Highly Stretchable and Biocompatible Wrinkled Nanoclay-Composite Hydrogel With Enhanced Sensing Capability for Precise Detection of Myocardial Infarction

Engineering functional electroconductive hydrogels for targeted therapy in myocardial infarction repair

Myocardial infarction (MI) is characterized by a paucity of cardiomyocyte regeneration, leading to significant morbidity and mortality. Contemporary therapeutic modalities, while mitigating ischemic effects, fail to reconstitute the impaired electromechanical coupling within the infracted myocardium. Emerging evidence supports the utility of electroconductive hydrogels (ECHs) in facilitating post-MI cardiac function recovery by restoring the conductive microenvironment of the infarcted tissue. This comprehensive review delineates the taxonomy of ECHs predicated on their constituent conductive materials. It also encapsulates prevailing research trends in ECH-mediated MI repair, encompassing innovative design paradigms and microenvironment-sensitive strategies. The review also provides a critical appraisal of various implantation techniques, underscored by a thorough examination of the attendant considerations. It elucidates the mechanistic underpinnings by which hydrogels exert salutary effects on myocardial repair, namely by augmenting mechanical and electrical integrity, exerting anti-inflammatory actions, fostering angiogenesis, and curtailing adverse remodeling processes. Furthermore, the review engages with the pressing challenge of optimizing ECH functionality to achieve superior reparative outcomes post-MI. The discourse concludes with an anticipatory perspective on the evolution of ECH scaffolds, advocating for a tailored approach that integrates multifaceted physicochemical properties to cater to the nuances of personalized medicine.

Advances in conducting nanocomposite hydrogels for wearable biomonitoring

Recent advancements in wearable biosensors and bioelectronics have led to innovative designs for personalized health management devices, with biocompatible conducting nanocomposite hydrogels emerging as a promising building block for soft electronics engineering. In this review, we provide a comprehensive framework for advancing biosensors using these engineered nanocomposite hydrogels, highlighting their unique properties such as high electrical conductivity, flexibility, self-healing, biocompatibility, biodegradability, and tunable architecture, broadening their biomedical applications. We summarize key properties of nanocomposite hydrogels for thermal, biomechanical, electrophysiological, and biochemical sensing applications on the human body, recent progress in nanocomposite hydrogel design and synthesis, and the latest technologies in developing flexible and wearable devices. This review covers various sensor types, including strain, physiological, and electrochemical sensors, and explores their potential applications in personalized healthcare, from daily activity monitoring to versatile electronic skin applications. Furthermore, we highlight the blueprints of design, working procedures, performance, detection limits, and sensitivity of these soft devices. Finally, we address challenges, prospects, and future outlook for advanced nanocomposite hydrogels in wearable sensors, aiming to provide a comprehensive overview of their current state and future potential in healthcare applications.

Adhesive conductive wood-based hydrogel with high tensile strength as a flexible sensor

Conductive hydrogels have promising applications for flexible strain sensors. However, most hydrogels have poor tensile strength and are susceptible to damage, significantly impeding their potential for further application. Wood has been used to reinforce hydrogels, significantly enhancing their strength and dimensional stability. However, wood-based hydrogels generally lack adhesive properties or exhibit low self-adhesion. To address this issue, we introduced acryloyloxyethyltrimethyl ammonium chloride (DAC) into the hydrogel network through graft aggregation. The resulting electrostatic interactions significantly enhanced the adhesion of the wood-based hydrogel up to 270 kPa (for glass) and concurrently strengthened its cohesion. The prepared novel wood-based hydrogel (WDDH) exhibited high tensile strength (3.38 MPa), low-swelling ratio (only 2 % longitudinal), and high tensile strain (274.40 %). When WDDH was used as the wearable strain sensor, it showed a gauge factor of approximately 4.94. The device effectively captured and detected human movements, including finger and joint flexion, walking patterns, and hydration habits. The objective of this research is to develop a wood-based hydrogel with enhanced mechanical strength, adhesive properties, and flexibility for use in wearable sensors. This study provides insight into the development of flexible sensor hydrogels with improved adhesion properties using biomass materials.

