Biodegradable and flexible arterial-pulse sensor for the wireless monitoring of blood flow

Synthesis of shape-programmable elastomer for a bioresorbable, wireless nerve stimulator

Materials that have the ability to manipulate shapes in response to stimuli such as heat, light, humidity and magnetism offer a means for versatile, sophisticated functions in soft robotics or biomedical implants, while such a reactive transformation has certain drawbacks including high operating temperatures, inherent rigidity and biological hazard. Herein, we introduce biodegradable, self-adhesive, shape-transformable poly (L-lactide-co-ε-caprolactone) (BSS-PLCL) that can be triggered via thermal stimulation near physiological temperature (∼38 °C). Chemical inspections confirm the fundamental properties of the synthetic materials in diverse aspects, and study on mechanical and biochemical characteristics validates exceptional stretchability up to 800 % and tunable dissolution behaviors under biological conditions. The integration of the functional polymer with a bioresorbable electronic system highlights potential for a wide range of biomedical applications.

Recent advancements in bio-based dielectric and piezoelectric polymers and their biomedical applications

The advent of polymer-based dielectrics marked a significant breakthrough in dielectric materials. However, despite their many advantages, they pose serious environmental threats. Therefore, in recent years, there has been growing interest in bio-based polymers as a sustainable alternative to traditional petroleum-based polymers. Their renewable nature and reduced environmental impact can fulfil the rising demand for eco-friendly substitutes. Beyond their ecological benefits, bio-based polymers also possess distinctive electrical properties that make them extremely attractive in a variety of applications. Considering these, herein, we present recent advancements in bio-based dielectric polymers and nanocomposites. First, the fundamental concepts of dielectric and polymer-based dielectric materials are covered. Then, we will delve into the discussion of recent advancements in the dielectric properties and thermal stability of bio-based polymers, including polylactic acid, polyhydroxyalkanoates, polybutylene succinate, starch, cellulose, chitosan, chitins, and alginates, and their nanocomposites. Other novel bio-based dielectric polymers and their distinct dielectric characteristics have also been pointed out. In an additional section, the piezoelectric properties of these polymers and their recent biomedical applications have been highlighted and discussed thoroughly. In conclusion, this paper thoroughly discusses the recent advances in bio-based dielectric polymers and their potential to revolutionize the biomedical industry while cultivating a more sustainable and greener future.

Degradable π-Conjugated Polymers

The integration of next-generation electronics into society is rapidly reshaping our daily interactions and lifestyles, revolutionizing communication and engagement with the world. Future electronics promise stimuli-responsive features and enhanced biocompatibility, such as skin-like health monitors and sensors embedded in food packaging, transforming healthcare and reducing food waste. Imparting degradability may reduce the adverse environmental impact of next-generation electronics and lead to opportunities for environmental and health monitoring. While advancements have been made in producing degradable materials for encapsulants, substrates, and dielectrics, the availability of degradable conducting and semiconducting materials remains restricted. π-Conjugated polymers are promising candidates for the development of degradable conductors or semiconductors due to the ability to tune their stimuli-responsiveness, biocompatibility, and mechanical durability. This perspective highlights three design considerations: the selection of π-conjugated monomers, synthetic coupling strategies, and degradation of π-conjugated polymers, for generating π-conjugated materials for degradable electronics. We describe the current challenges with monomeric design and present options to circumvent these issues by highlighting biobased π-conjugated compounds with known degradation pathways and stable monomers that allow for chemically recyclable polymers. Next, we present coupling strategies that are compatible for the synthesis of degradable π-conjugated polymers, including direct arylation polymerization and enzymatic polymerization. Lastly, we discuss various modes of depolymerization and characterization techniques to enhance our comprehension of potential degradation byproducts formed during polymer cleavage. Our perspective considers these three design parameters in parallel rather than independently while having a targeted application in mind to accelerate the discovery of next-generation high-performance π-conjugated polymers for degradable organic electronics.

Permanent fluidic magnets for liquid bioelectronics

Brownian motion allows microscopically dispersed nanoparticles to be stable in ferrofluids, as well as causes magnetization relaxation and prohibits permanent magnetism. Here we decoupled the particle Brownian motion from colloidal stability to achieve a permanent fluidic magnet with high magnetization, flowability and reconfigurability. The key to create such permanent fluidic magnets is to maintain a stable magnetic colloidal fluid by using non-Brownian magnetic particles to self-assemble a three-dimensional oriented and ramified magnetic network structure in the carrier fluid. This structure has high coercivity and permanent magnetization, with long-term magnetization stability. We establish a scaling theory model to decipher the permanent fluid magnet formation criteria and formulate a general assembly guideline. Further, we develop injectable and retrievable permanent-fluidic-magnet-based liquid bioelectronics for highly sensitive, self-powered wireless cardiovascular monitoring. Overall, our findings highlight the potential of permanent fluidic magnets as an ultrasoft material for liquid devices and systems, from bioelectronics to robotics.

3D Printing of Robust High-Performance Conducting Polymer Hydrogel-Based Electrical Bioadhesive Interface for Soft Bioelectronics

Electrical bioadhesive interface (EBI), especially conducting polymer hydrogel (CPH)-based EBI, exhibits promising potential applications in various fields, including biomedical devices, neural interfaces, and wearable devices. However, current fabrication techniques of CPH-based EBI mostly focus on conventional methods such as direct casting, injection, and molding, which remains a lingering challenge for further pushing them toward customized practical bioelectronic applications and commercialization. Herein, 3D printable high-performance CPH-based EBI precursor inks are developed through composite engineering of PEDOT:PSS and adhesive ionic macromolecular dopants within tough hydrogel matrices (PVA). Such inks allow the facile fabrication of high-resolution and programmable patterned EBI through 3D printing. Upon successive freeze-thawing, the as-printed PEDOT:PSS-based EBI simultaneously exhibits high conductivity of 1.2 S m-1, low interfacial impedance of 20 Ω, high stretchability of 349%, superior toughness of 109 kJ m-3, and satisfactory adhesion to various materials. Enabled by these advantageous properties and excellent printability, the facile and continuous manufacturing of EBI-based skin electrodes is further demonstrated via 3D printing, and the fabricated electrodes display excellent ECG and EMG signal recording capability superior to commercial products. This work may provide a new avenue for rational design and fabrication of next-generation EBI for soft bioelectronics, further advancing seamless human-machine integration.

