Wearable and Implantable Soft Bioelectronics: Device Designs and Material Strategies

Softening implantable bioelectronics: Material designs, applications, and future directions

Implantable bioelectronics, integrated directly within the body, represent a potent biomedical solution for monitoring and treating a range of medical conditions, including chronic diseases, neural disorders, and cardiac conditions, through personalized medical interventions. Nevertheless, contemporary implantable bioelectronics rely heavily on rigid materials (e.g., inorganic materials and metals), leading to inflammatory responses and tissue damage due to a mechanical mismatch with biological tissues. Recently, soft electronics with mechanical properties comparable to those of biological tissues have been introduced to alleviate fatal immune responses and improve tissue conformity. Despite their myriad advantages, substantial challenges persist in surgical handling and precise positioning due to their high compliance. To surmount these obstacles, softening implantable bioelectronics has garnered significant attention as it embraces the benefits of both rigid and soft bioelectronics. These devices are rigid for easy standalone implantation, transitioning to a soft state in vivo in response to environmental stimuli, which effectively overcomes functional/biological problems inherent in the static mechanical properties of conventional implants. This article reviews recent research and development in softening materials and designs for implantable bioelectronics. Examples featuring tissue-penetrating and conformal softening devices highlight the promising potential of these approaches in biomedical applications. A concluding section delves into current challenges and outlines future directions for softening implantable device technologies, underscoring their pivotal role in propelling the evolution of next-generation bioelectronics.

Guest Editorial: Implantable bioelectronics

The realm of implantable bioelectronics represents a frontier in medical science, merging technology, biology, and medicine to innovate treatments that enhance, restore, or monitor physiological functions. This field has yielded devices like cochlear implants, cardiac pacemakers, deep brain stimulators, and vagus nerve stimulators, each designed to address a specific health condition, ranging from sensorineural hearing loss to chronic pain, neurological disorders, and heart rhythm irregularities. Such devices underscore the potential of bioelectronics to significantly improve patient outcomes and quality of life. Recent technological breakthroughs in materials science, nanotechnology, and microfabrication have enabled the development of more sophisticated, smaller, and biocompatible bioelectronic devices. However, the field also encounters challenges, particularly in extending the capabilities of devices such as retinal prostheses, which aim to restore vision but currently offer limited visual acuity. Research in implantable bioelectronics is highly timely, driven by an aging global population with a growing prevalence of chronic diseases that could benefit from these technologies. The convergence of societal health needs, advancing technological capabilities, and a supportive ecosystem for innovation marks this era as pivotal for bioelectronic research.

Next-Generation Cardiac Interfacing Technologies Using Nanomaterial-Based Soft Bioelectronics

Cardiac interfacing devices are essential components for the management of cardiovascular diseases, particularly in terms of electrophysiological monitoring and implementation of therapies. However, conventional cardiac devices are typically composed of rigid and bulky materials and thus pose significant challenges for effective long-term interfacing with the curvilinear surface of a dynamically beating heart. In this regard, the recent development of intrinsically soft bioelectronic devices using nanocomposites, which are fabricated by blending conductive nanofillers in polymeric and elastomeric matrices, has shown great promise. The intrinsically soft bioelectronics not only endure the dynamic beating motion of the heart and maintain stable performance but also enable conformal, reliable, and large-area interfacing with the target cardiac tissue, allowing for high-quality electrophysiological mapping, feedback electrical stimulations, and even mechanical assistance. Here, we explore next-generation cardiac interfacing strategies based on soft bioelectronic devices that utilize elastic conductive nanocomposites. We first discuss the conventional cardiac devices used to manage cardiovascular diseases and explain their undesired limitations. Then, we introduce intrinsically soft polymeric materials and mechanical restraint devices utilizing soft polymeric materials. After the discussion of the fabrication and functionalization of conductive nanomaterials, the introduction of intrinsically soft bioelectronics using nanocomposites and their application to cardiac monitoring and feedback therapy follow. Finally, comments on the future prospects of soft bioelectronics for cardiac interfacing technologies are discussed.

