Tissue-like skin-device interface for wearable bioelectronics by using ultrasoft, mass-permeable, and low-impedance hydrogels

An Antidehydration Hydrogel Based on Zwitterionic Oligomers for Bioelectronic Interfacing

Hydrogels are ideal interfacing materials for on-skin healthcare devices, yet their susceptibility to dehydration hinders their practical use. While incorporating hygroscopic metal salts can prevent dehydration and maintain ionic conductivity, concerns arise regarding metal toxicity due to the passage of small ions through the skin barrier. Herein, an antidehydration hydrogel enabled by the incorporation of zwitterionic oligomers into its network is reported. This hydrogel exhibits exceptional water retention properties, maintaining ≈88% of its weight at 40% relative humidity, 25 °C for 50 days and about 84% after being heated at 50 °C for 3 h. Crucially, the molecular weight design of the embedded oligomers prevents their penetration into the epidermis, as evidenced by experimental and molecular simulation results. The hydrogel allows stable signal acquisition in electrophysiological monitoring of humans and plants under low-humidity conditions. This research provides a promising strategy for the development of epidermis-safe and biocompatible antidehydration hydrogel interfaces for on-skin devices.

Generating dual structurally and functionally skin-mimicking hydrogels by crosslinking cell-membrane compartments

The skin is intrinsically a cell-membrane-compartmentalized hydrogel with high mechanical strength, potent antimicrobial ability, and robust immunological competence, which provide multiple protective effects to the body. Methods capable of preparing hydrogels that can simultaneously mimic the structure and function of the skin are highly desirable but have been proven to be a challenge. Here, dual structurally and functionally skin-mimicking hydrogels are generated by crosslinking cell-membrane compartments. The crosslinked network is formed via free radical polymerization using olefinic double bond-functionalized extracellular vesicles as a crosslinker. Due to the dissipation of stretching energy mediated by vesicular deformation, the obtained compartment-crosslinked network shows enhanced mechanical strength compared to hydrogels crosslinked by regular divinyl monomers. Biomimetic hydrogels also exhibit specific antibacterial activity and adequate ability to promote the maturation and activation of dendritic cells given the existence of numerous extracellular vesicle-associated bioactive substances. In addition, the versatility of this approach to tune both the structure and function of the resulting hydrogels is demonstrated through introducing a second network by catalyst-free click reaction-mediated crosslinking between alkyne-double-ended polymers and azido-decorated extracellular vesicles. This study provides a platform to develop dual structure- and function-controllable skin-inspired biomaterials.

Artificial Octopus-Limb-Like Adhesive Patches for Cupping-Driven Transdermal Delivery with Nanoscale Control of Stratum Corneum

Drug delivery through complex skin is currently being studied using various innovative structural and material strategies due to the low delivery efficiency of the multilayered stratum corneum as a barrier function. Existing microneedle-based or electrical stimulation methods have made considerable advances, but they still have technical limitations to reduce skin discomfort and increase user convenience. This work introduces the design, operation mechanism, and performance of noninvasive transdermal patch with dual-layered suction chamber cluster (d-SCC) mimicking octopus-limb capable of wet adhesion with enhanced adhesion hysteresis and physical stimulation. The d-SCC facilitates cupping-driven drug delivery through the skin with only finger pressure. Our device enables nanoscale deformation control of stratum corneum of the engaged skin, allowing for efficient transport of diverse drugs through the stratum corneum without causing skin discomfort. Compared without the cupping effect of d-SCC, applying negative pressure to the porcine, human cadaver, and artificial skin for 30 min significantly improved the penetration depth of liquid-formulated subnanoscale medicines up to 44, 56, and 139%. After removing the cups, an additional acceleration in delivery to the skin was observed. The feasibility of d-SCC was demonstrated in an atopic dermatitis-induced model with thickened stratum corneum, contributing to the normalization of immune response.

A Generic Strategy to Create Mechanically Interlocked Nanocomposite/Hydrogel Hybrid Electrodes for Epidermal Electronics

Stretchable electronics are crucial enablers for next-generation wearables intimately integrated into the human body. As the primary compliant conductors used in these devices, metallic nanostructure/elastomer composites often struggle to form conformal contact with the textured skin. Hybrid electrodes have been consequently developed based on conductive nanocomposite and soft hydrogels to establish seamless skin-device interfaces. However, chemical modifications are typically needed for reliable bonding, which can alter their original properties. To overcome this limitation, this study presents a facile fabrication approach for mechanically interlocked nanocomposite/hydrogel hybrid electrodes. In this physical process, soft microfoams are thermally laminated on silver nanowire nanocomposites as a porous interface, which forms an interpenetrating network with the hydrogel. The microfoam-enabled bonding strategy is generally compatible with various polymers. The resulting interlocked hybrids have a 28-fold improved interfacial toughness compared to directly stacked hybrids. These electrodes achieve firm attachment to the skin and low contact impedance using tissue-adhesive hydrogels. They have been successfully integrated into an epidermal sleeve to distinguish hand gestures by sensing muscle contractions. Interlocked nanocomposite/hydrogel hybrids reported here offer a promising platform to combine the benefits of both materials for epidermal devices and systems.

A 10-micrometer-thick nanomesh-reinforced gas-permeable hydrogel skin sensor for long-term electrophysiological monitoring

Hydrogel-enabled skin bioelectronics that can continuously monitor health for extended periods is crucial for early disease detection and treatment. However, it is challenging to engineer ultrathin gas-permeable hydrogel sensors that can self-adhere to the human skin for long-term daily use (>1 week). Here, we present a ~10-micrometer-thick polyurethane nanomesh-reinforced gas-permeable hydrogel sensor that can self-adhere to the human skin for continuous and high-quality electrophysiological monitoring for 8 days under daily life conditions. This research involves two key steps: (i) material design by gelatin-based thermal-dependent phase change hydrogels and (ii) robust thinness geometry achieved through nanomesh reinforcement. The resulting ultrathin hydrogels exhibit a thickness of ~10 micrometers with superior mechanical robustness, high skin adhesion, gas permeability, and anti-drying performance. To highlight the potential applications in early disease detection and treatment that leverage the collective features, we demonstrate the use of ultrathin gas-permeable hydrogels for long-term, continuous high-precision electrophysiological monitoring under daily life conditions up to 8 days.

High-sensitivity flip chip blue Mini-LEDs miniaturized optical instrument for non-invasive glucose detection

The colorimetric detection of glucose typically involves a peroxidase reaction producing a color, which is then recorded and analyzed. However, enzyme detection has difficulties with purification and storage. In addition, replacing enzyme detection with chemical methods involves time-consuming steps such as centrifugation and purification and the optical instruments used for colorimetric detection are often bulky and not portable. In this study, ammonium metavanadate and sulfuric acid were used to prepare the detection solution instead of peroxidase to produce color. We also analyzed the effect of different concentrations of detection solution on absorbance sensitivity. Finally, a flip chip blue Mini-LEDs miniaturized optical instrument (FC blue Mini-LEDs MOI) was designed for glucose detection using optics fiber, collimating lenses, a miniaturized spectrometer, and an FC Blue Mini-LEDs with a center wavelength of 459 nm. While detecting glucose solutions in the concentration range of 0.1-10 mM by the developed MOI, the regression equation of y = 0.0941x + 0.1341, R2 of 0.9744, the limit of detection was 2.15 mM, and the limit of quantification was 7.163 mM. Furthermore, the preparation of the detection solution only takes 10 min, and the absorbance sensitivity of the optimized detection solution could be increased by 2.3 times. The detection solution remained stable with only a 0.6% decrease in absorbance compared to the original after storing it in a refrigerated environment at 3 °C for 14 days. The method proposed in this study for detecting glucose using FC blue light Mini-LEDs MOI reduces the use of peroxidase. In addition, it has a wide detection range that includes blood as well as non-invasive saliva and tear fluids, providing patients with a miniaturized, highly sensitive, and quantifiable glucose detection system.