Highly stretchable, self-healing, adhesive, 3D-printable and antibacterial double-network hydrogels for multifunctional wearable sensors

Conductive hydrogels based on sodium alginate (SA) have potential applications in human activity monitoring and personal medical diagnosis due to their good conductivity and flexibility. However, most sensing SA-hydrogels exhibit poor mechanical properties and lack of self-healing, self-adhesive, and antibacterial properties, greatly limiting their practical applications. Therefore, in this paper, a multifunctional double-network PAA-SA hydrogel consisting of poly(acrylic acid) (PAA) and sodium alginate (SA) was prepared by a simple strategy. As a rigid network structure, SA endowed the hydrogel double network structure with excellent mechanical performance. As a wearable sensor, the PAA-SA hydrogel exhibited excellent tensile properties (strain: 1799.2 %), self-healing, high sensitivity (GF = 9.9), reliable repeatability, self-adhesive, 3D printability and antibacterial activity. Additionally, the highly sensitive wearing sensing PAA-SA hydrogel could accurately and real-time monitor various intense or subtle human movements, such as joint bending, face and throat vibration. Moreover, PAA-SA hydrogels were not only used for handwritten recognition of Arabic numerals and English letters, but also for real-time sensing of temperature changes and monitoring of human sweating. The prepared multifunctional wearable sensing hydrogel has the advantages of simple and versatile methods and low cost, making it a promising candidate for applications in different fields such as electronic skin, soft robotics, and medical monitoring.

Tough Polyurethane Hydrogels with a Multiple Hydrogen-Bond Interlocked Bicontinuous Phase Structure Prepared by In Situ Water-Induced Microphase Separation

Hydrogels with mechanical performances similar to load-bearing tissues are in demand for in vivo applications. In this work, inspired by the self-assembly behavior of amphiphilic polymers, polyurethane-based tough hydrogels with a multiple hydrogen-bond interlocked bicontinuous phase structure through in situ water-induced microphase separation strategy are developed, in which poly(ethylene glycol)-based polyurethane (PEG-PU, hydrophilic) and poly(ε-caprolactone)-based polyurethane (PCL-PU, hydrophobic) are blended to form dry films followed by water swelling. A multiple hydrogen bonding factor, imidazolidinyl urea, is introduced into the synthesis of the two polyurethanes, and the formation of multiple hydrogen bonds between PEG-PU and PCL-PU can promote homogeneous microphase separation for the construction of bicontinuous phase structures in the hydrogel network, by which the hydrogel features break strength of 12.9 MPa, fracture energy of 2435 J m-2, and toughness of 48.2 MJ m-3. As a biomedical patch, the outstanding mechanical performances can withstand abdominal pressure to prevent hernia formation in the abdominal wall defect model. Compared to the commercial PP mesh, hydrogel can prevent tissue/organ adhesion to reduce inflammatory responses and promote angiogenesis, thereby accelerating the repair of abdominal wall defects. This work may provide useful inspiration for researchers to design different gel materials through solvent-induced microphase separation.

3D printing of stiff, tough, and ROS-scavenging nanocomposite hydrogel scaffold for in situ corneal repair

Despite significant advancements in hydrogels in recent years, their application in corneal repair remains limited by several challenges, including unfitted curvatures, inferior mechanical properties, and insufficient reactive oxygen species (ROS)-scavenging activities. To address these issues, this study introduces a 3D-printed corneal scaffold with nanocomposite hydrogel consisting of gelatin methacrylate (GelMA), poly (ethylene glycol) diacrylate (PEGDA), Laponite, and dopamine. GelMA and PEGDA act as matrix materials with photo-crosslinking abilities. As a two-dimensional nanoclay, Laponite enhances the rheological properties of the hydrogel, making it suitable for 3D printing. Dopamine self-polymerizes into polydopamine (PDA), providing the hydrogel with ROS-scavenging activity. The incorporation of Laponite and the synergistic effect of PDA endow the hydrogel with good mechanical properties. In vitro investigations demonstrated the cytocompatibility of GelMA-PEGDA-Laponite-dopamine (GPLD) hydrogel and its ROS-scavenging activity. Furthermore, in vivo experiments using a rabbit model of lamellar keratoplasty showed accelerated corneal re-epithelialization and complete stromal repair after the implantation of the 3D-printed scaffold. Overall, due to its high bioactivity and simple preparation, the 3D-printed scaffold using GPLD hydrogel offers an alternative for corneal repair with potential for clinical translation. STATEMENT OF SIGNIFICANCE: The clinical application of hydrogel corneal scaffolds has been constrained by their inadequate mechanical properties and the complex microenvironment created by elevated levels of ROS post-transplantation. In this study, we developed a kind of nanocomposite hydrogel by integrating Laponite and dopamine into GelMA and PEGDA. This advanced hydrogel was utilized to 3D print a corneal scaffold with high mechanical strength and ROS-scavenging abilities. When applied to a rabbit model of lamellar keratoplasty, the 3D-printed scaffold enabled complete re-epithelialization of the cornea within one week. Three months after surgery, the corneal stroma was fully repaired, and regeneration of corneal nerve fibers was also observed. This 3D-printed scaffold demonstrated exceptional efficacy in repairing corneal defects with potential for clinical translation.