Silicon-based transient electronics: principles, devices and applications

Recent advances in materials science, device designs and advanced fabrication technologies have enabled the rapid development of transient electronics, which represents a class of devices or systems that their functionalities and constitutions can be partially/completely degraded via chemical reaction or physical disintegration over a stable operation. Therefore, numerous potentials, including zero/reduced waste electronics, bioresorbable electronic implants, hardware security, and others, are expected. In particular, transient electronics with biocompatible and bioresorbable properties could completely eliminate the secondary retrieval surgical procedure after their in-body operation, thus offering significant potentials for biomedical applications. In terms of material strategies for the manufacturing of transient electronics, silicon nanomembranes (SiNMs) are of great interest because of their good physical/chemical properties, modest mechanical flexibility (depending on their dimensions), robust and outstanding device performances, and state-of-the-art manufacturing technologies. As a result, continuous efforts have been made to develop silicon-based transient electronics, mainly focusing on designing manufacturing strategies, fabricating various devices with different functionalities, investigating degradation or failure mechanisms, and exploring their applications. In this review, we will summarize the recent progresses of silicon-based transient electronics, with an emphasis on the manufacturing of SiNMs, devices, as well as their applications. After a brief introduction, strategies and basics for utilizing SiNMs for transient electronics will be discussed. Then, various silicon-based transient electronic devices with different functionalities are described. After that, several examples regarding on the applications, with an emphasis on the biomedical engineering, of silicon-based transient electronics are presented. Finally, summary and perspectives on transient electronics are exhibited.

Soft mechanical sensors for wearable and implantable applications

Wearable and implantable sensing of biomechanical signals such as pressure, strain, shear, and vibration can enable a multitude of human-integrated applications, including on-skin monitoring of vital signs, motion tracking, monitoring of internal organ condition, restoration of lost/impaired mechanoreception, among many others. The mechanical conformability of such sensors to the human skin and tissue is critical to enhancing their biocompatibility and sensing accuracy. As such, in the recent decade, significant efforts have been made in the development of soft mechanical sensors. To satisfy the requirements of different wearable and implantable applications, such sensors have been imparted with various additional properties to make them better suited for the varied contexts of human-integrated applications. In this review, focusing on the four major types of soft mechanical sensors for pressure, strain, shear, and vibration, we discussed the recent material and device design innovations for achieving several important properties, including flexibility and stretchability, bioresorbability and biodegradability, self-healing properties, breathability, transparency, wireless communication capabilities, and high-density integration. We then went on to discuss the current research state of the use of such novel soft mechanical sensors in wearable and implantable applications, based on which future research needs were further discussed. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices Implantable Materials and Surgical Technologies > Nanomaterials and Implants.

Temperature Self-Compensating Intelligent Wireless Measuring Contact Lens for Quantitative Intraocular Pressure Monitoring

Flexible bioelectronic devices that can perform real-time and accurate intraocular pressure (IOP) monitoring in both clinical and home settings hold significant implications for the diagnosis and treatment of glaucoma, yet they face challenges due to the open physiological environment of the ocular. Herein, we develop an intelligent wireless measuring contact lens (WMCL) incorporating a dual inductor-capacitor-resistor (LCR) resonant system to achieve temperature self-compensation for quantitative IOP monitoring in different application environments. The WMCL utilizes a compact circuitry design, which enables the integration of low-frequency and high-frequency resonators within a single layer of a sensing circuit without causing visual impairment. Mechanically guided microscale 3D encapsulation strategy combined with flexible circuit printing techniques achieves the surface-adaptive fabrication of the WMCL. The specific design of frequency separation imparts distinct temperature response characteristics to the dual resonators, and the linear combination of the dual resonators can eliminate the impact of temperature variations on measurement accuracy. The WMCL demonstrates outstanding sensitivity and linearity in monitoring the IOP of porcine eyes in vitro while maintaining satisfactory measurement accuracy even with internal temperature variations exceeding 10 °C. Overcoming the impact of temperature variations on IOP monitoring from the system level, the WMCL showcases immense potential as the next generation of all-weather IOP monitoring devices.

Wireless Technologies in Flexible and Wearable Sensing: From Materials Design, System Integration to Applications

Wireless and wearable sensors attract considerable interest in personalized healthcare by providing a unique approach for remote, noncontact, and continuous monitoring of various health-related signals without interference with daily life. Recent advances in wireless technologies and wearable sensors have promoted practical applications due to their significantly improved characteristics, such as reduction in size and thickness, enhancement in flexibility and stretchability, and improved conformability to the human body. Currently, most researches focus on active materials and structural designs for wearable sensors, with just a few exceptions reflecting on the technologies for wireless data transmission. This review provides a comprehensive overview of the state-of-the-art wireless technologies and related studies on empowering wearable sensors. The emerging functional nanomaterials utilized for designing unique wireless modules are highlighted, which include metals, carbons, and MXenes. Additionally, the review outlines the system-level integration of wireless modules with flexible sensors, spanning from novel design strategies for enhanced conformability to efficient transmitting data wirelessly. Furthermore, the review introduces representative applications for remote and noninvasive monitoring of physiological signals through on-skin and implantable wireless flexible sensing systems. Finally, the challenges, perspectives, and unprecedented opportunities for wireless and wearable sensors are discussed.

Soft bioreactor systems: a necessary step toward engineered MSK soft tissue?

A key objective of tissue engineering (TE) is to produce in vitro funcional grafts that can replace damaged tissues or organs in patients. TE uses bioreactors, which are controlled environments, allowing the application of physical and biochemical cues to relevant cells growing in biomaterials. For soft musculoskeletal (MSK) tissues such as tendons, ligaments and cartilage, it is now well established that applied mechanical stresses can be incorporated into those bioreactor systems to support tissue growth and maturation via activation of mechanotransduction pathways. However, mechanical stresses applied in the laboratory are often oversimplified compared to those found physiologically and may be a factor in the slow progression of engineered MSK grafts towards the clinic. In recent years, an increasing number of studies have focused on the application of complex loading conditions, applying stresses of different types and direction on tissue constructs, in order to better mimic the cellular environment experienced in vivo. Such studies have highlighted the need to improve upon traditional rigid bioreactors, which are often limited to uniaxial loading, to apply physiologically relevant multiaxial stresses and elucidate their influence on tissue maturation. To address this need, soft bioreactors have emerged. They employ one or more soft components, such as flexible soft chambers that can twist and bend with actuation, soft compliant actuators that can bend with the construct, and soft sensors which record measurements in situ. This review examines types of traditional rigid bioreactors and their shortcomings, and highlights recent advances of soft bioreactors in MSK TE. Challenges and future applications of such systems are discussed, drawing attention to the exciting prospect of these platforms and their ability to aid development of functional soft tissue engineered grafts.

Skin-adhesive and self-healing diagnostic wound dressings for diabetic wound healing recording and electrophysiological signal monitoring

Performing efficient wound management is essential for infected diabetic wounds due to the complex pathology. Flexible electronics have been recognized as one of the promising solutions for wound management. Herein, a kind of skin-adhesive and self-healing flexible bioelectronic was developed, which could be employed as a diagnostic wound dressing to record diabetic wound healing and monitor electrophysiological signals of the patients. The flexible substrate of diagnostic wound dressings showed excellent tissue adhesive (to various substrates including biological samples), self-healing (fracture strength restores by 96%), and intrinsic antibacterial properties (antibacterial ratio >96% against multidrug-resistant bacteria). The diagnostic wound dressings could record the glucose level (1-30 mM), pH values (4-7), and body temperature (18.8-40.0 °C) around the infected diabetic wounds. Besides, the dressings could help optimize treatment strategies based on electrophysiological signals of patients monitored in real-time. This study contributes to developing flexible bioelectronics for the diagnosis and management of diabetic wounds.

