguish an area of scar
from fat. A method for direct visualization of epicardial landmarks
using real-time video pericardioscopy has been described in the
literature. Multiple fluoroscopic techniques have also been used to
localize the coronary arteries at the time of epicardial mapping,
including simultaneous catheter-based coronary angiography and
fusion of a 3D electroanatomical map with previously acquired
computed tomography (CT) angiograms. Both methods require exposure
to intravenous (IV) contrast material, and both are limited by the
precision of merging two sets of images, whether by eye or using a
computer-assisted technique. In contrast, during traditional
epicardial mapping via a surgical approach, both coronary arteries
and epicardial fat are easily distinguished visually by the
operator.
[0408] The availability of a single instrument that can be used to
reliably map both the structures and electrical properties of the
heart with exquisite spatial resolution, despite the absence of
direct visualization, is very desirable. Such an instrument would
ideally take advantage of traditional endovascular approaches or a
percutaneous pericardial approach.
[0409] Reference is now made to FIG. 66 for an application of the
system 10 (FIG. 55) adapted for a simultaneous anatomic and
physiologic mapping and ablation application. In this application,
the body organ to be mapped and treated is the heart, but this is
only by way of example. The array device 100 is delivered to the
endocardium or epicardium via traditional endovascular techniques
or by a modified version of the nonsurgical transthoracic approach
now commonly used, e.g., as depicted and described above in
connection with FIGS. 58 and 59. The array device 100 is configured
to have a large number of electrodes over an array of spatial
locations that are configured as sensors for recording electrograms
and also elements that are configured as effectors for delivering
radiofrequency (RF) or other ablation energy. In addition, some of
array elements may be configured as one or more of a variety of
sensors (optical, chemical or other) for detection of epicardial
coronary artery blood flow and discrimination of tissue
properties.
[0410] The array device 100 is connected via a suitable lead 540 to
a control system shown at reference numeral 200' that is external
to the patient. The control system 200' comprises a signal
generator 310, a controller 320, a display 330 and a signal
processor 410. The signal processor 410 analyzes output of the
sensor array elements on the array device 100 and generates data
suitable for displaying mapping images on the display 330, such as
shown at the mapping image 335. In one example, the mapping image
335 may be a three-dimensional (3D) map of electrophysiologic
properties (e.g., voltage activation), anatomic properties (e.g.,
muscle, epicardial vessels, or fat), and ablation sites. In the
mapping image 335, there is a region 335a (dark purple) that
represents healthy muscle, a region 335b (rainbow range of colors)
that represents varying degrees of scared myocardium a region 335c
(light purple) that represents an area of epicardial fat. The bold
dashed lines shown at 337 represent epicardial coronary arteries
and the dots (red in color) 339 represent ablation sites. The
mapping image 335 thus illustrates, through color or other visual
indications, all of these anatomic and physiologic properties
identified by a single multimodal array device 100 employing the
techniques described herein.
[0411] Technologies that may be integrated on the flexible array
and adapted for sensing conditions of coronary arteries include
optical sensors, pressure or strain measurements, acoustic sensors,
and chemical sensors. These sensors may also be used to detect
ischemic changes and other abnormalities associated with tissue
compromise and disease. Relatively simple measurements of tissue
conductivity and impedance may be sufficient for distinguishing
epicardial fat from muscle.
[0412] The signal processor 410 may also generate data that is
useful to the controller 320 to control the signal generator 310.
The controller 320 may be an automated controller, e.g.,
microprocessor suitably programmed with control logic, or a manual
control apparatus. In either case, the controller 320 is configured
to modify the ablation energy produced by the signal generator 310
for application via any combination of effector elements on array
device 100.
[0413] The ability to include active circuitry on the array device
100 enables minimization of electrical connections between the
array and the operator, thereby promoting the primary goal of an
adaptable yet small device that can be delivered percutaneously or
endovascularly. Moreover, the ability to record and store localized
cardiac electrograms from multiple spatially diverse sites
simultaneously during ventricular arrhythmias enables faster and
more accurate localization of those arrhythmias in the
electrophysiology laboratory.
[0414] The spatial arrangement of sensors on the array device 100
allows for creation of a 3D electroanatomic map-analogous to the
functionality of the CARTO XP (BiosenseWebster) and EnSite NavX.TM.
(St. Jude Medical) mapping systems. Depending upon the array size
and density of the array device 100, all electrodes could be
localized in 3D space using only a select subset of elements
(electrodes) on the array device, with interpolation of the
remaining point locations. More specifically, the array device 100
is placed in or on the heart (only) during a mapping and/or
ablation procedure, and it may be moved around in or on the heart
in order to map as large an area as possible of the heart. This is
indicated by the arrows in FIG. 66. The select subset of electrodes
is used as select points on the array device that are localized
(relative to other structures or catheters in the heart) using, for
example, magnetic-based 3D localization techniques such as those of
the CARTO XP or impedance-based 3D localization NavX systems. Using
interpolation of the localization data for the select subset of
elements, the exact position of every element on the array device
100 is localized.
[0415] This position tracking technique is useful to create a
virtual 3D map of where the array device 100 has been on or in the
heart and some representation of the data collected at those
locations on or in the heart. One example is a voltage map. A 3D
"shell" of the surface is generated from the voltage measurements
made at elements of the array device and the voltage levels at
every measurement point may be color-coded. With numerous sensor
modalities on the array device 100, the array device 100 may be
used to superimpose multiple 3D maps at the same time, such as for
voltage measurements, blood flow measurements and strain (pressure)
measurements. Alternatively, given the 3D deformability of the
array device 100, emitters of different types can be linked to each
electrode contact to compute the location of all the elements of
the array device with higher resolution.
[0416] Thus, the array device 100 serves as a flexible, active,
multi-scale device with adjustable spatial and temporal resolution
capable of high-density recording from and stimulation to the
heart, delivered both through standard endovascular techniques to
the endocardium and minimally invasively to the epicardium.
[0417] The device 100 is an implantable flexible electronic device
with integrated active circuitry useful for both anatomic and
electrical mapping of the heart surface and surrounding structures
with high spatial and temporal resolution. Information gathered
from a variety of sensor modalities integrated on the device can be
used to distinguish myocardial tissue, epicardial fat, coronary
arteries, large nerves, and other structures underlying the
device.
[0418] The device 100 can deliver ablation energy via RF or other
modality and effect a clinically significant lesion with high
spatial resolution. Ablation can be spatially tuned in closed-loop
fashion at the resolution of individual electrodes on the
array.
[0419] In addition to mapping and ablating arrhythmias directly,
the cardiac applications for such a device are wide-ranging.
Mapping other cardiac and mediastinal structures, including
ganglionated plexi and other components of the cardiac autonomic
nervous system, are examples of such future direction in the
treatment of arrhythmias. The highly adaptable nature of the array
device 100 in terms of size, shape, and the type of electronic
components included also lends itself to incorporation with
existing long-term monitoring devices, such as the Chronicle.RTM.
implantable hemodynamic monitor or long-term arrhythmia event
monitors.
[0420] The foregoing concepts related to cardiac mapping have been
demonstrated in live animal experiments, together with the ability
to record useful electrical signals and reliably pace the heart
from an array device with passive circuitry placed on the
epicardial surface of the ventricle under direct visualization. In
addition, an array device with active circuitry has been used to
record electrograms from 288 array sensor elements of the array
device 100 covering a 2.2 square centimeter area of the left
ventricular epicardium using only 36 separate connecting wires
between the array and the recording apparatus. A much higher degree
of multiplexing is envisioned to allow for the use of a single USB
2.0, Firewire.TM. or similar connector providing input and output
access to and from the array device.
[0421] Example In-Vivo Experiments
[0422] With reference to FIGS. 67A-67C, data from in-vivo
experiments are now described. In-vivo experiments were performed
in two normal 80-90 pound male Yorkshire pigs. The heart was
surgically exposed via a median sternotomy and subsequent
pericardiotomy. An array device 100 was placed on the epicardial
surface while under direct visualization as shown in FIG. 67A. The
device adhered to the curvilinear surface of the heart, even during
vigorous cardiac motion and during rapid pacing. FIG. 67B shows
motion snapshots at various stages of the cardiac cycle and it is
seen that the array device adapts to the dynamic variations in the
surface shape of the heart in order to maintain conformal contact.
Given the average heart rate of approximately 77 beats per minute
(BPM) during in-vivo experiments and a recording duration of
approximately 137 minutes, the device provided reliable data over
the course of more than 10,000 bending cycles during our
experiments.
[0423] Unipolar voltage data were recorded from all 288 sensors on
the array device 100 using a multiplexing and sampling scheme.
Baseline electrogram data were collected in sinus rhythm with the
array in multiple positions and orientations on the epicardial
surface. Data were also recorded while pacing the heart from
multiple locations relative to the array device via a standard,
non-steerable decapolar electrode EP catheter held in contact with
the epicardial surface. FIG. 67C shows the array device 100
positioned over the left anterior descending (LAD) coronary artery,
with the pacing catheter shown at 32 positioned just inferior to
the array. The color coded map 340 in this frame shows a visual
representation of the data collected from the array device 100,
using procedures described below.
[0424] Data from all 288 sensors on the array device 100 were
filtered and processed using custom MATLAB software to determine
the relative activation time at each contact by comparing the time
of the maximum negative slope (dV/dt) of the unipolar electrogram
to the maximum negative slope of the average electrogram of all 288
sensor channels. These activation times were then used to generate
isochronal maps showing propagation of paced and unpaced cardiac
depolarization wavefronts spreading across the array for a variety
of sensor sites and pacing conditions.
[0425] Sample voltage trace data from a single channel without
remote pacing are shown in FIG. 4A. The inset at right highlights
the very low noise level of the recording, with a signal-to-noise
ratio (SNR) of approximately 50. Note that negative is plotted up
in the figure, by convention.
[0426] FIG. 4B shows voltage data for all channels taken at 4
points in time and showing paced cardiac wavefront propagation.
Voltage is plotted using the color scale in the right corner. FIG.
4C illustrates a plot of average voltage from sensing elements and
illustrating the point in time that each frame in FIG. 4B was
taken. The color of the dotted lines corresponds to the color of
the time label in FIG. 4B.
[0427] FIG. 4D illustrates a representative single voltage trace
with external pacing from a standard clinical electrode. The black
arrow and box highlight the pacing artifact. Note that negative is
plotted up by convention in FIGS. 4A, 4C and 4D.
[0428] FIG. 4E illustrates isochronal color maps of relative
activation times for two different external pacing sites. The
activation times are plotted using the color bar shown at the
right. Asterisks (*) indicate the relative location of the external
pacing electrode. The scale bar illustrates the spacing between
electrode locations. The data from the activation map at the
locations marked by lines i-iii are plotted in FIG. 4F in distance
vs. activation delay plots for selected rows of the sensor array
following the arrows in FIG. 4E.
[0429] These results clearly establish this technology as the basis
for devices with advanced capabilities. With straightforward
additions to the circuits and external control, the same systems
could provide multi-site cardiac pacing with closed-loop feedback
of local ventricular contractility or cardiac output measurements
via distributed arrays of active sensory and stimulation
electrodes. Furthermore, the mechanical properties of the circuits
permit packaging in catheter-based delivery systems, with the
ability to deploy on and conform to large and small, irregular
curvilinear surfaces of the body. Pursuing these possibilities and
other biomedical devices with other functionality using the
materials and electronics strategies reported here has great
potential to yield technologies with important benefits to human
health.
[0430] Example Array Device and Circuit Configurations
[0431] FIG. 68 illustrates an example of the array device 100. The
array device comprises an array of elements 110 that, in the
example shown in FIG. 68, are electrodes, each of which is coupled
to an associated preamplifier 120. The output of each preamplifier
is coupled to a column line 130 through an analog switch 140. By
activating a specific row signal 145 and de-activating the other
(N-1) row signals, the output of the selected row amplifier will be
allowed to drive the column line 130. In this manner, any one of
the N rows can be selected to drive the column amplifier 150. This
column amplifier 150 provides additional gain to match the range of
the signal to the input range of the column analog to digital
converter 160. The column analog to digital converter 160 converts
the analog signals from the electrode channels to digital values.
The digital output of the column analog to digital converter 160 is
connected to a digital buffer 170, and the outputs of all N digital
buffers 170 (one for each column) are connected together. Each
column signal 120 can be individually selected via the N column
select signals 180. In this way, the data from the N column analog
to digital converters 160 can be combined down to one digital input
on the integrated microprocessor 190.
[0432] With reference to FIGS. 69-70, schematic diagrams are shown
for various configurations of sensing and stimulation selection
control of elements in the array device 100. These configurations
are useful in connection with various sensing and stimulation
applications, examples of which are described above.
[0433] Turning to FIG. 69, a schematic diagram is shown that
illustrates how unit cells connect to other unit cells to create a
multiplexed signal output, for example for sensing from one of the
elements 110 that is configured to operate as a sensor electrode.
During multiplexed sampling, one row of electrodes is selected at a
time by driving one of the row select signals (such as R.sub.0)
high, and all of the other row select signals low. This allows the
elements in that row to drive the column output lines labeled C0,
C1, . . . , to a high-speed analog-to-digital converter. The row
select signals are rapidly cycled to sample all elements 110 on the
array device 100.
[0434] FIG. 70 is similar to FIG. 69, but adds stimulation control
capability. In this example, the stimulation input lines STIM0,
STIM1, etc., are provided. When a stimulation voltage is driven
onto one of the stimulation input lines while any or all of the row
select lines are enabled, the elements 110 (electrodes) will
deliver stimulation energy to the local tissue area. The
configuration shown in FIG. 70 adds a minimal amount of extra
wiring and complexity, but is tied to the recording multiplexing
rate due to the sharing of the row select signals.
[0435] FIG. 71 illustrates a schematic diagram that is similar to
FIG. 70, but uses independent stimulation row select signals. Like
the configuration of FIG. 69, when a stimulation voltage is driven
onto one of the stimulation input lines while any or all of the row
select lines are enabled, the elements 110 (electrodes) will
deliver a stimulation energy to the local tissue area. However,
stimulation row selection signals STIM R0, STIM R1, . . . , are
provided. These signals are used to selectively enable stimulation
at any or all of the rows. This configuration adds more external
wires but provides for a stimulation capability that is time
independent of sensing multiplexing.
[0436] FIG. 72 shows an example transistor level schematic for an
element 110 in a sensing configuration. There is a constant current
source 112, a current mirror 114 and a multiplexer 116.
[0437] FIG. 73 shows an example transistor level layout for an
element 110 with stimulation control according to that described
above in connection with FIG. 70. In this configuration, there is a
stimulation control demultiplexing transistor 118 that is connected
to the stimulation control line, e.g., STIM0. FIG. 74 shows an
example transistor level layout for an element 110 with row
independent selectable stimulation control according to that
described above in connection with FIG. 71. In the configuration of
FIG. 74, there is a demultiplexing transistor 118 that is connected
to both the stimulation control line, STIM0, and to the stimulation
row select control line STIM R0.
