Ultra-Thin Flexible Encapsulating Materials for Soft Bio-Integrated Electronics

Self-packaged stretchable printed circuits with ligand-bound liquid metal particles in elastomer

Packaging in stretchable electronics is crucial to protect components from environmental damage while preserving mechanical flexibility and providing electrical insulation. The conventional packaging process involves multiple steps that increase in complexity as the number of circuit layers multiply. In this study, we introduce a self-packaged stretchable printed circuit board enabled by the in situ phase separation of liquid metal particles (LMPs) within various polymer matrices during solution-based printing processes. The ligand-bound LMPs (LB-LMPs), engineered to inhibit oxide growth, undergo in situ sintering, prompting vertical phase separation. This synthesis strategy not only achieves high initial conductivity of the LMPs but also encapsulates them within the polymer matrix, preventing leakage and providing electrical insulation. Our method enables multi-layer circuit printing, eliminating the need for additional activation and packaging processes. Furthermore, by integrating conductive materials into packaging layers for selective electrical conductivity, vertical interconnect accesses and conductive pads can be formed, enabling large-scale, stretchable, and leakage-free multi-layer electrical circuits and bio-interfaces.

Implantable bioelectronics and wearable sensors for kidney health and disease

Established clinical practices for monitoring kidney health and disease - including biopsy and serum biomarker analysis - suffer from practical limitations in monitoring frequency and lack adequate sensitivity for early disease detection. Engineering advances in biosensors have led to the development of wearable and implantable systems for monitoring of kidney health. Non-invasive microfluidic systems have demonstrated utility in the detection of kidney-relevant biomarkers, such as creatinine, urea and electrolytes in peripheral body fluids such as sweat, interstitial fluid, tears and saliva. Implantable systems may aid the identification of early transplant rejection through analysis of organ temperature and perfusion, and enable real-time assessment of inflammation through the use of thermal sensors. These technologies enable continuous, real-time monitoring of kidney health, offering complementary information to standard clinical procedures to alert physicians of changes in kidney health for early intervention. In this Review, we explore devices for monitoring renal biomarkers in peripheral biofluids and discuss developments in implantable sensors for the direct measurement of the local, biophysical properties of kidney tissue. We also describe potential clinical applications, including monitoring of chronic kidney disease, acute kidney injury and allograft health.

Mechanically Compatible Sealing of Hydrogel with Coherent Interface

Long-term operation of hydrogels relies on protective coatings to avoid water swelling or evaporation, but these protections often cause substantial decreases in overall softness and stretchability. Here, a mechanically compatible seal with a coherent interfacial design is developed to encapsulate hydrogels. This seal is made from polybutylene (PIB) and polypropylene-graft-maleic anhydride (PP-g-MAH) blended poly(styrene-isobutylene-styrene) (SIBS). The PIB oligomers soften the SIBS networks, while the MAH groups facilitate covalent bonding between the SIBS and hydrogel. The sealed hydrogel exhibits an elastic modulus of 24 kPa and an elongation at a break of >1000%, both comparable to those of the pristine hydrogel. The adhesion energy between the seal and hydrogel reached >140 J m-2 and can be further increased to >400 J m-2 by a thermal treatment. This tough interface, together with the intrinsically low water vapor transmission rate of SIBS, allows the sealed hydrogel to maintain its modulus and stretchability after 10 days of drying in air. The sealed hydrogel is chemically and mechanically stable under harsh conditions, including acidic/alkaline/salty solutions, high temperatures, and cyclic mechanical deformation. This strategy applies to various hydrogels with diverse compositions and structures, leading to orders of magnitude improvements in the longevity of hydrogel-based electronic devices.

Soft Artificial Synapse Electronics

Soft electronics, known for their bendable, stretchable, and flexible properties, are revolutionizing fields such as biomedical sensing, consumer electronics, and robotics. A primary challenge in this domain is achieving low power consumption, often hampered by the limitations of the conventional von Neumann architecture. In response, the development of soft artificial synapses (SASs) has gained substantial attention. These synapses seek to replicate the signal transmission properties of biological synapses, offering an innovative solution to this challenge. This review explores the materials and device architectures integral to SAS fabrication, emphasizing flexibility and stability under mechanical deformation. Various architectures, including floating-gate dielectric, ferroelectric-gate dielectric, and electrolyte-gate dielectric, are analyzed for effective weight control in SASs. The utilization of organic and low-dimensional materials is highlighted, showcasing their plasticity and energy-efficient operation. Furthermore, the paper investigates the integration of functionality into SASs, particularly focusing on devices that autonomously sense external stimuli. Functionalized SASs, capable of recognizing optical, mechanical, chemical, olfactory, and auditory cues, demonstrate promising applications in computing and sensing. A detailed examination of photo-functionalized, tactile-functionalized, and chemoreception-functionalized SASs reveals their potential in image recognition, tactile sensing, and chemosensory applications, respectively. This study highlights that SASs and functionalized SAS devices hold transformative potential for bioelectronics and sensing for soft-robotics applications; however, further research is necessary to address scalability, long-time stability, and utilizing functionalized SASs for prosthetics and in vivo applications through clinical adoption. By providing a comprehensive overview, this paper contributes to the understanding of SASs, bridging research gaps and paving the way toward transformative developments in soft electronics, biomimicking and biointegrated synapse devices, and integrated systems.