Bioinspired nanoplatforms for human-machine interfaces: Recent progress in materials and device applications

The panoramic characteristics of human-machine interfaces (HMIs) have prompted the needs to update the biotechnology community with the recent trends, developments, and future research direction toward next-generation bioelectronics. Bioinspired materials are promising for integrating various bioelectronic devices to realize HMIs. With the advancement of scientific biotechnology, state-of-the-art bioelectronic applications have been extensively investigated to improve the quality of life by developing and integrating bioinspired nanoplatforms in HMIs. This review highlights recent trends and developments in the field of biotechnology based on bioinspired nanoplatforms by demonstrating recently explored materials and cutting-edge device applications. Section 1 introduces the recent trends and developments of bioinspired nanomaterials for HMIs. Section 2 reviews various flexible, wearable, biocompatible, and biodegradable nanoplatforms for bioinspired applications. Section 3 furnishes recently explored substrates as carriers for advanced nanomaterials in developing HMIs. Section 4 addresses recently invented biomimetic neuroelectronic, nanointerfaces, biointerfaces, and nano/microfluidic wearable bioelectronic devices for various HMI applications, such as healthcare, biopotential monitoring, and body fluid monitoring. Section 5 outlines designing and engineering of bioinspired sensors for HMIs. Finally, the challenges and opportunities for next-generation bioinspired nanoplatforms in extending the potential on HMIs are discussed for a near-future scenario. We believe this review can stimulate the integration of bioinspired nanoplatforms into the HMIs in addition to wearable electronic skin and health-monitoring devices while addressing prevailing and future healthcare and material-related problems in biotechnologies.

Skin-inspired, sensory robots for electronic implants

Living organisms with motor and sensor units integrated seamlessly demonstrate effective adaptation to dynamically changing environments. Drawing inspiration from cohesive integration of skeletal muscles and sensory skins in these organisms, we present a design strategy of soft robots, primarily consisting of an electronic skin (e-skin) and an artificial muscle, that naturally couples multifunctional sensing and on-demand actuation in a biocompatible platform. We introduce an in situ solution-based method to create an e-skin layer with diverse sensing materials (e.g., silver nanowires, reduced graphene oxide, MXene, and conductive polymers) incorporated within a polymer matrix (e.g., polyimide), imitating complex skin receptors to perceive various stimuli. Biomimicry designs (e.g., starfish and chiral seedpods) of the robots enable various motions (e.g., bending, expanding, and twisting) on demand and realize good fixation and stress-free contact with tissues. Furthermore, integration of a battery-free wireless module into these robots enables operation and communication without tethering, thus enhancing the safety and biocompatibility as minimally invasive implants. Demonstrations range from a robotic cuff encircling a blood vessel for detecting blood pressure, to a robotic gripper holding onto a bladder for tracking bladder volume, an ingestible robot residing inside stomach for pH sensing and on-site drug delivery, and a robotic patch wrapping onto a beating heart for quantifying cardiac contractility, temperature and applying cardiac pacing, highlighting the application versatilities and potentials of the nature-inspired soft robots. Our designs establish a universal strategy with a broad range of sensing and responsive materials, to form integrated soft robots for medical technology and beyond.

Soft and Conductive Polyethylene Glycol Hydrogel Electrodes for Electrocardiogram Monitoring

The measurement of biosignals in the clinical and healthcare fields is fundamental; however, conventional electrodes pose challenges such as incomplete skin contact and skin-related issues, hindering accurate biosignal measurement. To address these challenges, conductive hydrogels, which are valuable owing to their biocompatibility and flexibility, have been widely developed and explored for electrode applications. In this study, we fabricated a conductive hydrogel by mixing polyethylene glycol diacrylate (PEGDA) with poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) polymers dissolved in deionized water, followed by light-triggered crosslinking. Notably, this study pioneered the use of a PEGDA-PEDOT:PSS hydrogel for electrocardiogram (ECG) monitoring- a type of biosignal. The resulting PEGDA-PEDOT:PSS hydrogel demonstrated remarkable conductivity while closely approximating the modulus of skin elasticity. Additionally, it demonstrated biocompatibility and a high signal-to-noise ratio in the waveforms. This study confirmed the exceptional suitability of the PEGDA-PEDOT:PSS hydrogel for accurate biosignal measurements with potential applications in various wearable devices designed for biosignal monitoring.

Wet-Adaptive Electronic Skin

Skin electronics provides remarkable opportunities for non-invasive and long-term monitoring of a wide variety of biophysical and physiological signals that are closely related to health, medicine, and human-machine interactions. Nevertheless, conventional skin electronics fabricated on elastic thin films are difficult to adapt to the wet microenvironments of the skin: Elastic thin films are non-permeable, which block the skin perspiration; Elastic thin films are difficult to adhere to wet skin; Most skin electronics are difficult to work underwater. Here, a Wet-Adaptive Electronic Skin (WADE-skin) is reported, which consists of a next-to-skin wet-adhesive fibrous layer, a next-to-air waterproof fibrous layer, and a stretchable and permeable liquid metal electrode layer. While the electronic functionality is determined by the electrode design, this WADE-skin simultaneously offers superb stretchability, wet adhesion, permeability, biocompatibility, and waterproof property. The WADE-skin can rapidly adhere to human skin after contact for a few seconds and stably maintain the adhesion over weeks even under wet conditions, without showing any negative effect to the skin health. The use of WADE-skin is demonstrated for the stable recording of electrocardiogram during intensive sweating as well as underwater activities, and as the strain sensor for the underwater operation of virtual reality-mediated human-machine interactions.

A fully integrated, standalone stretchable device platform with in-sensor adaptive machine learning for rehabilitation

Post-surgical treatments of the human throat often require continuous monitoring of diverse vital and muscle activities. However, wireless, continuous monitoring and analysis of these activities directly from the throat skin have not been developed. Here, we report the design and validation of a fully integrated standalone stretchable device platform that provides wireless measurements and machine learning-based analysis of diverse vibrations and muscle electrical activities from the throat. We demonstrate that the modified composite hydrogel with low contact impedance and reduced adhesion provides high-quality long-term monitoring of local muscle electrical signals. We show that the integrated triaxial broad-band accelerometer also measures large body movements and subtle physiological activities/vibrations. We find that the combined data processed by a 2D-like sequential feature extractor with fully connected neurons facilitates the classification of various motion/speech features at a high accuracy of over 90%, which adapts to the data with noise from motion artifacts or the data from new human subjects. The resulting standalone stretchable device with wireless monitoring and machine learning-based processing capabilities paves the way to design and apply wearable skin-interfaced systems for the remote monitoring and treatment evaluation of various diseases.

pH biosensors based on hydrogel optical fiber

This paper presents a hydrogel optical fiber fluorescence pH sensor doped with 5(6)-carboxyfluorescein (5(6)-FAM). The hydrogel optical fiber was fabricated with 2-hydroxy-2-methylpropiophenone as a photoinitiator, with different concentrations of polyethylene glycol diacrylate (PEGDA) for the core and cladding. A pH-sensitive fluorescence indicator 5(6)-FAM was doped into the core of the fiber. The prepared hydrogel optical fiber pH sensor showed good response within the pH range of 5.0-9.0. The linear range of the pH sensor is 6.0 to 8.0, with R 2=0.9904; within this range, the sensor shows good repeatability and reversibility, and the resolution is 0.07 pH units. The pHs of pork tissues soaked in different pH buffers were detected by the hydrogel optical fiber pH sensor; the linearity is 0.9828 when the pork tissue pH is in the range of 6.0-7.5. Due to the good ion permeability and biocompatibility of the hydrogel, this hydrogel optical fiber pH sensor is expected to be used in biomedical applications.