Biocompatible Metal-Free Perovskite Membranes for Wearable X-ray Detectors

Halide perovskites are emerging as promising materials for X-ray detection owing to their compatibility with flexible fabrication, cost-effective solution processing, and exceptional carrier transport behaviors. However, the challenge of removing lead from high-performing perovskites, crucial for wearable electronics, while retaining their superior performance, persists. Here, we present for the first time a highly sensitive and robust flexible X-ray detector utilizing a biocompatible, metal-free perovskite, MDABCO-NH4I3 (MDABCO = methyl-N'-diazabicyclo[2.2.2]octonium). This wearable X-ray detector, based on a MDABCO-NH4I3 thick membrane, exhibits remarkable properties including a large resistivity of 1.13 × 1011 Ω cm, a high mobility-lifetime product (μ-τ) of 1.64 × 10-4 cm2 V-1, and spin Seebeck effect coefficient of 1.9 nV K-1. We achieve a high sensitivity of 6521.6 ± 700 μC Gyair-1 cm-2 and a low detection limit of 77 nGyair s-1, ranking among the highest for biocompatible X-ray detectors. Additionally, the device exhibits effective X-ray imaging at a low dose rate of 1.87 μGyair s-1, which is approximately one-third of the dose rate used in regular medical diagnostics. Crucially, both the MDABCO-NH4I3 thick membrane and the device showcase excellent mechanical robustness. These attributes render the flexible MDABCO-NH4I3 thick membranes highly competitive for next-generation, high-performance, wearable X-ray detection applications.

Living Synthelectronics: A New Era for Bioelectronics Powered by Synthetic Biology

Bioelectronics, which converges biology and electronics, has attracted great attention due to their vital applications in human-machine interfaces. While traditional bioelectronic devices utilize nonliving organic and/or inorganic materials to achieve flexibility and stretchability, a biological mismatch is often encountered because human tissues are characterized not only by softness and stretchability but also by biodynamic and adaptive properties. Recently, a notable paradigm shift has emerged in bioelectronics, where living cells, and even viruses, modified via gene editing within synthetic biology, are used as core components in a new hybrid electronics paradigm. These devices are defined as "living synthelectronics," and they offer enhanced potential for interfacing with human tissues at informational and substance exchange levels. In this Perspective, the recent advances in living synthelectronics are summarized. First, opportunities brought to electronics by synthetic biology are briefly introduced. Then, strategic approaches to designing and making electronic devices using living cells/viruses as the building blocks, sensing components, or power sources are reviewed. Finally, the challenges faced by living synthelectronics are raised. It is believed that this paradigm shift will significantly contribute to the real integration of bioelectronics with human tissues.

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.

Strategies in surface engineering for the regulation of microclimates in skin-medical product interactions

There is a growing number of personal healthcare devices that are in prolonged contact with the skin. The functionality of these products is linked to the interface formed by the contact between the medical apparatus and the skin. The interface can be characterised by its topology, compliance, and moisture and thermal regulating capabilities. Many devices are, however, described to have suboptimal and occlusive contacts, resulting in physiological unfavourable microclimates at the interface. The resulting poor management of moisture and temperature can impact the functionality and utility of the device and, in severe cases, lead to physical harm to the user. Being able to control the microclimate is therefore expected to limit medical-device related injuries and prevent associated skin complications. Surface engineering can modify and potentially enhance the regulation of the microclimate factors surrounding the interface between a product's surface and the skin. This review provides an overview of potential engineering solutions considering the needs for, and influences on, regulation of temperature and moisture by considering the skin-medical device interface as a system. These findings serve as a platform for the anticipated progress in the role of surface engineering for skin-device microclimate regulation.

Resorbable conductive materials for optimally interfacing medical devices with the living

Implantable and wearable bioelectronic systems are arising growing interest in the medical field. Linking the microelectronic (electronic conductivity) and biological (ionic conductivity) worlds, the biocompatible conductive materials at the electrode/tissue interface are key components in these systems. We herein focus more particularly on resorbable bioelectronic systems, which can safely degrade in the biological environment once they have completed their purpose, namely, stimulating or sensing biological activity in the tissues. Resorbable conductive materials are also explored in the fields of tissue engineering and 3D cell culture. After a short description of polymer-based substrates and scaffolds, and resorbable electrical conductors, we review how they can be combined to design resorbable conductive materials. Although these materials are still emerging, various medical and biomedical applications are already taking shape that can profoundly modify post-operative and wound healing follow-up. Future challenges and perspectives in the field are proposed.

