3D printed bionic ears

Innovative technologies for the fabrication of 3D/4D smart hydrogels and its biomedical applications - A comprehensive review

Repairing and regenerating damaged tissues or organs, and restoring their functioning has been the ultimate aim of medical innovations. 'Reviving healthcare' blends tissue engineering with alternative techniques such as hydrogels, which have emerged as vital tools in modern medicine. Additive manufacturing (AM) is a practical manufacturing revolution that uses building strategies like molding as a viable solution for precise hydrogel manufacturing. Recent advances in this technology have led to the successful manufacturing of hydrogels with enhanced reproducibility, accuracy, precision, and ease of fabrication. Hydrogels continue to metamorphose as the vital compatible bio-ink matrix for AM. AM hydrogels have paved the way for complex 3D/4D hydrogels that can be loaded with drugs or cells. Bio-mimicking 3D cell cultures designed via hydrogel-based AM is a groundbreaking in-vivo assessment tool in biomedical trials. This brief review focuses on preparations and applications of additively manufactured hydrogels in the biomedical spectrum, such as targeted drug delivery, 3D-cell culture, numerous regenerative strategies, biosensing, bioprinting, and cancer therapies. Prevalent AM techniques like extrusion, inkjet, digital light processing, and stereo-lithography have been explored with their setup and methodology to yield functional hydrogels. The perspectives, limitations, and the possible prospects of AM hydrogels have been critically examined in this study.

Setting up a biomodeling, virtual planning, and three-dimensional printing service in Uruguay

Virtual surgical planning and three-dimensional (D) printing are rapidly becoming essential for challenging and complex surgeries around the world. An Ibero-American survey reported a lack of awareness of technology benefits and scarce financial resources as the two main barriers to widespread adoption of 3-D technologies. The Pereira Rossell Hospital Center is a publicly funded maternal and pediatric academic clinical center in Uruguay, a low-resource Latin American country, that successfully created and has been running a 3-D unit for 4 years. The present work is a step-by-step review of the 3-D technology implementation process in a hospital with minimal financial investment. References to training, software, hardware, and the management of human resources are included. Difficulties throughout the process and future challenges are also discussed.

Stimuli-Responsive 3D Printable Conductive Hydrogel: A Step toward Regulating Macrophage Polarization and Wound Healing

Conductive hydrogels (CHs) are promising alternatives for electrical stimulation of cells and tissues in biomedical engineering. Wound healing and immunomodulation are complex processes that involve multiple cell types and signaling pathways. 3D printable conductive hydrogels have emerged as an innovative approach to promote wound healing and modulate immune responses. CHs can facilitate electrical and mechanical stimuli, which can be beneficial for altering cellular metabolism and enhancing the efficiency of the delivery of therapeutic molecules. This review summarizes the recent advances in 3D printable conductive hydrogels for wound healing and their effect on macrophage polarization. This report also discusses the properties of various conductive materials that can be used to fabricate hydrogels to stimulate immune responses. Furthermore, this review highlights the challenges and limitations of using 3D printable CHs for future material discovery. Overall, 3D printable conductive hydrogels hold excellent potential for accelerating wound healing and immune responses, which can lead to the development of new therapeutic strategies for skin and immune-related diseases.

Structure-activity relationships of bioactive polysaccharides extracted from macroalgae towards biomedical application: A review

Macroalgae are valuable and structurally diverse sources of bioactive compounds among marine resources. The cell walls of macroalgae are rich in polysaccharides which exhibit a wide range of biological activities, such as anticoagulant, antioxidant, antiviral, anti-inflammatory, immunomodulatory, and antitumor activities. Macroalgae polysaccharides (MPs) have been recognized as one of the most promising candidates in the biomedical field. However, the structure-activity relationships of bioactive polysaccharides extracted from macroalgae are complex and influenced by various factors. A clear understanding of these relationships is indeed critical in developing effective biomedical applications with MPs. In line with these challenges and knowledge gaps, this paper summarized the structural characteristics of marine MPs from different sources and relevant functional and bioactive properties and particularly highlighted those essential effects of the structure-bioactivity relationships presented in biomedical applications. This review not only focused on elucidating a particular action mechanism of MPs, but also intended to identify a novel or potential application of these valued compounds in the biomedical field in terms of their structural characteristics. In the last, the challenges and prospects of MPs in structure-bioactivity elucidation were further discussed and predicted, where they were emphasized on exploring modern biotechnology approaches potentially applied to expand their promising biomedical applications.

Suitability of Ex Vivo-Expanded Microtic Perichondrocytes for Auricular Reconstruction

Tissue engineering (TE) techniques offer solutions for tissue regeneration but require large quantities of cells. For microtia patients, TE methods represent a unique opportunity for therapies with low donor-site morbidity and reliance on the surgeon's individual expertise. Microtia-derived chondrocytes and perichondrocytes are considered a valuable cell source for autologous reconstruction of the pinna. The aim of this study was to investigate the suitability of perichondrocytes from microtia patients for autologous reconstruction in comparison to healthy perichondrocytes and microtia chondrocytes. Perichondrocytes were isolated via two different methods: explant culture and enzymatic digestion. The isolated cells were analyzed in vitro for their chondrogenic cell properties. We examined migration activity, colony-forming ability, expression of mesenchymal stem cell markers, and gene expression profile. We found that microtic perichondrocytes exhibit similar chondrogenic properties compared to chondrocytes in vitro. We investigated the behavior in three-dimensional cell cultures (spheroids and scaffold-based 3D cell cultures) and assessed the expression of cartilage-specific proteins via immunohistochemistry, e.g., collagen II, which was detected in all samples. Our results show that perichondrocytes from microtia patients are comparable to healthy perichondrocytes and chondrocytes in terms of chondrogenic cell properties and could therefore be a promising cell source for auricular reconstruction.