Injectable tissue prosthesis for instantaneous closed-loop rehabilitation

To construct tissue-like prosthetic materials, soft electroactive hydrogels are the best candidate owing to their physiological mechanical modulus, low electrical resistance and bidirectional stimulating and recording capability of electrophysiological signals from biological tissues1,2. Nevertheless, until now, bioelectronic devices for such prostheses have been patch type, which cannot be applied onto rough, narrow or deep tissue surfaces3-5. Here we present an injectable tissue prosthesis with instantaneous bidirectional electrical conduction in the neuromuscular system. The soft and injectable prosthesis is composed of a biocompatible hydrogel with unique phenylborate-mediated multiple crosslinking, such as irreversible yet freely rearrangeable biphenyl bonds and reversible coordinate bonds with conductive gold nanoparticles formed in situ by cross-coupling. Closed-loop robot-assisted rehabilitation by injecting this prosthetic material is successfully demonstrated in the early stage of severe muscle injury in rats, and accelerated tissue repair is achieved in the later stage.

Wireless and Closed-Loop Smart Dressing for Exudate Management and On-Demand Treatment of Chronic Wounds

Chronic wounds have become a significant threat to people's physical and mental health and have increased the burden of social medical care. Intelligent wound dressing (IWD) with wound condition monitoring and closed-loop on-demand drug therapy can shorten the healing process and alleviate patient suffering. However, single-function wound dressings cannot meet the current needs of chronic wound treatment. Here, a wearable IWD consisting of wound exudate management, sensor monitoring, closed-loop therapy, and flexible circuit modules is reported, which can achieve effective synergy between wound exudate management and on-demand wound therapy. The dressing is attached to the wound site, and the wound exudate is spontaneously pumped into the microfluidic channel for storage. Meanwhile, the IWD can detect the state of the wound through the temperature and humidity sensor, and use this as feedback to control the liquid metal (LM) heater through a smartphone, thereby realizing the on-demand drug release from the hydrogel. In a mouse model of infected wounds, IWD accelerates wound healing by reducing inflammatory responses, promoting angiogenesis and collagen deposition.

Metaverse Wearables for Immersive Digital Healthcare: A Review

The recent exponential growth of metaverse technology has been instrumental in reshaping a myriad of sectors, not least digital healthcare. This comprehensive review critically examines the landscape and future applications of metaverse wearables toward immersive digital healthcare. The key technologies and advancements that have spearheaded the metamorphosis of metaverse wearables are categorized, encapsulating all-encompassed extended reality, such as virtual reality, augmented reality, mixed reality, and other haptic feedback systems. Moreover, the fundamentals of their deployment in assistive healthcare (especially for rehabilitation), medical and nursing education, and remote patient management and treatment are investigated. The potential benefits of integrating metaverse wearables into healthcare paradigms are multifold, encompassing improved patient prognosis, enhanced accessibility to high-quality care, and high standards of practitioner instruction. Nevertheless, these technologies are not without their inherent challenges and untapped opportunities, which span privacy protection, data safeguarding, and innovation in artificial intelligence. In summary, future research trajectories and potential advancements to circumvent these hurdles are also discussed, further augmenting the incorporation of metaverse wearables within healthcare infrastructures in the post-pandemic era.

Soft Bioelectronics for Therapeutics

Soft bioelectronics play an increasingly crucial role in high-precision therapeutics due to their softness, biocompatibility, clinical accuracy, long-term stability, and patient-friendliness. In this review, we provide a comprehensive overview of the latest representative therapeutic applications of advanced soft bioelectronics, ranging from wearable therapeutics for skin wounds, diabetes, ophthalmic diseases, muscle disorders, and other diseases to implantable therapeutics against complex diseases, such as cardiac arrhythmias, cancer, neurological diseases, and others. We also highlight key challenges and opportunities for future clinical translation and commercialization of soft therapeutic bioelectronics toward personalized medicine.

Flexible electronics for cardiovascular healthcare monitoring

Cardiovascular diseases (CVDs) are one of the most urgent threats to humans worldwide, which are responsible for almost one-third of global mortality. Over the last decade, research on flexible electronics for monitoring and treatment of CVDs has attracted tremendous attention. In contrast to conventional medical instruments in hospitals that are usually bulky, hard to move, monofunctional, and time-consuming, flexible electronics are capable of continuous, noninvasive, real-time, and portable monitoring. Notable progress has been made in this emerging field, and thus a number of significant achievements and concomitant research prospects deserve attention for practical implementation. Here, we comprehensively review the latest progress of flexible electronics for CVDs, focusing on new functions provided by flexible electronics. First, the characteristics of CVDs and flexible electronics and the foundation of their combination are briefly reviewed. Then, four representative applications of flexible electronics for CVDs are elaborated: blood pressure (BP) monitoring, electrocardiogram (ECG) monitoring, echocardiogram monitoring, and direct epicardium monitoring. Their operational principles, progress, merits and demerits, and future efforts are discussed. Finally, the remaining challenges and opportunities for flexible electronics for cardiovascular healthcare are outlined.

Wearable Temperature Sensors Based on Reduced Graphene Oxide Films

With the development of medical technology and increasing demands of healthcare monitoring, wearable temperature sensors have gained widespread attention because of their portability, flexibility, and capability of conducting real-time and continuous signal detection. To achieve excellent thermal sensitivity, high linearity, and a fast response time, the materials of sensors should be chosen carefully. Thus, reduced graphene oxide (rGO) has become one of the most popular materials for temperature sensors due to its exceptional thermal conductivity and sensitive resistance changes in response to different temperatures. Moreover, by using the corresponding preparation methods, rGO can be easily combined with various substrates, which has led to it being extensively applied in the wearable field. This paper reviews the state-of-the-art advances in wearable temperature sensors based on rGO films and summarizes their sensing mechanisms, structure designs, functional material additions, manufacturing processes, and performances. Finally, the possible challenges and prospects of rGO-based wearable temperature sensors are briefly discussed.