[0438] The devices, configurations and techniques described herein
are meant to be by way of example only. Other applications for the
array device 100 include ablation for treatment of neurological
maladies and pain treatment in muscle and other tissues. In
addition, ablation techniques may be performed with different types
of energies and modalities. Ablation modalities that could be
applied include: RF energy (whether single frequency or phased),
cryoablation (freezing), laser energy, and high-intensity focused
ultrasound (HIFU). Additionally, high voltage electrical
stimulation can be used as an ablation technique. In this
application, the cells are destroyed through electroporation, which
is a mechanism by which high voltage electrical fields create pores
or the breakdown of the cell membrane. With enough energy, this
causes irreversible damage and cell death, achieving the goal of
ablation.
Example 6: Conformable Skin--Mounted Electronic Devices for
Interfacing with Tissue
[0439] The invention provides skin-mounted electronic devices for
electrophysiological mapping and sensing various other
characteristics from the body and/or tissue of a subject. A major
difference, however, from other implantable devices, such as a
conventional cardiac sensors, is that this skin-mounted electronic
device of the invention is non-invasive. For example, even though
it positioned on skin, i.e. non-invasive, the device of this aspect
is capable of making electrocardiography, electromyography,
electroencephalography (EKG, EMG and EEG) measurements, from the
heart, muscle and brain tissue, respectively.
[0440] An important issue of invasiveness with respect to medical
devices is post-surgery recovery. For example, many surgical
procedures require large incision that causes post-surgery trauma.
The present skin-mounted non-invasive device does not require
recovery since it is attached to skin, like a bandage, rather than
implanted or surgically administered as in some conventional
medical device. Another important advantage of the present
skin-mounted devices is that they can be used for long periods of
time, which is not feasible with conventional implantable and even
non-invasive devices. For example, many invasive medical devices
have issues of long time biocompatibility in the human body. Also
some conventional non-invasive sensors, such as commercial EEG
electrodes, require use of conductive gel to reduce impedance and
provide higher signal to noise ratios. Such conventional devices,
however, cannot be used for long periods of time as the conductive
gel is prone to drying out. In addition, the conductive gel can be
uncomfortable and cause skin irritation. The present skin-mounted
electronic devices do not require a conductive gel, for example
because it is capable of using active capacitance coupled devices
for electrophysiological mapping.
[0441] In an embodiment, the invention provides a device for
establishing an interface with a skin of a subject, the device
comprising: (1) a flexible or stretchable substrate having an
average modulus less than or equal to 1 MPa; (2) a flexible or
stretchable electronic circuit comprising one or more inorganic
semiconductor circuit elements, said flexible or stretchable
electronic circuit supported by the flexible or stretchable
substrate; and (3) a barrier layer encapsulating at least a portion
of the flexible or stretchable electronic circuit, the flexible or
stretchable substrate or both flexible or stretchable electronic
circuit and the substrate; wherein the substrate, barrier layer and
the electronic circuit provide a net bending stiffness of the
device low enough that the device establishes conformal contact
with the skin of the subject. Devices of this aspect of the
invention include skin mounted tissue sensors, tissue actuators and
arrays of tissue sensors and actuators. In come embodiments, for
example, matching of the modulii of components of the device (e.g.,
substrate, electronic circuit or barrier layer) and the skin is
useful for establishing robust conformal contact at the interface
with the skin. In an embodiment, the device does not include an
adhesive layer between the skin and the electronic circuit
component.
[0442] The composition, physical dimensions and properties of the
flexible or stretchable substrate is important in devices of this
aspect of the invention. In an embodiment, for example, flexible or
stretchable substrate has an average modulus less than or equal to
500 KPa, optionally for some applications less than or equal to 100
KPa, and optionally for some applications less than or equal to 50
KPa. In an embodiment, for example, the flexible or stretchable
substrate has an average modulus selected over the range of 0.5 KPa
to 100 KPa. In an embodiment, for example, the flexible or
stretchable substrate has an average modulus equal to or less than
50 times the average modulus of the skin of the subject at the
interface. In an embodiment, for example, the flexible or
stretchable substrate has a thickness less than or equal to 500
microns, optionally for some applications less than or equal to 100
microns and optionally for some applications less than or equal to
50 microns. In an embodiment, for example, the flexible or
stretchable substrate has a thickness selected over the range of 1
to 500 microns, and optionally selected over the range of 1 to 100
microns, and selected over the range of 1 to 50 microns. In an
embodiment, for example, the flexible or stretchable substrate is a
low modulus polymer, such as a low modulus rubber or a low modulus
silicone material. In an embodiment, for example, the flexible or
stretchable substrate is Ecoflex.RTM.. In an embodiment, for
example, the flexible or stretchable substrate is a bioinert or
biocompatible material.
[0443] The composition, physical dimensions and properties of the
flexible or stretchable substrate is important in devices of this
aspect of the invention. In an embodiment, the flexible or
stretchable electronic circuit comprises one or more sensors or
actuators and/or one or more amplifiers or multiplex circuits. For
example, devices of this aspect include a flexible or stretchable
electronic circuit comprising one or more electrodes, transistors,
light emitting diodes, photodiodes, temperature sensors,
electrocardiography sensors, electromyography sensors,
electroencephalography sensors, thermistors, diodes, capacitive
sensors, or any combinations of these. In an embodiment, the
flexible or stretchable electronic circuit comprises one or more
single crystalline inorganic semiconductor structures. In an
embodiment, the flexible or stretchable electronic circuit is
assembled on the flexible or stretchable substrate via contact
printing.
[0444] In an embodiment, a device of this aspect further comprises
a transfer substrate supporting the flexible or stretchable
substrate, the flexible or stretchable electronic circuit or both,
for example a transfer substrate in physical contact with the
flexible or stretchable substrate. In an embodiment, for example,
the transfer substrate is a removable substrate, wherein the
transfer substrate is partially or completely removed upon
providing the device in contact with the skin of the subject. In an
embodiment, for example, the removable substrate is a dissolvable
substrate, wherein the removable substrate is partially or
completely dissolved after the device is provided in contact with
the skin of the subject. In an embodiment, the transfer substrate
is a polymer such as polyvinyl acetate.
[0445] In an aspect, the invention provides a method of interfacing
an electronic device with skin of a subject, the method comprising:
(1) providing the skin of the subject; (2) providing a conformable
electronic device, the device comprising: (i) a flexible or
stretchable substrate having an average modulus less than or equal
to 1 MPa; (ii) a flexible or stretchable electronic circuit
comprising one or more inorganic semiconductor circuit elements,
said flexible or stretchable electronic circuit supported by the
flexible or stretchable substrate; (iii) a barrier layer
encapsulating at least a portion of the flexible or stretchable
electronic circuit; and (iv) a transfer substrate supporting said
flexible or stretchable substrate, said flexible or stretchable
electronic circuit or both; (3) contacting the conformable
electronic device to a receiving surface of the skin, wherein upon
contact the flexible or stretchable electronic circuit is
positioned between the skin and the a flexible or stretchable
substrate; and (4) at least partially removing the transfer
substrate, wherein the flexible or stretchable substrate, barrier
layer and the flexible or stretchable electronic circuit provide a
net bending stiffness of the device low enough that the device
establishes conformal contact with the skin of the subject upon at
least partial removal of the transfer substrate, thereby
interfacing the electronic device with the skin of the subject. In
an embodiment, the step of at least partially removing the transfer
substrate comprises entirely removing the transfer substrate. In an
embodiment, the step of at least partially removing the transfer
substrate comprises dissolving the transfer substrate after the
step of contacting the conformable electronic device to a receiving
surface of the skin.
[0446] Methods of this aspect of the invention may further
comprising sensing and/or actuating a tissue of the subject, for
example wherein the tissue of the subject is a heart, muscle or
brain of the subject. In an embodiment, for example, the method
further comprises making electrocardiography measurements,
electromyography measurements or electroencephalography
measurements of the subject. In an embodiment, for example, the
method further comprises providing electromagnetic radiation to the
tissue of the subject. In an embodiment, for example, the method
further comprises measuring the temperature of the tissue of the
subject. In an embodiment, for example, the method further
comprises making one or more voltage measurements, current
measurements, electromagnetic radiation intensity or power
measurements, temperature measurements, pressure measurements,
tissue acceleration measurements, or tissue movement measurements
of the tissue of the subject.
[0447] In some embodiments, a transfer substrate is a PVA backing
layer that is able to be dissolved with water. Benefits of the use
of a PVA backing layer include that it is biocompatible and does
not result in problems with the skin. Use of a low modulus flexible
or stretchable substrate is beneficial for providing very good
conformal contact to the skin, which is important in some sensing
applications for providing a low impedance and high signal to noise
ratio. Also good conformal contact enables very strong lamination
for long periods of time without the need for additional chemical
adhesive.
[0448] In the case of active skin electronic device, for example,
active EKG/EMG sensors, the electronic circuit component may
comprise an electrode. The electrode of this aspect may be in
physical contact with the skin or may not be in physical contact
with the skin at the interface. Embodiments of this aspect include,
for example, use of capacitance type circuit that do not require
physical contact. In some embodiments, for example, the device is
passivated with one or more thin layer of polyimide.
[0449] FIG. 50E provides a schematic diagram illustrating a
cross-sectional view of a skin-mounted conformal device of the
invention having an encapsulating barrier layer. As illustrated in
FIG. 50E the device comprises a flexible or stretchable Ecoflex
substrate supporting a flexible or stretchable electronic circuit
having a multilayer device geometry. The electronic circuit
component comprises a series of layers including encapsulating
polyimide layers (PI), and functional silicon (Si) layer, silicon
oxide layer (SiO.sub.2) and gold layers (AU1, AU2, and AU3). The
invention includes, however, skin-mounted devices having one or
more electrodes directly exposed and/or in physical contact with
the skin, for example, without polyimide encapsulation.
[0450] To demonstrate the applicability of this aspect of the
invention for a range of biomedical applications, the skin-mounted
electronic devices were fabricated and interfaced with skin in the
context of tissue sensing and actuation applications. FIGS.
50A-50E, 51A-51C, 52A-52H, 53A-53C and 54A-54G provide device
schematics, images and experimental results describing this aspect
of the invention.
[0451] FIG. 50A. Four frames of the electrode array transfer
printed onto thin, low modulus ecoflex. On skin (left top),
partially peeled off state (right top), magnified view of each top
frame (bottom). Blue dotted boxes correspond to the magnified
images at the bottom frame. The modulus and thickness of ecoflex
substrate is .about.50 kPa and .about.30 um, respectively. The
electrode array is facing down to skin, sandwiched by the skin and
ecoflex substrate. FIG. 50B. Schematic view of application
procedures of skin patch to the skin. The electrode array is
transfer printed onto ecoflex, coated on the PVA film, an water
dissolvable and biocompatible film. The transferred electrode array
is positioned onto the right location of skin. Some water can be
applied to the backside of PVA film to dissolve it away. Thin, low
modulus skin patch conforms very well to skin, like a tattoo. FIG.
50C. Deformed images of skin patch on skin to four different
directions and their magnified views. The highly conformal skin
patch follows the wrinkles on skin very well. FIG. 50D. Electrode
array transfer printed at the backside of the commercial temporary
tattoo. It is applied to the skin. Instead of ecoflex thin film, a
temporary tattoo can be used for the purpose of camouflage or
cover-up.
[0452] FIG. 51A. Mechanically optimized fully serpentine electrode
array (left). The right frame shows the stress-strain relationship
from which the modulus in the plot was calculated. The optimized
design shows comparable modulus with the bare skin. FIG. 51B.
Debonding experiment results under tension (left) and compression
(right). As the modulus and thickness decrease, the debonding
happens at larger strain. FIG. 51C. Cross-sectional image (X-ray)
of skin electronic devices located on the pig skin.
[0453] FIG. 52A. Serpentine shape active EMG/EKG sensor. Left top
frame shows source, drain and gate of nmos transistor and silicon
drain to gate feedback resistor. Inset shows conventional shape
active EMG/EKG sensor. Left bottom image shows the final device
image for serpentine shape device and its magnified view (inset).
Right top and bottom frame shows transfer and IV curve for the
transistor. FIG. 52B. Circuit diagram for active EMG/EKG sensor and
the frequency response of active sensor (common source amplifier).
FIG. 52C. Microscope image of temperature sensor using platinum
resistor and gold serpentine wires. Right frame shows the
calibration curve, showing different resistances of temperature
sensor at different temperatures. FIG. 52D. Microscope image of
strain gauge using conductive PDMS (CPDMS). Right frame shows the
calibration curve of the strain gauge. FIG. 52E. Microscope images
of proximity sensor using forward and reverse biased LED array.
Forward biased LED array radiates light and reverse biased LED
array detects the reflected light from the object. As the distance
between the object and LED array decreases, the reflectance
increases and thereby the photocurrent increases, as shown in the
right frame. FIG. 52F. A single LED pixel powered by wireless power
transmission coil. Right frame shows the IV curve of LED pixel.
FIG. 52G. Microscope image of PN diodes (left) and it S21 value
measured at different frequencies in radio frequency range. FIG.
52H. Microscope image of inductor and capacitor pair (left top).
Right top plot shows S21 value of capacitor at various RF
frequencies and left bottom plot shows S21 and S11 values of
inductor at RF frequencies. Right bottom plot shows the estimated
oscillation frequencies for different capacitors.
[0454] FIG. 53A. Passive electrode array on forehead for undeformed
(left top) and deformed (right top and bottom) state. Left bottom
image shows the partially peeled off state. FIG. 53B. EEG
measurement results for Stroop test. When the target letter matches
with the highlighted letter (congruent case) the response speed is
faster than unmatched (incongruent case) case. FIG. 53C. EEG
measurement results for eye open and eye close case. Left plot
shows raw EEG and right plot shows results after Fourier
transformation.
[0455] FIG. 54A. EKG measurement result measured with active EKG
sensor (left) and magnified view of single heartbeat (right). FIG.
54B. EMG measurement result from a right leg during walking (from 0
sec to 10 sec) and standing (from 10 sec to 20 sec) measured with
active EMG sensor (left) and conventional passive EMG sensor with
conductive gel (right). FIG. 54C. Magnified view of EMG signal of
FIG. 54B. FIG. 54D. Corresponding spectrogram for each electrode.
FIG. 54E. EMG measurement result from neck for four different
words, "up", "down", "left" and "right". FIG. 54F. Corresponding
spectrogram for four words. FIG. 54G. Video game control using
recorded EMG signal.