Recent advances in lignin-based 3D printing materials: A mini-review

With the growing global population and rapid economic development, the demand for energy and raw materials is increasing, and the supply of fossil resources as the main source of energy and raw materials has reached a critical juncture. However, our overexploitation and overconsumption of fossil resources have led to serious problems, including environmental pollution, climate change, and ecosystem destruction. In the face of these challenges, we must recognize the negative impacts of the shortage of fossil resources and actively seek sustainable alternative sources of energy and resources to protect our environment and sustainable development in the future. Three-dimensional (3D) printing, an additive manufacturing technology, has been used in many fields to manufacture complex and high-precision products. While traditional manufacturing processes typically produce large amounts of waste and emissions that are harmful to the environment, 3D printing is much more energy efficient compared to traditional manufacturing methods, which helps to lower energy costs and reduce reliance on non-renewable energy sources. The development of low-carbon and environmentally friendly 3D printing materials can help to reduce carbon emissions and environmental pollution and realize the goal of sustainable development. Lignin, as the second largest renewable green biomass resource after cellulose, has great potential for manufacturing low-carbon and environmentally friendly 3D printing materials. This review presents some recent studies on the applications of lignin and its derivatives in photo-curing 3D printing, including the preparation and performance of lignin-based photosensitive prepolymers, lignin-based reactive diluents, lignin-based photo-initiators, and lignin-based additive. This review also provides recent studies on the preparation and performance of lignin-based thermoplastic polymer for Fused Deposition Modeling (FDM) 3D printing. Finally, the future challenges and industrialization prospects of lignin-based 3D printing materials are discussed.

3D Printed Integrated Sensors: From Fabrication to Applications-A Review

The integration of 3D printed sensors into hosting structures has become a growing area of research due to simplified assembly procedures, reduced system complexity, and lower fabrication cost. Embedding 3D printed sensors into structures or bonding the sensors on surfaces are the two techniques for the integration of sensors. This review extensively discusses the fabrication of sensors through different additive manufacturing techniques. Various additive manufacturing techniques dedicated to manufacture sensors as well as their integration techniques during the manufacturing process will be discussed. This review will also discuss the basic sensing mechanisms of integrated sensors and their applications. It has been proven that integrating 3D printed sensors into infrastructures can open new possibilities for research and development in additive manufacturing and sensor materials for smart goods and the Internet of Things.

Recent advances of additively manufactured noninvasive kinematic biosensors

The necessity of reliable measurement data assessment in the realm of human life has experienced exponential growth due to its extensive utilization in health monitoring, rehabilitation, surgery, and long-term treatment. As a result, the significance of kinematic biosensors has substantially increased across various domains, including wearable devices, human-machine interaction, and bioengineering. Traditionally, the fabrication of skin-mounted biosensors involved complex and costly processes such as lithography and deposition, which required extensive preparation. However, the advent of additive manufacturing has revolutionized biosensor production by facilitating customized manufacturing, expedited processes, and streamlined fabrication. AM technology enables the development of highly sensitive biosensors capable of measuring a wide range of kinematic signals while maintaining a low-cost aspect. This paper provides a comprehensive overview of state-of-the-art noninvasive kinematic biosensors created using diverse AM technologies. The detailed development process and the specifics of different types of kinematic biosensors are also discussed. Unlike previous review articles that primarily focused on the applications of additively manufactured sensors based on their sensing data, this article adopts a unique approach by categorizing and describing their applications according to their sensing frequencies. Although AM technology has opened new possibilities for biosensor fabrication, the field still faces several challenges that need to be addressed. Consequently, this paper also outlines these challenges and provides an overview of future applications in the field. This review article offers researchers in academia and industry a comprehensive overview of the innovative opportunities presented by kinematic biosensors fabricated through additive manufacturing technologies.

Cost-effective 3D scanning and printing technologies for outer ear reconstruction: current status

Current 3D scanning and printing technologies offer not only state-of-the-art developments in the field of medical imaging and bio-engineering, but also cost and time effective solutions for surgical reconstruction procedures. Besides tissue engineering, where living cells are used, bio-compatible polymers or synthetic resin can be applied. The combination of 3D handheld scanning devices or volumetric imaging, (open-source) image processing packages, and 3D printers form a complete workflow chain that is capable of effective rapid prototyping of outer ear replicas. This paper reviews current possibilities and latest use cases for 3D-scanning, data processing and printing of outer ear replicas with a focus on low-cost solutions for rehabilitation engineering.

Self-Healing Polymeric Materials and Composites for Additive Manufacturing

Self-healing polymers have received widespread attention due to their ability to repair damage autonomously and increase material stability, reliability, and economy. However, the processability of self-healing materials has yet to be studied, limiting the application of rich self-healing mechanisms. Additive manufacturing effectively improves the shortcomings of conventional processing while increasing production speed, accuracy, and complexity, offering great promise for self-healing polymer applications. This article summarizes the current self-healing mechanisms of self-healing polymers and their corresponding additive manufacturing methods, and provides an outlook on future developments in the field.

Frontiers of Cranial Base Surgery: Integrating Technique, Technology, and Teamwork for the Future of Neurosurgery

The landscape of cranial base surgery has undergone monumental transformations over the past several decades. This article serves as a comprehensive survey, detailing both the historical and current techniques and technologies that have propelled this field into an era of unprecedented capabilities and sophistication. In the prologue, we traverse the historical evolution from rudimentary interventions to the state-of-the-art neurosurgical methodologies that define today's practice. Subsequent sections delve into the anatomical complexities of the anterior, middle, and posterior cranial fossa, shedding light on the intricacies that dictate surgical approaches. In a section dedicated to advanced techniques and modalities, we explore cutting-edge evolutions in minimally invasive procedures, pituitary surgery, and cranial base reconstruction. Here, we highlight the seamless integration of endocrinology, biomaterial science, and engineering into neurosurgical craftsmanship. The article emphasizes the paradigm shift towards "Functionally" Guided Surgery facilitated by intraoperative neuromonitoring. We explore its historical origins, current technologies, and its invaluable role in tailoring surgical interventions across diverse pathologies. Additionally, the digital era's contributions to cranial base surgery are examined. This includes breakthroughs in endoscopic technology, robotics, augmented reality, and the potential of machine learning and AI-assisted diagnostic and surgical planning. The discussion extends to radiosurgery and radiotherapy, focusing on the harmonization of precision and efficacy through advanced modalities such as Gamma Knife and CyberKnife. The article also evaluates newer protocols that optimize tumor control while preserving neural structures. In acknowledging the holistic nature of cranial base surgery, we advocate for an interdisciplinary approach. The ecosystem of this surgical field is presented as an amalgamation of various medical disciplines, including neurology, radiology, oncology, and rehabilitation, and is further enriched by insights from patient narratives and quality-of-life metrics. The epilogue contemplates future challenges and opportunities, pinpointing potential breakthroughs in stem cell research, regenerative medicine, and genomic tailoring. Ultimately, the article reaffirms the ethos of continuous learning, global collaboration, and patient-first principles, projecting an optimistic trajectory for the field of cranial base surgery in the coming decade.