Transparent Electronics for Wearable Electronics Application

Recent advancements in wearable electronics offer seamless integration with the human body for extracting various biophysical and biochemical information for real-time health monitoring, clinical diagnostics, and augmented reality. Enormous efforts have been dedicated to imparting stretchability/flexibility and softness to electronic devices through materials science and structural modifications that enable stable and comfortable integration of these devices with the curvilinear and soft human body. However, the optical properties of these devices are still in the early stages of consideration. By incorporating transparency, visual information from interfacing biological systems can be preserved and utilized for comprehensive clinical diagnosis with image analysis techniques. Additionally, transparency provides optical imperceptibility, alleviating reluctance to wear the device on exposed skin. This review discusses the recent advancement of transparent wearable electronics in a comprehensive way that includes materials, processing, devices, and applications. Materials for transparent wearable electronics are discussed regarding their characteristics, synthesis, and engineering strategies for property enhancements. We also examine bridging techniques for stable integration with the soft human body. Building blocks for wearable electronic systems, including sensors, energy devices, actuators, and displays, are discussed with their mechanisms and performances. Lastly, we summarize the potential applications and conclude with the remaining challenges and prospects.

Deep-Learning Enabled Active Biomimetic Multifunctional Hydrogel Electronic Skin

There is huge demand for recreating human skin with the functions of epidermis and dermis for interactions with the physical world. Herein, a biomimetic, ultrasensitive, and multifunctional hydrogel-based electronic skin (BHES) was proposed. Its epidermis function was mimicked using poly(ethylene terephthalate) with nanoscale wrinkles, enabling accurate identification of materials through the capabilities to gain/lose electrons during contact electrification. Internal mechanoreceptor was mimicked by interdigital silver electrodes with stick-slip sensing capabilities to identify textures/roughness. The dermis function was mimicked by patterned microcone hydrogel, achieving pressure sensors with high sensitivity (17.32 mV/Pa), large pressure range (20-5000 Pa), low detection limit, and fast response (10 ms)/recovery time (17 ms). Assisted by deep learning, this BHES achieved high accuracy and minimized interference in identifying materials (95.00% for 10 materials) and textures (97.20% for four roughness cases). By integrating signal acquisition/processing circuits, a wearable drone control system was demonstrated with three-degree-of-freedom movement and enormous potentials for soft robots, self-powered human-machine interaction interfaces of digital twins.

Achieving tissue-level softness on stretchable electronics through a generalizable soft interlayer design

Soft and stretchable electronics have emerged as highly promising tools for biomedical diagnosis and biological studies, as they interface intimately with the human body and other biological systems. Most stretchable electronic materials and devices, however, still have Young's moduli orders of magnitude higher than soft bio-tissues, which limit their conformability and long-term biocompatibility. Here, we present a design strategy of soft interlayer for allowing the use of existing stretchable materials of relatively high moduli to versatilely realize stretchable devices with ultralow tissue-level moduli. We have demonstrated stretchable transistor arrays and active-matrix circuits with moduli below 10 kPa-over two orders of magnitude lower than the current state of the art. Benefiting from the increased conformability to irregular and dynamic surfaces, the ultrasoft device created with the soft interlayer design realizes electrophysiological recording on an isolated heart with high adaptability, spatial stability, and minimal influence on ventricle pressure. In vivo biocompatibility tests also demonstrate the benefit of suppressing foreign-body responses for long-term implantation. With its general applicability to diverse materials and devices, this soft-interlayer design overcomes the material-level limitation for imparting tissue-level softness to a variety of bioelectronic devices.

Biomimetic Flexible Sensors and Their Applications in Human Health Detection

Bionic flexible sensors are a new type of biosensor with high sensitivity, selectivity, stability, and reliability to achieve detection in complex natural and physiological environments. They provide efficient, energy-saving and convenient applications in medical monitoring and diagnosis, environmental monitoring, and detection and identification. Combining sensor devices with flexible substrates to imitate flexible structures in living organisms, thus enabling the detection of various physiological signals, has become a hot topic of interest. In the field of human health detection, the application of bionic flexible sensors is flourishing and will evolve into patient-centric diagnosis and treatment in the future of healthcare. In this review, we provide an up-to-date overview of bionic flexible devices for human health detection applications and a comprehensive summary of the research progress and potential of flexible sensors. First, we evaluate the working mechanisms of different classes of bionic flexible sensors, describing the selection and fabrication of bionic flexible materials and their excellent electrochemical properties; then, we introduce some interesting applications for monitoring physical, electrophysiological, chemical, and biological signals according to more segmented health fields (e.g., medical diagnosis, rehabilitation assistance, and sports monitoring). We conclude with a summary of the advantages of current results and the challenges and possible future developments.

Microfluidic-Based Continuous Fabrication of Ultrathin Hydrogel Films with Controllable Thickness

Ultrathin hydrogel films composed of cross-linked polymer networks swollen by water, with soft and moisturized features similar to biological tissue, play a vital role in flexible biosensors and wearable electronics. However, achieving efficient and continuous fabrication of such films remains a challenge. Here, we present a microfluidic-based strategy for the continuous fabrication of free-standing ultrathin hydrogel films by using laminar flow, which can be precisely controlled in the micrometer scale. Compared with conventional methods, the microfluidic-based method shows advantages in producing hydrogel films with a high homogeneity as well as maintaining the structural integrity, without the need of supporting substrates and sophisticated equipment. This strategy allows the precise control over the thickness of the hydrogel films ranging from 15 ± 0.2 to 39 ± 0.5 μm, by adjusting the height of the microfluidic channels, with predictable opportunities for scaling up. Therefore, our strategy provides a facile route to produce advanced thin polymer films in a universal, steerable, and scalable manner and will promote the applications of thin polymer films in biosensors and wearable electronics.

Poisson-Nernst-Planck framework for modelling ionic strain and temperature sensors

Ionically conductive hydrogels are gaining traction as sensing and structural materials for use bioelectronic devices. Hydrogels that feature large mechanical compliances and tractable ionic conductivities are compelling materials that can sense physiological states and potentially modulate the stimulation of excitable tissue because of the congruence in electro-mechanical properties across the tissue-material interface. However, interfacing ionic hydrogels with conventional DC voltage-based circuits poses several technical challenges including electrode delamination, electrochemical reaction, and drifting contact impedance. Utilizing alternating voltages to probe ion-relaxation dynamics has been shown to be a viable alternative for strain and temperature sensing. In this work, we present a Poisson-Nernst-Planck theoretical framework to model ion transport under alternating fields within conductors subject to varying strains and temperatures. Using simulated impedance spectra, we develop key insights about the relationship between frequency of the applied voltage perturbation and sensitivity. Lastly, we perform preliminary experimental characterization to demonstrate the applicability of the proposed theory. We believe this work provides a useful perspective that is applicable to the design of a variety of ionic hydrogel-based sensors for biomedical and soft robotic applications.

Hydrogel fibers for wearable sensors and soft actuators

Owing to superior softness, wetness, responsiveness, and biocompatibility, bulk hydrogels are being intensively investigated for versatile functions in devices and machines including sensors, actuators, optics, and coatings. The one-dimensional (1D) hydrogel fibers possess the metrics from both the hydrogel materials and structural topology, endowing them with extraordinary mechanical, sensing, breathable and weavable properties. As no comprehensive review has been reported for this nascent field, this article aims to provide an overview of hydrogel fibers for soft electronics and actuators. We first introduce the basic properties and measurement methods of hydrogel fibers, including mechanical, electrical, adhesive, and biocompatible properties. Then, typical manufacturing methods for 1D hydrogel fibers and fibrous films are discussed. Next, the recent progress of wearable sensors (e.g., strain, temperature, pH, and humidity) and actuators made from hydrogel fibers is discussed. We conclude with future perspectives on next-generation hydrogel fibers and the remaining challenges. The development of hydrogel fibers will not only provide an unparalleled one-dimensional characteristic, but also translate fundamental understanding of hydrogels into new application boundaries.