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Example 7: Epidermal Electronics
[0517] Disclosed herein are materials, mechanics principles and
designs layouts for electronic systems that achieve thicknesses
(.about.30 .mu.m), effective elastic moduli (<150 kPa), bending
stiffnesses (<1 nNm) and areal mass densities (<3.8
mg/cm.sup.2) matched to the epidermis. Laminating such devices onto
the skin leads to conformal contact, intimate integration and
adequate adhesion based on van der Waals interactions alone, in a
manner that is mechanically invisible to the user. We describe a
diverse collection of devices in this format, ranging from
elecrophysiological (EP), temperature and strain sensors, to
transistors, light emitting diodes, photodetectors and a variety of
components capable of radio frequency operation, including
inductors, capacitors, oscillators and rectifying diodes. Silicon
solar cells and wireless inductive coils provide options for power
supply. As systems-level demonstrators of this technology, this
Example discloses skin-mounted, amplified monitors of EP activity
produced by the heart, brain and skeletal muscles. Data collected
with such devices contain sufficient information for meaningful
human/machine interfaces, for example, as illustrated herein with
an unusual type of computer game controller.
[0518] Physiological measurement and stimulation techniques that
exploit interfaces to the skin have been of interest for more than
40 years, the former beginning in 1966 with electromyography of
laryngeal muscles [1-3]. Despite much progress over this time,
nearly all associated device technologies continue to rely on
conceptually old designs. Typically, small numbers of bulk
electrodes mount on the skin via adhesive tapes, mechanical
clamps/straps and/or penetrating needles, often mediated by
conductive gels, with terminal connections to separate boxes that
house collections of rigid circuit boards, power supplies and
communication components [4-9]. These systems have many important
capabilities, but they are poorly suited for practical application
outside of research labs or clinical settings, due to difficulties
in establishing long-lived, robust electrical contacts that do not
irritate the skin, and in achieving integrated systems with overall
sizes, weights and shapes that do not cause discomfort during
prolonged use [8,9]. Illustrated in this Example is a different
approach, in which the electrodes, electronics, sensors, power
supply and communication components are configured together into
ultrathin, low modulus, lightweight, stretchable `skin-like`
membranes that conformally laminate onto the surface of the skin by
soft contact, in a manner that is mechanically invisible to the
user, much like a temporary transfer tattoo.
[0519] FIGS. 75A-75D show a demonstration platform for the
individual components of such a technology, including a collection
of multifunctional sensors (e.g. temperature, strain,
electrophysiological), microscale light emitting diodes (LEDs),
active/passive circuit elements (e.g. transistors, diodes,
resistors), wireless power coils and devices for radio frequency
(RF) communications (e.g. high frequency inductors, capacitors,
oscillators and antennae), all integrated on the surface of a thin
(.about.30 .mu.m), gas-permeable elastomeric sheet based on a
modified polyester (PE; BASF, Germany) with low Young's modulus
(.about.60 kPa, as shown in FIG. 79A). The devices and
interconnects exploit ultrathin layouts (<7 .mu.m), neutral
mechanical plane (NMP) configurations and optimized geometrical
designs. The active elements use established electronic materials
such as silicon and gallium arsenide, in the form of filamentary
serpentine nanoribbons and micro/nanomembranes. The result is a
high performance system that offers reversible, elastic responses
to large strain deformations with effective moduli, bending
stiffnesses and areal mass densities that are orders of magnitude
smaller than those possible with conventional electronics, or even
with recently explored flexible/stretchable device technologies
[10-19]. These and other key physical properties are, in fact,
comparable to those of the skin itself. Water-soluble polymer
sheets (polyvinyl alcohol; PVA, Aicello, Japan; Young's modulus
.about.1.9 GPa, thickness .about.50 .mu.m (as shown in FIG. 79B)),
serve as temporary supports for manual mounting of these systems on
the skin, in an overall construct that is directly analogous to
that of a temporary transfer tattoo. The top frame of FIG. 75B
provides an image of a device like the one in FIG. 75A, after
integrating it onto the skin by washing away the PVA and then
partially peeling it back using a pair of tweezers. When completely
removed, the system collapses on itself due to its extreme
deformability and `skin-like` physical properties, as shown in the
bottom frame of FIG. 75B. The schematic illustration in the inset
shows an approximate cross sectional layout.
[0520] These mechanical characteristics lead to robust adhesion to
the skin via van der Waals forces alone, without any mechanical
fixturing hardware or adhesive tapes. The devices impose negligible
mechanical or mass loading, as is evident from the images of FIG.
75C, which show the skin deforming freely and reversibly, without
any apparent constraints in motion due to the devices. Electronics
in this form can even be integrated directly with commercial
temporary transfer tattoos, as a substrate alternative to PE/PVA.
The result, shown in FIG. 75D, is of possible interest as a way to
conceal the active components and/or to exploit low cost materials
(i.e. substrate, adhesives, backing layers) already developed for
temporary transfer tattoos. Potential uses include physiological
status monitoring, wound measurement/treatment, biological/chemical
sensing, human-machine interfaces, covert communications and
others.
[0521] Understanding the mechanics of this kind of device, the
mechanophysiology of the skin, and the behavior of the coupled
abiotic-biotic system, are all critically important. For present
purposes, the skin can be approximated as a bilayer, consisting of
the epidermis (modulus: 140-600 kPa; thickness 0.05-1.5 mm) and the
dermis (modulus: 2-80 kPa; thickness 0.3-3 mm) [20-23]. This
bilayer exhibits linear elastic response to tensile strains
<.about.15%, which transitions to non-linear behavior at higher
strains, with adverse, irreversible effects beyond 30% [24]. The
surface of the skin typically has natural wrinkles, creases and
pits with amplitudes and feature sizes of 15-100 .mu.m [25] and
40-1000 .mu.m [26], respectively. The devices described here (i.e.
FIGS. 75A-75D) have moduli, thicknesses and other physical
properties that are well matched to the epidermis itself, with the
ability to conform to the relief on its surface. We therefore refer
to this class of technology as an `epidermal electronic system`
(EES).
[0522] Macroscopically, EES on skin can be treated as a thin film
on an epidermis/dermis bilayer substrate. Microscopically, the
sizes of the individual electronic components and interconnects are
comparable to those of relief features on the skin, and therefore
must be considered explicitly. Multi-scale analysis and
experimental measurements can capture the detailed behaviors. We
begin by considering aspects of adhesion, in the macroscopic limit.
Globally, detachment can occur in either tension or compression,
due to interfacial cracks that initiate at the edges or the central
regions of the EES, respectively. Low effective moduli and small
thicknesses minimize the deformation-induced stored elastic energy
that drives both of these failure modes. Analytical calculation
discussed in this Example shows that compared to silicon chips
(thickness .about.1 mm) and sheets of polyimide (thickness
.about.75 .mu.m), the driving forces for delamination of the
EES/skin interface are reduced by more than five orders of
magnitude. The values are so small, in fact, that adequate adhesion
is possible, immediately upon lamination, due simply to van der
Waals interactions. FIG. 76A shows measurements and theoretical
calculations discussed in this Example that explore the relevant
scaling behaviors, in structures that provide simplified,
macroscopic models of EES/skin. The experiments use sheets of PE
(.about.2 mm thick) for the skin and films of
poly(dimethylsiloxane) (PDMS, Dow Corning, USA) for the EES. FIG.
76A plots the critical delamination strain as a function of PDMS
thickness, for two different formulations: one with a modulus of 19
kPa (50:1) and the other 145 kPa (30:1, FIG. 79C). The results
confirm that reducing the modulus and thickness lowers the forces
that drive interface delamination, for a given applied strain
(bending or stretching), without lower bound.
[0523] To explore the limits, consider that the mechanical
properties of the EES depend on the effective modulus and thickness
of both the circuits/sensors and the substrate. In samples like
those in FIGS. 75A-75D, the properties of the active components and
interconnects can dominate the mechanics of the overall system. The
in-plane layouts and materials of this layer are, therefore, key
design parameters. Recent work in stretchable electronics
establishes that the overall range of deformability can be
optimized in systems composed of active devices joined together in
open mesh structures by non-coplanar interconnects in NMP
configurations, where elastomers with relatively large modulus
(2-10 MPa) and thickness (mm's to cm's) serve as substrates [13,
14]. For EES, the effective modulus (EEEs) and bending stiffness
(EIEEs), rather than the range of stretchability, are paramount.
These requirements demand alternative designs and choices of
materials. If we assume that the moduli of the individual devices
(e.g. .about.160 GPa for Si and .about.90 GPa for GaAs) are much
higher than the compliance of the interconnects, then we can write
the approximate expression E.sub.EES=E.sub.int (1+L.sub.d/L.sub.s),
which has been verified by the finite element method (FEM), where
E.sub.int is the effective modulus of the interconnects, L.sub.d is
the characteristic device size, and L.sub.s is the distance between
devices, as illustrated in FIG. 79D. The value of E.sub.EES can be
minimized by reducing E.sub.int and L.sub.d/L.sub.s. For the
former, thin, narrow interconnect lines, formed into
large-amplitude, `filamentary serpentine` (FS) shapes represent
effective designs. For the latter, ultrathin active devices that
adopt similar FS layouts and continuously integrate with FS
interconnects reduce the effective value of L.sub.d to zero. The
value of EI.sub.EES decreases rapidly with the thicknesses of the
devices, interconnects and substrate. FIG. 76B (left frame) shows
an ultrathin FS construct, with a cross sectional schematic
illustration as an inset. Results of tensile testing (right frame
of FIG. 76B) indicate that such FS-EES samples (left frame of FIG.
76B) achieve E.sub.EES (.about.140 kPa) and EI.sub.EES (.about.0.3
nNm, calculation shown in SOM) that are comparable to the
epidermis, and more than one and five orders of magnitude smaller
than previously reported stretchable electronic devices,
respectively [27]. Furthermore, highly repeatable loading and
unloading stress-strain curves up to strains of 30% demonstrate the
pure elastic response of the FS-EES, with a range of stretchability
that is much larger than that of the epidermis. Such highly elastic
FS layouts can maintain nearly 20% areal contact of active elements
with the skin, for effective electrical interfaces. FEM captures
quantitatively the strains and stresses in FS-EES, as a function of
induced deformation, as shown in FIG. 76C for stretching to
.about.30% strain along the x (left) and y (right) directions. In
both cases, the maximum principal strains in the metal are less
than .about.0.2%. The same calculations yield effective tensile
moduli (FIG. 76B, right frame), with excellent correspondence to
experiment. In certain applications, layouts that involve some
combination of FS geometries and device islands (i.e. L.sub.d not
equal to zero) connected by FS interconnects (e.g. FIGS. 75A-75D
and FIG. 79E) can be used, with expected consequences on the local
mechanics (FIG. 79F). In both options, suitable designs lead to
mechanical and adhesive properties that allow conformal adhesion to
the skin and minimal loading effects (FIG. 76D). Without optimized
layouts, we observe delamination under similar conditions of
deformation, consistent with the fracture modes illustrated in FIG.
76A.
[0524] For many uses of EES, physical coupling of electrodes to the
surface of the skin is important. Microscopic characterization and
modeling of the skin-EES interface provides some insights. Confocal
micrographs of EES mounted on pig skin appear in FIGS. 76E and 76F
as well as FIG. 80C. With FS structures, the results show
remarkably conformal contact, not only at the PE regions of the
EES, but also at the FS elements (FIGS. 76E and 76F). Similar
behavior obtains, but in a less ideal fashion (FIG. 80C), with
layouts that incorporate large device islands. These observations
are consistent with analytical mechanics treatments that use
macroscopic models of the EES and account for microscopic
structures on the skin. Here, it can be shown discussed in this
Example that contact will occur spontaneously, without an applied
pressure, when
.pi. E _ skin h rough 2 .gamma. .lamda. rough < 16 + E _ skin
.lamda. rough 3 .pi. 3 EI _ EES , ( 1 ) ##EQU00012##
[0525] where .gamma., .sub.skin, h.sub.rough and .lamda..sub.rough
are the effective work of adhesion, and the plane-strain modulus,
roughness amplitude and wavelength of the skin, respectively. The
scaling law in Eq. (1), which involves two dimensionless
combinations of EES and skin properties, shows that EES with low
bending stiffness, on smooth and soft skin with strong adhesion all
promote conformal contact. Using experimental data and a measured
value of .gamma..about.0.16 N/m as discussed in this Example, this
criterion implies that the FS-EES can conform to the skin, without
applied pressure, when h.sub.rough is <.about.50 .mu.m (FIG.
76G) for .lamda..sub.rough=140 .mu.m, consistent with observation
in FIG. 76F where the roughness amplitude is 5.about.20 .mu.m.
Related calculations indicate that the contact pressure created by
surface interactions is .about.10 kPa (FIG. 88B), which is below
the sensitivity of human skin (.about.20 kPa, [28]) but still
sufficient to offer reasonable adhesion. (Improved bonding can be
achieved by using adhesives that are built into platforms for
temporary transfer tattoos, as in FIG. 75D). From a microscopic
point of view, the soft, conformal nature of the EES helps to drive
adhesion to the skin, with strongest effects in regions away from
the devices and interconnects, where the local effective modulus is
lowest. These interfacial forces assist in bringing neighboring FS
structures into contact with the skin as well. Narrow, thin FS
geometries facilitate this process. For materials and layouts
explored here, the result is a total compressive force (per unit
length) of .about.-0.1 N/m for each FS strip. Calculations show
that these interactions reduce the widths of the gaps between the
PE and skin that exist proximal to the edges of the FS elements to
<0.2 .mu.m, even for the thickest device structure (.about.3
.mu.m) in experiments (FIG. 79E).
[0526] A key capability of EES is in monitoring
electrophysiological (EP) processes related to activity of the
brain (electroencephalograms; EEG), the heart (electrocardiograms;
ECG) and muscle tissue (electromyograms; EMG). Amplified sensor
electrodes that incorporate silicon metal oxide semiconductor field
effect transistors (MOSFETs) in circuits where all components adopt
FS designs provide devices for this purpose. Here, the gate of a
FS-MOSFET connects to an extended FS electrode for efficient
coupling to the body potential (FIG. 77A; the inset shows an
analogous design based on a rectangular device island and FS
interconnects), via contact with the skin, in a common-source
amplifier configuration (FIG. 77B, left frame). FIG. 77B (right
frame) indicates the measured frequency response at different input
capacitances (C.sub.IN), in quantitative agreement with circuit
simulations (FIGS. 81A and 81B). The value of C.sub.IN is
determined by the sum of capacitances of gate electrode, the
encapsulating PI and junction between the gate electrode and the
body surface. The bandwidth matches requirements for high
performance EP recording. A typical layout for this purpose
includes four amplified channels, each comprised of a FS-MOSFET, a
silicon-based FS resistor and an FS electrode. One channel provides
a reference, while the others serve as sites for measurement.
Results of demonstration experiments appear subsequently.
[0527] Many other classes of semiconductor devices and sensors are
also possible in EES, including resistance-based temperature
sensors built with meander electrodes of Pt (FIG. 81E left and FIG.
81C), in-plane strain gauges based on carbon-doped silicones (FIG.