Biomimetic Versatile Anisotropic, Electroactive Cellulose Hydrogel Scaffolds Tailored from Fern Stem Serving as Nerve Conduit and Cardiac Patch

Peripheral nerve injury (PNI) and myocardial infarction (MI) are the two most clinically common soft excitable tissue injuries. Both nerve and cardiac tissues exhibit structural anisotropy and electrophysiological activity, providing a wide range of biophysical cues for cell and tissue repair. However, balancing microstructural anisotropy, electroactivity, and biocompatibility is challenging. To address this issue, Dicranopteris linearis (D. linearis) is proposed as a low-perceived value fern plant. Moreover, to enhance its usefulness, it can be designed into a tubular structure and a lamellar structure to bridge the damaged tissue. Therefore, a robust yet simple top-down approach is proposed to designing and fabricating the desired biomimetic versatile hydrogels orienting from the D. linearis to customize for different soft excitable tissue repair applications. These anisotropic electroactive hydrogels performed well as nerve guidance conduits (NGC) and engineered cardiac patches (ECP) in the repair of PNI and MI, respectively. Two birds, one stone. Accordingly, the biomimetic strategy of D. linearis to NGC and D. linearis to ECP is first proposed, opening a new horizon for constructing tissue engineering using natural sources.

Soft Cardiac Patch Using a Bifacial Architecture of Adhesive/Low‐Impedance Hydrogel Nanocomposites and Highly Conductive Elastomer Nanocomposites

Soft implantable multichannel cardiac electrode arrays that establish direct monolithic interfaces with the heart are key components for advanced cardiac monitoring and electrical modulation. A significant technological advancement in this area is the development of stretchable conductive nanocomposites, fabricated through the integration of metallic nanomaterials and elastic polymers, aimed at achieving both high electrical conductivity and mechanical elasticity. Despite these advances, further progress in material performance and device designs is required to ensure seamless, reliable, biocompatible, and high‐fidelity cardiac interfacing. Herein, the development of a soft multichannel cardiac patch based on a bifacial architecture of adhesive/low‐impedance hydrogel nanocomposites and highly conductive elastomer nanocomposites is reported. The bifacial design facilitates the integration of the cardiac patch between the heart and other tissues/organs can be achieved. The hydrogel nanocomposite layer, positioned on the epicardial side, provides stable adhesion to the target cardiac tissue and enables low‐impedance biocompatible interfacing with the heart, while the elastomer nanocomposite layer, positioned on the opposite side, offers high electrical conductivity for facile electrophysiological signal transfer and a low‐friction surface minimizing unwanted interactions with surrounding tissues. The effectiveness of this bifacial patch in multiple applications involving various cardiac signal recordings and electromechanical modulation demonstrations is showcased.

Functional Hydrogels for Aqueous Zinc-Based Batteries: Progress and Perspectives

Aqueous zinc batteries (AZBs) hold great potential for green grid-scale energy storage due to their affordability, resource abundance, safety, and environmental friendliness. However, their practical deployment is hindered by challenges related to the electrode, electrolyte, and interface. Functional hydrogels offer a promising solution to address such challenges owing to their broad electrochemical window, tunable structures, and pressure-responsive mechanical properties. In this review, the key properties that functional hydrogels must possess for advancing AZBs, including mechanical strength, ionic conductivity, swelling behavior, and degradability, from a perspective of the full life cycle of hydrogels in AZBs are summarized. Current modification strategies aimed at enhancing these properties and improving AZB performance are also explored. The challenges and design considerations for integrating functional hydrogels with electrodes and interface are discussed. In the end, the limitations and future directions for hydrogels to bridge the gap between academia and industries for the successful deployment of AZBs are discussed.

