Self-adaptive cardiac optogenetics device based on negative stretching-resistive strain sensor

Soft Materials and Devices Enabling Sensorimotor Functions in Soft Robots

Sensorimotor functions, the seamless integration of sensing, decision-making, and actuation, are fundamental for robots to interact with their environments. Inspired by biological systems, the incorporation of soft materials and devices into robotics holds significant promise for enhancing these functions. However, current robotics systems often lack the autonomy and intelligence observed in nature due to limited sensorimotor integration, particularly in flexible sensing and actuation. As the field progresses toward soft, flexible, and stretchable materials, developing such materials and devices becomes increasingly critical for advanced robotics. Despite rapid advancements individually in soft materials and flexible devices, their combined applications to enable sensorimotor capabilities in robots are emerging. This review addresses this emerging field by providing a comprehensive overview of soft materials and devices that enable sensorimotor functions in robots. We delve into the latest development in soft sensing technologies, actuation mechanism, structural designs, and fabrication techniques. Additionally, we explore strategies for sensorimotor control, the integration of artificial intelligence (AI), and practical application across various domains such as healthcare, augmented and virtual reality, and exploration. By drawing parallels with biological systems, this review aims to guide future research and development in soft robots, ultimately enhancing the autonomy and adaptability of robots in unstructured environments.

Multi-axis robotic forceps with decoupled pneumatic actuation and force sensing for cochlear implantation

Delicate manual microsurgeries rely on sufficient hands-on experience for safe manipulations. Automated surgical devices can enhance the effectiveness, but developing high-resolution, multi-axis force-sensing devices for micro operations remains challenging. In this study, a 6-axis force-sensing pneumatic forceps with a serial-parallel robotic platform for cochlear implantation is developed. The forceps features a curved body shape embedded with parallel and inclined fiber Bragg grating sensors for 6-axis force sensing, and a pneumatic gripper with decoupled actuation is located at its end for actively grasping and releasing the electrode array. The robotic platform comprises a customized spherical parallel mechanism and a robotic arm, which can provide independent 3-DOF rotations and 3-DOF translations. The feasibility of the developed robotic forceps is validated through cadaveric studies on a temporal bone and a human cadaveric head. In summary, the robotic forceps provides a decoupled mechanism for pneumatic actuation and force sensing, further demonstrating its potential for force interaction and stable operation during robotic microsurgery.

Capturing forceful interaction with deformable objects using a deep learning-powered stretchable tactile array

Capturing forceful interaction with deformable objects during manipulation benefits applications like virtual reality, telemedicine, and robotics. Replicating full hand-object states with complete geometry is challenging because of the occluded object deformations. Here, we report a visual-tactile recording and tracking system for manipulation featuring a stretchable tactile glove with 1152 force-sensing channels and a visual-tactile joint learning framework to estimate dynamic hand-object states during manipulation. To overcome the strain interference caused by contact with deformable objects, an active suppression method based on symmetric response detection and adaptive calibration is proposed and achieves 97.6% accuracy in force measurement, contributing to an improvement of 45.3%. The learning framework processes the visual-tactile sequence and reconstructs hand-object states. We experiment on 24 objects from 6 categories including both deformable and rigid ones with an average reconstruction error of 1.8 cm for all sequences, demonstrating a universal ability to replicate human knowledge in manipulating objects with varying degrees of deformability.

Advances in Biointegrated Wearable and Implantable Optoelectronic Devices for Cardiac Healthcare

With the prevalence of cardiovascular disease, it is imperative that medical monitoring and treatment become more instantaneous and comfortable for patients. Recently, wearable and implantable optoelectronic devices can be seamlessly integrated into human body to enable physiological monitoring and treatment in an imperceptible and spatiotemporally unconstrained manner, opening countless possibilities for the intelligent healthcare paradigm. To achieve biointegrated cardiac healthcare, researchers have focused on novel strategies for the construction of flexible/stretchable optoelectronic devices and systems. Here, we overview the progress of biointegrated flexible and stretchable optoelectronics for wearable and implantable cardiac healthcare devices. Firstly, the device design is addressed, including the mechanical design, interface adhesion, and encapsulation strategies. Next, the practical applications of optoelectronic devices for cardiac physiological monitoring, cardiac optogenetics, and nongenetic stimulation are presented. Finally, an outlook on biointegrated flexible and stretchable optoelectronic devices and systems for intelligent cardiac healthcare is discussed.