81E right frame and FIG. 81D), LEDs and photodetectors based on
AlInGaP (FIG. 77D left frame and FIGS. 81E-81G; for possible use in
optical characterization of the skin/biofluids), and silicon FS
photovoltaic cells (FIG. 77D right frame). Such cells can generate
of a few tens of .mu.W (FIG. 81H); increasing the areas or areal
coverages can improve the output, but not without compromises in
size and mechanics. Wireless powering via inductive effects
represents an appealing alternative. FIG. 77E shows an example of
an FS inductive coil connected to a microscale InGaN LED, and
electromagnetic modeling of its RF response. The resonance
frequency (.about.35 MHz) matches that of a separately located
transmission coil powered by an external supply. Voltage and
current outputs in the receiver are sufficient to operate the
microscale LEDs remotely, as shown in FIG. 77E. Such coils provide
power directly in this example; they can also, conceivably, be
configured to charge future classes of EES-integrated storage
capacitors or batteries.
[0528] FIGS. 77F and 77G present examples of various RF components,
of the type needed for wireless communications or for scavenging RF
energy. FIG. 77F shows an optical image of silicon PIN diode (left
frame) and its small-signal scattering parameters (right frame),
indicating insertion loss (S21 in forward condition) of <6 dB
and isolation (S21 in reverse condition) of >15 dB for
frequencies up to 2 GHz. Examples of FS inductors and capacitors
and their RF responses appear in FIG. 77F. Connecting pairs of such
devices yields oscillators with expected resonant frequencies (FIG.
77F, lower right frame). A notable behavior is that the response
varies with state of deformation, due the dependence of the RF
inductance on geometry. For example, at tensile strains of
.about.12%, the resonance frequency shifts by .about.30%. (FIGS.
81I and 81J). Such effects, which also appear in the wireless power
coils but not in the other devices of FIGS. 77A-77G, will influence
the behavior of antenna structures and certain related RF
components. These issues must be considered explicitly in EES
design and modes of operation.
[0529] EES configured for measuring ECG, EMG and EEG, in conformal,
skin-mounted modes without conductive gels or penetrating needles
provide important, system-level demonstrations of the ideas. ECG
recordings from the chest reveal high quality signals with
information on all phases of the heartbeat, including rapid
depolarization of the cardiac wave, and the associated QRS complex
(FIG. 78A, right frame)[29]. EMG measured on the leg, with muscle
contractions to simulate walking and resting are presented in FIG.
78B, left frame. The measurements agree remarkably well with
signals simultaneously collected using commercial, bulk tin
electrodes that require conductive gels, mounted with tapes at the
same location (FIG. 78B, right frame; FIG. 82). FIG. 78C shows an
alternative way to view the data (spectrogram), where the spectral
content appears in a color contour plot with frequency and time
along the y and x axes, respectively. Each muscle contraction
corresponds to a red, vertical stripe that spans from 10 Hz to 300
Hz [29].
[0530] To demonstrate EMG recording in a mode where conventional
devices are particularly ill-suited, an EES mounted on the throat
can monitor muscle activity, non-invasively, during speech (FIG.
83A). Here, recordings collected during vocalization of four words
("up", "down", "left" and "right"), repeated 10 times each (FIG.
84) exhibit distinctive patterns, as in FIG. 78D. Measurements from
another set of words ("go", "stop" and "great"; FIGS. 83B and 85)
suggest sufficient structure in the signals for recognizing a
vocabulary of words. These capabilities create opportunities for
EES-based human/machine interfaces. As an example, dynamic time
warping pattern recognition algorithms applied to throat-based EMG
data (FIG. 78D) enable control of a computer strategy game
(Sokoban), as illustrated in FIG. 78E. The classifications occur in
less than 3 s on a dual-core PC running codes in MATLAB, with an
accuracy >90% (FIG. 86). Significant increases in speed are
possible via optimized software and hardware implementations.
[0531] As a human/machine interface, EEG data offer additional
promise, for use separately or together with EMG signals. EES
mounted on a region of the forehead that is first prepared by
exfoliating the stratum corneum using Scotch tape, yields
reproducible, high quality results, as demonstrated in alpha
rhythms recorded from awake subjects with their eyes closed (FIG.
87A). The expected feature at .about.10 Hz appears clearly in the
Fourier transformed data of FIG. 78F (left frame). The spectrogram
of FIG. 78F (center) shows similar signatures during an experiment
in which the subject's eyes are closed for first 10 seconds and
then open for the next 10 seconds. The responses at .about.10 and
.about.14 seconds correspond to eye opening and blinking,
respectively. This activity disappears when the eyes are held open.
The signal-to-noise ratios are comparable to those obtained in
otherwise identical experiments using conventional, rigid bulk
electrodes applied to the skin with conducting, coupling gels. In
further demonstrations, EEG measured by EES reveal well-known
cognitive phenomena such as the Stroop effect [30, 31]. In these
experiments, subjects randomly presented with congruent or
incongruent (FIG. 87B) colored words, whisper the color (not the
word) as quickly as possible. The data show that the motor
responses pertaining to the whispering are manifested by two peaks
at .about.650 ms (congruent case) and .about.1000 ms (incongruent
case) in the right frame of FIG. 78F. The time delay implies that
the congruent stimuli require fewer cognitive resources and are
quicker to process than the incongruent ones, consistent with the
literature [30, 31].
[0532] The materials and mechanics ideas presented here enable
intimate, mechanically `invisible`, integration of high performance
electronic functionality with the surface of the skin, in ways that
bypass limitations of previous approaches. Integration of the
individual components exemplified here with one another and with
additional ones such as power storage devices, may provide systems
with expanded capabilities in sensing, computation, communication
and others, for both healthcare and non-healthcare related
applications. An important perspective is that many of the EES
concepts are fully compatible with small-scale integrated circuits
that can be released from ultrathin body silicon-on-wafer
substrates. For long-term use, materials and device strategies may
be employed to accommodate the continuous efflux of dead cells from
the surface of the skin, and the processes of transpiration will
also be needed.
Estimation of Driving Forces for Interfacial Delamination Between
Devices and Skin
[0533] Fracture mechanics of a linear elastic bilayer system [32]
gives the steady-state driving force G=1/2Eh.epsilon..sup.2 for
interface delamination between a thin film of Young's modulus E and
thickness h and a thick substrate under uniform tensile strain
.epsilon.. For tensile strain of 1%, the driving forces for
interface delamination of 1 mm-thick silicon (E=180 GPa) and 75
.mu.m-thick polyimide (E=4 GPa) are 9.times.10.sup.3 J/m.sup.2 and
15 J/m.sup.2, respectively. For EES (E=150 kPa, h=30 .mu.m), the
driving force is only 2.25.times.10.sup.-4 J/m.sup.2, which is more
than five orders of magnitude lower than silicon or polyimide based
devices.
Sample Preparation for Confocal Microscopy
[0534] To prepare samples for confocal microscopy, we stained the
polymers and the pig skin with fluorescent dyes having distinct
excitation and emission bands, as shown in FIG. 80A. Alexa 488
(Invitrogen) was used to stain the PE substrate. Ten grams of Alexa
488 powder was first dissolved in 300 .mu.l DMSO (Dimethyl
sulfoxide). Next, 1 .mu.l of the 488-DMSO solution was diluted by 1
ml toluene and 100 .mu.l of the resulting 488-DMSO-toluene solution
was added to 2 ml Part A pre-polymer of 0030 Ecoflex. A magnetic
stir bar was used to facilitate mixing, for 1 hour. We next added 2
ml Part B pre-polymer of Ecoflex and further mixed for 5 minutes.
Spin coating this pre-polymer mixture at 3000 rpm onto a
water-soluble PVA substrate and curing at room temperature for 4
hours and then at 70.degree. C. for 2 hours completed the
preparation of PE. Alexa 647 was used to stain a film of polyimide,
patterned into the shape of electronic circuitry. For the polyimide
we dissolved ten grams of Alexa 647 powder into 300 .mu.l DMSO. We
then added 1 .mu.l 647-DMSO to 1 ml NMP (N-Methylpyrrolidone) and
mixed 10 .mu.l of the resulting 647-DMSO-NMP solution into 1 ml of
polyimide pre-polymer. As before, we used a magnetic stir bar to
mix for 1 hour. Spin coating at 4000 rpm onto a PMMA coated Si
wafer and bake at 250.degree. C. in glove box for 1 hour completed
the preparation. Patterning the PI into desired structures of
island-plus-serpentine and filamentary serpentine was accomplished
by photolithography and dry etching. The final step involved
transfer-printing the polyimide structure onto the
PE(Ecoflex)-coated PVA substrate.
[0535] To stain the pig skin, we first mixed 10 gram FM 1-43FX into
300 .mu.l DMSO. We then diluted 1 .mu.l FM-DMSO solution with 1 ml
1.times.PBS (Phosphate Buffered Saline). We rinsed a the pig skin
in 1.times.PBS thoroughly. Applying a drop of the 1 ml FM-DMSO-PBS
solution onto the skin surface and waiting for 10 minutes produced
the desired stain. Rinsing with 1.times.PBS removed excess dye.
Fluorescent EES was then applied to stained pig skin sample by
placing the device side against the surface of the skin and the
gently spraying 1.times.PBS to dissolve away the PVA backing
layer.
[0536] During imaging, a 488 nm laser was used to excite both Alexa
488 as well as FM 1-43. Alexa 647 was excited by a 639 nm laser.
Three tracks were created for the PE substrate (Alexa 488, blue),
polyimide (Alexa 647, red), and pig skin (FM 1-43FX, blue and
green) respectively. In-plane as well as thickness direction
resolution was .about.1 .mu.m. Three dimensional confocal scanning
results from bare pig skin and island-plus-serpentine EES on pig
skin appear in FIGS. 80B and 80C, respectively.
Macroscopic Mechanics Models for Interfacial Delamination Under
Tension/Compression
[0537] The driving force for interfacial delamination between a
PDMS film and a PE sheet subject to tensile strain s in the PE can
be obtained analytically as
G = E _ PDMS h PDMS E _ PE h PE 2 2 ( 1 - E _ PDMS h PDMS E _ PDMS
h PDMS + E _ PE h PE L PDMS L PE ) 2 E _ PDMS h PDMS 3 + E _ PE h
PE 3 ( E _ PDMS h PDMS 2 - E _ PE h PE 2 ) 2 + 4 E _ PDMS h PDMS E
_ PE h PE ( h PDMS + h PE ) 2 ( S2 ) ##EQU00013##
where , h and L are the plane-strain modulus, thickness and length
of the corresponding layers. Equation (S2) is an extension of the
steady-state driving force for interfacial delamination of a linear
elastic bilayer to account for the finite lengths of PDMS film and
PE sheet. FEM has been used to calculate the interfacial crack tip
energy release rate. For relatively long delamination (much larger
than h.sub.PDMS and h.sub.PE), FEM validates Eq. (S2) for a wide
range of PDMS and PE elastic moduli and layer thickness. For short
interfacial delamination (.about.h.sub.PE), the numerical results
show similar dependence on the layer thickness as Eq. (S2), but are
2.about.2.5 times larger than Eq. (S2). The critical delamination
strain is obtained once the driving force for interfacial
delamination reaches the adhesion energy .gamma..sub.PDMS/PE
between PDMS and PE. For 50:1 and 30:1 PDMS, the adhesion energy is
250 mJ/m.sup.2 and 50 mJ/m.sup.2, respectively.
[0538] For compression in the PE, initiation of interfacial
delamination is more challenging to determine the case of tension
because of compression on the interface. The large pre-stretch in
the PE, as performed in experiments, prevents Euler-type buckling
(to an arch shape). Therefore, increasing the compression induced
in this manner eventually leads to wrinkling of the PDMS on PE.
This behavior is similar to surface wrinkling of a semi-infinite
solid subject to compression parallel to the surface [33], but it
is different in the following three aspects:
[0539] It involves two materials (PDMS and PE) such that the
continuity of displacements and stress tractions must be
enforced;
[0540] Both layers have finite thickness, and cannot be modeled as
semi-infinite solids;
[0541] PE has large prestretch, which is not completely released
during compression.
[0542] These features give the critical strain for wrinkling
determined from the eigenvalue of a 8*8 matrix. The critical strain
for wrinkling degenerates to [33] a semi-infinite solid.
Microscopic Mechanics Models for Contact Between EES and Skin
[0543] Microscopic mechanics models are developed to study contact
between EES and skin, particularly on the effects of skin
roughness, and device thickness and size. The skin morphology can
be represented by a sinusoidal form
y(x)=h.sub.rough[1+cos(2.pi.x/.lamda..sub.rough)]/2 with skin
roughness amplitude h.sub.rough and wavelength .lamda..sub.rough.
For non-conformal contact between EES and skin, EES does not follow
the skin morphology and remains flat, which gives the total energy
.sub.non-conformal=0. For conformal contact, both EES and skin
deform such that the total displacement is y(x). The displacements
of EES and skin surface can be represented by
w(x)=h[1+cos(2.pi.x/.lamda..sub.rough)]/2 and
u.sub.z(x)=(h.sub.rough-h)[1+cos(2.pi.X/.lamda..sub.rough)]/2,
respectively, where the maximum deflection h of EES is to be
determined.
[0544] The total energy (per unit length along the wavelength
direction) for conformal contact is .sub.conformal= .sub.bending+
.sub.skin+ .sub.adhesion, where the bending energy of EES is
.sub.bending=(1/.lamda..sub.rough).intg..sub.0.sup..lamda..sup.rough(EI.s-
ub.EES/2)(w.sup.n).sup.2dx=.pi..sup.4EI.sub.EESh.sup.2/.lamda..sub.rough.s-
up.4, the elastic energy of skin is .sub.skin.apprxeq..pi.
.sub.skin (h.sub.rough-h).sup.2/(16.lamda..sub.rough), and the
interfacial adhesion energy is
.sub.adhesion==.gamma..intg..sub.0.sup..lamda..sup.rough {square
root over
(1+(w').sup.2)}dx.apprxeq.-.gamma.[1+.pi..sup.2h.sup.2/(4.lamda..sub.roug-
h.sup.2)]. Minimization of the total energy then gives analytically
the maximum deflection of EES h=
.sub.skinh.sub.rough/(16.pi..sup.3EI.sub.EES/.lamda..sub.rough.sup.3+
.sub.skin).
[0545] Conformal contact requires .sub.conformal<
.sub.non-conformal which gives
4 .pi. 2 EI _ EES .gamma. .lamda. rough 2 < 4 .lamda. rough 2 h
rough 2 .pi. 2 ( 16 .pi. 2 EI _ EES E _ skin .lamda. rough 3 + 1 )
+ 1 16 .pi. 2 EI _ EES E _ skin .lamda. rough 3 + 1 . ( S 3 )
##EQU00014##
[0546] Since .lamda..sub.rough.about.7h.sub.rough in experiments
(FIG. 76F), the second term on the right hand side is negligible
and the above equation becomes
.pi. E _ skin h rough 2 .gamma. .lamda. rough < 16 + E _ skin
.lamda. rough 3 .pi. 3 EI _ EES . ( S4 ) ##EQU00015##
[0547] For the FS-EES (FIG. 76B),
EI.sub.EES.apprxeq.0.27.times.10.sup.-9 N-m (see Section S5),
.sub.skin.apprxeq.130 kPa, .lamda..sub.rough.apprxeq.140 .mu.m,
.gamma..apprxeq.0.16 N/m (see Section S5), the above criterion
implies that EES can have conformal contact with skin when the skin
roughness is smaller than .about.56 .mu.m (FIG. 76G). This result
is consistent with conformal contact observed in FIG. 76F
(roughness in the range of 5.about.20 .mu.m, as marked by the color
bar in FIG. 76G).