Taste Bud-Inspired Single-Drop Multitaste Sensing for Comprehensive Flavor Analysis with Deep Learning Algorithms

The electronic tongue (E-tongue) system has emerged as a significant innovation, aiming to replicate the complexity of human taste perception. In spite of the advancements in E-tongue technologies, two primary challenges remain to be addressed. First, evaluating the actual taste is complex due to interactions between taste and substances, such as synergistic and suppressive effects. Second, ensuring reliable outcomes in dynamic conditions, particularly when faced with high deviation error data, presents a significant challenge. The present study introduces a bioinspired artificial E-tongue system that mimics the gustatory system by integrating multiple arrays of taste sensors to emulate taste buds in the human tongue and incorporating a customized deep-learning algorithm for taste interpretation. The developed E-tongue system is capable of detecting four distinct tastes in a single drop of dietary compounds, such as saltiness, sourness, astringency, and sweetness, demonstrating notable reversibility and selectivity. The taste profiles of six different wines are obtained by the E-tongue system and demonstrated similarities in taste trends between the E-tongue system and user reviews from online, although some disparities still exist. To mitigate these disparities, a prototype-based classifier with soft voting is devised and implemented for the artificial E-tongue system. The artificial E-tongue system achieved a high classification accuracy of ∼95% in distinguishing among six different wines and ∼90% accuracy even in an environment where more than 1/3 of the data contained errors. Moreover, by harnessing the capabilities of deep learning technology, a recommendation system was demonstrated to enhance the user experience.

Emerging Advances in Microfluidic Hydrogel Droplets for Tissue Engineering and STEM Cell Mechanobiology

Hydrogel droplets are biodegradable and biocompatible materials with promising applications in tissue engineering, cell encapsulation, and clinical treatments. They represent a well-controlled microstructure to bridge the spatial divide between two-dimensional cell cultures and three-dimensional tissues, toward the recreation of entire organs. The applications of hydrogel droplets in regenerative medicine require a thorough understanding of microfluidic techniques, the biocompatibility of hydrogel materials, and droplet production and manipulation mechanisms. Although hydrogel droplets were well studied, several emerging advances promise to extend current applications to tissue engineering and beyond. Hydrogel droplets can be designed with high surface-to-volume ratios and a variety of matrix microstructures. Microfluidics provides precise control of the flow patterns required for droplet generation, leading to tight distributions of particle size, shape, matrix, and mechanical properties in the resultant microparticles. This review focuses on recent advances in microfluidic hydrogel droplet generation. First, the theoretical principles of microfluidics, materials used in fabrication, and new 3D fabrication techniques were discussed. Then, the hydrogels used in droplet generation and their cell and tissue engineering applications were reviewed. Finally, droplet generation mechanisms were addressed, such as droplet production, droplet manipulation, and surfactants used to prevent coalescence. Lastly, we propose that microfluidic hydrogel droplets can enable novel shear-related tissue engineering and regeneration studies.

Beyond Tissue replacement: The Emerging role of smart implants in healthcare

Smart implants are increasingly used to treat various diseases, track patient status, and restore tissue and organ function. These devices support internal organs, actively stimulate nerves, and monitor essential functions. With continuous monitoring or stimulation, patient observation quality and subsequent treatment can be improved. Additionally, using biodegradable and entirely excreted implant materials eliminates the need for surgical removal, providing a patient-friendly solution. In this review, we classify smart implants and discuss the latest prototypes, materials, and technologies employed in their creation. Our focus lies in exploring medical devices beyond replacing an organ or tissue and incorporating new functionality through sensors and electronic circuits. We also examine the advantages, opportunities, and challenges of creating implantable devices that preserve all critical functions. By presenting an in-depth overview of the current state-of-the-art smart implants, we shed light on persistent issues and limitations while discussing potential avenues for future advancements in materials used for these devices.

The application and progress of tissue engineering and biomaterial scaffolds for total auricular reconstruction in microtia

Microtia is a congenital deformity of the ear with an incidence of about 0.8-4.2 per 10,000 births. Total auricular reconstruction is the preferred treatment of microtia at present, and one of the core technologies is the preparation of cartilage scaffolds. Autologous costal cartilage is recognized as the best material source for constructing scaffold platforms. However, costal cartilage harvest can lead to donor-site injuries such as pneumothorax, postoperative pain, chest wall scar and deformity. Therefore, with the need of alternative to autologous cartilage, in vitro and in vivo studies of biomaterial scaffolds and cartilage tissue engineering have gradually become novel research hot points in auricular reconstruction research. Tissue-engineered cartilage possesses obvious advantages including non-rejection, minimally invasive or non-invasive, the potential of large-scale production to ensure sufficient donors and controllable morphology. Exploration and advancements of tissue-engineered cartilaginous framework are also emerging in aspects including three-dimensional biomaterial scaffolds, acquisition of seed cells and chondrocytes, 3D printing techniques, inducing factors for chondrogenesis and so on, which has greatly promoted the research process of biomaterial substitute. This review discussed the development, current application and research progress of cartilage tissue engineering in auricular reconstruction, particularly the usage and creation of biomaterial scaffolds. The development and selection of various types of seed cells and inducing factors to stimulate chondrogenic differentiation in auricular cartilage were also highlighted. There are still confronted challenges before the clinical application becomes widely available for patients, and its long-term effect remains to be evaluated. We hope to provide guidance for future research directions of biomaterials as an alternative to autologous cartilage in ear reconstruction, and finally benefit the transformation and clinical application of cartilage tissue engineering and biomaterials in microtia treatment.