Wearable patches for transdermal drug delivery

Transdermal drug delivery systems (TDDs) avoid gastrointestinal degradation and hepatic first-pass metabolism, providing good drug bioavailability and patient compliance. One emerging type of TDDs is the wearable patch worn on the skin surface to deliver medication through the skin. They can generally be grouped into passive and active types, depending on the properties of materials, design principles and integrated devices. This review describes the latest advancement in the development of wearable patches, focusing on the integration of stimulus-responsive materials and electronics. This development is deemed to provide a dosage, temporal, and spatial control of therapeutics delivery.

Functionalized Hydrogel-Based Wearable Gas and Humidity Sensors

Breathing is an inherent human activity; however, the composition of the air we inhale and gas exhale remains unknown to us. To address this, wearable vapor sensors can help people monitor air composition in real time to avoid underlying risks, and for the early detection and treatment of diseases for home healthcare. Hydrogels with three-dimensional polymer networks and large amounts of water molecules are naturally flexible and stretchable. Functionalized hydrogels are intrinsically conductive, self-healing, self-adhesive, biocompatible, and room-temperature sensitive. Compared with traditional rigid vapor sensors, hydrogel-based gas and humidity sensors can directly fit human skin or clothing, and are more suitable for real-time monitoring of personal health and safety. In this review, current studies on hydrogel-based vapor sensors are investigated. The required properties and optimization methods of wearable hydrogel-based sensors are introduced. Subsequently, existing reports on the response mechanisms of hydrogel-based gas and humidity sensors are summarized. Related works on hydrogel-based vapor sensors for their application in personal health and safety monitoring are presented. Moreover, the potential of hydrogels in the field of vapor sensing is elucidated. Finally, the current research status, challenges, and future trends of hydrogel gas/humidity sensing are discussed.

Stimuli-bioresponsive hydrogels as new generation materials for implantable, wearable, and disposable biosensors for medical diagnostics: Principles, opportunities, and challenges

Hydrogels are excellent water-swollen polymeric materials for use in wearable, implantable, and disposable biosensors. Hydrogels have unique properties such as low cost, ease of preparation, transparency, rapid response to external conditions, biocompatibility and self-adhesion to the skin, flexibility, and strain sensitivity, making them ideal for use in biosensor platforms. This review provides a detailed overview of advanced applications of stimuli-responsive hydrogels in biosensor platforms, from hydrogel synthesis and functionalization for bioreceptor immobilization to several important diagnostic applications. Emphasis is placed on recent advances in the fabrication of ultrasensitive fluorescent and electrically conductive hydrogels and their applications in wearable, implantable, and disposable biosensors for quantitative measurements. Design, modification, and assembly techniques of fluorescent, ionically conductive, and electrically conductive hydrogels to improve performance will be addressed. The advantages and performance improvements of immobilizing bioreceptors (e.g., antibodies, enzymes, and aptamers), and incorporating fluorescent and electrically conductive nanomaterials are described, as are their limitations. Potential applications of hydrogels in implantable, wearable, disposable portable biosensors for quantitative detection of the various bioanalytes (ions, molecules, drugs, proteins, and biomarkers) are discussed. Finally, the global market for hydrogel-based biosensors and future challenges and prospects are discussed in detail.

Evolution of nanostructured skin patches towards multifunctional wearable platforms for biomedical applications

Recent advances in the field of skin patches have promoted the development of wearable and implantable bioelectronics for long-term, continuous healthcare management and targeted therapy. However, the design of electronic skin (e-skin) patches with stretchable components is still challenging and requires an in-depth understanding of the skin-attachable substrate layer, functional biomaterials and advanced self-powered electronics. In this comprehensive review, we present the evolution of skin patches from functional nanostructured materials to multi-functional and stimuli-responsive patches towards flexible substrates and emerging biomaterials for e-skin patches, including the material selection, structure design and promising applications. Stretchable sensors and self-powered e-skin patches are also discussed, ranging from electrical stimulation for clinical procedures to continuous health monitoring and integrated systems for comprehensive healthcare management. Moreover, an integrated energy harvester with bioelectronics enables the fabrication of self-powered electronic skin patches, which can effectively solve the energy supply and overcome the drawbacks induced by bulky battery-driven devices. However, to realize the full potential offered by these advancements, several challenges must be addressed for next-generation e-skin patches. Finally, future opportunities and positive outlooks are presented on the future directions of bioelectronics. It is believed that innovative material design, structure engineering, and in-depth study of fundamental principles can foster the rapid evolution of electronic skin patches, and eventually enable self-powered close-looped bioelectronic systems to benefit mankind.

Highly conductive tissue-like hydrogel interface through template-directed assembly

Over the past decade, conductive hydrogels have received great attention as tissue-interfacing electrodes due to their soft and tissue-like mechanical properties. However, a trade-off between robust tissue-like mechanical properties and good electrical properties has prevented the fabrication of a tough, highly conductive hydrogel and limited its use in bioelectronics. Here, we report a synthetic method for the realization of highly conductive and mechanically tough hydrogels with tissue-like modulus. We employed a template-directed assembly method, enabling the arrangement of a disorder-free, highly-conductive nanofibrous conductive network inside a highly stretchable, hydrated network. The resultant hydrogel exhibits ideal electrical and mechanical properties as a tissue-interfacing material. Furthermore, it can provide tough adhesion (800 J/m²) with diverse dynamic wet tissue after chemical activation. This hydrogel enables suture-free and adhesive-free, high-performance hydrogel bioelectronics. We successfully demonstrated ultra-low voltage neuromodulation and high-quality epicardial electrocardiogram (ECG) signal recording based on in vivo animal models. This template-directed assembly method provides a platform for hydrogel interfaces for various bioelectronic applications.

Innovative Strategies for Hair Regrowth and Skin Visualization

Today, about 50% of men and 15-30% of women are estimated to face hair-related problems, which create a significant psychological burden. Conventional treatments, including drug therapy and transplantation, remain the main strategies for the clinical management of these problems. However, these treatments are hindered by challenges such as drug-induced adverse effects and poor drug penetration due to the skin's barrier. Therefore, various efforts have been undertaken to enhance drug permeation based on the mechanisms of hair regrowth. Notably, understanding the delivery and diffusion of topically administered drugs is essential in hair loss research. This review focuses on the advancement of transdermal strategies for hair regrowth, particularly those involving external stimulation and regeneration (topical administration) as well as microneedles (transdermal delivery). Furthermore, it also describes the natural products that have become alternative agents to prevent hair loss. In addition, given that skin visualization is necessary for hair regrowth as it provides information on drug localization within the skin's structure, this review also discusses skin visualization strategies. Finally, it details the relevant patents and clinical trials in these areas. Together, this review highlights the innovative strategies for skin visualization and hair regrowth, aiming to provide novel ideas to researchers studying hair regrowth in the future.