Sodium alginate-based coaxial fibers synergistically integrate moisture actuation, length tracing, humidity sensing, and electric heating

The development of wearable electronics has driven the need for smart fibers with advanced multifunctional synergy. In this paper, we present a design of a multifunctional coaxial fiber that is composed of a biopolymer-derived core and an MXene/silver nanowire (AgNW) sheath by wet spinning. The fiber synergistically integrates moisture actuation, length tracing, humidity sensing, and electric heating, making it highly promising for portable devices and protective systems. The biopolymer-derived core provides deformation for moisture-sensitive actuation, while the MXene/AgNW sheath with good conductivity enables the fiber to perform electric heating, humidity sensing, and self-sensing actuation. The coaxial fiber can be programmed to rapidly desorb water molecules to shrink to its original length by using the MXene/AgNW sheath as an electrical heater. We demonstrate proof-of-concept applications based on the multifunctional fibers for thermal physiotherapy and wound healing/monitoring. The sodium alginate@MXene-based coaxial fiber presents a promising solution for the next-generation of smart wearable electronics.

Soft Bioelectronics for Heart Monitoring

Cardiovascular diseases (CVDs) are a predominant global health concern, accounting for over 17.9 million deaths in 2019, representing approximately 32% of all global fatalities. In North America and Europe, over a million adults undergo cardiac surgeries annually. Despite the benefits, such surgeries pose risks and require precise postsurgery monitoring. However, during the postdischarge period, where monitoring infrastructures are limited, continuous monitoring of vital signals is hindered. In this area, the introduction of implantable electronics is altering medical practices by enabling real-time and out-of-hospital monitoring of physiological signals and biological information postsurgery. The multimodal implantable bioelectronic platforms have the capability of continuous heart sensing and stimulation, in both postsurgery and out-of-hospital settings. Furthermore, with the emergence of machine learning algorithms into healthcare devices, next-generation implantables will benefit artificial intelligence (AI) and connectivity with skin-interfaced electronics to provide more precise and user-specific results. This Review outlines recent advancements in implantable bioelectronics and their utilization in cardiovascular health monitoring, highlighting their transformative deployment in sensing and stimulation to the heart toward reaching truly personalized healthcare platforms compatible with the Sustainable Development Goal 3.4 of the WHO 2030 observatory roadmap. This Review also discusses the challenges and future prospects of these devices.

Optoelectronic control of cardiac rhythm: Toward shock-free ambulatory cardioversion of atrial fibrillation

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, progressive in nature, and known to have a negative impact on mortality, morbidity, and quality of life. Patients requiring acute termination of AF to restore sinus rhythm are subjected to electrical cardioversion, which requires sedation and therefore hospitalization due to pain resulting from the electrical shocks. However, considering the progressive nature of AF and its detrimental effects, there is a clear need for acute out-of-hospital (i.e., ambulatory) cardioversion of AF. In the search for shock-free cardioversion methods to realize such ambulatory therapy, a method referred to as optogenetics has been put forward. Optogenetics enables optical control over the electrical activity of cardiomyocytes by targeted expression of light-activated ion channels or pumps and may therefore serve as a means for cardioversion. First proof-of-principle for such light-induced cardioversion came from in vitro studies, proving optogenetic AF termination to be very effective. Later, these results were confirmed in various rodent models of AF using different transgenes, illumination methods, and protocols, whereas computational studies in the human heart provided additional translational insight. Based on these results and fueled by recent advances in molecular biology, gene therapy, and optoelectronic engineering, a basis is now being formed to explore clinical translations of optoelectronic control of cardiac rhythm. In this review, we discuss the current literature regarding optogenetic cardioversion of AF to restore normal rhythm in a shock-free manner. Moreover, key translational steps will be discussed, both from a biological and technological point of view, to outline a path toward realizing acute shock-free ambulatory termination of AF.

Soft Bioelectronics for Therapeutics

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

Strain-Driven Negative Resistance Switching of Conductive Fibers with Adjustable Sensitivity for Wearable Healthcare Monitoring Systems with Near-Zero Standby Power

Recently, one of the primary concerns in e-textile-based healthcare monitoring systems for chronic illness patients has been reducing wasted power consumption, as the system should be always-on to capture diverse biochemical and physiological characteristics. However, the general conductive fibers, a major component of the existing wearable monitoring systems, have a positive gauge-factor (GF) that increases electrical resistance when stretched, so that the systems have no choice but to consume power continuously. Herein, a twisted conductive-fiber-based negatively responsive switch-type (NRS) strain-sensor with an extremely high negative GF (resistance change ratio ≈ 3.9 × 108 ) that can significantly increase its conductivity from insulating to conducting properties is developed. To this end, a precision cracking technology is devised, which could induce a difference in the Young's modulus of the encapsulated layer on the fiber through selective ultraviolet-irradiation treatment. Owing to this technology, the NRS strain-sensors can allow for effective regulation of the mutual contact resistance under tensile strain while maintaining superior durability for over 5000 stretching cycles. For further practical demonstrations, three healthcare monitoring systems (E-fitness pants, smart-masks, and posture correction T-shirts) with near-zero standby power are also developed, which opens up advancements in electronic textiles by expanding the utilization range of fiber strain-sensors.