Bioresorbable, wireless, passive sensors for continuous pH measurements and early detection of gastric leakage

Continuous monitoring of biomarkers at locations adjacent to targeted internal organs can provide actionable information about postoperative status beyond conventional diagnostic methods. As an example, changes in pH in the intra-abdominal space after gastric surgeries can serve as direct indicators of potentially life-threatening leakage events, in contrast to symptomatic reactions that may delay treatment. Here, we report a bioresorbable, wireless, passive sensor that addresses this clinical need, designed to locally monitor pH for early detection of gastric leakage. A pH-responsive hydrogel serves as a transducer that couples to a mechanically optimized inductor-capacitor circuit for wireless readout. This platform enables real-time monitoring of pH with fast response time (within 1 hour) over a clinically relevant period (up to 7 days) and timely detection of simulated gastric leaks in animal models. These concepts have broad potential applications for temporary sensing of relevant biomarkers during critical risk periods following diverse types of surgeries.

A Compact-Sized Fully Self-Powered Wireless Flowmeter Based on Triboelectric Discharge

Flow sensing exhibits significant potential for monitoring, controlling, and optimizing processes in industries, resource management, and environmental protection. However, achieving wireless real-time and omnidirectional sensing of gas/liquid flow on a simple, self-contained device without external power support has remained a formidable challenge. In this study, a compact-sized, fully self-powered wireless sensing flowmeter (CSWF) is introduced with a small size diameter of down to less than 50 mm, which can transmit real-time and omnidirectional wireless signals, as driven by a rotating triboelectric nanogenerator (R-TENG). The R-TENG triggers the breakdown discharge of a gas discharge tube (GDT), which enables flow rate wireless sensing through emitted electromagnetic waves. Importantly, the performance of the CSWF is not affected by the R-TENG's varied output, while the transmission distance is greater than 10 m. Real-time wireless remote monitoring of wind speed and water flow rate is successfully demonstrated. This research introduces an approach to achieve a wireless, self-powered environmental monitoring system with a diverse range of potential applications, including prolonged meteorological observations, marine environment monitoring, early warning systems for natural disasters, and remote ecosystem monitoring.

A Novel Induction-Type Pressure Sensor based on Magneto-Stress Impedance and Magnetoelastic Coupling Effect for Monitoring Hand Rehabilitation

Visualization of training effectiveness is critical to patients' confidence and eventual rehabilitation. Here, an innovative magnetoinductive pressure sensor is proposed for monitoring hand rehabilitation in stroke hemiplegic patients. It couples the giant magneto and stress-impedance effects of a square spiral amorphous wire with the giant magnetoelastic effect of a polymer magnet (NdFeB@PDMS). The addition of the magnetoelastic layer results in a sensitivity improvement of 178%, a wide sensing range (up to 1 MPa), fast response/recovery times (40 ms), and excellent mechanical robustness (over 15 000 cycles). Further integration with an LC oscillation circuit enables frequency adjustment into the MHz range resulting in a sensitivity of 6.6% kPa-1 and outstanding linearity (R2 =  0.99717) over a stress range of up to 100 kPa. When attached to a commercial split-fingerboard, the sensor is capable of dynamically monitoring the force in each finger, providing a reading of the rehabilitation process. Unlike conventional inductive sensors, the sensor is based on an inductive force-responsive material (amorphous wire), which significantly boosts the sensitivity. The approach also demonstrates the potential of magnetoelasticity in static pressure sensing, which is highly sensitive to dynamic pressure only through electromagnetic induction. This makes it more suitable for long-term and continuous human health monitoring.

Highly Sensitive Near-Field Electrochemical Sensor for In Vivo Monitoring of Respiratory Patterns

Real-time tracking of respiratory patterns provides noninvasive and quick access for evaluating pathophysiological conditions yet remains challenging due to limited temporal resolution and poor sensitivity to dig out fingerprints of respiratory waveforms. Here, we report an electrochemical sensor for accurately tracing respiratory patterns of small animal models based on the electrochemical impedance mechanism for wireless coupling of a graphdiyne oxide (GYDO)-modified sensing coil chip and a reader coil chip via near-field magnetic induction. In the electrochemical impedance measurement mode, an alternating current is applied through the reader coil chip to perturb proton transport at the GYDO interface of the sensing coil chip. As demonstrated, a high-frequency perturbing condition significantly reduces the interfacial resistance for proton transport by 5 orders of magnitude under 95% relative humidity (RH) and improves the low-humidity responses with a limit of detection down to 0.2% RH, enabling in vivo accurate profiling of respiratory patterns on epileptic rats. The electrochemical impedance coupling system holds great potential for new wireless bioelectronics.

Evolution of Musculoskeletal Electronics

The musculoskeletal system, constituting the largest human physiological system, plays a critical role in providing structural support to the body, facilitating intricate movements, and safeguarding internal organs. By virtue of advancements in revolutionized materials and devices, particularly in the realms of motion capture, health monitoring, and postoperative rehabilitation, "musculoskeletal electronics" has actually emerged as an infancy area, but has not yet been explicitly proposed. In this review, the concept of musculoskeletal electronics is elucidated, and the evolution history, representative progress, and key strategies of the involved materials and state-of-the-art devices are summarized. Therefore, the fundamentals of musculoskeletal electronics and key functionality categories are introduced. Subsequently, recent advances in musculoskeletal electronics are presented from the perspectives of "in vitro" to "in vivo" signal detection, interactive modulation, and therapeutic interventions for healing and recovery. Additionally, nine strategy avenues for the development of advanced musculoskeletal electronic materials and devices are proposed. Finally, concise summaries and perspectives are proposed to highlight the directions that deserve focused attention in this booming field.

Recent Progress and Challenges of Implantable Biodegradable Biosensors

Implantable biosensors have evolved to the cutting-edge technology of personalized health care and provide promise for future directions in precision medicine. This is the reason why these devices stand to revolutionize our approach to health and disease management and offer insights into our bodily functions in ways that have never been possible before. This review article tries to delve into the important developments, new materials, and multifarious applications of these biosensors, along with a frank discussion on the challenges that the devices will face in their clinical deployment. In addition, techniques that have been employed for the improvement of the sensitivity and specificity of the biosensors alike are focused on in this article, like new biomarkers and advanced computational and data communicational models. A significant challenge of miniaturized in situ implants is that they need to be removed after serving their purpose. Surgical expulsion provokes discomfort to patients, potentially leading to post-operative complications. Therefore, the biodegradability of implants is an alternative method for removal through natural biological processes. This includes biocompatible materials to develop sensors that remain in the body over longer periods with a much-reduced immune response and better device longevity. However, the biodegradability of implantable sensors is still in its infancy compared to conventional non-biodegradable ones. Sensor design, morphology, fabrication, power, electronics, and data transmission all play a pivotal role in developing medically approved implantable biodegradable biosensors. Advanced material science and nanotechnology extended the capacity of different research groups to implement novel courses of action to design implantable and biodegradable sensor components. But the actualization of such potential for the transformative nature of the health sector, in the first place, will have to surmount the challenges related to biofouling, managing power, guaranteeing data security, and meeting today's rules and regulations. Solving these problems will, therefore, not only enhance the performance and reliability of implantable biodegradable biosensors but also facilitate the translation of laboratory development into clinics, serving patients worldwide in their better disease management and personalized therapeutic interventions.