A fabric-based wearable sensor for continuous monitoring of decubitus ulcer of subjects lying on a bed

For multifunctional wearable sensing systems, problems related to wireless and continuous communication and soft, noninvasive, and disposable functionality issues should be solved for precise physiological signal detection. To measure the critical transitions of pressure, temperature, and skin impedance when continuous pressure is applied on skin and tissue, we developed a sensor for decubitus ulcers using conventional analog circuitry for wireless and continuous communication in a disposable, breathable fabric-based multifunctional sensing system capable of conformal contact. By integrating the designed wireless communication module into a multifunctional sensor, we obtained sensing data that were sent sequentially and continuously to a customized mobile phone app. With a small-sized and lightweight module, our sensing system operated over 24 h with a coin-cell battery consuming minimum energy for intermittent sensing and transmission. We conducted a pilot test on healthy subjects to evaluate the adequate wireless operation of the multifunctional sensing system when applied to the body. By solving the aforementioned practical problems, including those related to wireless and continuous communication and soft, noninvasive, and disposable functionality issues, our fabric-based multifunctional decubitus ulcer sensor successfully measured applied pressure, skin temperature, and electrical skin impedance.

Wearable Smart Bandage-Based Bio-Sensors

Bandage is a well-established industry, whereas wearable electronics is an emerging industry. This review presents the bandage as the base of wearable bioelectronics. It begins with introducing a detailed background to bandages and the development of bandage-based smart sensors, which is followed by a sequential discussion of the technical characteristics of the existing bandages, a more practical methodology for future applications, and manufacturing processes of bandage-based wearable biosensors. The review then elaborates on the advantages of basing the next generation of wearables, such as acceptance by the customers and system approvals, and disposal.

Opportunities of Electronic and Optical Sensors in Autonomous Medical Plasma Technologies

Low temperature plasma technology is proving to be at the frontier of emerging medical technologies with real potential to overcome escalating healthcare challenges including antimicrobial and anticancer resistance. However, significant improvements in efficacy, safety, and reproducibility of plasma treatments need to be addressed to realize the full clinical potential of the technology. To improve plasma treatments recent research has focused on integrating automated feedback control systems into medical plasma technologies to maintain optimal performance and safety. However, more advanced diagnostic systems are still needed to provide data into feedback control systems with sufficient levels of sensitivity, accuracy, and reproducibility. These diagnostic systems need to be compatible with the biological target and to also not perturb the plasma treatment. This paper reviews the state-of-the-art electronic and optical sensors that might be suitable to address this unmet technological need, and the steps needed to integrate these sensors into autonomous plasma systems. Realizing this technological gap could facilitate the development of next-generation medical plasma technologies with strong potential to yield superior healthcare outcomes.

Sequentially Coated Wavy Nanowire Composite Transparent Electrode for Stretchable Solar Cells

Recent advances in fabricating stretchable and transparent electrodes have led to various techniques for establishing next-generation form-factor optoelectronic devices. Wavy Ag nanowire networks with large curvature radii are promising platforms as stretchable and transparent electrodes due to their high electrical conductivity and stretchability even at very high transparency. However, there are disadvantages such as intrinsic nonregular conductivity, large surface roughness, and nanowire oxidation in air. Here, we introduce electrically synergistic but mechanically independent composite electrodes by sequentially introducing conducting polymers and ionic liquids into the wavy Ag nanowire network to maintain the superior performance of the stretchable transparent electrode while ensuring overall conductivity, lower roughness, and long-term stability. In particular, plenty of ionic liquids can be incorporated into the uniformly coated conducting polymer so that the elastic modulus can be significantly lowered and sliding can occur at the nanowire interface, thereby obtaining the high mechanical stretchability of the composite electrode. Finally, as a result of applying the composite film as the stretchable transparent electrode of stretchable organic solar cells, the organic solar cell exhibits a high power conversion efficiency of 11.3% and 89% compared to the initial efficiency even at 20% tensile strain, demonstrating excellent stretching stability.

"Water-in-Deep Eutectic Solvent" Gel Electrolytes Synergistically Controlled by Solvation Regulation and Gelation Strategies for Flexible Electronic Devices

Recent developments in flexible electronics have heightened the need for electrolytes with high safety, ionic conductivity, and electrochemical stability. However, neither conventional organic electrolytes nor aqueous electrolytes can meet the above requirements simultaneously. Herein, a novel "water-in-deep eutectic solvent" gel (WIDG) electrolyte synergistically controlled by the solvation regulation and gelation strategies is reported. The water molecules introduced into deep eutectic solvent (DES) participate in the solvation structure regulation of Li⁺, thus endowing the WIDG electrolyte with high safety, thermal stability, and outstanding electrochemical performance, including high ionic conductivity (∼1.23 mS cm^-1) and a wide electrochemical window (∼5.4 V). Besides, the polymer in the gel interacts with DES and H₂O, further optimizing the electrolyte with excellent mechanical strength and higher operating voltage. Benefiting from these advantages, the lithium-ion capacitor constructed by WIDG electrolyte presents a high areal capacitance of 246 mF cm^-2 with an energy density of 87.3 μWh cm^-2. The use of the gel enhances the electrode structure stability, resulting in desirable cycling stability (>90% capacity retention after 1400 cycles). Moreover, the WIDG-assembled sensor exhibits high sensitivity and rapid real-time detection of motion. This work will provide guidelines for designing high-safety and high-operating-voltage electrolytes for flexible electronics.

Flexible Nanoarchitectonics for Biosensing and Physiological Monitoring Applications

Flexible and implantable electronics hold tremendous promises for advanced healthcare applications, especially for physiological neural recording and modulations. Key requirements in neural interfaces include miniature dimensions for spatial physiological mapping and low impedance for recognizing small biopotential signals. Herein, a bottom-up mesoporous formation technique and a top-down microlithography process are integrated to create flexible and low-impedance mesoporous gold (Au) electrodes for biosensing and bioimplant applications. The mesoporous architectures developed on a thin and soft polymeric substrate provide excellent mechanical flexibility and stable electrical characteristics capable of sustaining multiple bending cycles. The large surface areas formed within the mesoporous network allow for high current density transfer in standard electrolytes, highly suitable for biological sensing applications as demonstrated in glucose sensors with an excellent detection limit of 1.95 µm and high sensitivity of 6.1 mA cm^-2  µM^-1 , which is approximately six times higher than that of benchmarking flat/non-porous films. The low impedance of less than 1 kΩ at 1 kHz in the as-synthesized mesoporous electrodes, along with their mechanical flexibility and durability, offer peripheral nerve recording functionalities that are successfully demonstrated in vivo. These features highlight the new possibilities of our novel flexible nanoarchitectonics for neuronal recording and modulation applications.

Hydrogel Nanoarchitectonics of a Flexible and Self-Adhesive Electrode for Long-Term Wireless Electroencephalogram Recording and High-Accuracy Sustained Attention Evaluation

Hydrogels are ideal building blocks to fabricate the next generation of electrodes for acquiring high-quality physiological electrical signals, for example, electroencephalography (EEG). However, collection of EEG signals still suffers from electrode deformation, sweating, extensive body motion and vibration, and environmental interference. Herein, polyvinyl alcohol and polyvinylpyrrolidone are selected to prepare a hydrogel network with tissue-like modulus and excellent flexibility. Additionally, polydopamine nanoparticles, obtained by polydopamine peroxidation, are integrated into the hydrogel to endow them with higher transparency, higher self-adhesion, and lower impedance. Consequently, a multichannel and wirelessly operated hydrogel electrode can establish a conformal and stable interface with tissue and illustrate high channel uniformity, low interfacial contact impedance, low power noise, long-term stability, and a tolerance to sweat and motion. Furthermore, the hydrogel electrode shows the unprecedented ability to classify the recorded high-quality prefrontal EEG signals into seven-category sustained attention with high accuracy (91.5%), having great potential applications in the assessment of human consciousness and in multifunctional diagnoses.