Super-Tough, Non-Swelling Zwitterionic Hydrogel Sensor Based on the Hofmeister Effect for Potential Motion Monitoring of Marine Animals

Hydrogel-based electronic devices in aquatic environments have sparked widespread research interest. Nevertheless, the challenge of developing hydrogel electronics underwater has not been profoundly surmounted because of the fragility and swelling of hydrogels in aquatic environments. In this work, a zwitterionic double network hydrogel comprised of polyvinyl alcohol (PVA), poly(sulfobetaine methacrylate) (PSBMA), and sulfuric acid (H2SO4) demonstrates super-tough and non-swelling performance. The Hofmeister effect of H2SO4 and PSBMA induces the PVA chains to form numerous nanocrystalline domains, which serve as the primary physical crosslinking points and provide effective energy dissipation. H2SO4 induces a strong salting-out effect to facilitate PVA crystallization and the formation of a dense and stable network structure that inhibits swelling. The resulting hydrogel exhibits an ultra-high toughness of 4.61 MJ m-3, non-swelling, and long-term stability for up to a month in pure water and seawater. Based on this, a hydrogel-based seawater strain sensor has been developed to monitor the underwater movements of marine animal models. Reliable and stable sensing performance ensures real-time collection of underwater motion signals, despite the impacts of water flow and the interference of ions. This study provides a facile approach to designing super-tough and non-swelling hydrogels and further expands the application of underwater electronic devices.

Smart Wrinkled Interfaces: Patterning, Morphing, and Coding of Polymer Surfaces by Dynamic Anisotropic Wrinkling

In contrast to traditional static surfaces, smart patterned surfaces with periodical and reversible morphologies offer limitless opportunities for encoding surface functions and properties on demand, facilitating their widespread application as functional building blocks in various devices. Advances in intelligently controlling the macroscopic properties of these smart surfaces have been accomplished through various techniques (such as three-dimensional printing, imprint lithography and femtosecond laser) and responsive materials. In contrast to the sophisticated techniques above, dynamic anisotropic wrinkling, taking advantage of dynamic programmable manipulation of surface wrinkling and its orientation, offers a powerful alternative for fabricating dynamic periodical patterns due to its spontaneous formation, versatility, convenient scale-up fabrication, and sensitivity to various stimuli. This review comprehensively summarizes recent advances in smart patterned surfaces with dynamic oriented wrinkles, covering design principles, fabrication techniques, representative types of physical and chemical stimuli, as well as fine-tuning of wrinkle dimensions and orientation. Finally, advanced applications of these smart patterned surfaces are presented, along with a discussion of current challenges and future prospects in this rapidly evolving field. This review would offer some insights and guidelines for designing and engineering novel stimuli-responsive smart wrinkled surfaces, thereby facilitating their sustainable development and progressing toward commercialization.

Recent Advances of Stretchable Nanomaterial-Based Hydrogels for Wearable Sensors and Electrophysiological Signals Monitoring

Electrophysiological monitoring is a commonly used medical procedure designed to capture the electrical signals generated by the body and promptly identify any abnormal health conditions. Wearable sensors are of great significance in signal acquisition for electrophysiological monitoring. Traditional electrophysiological monitoring devices are often bulky and have many complex accessories and thus, are only suitable for limited application scenarios. Hydrogels optimized based on nanomaterials are lightweight with excellent stretchable and electrical properties, solving the problem of high-quality signal acquisition for wearable sensors. Therefore, the development of hydrogels based on nanomaterials brings tremendous potential for wearable physiological signal monitoring sensors. This review first introduces the latest advancement of hydrogels made from different nanomaterials, such as nanocarbon materials, nanometal materials, and two-dimensional transition metal compounds, in physiological signal monitoring sensors. Second, the versatile properties of these stretchable composite hydrogel sensors are reviewed. Then, their applications in various electrophysiological signal monitoring, such as electrocardiogram monitoring, electromyographic signal analysis, and electroencephalogram monitoring, are discussed. Finally, the current application status and future development prospects of nanomaterial-optimized hydrogels in wearable physiological signal monitoring sensors are summarized. We hope this review will inspire future development of wearable electrophysiological signal monitoring sensors using nanomaterial-based hydrogels.