Flexible Electrode Arrays Based on a Wide Bandgap Semiconductors for Chronic Implantable Multiplexed Sensing and Heart Pacemakers

Implantable systems with chronic stability, high sensing performance, and extensive spatial-temporal resolution are a growing focus for monitoring and treating several diseases such as epilepsy, Parkinson's disease, chronic pain, and cardiac arrhythmias. These systems demand exceptional bendability, scalable size, durable electrode materials, and well-encapsulated metal interconnects. However, existing chronic implantable bioelectronic systems largely rely on materials prone to corrosion in biofluids, such as silicon nanomembranes or metals. This study introduces a multielectrode array featuring a wide bandgap (WBG) material as electrodes, demonstrating its suitability for chronic implantable applications. Our devices exhibit excellent flexibility and longevity, taking advantage of the low bending stiffness and chemical inertness in WBG nanomembranes and multimodalities for physical health monitoring, including temperature, strain, and impedance sensing. Our top-down manufacturing process enables the formation of distributed electrode arrays that can be seamlessly integrated onto the curvilinear surfaces of skins. As proof of concept for chronic cardiac pacing applications, we demonstrate the effective pacing functionality of our devices on rabbit hearts through a set of ex vivo experiments. The engineering approach proposed in this study overcomes the drawbacks of prior WBG material fabrication techniques, resulting in an implantable system with high bendability, effective pacing, and high-performance sensing.

Innovative bioinks for 3D bioprinting: Exploring technological potential and regulatory challenges

The field of three dimensional (3D) bioprinting has witnessed significant advancements, with bioinks playing a crucial role in enabling the fabrication of complex tissue constructs. This review explores the innovative bioinks that are currently shaping the future of 3D bioprinting, focusing on their composition, functionality, and potential for tissue engineering, drug delivery, and regenerative medicine. The development of bioinks, incorporating natural and synthetic materials, offers unprecedented opportunities for personalized medicine. However, the rapid technological progress raises regulatory challenges regarding safety, standardization, and long-term biocompatibility. This paper addresses these challenges, examining the current regulatory frameworks and the need for updated guidelines to ensure patient safety and product efficacy. By highlighting both the technological potential and regulatory hurdles, this review offers a comprehensive overview of the future landscape of bioinks in bioprinting, emphasizing the necessity for cross-disciplinary collaboration between scientists, clinicians, and regulatory bodies to achieve successful clinical applications.

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.

Breathable and Stretchable Epidermal Electronics for Health Management: Recent Advances and Challenges

Advanced epidermal electronic devices, capable of real-time monitoring of physical, physiological, and biochemical signals and administering appropriate therapeutics, are revolutionizing personalized healthcare technology. However, conventional portable electronic devices are predominantly constructed from impermeable and rigid materials, which thus leads to the mechanical and biochemical disparities between the devices and human tissues, resulting in skin irritation, tissue damage, compromised signal-to-noise ratio (SNR), and limited operational lifespans. To address these limitations, a new generation of wearable on-skin electronics built on stretchable and porous substrates has emerged. These substrates offer significant advantages including breathability, conformability, biocompatibility, and mechanical robustness, thus providing solutions for the aforementioned challenges. However, given their diverse nature and varying application scenarios, the careful selection and engineering of suitable substrates is paramount when developing high-performance on-skin electronics tailored to specific applications. This comprehensive review begins with an overview of various stretchable porous substrates, specifically focusing on their fundamental design principles, fabrication processes, and practical applications. Subsequently, a concise comparison of various methods is offered to fabricate epidermal electronics by applying these porous substrates. Following these, the latest advancements and applications of these electronics are highlighted. Finally, the current challenges are summarized and potential future directions in this dynamic field are explored.