Smart Contact Lens Systems for Ocular Drug Delivery and Therapy

Ocular drug delivery and therapy systems have been extensively investigated with various methods including direct injections, eye drops and contact lenses. Nowadays, smart contact lens systems are attracting a lot of attention for ocular drug delivery and therapy due to their minimally invasive or non-invasive characteristics, highly enhanced drug permeation, high bioavailability, and on-demand drug delivery. Furthermore, smart contact lens systems can be used for direct light delivery into the eyes for biophotonic therapy replacing the use of drugs. Here, we review smart contact lens systems which can be classified into two groups of drug-eluting contact lens and ocular device contact lens. More specifically, this review covers smart contact lens systems with nanocomposite-laden systems, polymeric film-incorporated systems, micro and nanostructure systems, iontophoretic systems, electrochemical systems, and phototherapy systems for ocular drug delivery and therapy. After that, we discuss the future opportunities, challenges and perspectives of smart contact lens systems for ocular drug delivery and therapy.

A Breathable, Passive-Cooling, Non-Inflammatory, and Biodegradable Aerogel Electronic Skin for Wearable Physical-Electrophysiological-Chemical Analysis

Real-time monitoring of human health can be significantly improved by designing novel electronic skin (E-skin) platforms that mimic the characteristics and sensitivity of human skin. A high-quality E-skin platform that can simultaneously monitor multiple physiological and metabolic biomarkers without introducing skin discomfort or irritation is an unmet medical need. Conventional E-skins are either monofunctional or made from elastomeric films that do not include key synergistic features of natural skin, such as multi-sensing, breathability, and thermal management capabilities in a single patch. Herein, a biocompatible and biodegradable E-skin patch based on flexible gelatin methacryloyl aerogel (FGA) for non-invasive and continuous monitoring of multiple biomarkers of interest is engineered and demonstrated. Taking advantage of cryogenic temperature treatment and slow polymerization, FGA is fabricated with a highly interconnected porous structure that displays good flexibility, passive-cooling capabilities, and ultra-lightweight properties that make it comfortable to wear for long periods of time. It also provides numerous permeable capillary channels for thermal-moisture transfer, ensuring its excellent breathability. Therefore, the engineered FGA-based E-skin can simultaneously monitor body temperature, hydration, and biopotentials via electrophysiological sensors and detect glucose, lactate, and alcohol levels via electrochemical sensors. This work offers a previously unexplored materials strategy for next-generation E-skin platforms with superior practicality.

Deep Eutectic Solvents-based Ionogels with Ultrafast Gelation and High Adhesion in Harsh Environments

Adhesive materials have recently drawn intensive attention due to their excellent sealing ability, thereby stimulating advances in materials science and industrial usage. However, reported adhesives usually exhibit weak adhesion strength, require high pressure for strong bonding, and display severe adhesion deterioration in various harsh environments. In this work, instead of water or organic solvents, a deep eutectic solution (DES) was used as the medium for photopolymerization of zwitterionic and polarized monomers, thus generating a novel ionogel with tunable mechanical properties. Multiple hydrogen bonds and electrostatic interactions between DES and monomers facilitated ultrafast gelation and instant bonding without any external pressure, which was rarely reported previously. Furthermore, high adhesion in different harsh environments (e.g., water, acidic and basic buffers, and saline solutions) and onto hydrophilic (e.g., glass and tissues) and hydrophobic (e.g., polymethyl methacrylate, polystyrene, and polypropylene) adherends was demonstrated. Also, high stretchability of the ionogel at extreme temperatures (-80 and 80 °C) indicated its widespread applications. Furthermore, the biocompatible ionogel showed high burst pressure onto stomach and intestine tissues to prevent liquid leakage, highlighting its potential as an adhesive patch. This ionogel provides unprecedented opportunities in the fields of packaging industry, marine engineering, medical adhesives, and electronic assembly.

Bioresorbable, wireless, and battery-free system for electrotherapy and impedance sensing at wound sites

Chronic wounds, particularly those associated with diabetes mellitus, represent a growing threat to public health, with additional notable economic impacts. Inflammation associated with these wounds leads to abnormalities in endogenous electrical signals that impede the migration of keratinocytes needed to support the healing process. This observation motivates the treatment of chronic wounds with electrical stimulation therapy, but practical engineering challenges, difficulties in removing stimulation hardware from the wound site, and absence of means to monitor the healing process create barriers to widespread clinical use. Here, we demonstrate a miniaturized wireless, battery-free bioresorbable electrotherapy system that overcomes these challenges. Studies based on a splinted diabetic mouse wound model confirm the efficacy for accelerated wound closure by guiding epithelial migration, modulating inflammation, and promoting vasculogenesis. Changes in the impedance provide means for tracking the healing process. The results demonstrate a simple and effective platform for wound site electrotherapy.

Conductive and Adhesive Granular Alginate Hydrogels for On-Tissue Writable Bioelectronics

Conductive hydrogels are promising materials in bioelectronics that ensure a tissue-like soft modulus and re-enact the electrophysiological function of damaged tissues. However, recent approaches to fabricating conductive hydrogels have proved difficult: fixing of the conductive hydrogels on the target tissues hydrogels requires the aids from other medical glues because of their weak tissue-adhesiveness. In this study, an intrinsically conductive and tissue-adhesive granular hydrogel consisting of a PEDOT:PSS conducting polymer and an adhesive catechol-conjugated alginate polymer was fabricated via an electrohydrodynamic spraying method. Because alginate-based polymers can be crosslinked by calcium ions, alginate-catechol polymers mixed with PEDOT:PSS granular hydrogels (ACP) were easily fabricated. The fabricated ACP exhibited not only adhesive and shear-thinning properties but also conductivity similar to that of muscle tissue. Additionally, the granular structure makes the hydrogel injectable through a syringe, enabling on-tissue printing. This multifunctional granular hydrogel can be applied to soft and flexible electronics to connect humans and machines.

Basic amino acid-mediated cationic amphiphilic surfaces for antimicrobial pH monitoring sensor with wound healing effects

BACKGROUND

The wound healing process is a complex cascade of physiological events, which are vulnerable to both our body status and external factors and whose impairment could lead to chronic wounds or wound healing impediments. Conventional wound healing materials are widely used in clinical management, however, they do not usually prevent wounds from being infected by bacteria or viruses. Therefore, simultaneous wound status monitoring and prevention of microbial infection are required to promote healing in clinical wound management.

METHODS

Basic amino acid-modified surfaces were fabricated in a water-based process via a peptide coupling reaction. Specimens were analyzed and characterized by X-ray photoelectron spectroscopy, Kelvin probe force microscopy, atomic force microscopy, contact angle, and molecular electrostatic potential via Gaussian 09. Antimicrobial and biofilm inhibition tests were conducted on Escherichia coli and Staphylococcus epidermidis. Biocompatibility was determined through cytotoxicity tests on human epithelial keratinocytes and human dermal fibroblasts. Wound healing efficacy was confirmed by mouse wound healing and cell staining tests. Workability of the pH sensor on basic amino acid-modified surfaces was evaluated on normal human skin and Staphylococcus epidermidis suspension, and in vivo conditions.