Toward Single Cell Tattoos: Biotransfer Printing of Lithographic Gold Nanopatterns on Live Cells

Lithographic nanopatterning techniques such as photolithography, electron-beam lithography, and nanoimprint lithography (NIL) have revolutionized modern-day electronics and optics. Yet, their application for creating nanobio interfaces is limited by the cytotoxic and two-dimensional nature of conventional fabrication methods. Here, we present a biocompatible and cost-effective transfer process that leverages (a) NIL to define sub-300 nm gold (Au) nanopattern arrays, (b) amine functionalization of Au to transfer the NIL-arrays from a rigid substrate to a soft transfer layer, (c) alginate hydrogel as a flexible, degradable transfer layer, and (d) gelatin conjugation of the Au NIL-arrays to achieve conformal contact with live cells. We demonstrate biotransfer printing of the Au NIL-arrays on rat brains and live cells with high pattern fidelity and cell viability and observed differences in cell migration on the Au NIL-dot and NIL-wire printed hydrogels. We anticipate that this nanolithography-compatible biotransfer printing method could advance bionics, biosensing, and biohybrid tissue interfaces.

Investigating the Mechanical Properties of Annealed 3D-Printed PLA-Date Pits Composite

Biomedical applications are crucial in rehabilitation medicine, assisting individuals with disabilities. Nevertheless, materials failure can sometimes result in inconvenience for users. Polylactic Acid (PLA) is a popular 3D-printed material that offers design flexibility. However, it is limited in use because its mechanical properties are inadequate. Thus, this study introduces an artificial intelligence model that utilizes ANFIS to estimate the mechanical properties of PLA composites. The model was developed based on an actual data set collected from experiments. The experimental results were obtained by preparing samples of PLA green composites with different weight fractions of date pits, which were then annealed for varying durations to remove residual stresses resulting from 3D printing. The mechanical characteristics of the produced PLA composite specimens were measured experimentally, while the ANSYS model was established to identify the composites' load-carrying capacity. The results showed that ANFIS models are exceptionally robust and compatible and possess good predictive capabilities for estimating the hardness, strength, and Young's modulus of the 3D-printed PLA composites. The model results and experimental outcomes were nearly identical.

Cartilage Tissue Engineering for Nasal Alar and Auricular Reconstruction: A Critical Review of the Literature and Implications for Practice in Dermatologic Surgery

BACKGROUND

Reconstructing defects requiring replacement of nasal or auricular cartilage after Mohs micrographic surgery can at times be challenging. While autologous cartilage grafting is considered the mainstay for repair, it may be limited by cartilage quality/quantity, donor site availability/morbidity, and surgical complications. Tissue-engineered cartilage has recently shown promise for repairing properly selected facial defects.

OBJECTIVE

To (1) provide a comprehensive overview of the literature on the use of tissue-engineered cartilage for nasal alar and auricular defects, and (2) discuss this technology's advantages and future implications for dermatologic surgery.

MATERIALS AND METHODS

A literature search was performed using PubMed/MEDLINE and Google Scholar databases. Studies discussing nasal alar or auricular cartilage tissue engineering were included.

RESULTS

Twenty-seven studies were included. Using minimal donor tissue, tissue-engineered cartilage can create patient-specific, three-dimensional constructs that are biomechanically and histologically similar to human cartilage. The constructs maintain their shape and structural integrity after implantation into animal and human models.

CONCLUSION

Tissue-engineered cartilage may be able to replace native cartilage in reconstructing nasal alar and auricular defects given its ability to overcome several limitations of autologous cartilage grafting. Although further research is necessary, dermatologic surgeons should be aware of this innovative technique and its future implications.

Bioinspired Additive Manufacturing of Hierarchical Materials: From Biostructures to Functions

Throughout billions of years, biological systems have evolved sophisticated, multiscale hierarchical structures to adapt to changing environments. Biomaterials are synthesized under mild conditions through a bottom-up self-assembly process, utilizing substances from the surrounding environment, and meanwhile are regulated by genes and proteins. Additive manufacturing, which mimics this natural process, provides a promising approach to developing new materials with advantageous properties similar to natural biological materials. This review presents an overview of natural biomaterials, emphasizing their chemical and structural compositions at various scales, from the nanoscale to the macroscale, and the key mechanisms underlying their properties. Additionally, this review describes the designs, preparations, and applications of bioinspired multifunctional materials produced through additive manufacturing at different scales, including nano, micro, micro-macro, and macro levels. The review highlights the potential of bioinspired additive manufacturing to develop new functional materials and insights into future directions and prospects in this field. By summarizing the characteristics of natural biomaterials and their synthetic counterparts, this review inspires the development of new materials that can be utilized in various applications.

Toward single cell tattoos: Biotransfer printing of lithographic gold nanopatterns on live cells

Lithographic nanopatterning techniques like photolithography, electron-beam lithography, and nanoimprint lithography (NIL) have revolutionized modern-day electronics and optics. Yet, their application for creating nano-bio interfaces is limited by the cytotoxic and two-dimensional nature of conventional fabrication methods. Here, we present a biocompatible and cost-effective transfer process that leverages (a) NIL to define sub-300 nm gold (Au) nanopattern arrays, (b) amine functionalization of Au to transfer the NIL-arrays from a rigid substrate to a soft transfer layer, (c) alginate hydrogel as a flexible, degradable transfer layer, and (d) gelatin conjugation of the Au NIL-arrays to achieve conformal contact with live cells. We demonstrate biotransfer printing of the Au NIL-arrays on rat brains and live cells with high pattern fidelity and cell viability and observed differences in cell migration on the Au NIL-dot and NIL-wire printed hydrogels. We anticipate that this nanolithography-compatible biotransfer printing method could advance bionics, biosensing, and biohybrid tissue interfaces.

