## 2 Architectural Framework of IBSN and Its Components
### Actuation Strategies  
The actuation in IBSN refers to the medical therapy provided by the medical implants, such as a cardiac pace-maker, neural stimulators, and drug-delivery devices. In most case, actuation is pre-programmed. Similar to a typical sensor node, actuation devices in IBSN usually consist of three fundamental blocks, i.e., an energy source, a micro-controller, and a communication module. In addition to these blocks, bio-medical devices will have an additional block responsible for delivering the therapy.  
In the context of a closed-loop medical system, these actuation devices should be programmed based on the feedback from the implanted sensor nodes. In an IBSN, these actuation devices have the highest priority. The medical devices will have dynamic requirements for wireless communication and these requirements are patient-centric. The requirements of different implantable medical actuation devices are listed in the Table 4. The actuation strategy must be adaptive to the requirements of the patient-centric closed-loop medical devices.  
\begin{table}
\begin{tabular}{p{56.9 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**Disease Process** & **Physiological Parameter (Sensor Type)** & **Biochemical Parameter (Sensor Type)** \\ \hline Hypertension & Blood Pressure (implantable/wearable) mechanoreceptor & Adrenocorticosteroids (implantable biosensor) \\ \hline Ischaemic Heart Disease & Electrocardiogram (ECG), cardiac output (implantable/wearable ECG sensor) & Troponin, creatine kinase (implantable biosensor) \\ \hline Cardiac Arrhythmia/Hear Failure & Heart rate, blood pressure, ECG, cardiac output (implantable/wearable mechanoreceptor and ECG sensor) & Troponin, creatine kinase (implantable biosensor) \\ \hline Cancer (Breast, Prostate, Lung, Colon) & Weight loss (body fat sensor) (implantable/wearable mechanoreceptor) & Tumor markers, blood detection, nutritional albumin (implantable biosensor) \\ \hline Asthma/COPD & Respiration, peak expiratory flow, oxygen saturation (implantable/wearable mechanoreceptor) & Oxygen partial pressure (implantable/wearable optical sensor, implantable biosensor) \\ \hline Parkinson’s Disease & Gait, tremor, muscle tone, activity (wearable EEG, accelerometer, gyroscope) & Brain dopamine level (implantable biosensor) \\ \hline Alzheimer’s Disease & Activity, memory, orientation, cognition (wearable accelerometer, gyroscope) & Amyloid deposits (brain) (implantable biosensor, wearable EEG) \\ \hline Stroke & Gait, muscle tone, activity, impaired speech, memory (wearable EEG, accelerometer, gyroscope) & N/A \\ \hline Diabetes & Visual impairment, sensory disturbance (wearable accelerometer, gyroscope) & Blood glucose level (implantable biosensor) \\ \hline Rheumatoid Arthritis & Joint stiffness, reduced function, temperature (wearable accelerometer, gyroscope, thermistor) & Rheumatoid factor, inflammatory and auto-immune markers (implantable biosensor) \\ \hline Renal Failure & Urine output (implantable bladder pressure/volume sensor) & Urea, creatine, potassium (implantable biosensor) \\ \hline Vascular Disease (Peripheral Vascular and Aneuryss) & Peripheral perfusion, blood pressure, aneurysm sac pressure (wearable sensors) & Hemoglobin level (implantable biosensor) \\ \hline Infectious Diseases & Body temperature (wearable thermistor) & Inflammatory markers, white cell count, pathogen metabolites (implantable biosensor) \\ \hline Post-Operative Monitoring & Heart rate, blood pressure, ECG, oxygen saturation, temperature (wearable ECG sensor, thermistor and mechanoreceptor) & Hemoglobin, blood glucose, enzymes at the operative site (implantable biosensor) \\ \hline \hline \end{tabular}
\end{table}
Table 3: Parameters to be monitored for different medical conditions. Inspired from [7].