Self-Adhesive, Stretchable, and Thermosensitive Iontronic Hydrogels for Highly Sensitive Neuromorphic Sensing-Synaptic Systems

Artificial sensory afferent nerves that emulate receptor nanochannel perception and synaptic ionic information processing in chemical environments are highly desirable for bioelectronics. However, challenges persist in achieving life-like nanoscale conformal contact, agile multimodal sensing response, and synaptic feedback with ions. Here, a precisely tuned phase transition poly(N-isopropylacrylamide) (PNIPAM) hydrogel is introduced through the water molecule reservoir strategy. The resulting hydrogel with strongly cross-linked networks exhibits excellent mechanical performance (∼2000% elongation) and robust adhesive strength. Importantly, the hydrogel's enhanced ionic conductance and heterogeneous structure of the temperature-sensitive component enable highly sensitive strain information perception (GFmax = 7.94, response time ∼ 87 ms), temperature information perception (TCRmax = -1.974%/°C, response time ∼ 270 ms), and low energy consumption synaptic plasticity (42.2 fJ/spike). As a demonstration, a neuromorphic sensing-synaptic system is constructed integrating iontronic strain/temperature sensors with fiber synapses for real-time information sensing, discrimination, and feedback. This work holds enormous potential in bioinspired robotics and bioelectronics.

Chemically Programmed Hydrogels for Spatiotemporal Modulation of the Cardiac Pathological Microenvironment

After myocardial infarction (MI), sustained ischemic events induce pathological microenvironments characterized by ischemia-hypoxia, oxidative stress, inflammatory responses, matrix remodeling, and fibrous scarring. Conventional clinical therapies lack spatially targeted and temporally responsive modulation of the infarct microenvironment, leading to limited myocardial repair. Engineered hydrogels have a chemically programmed toolbox for minimally invasive localization of the pathological microenvironment and personalized responsive modulation over different pathological periods. Chemically programmed strategies for crosslinking interactions, interfacial binding, and topological microstructures in hydrogels enable minimally invasive implantation and in situ integration tailored to the myocardium. This enhances substance exchange and signal interactions within the infarcted microenvironment. Programmed responsive polymer networks, intelligent micro/nanoplatforms, and biological therapeutic cues contribute to the formation of microenvironment-modulated hydrogels with precise targeting, spatiotemporal control, and on-demand feedback. Therefore, this review summarizes the features of the MI microenvironment and chemically programmed schemes for hydrogels to conform, integrate, and modulate the cardiac pathological microenvironment. Chemically programmed strategies for oxygen-generating, antioxidant, anti-inflammatory, provascular, and electrointegrated hydrogels to stimulate iterative and translational cardiac tissue engineering are discussed.

Advanced Cardiac Patches for the Treatment of Myocardial Infarction

Myocardial infarction is a cardiovascular disease characterized by a high incidence rate and mortality. It leads to various cardiac pathophysiological changes, including ischemia/reperfusion injury, inflammation, fibrosis, and ventricular remodeling, which ultimately result in heart failure and pose a significant threat to global health. Although clinical reperfusion therapies and conventional pharmacological interventions improve emergency survival rates and short-term prognoses, they are still limited in providing long-lasting improvements in cardiac function or reversing pathological progression. Recently, cardiac patches have gained considerable attention as a promising therapy for myocardial infarction. These patches consist of scaffolds or loaded therapeutic agents that provide mechanical reinforcement, synchronous electrical conduction, and localized delivery within the infarct zone to promote cardiac restoration. This review elucidates the pathophysiological progression from myocardial infarction to heart failure, highlighting therapeutic targets and various cardiac patches. The review considers the primary scaffold materials, including synthetic, natural, and conductive materials, and the prevalent fabrication techniques and optimal properties of the patch, as well as advanced delivery strategies. Last, the current limitations and prospects of cardiac patch research are considered, with the goal of shedding light on innovative products poised for clinical application.

Chronological-Programmed Black Phosphorus Hydrogel for Responsive Modulation of the Pathological Microenvironment in Myocardial Infarction