Recent Advances in Bioinspired Hydrogels: Materials, Devices, and Biosignal Computing

The remarkable ability of biological systems to sense and adapt to complex environmental conditions has inspired new materials and novel designs for next-generation wearable devices. Hydrogels are being intensively investigated for their versatile functions in wearable devices due to their superior softness, biocompatibility, and rapid stimulus response. This review focuses on recent strategies for developing bioinspired hydrogel wearable devices that can accommodate mechanical strain and integrate seamlessly with biological systems. We will provide an overview of different types of bioinspired hydrogels tailored for wearable devices. Next, we will discuss the recent progress of bioinspired hydrogel wearable devices such as electronic skin and smart contact lenses. Also, we will comprehensively summarize biosignal readout methods for hydrogel wearable devices as well as advances in powering and wireless data transmission technologies. Finally, current challenges facing these wearable devices are discussed, and future directions are proposed.

The Additive Manufacturing Approach to Polydimethylsiloxane (PDMS) Microfluidic Devices: Review and Future Directions

This paper presents a comprehensive review of the literature for fabricating PDMS microfluidic devices by employing additive manufacturing (AM) processes. AM processes for PDMS microfluidic devices are first classified into (i) the direct printing approach and (ii) the indirect printing approach. The scope of the review covers both approaches, though the focus is on the printed mold approach, which is a kind of the so-called replica mold approach or soft lithography approach. This approach is, in essence, casting PDMS materials with the mold which is printed. The paper also includes our on-going effort on the printed mold approach. The main contribution of this paper is the identification of knowledge gaps and elaboration of future work toward closing the knowledge gaps in fabrication of PDMS microfluidic devices. The second contribution is the development of a novel classification of AM processes from design thinking. There is also a contribution in clarifying confusion in the literature regarding the soft lithography technique; this classification has provided a consistent ontology in the sub-field of the fabrication of microfluidic devices involving AM processes.

Full-colour Jabuticaba-like nanostructures via the multiplex and orthogonal self-assembly of protein-conjugated quantum dots with engineered biofilms

The integration of inorganic components with bacterial biofilms is of great significance for expanding the functionality of artificial biological materials. However, so far, the complexities and functionalities of biofilm-based scaffolds assembled via metal-peptide coordination chemistries remain limited. Here, we present a platform for the multiplexed and specific coupling of recombinant protein-functionalized fluorescent red-green-blue (RGB) quantum dots (QDs) with engineered biofilms to form Jabuticaba-like nanostructures. Full-color living Jabuticaba-like nanostructures have been achieved through the interaction of extracellular peptides that are fabricated by biofilms with the proteins that modify the surface of the RGB QDs through orthogonal SpyTag/SpyCatcher, IsopeptagN/PilinN, and IsopeptagC/PilinC pairs. We envision that living cell populations will enable the multiplexable, scalable and bottom-up assembly of versatile materials that integrate both abiotic and biotic components into multifunctional systems.

3D printed electronics with nanomaterials

A large variety of printing, deposition and writing techniques have been incorporated to fabricate electronic devices in the last decades. This approach, printed electronics, has gained great interest in research and practical applications and is successfully fuelling the growth in materials science and technology. On the other hand, a new player is emerging, additive manufacturing, called 3D printing, introducing a new capability to create geometrically complex constructs with low cost and minimal material waste. Having such tremendous technology in our hands, it was just a matter of time to combine advances of printed electronics technology for the fabrication of unique 3D structural electronics. Nanomaterial patterning with additive manufacturing techniques can enable harnessing their nanoscale properties and the fabrication of active structures with unique electrical, mechanical, optical, thermal, magnetic and biological properties. In this paper, we will briefly review the properties of selected nanomaterials suitable for electronic applications and look closer at the current achievements in the synergistic integration of nanomaterials with additive manufacturing technologies to fabricate 3D printed structural electronics. The focus is fixed strictly on techniques allowing as much as possible fabrication of spatial 3D objects, or at least conformal ones on 3D printed substrates, while only selected techniques are adaptable for 3D printing of electronics. Advances in the fabrication of conductive paths and circuits, passive components, antennas, active and photonic components, energy devices, microelectromechanical systems and sensors are presented. Finally, perspectives for development with new nanomaterials, multimaterial and hybrid techniques, bioelectronics, integration with discrete components and 4D-printing are briefly discussed.

Perspective for soft robotics: the field's past and future

Since its beginnings in the 1960s, soft robotics has been a steadily growing field that has enjoyed recent growth with the advent of rapid prototyping and the provision of new flexible materials. These two innovations have enabled the development of fully flexible and untethered soft robotic systems. The integration of novel sensors enabled by new manufacturing processes and materials shows promise for enabling the production of soft systems with 'embodied intelligence'. Here, four experts present their perspectives for the future of the field of soft robotics based on these past innovations. Their focus is on finding answers to the questions of: how to manufacture soft robots, and on how soft robots can sense, move, and think. We highlight industrial production techniques, which are unused to date for manufacturing soft robots. They discuss how novel tactile sensors for soft robots could be created to enable better interaction of the soft robot with the environment. In conclusion this article highlights how embodied intelligence in soft robots could be used to make soft robots think and to make systems that can compute, autonomously, from sensory inputs.

Digital manufacturing of personalised footwear with embedded sensors

The strong clinical demand for more accurate and personalized health monitoring technologies has called for the development of additively manufactured wearable devices. While the materials palette for additive manufacturing continues to expand, the integration of materials, designs and digital fabrication methods in a unified workflow remains challenging. In this work, a 3D printing platform is proposed for the integrated fabrication of silicone-based soft wearables with embedded piezoresistive sensors. Silicone-based inks containing cellulose nanocrystals and/or carbon black fillers were thoroughly designed and used for the direct ink writing of a shoe insole demonstrator with encapsulated sensors capable of measuring both normal and shear forces. By fine-tuning the material properties to the expected plantar pressures, the patient-customized shoe insole was fully 3D printed at room temperature to measure in-situ gait forces during physical activity. Moreover, the digitized approach allows for rapid adaptation of the sensor layout to meet specific user needs and thereby fabricate improved insoles in multiple quick iterations. The developed materials and workflow enable a new generation of fully 3D printed soft electronic devices for health monitoring.