Flexible and Stretchable Light-Emitting Diodes and Photodetectors for Human-Centric Optoelectronics

Optoelectronic devices with unconventional form factors, such as flexible and stretchable light-emitting or photoresponsive devices, are core elements for the next-generation human-centric optoelectronics. For instance, these deformable devices can be utilized as closely fitted wearable sensors to acquire precise biosignals that are subsequently uploaded to the cloud for immediate examination and diagnosis, and also can be used for vision systems for human-interactive robotics. Their inception was propelled by breakthroughs in novel optoelectronic material technologies and device blueprinting methodologies, endowing flexibility and mechanical resilience to conventional rigid optoelectronic devices. This paper reviews the advancements in such soft optoelectronic device technologies, honing in on various materials, manufacturing techniques, and device design strategies. We will first highlight the general approaches for flexible and stretchable device fabrication, including the appropriate material selection for the substrate, electrodes, and insulation layers. We will then focus on the materials for flexible and stretchable light-emitting diodes, their device integration strategies, and representative application examples. Next, we will move on to the materials for flexible and stretchable photodetectors, highlighting the state-of-the-art materials and device fabrication methods, followed by their representative application examples. At the end, a brief summary will be given, and the potential challenges for further development of functional devices will be discussed as a conclusion.

Soft Bioelectronics for Neuroengineering: New Horizons in the Treatment of Brain Tumor and Epilepsy

Soft bioelectronic technologies for neuroengineering have shown remarkable progress, which include novel soft material technologies and device design strategies. Such technological advances that are initiated from fundamental brain science are applied to clinical neuroscience and provided meaningful promises for significant improvement in the diagnosis efficiency and therapeutic efficacy of various brain diseases recently. System-level integration strategies in consideration of specific disease circumstances can enhance treatment effects further. Here, recent advances in soft implantable bioelectronics for neuroengineering, focusing on materials and device designs optimized for the treatment of intracranial disease environments, are reviewed. Various types of soft bioelectronics for neuroengineering are categorized and exemplified first, and then details for the sensing and stimulating device components are explained. Next, application examples of soft implantable bioelectronics to clinical neuroscience, particularly focusing on the treatment of brain tumor and epilepsy are reviewed. Finally, an ideal system of soft intracranial bioelectronics such as closed-loop-type fully-integrated systems is presented, and the remaining challenges for their clinical translation are discussed.

Biofluid-Activated Biofuel Cells, Batteries, and Supercapacitors: A Comprehensive Review

Recent developments in wearable and implanted devices have resulted in numerous, unprecedented capabilities that generate increasingly detailed information about a user's health or provide targeted therapy. However, options for powering such systems remain limited to conventional batteries which are large and have toxic components and as such are not suitable for close integration with the human body. This work provides an in-depth overview of biofluid-activated electrochemical energy devices, an emerging class of energy sources judiciously designed for biomedical applications. These unconventional energy devices are composed of biocompatible materials that harness the inherent chemistries of various biofluids to produce useable electrical energy. This work covers examples of such biofluid-activated energy devices in the form of biofuel cells, batteries, and supercapacitors. Advances in materials, design engineering, and biotechnology that form the basis for high-performance, biofluid-activated energy devices are discussed. Innovations in hybrid manufacturing and heterogeneous integration of device components to maximize power output are also included. Finally, key challenges and future scopes of this nascent field are provided.

Manufacturing of stretchable substrate with biaxial strain control for highly-efficient stretchable solar cells and displays

There has been significant research focused on the development of stretchable materials that can provide a large area with minimal material usage for use in solar cells and displays. However, most materials exhibit perpendicular shrinkage when stretched, which is particularly problematic for polymer-based substrates commonly used in stretchable devices. To address this issue, biaxial strain-controlled substrates have been proposed as a solution to increase device efficiency and conserve material resources. In this study, we present the design and fabrication of a biaxial strain-controlled substrate with a re-entrant honeycomb structure and a negative Poisson's ratio. Using a precisely machined mold with a shape error of less than 0.15%, we successfully fabricated polydimethylsiloxane substrates with a 500 μm thick re-entrant honeycomb structure, resulting in a 19.1% reduction in perpendicular shrinkage. This improvement translates to a potential increase in device efficiency by 9.44% and an 8.60% reduction in material usage for substrate fabrication. We demonstrate that this design and manufacturing method can be applied to the fabrication of efficient stretchable devices, such as solar cells and displays.

A monolithically integrated in-textile wristband for wireless epidermal biosensing

Textile bioelectronics that allow comfortable epidermal contact hold great promise in noninvasive biosensing. However, their applications are limited mainly because of the large intrinsic electrical resistance and low compatibility for electronics integration. We report an integrated wristband that consists of multifunctional modules in a single piece of textile to realize wireless epidermal biosensing. The in-textile metallic patterning and reliable interconnect encapsulation contribute to the excellent electrical conductivity, mechanical robustness, and waterproofness that are competitive with conventional flexible devices. Moreover, the well-maintained porous textile architectures deliver air permeability of 79 mm s-1 and moisture permeability of 270 g m-2 day-1, which are more than one order of magnitude higher than medical tapes, thus ensuring superior wearing comfort. The integrated in-textile wristband performed continuous sweat potassium monitoring in the range of 0.3 to 40 mM with long-term stability, demonstrating its great potential for wearable fitness monitoring and point-of-care testing.