Flexible Pressure, Humidity, and Temperature Sensors for Human Health Monitoring

The rapid advancements in artificial intelligence, micro-nano manufacturing, and flexible electronics technology have unleashed unprecedented innovation and opportunities for applying flexible sensors in healthcare, wearable devices, and human-computer interaction. The human body's tactile perception involves physical parameters such as pressure, temperature, and humidity, all of which play an essential role in maintaining human health. Inspired by the sensory function of human skin, many bionic sensors have been developed to simulate human skin's perception to various stimuli and are widely applied in health monitoring. Given the urgent requirements for sensing performance and integration of flexible sensors in the field of wearable devices and health monitoring, here is a timely overview of recent advances in pressure, humidity, temperature, and multi-functional sensors for human health monitoring. It covers the fundamental components of flexible sensors and categorizes them based on different response mechanisms, including resistive, capacitive, voltage, and other types. Specifically, the application of these flexible tactile sensors in the area of human health monitoring is highlighted. Based on this, an extended overview of recent advances in dual/triple-mode flexible sensors integrating pressure, humidity, and temperature tactile sensing is presented. Finally, the challenges and opportunities of flexible sensors are discussed.

Applied research and recent advances in the development of flexible sensing hydrogels from cellulose: A review

Flexible wearable smart sensing materials have gained immense momentum, and biomass-based hydrogel sensors for renewable and biologically safe wearable sensors have attracted significant attention in order to meet the growing demand for sustainability and ecological friendliness. Cellulose has been widely used in the field of biomass-based hydrogel sensing materials, being the most abundant biomass material in nature. This review mainly focuses on the types of cellulose hydrogels, the preparation methods and their applications in smart flexible sensing materials. The structure-functional properties-application relationship of cellulose hydrogels and the applications of various cellulose hydrogels in flexible sensing are described in detail. Then it focuses on the methods and mechanisms of cellulose hydrogel flexible sensors preparation, and then summarizes the research of cellulose hydrogel sensors for different types of stimulus response mechanisms to pressure, pH, biomolecules, ions, temperature, humidity, and light. The applications of cellulose hydrogels as flexible sensing materials in biomedical sensing, smart wearable and environmental monitoring are further summarized. Finally, the future development trend of cellulose hydrogels is briefly introduced and the future development of cellulose hydrogel sensing materials is envisioned.

An implantable system for opioid safety

Naloxone can effectively rescue victims from opioid overdose, but less than 5% survive due to delayed or absent first responder intervention. Current overdose reversal systems face key limitations, including low user adherence, false positive detection, and slow antidote delivery. Here, we describe a subcutaneously implanted robotic first responder to overcome these challenges. This implantable system for opioid safety continuously monitors vital signs, detecting opioid overdose through an algorithm analyzing the interplay of cardiorespiratory responses. To address battery concerns with continuous monitoring and multi-sensing modality, an adaptive algorithm dynamically adjusts sensor resolution, reducing the need for frequent charging. Furthermore, the implant includes an ultra-rapid naloxone delivery pump, delivering the 10-mg antidote within 10 s. In animal trials, the robotic first responder successfully revived 96% of overdosed pigs (n = 25) within 3.2 min, showcasing its potential to dramatically improve survival rates and combat the opioid epidemic.

Extremely durable electrical impedance tomography-based soft and ultrathin wearable e-skin for three-dimensional tactile interfaces

In the rapidly evolving field of human-machine interfaces (HMIs), high-resolution wearable electronic skin (e-skin) is essential for user interaction. However, traditional array-structured tactile interfaces require increased number of interconnects, while soft material-based computational methods have limited functionalities. Here, we introduce a thin and soft e-skin for tactile interfaces, offering high mapping capabilities through electrical impedance tomography (EIT). We employed an organic/inorganic hybrid structure with simple, cost-effective fabrication processes, ensuring flexibility and stability. The conductive and stretchable sensing domain includes a micropatterned multiwall carbon nanotube and elastomer composite. The skin-like tactile interface effectively detects pressure-induced conductivity changes, offering superior spatiotemporal resolution with fewer interconnects (pixel/interconnects >57). This EIT-based tactile interface discerns external pressures to a submillimeter degree and vertical deformations of a few hundred micrometers. It sustains stable functions under external damage or environmental changes, confirming its suitability for persistent wearable use. We demonstrate practical applications in real-time HMIs: handwriting recognition and drone control.

Monolayer, open-mesh, pristine PEDOT:PSS-based conformal brain implants for fully MRI-compatible neural interfaces