Electroactive hydrogels have garnered extensive interest as a promising approach to myocardial tissue engineering. However, the challenges of spatiotemporal-specific modulation of individual pathological processes and achieving nontoxic bioresorption still remain. Herein, inspired by the entire postinfarct pathological processes, an injectable conductive bioresorbable black phosphorus nanosheets (BPNSs)-loaded hydrogel (BHGD) was developed via reactive oxide species (ROS)-sensitive disulfide-bridge and photomediated cross-linking reaction. Significantly, the chronologically programmed BHGD hydrogel can achieve graded modulation during the inflammatory, proliferative, and maturation phases of myocardial infarction (MI). More details, during early infarction, the BHGD hydrogel can effectively reduce ROS levels in the MI area, inhibit cellular oxidative stress damage, and promote macrophage M2 polarization, creating a favorable environment for damaged myocardium repair. Meanwhile, the ROS-responsive structure can protect BPNSs from degradation and maintain good conductivity under MI microenvironments. Therefore, the BHGD hydrogel possesses tissue-matched modulus and conductivity in the MI area, facilitating cardiomyocyte maturation and electrical signal exchange, compensating for impaired electrical signaling, and promoting vascularization in infarcted areas in the maturation phase. More importantly, all components of the hydrogel degrade into nontoxic substances without adverse effects on vital organs. Overall, the presented BPNS-loaded hydrogel offers an expandable and safe option for clinical treatment of MI.

Triboelectric micro-flexure-sensitive fiber electronics

Developing fiber electronics presents a practical approach for establishing multi-node distributed networks within the human body, particularly concerning triboelectric fibers. However, realizing fiber electronics for monitoring micro-physiological activities remains challenging due to the intrinsic variability and subtle amplitude of physiological signals, which differ among individuals and scenarios. Here, we propose a technical approach based on a dynamic stability model of sheath-core fibers, integrating a micro-flexure-sensitive fiber enabled by nanofiber buckling and an ion conduction mechanism. This scheme enhances the accuracy of the signal transmission process, resulting in improved sensitivity (detectable signal at ultra-low curvature of 0.1 mm-1; flexure factor >21.8% within a bending range of 10°.) and robustness of fiber under micro flexure. In addition, we also developed a scalable manufacturing process and ensured compatibility with modern weaving techniques. By combining precise micro-curvature detection, micro-flexure-sensitive fibers unlock their full potential for various subtle physiological diagnoses, particularly in monitoring fiber upper limb muscle strength for rehabilitation and training.

Bioinspired Multifunctional Self-Sensing Actuated Gradient Hydrogel for Soft-Hard Robot Remote Interaction

The development of bioinspired gradient hydrogels with self-sensing actuated capabilities for remote interaction with soft-hard robots remains a challenging endeavor. Here, we propose a novel multifunctional self-sensing actuated gradient hydrogel that combines ultrafast actuation and high sensitivity for remote interaction with robotic hand. The gradient network structure, achieved through a wettability difference method involving the rapid precipitation of MoO2 nanosheets, introduces hydrophilic disparities between two sides within hydrogel. This distinctive approach bestows the hydrogel with ultrafast thermo-responsive actuation (21° s-1) and enhanced photothermal efficiency (increase by 3.7 °C s-1 under 808 nm near-infrared). Moreover, the local cross-linking of sodium alginate with Ca2+ endows the hydrogel with programmable deformability and information display capabilities. Additionally, the hydrogel exhibits high sensitivity (gauge factor 3.94 within a wide strain range of 600%), fast response times (140 ms) and good cycling stability. Leveraging these exceptional properties, we incorporate the hydrogel into various soft actuators, including soft gripper, artificial iris, and bioinspired jellyfish, as well as wearable electronics capable of precise human motion and physiological signal detection. Furthermore, through the synergistic combination of remarkable actuation and sensitivity, we realize a self-sensing touch bioinspired tongue. Notably, by employing quantitative analysis of actuation-sensing, we realize remote interaction between soft-hard robot via the Internet of Things. The multifunctional self-sensing actuated gradient hydrogel presented in this study provides a new insight for advanced somatosensory materials, self-feedback intelligent soft robots and human-machine interactions.

Gelatin-Based Metamaterial Hydrogel Films with High Conformality for Ultra-Soft Tissue Monitoring

Implantable hydrogel-based bioelectronics (IHB) can precisely monitor human health and diagnose diseases. However, achieving biodegradability, biocompatibility, and high conformality with soft tissues poses significant challenges for IHB. Gelatin is the most suitable candidate for IHB since it is a collagen hydrolysate and a substantial part of the extracellular matrix found naturally in most tissues. This study used 3D printing ultrafine fiber networks with metamaterial design to embed into ultra-low elastic modulus hydrogel to create a novel gelatin-based conductive film (GCF) with mechanical programmability. The regulation of GCF nearly covers soft tissue mechanics, an elastic modulus from 20 to 420 kPa, and a Poisson's ratio from - 0.25 to 0.52. The negative Poisson's ratio promotes conformality with soft tissues to improve the efficiency of biological interfaces. The GCF can monitor heartbeat signals and respiratory rate by determining cardiac deformation due to its high conformability. Notably, the gelatin characteristics of the biodegradable GCF enable the sensor to monitor and support tissue restoration. The GCF metamaterial design offers a unique idea for bioelectronics to develop implantable sensors that integrate monitoring and tissue repair and a customized method for endowing implanted sensors to be highly conformal with soft tissues.