Millimeter-scale magnetic implants paired with a fully integrated wearable device for wireless biophysical and biochemical sensing

Implantable sensors can directly interface with various organs for precise evaluation of health status. However, extracting signals from such sensors mainly requires transcutaneous wires, integrated circuit chips, or cumbersome readout equipment, which increases the risks of infection, reduces biocompatibility, or limits portability. Here, we develop a set of millimeter-scale, chip-less, and battery-less magnetic implants paired with a fully integrated wearable device for measuring biophysical and biochemical signals. The wearable device can induce a large amplitude damped vibration of the magnetic implants and capture their subsequent motions wirelessly. These motions reflect the biophysical conditions surrounding the implants and the concentration of a specific biochemical depending on the surface modification. Experiments in rat models demonstrate the capabilities of measuring cerebrospinal fluid (CSF) viscosity, intracranial pressure, and CSF glucose levels. This miniaturized system opens the possibility for continuous, wireless monitoring of a wide range of biophysical and biochemical conditions within the living organism.

Wireless Battery-free and Fully Implantable Organ Interfaces

Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.

Bioresorbable shape-adaptive structures for ultrasonic monitoring of deep-tissue homeostasis

Monitoring homeostasis is an essential aspect of obtaining pathophysiological insights for treating patients. Accurate, timely assessments of homeostatic dysregulation in deep tissues typically require expensive imaging techniques or invasive biopsies. We introduce a bioresorbable shape-adaptive materials structure that enables real-time monitoring of deep-tissue homeostasis using conventional ultrasound instruments. Collections of small bioresorbable metal disks distributed within thin, pH-responsive hydrogels, deployed by surgical implantation or syringe injection, allow ultrasound-based measurements of spatiotemporal changes in pH for early assessments of anastomotic leaks after gastrointestinal surgeries, and their bioresorption after a recovery period eliminates the need for surgical extraction. Demonstrations in small and large animal models illustrate capabilities in monitoring leakage from the small intestine, the stomach, and the pancreas.

Fully bioresorbable hybrid opto-electronic neural implant system for simultaneous electrophysiological recording and optogenetic stimulation

Bioresorbable neural implants based on emerging classes of biodegradable materials offer a promising solution to the challenges of secondary surgeries for removal of implanted devices required for existing neural implants. In this study, we introduce a fully bioresorbable flexible hybrid opto-electronic system for simultaneous electrophysiological recording and optogenetic stimulation. The flexible and soft device, composed of biodegradable materials, has a direct optical and electrical interface with the curved cerebral cortex surface while exhibiting excellent biocompatibility. Optimized to minimize light transmission losses and photoelectric artifact interference, the device was chronically implanted in the brain of transgenic mice and performed to photo-stimulate the somatosensory area while recording local field potentials. Thus, the presented hybrid neural implant system, comprising biodegradable materials, promises to provide monitoring and therapy modalities for versatile applications in biomedicine.

Solid-state, liquid-free ion-conducting elastomers: rising-star platforms for flexible intelligent devices

Soft ionic conductors have emerged as a powerful toolkit to engineer transparent flexible intelligent devices that go beyond their conventional counterparts. Particularly, due to their superior capacities of eliminating the evaporation, freezing and leakage issues of the liquid phase encountered with hydrogels, organohydrogels and ionogels, the emerging solid-state, liquid-free ion-conducting elastomers have been largely recognized as ideal candidates for intelligent flexible devices. However, despite their extensive development, a comprehensive and timely review in this emerging field is lacking, particularly from the perspective of design principles, advanced manufacturing, and distinctive applications. Herein, we present (1) the design principles and intriguing merits of solid-state, liquid-free ion-conducting elastomers; (2) the methods to manufacture solid-state, liquid-free ion-conducting elastomers with preferential architectures and functions using advanced technologies such as 3D printing; (3) how to leverage solid-state, liquid-free ion-conducting elastomers in exploiting advanced applications, especially in the fields of flexible wearable sensors, bioelectronics and energy harvesting; (4) what are the unsolved scientific and technical challenges and future opportunities in this multidisciplinary field. We envision that this review will provide a paradigm shift to trigger insightful thinking and innovation in the development of intelligent flexible devices and beyond.

Soft, Long-Lived, Bioresorbable Electronic Surgical Mesh with Wireless Pressure Monitor and On-Demand Drug Delivery

Current research in the area of surgical mesh implants is somewhat limited to traditional designs and synthesis of various mesh materials, whereas meshes with multiple functions may be an effective approach to address long-standing challenges including postoperative complications. Herein, a bioresorbable electronic surgical mesh is presented that offers high mechanical strength over extended timeframes, wireless post-operative pressure monitoring, and on-demand drug delivery for the restoration of tissue structure and function. The study of materials and mesh layouts provides a wide range of tunability of mechanical and biochemical properties. Dissolvable dielectric composite with porous structure in a pyramidal shape enhances sensitivity of a wireless capacitive pressure sensor, and resistive microheaters integrated with inductive coils provide thermo-responsive drug delivery system for an antibacterial agent. In vivo evaluations demonstrate reliable, long-lived operation, and effective treatment for abdominal hernia defects, by clear evidence of suppressed complications such as adhesion formation and infections.

Open-source controller for dynamic cardiovascular models

Cardiovascular pressure sensors require dedicated, reliable, and customisable performance testing equipment. Devices available on the market, such as pulsatile pumps and pulse multipliers, offer limited adaptability to the needs of pressure sensor testing or are highly complex tools designed for other purposes. Therefore, there is a strong need to provide an adaptable and versatile device for characterisation during prototype development, prior to animal model testing. Early development requires detailed characterisation of a sensor performance in a realistic environmental scenario. To address this need, we adapted an off-the-shelf pressure chamber with a custom Arduino-based controller to achieve a rapid change in pressure that simulates the pulsatile profile of human blood pressure. The system is a highly customisable tool, and we have experimentally shown that it works successfully in a wide range of pressures from 30 mmHg to 400 mmHg with a resolution of 2 mmHg. By adjusting the chamber volume using a water balloon, we achieved a cycle rate of up to 120 beats per minute. The device can be operated directly from the Arduino IDE or with a customised graphical user interface developed by our research group. The proposed system is intended to assist other researchers in the development of industrial and biomedical pressure sensors.

Room-Temperature Liquid Metals for Flexible Electronic Devices

Room-temperature gallium-based liquid metals (RT-GaLMs) have garnered significant interest recently owing to their extraordinary combination of fluidity, conductivity, stretchability, self-healing performance, and biocompatibility. They are ideal materials for the manufacture of flexible electronics. By changing the composition and oxidation of RT-GaLMs, physicochemical characteristics of the liquid metal can be adjusted, especially the regulation of rheological, wetting, and adhesion properties. This review highlights the advancements in the liquid metals used in flexible electronics. Meanwhile related characteristics of RT-GaLMs and underlying principles governing their processing and applications for flexible electronics are elucidated. Finally, the diverse applications of RT-GaLMs in self-healing circuits, flexible sensors, energy harvesting devices, and epidermal electronics, are explored. Additionally, the challenges hindering the progress of RT-GaLMs are discussed, while proposing future research directions and potential applications in this emerging field. By presenting a concise and critical analysis, this paper contributes to the advancement of RT-GaLMs as an advanced material applicable for the new generation of flexible electronics.