Understanding brain function is essential for advancing our comprehension of human cognition, behavior, and neurological disorders. Magnetic resonance imaging (MRI) stands out as a powerful tool for exploring brain function, providing detailed insights into its structure and physiology. Combining MRI technology with electrophysiological recording system can enhance the comprehension of brain functionality through synergistic effects. However, the integration of neural implants with MRI technology presents challenges because of its strong electromagnetic (EM) energy during MRI scans. Therefore, MRI-compatible neural implants should facilitate detailed investigation of neural activities and brain functions in real-time in high resolution, without compromising patient safety and imaging quality. Here, we introduce the fully MRI-compatible monolayer open-mesh pristine PEDOT:PSS neural interface. This approach addresses the challenges encountered while using traditional metal-based electrodes in the MRI environment such as induced heat or imaging artifacts. PEDOT:PSS has a diamagnetic property with low electrical conductivity and negative magnetic susceptibility similar to human tissues. Furthermore, by adopting the optimized open-mesh structure, the induced currents generated by EM energy are significantly diminished, leading to optimized MRI compatibility. Through simulations and experiments, our PEDOT:PSS-based open-mesh electrodes showed improved performance in reducing heat generation and eliminating imaging artifacts in an MRI environment. The electrophysiological recording capability was also validated by measuring the local field potential (LFP) from the somatosensory cortex with an in vivo experiment. The development of neural implants with maximized MRI compatibility indicates the possibility of potential tools for future neural diagnostics.

A Biodegradable Fiber Calcium Ion Sensor by Covalently Bonding Ionophores on Bioinert Nanoparticles

Implantable sensors, especially ion sensors, facilitate the progress of scientific research and personalized healthcare. However, the permanent retention of implants induces health risks after sensors fulfill their mission of chronic sensing. Biodegradation is highly anticipated; while; biodegradable chemical sensors are rare due to concerns about the leakage of harmful active molecules after degradation, such as ionophores. Here, a novel biodegradable fiber calcium ion sensor is introduced, wherein ionophores are covalently bonded with bioinert nanoparticles to replace the classical ion-selective membrane. The fiber sensor demonstrates comparable sensing performance to classical ion sensors and good flexibility. It can monitor the fluctuations of Ca2+ in a 4-day lifespan in vivo and biodegrade in 4 weeks. Benefiting from the stable bonding between ionophores and nanoparticles, the biodegradable sensor exhibits a good biocompatibility after degradation. Moreover, this approach of bonding active molecules on bioinert nanoparticles can serve as an effective methodology for minimizing health concerns about biodegradable chemical sensors.

Biodegradable MoNx@Mo-foil electrodes for human-friendly supercapacitors

With the advancement in the field of biomedical research, there is a growing demand for biodegradable electronic devices. Biodegradable supercapacitors (SCs) have emerged as an ideal solution for mitigating the risks associated with secondary surgeries, reducing patient discomfort, and promoting environmental sustainability. In this study, MoNx@Mo-foil was prepared as an active material for biodegradable supercapacitors through high-temperature and nitridation processes. The composite electrode exhibited superior electrochemical performance in both aqueous and solid-state electrolytes. In the case of the solid-state electrolyte, the MoNx@Mo-foil composite electrode-based device demonstrated excellent cycling stability and electrochemical performance. Additionally, the composite electrode exhibited rapid and complete biodegradability in a 3% H2O2 solution. Through detailed experimental analysis and performance testing, we verified the potential application of the MoNx@Mo-foil composite electrode in biodegradable supercapacitors. This work provides a new choice of degradable material for developing biomedical electronic devices.

Porous Conductive Textiles for Wearable Electronics

Over the years, researchers have made significant strides in the development of novel flexible/stretchable and conductive materials, enabling the creation of cutting-edge electronic devices for wearable applications. Among these, porous conductive textiles (PCTs) have emerged as an ideal material platform for wearable electronics, owing to their light weight, flexibility, permeability, and wearing comfort. This Review aims to present a comprehensive overview of the progress and state of the art of utilizing PCTs for the design and fabrication of a wide variety of wearable electronic devices and their integrated wearable systems. To begin with, we elucidate how PCTs revolutionize the form factors of wearable electronics. We then discuss the preparation strategies of PCTs, in terms of the raw materials, fabrication processes, and key properties. Afterward, we provide detailed illustrations of how PCTs are used as basic building blocks to design and fabricate a wide variety of intrinsically flexible or stretchable devices, including sensors, actuators, therapeutic devices, energy-harvesting and storage devices, and displays. We further describe the techniques and strategies for wearable electronic systems either by hybridizing conventional off-the-shelf rigid electronic components with PCTs or by integrating multiple fibrous devices made of PCTs. Subsequently, we highlight some important wearable application scenarios in healthcare, sports and training, converging technologies, and professional specialists. At the end of the Review, we discuss the challenges and perspectives on future research directions and give overall conclusions. As the demand for more personalized and interconnected devices continues to grow, PCT-based wearables hold immense potential to redefine the landscape of wearable technology and reshape the way we live, work, and play.