3D bioprinting and its innovative approach for biomedical applications

3D bioprinting or additive manufacturing is an emerging innovative technology revolutionizing the field of biomedical applications by combining engineering, manufacturing, art, education, and medicine. This process involved incorporating the cells with biocompatible materials to design the required tissue or organ model in situ for various in vivo applications. Conventional 3D printing is involved in constructing the model without incorporating any living components, thereby limiting its use in several recent biological applications. However, this uses additional biological complexities, including material choice, cell types, and their growth and differentiation factors. This state-of-the-art technology consciously summarizes different methods used in bioprinting and their importance and setbacks. It also elaborates on the concept of bioinks and their utility. Biomedical applications such as cancer therapy, tissue engineering, bone regeneration, and wound healing involving 3D printing have gained much attention in recent years. This article aims to provide a comprehensive review of all the aspects associated with 3D bioprinting, from material selection, technology, and fabrication to applications in the biomedical fields. Attempts have been made to highlight each element in detail, along with the associated available reports from recent literature. This review focuses on providing a single platform for cancer and tissue engineering applications associated with 3D bioprinting in the biomedical field.

3D printed bionic ear and microtia-anotia: Medical and forensic implications

Advances in science and technology result in continuous upgrading of the medical and clinical fields. These upgrades have been beneficial to many patients suffering from congenital and developmental diseases causing compromised functionality as well as the structural integrity of the affected organs. One such congenital anomaly is the microtia-anotia spectrum, which results in deformities of the external ear, affecting the hearing capability of an individual. The collaboration and integration of electronics in human biology are exemplified by the development of a 3D printed cyborg bionic ear from the patient's own cells, which is implanted to ameliorate microtia and improve the patient's hearing capacity. Since the late nineteenth century, forensic scientists have explored the external ear, establishing the significance of ear biometrics in the identification process. Similarly, ear prints can also play an important role in identifying the felon of a crime. In this regard, we examine the structure and functionality of implanted ears. This communication is an attempt to enlighten investigators on the forensic importance and limitations of the use of bionic ears for identification.

A review on the recent progress, opportunities, and challenges of 4D printing and bioprinting in regenerative medicine

Four-dimensional (4 D) printing is a novel emerging technology, which can be defined as the ability of 3 D printed materials to change their form and functions. The term 'time' is added to 3 D printing as the fourth dimension, in which materials can respond to a stimulus after finishing the manufacturing process. 4 D printing provides more versatility in terms of size, shape, and structure after printing the construct. Complex material programmability, multi-material printing, and precise structure design are the essential requirements of 4 D printing systems. The utilization of stimuli-responsive polymers has increasingly taken the place of cell traction force-dependent methods and manual folding, offering a more advanced technique to affect a construct's adjusted shape transformation. The present review highlights the concept of 4 D printing and the responsive bioinks used in 4 D printing, such as water-responsive, pH-responsive, thermo-responsive, and light-responsive materials used in tissue regeneration. Cell traction force methods are described as well. Finally, this paper aims to introduce the limitations and future trends of 4 D printing in biomedical applications based on selected key references from the last decade.

Recent advances in neuromorphic transistors for artificial perception applications: FOCUS ISSUE REVIEW

Conventional von Neumann architecture is insufficient in establishing artificial intelligence (AI) in terms of energy efficiency, computing in memory and dynamic learning. Delightedly, rapid developments in neuromorphic computing provide a new paradigm to solve this dilemma. Furthermore, neuromorphic devices that can realize synaptic plasticity and neuromorphic function have extraordinary significance for neuromorphic system. A three-terminal neuromorphic transistor is one of the typical representatives. In addition, human body has five senses, including vision, touch, auditory sense, olfactory sense and gustatory sense, providing abundant information for brain. Inspired by the human perception system, developments in artificial perception system will give new vitality to intelligent robots. This review discusses the operation mechanism, function and application of neuromorphic transistors. The latest progresses in artificial perception systems based on neuromorphic transistors are provided. Finally, the opportunities and challenges of artificial perception systems are summarized.

Latest Advances in 3D Bioprinting of Cardiac Tissues

Cardiovascular diseases (CVDs) are known as the major cause of death worldwide. In spite of tremendous advancements in medical therapy, the gold standard for CVD treatment is still transplantation. Tissue engineering, on the other hand, has emerged as a pioneering field of study with promising results in tissue regeneration using cells, biological cues, and scaffolds. Three-dimensional (3D) bioprinting is a rapidly growing technique in tissue engineering because of its ability to create complex scaffold structures, encapsulate cells, and perform these tasks with precision. More recently, 3D bioprinting has made its debut in cardiac tissue engineering, and scientists are investigating this technique for development of new strategies for cardiac tissue regeneration. In this review, the fundamentals of cardiac tissue biology, available 3D bioprinting techniques and bioinks, and cells implemented for cardiac regeneration are briefly summarized and presented. Afterwards, the pioneering and state-of-the-art works that have utilized 3D bioprinting for cardiac tissue engineering are thoroughly reviewed. Finally, regulatory pathways and their contemporary limitations and challenges for clinical translation are discussed.

High-Resolution, Transparent, and Flexible Printing of Polydimethylsiloxane via Electrohydrodynamic Jet Printing for Conductive Electronic Device Applications

In the field of soft electronics, high-resolution and transparent structures based on various flexible materials constructed via various printing techniques are gaining attention. With the support of electrical stress-induced conductive inks, the electrohydrodynamic (EHD) jet printing technique enables us to build high-resolution structures compared with conventional inkjet printing techniques. Here, EHD jet printing was used to fabricate a high-resolution, transparent, and flexible strain sensor using a polydimethylsiloxane (PDMS)/xylene elastomer, where repetitive and controllable high-resolution printed mesh structures were obtained. The parametric effects of voltage, flow rate, nozzle distance from the substrate, and speed were experimentally investigated to achieve a high-resolution (5 µm) printed mesh structure. Plasma treatment was performed to enhance the adhesion between the AgNWs and the elastomer structure. The plasma-treated functional structure exhibited stable and long strain-sensing cycles during stretching and bending. This simple printing technique resulted in high-resolution, transparent, flexible, and stable strain sensing. The gauge factor of the strain sensor was significantly increased, owing to the high resolution and sensitivity of the printed mesh structures, demonstrating that EHD technology can be applied to high-resolution microchannels, 3D printing, and electronic devices.