Ultraconformable Capacitive Strain Sensor Utilizing Network Structure of Single-Walled Carbon Nanotubes for Wireless Body Sensing

Capture and real-time recording of precise body movements using strain sensors provide personal information for healthcare monitoring and management. To acquire this information, a sensor that conforms to curved irregular surfaces, including biological tissue, is desired to record complex body movements while acting like a second skin to avoid interference with the movements. In this study, we developed a thin-film-type capacitive strain sensor that is flexible and stretchable on the surface of a living body. We fabricated conductive polymeric ultrathin films ("nanosheets") comprising polystyrene-block-polybutadiene (SB) elastomers and single-walled carbon nanotubes (SWCNTs) (i.e., SWCNT-SB nanosheets) via gravure coating; the SWCNT-SB-coated nanosheets were used as the flexible electrode in a capacitive strain sensor. The dielectric (DE) layer was then prepared using the silicone elastomer Ecoflex 00-30 because its Young's modulus is comparable to that of the epidermis. The normalized capacitance changes (ΔC/C0) in the sensor increased with increasing tensile strain over a range from 0-100%, indicating that the proposed sensor can measure the strain of biological movements, including those of skin and blood vessels. To improve sensor conformability further, the effect of sensor thickness on the gauge factor (GF) was investigated using thinner DE layers by focusing on their flexural rigidity. As a result, the GF increased from 0.64 to 1.13 as the DE layer thickness decreased from 260 to 40 μm. Finally, we evaluated the fabricated sensor's signal stability and mechanical durability, including during wireless sensing when applied to human skin and a vascular model. The ΔC/C0 values varied in response to the bending motion of a finger, dilation of a blood vessel, and the swallowing movement of the throat. These results indicate that our capacitive strain sensor is conformable and functional on biological tissue to enable monitoring of dynamic biological movements (e.g., pulse rate and arterial dilation) without wearer discomfort.

MXene-Based Elastomer Mimetic Stretchable Sensors: Design, Properties, and Applications

Flexible sensors based on MXene-polymer composites are highly prospective for next-generation wearable electronics used in human-machine interfaces. One of the motivating factors behind the progress of flexible sensors is the steady arrival of new conductive materials. MXenes, a new family of 2D nanomaterials, have been drawing attention since the last decade due to their high electronic conductivity, processability, mechanical robustness and chemical tunability. In this review, we encompass the fabrication of MXene-based polymeric nanocomposites, their structure-property relationship, and applications in the flexible sensor domain. Moreover, our discussion is not only limited to sensor design, their mechanism, and various modes of sensing platform, but also their future perspective and market throughout the world. With our article, we intend to fortify the bond between flexible matrices and MXenes thus promoting the swift advancement of flexible MXene-sensors for wearable technologies.

Covalently-Bonded Laminar Assembly of Van der Waals Semiconductors with Polymers: Toward High-Performance Flexible Devices

Van der Waals semiconductors (vdWS) offer superior mechanical and electrical properties and are promising for flexible microelectronics when combined with polymer substrates. However, the self-passivated vdWS surfaces and their weak adhesion to polymers tend to cause interfacial sliding and wrinkling, and thus, are still challenging the reliability of vdWS-based flexible devices. Here, an effective covalent vdWS-polymer lamination method with high stretch tolerance and excellent electronic performance is reported. Using molybdenum disulfide (MoS2 )and polydimethylsiloxane (PDMS) as a case study, gold-chalcogen bonding and mercapto silane bridges are leveraged. The resulting composite structures exhibit more uniform and stronger interfacial adhesion. This enhanced coupling also enables the observation of a theoretically predicted tension-induced band structure transition in MoS2 . Moreover, no obvious degradation in the devices' structural and electrical properties is identified after numerous mechanical cycle tests. This high-quality lamination enhances the reliability of vdWS-based flexible microelectronics, accelerating their practical applications in biomedical research and consumer electronics.

Exploring the Potentials of Chitin and Chitosan-Based Bioinks for 3D-Printing of Flexible Electronics: The Future of Sustainable Bioelectronics

Chitin and chitosan-based bioink for 3D-printed flexible electronics have tremendous potential for innovation in healthcare, agriculture, the environment, and industry. This biomaterial is suitable for 3D printing because it is highly stretchable, super-flexible, affordable, ultrathin, and lightweight. Owing to its ease of use, on-demand manufacturing, accurate and regulated deposition, and versatility with flexible and soft functional materials, 3D printing has revolutionized free-form construction and end-user customization. This study examined the potential of employing chitin and chitosan-based bioinks to build 3D-printed flexible electronic devices and optimize bioink formulation, printing parameters, and postprocessing processes to improve mechanical and electrical properties. The exploration of 3D-printed chitin and chitosan-based flexible bioelectronics will open new avenues for new flexible materials for numerous industrial applications.

Sensitive, Robust, Wide-Range, and High-Consistency Capacitive Tactile Sensors with Ordered Porous Dielectric Microstructures

Flexible capacitive tactile sensors show great promise in personalized healthcare monitoring and human-machine interfaces, but their practical application is normally hindered because they rarely possess the required comprehensive performance, that is, high pressure sensitivity and fast response within a broad pressure range, high structure robustness, performance consistency, etc. This paper aims to engineer flexible capacitive pressure sensors with highly ordered porous dielectric microstructures and a 3D-printing-based fully solution-processable fabrication process. The proposed dielectric layer with uniformly distributed interior microporous can not only increase its compressibility and dynamic response within an extended pressure range but also enlarge its contact area with electrodes, contributing to a simultaneous improvement in the sensitivity, response speed, detection range, and structure robustness. Meanwhile, owing to its superior abilities in complex structure manufacturing and dimension controlling, the proposed 3D-printing-based fabrication process enables the consistent fabrication of the porous microstructure and thus guarantees device consistency. As a result, the prepared pressure sensors exhibit a high sensitivity of 0.21 kPa-1, fast response and relaxation times of 112 and 152 ms, an interface bonding strength of more than 455.2 kPa, and excellent performance consistency (≤5.47% deviation among different batches of sensors) and tunability. Encouraged by this, the pressure sensor is further integrated with a wireless readout circuit and realizes wireless wearable monitoring of various biosignals (pulse waves and heart rate) and body movements (from slight finger touch to large knee bending). Finally, the influence law of the feature parameters of the porous microstructure on device performance is established by the finite element method, paving the way for sensor optimization. This study motivates the development of flexible capacitive pressure sensors toward practical application.