Mechanoresponsive Flexible Crystals

Flexible crystals have gained significant attention owing to their remarkable pliability, plasticity, and adaptability, making them highly popular in various research and application fields. The main challenges in developing flexible crystals lie in the rational design, preparation, and performance optimization of such crystals. Therefore, a comprehensive understanding of the fundamental origins of crystal flexibility is crucial for establishing evaluation criteria and design principles. This Perspective offers a retrospective analysis of the development of flexible crystals over the past two decades. It summarizes the elastic standards and possible plastic bending mechanisms tailored to diverse flexible crystals and analyzes the assessment of their theoretical basis and applicability. Meanwhile, the compatibility between crystal elasticity and plasticity has been discussed, unveiling the immense prospects of elastic/plastic crystals for applications in biomedicine, flexible electronic devices, and flexible optics. Furthermore, this Perspective presents state-of-the-art experimental avenues and analysis methods for investigating molecular interactions in molecular crystals, which is vital for the future exploration of the mechanisms of crystal flexibility.

Minimally invasive power sources for implantable electronics

As implantable medical electronics (IMEs) developed for healthcare monitoring and biomedical therapy are extensively explored and deployed clinically, the demand for non-invasive implantable biomedical electronics is rapidly surging. Current rigid and bulky implantable microelectronic power sources are prone to immune rejection and incision, or cannot provide enough energy for long-term use, which greatly limits the development of miniaturized implantable medical devices. Herein, a comprehensive review of the historical development of IMEs and the applicable miniaturized power sources along with their advantages and limitations is given. Despite recent advances in microfabrication techniques, biocompatible materials have facilitated the development of IMEs system toward non-invasive, ultra-flexible, bioresorbable, wireless and multifunctional, progress in the development of minimally invasive power sources in implantable systems has remained limited. Here three promising minimally invasive power sources summarized, including energy storage devices (biodegradable primary batteries, rechargeable batteries and supercapacitors), human body energy harvesters (nanogenerators and biofuel cells) and wireless power transfer (far-field radiofrequency radiation, near-field wireless power transfer, ultrasonic and photovoltaic power transfer). The energy storage and energy harvesting mechanism, configurational design, material selection, output power and in vivo applications are also discussed. It is expected to give a comprehensive understanding of the minimally invasive power sources driven IMEs system for painless health monitoring and biomedical therapy with long-term stable functions.

Multifunctional Acrylic Polymers with Enhanced Adhesive Property Serving as Excellent Edge Encapsulant for Stable Optoelectronic Devices

Pendant groups in acrylic adhesive polymers (Ads) have a profound influence on adhesive and cohesive properties and additionally on encapsulant application. However, a systematic investigation to assess the impact of the pendant groups' length and bulkiness is rare, and there is not even a single report on applying Ads as interfacial adhesion promotors and encapsulation materials simultaneously. Herein, we have developed a series of multifunctional methacrylic polymers, namely, R-co-Ads, with varying pendant length and bulkiness (R = methyl (C1), ethyl (C2), propyl (C3), butyl (C4), pentyl (C5), hexyl (C6), isobutyl (iC4), and 2-ethylhexyl (2EH)). The adhesion-related experimental results reveal that R-co-Ads have high transparency, strong adhesion strength to the various contact surfaces, and a fast cure speed. In particular, C1-co-Ad shows a superior adhesion performance with an improved cross-cut index of 4B and a shear bonding strength of 1.56 MPa. We also have adopted C1-co-Ad for encapsulation of various emerging optoelectronic applications (e.g., perovskite solar cell-, charge transport-, and conductivity-related characteristics), demonstrating its excellent edge encapsulant served to improve the device stability against ambient air conditions. Our study establishes the structure-adhesion-surface relationships, advancing the better design of adhesives and encapsulants for various research fields.

An in vitro demonstration of a passive, acoustic metamaterial as a temperature sensor with mK resolution for implantable applications

Wireless medical sensors typically utilize electromagnetic coupling or ultrasound for energy transfer and sensor interrogation. Energy transfer and management is a complex aspect that often limits the applicability of implantable sensor systems. In this work, we report a new passive temperature sensing scheme based on an acoustic metamaterial made of silicon embedded in a polydimethylsiloxane matrix. Compared to other approaches, this concept is implemented without additional electrical components in situ or the need for a customized receiving unit. A standard ultrasonic transducer is used for this demonstration to directly excite and collect the reflected signal. The metamaterial resonates at a frequency close to a typical medical value (5 MHz) and exhibits a high-quality factor. Combining the design features of the metamaterial with the high-temperature sensitivity of the polydimethylsiloxane matrix, we achieve a temperature resolution of 30 mK. This value is below the current standard resolution required in infrared thermometry for monitoring postoperative complications (0.1 K). We fabricated, simulated, in vitro tested, and compared three acoustic sensor designs in the 29-43 °C (~302-316 K) temperature range. With this concept, we demonstrate how our passive metamaterial sensor can open the way toward new zero-power smart medical implant concepts based on acoustic interrogation.