A Core-Shell Nanoreinforced Ion-Conductive Implantable Hydrogel Bioelectronic Patch with High Sensitivity and Bioactivity for Real-Time Synchronous Heart Monitoring and Repairing

To achieve synchronous repair and real-time monitoring the infarcted myocardium based on an integrated ion-conductive hydrogel patch is challenging yet intriguing. Herein, a novel synthetic strategy is reported based on core-shell-structured curcumin-nanocomposite-reinforced ion-conductive hydrogel for synchronous heart electrophysiological signal monitoring and infarcted heart repair. The nanoreinforcement and multisite cross-linking of bioactive curcumin nanoparticles enable well elasticity with negligible hysteresis, implantability, ultrahigh mechanoelectrical sensitivity (37 ms), and reliable sensing capacity (over 3000 cycles) for the nanoreinforced hydrogel. Results of in vitro and in vivo experiments demonstrate that such solely physical microenvironment of electrophysiological and biomechanical characteristics combining with the role of bioactive curcumin exert the synchronous benefit of regulating inflammatory microenvironment, promoting angiogenesis, and reducing myocardial fibrosis for effective myocardial infarction (MI) repair. Especially, the hydrogel sensors offer the access for achieving accurate acquisition of cardiac signals, thus monitoring the whole MI healing process. This novel bioactive and electrophysiological-sensing ion-conductive hydrogel cardiac patch highlights a versatile strategy promising for synchronous integration of in vivo real-time monitoring the MI status and excellent MI repair performance.

Chronological adhesive cardiac patch for synchronous mechanophysiological monitoring and electrocoupling therapy

With advances in tissue engineering and bioelectronics, flexible electronic hydrogels that allow conformal tissue integration, online precision diagnosis, and simultaneous tissue regeneration are expected to be the next-generation platform for the treatment of myocardial infarction. Here, we report a functionalized polyaniline-based chronological adhesive hydrogel patch (CAHP) that achieves spatiotemporally selective and conformal embedded integration with a moist and dynamic epicardium surface. Significantly, CAHP has high adhesion toughness, rapid self-healing ability, and enhanced electrochemical performance, facilitating sensitive sensing of cardiac mechanophysiology-mediated microdeformations and simultaneous improvement of myocardial fibrosis-induced electrophysiology. As a result, the flexible CAHP platform monitors diastolic-systolic amplitude and rhythm in the infarcted myocardium online while effectively inhibiting ventricular remodeling, promoting vascular regeneration, and improving electrophysiological function through electrocoupling therapy. Therefore, this diagnostic and therapeutic integration provides a promising monitorable treatment protocol for cardiac disease.

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.

Transdermal drug delivery via microneedles for musculoskeletal systems

As the population is ageing and lifestyle is changing, the prevalence of musculoskeletal (MSK) disorders is gradually increasing with each passing year, posing a serious threat to the health and quality of the public, especially the elderly. However, currently prevalent treatments for MSK disorders, mainly administered orally and by injection, are not targeted to the specific lesion, resulting in low efficacy along with a series of local and systemic adverse effects. Microneedle (MN) patches loaded with micron-sized needle array, combining the advantages of oral administration and local injection, have become a potentially novel strategy for the administration and treatment of MSK diseases. In this review, we briefly introduce the basics of MNs and focus on the main characteristics of the MSK systems and various types of MN-based transdermal drug delivery (TDD) systems. We emphasize the progress and broad applications of MN-based transdermal drug delivery (TDD) for MSK systems, including osteoporosis, nutritional rickets and some other typical types of arthritis and muscular damage, and in closing summarize the future prospects and challenges of MNs application.