Tough and Water-Resistant Bioelastomers with Active-Controllable Degradation Rates

Biodegradable electronic devices have gained significant traction in modern medical applications. These devices are generally desired to have a long enough working lifetime for stable operation and allow for active control over their degradation rates after usage. However, current biodegradable materials used as encapsulations or substrates for these devices are challenging to meet the two requirements due to the constraints of inadequate water resistance, poor mechanical properties, and passive degradation characteristics. Herein, we develop a novel biodegradable elastomer named POC-SS-Res by introducing disulfide linkage and resveratrol (Res) into poly(1,8-octanediol-co-citrate) (POC). Compared to POC, POC-SS-Res exhibits good water resistance and excellent mechanical properties in PBS, providing effective protection for devices. At the same time, POC-SS-Res offers the unique advantage of an active-controllable degradation rate, and its degradation products express low biotoxicity. Good biocompatibility of POC-SS-Res is also demonstrated. Bioelectronic components encapsulated with POC-SS-Res have an obvious prolongation of working lifetime in PBS compared to that encapsulated with POC, and its degradation rate can be actively controlled by the addition of glutathione (GSH).

An Emerging Era: Conformable Ultrasound Electronics

Conformable electronics are regarded as the next generation of personal healthcare monitoring and remote diagnosis devices. In recent years, piezoelectric-based conformable ultrasound electronics (cUSE) have been intensively studied due to their unique capabilities, including nonradiative monitoring, soft tissue imaging, deep signal decoding, wireless power transfer, portability, and compatibility. This review provides a comprehensive understanding of cUSE for use in biomedical and healthcare monitoring systems and a summary of their recent advancements. Following an introduction to the fundamentals of piezoelectrics and ultrasound transducers, the critical parameters for transducer design are discussed. Next, five types of cUSE with their advantages and limitations are highlighted, and the fabrication of cUSE using advanced technologies is discussed. In addition, the working function, acoustic performance, and accomplishments in various applications are thoroughly summarized. It is noted that application considerations must be given to the tradeoffs between material selection, manufacturing processes, acoustic performance, mechanical integrity, and the entire integrated system. Finally, current challenges and directions for the development of cUSE are highlighted, and research flow is provided as the roadmap for future research. In conclusion, these advances in the fields of piezoelectric materials, ultrasound transducers, and conformable electronics spark an emerging era of biomedicine and personal healthcare.

Highly Elastic, Bioresorbable Polymeric Materials for Stretchable, Transient Electronic Systems

Substrates or encapsulants in soft and stretchable formats are key components for transient, bioresorbable electronic systems; however, elastomeric polymers with desired mechanical and biochemical properties are very limited compared to non-transient counterparts. Here, we introduce a bioresorbable elastomer, poly(glycolide-co-ε-caprolactone) (PGCL), that contains excellent material properties including high elongation-at-break (< 1300%), resilience and toughness, and tunable dissolution behaviors. Exploitation of PGCLs as polymer matrices, in combination with conducing polymers, yields stretchable, conductive composites for degradable interconnects, sensors, and actuators, which can reliably function under external strains. Integration of device components with wireless modules demonstrates elastic, transient electronic suture system with on-demand drug delivery for rapid recovery of post-surgical wounds in soft, time-dynamic tissues.

Two way workable microchanneled hydrogel suture to diagnose, treat and monitor the infarcted heart

During myocardial infarction, microcirculation disturbance in the ischemic area can cause necrosis and formation of fibrotic tissue, potentially leading to malignant arrhythmia and myocardial remodeling. Here, we report a microchanneled hydrogel suture for two-way signal communication, pumping drugs on demand, and cardiac repair. After myocardial infarction, our hydrogel suture monitors abnormal electrocardiogram through the mobile device and triggers nitric oxide on demand via the hydrogel sutures' microchannels, thereby inhibiting inflammation, promoting microvascular remodeling, and improving the left ventricular ejection fraction in rats and minipigs by more than 60% and 50%, respectively. This work proposes a suture for bidirectional communication that acts as a cardio-patch to repair myocardial infarction, that remotely monitors the heart, and can deliver drugs on demand.

Biodegradable, Biocompatible, and Implantable Multifunctional Sensing Platform for Cardiac Monitoring

Cardiac monitoring after heart surgeries is crucial for health maintenance and detecting postoperative complications early. However, current methods like rigid implants have limitations, as they require performing second complex surgeries for removal, increasing infection and inflammation risks, thus prompting research for improved sensing monitoring technologies. Herein, we introduce a nanosensor platform that is biodegradable, biocompatible, and integrated with multifunctions, suitable for use as implants for cardiac monitoring. The device has two electrochemical biosensors for sensing lactic acid and pH as well as a pressure sensor and a chemiresistor array for detecting volatile organic compounds. Its biocompatibility with myocytes has been tested in vitro, and its biodegradability and sensing function have been proven with ex vivo experiments using a three-dimensional (3D)-printed heart model and 3D-printed cardiac tissue patches. Moreover, an artificial intelligence-based predictive model was designed to fuse sensor data for more precise health assessment, making it a suitable candidate for clinical use. This sensing platform promises impactful applications in the realm of cardiac patient care, laying the foundation for advanced life-saving developments.

Materials-Driven Soft Wearable Bioelectronics for Connected Healthcare

In the era of Internet-of-things, many things can stay connected; however, biological systems, including those necessary for human health, remain unable to stay connected to the global Internet due to the lack of soft conformal biosensors. The fundamental challenge lies in the fact that electronics and biology are distinct and incompatible, as they are based on different materials via different functioning principles. In particular, the human body is soft and curvilinear, yet electronics are typically rigid and planar. Recent advances in materials and materials design have generated tremendous opportunities to design soft wearable bioelectronics, which may bridge the gap, enabling the ultimate dream of connected healthcare for anyone, anytime, and anywhere. We begin with a review of the historical development of healthcare, indicating the significant trend of connected healthcare. This is followed by the focal point of discussion about new materials and materials design, particularly low-dimensional nanomaterials. We summarize material types and their attributes for designing soft bioelectronic sensors; we also cover their synthesis and fabrication methods, including top-down, bottom-up, and their combined approaches. Next, we discuss the wearable energy challenges and progress made to date. In addition to front-end wearable devices, we also describe back-end machine learning algorithms, artificial intelligence, telecommunication, and software. Afterward, we describe the integration of soft wearable bioelectronic systems which have been applied in various testbeds in real-world settings, including laboratories that are preclinical and clinical environments. Finally, we narrate the remaining challenges and opportunities in conjunction with our perspectives.

2D Materials in Flexible Electronics: Recent Advances and Future Prospectives

Flexible electronics have recently gained considerable attention due to their potential to provide new and innovative solutions to a wide range of challenges in various electronic fields. These electronics require specific material properties and performance because they need to be integrated into a variety of surfaces or folded and rolled for newly formatted electronics. Two-dimensional (2D) materials have emerged as promising candidates for flexible electronics due to their unique mechanical, electrical, and optical properties, as well as their compatibility with other materials, enabling the creation of various flexible electronic devices. This article provides a comprehensive review of the progress made in developing flexible electronic devices using 2D materials. In addition, it highlights the key aspects of materials, scalable material production, and device fabrication processes for flexible applications, along with important examples of demonstrations that achieved breakthroughs in various flexible and wearable electronic applications. Finally, we discuss the opportunities, current challenges, potential solutions, and future investigative directions about this field.