Coaxial Electrohydrodynamic Printing of Microscale Core-Shell Conductive Features for Integrated Fabrication of Flexible Transparent Electronics

Reliable insulation of microscale conductive features is required to fabricate functional multilayer circuits or flexible electronics for providing specific physical/chemical/electrical protection. However, the existing strategies commonly rely on manual assembling processes or multiple microfabrication processes, which is time-consuming and a great challenge for the fabrication of flexible transparent electronics with microscale features and ultrathin thickness. Here, we present a novel coaxial electrohydrodynamic (CEHD) printing strategy for the one-step fabrication of microscale flexible electronics with conductive materials at the core and insulating material at the outer layer. A finite element analysis (FEA) method is established to simulate the CEHD printing process. The extrusion sequence of the conductive and insulating materials during the CEHD printing process shows little effect on the morphology of the core-shell filaments, which can be achieved on different flexible substrates with a minimum conductive line width of 32 ± 3.2 μm, a total thickness of 53.6 ± 4.8 μm, and a conductivity of 0.23 × 107 S/m. The thin insulating layer can provide the inner conductive filament enough protection in 3D, which endows the resultant microscale core-shell electronics with good electrical stability when working in different chemical solvent solutions or under large deformation conditions. Moreover, the presented CEHD printing strategy offers a unique capability to sequentially fabricate an insulating layer, core-shell conductive pattern, and exposed electrodes by simply controlling the material extrusion sequence. The resultant large-area transparent electronics with two-layer core-shell patterns exhibit a high transmittance of 98% and excellent electrothermal performance. The CEHD-printed flexible microelectrode array is successfully used to record the electrical signals of beating mouse hearts. It can also be used to fabricate large-area flexible capacitive sensors to accurately measure the periodical pressure force. We envision that the present CEHD printing strategy can provide a promising tool to fabricate complex three-dimensional electronics with microscale resolution, high flexibility, and multiple functionalities.

Recent Advances in Bioelectronics for Localized Drug Delivery

The last decade has witnessed remarkable advancements in bioelectronics, ushering in a new era of wearable and implantable devices for drug delivery. By utilizing miniaturized system design and/or flexible materials, bioelectronics illustrates ideal integration with target organs and tissues, making them ideal platforms for localized drug delivery. Furthermore, the development of electrically assisted drug delivery systems has enhanced the efficiency and safety of therapeutic administration, particularly for the macromolecules that encounter additional challenges in penetrating biological barriers. In this review, a concise overview of recent progress in bioelectronic devices for in vivo localized drug delivery, with highlights on the latest trends in device design, working principles, and their corresponding functionalities, is provided. The reported systems based on their targeted delivery locations as wearable systems, ingestible systems, and implantable systems are categorized. Each category is introduced in detail by highlighting the special requirements for devices and the corresponding solutions. The remaining challenges in this field and future directions are also discussed.

Ultrathin Flexible Encapsulation Materials Based on Al2O3/Alucone Nanolaminates for Improved Electrical Stability of Silicon Nanomembrane-Based MOS Capacitors

Ultrathin flexible encapsulation (UFE) using multilayered films has prospects for practical applications, such as implantable and wearable electronics. However, existing investigations of the effect of mechanical bending strains on electrical properties after the encapsulation procedure provide insufficient information for improving the electrical stability of ultrathin silicon nanomembrane (Si NM)-based metal oxide semiconductor capacitors (MOSCAPs). Here, we used atomic layer deposition and molecular layer deposition to generate 3.5 dyads of alternating 11 nm Al2O3 and 3.5 nm aluminum alkoxide (alucone) nanolaminates on flexible Si NM-based MOSCAPs. Moreover, we bent the MOSCAPs inwardly to radii of 85 and 110.5 mm and outwardly to radii of 77.5 and 38.5 mm. Subsequently, we tested the unbent and bent MOSCAPs to determine the effect of strain on various electrical parameters, namely the maximum capacitance, minimum capacitance, gate leakage current density, hysteresis voltage, effective oxide charge, oxide trapped charge, interface trap density, and frequency dispersion. The comparison of encapsulated and unencapsulated MOSCAPs on these critical parameters at bending strains indicated that Al2O3/alucone nanolaminates stabilized the electrical and interfacial characteristics of the Si NM-based MOSCAPs. These results highlight that ultrathin Al2O3/alucone nanolaminates are promising encapsulation materials for prolonging the operational lifetimes of flexible Si NM-based metal oxide semiconductor field-effect transistors.