RESULTS

Basic amino acids (lysine and arginine) have pH-dependent zwitterionic functional groups. The basic amino acid-modified surfaces had antifouling and antimicrobial properties similar to those of cationic antimicrobial peptides because zwitterionic functional groups have intrinsic cationic amphiphilic characteristics. Compared with untreated polyimide and modified anionic acid (leucine), basic amino acid-modified polyimide surfaces displayed excellent bactericidal, antifouling (reduction ~ 99.6%) and biofilm inhibition performance. The basic amino acid-modified polyimide surfaces also exhibited wound healing efficacy and excellent biocompatibility, confirmed by cytotoxicity and ICR mouse wound healing tests. The basic amino acid-modified surface-based pH monitoring sensor was workable (sensitivity 20 mV pH-1) under various pH and bacterial contamination conditions.

CONCLUSION

Here, we developed a biocompatible and pH-monitorable wound healing dressing with antimicrobial activity via basic amino acid-mediated surface modification, creating cationic amphiphilic surfaces. Basic amino acid-modified polyimide is promising for monitoring wounds, protecting them from microbial infection, and promoting their healing. Our findings are expected to contribute to wound management and could be expanded to various wearable healthcare devices for clinical, biomedical, and healthcare applications.

Nanomaterial-based biohybrid hydrogel in bioelectronics

Despite the broadly applicable potential in the bioelectronics, organic/inorganic material-based bioelectronics have some limitations such as hard stiffness and low biocompatibility. To overcome these limitations, hydrogels capable of bridging the interface and connecting biological materials and electronics have been investigated for development of hydrogel bioelectronics. Although hydrogel bioelectronics have shown unique properties including flexibility and biocompatibility, there are still limitations in developing novel hydrogel bioelectronics using only hydrogels such as their low electrical conductivity and structural stability. As an alternative solution to address these issues, studies on the development of biohybrid hydrogels that incorporating nanomaterials into the hydrogels have been conducted for bioelectronic applications. Nanomaterials complement the shortcomings of hydrogels for bioelectronic applications, and provide new functionality in biohybrid hydrogel bioelectronics. In this review, we provide the recent studies on biohybrid hydrogels and their bioelectronic applications. Firstly, representative nanomaterials and hydrogels constituting biohybrid hydrogels are provided, and next, applications of biohybrid hydrogels in bioelectronics categorized in flexible/wearable bioelectronic devices, tissue engineering, and biorobotics are discussed with recent studies. In conclusion, we strongly believe that this review provides the latest knowledge and strategies on hydrogel bioelectronics through the combination of nanomaterials and hydrogels, and direction of future hydrogel bioelectronics.

Marine‐Derived Hydrogels for Biomedical Applications

Marine organisms provide novel and broad sources for the preparations and applications of biomaterials. Since the urgent requirement of bio‐hydrogels to mimic tissue extracellular matrix (ECM), the natural biomacromolecule hydrogels derived from marine sources have received increasing attention. Benefiting from their outstanding bioactivity and biocompatibility, many attempts have been made to reconstruct ECM components by applying marine‐derived natural hydrogels. Moreover, marine hydrogels have been successfully applied in biomedicine by means of microfluidics, electrospray, and bioprinting. In this review, the classification and characteristics of marine‐derived hydrogels are summarized. In particular, their role in the development of biomaterials is also introduced. Then, the recent advances in bio‐fabrication strategies for various hydrogel materials are focused upon. Besides, the influences of hydrogel types on their functions in biomedical applications are discussed in depth. Finally, critical reflections on the limitations and future development of marine‐derived hydrogels are presented.

A Highly Efficacious Electrical Biofilm Treatment System for Combating Chronic Wound Bacterial Infections

Biofilm infection has a high prevalence in chronic wounds and can delay wound healing. Current treatment using debridement and antibiotic administration imposes a significant burden on patients and healthcare systems. To address their limitations, a highly efficacious electrical antibiofilm treatment system is described in this paper. This system uses high-intensity current (75 mA cm-2 ) to completely debride biofilm above the wound surface and enhance antibiotic delivery into biofilm-infected wounds simultaneously. Combining these two effects, this system uses short treatments (≤2 h) to reduce bacterial count of methicillin-resistant S. aureus (MRSA) biofilm-infected ex vivo skin wounds from 1010 to 105.2 colony-forming units (CFU) g-1 . Taking advantage of the hydrogel ionic circuit design, this system enhances the in vivo safety of high-intensity current application compared to conventional devices. The in vivo antibiofilm efficacy of the system is tested using a diabetic mouse-based wound infection model. MRSA biofilm bacterial count decreases from 109.0 to 104.6 CFU g-1 at 1 day post-treatment and to 103.3 CFU g-1 at 7 days post-treatment, both of which are below the clinical threshold for infection. Overall, this novel technology provides a quick, safe, yet highly efficacious treatment to chronic wound biofilm infections.

Polydopamine-Reinforced Hemicellulose-Based Multifunctional Flexible Hydrogels for Human Movement Sensing and Self-Powered Transdermal Drug Delivery

The preparation of bio-based hydrogels with excellent mechanical properties, stable electrochemical properties, and self-adhesive properties remains a challenge. In this study, nano-polydopamine-reinforced hemicellulose-based hydrogels with typical multistage pore structures were prepared. The nanocomposite hydrogels exhibit stable mechanical properties and show no significant crushing phenomenon after 1000 cycles of cyclic compression. Its ultimate tensile strain was 101%, which is significantly higher than that of native skin. The shear adhesion strength of the hydrogel to skin tissue reaches 7.52 kPa, which is better than fibrin glue (Greenplast) (5 kPa), and the excellent adhesion property prolongs the service time of the hydrogel in biomedicine applications. The impedance of the hydrogel was reduced and the electrical conductivity was increased with the addition of nano-polydopamine. The prepared nanocomposite hydrogel can detect various body movements (even throat vibrations) in real time as a motion sensor while being able to rapidly load cationic drugs and facilitate transdermal introduction of electrically stimulated drug ions as a drug patch. It provides theoretical support for the fabrication of hemicellulose-based hydrogels with excellent properties through molecular design and nanoparticle reinforcement. This has important implications for the development of next-generation flexible materials suitable for health monitoring and self-administration.

The Role of Hydrogel in Cardiac Repair and Regeneration for Myocardial Infarction: Recent Advances and Future Perspectives

A myocardial infarction (MI) is the leading cause of morbidity and mortality, seriously threatens human health, and becomes a major health burden of our society. It is urgent to pursue effective therapeutic strategies for the regeneration and restore myocardial function after MI. This review discusses the role of hydrogel in cardiac repair and regeneration for MI. Hydrogel-based cardiac patches and injectable hydrogels are the most commonly used applications in cardiac regeneration medicine. With injectable hydrogels, bioactive compounds and cells can be delivered in situ, promoting in situ repair and regeneration, while hydrogel-based cardiac patches reduce myocardial wall stress, which passively inhibits ventricular expansion. Hydrogel-based cardiac patches work as mechanically supportive biomaterials. In cardiac regeneration medicine, clinical trials and commercial products are limited. Biomaterials, biochemistry, and biological actives, such as intelligent hydrogels and hydrogel-based exosome patches, which may serve as an effective treatment for MI in the future, are still under development. Further investigation of clinical feasibility is warranted. We can anticipate hydrogels having immense translational potential for cardiac regeneration in the near future.