Stretchable and Smart Wettable Sensing Patch with Guided Liquid Flow for Multiplexed in Situ Perspiration Analysis

Stretchable sweat sensors have become a personalized wearable platform for continuous, noninvasive health monitoring through conformal integration with the human body. Typically, these devices are coupled with soft microfluidic systems to control sweat flow during advanced analysis processes. However, the implementation of these soft microfluidic devices is limited by their high fabrication costs and the need for skin adhesives to block natural perspiration. To overcome these limitations, a stretchable and smart wettable patch has been proposed for multiplexed in situ perspiration analysis. The patch includes a porous membrane in the form of a patterned microfoam and a nanofiber layer laminate, which extracts sweat selectively from the skin and directs its continuous flow across the device. The integrated electrochemical sensor array measures multiple biomarkers simultaneously such as pH, K+, and Na+. The soft sensing patch comprises compliant materials and structures that allow deformability of up to 50% strain, which enables a stable and seamless interface with the curvilinear human body. During continuous physical exercise, the device has demonstrated a special operating mode by actively accumulating sweat from the skin for multiplex electrochemical analysis of biomarker profiles. The smart wettable membrane provides an affordable solution to address the sampling challenges of in situ perspiration analysis.

Flexible Strain Sensors Based on Bionic Parallel Vein-like Structures for Human Motion Monitoring

In recent years, strain sensors have penetrated various fields. The capability of sensors to convert physical signals into electrical signals is of great importance in healthcare. However, it is still challenging to obtain sensors with high sensitivity, large operating range and low cost. In this paper, a stretchable strain sensor made of a double-layer conductive network, including a biomimetic multilayer graphene-Ecoflex (MLG-Ecoflex) substrate and a multilayer graphene-carbon nanotube (MLG-CNT) composite up-layer was developed. The combined action of the two layers led to an excellent performance with an operating range of up to 580% as well as a high sensitivity (gauge factor (GFmax) of 1517.94). In addition, a pressure sensor was further designed using the bionic vein-like structure with a multi-layer stacking of MLG-Ecoflex/MLG-CNT/MLG-Ecoflex to obtain a relatively high deformation along the direction of thickness. The device presented a high sensing performance (up to a sensitivity of 0.344 kPa-1) capable of monitoring small movements of the human body such as vocalizations and gestures. The good performance of the sensors together with a simple fabrication procedure (flip-molding) make it of potential use for some applications, for example human health monitoring and other areas of human interaction.

Unconstrained Piezoelectric Vascular Electronics for Wireless Monitoring of Hemodynamics and Cardiovascular Health

The patient-centered healthcare requires timely disease diagnosis and prognostic assessment, calling for individualized physiological monitoring. To assess the postoperative hemodynamic status of patients, implantable blood flow monitoring devices are highly expected to deliver real time, long-term, sensitive, and reliable hemodynamic signals, which can accurately reflect multiple physiological conditions. Herein, an implantable and unconstrained vascular electronic system based on a piezoelectric sensor immobilized is presented by a "growable" sheath around continuously growing arterial vessels for real-timely and wirelessly monitoring of hemodynamics. The piezoelectric sensor made of circumferentially aligned polyvinylidene fluoride nanofibers around pulsating artery can sensitively perceive mechanical signals, and the growable sheath bioinspired by the structure and function of leaf sheath has elasticity and conformal shape adaptive to the dynamically growing arterial vessels to avoid growth constriction. With this integrated and smart design, long-term, wireless, and sensitive monitoring of hemodynamics are achieved and demonstrated in rats and rabbits. It provides a simple and versatile strategy for designing implantable sensors in a less invasive way.

Micropyramid Array Bimodal Electronic Skin for Intelligent Material and Surface Shape Perception Based on Capacitive Sensing

Developing electronic skins (e-skins) that are comparable to or even beyond human tactile perception holds significant importance in advancing the process of intellectualization. In this context, a machine-learning-motivated micropyramid array bimodal (MAB) e-skin based on capacitive sensing is reported, which enables spatial mapping applications based on bimodal sensing (proximity and pressure) implemented via fringing and iontronic effects, such as contactless measurement of 3D objects and contact recognition of Braille letters. Benefiting from the iontronic effect and single-micropyramid structure, the MAB e-skin in pressure mode yields impressive features: a maximum sensitivity of 655.3 kPa-1 (below 0.5 kPa), a linear sensitivity of 327.9 kPa-1 (0.5-15 kPa), and an ultralow limit of detection of 0.2 Pa. With the assistance of multilayer perceptron and convolutional neural network, the MAB e-skin can accurately perceive 6 materials and 10 surface shapes based on the training and learning using the collected datasets from proximity and pressure modes, thus allowing it to achieve the precise perception of different objects within one proximity-pressure cycle. The development of this MAB e-skin opens a new avenue for robotic skin and the expansion of advanced applications.

Implantable Flexible Sensors for Health Monitoring

Flexible sensors, as a significant component of flexible electronics, have attracted great interest the realms of human-computer interaction and health monitoring due to their high conformability, adjustable sensitivity, and excellent durability. In comparison to wearable sensor-based in vitro health monitoring, the use of implantable flexible sensors (IFSs) for in vivo health monitoring offers more accurate and reliable vital sign information due to their ability to adapt and directly integrate with human tissue. IFSs show tremendous promise in the field of health monitoring, with unique advantages such as robust signal reading capabilities, lightweight design, flexibility, and biocompatibility. Herein, a review of IFSs for vital signs monitoring is detailly provided, highlighting the essential conditions for in vivo applications. As the prerequisites of IFSs, the stretchability and wireless self-powered properties of the sensor are discussed, with a special attention paid to the sensing materials which can maintain prominent biosafety (i.e., biocompatibility, biodegradability, bioresorbability). Furthermore, the applications of IFSs monitoring various parts of the body are described in detail, with a summary in brain monitoring, eye monitoring, and blood monitoring. Finally, the challenges as well as opportunities in the development of next-generation IFSs are presented.

Wide Remote-Range and Accurate Wireless LC Temperature-Humidity Sensor Enabled by Efficient Mutual Interference Mitigation

Inductor-capacitor wireless integrated sensors (LCWISs) featuring untethered and multitarget measurements are promising in health monitoring and human-machine interfaces. However, the lack of a profound understanding of the internal interference hinders the design of the LCWIS, which has a wide remote sensing range and high accuracy. Herein, a mutually exclusive effect of the mutual inductance interferences in LCWIS was revealed and quantified, enabling a design with a wide range of remote sensing (working distance comparable to the single-target device, working radius: 4 mm) and 16% reduced area. As a key to accurate multitarget measurement, a quantified target interference model based on interference decomposition was proposed to understand the target interferences, providing profound guidance for the design of ultra-accurate LCWIS. As a proof, we designed a cellulose-polyacrylate-cellulose LCWIS (CPC-LCWIS) with ultrahigh accuracies (∼1.2% RH and ∼0.18 °C) beyond commercial wired gauges. The CPC-LCWIS with full-coil sensing structures achieved exceptionally high sensitivities (0.36 MHz/°C and 0.25 MHz/% RH). The CPC-LCWIS was validated for health monitoring and human-machine interfaces. The concept studied in this work provides profound guidance for designing a high-performance flexible LCWIS for advanced wearable electronics.