Applications of flexible electronics related to cardiocerebral vascular system

Ensuring accessible and high-quality healthcare worldwide requires field-deployable and affordable clinical diagnostic tools with high performance. In recent years, flexible electronics with wearable and implantable capabilities have garnered significant attention from researchers, which functioned as vital clinical diagnostic-assisted tools by real-time signal transmission from interested targets in vivo. As the most crucial and complex system of human body, cardiocerebral vascular system together with heart-brain network attracts researchers inputting profuse and indefatigable efforts on proper flexible electronics design and materials selection, trying to overcome the impassable gulf between vivid organisms and rigid inorganic units. This article reviews recent breakthroughs in flexible electronics specifically applied to cardiocerebral vascular system and heart-brain network. Relevant sensor types and working principles, electronics materials selection and treatment methods are expounded. Applications of flexible electronics related to these interested organs and systems are specially highlighted. Through precedent great working studies, we conclude their merits and point out some limitations in this emerging field, thus will help to pave the way for revolutionary flexible electronics and diagnosis assisted tools development.

A self-assembled implantable microtubular pacemaker for wireless cardiac electrotherapy

The current cardiac pacemakers are battery dependent, and the pacing leads are prone to introduce valve damage and infection, plus a complete pacemaker retrieval is needed for battery replacement. Despite the reported wireless bioelectronics to pace the epicardium, open-chest surgery (thoracotomy) is required to implant the device, and the procedure is invasive, requiring prolonged wound healing and health care burden. We hereby demonstrate a fully biocompatible wireless microelectronics with a self-assembled design that can be rolled into a lightweight microtubular pacemaker for intravascular implantation and pacing. The radio frequency was used to transfer energy to the microtubular pacemaker for electrical stimulation. We show that this pacemaker provides effective pacing to restore cardiac contraction from a nonbeating heart and have the capacity to perform overdrive pacing to augment blood circulation in an anesthetized pig model. Thus, this microtubular pacemaker paves the way for the minimally invasive implantation of leadless and battery-free microelectronics.

Degradable Elastomeric Silk Biomaterial for Flexible Bioelectronics

The integration of degradable and biomimetic approaches in material and device development can facilitate the next generation of sustainable (bio) electronics. The use of functional degradable materials presents exciting opportunities for applications in healthcare, soft robotics, energy, and electronics. These include conformability to curved surfaces, matching of stiffness of tissue, and the ability to withstand mechanical deformations. Nature-derived materials such as silk fibroin (SF) provide excellent biocompatibility, resorbability, and tunable properties toward such goals. However, fibroin alone lacks the required mechanical properties and durability for processing in biointegrated electronics and dry conditions. To overcome these limitations, we report on an elastomeric photocurable composite of silk fibroin and poly(dimethylsiloxane) (PDMS). Photofibroin (containing methacryl functionalities) is doped with photoPDMS (methacryloxypropyl-terminated poly(dimethylsiloxane)) to form an elastomeric photofibroin (ePF) composite. The elastomeric silk is photocurable, allowing for microfabrication using UV photolithography. It is suitable for circuits, strain-sensing devices, and biointegrated systems. The ePF exhibits flexibility in both wet and dry conditions, enhanced mechanical strength and long-term durability, and optical transparency. It is stable at high temperatures, compatible with electronic materials, and cytocompatible while being enzymatically degradable. This work therefore highlights a path toward combining natural and synthetic materials to achieve versatile properties and demonstrates the potential of silk fibroin composites in (bio) electronics, encapsulation, and packaging.

Electrochemical Wearable Biosensors and Bioelectronic Devices Based on Hydrogels: Mechanical Properties and Electrochemical Behavior

Hydrogel-based wearable electrochemical biosensors (HWEBs) are emerging biomedical devices that have recently received immense interest. The exceptional properties of HWEBs include excellent biocompatibility with hydrophilic nature, high porosity, tailorable permeability, the capability of reliable and accurate detection of disease biomarkers, suitable device-human interface, facile adjustability, and stimuli responsive to the nanofiller materials. Although the biomimetic three-dimensional hydrogels can immobilize bioreceptors, such as enzymes and aptamers, without any loss in their activities. However, most HWEBs suffer from low mechanical strength and electrical conductivity. Many studies have been performed on emerging electroactive nanofillers, including biomacromolecules, carbon-based materials, and inorganic and organic nanomaterials, to tackle these issues. Non-conductive hydrogels and even conductive hydrogels may be modified by nanofillers, as well as redox species. All these modifications have led to the design and development of efficient nanocomposites as electrochemical biosensors. In this review, both conductive-based and non-conductive-based hydrogels derived from natural and synthetic polymers are systematically reviewed. The main synthesis methods and characterization techniques are addressed. The mechanical properties and electrochemical behavior of HWEBs are discussed in detail. Finally, the prospects and potential applications of HWEBs in biosensing, healthcare monitoring, and clinical diagnostics are highlighted.