[0548] For the island-plus-serpentine EES (FIG. 79D), the device is
much thicker (Au 0.5 .mu.m-PI 1.2 .mu.m-Au 0.2 .mu.m-PI 1.2 .mu.m)
and larger (500 .mu.m.times.500 .mu.m) than the FS strips (0.5
.mu.m thick, 100 .mu.m wide). For 400 .mu.m spacing between
adjacent islands (FIG. 79D), the effective bending stiffness is
EIEEs 1.6.times.10.sup.-9 N-m from FEM, and the effective work of
adhesion is .gamma..apprxeq.0.14 N/m (see Section S5). The
criterion above implies that EES loses conformal contact once the
skin roughness exceeds 27 .mu.m, which is consistent with partial
contact observed in the experiments for the range of skin roughness
20.about.50 .mu.m (FIG. 80C).
[0549] For the FS-EES design, the effect of device thickness is
studied by changing thicknesses of all layers proportionally. Let
h.sub.device denote the total thickness of device. FIG. 88A shows
that, for FS made of Au-PI as in experiments (red curve), the skin
roughness for conformal contact decreases from .about.56 .mu.m to
.about.30 .mu.m as the device thickness increases by 8 times. If
all elastic moduli are proportionally reduced by 1000 times (blue
curve), FS-EES would have conformal contact with much rougher skin.
Therefore, thinner, softer devices promote conformal contact
between EES and skin.
[0550] The thickness and modulus of the device and the skin
roughness also play important roles on the comfort, or
`wearability`, of EES. The contact pressure at the EES-skin
interface is obtained analytically as [34]
.sigma. contact - global = 8 .pi. 4 E _ skin h rough 16 .pi. 3
.lamda. rough + E _ skin .lamda. rough 4 EI _ EES cos 2 .pi. x
.lamda. rough . ( S 5 ) ##EQU00016##
[0551] FIG. 88B (blue curve) shows the contact pressure between the
FS-EES and skin of average roughness (h.sub.rough=30 .mu.m) for EES
with device thickness of 0.5 .mu.m. The maximum contact pressure is
only 12.5 kPa, which is below the human skin sensitivity (.about.20
kPa [28]) and therefore would not induce discomfort; devices
thicker than 1.2 .mu.m give a contact pressure higher than 20 kPa,
while devices thicker than 3.8 .mu.m lose conformal contact to the
skin. Larger skin roughness of 40 .mu.m (red curve) results in
higher interfacial pressure, and the device thickness to lose
conformal contact becomes much smaller (1.5 .mu.m). From Eq. (S5),
it is obvious that softer device materials will give smaller
contact pressure.
[0552] FIG. 89 illustrates the mechanics model to determine the gap
width a along the edges of EES. Since FS thickness h.sub.device
(.about.1 .mu.m) is much smaller than that of the skin (.about.1
mm) and the PE (.about.30 .mu.m) and the FS strip width (.about.100
.mu.m), the FS between the skin and PE is analogous to inserting a
rigid wedge of uniform thickness h.sub.device at the skin/PE
interface, leading to an interfacial crack [35]. The interfacial
crack tip energy release rate is [36]
G .apprxeq. ( E _ skin + E _ PE ) h device 2 16 .pi. a . ( S 6 )
##EQU00017##
[0553] The gap width a is obtained by G reaching the adhesion
energy .gamma..sub.PE/skin as
a .apprxeq. ( E _ skin + E _ PE ) h device 2 16 .pi. .gamma. PE /
skin , ( S7 ) ##EQU00018##
[0554] which has been verified by FEM for the range of FS thickness
in experiments.
[0555] The stress distribution .sigma..sub.contact-local over FS
width is obtained analytically (Huang et al., Langmuir, 2005), and
is shown schematically in FIG. 89. The total force on FS strip is
the integration of this .sigma..sub.contact-local and
.sigma..sub.contact-global in Eq. (S4) over FS strip width,
F total = .intg. FS width ( .sigma. contact - global + .sigma.
contact - local ) dx , ##EQU00019##
which has an average of -0.1 N/m for skin with h.sub.rough=15 .mu.m
and .lamda..sub.rough=140 .mu.m.
Effective Work of Adhesion Between EES and Skin, and Effective
Bending Stiffness of EES
[0556] The effective work of adhesion between EES and skin is given
by
.gamma.=.alpha..gamma..sub.device-skin+(1-.alpha.).gamma..sub.PE-skin,
(S8)
[0557] where a is the area fraction of devices, and
.lamda..sub.device-skin and .gamma..sub.PE-skin are the work of
adhesion for device-skin and PE-skin interfaces, respectively.
Since adhesion between device (Au) and skin is very weak, Eq. (S8)
is simplified to .gamma..apprxeq.(1-.alpha.) .gamma..sub.PE-Skin.
For the experimental value of .gamma..sub.PE-skin=0.2 N/m measured
by rod-rolling set-up described in [37], the effective work of
adhesion is .gamma..apprxeq.0.16 N/m for the FS-EES
(.alpha..apprxeq.22.5%) and .gamma..apprxeq.0.14 N/m for the
island-plus-serpentine EES (.alpha..apprxeq.30.9%).
[0558] Similarly, for FS strips distributed over the entire surface
of FS-EES electronics, the effective bending stiffness of EES is
given by
EI.sub.EES-.alpha.EI.sub.device+(1-a)EI.sub.PE, (S9)
[0559] where EI.sub.PE= .sub.PEh.sub.PE.sup.3/12 is the bending
stiffness of PE ( .sub.PE=65 kPa and h.sub.PE=30 .mu.m are the
plane-strain modulus and thickness of PE, respectively), and the
bending stiffness for PE with device is
EI _ device = i = 1 3 E _ i h i [ ( b - j = 1 i h j ) 2 + ( b - j =
1 i h j ) h i + 1 3 h i 2 ] ##EQU00020## ( where b = i = 1 3 E _ i
h i ( j = 1 i h j - 1 2 h i ) / i = 1 3 E _ i h i ; E _ 1 = E _ PE
, h 1 = h PE ; E _ 2 = 2.8 GPa , h 2 = 0.3 m ##EQU00020.2##
are the plane-strain modulus and thickness for PI, respectively;
and E.sub.3=97 GPa, h.sub.3=0.2 .mu.m for Au). For a
.alpha..apprxeq.22.5% from FIG. 76B, Eq. (S9) gives the effective
bending stiffness 0.27.times.10.sup.-9 N-m, which agrees reasonably
well with 0.30.times.10.sup.-9 N-m obtained by FEM.
Sample Fabrication of an FS-EES EP Sensor
[0560] The sample fabrication begins with high temperature
diffusion doping to define low resistance source and drain area for
Ohmic contacts. Phosphorous spin-on-dopant (P509, Filmtronics, USA)
was diffused at 950.degree. C. with constant supply of gas mixture
(nitrogen:oxygen, 8:2). Transfer printing the resulting doped
silicon nanomembrane to a handle wafer coated with PMMA/PI,
followed by dry etching for isolation active regions, defined
silicon areas on thin PI, as shown in FIG. 77A left frame.
Electron-beam evaporation of metal (Cr/Au, 50/1500A) interconnects
ground and output to the sensor and defines source, drain and gate
electrodes (FIG. 77A right frame and its inset for a magnified
view). Additional metallization for larger area sensor electrode,
connection different layers through vias and second transfer
printing to PE/PVA results in final sensor, as shown in FIG.
90.
S7. ECG Measurement
[0561] The body ground electrode was a tin electrode filled with
conductive gel, attached to the bony area on the right side of the
subject's right ankle. The EES was attached to the lower-left edge
of the rib cage, near the left side of the midline of the chest.
Usually one of the electrodes on the EES was used as reference
electrode, while another was recording electrode. The negative end
of the AA battery that powered the EES was also tied to the body
ground. The gain of the main amplifier was 10000, with a high-pass
frequency (HPF) of 0.1 Hz, and a low-pass-frequency (LPF) of 100
Hz. The sampling frequency was 1000 Hz. A notch filter was applied
in software to eliminate 60 Hz power line interference.
EMG Measurement from Leg
[0562] The EES was attached at about 1/3 the distance from the knee
to the ankle, on the interior side of the left leg. Other
parameters were the same as those for ECG, but with HPF=0.01 Hz and
LPF=300 Hz. Passive measurements were done separately after
recording with the EES, with otherwise exactly the same
configurations. Two tin electrodes were attached in close vicinity
of the EES, one on each side of it, vertically along the axis of
extension of the muscle. The voltage differences between them were
reported as the passive EMG.
EMG Measurement from Neck
[0563] The EES was attached at the skin overlying the cricothyroid
muscle. The measurement parameters were the same as those for EMG
on the leg.
EEG Measurement from Forehead (Alpha Rhythms and Stroop
Effects)
[0564] The body ground and reference electrodes were gold
electrodes IN EES FORMAT without using conductive gel, attached to
the subject's left and right earlobes respectively. The passive EES
was attached the center of the subject's forehead without applying
conductive gel. If the EES has multiple channels, then usually one
of the electrodes on it would be used as reference electrode, while
another would be recording electrode. The gain of the main
amplifier was 10000, HPF=0.01 Hz, LPF=300 Hz. Sampling frequency
was 1000 Hz. A notch filter was applied in software to eliminate 60
Hz power line interference.
Simulated Computer Game Control Via Neck EMG Measured by EES
[0565] All computations were done in Matlab.RTM.. After eliminating
60 Hz interference from the raw data using an offline notch filter,
the feature vector associated with each utterance was generated
from the spectrogram of the data, using sliding window length of
256, overlap size of 250, and the fast-fourier transform (FFT)
length of 512. Spectrograms were generated for an entire trial
first, and then sliced into 750 ms intervals that correspond to the
utterances of words, according to EMG onset times. These onset
times were determined by an energy detecting procedure, where raw
data were first sent through a high pass filter (Chebyshev type I,
cutoff 70 Hz, high-pass 80 Hz), concatenated by a matched filter,
and the signals were then squared. Whenever the power crossed a
threshold value, a pair of onset and offset times of EMG activity
was recorded.
[0566] In the original labeled dataset, there were 63 feature
vectors for each of the 4 words. The metric of distance between any
two feature vectors was the L1-norm, and dynamic time warping (DTW)
was used to calculate the similarity score between them. In the
computer game control demonstration, the user manipulated an avatar
that can move in 4 directions in the game called Sokoban. In a
simulated demonstration, when the user presses a key to signify the
intended direction for the avatar, a candidate feature vector is
randomly drawn from the EMG feature pool for that direction, and
compared with all the rest of the feature vectors in all four pools
as references, in terms of DTW scores. As a result, a nearest
neighbor can be found for the candidate from one of the four pools,
and it will be classified as a member from this nearest neighbor's
group.
[0567] The classification accuracy depends on the number of
reference feature vectors available for each direction (FIG. 86).
We have simulated (by resampling the data pool without replacement
in 100 trials) the situation where various numbers of references
were randomly available from each of the four pools, and found that
the classification accuracy estimated across 100 trials increased
with the number of references. When 62 references in each pool were
used, the averaged accuracy could be higher than 95% for "up" and
"down", and higher than 85% for "left" and "right". Thereby, the
intended directions can be accurately classified and conveyed to
the avatar, and gaming can thus be accomplished.
[0568] DFT (discrete Fourier transform) coefficient
[0569] Given a vector of length N, x[1], . . . ,x[N] the definition
of the DFT coefficients, X(k), is as follows.
X ( k ) = j = 1 N x [ j ] exp { - 2 .pi. i N ( j - 1 ) ( k - 1 ) }
##EQU00021##
[0570] Where k=1, . . . , N
Fatigue Test
[0571] Repetitive stretching up to 1000 times with 30% tensile
strain at 20 rpm shows no performance (resistance) degradation of
FS electrodes, as shown in FIG. 91.
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Example 8: Epidermal Skin Hydration Sensors
[0609] Skin hydration monitoring is important for dermatology to
analyze several diseases and evaluate the effectiveness of medical
therapies [1-4]. Aesthetically speaking, hydration measurement is
also important for cosmetology to assess the effectiveness of
anti-aging and moisturization treatments. Skin hydration levels
have been characterized through measurement of skin electrical
impedance [5-7], mechanical [8-10], thermal conductivity,
spectroscopy [5, 11, 12] and reflectivity [13]. Among these
methods, the electrical impedance detection is most convenient and
is represented by several commercial products [14-17]. However,
these commercial sensors generally realize hydration detection by
bulky electrodes [14], whose accuracies are subjective to the
inconsistency of contact force between the electrode and the skin.
In addition, these sensors measure skin hydration at a fixed
frequency, lacking the flexibility to probe the hydration level at
different skin depths with various clinic and cosmetic
interests.
[0610] We have demonstrated epidermal electronics circuits that can
be conformably attached to the skin as tattoos [18]. Integrated
with multiple functions, these epidermal circuits allow
non-invasive detection of physiological parameters with maximized
stretchability and flexibility. This example presents three types
of epidermal hydration sensors based on impedance detection. These
sensors effectively resolve the requirement of precise contact
force and provide improved flexibility to bio-impedance measurement
applications [19,20]. One sensor conducts differential hydration
measurement, which compensates for temperature variation, human
activity, and other disturbances that may lead to unexpected
impedance changes. In addition, these sensors allow for measurement
of hydration level at different depths of the skin and conduct
large area hydration mapping through multiplexing techniques. The
experimental results demonstrate that these sensors possess
comparable accuracy and stability to commercial moisture meter
(CMM) and can integrate with other sensing or actuating elements to
realize multifunctional epidermal applications.
[0611] Principle and Designs: Epidermal skin hydration sensors are
based on impedance measurement of the hydration induced changes in
the electrical properties of the skin. Varied moisture levels can
alter the electrical conductance as well as permittivity of the
skin, leading to different skin impedance [21]. As shown in FIG.
92, by applying an alternative changing voltage to the skin through
the central electrode, and measuring the attenuation of this
voltage during the transportation within the skin through
peripheral electrodes, the impedance along the path that the
electrical field has passed can be determined.
[0612] Three types of epidermal sensors that can realize
differential hydration sensing, skin hydration depth profiling and
hydration mapping in large area have been developed. The sensor
that is used for differential hydration measurement contains four
pairs of electrodes that explore capacitive and resistive hydration
measurement (FIG. 93A). These electrodes, which are named by
channel 1 to 8 when counted from right to left, include two pairs
of circular electrodes, one pair of interdigitated electrodes, and
one pair of meander electrodes, The circular electrodes and
interdigitated electrodes measure skin hydration through capacitive
detection, while the meander electrode measures the
hydration-induced resistive changes or can be used as a temperature
sensor. All channels of the sensor share a common ground, which is
located at the center of the device. The sensing electrodes
(sensing module) are exposed and directly contact with the skin,
while the reference electrodes are embedded in a polymer film and
blocked by solid metal films that act as flowing ground. These
sensors are connected with serpentine metallic wires, which are
used for the communication between the sensor and a measurement
setup while maintaining the stretchability and flexibility of the
entire device. The entire device is passivated in a polymer film
that is bond to a silicone substrate through covalent bonding. The
differential measurement provides excellent rejection to common
mode disturbances in the measurement system and eliminates the
impedance changes caused by serpentine interconnections.