4D Multiscale Origami Soft Robots: A Review

Time-dependent shape-transferable soft robots are important for various intelligent applications in flexible electronics and bionics. Four-dimensional (4D) shape changes can offer versatile functional advantages during operations to soft robots that respond to external environmental stimuli, including heat, pH, light, electric, or pneumatic triggers. This review investigates the current advances in multiscale soft robots that can display 4D shape transformations. This review first focuses on material selection to demonstrate 4D origami-driven shape transformations. Second, this review investigates versatile fabrication strategies to form the 4D mechanical structures of soft robots. Third, this review surveys the folding, rolling, bending, and wrinkling mechanisms of soft robots during operation. Fourth, this review highlights the diverse applications of 4D origami-driven soft robots in actuators, sensors, and bionics. Finally, perspectives on future directions and challenges in the development of intelligent soft robots in real operational environments are discussed.

The Promise of Emergent Nanobiotechnologies for In Vivo Applications and Implications for Safety and Security

Nanotechnology, the multidisciplinary field based on the exploitation of the unique physicochemical properties of nanoparticles (NPs) and nanoscale materials, has opened a new realm of possibilities for biological research and biomedical applications. The development and deployment of mRNA-NP vaccines for COVID-19, for example, may revolutionize vaccines and therapeutics. However, regulatory and ethical frameworks that protect the health and safety of the global community and environment are lagging, particularly for nanotechnology geared toward biological applications (ie, bionanotechnology). In this article, while not comprehensive, we attempt to illustrate the breadth and promise of bionanotechnology developments, and how they may present future safety and security challenges. Specifically, we address current advancements to streamline the development of engineered NPs for in vivo applications and provide discussion on nano–bio interactions, NP in vivo delivery, nanoenhancement of human performance, nanomedicine, and the impacts of NPs on human health and the environment.

Discussion on the possibility of multi-layer intelligent technologies to achieve the best recover of musculoskeletal injuries: Smart materials, variable structures, and intelligent therapeutic planning

Although intelligent technologies has facilitated the development of precise orthopaedic, simple internal fixation, ligament reconstruction or arthroplasty can only relieve pain of patients in short-term. To achieve the best recover of musculoskeletal injuries, three bottlenecks must be broken through, which includes scientific path planning, bioactive implants and personalized surgical channels building. As scientific surgical path can be planned and built by through AI technology, 4D printing technology can make more bioactive implants be manufactured, and variable structures can establish personalized channels precisely, it is possible to achieve satisfied and effective musculoskeletal injury recovery with the progress of multi-layer intelligent technologies (MLIT).

Topographic Orientation of Scaffolds for Tissue Regeneration: Recent Advances in Biomaterial Design and Applications

Tissue engineering to develop alternatives for the maintenance, restoration, or enhancement of injured tissues and organs is gaining more and more attention. In tissue engineering, the scaffold used is one of the most critical elements. Its characteristics are expected to mimic the native extracellular matrix and its unique topographical structures. Recently, the topographies of scaffolds have received increasing attention, not least because different topographies, such as aligned and random, have different repair effects on various tissues. In this review, we have focused on various technologies (electrospinning, directional freeze-drying, magnetic freeze-casting, etching, and 3-D printing) to fabricate scaffolds with different topographic orientations, as well as discussed the physicochemical (mechanical properties, porosity, hydrophilicity, and degradation) and biological properties (morphology, distribution, adhesion, proliferation, and migration) of different topographies. Subsequently, we have compiled the effect of scaffold orientation on the regeneration of vessels, skin, neural tissue, bone, articular cartilage, ligaments, tendons, cardiac tissue, corneas, skeletal muscle, and smooth muscle. The compiled information in this review will facilitate the future development of optimal topographical scaffolds for the regeneration of certain tissues. In the majority of tissues, aligned scaffolds are more suitable than random scaffolds for tissue repair and regeneration. The underlying mechanism explaining the various effects of aligned and random orientation might be the differences in “contact guidance”, which stimulate certain biological responses in cells.

Auricular reconstruction via 3D bioprinting strategies: An update

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Evaluating the Performance of 3D-Printed PLA Reinforced with Date Pit Particles for Its Suitability as an Acetabular Liner in Artificial Hip Joints

Off-the-shelf hip joints are considered essential parts in rehabilitation medicine that can help the disabled. However, the failure of the materials used in such joints can cause individual discomfort. In support of the various motor conditions of the influenced individuals, the aim of the current research is to develop a new composite that can be used as an acetabular liner inside the hip joint. Polylactic acid (PLA) can provide the advantage of design flexibility owing to its well-known applicability as a 3D printed material. However, using PLA as an acetabular liner is subject to limitations concerning mechanical properties. We developed a complete production process of a natural filler, i.e., date pits. Then, the PLA and date pit particles were extruded for homogenous mixing, producing a composite filament that can be used in 3D printing. Date pit particles with loading fractions of 0, 2, 4, 6, 8, and 10 wt.% are dispersed in the PLA. The thermal, physical, and mechanical properties of the PLA–date pit composites were estimated experimentally. The incorporation of date pit particles into PLA enhanced the compressive strength and stiffness but resulted in a reduction in the elongation and toughness. A finite element model (FEM) for hip joints was constructed, and the contact stresses on the surface of the acetabular liner were evaluated. The FEM results showed an enhancement in the composite load carrying capacity, in agreement with the experimental results.