Advanced Temporally-Spatially Precise Technologies for On-Demand Neurological Disorder Intervention

Temporal-spatial precision has attracted increasing attention for the clinical intervention of neurological disorders (NDs) to mitigate adverse effects of traditional treatments and achieve point-of-care medicine. Inspiring steps forward in this field have been witnessed in recent years, giving the credit to multi-discipline efforts from neurobiology, bioengineering, chemical materials, artificial intelligence, and so on, exhibiting valuable clinical translation potential. In this review, the latest progress in advanced temporally-spatially precise clinical intervention is highlighted, including localized parenchyma drug delivery, precise neuromodulation, as well as biological signal detection to trigger closed-loop control. Their clinical potential in both central and peripheral nervous systems is illustrated meticulously related to typical diseases. The challenges relative to biosafety and scaled production as well as their future perspectives are also discussed in detail. Notably, these intelligent temporally-spatially precision intervention systems could lead the frontier in the near future, demonstrating significant clinical value to support billions of patients plagued with NDs.

Fabrication of practical deformable displays: advances and challenges

Display form factors such as size and shape have been conventionally determined in consideration of usability and portability. The recent trends requiring wearability and convergence of various smart devices demand innovations in display form factors to realize deformability and large screens. Expandable displays that are foldable, multi-foldable, slidable, or rollable have been commercialized or on the edge of product launches. Beyond such two-dimensional (2D) expansion of displays, efforts have been made to develop three dimensional (3D) free-form displays that can be stretched and crumpled for use in realistic tactile sensation, artificial skin for robots, and on-skin or implantable displays. This review article analyzes the current state of the 2D and 3D deformable displays and discusses the technological challenges to be achieved for industrial commercialization.

Highly stretchable and sensitive silicone composites with positive piezoconductivity using nickel powder and ionic liquid

Conductive rubber composites are mixtures of stretchable rubber and conductive materials. They can achieve conductivity and high elasticity and are used in soft robots and wearable devices. In general, these composites exhibit high electrical resistance owing to their bonds between the fillers breaking during elongation. However, there are several types of composite materials that decrease resistance by increasing contact between the conductive materials during elongation through optimization of the shape and size of the filler. These composite materials can rapidly decrease the resistance and are expected to be applicable to switch in electric circuits and sensors. However, to use such composite materials in circuits, the electrical resistance at the time of resistance reduction must be sufficiently low to not affect the electric circuit. To achieve this, a considerable amount of filler must be mixed; however, this reduces the elasticity of the composite. Simultaneously achieving elasticity of the composite and a sufficient decrease in the resistance is challenging. This study developed a conductive rubber composite gel by mixing silicone rubber, ionic liquid, and metal filler. Consequently, the composite achieved an elongation rate of over six times and a decrease in the resistance of less than 1/10⁵. In addition, this composite material was used as a switch circuit wherein an electric circuit is turned on and off according to elongation through a connection to a DC power source.

Wireless, fully implantable cardiac stimulation and recording with on-device computation for closed-loop pacing and defibrillation

Monitoring and control of cardiac function are critical for investigation of cardiovascular pathophysiology and developing life-saving therapies. However, chronic stimulation of the heart in freely moving small animal subjects, which offer a variety of genotypes and phenotypes, is currently difficult. Specifically, real-time control of cardiac function with high spatial and temporal resolution is currently not possible. Here, we introduce a wireless battery-free device with on-board computation for real-time cardiac control with multisite stimulation enabling optogenetic modulation of the entire rodent heart. Seamless integration of the biointerface with the heart is enabled by machine learning-guided design of ultrathin arrays. Long-term pacing, recording, and on-board computation are demonstrated in freely moving animals. This device class enables new heart failure models and offers a platform to test real-time therapeutic paradigms over chronic time scales by providing means to control cardiac function continuously over the lifetime of the subject.

Understanding the Origin of Tensile Response in a Graphene Textile Strain Sensor with Negative Differential Resistance

The flexible strain sensors based on the textile substrate have natural flexibility, high sensitivity, and wide-range tensile response. However, the textile's complex and anisotropic substructure leads to a negative differential resistance (NDR) response, lacking a deeper understanding of the mechanism. Therefore, we examined a graphene textile strain sensor with a conspicuous NDR tensile response, providing a requisite research platform for mechanism investigation. The pioneering measurement of single fiber bundles confirmed the existence of the NDR effect on the subgeometry scale. Based on the in situ characterization of tensile morphology and measurement, we conducted quantitative behavior analyses to reveal the origin of tensile electrical responses in the full range comprehensively. The results showed that the dominant factor in generating the NDR effect is the relative displacement of fibers within the textile bundles. Based on the neural spiking-like tensile response, we further demonstrated the application potential of the textile strain sensor in threshold detection and near-sensor signal processing. The proposed NDR behavior model would provide a reference for the design and application of wearable intelligent textiles.