[0613] The device used for skin hydration depth profiling contains
8.times.8 electrodes connected with serpentine wires (FIG. 94).
Each of the electrodes is formed by concentric circular and annular
electrodes. The annular electrodes have fixed inner and outer
diameters, while the diameter of circular electrodes on the same
row steadily increases, resulting in different spacing between the
circular electrodes and annular electrodes on the same row. The
circular electrodes on the same row share the same serpentine
connections, while the annular electrodes on the same column are
connected with the same serpentine wires. This configuration
facilitates measurement of 64 sensors through 16 channels using
multiplexing technique. Anisotropic conductive films (ACF) cable
can be bond with the wire bonding pads to connect the device with a
measurement setup. The device is passivated in a polymer film with
all 64 electrode pairs exposed. The entire device is supported by a
silicone substrate that is flexible and stretchable. The device
used for hydration mapping also contains 8.times.8 electrode pairs
and share common features as the hydration depth profiling sensor
(FIG. 94). Differently, these electrodes have the same spacing
between the inner circular electrodes and outer annular
electrodes.
[0614] Fabrication processes: All epidermal hydration sensors are
fabricated using similar processes. The fabrication starts with
spin-coating a sacrificial PMMA layer (500 nm) and a supporting
polyimide film (1 .mu.m) on silicon (Si) substrate (FIG. 95A). Cr
(5 nm) and Au (400 nm) layers are then deposited and patterned to
form the serpentine interconnections (FIG. 95B), which are then
passivated by another polyimide film (1 .mu.m). A patterned
photoresist layer (AZ4620, 10 .mu.m) then define the area for vias,
which are later formed by etching polyimide film through reactive
ion etching (RIE) (FIG. 95C). Following the removal of the
photoresist layer, an addition Cr/Au (5 nm/200 nm) layer were
deposited and patterned to form the electrodes (FIG. 95D).
Afterwards, a photoresist layer (AZ4620, 20 .mu.m) that defines the
device outline is used as a mask layer to etch through the
polyimide film and PMMA film by RIE. The photoresist on the device
as well as the PMMA underneath the device is then stripped in
acetone for 5 minutes at 100.degree. C. The resulting device
collapses onto the Si substrate and is picked up by water-soluble
PVA tape. Ti/SiO.sub.2 layers (5/40 nm) are then deposited as an
adhesion layer to bond the device with silicone substrate (500 um
PDMS or Solaris) (FIG. 95I). Finally, the entire device is put into
water to remove the PVA tape, resulting in a flexible and
stretchable hydration sensor (FIG. 95J). FIGS. 96A-96D show a
fabricated differential hydration sensor (FIG. 96A), which has
excellent flexibility (FIG. 96B). This differential hydration
sensor can be further connected with a releasable connector that
contains serpentine wires (FIG. 96C). The releasable connector
provides a flexible interface between the hydration sensor and ACF
and is fabricated using similar fabrication processes as the
hydration sensors. The device as well as the releasable connector
is finally put on the skin for hydration detection (FIG. 96D). A
hydration mapping device is shown in FIG. 97A, which also has
excellent flexibility (FIG. 97B) and can be put on to the skin for
hydration measurement (FIG. 97C). The device used for skin
hydration depth profiling is similar to the hydration mapping
device (FIG. 97D).
[0615] Experimental Setup: The impedance of the differential
hydration sensor can be measured using a setup as shown in FIG. 98.
An impedance analyzer chip (AD5933, Analog Devices) is used to
measure the impedance changes of the differential hydration sensor
at sweeping frequencies ranging from 10 kHz to 100 kHz. The
impedance analyzer provided an excitation AC voltage (Din) at the
sweeping frequencies to each channel of the hydration sensor
through a multiplexer (ADG 708, Analog Devices). By changing the
combination of voltage supplies to a1, a2, and a3 in the
multiplexer through a computer controlled I/O controller, 8
channels of the sensor (labeled from A1 to A8) can be individually
selected. The amplitude and phase of Din changed with the impedance
of each channel. As a result, the attenuated signal from all
electrodes is read through D.sub.out, which is shared by all sensor
channels in a time-sequence.
[0616] The experimental setup (FIG. 99) for skin hydration depth
profiling and mapping shares the various features as the one used
for differential measurements (FIG. 98). In addition to the
impedance analyzer chip, a LCR meter that provides sweeping
frequency ranging from 20 Hz to 2 MHz is used to provide more
sophisticated impedance measurement at higher frequency. To sweep
both columns and rows of the high density hydration sensors, an
additional multiplexer is added into the system to allow the
selection of the channel of D.sub.out. The computer controls the
I/O controller to send out 6 bits digital signal that selects one
column and one row of the hydration sensor at a time. As a result,
impedance from one of the 64 electrode pairs is read out each time.
The LCR meter, multiplexer, and the I/O controller are fast enough
to complete the sweeping of 64 electrodes in 1 second.
[0617] Experimental Methods: The hydration sensors are attached to
the ventral forearm for convenience of self-monitoring of skin
impedance. The hydration sensor is compatible with any other skin
location as desired. The skin hydration is manipulated by
application of body lotion. The sensor response of all three types
of devices to various hydration levels is characterized, while a
CMM (MoistureMeterSC Compact, Delfin Inc) measures the skin
hydration levels as references, which re then used to calibrate the
impedance from the hydration sensor. The repeatability of device
output is assessed by repeatedly peeling off and reattaching the
sensor to the skin at a stable hydration level. In addition, the
stability of the epidermal hydration sensor is compared with the
CMM at a fixed hydration level.
[0618] The effective measurement depth of the hydration sensors is
characterized using molded PDMS chambers with height varied from 10
to 60 .mu.m (FIG. 100). During the measurement, the PDMS chambers
are filled with PBS buffer and sealed with a regenerated cellulose
semi-permeable membrane with a thickness of 20 .mu.m. As a result,
if the electrode is capable of measuring the PBS in the chamber,
height-dependent impedance changes can be observed. Otherwise, the
sensor impedance will become leveled above certain height of the
chambers. Thus, we can determine the sensors' effective measurement
depth from impedance measurement. Using a hydration sensor with
various electrode spacing from 60 to 200 um and measured at varying
frequencies ranging from 15 kHz to 2 MHz, we obtain the frequency
[22] and geometry dependence of effective measurement depth of
hydration sensors.
[0619] Hydration sensors presented in this example are mostly
characterized at a frequency ranging from 15 kHz to 2 MHz. The
relatively low frequencies allow measurement deeper into the skin
and offer larger response to hydration changes, while the high
frequencies limit the effective depth of the measurement and are
less subjective to the influence from electrolyte. In addition, the
selection of measurement frequencies also allows electrode
polarization minimization, which is most prominent at low frequency
(below 10 kHz). Furthermore, this frequency range covers the
frequency used by the CMM, providing direct comparison between the
measured impedance and hydration levels obtained by CMM.
[0620] Experimental Results and Discussions: Comparison between
hydration measured by moisture meter and impedance measured by
hydration sensor of the present example. The relation between
hydration levels measured by the CMM and the impedance of a
differential hydration sensor is first characterized. The time
course of the skin impedance and hydration is obtained in turn
through a differential hydration sensor and the CMM after
application of body lotion to the forearm of the volunteer. At a
fixed frequency of 15 kHz, the impedance of the channel 4 of the
hydration sensor is obtained and compared with hydration levels
from the CMM with an arbitrary unit (FIG. 101A). The impedance
values are inversely proportional to the hydration levels. As
sensor impedance difference changed from 25 k.OMEGA. to 48
k.OMEGA., the skin hydration level decreases from 110 to 22. This
result indicates that higher hydration levels lead to increase of
electrical conductivity as well as decrease in the permittivity of
the skin. The impedance values are converted into hydration levels
using a first order linear equation, whose coefficients are
calculated using two reference hydration levels and the
corresponding electrode impedance. FIG. 101B shows the results
after converting the sensor impedance into hydration levels. The
converted results show excellent consistency with the CMM,
indicating that the epidermal hydration sensor is a good
alternative to the CMM.
[0621] Repeatability: The repeatability of the epidermal sensor is
assessed at varying frequencies at a stable skin hydration level.
During the measurement, the sensor is repeatedly attached onto and
retrieved from the skin. The data from channel 4 and 5 of the
hydration sensor is recorded (FIGS. 102A-102D). As can be seen from
FIGS. 102A and 102B, both the amplitude and phase of the impedance
are very stable with the exception that significant noise and
fluctuations are observed at frequencies around 60 kHz. This may be
due to the harmonic frequency from the supply power. At 15 kHz, the
impedance amplitude of channel 4 varies by 7.4%, while the phase
varies within 8.3%. The impedance of channel 5 also shows similar
repeatability with an impedance amplitude change within 5.15% and a
phase change within 5.52%. These results indicate that the
hydration sensor has excellent reliability and repeatability, and
is suitable for applications were repeated attachment and removal
is required.
[0622] The stability of the hydration sensor is compared with the
CMM. Both the hydration sensor and the CMM are used to measure the
skin hydration at a stable level without application of lotion. The
impedance difference between channel 4 and 5 are converted into
hydration levels using the first two reference points from the CMM.
Among the ten measured points (FIG. 103), the hydration sensor
exhibits comparable stability as the CMM. The hydration levels from
the hydration sensor are stable at approximately 28.15 with a
standard deviation of 0.74, while the CMM shows an average
hydration value of 28.28 and a standard deviation of 0.68. Note
that the relatively smaller deviation of the CMM is achieved by
manually controlling the contact force between the electrode and
the skin in a designated range. The operation of the epidermal
hydration sensor is more convenient without the concern of contact
force, while allowing comparable stability as the CMM.
[0623] Differential hydration sensor response to hydration changes.
The sensor responses at varying hydration level are measured at
frequencies ranging from 15 kHz to 95 kHz. The impedance amplitude
and phase of all sensor channels changes with skin hydration levels
(FIGS. 104A-104D and 105A-105D). But the impedance of sensing
modules changed larger than the impedance from the reference
modules. For example, as the hydration levels changes from 40 to
110, the impedance amplitude of channel 4 changed by 1.58 M.OMEGA.,
while the impedance amplitude of channel 5 changed by 1.04
M.OMEGA.. The change of the impedance in the reference module with
the hydration levels can be mostly attributed to the parasitic
capacitance and resistance from the serpentine wires, and is
effectively compensated by subtracting the impedance from the
sensing module. The results again exhibit some noise at frequencies
ranging from 50 to 60 kH due to the harmonic frequency from the
power supply. In addition, the impedance amplitude and phase of
channel 4 change by 89% and 73% when hydration levels change from
40 to 110. The percentage change of impedance is 10 times larger
than the percentage changes in repeatability measurements,
indicating that the epidermal hydration sensor is practically
applicable in hydration level monitoring that requires repeated
sensor reattachment.
[0624] The impedance differences between channel 3 and 6 as well as
channel 4 and 5 are converted into hydration levels using two
reference values from the CMM (FIG. 106). The converted results
exhibit excellent consistency between CMM and epidermal sensors. At
a measurement period of approximately 35 minutes, the maximum
deviation between the measured hydration levels from CMM and
converted values from epidermal sensor is only 10%. These results
indicate that the epidermal hydration sensor is readily used for
skin hydration monitoring with comparable performance as the CMM
and improved convenience.
[0625] In-vitro characterization of depth profiling sensor. The
frequency and geometry dependence on electrode impedance are
conducted at various frequencies from 15 kHz to 2 MHz. Using the
test chamber that simulates the structure of human skin as shown in
FIG. 97D and FIG. 100, electrode impedance with respect to chamber
heights can be obtained to determine the effective measurement
depth of the hydration sensors. As shown in FIGS. 107A-107D, the
electrodes respond to changes in chamber height differently. The
capability of electrode in measuring PBS buffer in chambers of
different height is determined by both measurement frequencies and
the electrode spacing. However, frequency changes produce more
significant influence as compared to the electrode spacing. For
example, at a frequency of 15 kHz, all electrodes exhibit
decreasing impedance with the chamber height up to 40 .mu.m (FIG.
107A). Considering the thickness of the semi-permeable membrane,
the electrodes are capable of measuring a depth that is larger than
60 .mu.m. However, this capability decreased quickly with
frequencies. At 250 kHz, most electrode impedance became leveled at
a chamber height of 20 .mu.m, equivalent to a 40 .mu.m effective
measurement depth (FIG. 107B). Ignoring the fluctuation caused by
sensing errors, electrode impedance does not change with chamber
height at 500 kHz and 1.25 MHz, indicating an effective measurement
depths lower than 20 .mu.m.
[0626] Compared to the influence from the measurement frequency,
the influence of the electrode spacing is more prominent at low
frequency. For example, at 15 kHz, impedance of the electrode with
80 .mu.m spacing becomes gradually leveled at approximately 35
.mu.m, while impedance of electrode with 200 .mu.m spacing
decreases steadily up to 60 .mu.m. This observation indicates that
electrodes with larger spacing have a deeper skin depth. The
results of frequency and geometry dependence of effective
measurement depth is used to assess the electrodes used in the
differential hydration sensor having electrode spacing of 50 or 80
.mu.m. This spacing indicates an effective measurement depth lower
than 55 .mu.m at 15 kHz, which is comparable to the thickness of
stratum corneum. These in-vitro depth profiling results demonstrate
the ability to measure hydration at different skin depths by
changing the measurement frequency and electrode spacing.
[0627] Depth profiling hydration sensor response to hydration
changes. The depth profiling sensor can be in-vivo characterized at
a low frequency, at which the effects of measurement frequencies
and electrode spacing are most prominent. Here, 8.times.8 depth
profiling sensor is used to measure the hydration level at
different depths of the skin. FIGS. 108A-108C demonstrate the
electrode impedance exhibits an impedance gradient related to the
electrode spacing. Impedance decreases with increasing hydration
levels. Impedance of electrodes with three different spacing (200,
140 and 60 .mu.m) are selected to compare with hydration levels
obtained by the CMM. As shown in FIG. 109, the skin hydration
changes from 64 to 114 after the lotion application, and then
decreases back to 56. The electrodes with spacing of 200 and 140
.mu.m follow the trend well. In contrast, the electrode with 60
.mu.m spacing has initial impedance that is larger than terminated
impedance. These results are consistent with the in-vitro
experiments and indicate that electrodes with 200 and 140 .mu.m
spacing can follow the hydration levels changes in the stratum
corneum, while the electrode with 60 .mu.m may capture the
hydration level changes beyond the layer of stratum corneum.