Micropatterned Elastomeric Composites for Encapsulation of Transient Electronics

Although biodegradable, transient electronic devices must dissolve or decompose via environmental factors, an effective waterproofing or encapsulation system is essential for reliable, durable operation for a desired period of time. Existing protection approaches use multiple or alternate layers of electrically inactive organic/inorganic elements combined with polymers; however, their high mechanical stiffness is not suitable for soft, time-dynamic biological tissues/skins/organs. Here, we introduce a stretchable, bioresorbable encapsulant using nanoparticle-incorporated elastomeric composites with modifications of surface morphology. Nature-inspired micropatterns reduce the diffusion area for water molecules, and embedded nanoparticles impede water permeation, which synergistically enhances the water-barrier performance. Empirical and theoretical evaluations validate the encapsulation mechanisms under strains. Demonstration of a soft, degradable shield with an optical component under a biological solution highlights the potential applicability of the proposed encapsulation strategy.

Fluorescent-based biodegradable microneedle sensor array for tether-free continuous glucose monitoring with smartphone application

Continuous glucose monitoring (CGM) allows patients with diabetes to manage critical disease effectively and autonomously and prevent exacerbation. A painless, wireless, compact, and minimally invasive device that can provide CGM is essential for monitoring the health conditions of freely moving patients with diabetes. Here, we propose a glucose-responsive fluorescence-based highly sensitive biodegradable microneedle CGM system. These ultrathin and ultralight microneedle sensor arrays continuously and precisely monitored glucose concentration in the interstitial fluid with minimally invasive, pain-free, wound-free, and skin inflammation-free outcomes at various locations and thicknesses of the skin. Bioresorbability in the body without a need for device removal after use was a key characteristic of the microneedle glucose sensor. We demonstrated the potential long-term use of the bioresorbable device by applying the tether-free CGM system, thus confirming the successful detection of glucose levels based on changes in fluorescence intensity. In addition, this microneedle glucose sensor with a user-friendly designed home diagnosis system using mobile applications and portable accessories offers an advance in CGM and its applicability to other bioresorbable, wearable, and implantable monitoring device technology.

Intrinsically Nonswellable Multifunctional Hydrogel with Dynamic Nanoconfinement Networks for Robust Tissue-Adaptable Bioelectronics

Developing bioelectronics that retains their long-term functionalities in the human body during daily activities is a current critical issue. To accomplish this, robust tissue adaptability and biointerfacing of bioelectronics should be achieved. Hydrogels have emerged as promising materials for bioelectronics that can softly adapt to and interface with tissues. However, hydrogels lack toughness, requisite electrical properties, and fabrication methodologies. Additionally, the water-swellable property of hydrogels weakens their mechanical properties. In this work, an intrinsically nonswellable multifunctional hydrogel exhibiting tissue-like moduli ranging from 10 to 100 kPa, toughness (400-873 J m-3 ), stretchability (≈1000% strain), and rapid self-healing ability (within 5 min), is developed. The incorporation of carboxyl- and hydroxyl-functionalized carbon nanotubes (fCNTs) ensures high conductivity of the hydrogel (≈40 S m-1 ), which can be maintained and recovered even after stretching or rupture. After a simple chemical modification, the hydrogel shows tissue-adhesive properties (≈50 kPa) against the target tissues. Moreover, the hydrogel can be 3D printed with a high resolution (≈100 µm) through heat treatment owing to its shear-thinning capacity, endowing it with fabrication versatility. The hydrogel is successfully applied to underwater electromyography (EMG) detection and ex vivo bladder expansion monitoring, demonstrating its potential for practical bioelectronics.

End-User Assessment of an Innovative Clothing-Based Sensor Developed for Pressure Injury Prevention: A Mixed-Method Study

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups' show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated.

Reliability of printed stretchable electronics based on nano/micro materials for practical applications

Recent decades have witnessed the booming development of stretchable electronics based on nano/micro composite inks. Printing is a scalable, low-cost, and high-efficiency fabrication tool to realize stretchable electronics through additive processes. However, compared with conventional flexible electronics, stretchable electronics need to experience more severe mechanical deformation which may cause destructive damage. Most of the reported works in this field mainly focus on how to achieve a high stretchability of nano/micro composite conductors or single working modules/devices, with limited attention given to the reliability for practical applications. In this minireview, we summarized the failure modes when printing stretchable electronics using nano/micro composite ink, including dysfunction of the stretchable interconnects, the stress-concentrated rigid-soft interfaces for hybrid electronics, the vulnerable vias upon stretching, thermal accumulation, and environmental instability of stretchable materials. Strategies for tackling these challenges to realize reliable performances are proposed and discussed. Our review provides an overview on the importance of reliable, printable, and stretchable electronics, which are the key enablers in propelling stretchable electronics from fancy demos to practical applications.