A dual-mode fiber-shaped flexible capacitive strain sensor fabricated by direct ink writing technology for wearable and implantable health monitoring applications

Flexible fiber-shaped strain sensors show tremendous potential in wearable health monitoring and human‒machine interactions due to their compatibility with everyday clothing. However, the conductive and sensitive materials generated by traditional manufacturing methods to fabricate fiber-shaped strain sensors, including sequential coating and solution extrusion, exhibit limited stretchability, resulting in a limited stretch range and potential interface delamination. To address this issue, we fabricate a fiber-shaped flexible capacitive strain sensor (FSFCSS) by direct ink writing technology. Through this technology, we print parallel helical Ag electrodes on the surface of TPU tube fibers and encapsulate them with a high dielectric material BTO@Ecoflex, endowing FSFCSS with excellent dual-mode sensing performance. The FSFCSS can sense dual-model strain, namely, axial tensile strain and radial expansion strain. For axial tensile strain sensing, FSFCSS exhibits a wide detection range of 178%, a significant sensitivity of 0.924, a low detection limit of 0.6%, a low hysteresis coefficient of 1.44%, and outstanding mechanical stability. For radial expansion strain sensing, FSFCSS demonstrates a sensitivity of 0.00086 mmHg-1 and exhibits excellent responsiveness to static and dynamic expansion strain. Furthermore, FSFCSS was combined with a portable data acquisition circuit board for the acquisition of physiological signals and human‒machine interaction in a wearable wireless sensing system. To measure blood pressure and heart rate, FSFCSS was combined with a printed RF coil in series to fabricate a wireless hemodynamic sensor. This work enables simultaneous application in wearable and implantable health monitoring, thereby advancing the development of smart textiles.

Advances in Wireless, Batteryless, Implantable Electronics for Real-Time, Continuous Physiological Monitoring

This review summarizes recent progress in developing wireless, batteryless, fully implantable biomedical devices for real-time continuous physiological signal monitoring, focusing on advancing human health care. Design considerations, such as biological constraints, energy sourcing, and wireless communication, are discussed in achieving the desired performance of the devices and enhanced interface with human tissues. In addition, we review the recent achievements in materials used for developing implantable systems, emphasizing their importance in achieving multi-functionalities, biocompatibility, and hemocompatibility. The wireless, batteryless devices offer minimally invasive device insertion to the body, enabling portable health monitoring and advanced disease diagnosis. Lastly, we summarize the most recent practical applications of advanced implantable devices for human health care, highlighting their potential for immediate commercialization and clinical uses.

Personalized Machine Learning-Coupled Nanopillar Triboelectric Pulse Sensor for Cuffless Blood Pressure Continuous Monitoring

A wearable system that can continuously track the fluctuation of blood pressure (BP) based on pulse signals is highly desirable for the treatments of cardiovascular diseases, yet the sensitivity, reliability, and accuracy remain challenging. Since the correlations of pulse waveforms to BP are highly individualized due to the diversity of the patients' physiological characteristics, wearable sensors based on universal designs and algorithms often fail to derive BP accurately when applied on individual patients. Herein, a wearable triboelectric pulse sensor based on a biomimetic nanopillar layer was developed and coupled with Personalized Machine Learning (ML) to provide accurate and continuous monitoring of BP. Flexible conductive nanopillars as the triboelectric layer were fabricated through soft lithography replication of a cicada wing, which could effectively enhance the sensor's output performance to detect weak signal characteristics of pulse waveform for BP derivation. The sensors were coupled with a personalized Partial Least-Squares Regression (PLSR) ML to derive unknown BP based on individual pulse characteristics with reasonable accuracy, avoiding the issue of individual variability that was encountered by General PLSR ML or formula algorithms. The cuffless and intelligent design endow this ML-sensor as a highly promising platform for the care and treatments of hypertensive patients.

Recent Progress in Advanced Polyester Elastomers for Tissue Engineering and Bioelectronics

Polyester elastomers are highly flexible and elastic materials that have demonstrated considerable potential in various biomedical applications including cardiac, vascular, neural, and bone tissue engineering and bioelectronics. Polyesters are desirable candidates for future commercial implants due to their biocompatibility, biodegradability, tunable mechanical properties, and facile synthesis and fabrication methods. The incorporation of bioactive components further improves the therapeutic effects of polyester elastomers in biomedical applications. In this review, novel structural modification methods that contribute to outstanding mechanical behaviors of polyester elastomers are discussed. Recent advances in the application of polyester elastomers in tissue engineering and bioelectronics are outlined and analyzed. A prospective of the future research and development on polyester elastomers is also provided.

Recent Advances in Biodegradable Green Electronic Materials and Sensor Applications

As environmental issues have become the dominant agenda worldwide, the necessity for more environmentally friendly electronics has recently emerged. Accordingly, biodegradable or nature-derived materials for green electronics have attracted increased interest. Initially, metal-green hybrid electronics are extensively studied. Although these materials are partially biodegradable, they have high utility owing to their metallic components. Subsequently, carbon-framed materials (such as graphite, cylindrical carbon nanomaterials, graphene, graphene oxide, laser-induced graphene) have been investigated. This has led to the adoption of various strategies for carbon-based materials, such as blending them with biodegradable materials. Moreover, various conductive polymers have been developed and researchers have studied their potential use in green electronics. Researchers have attempted to fabricate conductive polymer composites with high biodegradability by shortening the polymer chains. Furthermore, various physical, chemical, and biological sensors that are essential to modern society have been studied using biodegradable compounds. These recent advances in green electronics have paved the way toward their application in real life, providing a brighter future for society.

Soft implantable printed bioelectronic system for wireless continuous monitoring of restenosis

Atherosclerosis is a prominent cause of coronary artery disease and broader cardiovascular diseases, the leading cause of death worldwide. Angioplasty and stenting is a common treatment, but in-stent restenosis, where the artery re-narrows, is a frequent complication. Restenosis is detected through invasive procedures and is not currently monitored frequently for patients. Here, we report an implantable vascular bioelectronic device using a newly developed miniaturized strain sensor via microneedle printing methods. A capillary-based printing system achieves high-resolution patterning of a soft, capacitive strain sensor. Ink and printing parameters are evaluated to create a fully printed sensor, while sensor design and sensing mechanism are studied to enhance sensitivity and minimize sensor size. The sensor is integrated with a wireless vascular stent, offering a biocompatible, battery-free, wireless monitoring system compatible with conventional catheterization procedures. The vascular sensing system is demonstrated in an artery model for monitoring restenosis progression. Collectively, the artery implantable bioelectronic system shows the potential for wireless, real-time monitoring of various cardiovascular diseases and stent-integrated sensing/treatments.

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.