[0628] Hydration mapping sensor response to hydration changes. An
8.times.8 hydration mapping sensor is used to obtain the hydration
levels over a relatively large skin surface area. Results from both
the hydration sensor and the CMM are obtained at a fixed frequency
of 1.25 MHz, at which the hydration measurements are constrained in
the region of straturm corneum according to the experiments above.
As shown by FIGS. 110A-110B, the electrode impedance is very
uniform on the dry skin due to the same electrode spacing. After
application of the lotion, both impedance amplitude and phase
changes with the hydration levels on the skin. The initial
hydration level of the skin is 40, corresponding to an average
electrode impedance at about 161 k.OMEGA. (FIG. 110A). After
application of the lotion, the skin hydration changes to 114 (FIG.
110B), corresponding to an average impedance of 155 k.OMEGA.. At a
hydration level of 77, the impedance changes back to 158 k.OMEGA.
(FIG. 110C). Selecting one of the electrodes on the center of the
device, the time course of electrode impedance and phase is
obtained before and after the lotion application (FIG. 111A).
During the measurement, the hydration level changes from 40 to 114
then back to 65. This corresponds to an electrode impedance change
from 160 k.OMEGA. to 151 k.OMEGA. and then to 157 k.OMEGA..
Corresponding changes also occur in the phase of the electrode
impedance. The impedance amplitude and phase are converted back to
hydration levels and compared with the hydration levels obtained by
the CMM (FIG. 111B). The results demonstrate excellent consistency
between the bulky electrode from the CMM and miniaturized
electrodes from the hydration sensor, indicating that both the
impedance amplitude and phase can be used to obtain skin hydration
levels. This result is obtained at the same frequency as the CMM to
facilitate direct performance comparison. However, this sacrifices
the sensitivity of the miniaturized electrodes. By appropriately
decreasing the measurement frequency, a more sensitive hydration
measurement is achieved with performance that outweighs the
CMM.
[0629] In this example, three types of epidermal hydration sensors
are presented that can conformally attach to the skin and have
demonstrated their ability to measure hydration in non-invasive
manner. These sensors use miniaturized electrodes to achieve
performance that is comparable to CMM. More importantly, these
hydration sensors provide improved simplicity and convenience in
operation, making these sensors ideal alternatives to CMM. Sensor
characterizations conducted under different frequencies and sensor
geometry demonstrate excellent reliability, repeatability, and
stability of these sensors in hydration measurements. These sensors
can be readily integrated with wireless components to realize
wireless hydration monitoring. In addition, by integrating with
multiple sensing elements or using different sensing parameters
(e.g. frequency, spacing), these sensors can be used in other
biophysical and biomedical sensing applications.
REFERENCES
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hand eczema," Contact Dermatitis, 16: 155-159, 1987. [0631] [2] M.
Boguniewicz, et al., "A Multidisciplinary Approach to Evaluation
and Treatment of Atopic Dermatitis," Seminars in Cutaneous Medicine
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Ergonomics, 29: 791-9, 1986. [0633] [4] S. M. Kleiner, "Water: An
Essential But Overlooked Nutrient," Journal of the American
Dietetic Association, 99: 200-206, 1999. [0634] [5] T. Frodin, et
al., "Hydration of human stratum corneum studied in vivo by
optothermal infrared spectrometry, electrical capacitance
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Hydration in Vivo by Electrical Measurement," J Investig Dermatol,
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measurements to evaluate skin dryness in the modified soap chamber
test*," Skin Research and Technology, 1: 123-127, 1995. [0637] [8]
H. Dobrev, "Use of Cutometer to assess epidermal hydration," Skin
Research and Technology, 6: 239-244, 2000. [0638] [9] F. M.
Hendriks, et al., "Influence of hydration and experimental length
scale on the mechanical response of human skin in vivo, using
optical coherence tomography," Skin Research and Technology, 10:
231-241, 2004. [0639] [11] E. M. Attas, et al., "Near-IR
spectroscopic imaging for skin hydration: The long and the short of
it," Biopolymers, 67: 96-106, 2002. [0640] [12] F. Kadlec, et al.,
"Assessing skin hydration status in haemodialysis patients using
terahertz spectroscopy: a pilot/feasibility study," Physics in
Medicine and Biology, 53: 7063, 2008. [0641] [13] S. I. Alekseev,
et al., "Millimeter wave reflectivity used for measurement of skin
hydration with different moisturizers," Skin Res Technol, 14:
390-6, 2008. [0642] [14] E. Alanen, et al., "Measurement of
hydration in the stratum corneum with the MoistureMeter and
comparison with the Corneometer," Skin Research and Technology, 10:
32-37, 2004. [0643] [15] J. W. Fluhr, et al., "Comparative study of
five instruments measuring stratum corneum hydration (Corneometer
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vitro," Skin Research and Technology, 5: 161-170, 1999. [0644] [16]
A. O. Barel and P. Clarys, "In vitro calibration of the capacitance
method (Corneometer CM 825) and conductance method (Skicon-200) for
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Example 9. Direct and Conformal Lamination of Multifunctional
Electronics on Skin for Long-Term Health Monitoring
[0651] Fabrication and mounting of skin-like electronics: The
multifunctional, skin-like electronics incorporates filamentary
serpentine (FS) shaped sensing components such as
electrophysiological (EP)-, strain-, and temperature sensors (FIG.
112A, detail layout in FIG. 116A). Gold (Au) EP sensors integrate
measurement, ground and reference electrodes together for EP
recording on skin, while strain and temperature sensors are based
on silicon nanomembrane and platinum, respectively. The FS shapes
of the skin-like electronics are designed to ensure the mechanical
stability upon skin motion of stretching and compression to which
the device is attached.
[0652] Fabrication of the skin-like sensor begins with high
temperature diffusion doping of silicon (Si) nano-ribbons (260 nm
in thickness) on a silicon-on-insulator wafer. The doped
nano-ribbons are transfer-printed on a polyimide (PI) coated
handling wafer. The remaining fabrication processes on a Si wafer
follow conventional microelectronic techniques. Photolithography
and dry etching process isolate the active region of nano-ribbons,
to construct a silicon nanomembrane-strain sensor. A temperature
sensor made of platinum (Pt, 40 nm in thickness) is prepared
through electron-beam evaporation. Au-EP sensors including
measurement (MEA), ground (GND), and reference (REF) electrodes and
contact electrical pads are defined by photolithography after
metallization, to complete the multifunctional device on a handling
Si wafer (FIG. 112A). The completed device is immersed in acetone
to dissolve a sacrificial photoresist layer on the wafer. The
released electronics from the wafer are picked up by an elastomeric
stamp (FIG. 112B). Afterwards, the electronics on the stamp is
directly transfer-printed onto the skin using a thin glue layer
(.about.200 nm) of spray-on-bandage ("liquid bandage"; in this
example Nexcare.TM.) as shown in FIG. 112C. Finally, the
electronics on the skin is covered by multiple layers (in this
example: four) of spray bandages ("liquid bandages") to ensure
long-term wearability (FIG. 112D).
[0653] Long-term wearability and adhesion force. As discussed above
(see, e.g., Example 7), and in [1], an epidermal electronic device
can be mounted on skin with van der Waals force alone. That method
provides robust adhesion of the light weight, ultrathin device on
the skin. However, the use of the epidermal device is limited for
long-term (seven days) wearing because the thin, skin-like membrane
can be damaged or peeled off with hand contact, fluid contact such
as from showering, bathing or sweating, or physical abrasion
arising from exercise and other day-to-day activity. For long-term
use of the skin-like electronics, this example provides a new
method that utilizes commercial skin products such as medical spray
bandage, thin medical dressing, or silicone tapes. The advantages
of these medical products lie on their pre-approved ingredients for
skin application and proven characteristics such as water proof and
breathability, which are crucial factors for long-term use on
skin.
[0654] We exploit spray-type liquid bandages (Walgreen.RTM. and
Nexcare.TM.) that provide a thin shielding layer on skin along with
breathability and waterproof protection. After direct mounting of
electronics on skin, Walgreen spray bandage made first coating
layer, then Nexcare bandage was sprayed over the first layer.
Through sequential repetition, a total of four layers shield the
electronics on skin for long-term wearability. The reason for use
of two products is to take advantage of their unique properties;
Walgreen spray bandage provides more robust coating layer, while
Nexcare has better water proofing characteristics. The sprayed
shielding layer on skin was measured to be about 1.1.+-.0.3 .mu.m
in thickness (n=3). The assessment of the thickness and roughness
is conducted by using a surface profilometer (Dektak) and atomic
force microscopy (AFM; Asylum) as shown in FIG. 113A. This
ultrathin polymer layer ensures conformal coverage on curvy, wavy
skin surface since the amplitudes of the skin are about 15 to 100
.mu.m and the feature sizes are about 40 to 1000 .mu.m [2, 3].
[0655] The medical spray bandage is a polymer dissolved in
solvents. Thus, when it is sprayed on skin, solvents are
evaporated, such that it forms a thin polymer layer sheet on skin.
The major ingredient of the spray bandage is Hexamethyldisiloxane,
which is a solvent. Among other ingredients, acrylate terpolymer
forms the transparent polymer on skin and polyphenylmethylsiloxane
provides water proof characteristics. The schematic illustration in
FIG. 113B represents the characteristics of the spray-on-bandage
when it covers the electronics on the skin. The breathable polymer
layer allows oxygen onto the skin, penetration of moisture out of
the membrane, and blocks water, dirt and other particles. Referring
to FIG. 113B, the flexible and stretchable electronic circuit 900
is mounted to skin 910, optionally by a contact layer 930 that may
be a spray or liquid bandage. After mounting, spray or liquid
bandage is used as a cover layer 920 to cover the flexible and
stretchable electronic circuit from surrounding environment. For
comfort and to minimize adverse biological event to the skin,
layers 920 and 930 are preferably a commercially-approved spray or
liquid bandage approved for biological use. In this embodiment, the
electronic circuit 900 comprises an array of sensors or actuators
901 that are interconnected by serpentine interconnects 902. The
cover layer 920 may be applied in multiple layers. In an aspect, at
least one of the cover layers is chemically or materially different
than another cover layer. Such a cover layer configuration is
referred herein as a "composite" cover layer and is advantageous
for tailoring functional attributes of the cover layer to the
application of interest (e.g., waterproofing, heat resistance,
chemical resistance, durability, coloring, and the like) via
independent selection and ordering of the layers.
[0656] For demonstration of long-term wearability, some of
skin-like electronic devices are mounted on a subject's forearm and
chest with the coverage of spray bandages (FIG. 113C). The wearing
test for a week with five volunteers (age: 21-32) showed good
wearability and robustness against motions, water and sweat from
normal life without damaging or fracturing the electronics. Note
that a subject sprayed Walgreen bandage on the device once a day
before going to bed.
[0657] For quantitative study of the bandage robustness, adhesion
forces of various materials on skin were measured by using a
digital force meter (WeiHeng). Following the similar measurement
setup of the reported study [4], adhesion forces of skin-like
membranes, spray bandage and typical medical dressing are measured
on a subject's forearm (FIG. 113D). Low modulus, skin-like
membranes (Ecoflex, Solaris; Smooth-On) have an adhesive force less
than 0.4 N at the fixed area (9 cm.sup.2) on the skin. The
spray-on-bandage (liquid bandage) showed a much higher adhesion
force (0.98 N) than the skin-like membrane (Ecoflex; 0.24 N) used
in our previous study [1]. A typical medical dressing (Tegaderm,
Nexcare) is selected for comparison because it is widely used in
hospitals and known to stay on the skin more than a week. When the
adhesion force of spray bandage is compared to that of Tegaderm,
the force magnitude was very similar. Thus, this study illustrates
that the spray-on-bandage has a strong binding force to keep the
electronics on the skin for long time. It should be noted that the
adhesion force of Tegaderm with this measurement setup was
consistent with the reported value [4]. The measured Young's
modulus of the spray-on-bandage is 84.5 MPa and the elongation is
131%. Even though the modulus shows a larger value than the modulus
range of epidermis (140-600 kPa), the spray-on-bandage only imposed
little constraints on skin motion in normal life (FIG. 112D).
Compared to other medical bandages or tapes (GPa range of moduli)
on skin, the spray-on-bandage does not show discomfort of
wearability. In addition, the extreme elongation provides enough
stretchability of the bandage without fracture upon skin motion.
Note that our unique transfer printing technology allow the
placement of the electronics on various commercial medical products
such as micropore tape (3M), Tegaderm (Nexcare), and silicone
medical tape (3M).
[0658] Conformability of skin-like electronics on skin: The
skin-like electronic sensor is designed with FS layout to follow
the skin morphology. The finite element modeling (FEM) computation
is conducted to study the mechanical stability of the skin-like
electronics. The study considered 30% stretching of electronics in
x- and y-orientations since the strain on skin beyond 30% results
in nonlinear and irreversible effects [5]. The total thickness of
electronics is 0.8 .mu.m from two layers of PI (0.3 .mu.m) and
silicon nanomembrane, Pt and Au layers (0.2 .mu.m). The sensing
components are placed in neutral mechanical plane (NMP) as shown in
FIG. 114A. The FEM study of 10 .mu.m-width FS electrode results in
the maximum principal strain as 0.6%, which shows mechanical
stability (fracture strain: 1%) of the electronics upon repeated
motion and stretching of skin.
[0659] We also conduct quantitative mechanical study on the
conformal contact of electronics on skin as the relationship
between the width of FS electrode and the required adhesion force
of a backing layer (FIG. 114B). The skin surface is modeled by a
sinusoidal form, y(x)=h.sub.rough
[1+cos(2.pi.x/.lamda..sub.rough)]/2 with skin roughness amplitude
(h.sub.rough) and wavelength (.lamda..sub.rough). Low bending
stiffness from a thin, soft and compliant material provides
conformal contact on the skin [6], which means that the thickness
and modulus of the electronic device can change the conformability
on the skin. In this mechanical study, the scaling law represented
that as FS width increases, more adhesion force from a backing
layer is required for conformal contact (FIG. 114B). Hence,
assuming the same adhesion force from the same backing layer, the
narrower FS electrode can show better conformal contact than that
of wider FS electrode.
[0660] To demonstrate the relationship between the conformal
contact and width of FS electrode, skin replicas are prepared by
using commercial silicone products, Dragon Skin.RTM. (Smooth-On),
and polydimethylsiloxane (PDMS, Dow Corning). First mold is made
using Dragon skin-kit by curing it on a subject's forearm,
particularly on a smooth and hairless surface. Based on the first
mold, the second mold for a skin replica is fabricated with PDMS.
Following the same skin-mounting process of electronics (FIGS.