Multifunctional Flexible Sensor Based on PU-TA@MXene Janus Architecture for Selective Direction Recognition

Multifunctional selectivity and mechanical properties are always a focus of attention in the field of flexible sensors. In particular, the construction of biomimetic architecture for sensing materials can endow the fabricated sensors with intrinsic response features and extra-derived functions. Here, inspired by the asymmetric structural features of human skin, a novel tannic acid (TA)-modified MXene-polyurethane film with a bionic Janus architecture is proposed, which is prepared by gravity-driven self-assembly for the gradient dispersion of 2D TA@MXene nanosheets into a PU network. This obtained film reveals strong mechanical properties of a superior elongation at a break of 2056.67% and an ultimate tensile strength of 50.78 MPa with self-healing performance. Moreover, the Janus architecture can lead to a selective multifunctional response of flexible sensors to directional bending, pressure, and stretching. Combined with a machine learning module, the sensor is endowed with high recognition rates for force detection (96.1%). Meanwhile, direction identification in rescue operations and human movement monitoring can be realized by this sensor. This work offers essential research value and practical significance for the material structures, mechanical properties, and application platforms of flexible sensors.

Hydrogel-Based Bioelectronics and Their Applications in Health Monitoring

Flexible bioelectronics exhibit promising potential for health monitoring, owing to their soft and stretchable nature. However, the simultaneous improvement of mechanical properties, biocompatibility, and signal-to-noise ratio of these devices for health monitoring poses a significant challenge. Hydrogels, with their loose three-dimensional network structure that encapsulates massive amounts of water, are a potential solution. Through the incorporation of polymers or conductive fillers into the hydrogel and special preparation methods, hydrogels can achieve a unification of excellent properties such as mechanical properties, self-healing, adhesion, and biocompatibility, making them a hot material for health monitoring bioelectronics. Currently, hydrogel-based bioelectronics can be used to fabricate flexible bioelectronics for motion, bioelectric, and biomolecular acquisition for human health monitoring and further clinical applications. This review focuses on materials, devices, and applications for hydrogel-based bioelectronics. The main material properties and research advances of hydrogels for health monitoring bioelectronics are summarized firstly. Then, we provide a focused discussion on hydrogel-based bioelectronics for health monitoring, which are classified as skin-attachable, implantable, or semi-implantable depending on the depth of penetration and the location of the device. Finally, future challenges and opportunities of hydrogel-based bioelectronics for health monitoring are envisioned.

Cardiac-Adaptive Conductive Hydrogel Patch Enabling Construction of Mechanical-Electrical Anisotropic Microenvironment for Heart Repair

The biomimetic construction of a microstructural-mechanical-electrical anisotropic microenvironment adaptive to the native cardiac tissue is essential to repair myocardial infarction (MI). Inspired by the 3D anisotropic characteristic of the natural fish swim bladder (FSB), a novel flexible, anisotropic, and conductive hydrogel was developed for tissue-specific adaptation to the anisotropic structural, conductive, and mechanical features of the native cardiac extracellular matrix. The results revealed that the originally stiff, homogeneous FSB film was tailored to a highly flexible anisotropic hydrogel, enabling its potential as a functional engineered cardiac patch (ECP). In vitro and in vivo experiments demonstrated the enhanced electrophysiological activity, maturation, elongation, and orientation of cardiomyocytes (CMs), and marked MI repair performance with reduced CM apoptosis and myocardial fibrosis, thereby promoting cell retention, myogenesis, and vascularization, as well as improving electrical integration. Our findings offer a potential strategy for functional ECP and provides a novel strategy to bionically simulate the complex cardiac repair environment.

Non-equilibrium-Growing Aesthetic Ionic Skin for Fingertip-Like Strain-Undisturbed Tactile Sensation and Texture Recognition

Humans use periodically ridged fingertips to precisely perceive the characteristics of objects via ion-based fast- and slow-adaptive mechanotransduction. However, designing artificial ionic skins with fingertip-like tactile capabilities remains challenging because of the contradiction between structural compliance and pressure sensing accuracy (e.g., anti-interference from stretch and texture recognition). Inspired by the formation and modulus-contrast hierarchical structure of fingertips, an aesthetic ionic skin grown from a non-equilibrium Liesegang patterning process is introduced. This ionic skin with periodic stiff ridges embedded in a soft hydrogel matrix enables strain-undisturbed triboelectric dynamic pressure sensing as well as vibrotactile texture recognition. By coupling with another piezoresistive ionogel, an artificial tactile sensory system is further fabricated as a soft robotic skin to mimic the simultaneous fast- and slow-adaptive multimodal sensations of fingers in grasping actions. This approach may inspire the future design of high-performance ionic tactile sensors for intelligent applications in soft robotics and prosthetics.