Morphological Fabrication of Equilibrium and Auditory Sensors through Electrolytic Polymerization on Hybrid Fluid Rubber (HF Rubber) for Smart Materials of Robotics

The development of auditory sensors and systems is essential in smart materials of robotics and is placed at the strategic category of mutual communication between humans and robots. We designed prototypes of the rubber-made equilibrium and auditory sensors, mimicking hair cells in the saccule and the cochlea at the vestibule of the human ear by utilizing our previously proposed technique of electrolytic polymerization on the hybrid fluid rubber (HF rubber). The fabricated artificial hair cells embedded with mimicked free nerve endings and Pacinian corpuscles, which are well-known receptors in the human skin and have already been elucidated effective in the previous study, have the intelligence of equilibrium and auditory sensing. Moreover, they have a voltage that is generated from built-in electricity caused by the ionized particles and molecules in the HF rubber due to piezoelectricity. We verified the equilibrium and auditory characteristics by measuring the changes in voltage with inclination, vibration over a wide frequency range, and sound waves. We elucidated experimentally that the intelligence has optimum morphological conditions. This work has the possibility of advancing the novel technology of state-of-the-art social robotics.

Recent Advances in Transistor-Based Bionic Perceptual Devices for Artificial Sensory Systems

The sensory nervous system serves as the window for human beings to perceive the outside world by converting external stimuli into distinctive spiking trains. The sensory neurons in this system can process multimodal sensory signals with extremely low power consumption. Therefore, new-concept devices inspired by the sensory neuron are promising candidates to address energy issues in nowadays’ robotics, prosthetics and even computing systems. Recent years have witnessed rapid development in transistor-based bionic perceptual devices, and it is urgent to summarize the research and development of these devices. In this review, the latest progress of transistor-based bionic perceptual devices for artificial sense is reviewed and summarized in five aspects, i.e., vision, touch, hearing, smell, and pain. Finally, the opportunities and challenges related to these areas are also discussed. It would have bright prospects in the fields of artificial intelligence, prosthetics, brain-computer interface, robotics, and medical testing.

Application and Prospects of Hydrogel Additive Manufacturing

Hydrogel has become a commonly used material for 3D and 4D printing due to its favorable biocompatibility and low cost. Additive manufacturing, also known as 3D printing, was originally referred to as rapid prototyping manufacturing. Variable-feature rapid prototyping technology, also known as 4D printing, is a combination of materials, mathematics, and additives. This study constitutes a literature review to address hydrogel-based additive manufacturing technologies, introducing the characteristics of commonly used 3D printing hydrogel methods, such as direct ink writing, fused deposition modeling, and stereolithography. With this review, we also investigated the stimulus types, as well as the advantages and disadvantages of various stimulus-responsive hydrogels in smart hydrogels; non-responsive hydrogels; and various applications of additive manufacturing hydrogels, such as neural catheter preparation and drug delivery. The opportunities, challenges, and future prospects of hydrogel additive manufacturing technologies are discussed.

Waterborne Polyurethane Acrylates Preparation towards 3D Printing for Sewage Treatment

Conventional immobilized nitrifying bacteria technologies are limited to fixed beds with regular shapes such as spheres and cubes. To achieve a higher mass transfer capacity, a complex-structured cultivate bed with larger specific surface areas is usually expected. Direct ink writing (DIW) 3D printing technology is capable of preparing fixed beds where nitrifying bacteria are embedded in without geometry limitations. Nevertheless, conventional bacterial carrier materials for sewage treatment tend to easily collapse during printing procedures. Here, we developed a novel biocompatible waterborne polyurethane acrylate (WPUA) with favorable mechanical properties synthesized by introducing amino acids. End-capped by hydroxyethyl acrylate and mixed with sodium alginate (SA), a dual stimuli-responsive ink for DIW 3D printers was prepared. A robust and insoluble crosslinking network was formed by UV-curing and ion-exchange curing. This dual-cured network with a higher crosslinking density provides better recyclability and protection for cryogenic preservation. The corresponding results show that the nitrification efficiency for printed bioreactors reached 99.9% in 72 h, which is faster than unprinted samples and unmodified WPUA samples. This work provides an innovative immobilization method for 3D printing bacterial active structures and has high potential for future sewage treatment.

Design of 3D-printed macro-models for undergraduates' preclinical practice of endodontic access cavities

INTRODUCTION

Endodontic access cavity is one of the steps most feared by dental students. The objective of the present work was to show the design phases of different realistic macro-models of a lower first molar, showing root canal anatomy and the ideal access cavity.

MATERIALS AND METHODS

Virtual models were designed with MeshMixer, MeshLab and Blender from the data collected (X-rays, CBCT and optical impression) and then printed. Two types of printers-FDM (fused deposition modelling) and SLA (stereolithography) printers-were used to obtain different prototypes which led to final models. A satisfaction questionnaire was then sent to students, after manipulation, to assess the relevance of these models.

RESULTS

Two final models of a lower first molar with an extended size (×9) were finally printed with an SLA laser printer with a transparent liquid resin. The first model represented the tooth with its optimal endodontic access cavity. The second one was designed to be divided into two parts according to a mesio-distal axis in order to visualise the root canal system. Most students found these macro-models to be effective tools for endodontic training.

DISCUSSION

3D printing is a proven technology which is no exception in dentistry. Some authors have already proposed 3D-printed replicas of teeth for endodontic education. Macro-models have been designed, printed and made available to students during preclinical courses before and during training.

CONCLUSION

These educational macro-models should strengthen the knowledge and skills of students to improve their clinical and future practice within the dental office.

3D Bioprinting for Spinal Cord Injury Repair

Spinal cord injury (SCI) is considered to be one of the most challenging central nervous system injuries. The poor regeneration of nerve cells and the formation of scar tissue after injury make it difficult to recover the function of the nervous system. With the development of tissue engineering, three-dimensional (3D) bioprinting has attracted extensive attention because it can accurately print complex structures. At the same time, the technology of blending and printing cells and related cytokines has gradually been matured. Using this technology, complex biological scaffolds with accurate cell localization can be manufactured. Therefore, this technology has a certain potential in the repair of the nervous system, especially the spinal cord. So far, this review focuses on the progress of tissue engineering of the spinal cord, landmark 3D bioprinting methods, and landmark 3D bioprinting applications of the spinal cord in recent years.