112A-112D), three types of FS-based electrodes are mounted on skin
replicas, and they are investigated by scanning electron microscopy
(SEM) as shown in FIG. 114C. For better SEM imaging of
non-conductive silicone molds, the skin replicas with electronics
are coated with 10 nm of palladium/gold. In the SEM images,
electronics are colorized as gold for ease of viewing, while black
background with various features and amplitudes represent the skin
replica. The first pattern (500 .mu.m-IS) is made of 500
.mu.m.sup.2-square island and 100 .mu.m-FS interconnects show that
the big island and serpentines are not conformally mounted on the
fine, skin geometry. When the second pattern (100 .mu.m-FS) is
used, it mostly followed the skin morphology, but could not
entirely cover the deep creases and pits of the skin. It can be
explained that the 100 .mu.m-width is at the outer range of the
fine skin amplitudes and feature sizes [2, 3] as described earlier.
Thereafter, when the width of FS electrode is reduced 10-fold to 10
.mu.m, the 10 .mu.m-FS electrode demonstrates extreme conformal
lamination on the skin.
[0661] With the 10 .mu.m-FS shaped electronics, a quantitative
study of the conformal adhesion on skin is conducted. The impedance
between skin and electrode is measured using a pre-amplifier (James
Long Co.) and compared with the conventional gel-based metal
electrodes. For the impedance measurement, the applied frequency
and amplitude of the sinusoidal inputs are 37 Hz and 0.5 V.sub.rms
(root-mean-square voltage). As shown in FIG. 114D, even with about
20% areal contact coverage of FS-patterns, it showed the similar
impedance value of .about.50 k.OMEGA. as the conductive-gel based
electrodes (.about.56 k.OMEGA.). It can be simply explained
considering that the skin-like electronics can be conformally
mounted on the skin unlike the conventional electrode that needs
gels to compensate the geometry mismatch between the planar
electrode and curvy skin (illustrations in FIG. 114D). As expected,
the conventional rigid electrode without applying gels shows much
higher impedance of .about.180 k.OMEGA. than that with gels. Note
that the dimension of each electrode for both skin-like device and
conventional electrode is about 1 cm in diameter, and the three
electrodes (measurement, ground, and reference) are placed
sequentially with the interdistance of .about.2.5 cm for the direct
comparison with integrated EP sensors of a skin-device.
[0662] Releasable connector and wireless data acquisition: To
measure and record physiological signals on skin, a commercial
wireless data acquisition (DAQ) system is utilized (BioRadio 150,
Cleveland Medical Devices; 2.4 GHz RF band, 100 feet light of sight
transmission range). FIG. 115A shows the experimental setup that
includes the skin-like electronics on a subject's forearm, a
transmitter, a wireless receiver, and a laptop with data recording
software. The portable transmitter acquires the signals from the
skin-like electronics using a releasable, skin-like connector, and
then amplifies, digitizes and transmits the signals to the USB
receiver for real-time monitoring or recording. To avoid wearing
many electrical wires on the sensors like the conventional rigid
electrodes, a releasable, skin-like connector that is configured on
a stretchable, skin-like membrane (500 .mu.m-thick sheet; Solaris,
Smooth-On) is provided. The stretchable connector on a thin
membrane is fabricated by using the transfer-printing technology
(FIG. 115B). The releasable connector is repeatedly contacted with
the sensor through a simple, mount-release process. For the
connection of the skin-sensor with the releasable connector, an
epidermal pad is embedded onto the skin-like electronics (FIG.
115C). The releasable connector makes physical contact with the
epidermal pads for data acquisition with the help of sticky
membranes and van der Waals interaction between gold pads (FIG.
115D). With this class of data recording strategy, a subject can
avoid wearing wires and attendant discomfort for long-term
continuous measurement of signals.
[0663] Multifunctionality and long-term EP measurement: The
skin-like electronics is compatible with a plurality of sensing
elements and actuators as well as different types of sensors and
actuators depending on the application of interest. In this example
different sensors are used: EP sensor, temperature, and strain
sensing gauges in the stretchable system for multimodal
functionality. FIG. 116A shows the multifunctional electronic
device that is encapsulated in top and bottom polymer (PI) layers,
which locate the silicon nanomembrane, Pt and Au
electrodes/serpentine interconnectors at NMP. For EP measurement,
FS shaped Au electrodes including MEA, GND, and REF are configured
into one passive-type device that does not include signal
amplifiers or power supply on the device (FIG. 116A). The dry
electrodes without conductive gels record EP signals on skin
through direct electrode-skin contact. The GND electrode define the
common zero potential when placed at the center between the MEA and
REF electrodes (5 cm apart). The EP signal is recorded by the
potential difference measured from the MEA and REF electrodes on
skin. All measured signals are transmitted in a wireless system and
analyzed in a commercial software (BioRadio 150, Cleveland Medical
Devices) having data filters. The strain sensor to measure the
mechanical motion on skin is made of ultra-thin sheet of silicon
nanomembrane in a longitudinal direction. The rectangular
nanomembrane sensor (width: 30 .mu.m, length: 510 .mu.m) is made by
microfabrication and is anchored with Au-serpentine pads to record
resistance change from the mechanical strain on skin (FIG. 116A).
The gauge factor (GF) of this piezoresistor based on Si
semiconductor is: GF=(.DELTA.R/R.sub.0)/.epsilon., where .DELTA.R
is the resistance change, R.sub.0 is the initial state, and
.epsilon. is the strain deformation. Even though GF of single
crystalline silicon is .about.100, the GF of the skin-like
electronics is measured to be 5 under uniaxial in-plane strain of
10%. It can be originated from the elastic mismatch between the
nanomembrane resistor and the substrate. The temperature sensor
made of Pt electrode has the meander or serpentine pattern for
structure stability against mechanical stretching and for
conformability on skin. The serpentine array composed of Ti/Pt is
connected with Au pads for electrical connection and data
acquisition, which read the resistance change according to the
temperature variation. The width of serpentine is 10 .mu.m. To
calibrate the temperature sensor, the resistance (.OMEGA.) change
is recorded following the temperature change (.degree. C.). The
sensitivity of the sensor is .about.1.OMEGA./.degree. C., which
shows good temperature reading as a resistor.
[0664] FIG. 116B demonstrates the multimodal measurements of
electromyography (EMG), strain, and temperature signals on a
forearm when a subject is bending his wrist. For EMG measurement,
the skin-like electronics is mounted on a skeletal muscle on the
front end of the interior side of a subject's left forearm. The
subject repeated the bending and releasing motion of a wrist for 30
seconds. The differential voltage potential from the skeletal
muscle is recorded after filtering the signal with 60 Hz notch
filter. In the EMG graph, the high frequency triangle-shaped
waveforms show the voltage amplitude from 500 .mu.V to 1 mV. Upon
the skin movement during wrist bending, the strain resistor in the
sensor detects the strain change as voltage amplitude that reached
to 334 mV. The recorded signal went through 60 Hz notch and
bandpass (butterworth) filters for 60 seconds. In addition, the
repetition of bending-releasing of a wrist causes the temperature
change, which is detected by the temperature resistor for 60
seconds. The signal amplitude recorded through 60 Hz notch and
lowpass (Bessel) filters. Even though the signal fluctuates, after
60 seconds .about.0.001 mV difference is recorded, corresponding to
a temperature increase of .about.1.degree. C.
[0665] For demonstration of long-term health monitoring using the
skin-like electronics, electrocardiography (ECG) on chest and EMG
on forearm are recorded for seven days. As shown in FIG. 116C, the
skin-like devices showed high quality ECG over time on the
subject's chest near the left side of the midline of the chest. The
sampling frequency is 960 samples/seconds with 16 bit resolution.
The 60 Hz notch filter is applied to eliminate the power line noise
on the signal. The ECG signals reveal high quality data with
information of all phases of heartbeats with QRS complex (insets in
the graphs). The signal-to-noise ratios of those ECG signals are
favorably comparable to the conventional gel-based electrode
system. In addition, EMG signals are recorded on a subject's
forearm through bending and releasing of a wrist for a week. The
recorded muscle activity on forearm demonstrate consistent signal
quality over time, even the frequency spectrum and recorded voltage
amplitude are changed slightly. In the measurement, the sampling
frequency and filters are the same as ECG measurement. Note that
after a week wearing of the device, the device shows consistent ECG
signals even though the background noise increases slightly, which
may be caused by accumulated dead cells on the skin surface.
[0666] FIG. 116D demonstrates the skin irritation test for a week
with the skin-like electronics on a subject's forearm and chest. As
photos show the skin conditions before mounting and after removal
of electronics, there are no negative influence on skin such as
itching, allergy or erythema.
[0667] The multifunctional electronics that are directly and
conformally mounted on skin introduce a new class of `skin-like`
electronic system for long-term health monitoring. The
spray-on-bandage that cover the electronics make a breathable,
water proof shielding layer on skin without noticeable constraints
in motion. The quantitative mechanical study supports a 10
.mu.m-width serpentine design for extreme conformability and high
quality EP recording without use of conductive gels. A skin-like,
releasable connector in conjunction with a wireless DAQ system can
benefit wearing of a skin-like device with high quality data
acquisition on the skin. When this multifunctional electronics is
integrated with fully embedded wireless communication system, this
class of technology as an `instrumented` medical patch can enable
ubiquitous, long-term wearable health monitoring system at home
settings.
REFERENCES
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STATEMENTS REGARDING INCORPORATION BY REFERENCE AND VARIATIONS
[0675] All references cited throughout this application, for
example patent documents including issued or granted patents or
equivalents; patent application publications; and non-patent
literature documents or other source material; are hereby
incorporated by reference herein in their entireties, as though
individually incorporated by reference, to the extent each
reference is at least partially not inconsistent with the
disclosure in this application (for example, a reference that is
partially inconsistent is incorporated by reference except for the
partially inconsistent portion of the reference).
[0676] The following references relate generally to flexible and/or
stretchable electronic devices, systems and related methods for
biomedical applications, and are hereby incorporated by reference
to the extent not inconsistent with the disclosure herein: (1) U.S.
patent application Ser. No. 12/968,637, filed on Dec. 15, 2010, (2)
PCT International Patent Application No. PCT/US10/60425, filed on
Dec. 15, 2010, (3) U.S. patent application Ser. No. 12/892,001,
Sep. 28, 2010, (4) PCT International Patent Application No.
PCT/US10/50468, Sep. 28, 2010; (5) U.S. Pat. App. 12/916,282 and
PCT App. PCT/US12/40482, both filed Jun. 1, 2012.
[0677] The terms and expressions which have been employed herein
are used as terms of description and not of limitation, and there
is no intention in the use of such terms and expressions of
excluding any equivalents of the features shown and described or
portions thereof, but it is recognized that various modifications
are possible within the scope of the invention claimed. Thus, it
should be understood that although the present invention has been
specifically disclosed by preferred embodiments, exemplary
embodiments and optional features, modification and variation of
the concepts herein disclosed may be resorted to by those skilled
in the art, and that such modifications and variations are
considered to be within the scope of this invention as defined by
the appended claims. The specific embodiments provided herein are
examples of useful embodiments of the present invention and it will
be apparent to one skilled in the art that the present invention
may be carried out using a large number of variations of the
devices, device components, methods steps set forth in the present
description. As will be obvious to one of skill in the art, methods
and devices useful for the present methods can include a large
number of optional composition and processing elements and
steps.
[0678] When a group of substituents is disclosed herein, it is
understood that all individual members of that group and all
subgroups, including any isomers, enantiomers, and diastereomers of
the group members, are disclosed separately. When a Markush group
or other grouping is used herein, all individual members of the
group and all combinations and subcombinations possible of the
group are intended to be individually included in the disclosure.
When a compound is described herein such that a particular isomer,
enantiomer or diastereomer of the compound is not specified, for
example, in a formula or in a chemical name, that description is
intended to include each isomers and enantiomer of the compound
described individual or in any combination. Additionally, unless
otherwise specified, all isotopic variants of compounds disclosed
herein are intended to be encompassed by the disclosure. For
example, it will be understood that any one or more hydrogens in a
molecule disclosed can be replaced with deuterium or tritium.
Isotopic variants of a molecule are generally useful as standards
in assays for the molecule and in chemical and biological research
related to the molecule or its use. Methods for making such
isotopic variants are known in the art. Specific names of compounds
are intended to be exemplary, as it is known that one of ordinary
skill in the art can name the same compounds differently.
[0679] It must be noted that as used herein and in the appended
claims, the singular forms "a", "an", and "the" include plural
reference unless the context clearly dictates otherwise. Thus, for
example, reference to "a cell" includes a plurality of such cells
and equivalents thereof known to those skilled in the art, and so
forth. As well, the terms "a" (or "an"), "one or more" and "at
least one" can be used interchangeably herein. It is also to be
noted that the terms "comprising", "including", and "having" can be
used interchangeably. The expression "of any of claims XX-YY"
(wherein XX and YY refer to claim numbers) is intended to provide a
multiple dependent claim in the alternative form, and in some
embodiments is interchangeable with the expression "as in any one
of claims XX-YY."
[0680] Unless defined otherwise, all technical and scientific terms
used herein have the same meanings as commonly understood by one of
ordinary skill in the art to which this invention belongs. Although
any methods and materials similar or equivalent to those described
herein can be used in the practice or testing of the present
invention, the preferred methods and materials are now described.
Nothing herein is to be construed as an admission that the
invention is not entitled to antedate such disclosure by virtue of
prior invention.
[0681] Whenever a range is given in the specification, for example,
a temperature range, a time range, or a composition or
concentration range, all intermediate ranges and subranges, as well
as all individual values included in the ranges given are intended
to be included in the disclosure. As used herein, ranges
specifically include the values provided as endpoint values of the
range. For example, a range of 1 to 100 specifically includes the
end point values of 1 and 100. It will be understood that any
subranges or individual values in a range or subrange that are
included in the description herein can be excluded from the claims
herein.
[0682] As used herein, "comprising" is synonymous with "including,"
"containing," or "characterized by," and is inclusive or open-ended
and does not exclude additional, unrecited elements or method
steps. As used herein, "consisting of" excludes any element, step,
or ingredient not specified in the claim element. As used herein,
"consisting essentially of" does not exclude materials or steps
that do not materially affect the basic and novel characteristics
of the claim. In each instance herein any of the terms
"comprising", "consisting essentially of" and "consisting of" may
be replaced with either of the other two terms. The invention
illustratively described herein suitably may be practiced in the
absence of any element or elements, limitation or limitations which
is not specifically disclosed herein.
[0683] One of ordinary skill in the art will appreciate that
starting materials, biological materials, reagents, synthetic
methods, purification methods, analytical methods, assay methods,
and biological methods other than those specifically exemplified
can be employed in the practice of the invention without resort to
undue experimentation. All art-known functional equivalents, of any
such materials and methods are intended to be included in this
invention. The terms and expressions which have been employed are
used as terms of description and not of limitation, and there is no
intention that in the use of such terms and expressions of
excluding any equivalents of the features shown and described or
portions thereof, but it is recognized that various modifications
are possible within the scope of the invention claimed. Thus, it
should be understood that although the present invention has been
specifically disclosed by preferred embodiments and optional
features, modification and variation of the concepts herein
disclosed may be resorted to by those skilled in the art, and that
such modifications and variations are considered to be within the
scope of this invention as defined by the appended claims.
* * * * *
References