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.

Communication Protocols Integrating Wearables, Ingestibles, and Implantables for Closed-Loop Therapies

Body-conformal sensors and tissue interfacing robotic therapeutics enable the real-time monitoring and treatment of diabetes, wound healing, and other critical conditions. By integrating sensors and drug delivery devices, scientists and engineers have developed closed-loop drug delivery systems with on-demand therapeutic capabilities to provide just-in-time treatments that correspond to chemical, electrical, and physical signals of a target morbidity. To enable closed-loop functionality in vivo, engineers utilize various low-power means of communication that reduce the size of implants by orders of magnitude, increase device lifetime from hours to months, and ensure the secure high-speed transfer of data. In this review, we highlight how communication protocols used to integrate sensors and drug delivery devices, such as radio frequency communication (e.g., Bluetooth, near-field communication), in-body communication, and ultrasound, enable improved treatment outcomes.

A low-profile electromechanical packaging system for soft-to-flexible bioelectronic interfaces

Interfacing the human body with the next generation of electronics requires technological advancement in designing and producing bioelectronic circuits. These circuits must integrate electrical functionality while simultaneously addressing limitations in mechanical compliance and dynamics, biocompatibility, and consistent, scalable manufacturing. The combination of mechanically disparate materials ranging from elastomers to inorganic crystalline semiconductors calls for modular designs with reliable and scalable electromechanical connectors. Here, we report on a novel interconnection solution for soft-to-flexible bioelectronic interfaces using a patterned and machined flexible printed circuit board, which we term FlexComb, interfaced with soft transducing systems. Using a simple assembly process, arrays of protruding "fingers" bearing individual electrical terminals are laser-machined on a standard flexible printed circuit board to create a comb-like structure, namely, the FlexComb. A matching pattern is also machined in the soft system to host and interlock electromechanically the FlexComb connections via a soft electrically conducting composite. We examine the electrical and electromechanical properties of the interconnection and demonstrate the versatility and scalability of the method through various customized submillimetric designs. In a pilot in vivo study, we validate the stability and compatibility of the FlexComb technology in a subdural electrocorticography system implanted for 6 months on the auditory cortex of a minipig. The FlexComb provides a reliable and simple technique to bond and connect soft transducing systems with flexible or rigid electronic boards, which should find many implementations in soft robotics and wearable and implantable bioelectronics.

Bioadhesive polymer semiconductors and transistors for intimate biointerfaces

The use of bioelectronic devices relies on direct contact with soft biotissues. For transistor-type bioelectronic devices, the semiconductors that need to have direct interfacing with biotissues for effective signal transduction do not adhere well with wet tissues, thereby limiting the stability and conformability at the interface. We report a bioadhesive polymer semiconductor through a double-network structure formed by a bioadhesive brush polymer and a redox-active semiconducting polymer. The resulting semiconducting film can form rapid and strong adhesion with wet tissue surfaces together with high charge-carrier mobility of ~1 square centimeter per volt per second, high stretchability, and good biocompatibility. Further fabrication of a fully bioadhesive transistor sensor enabled us to produce high-quality and stable electrophysiological recordings on an isolated rat heart and in vivo rat muscles.

Tough Hydrogel Electrolytes for Anti-Freezing Zinc-Ion Batteries

As the soaring demand for energy storage continues to grow, batteries that can cope with extreme conditions are highly desired. Yet, existing battery materials are limited by weak mechanical properties and freeze-vulnerability, prohibiting safe energy storage in devices that are exposed to low temperature and unusual mechanical impacts. Herein, a fabrication method harnessing the synergistic effect of co-nonsolvency and "salting-out" that can produce poly(vinyl alcohol) hydrogel electrolytes with unique open-cell porous structures, composed of strongly aggregated polymer chains, and containing disrupted hydrogen bonds among free water molecules, is introduced. The hydrogel electrolyte simultaneously combines high strength (tensile strength 15.6 MPa), freeze-tolerance (< -77 °C), high mass transport (10× lower overpotential), and dendrite and parasitic reactions suppression for stable performance (30 000 cycles). The high generality of this method is further demonstrated with poly(N-isopropylacrylamide) and poly(N-tertbutylacrylamide-co-acrylamide) hydrogels. This work takes a further step toward flexible battery development for harsh environments.

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

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

Boosting the Piezoelectric Sensitivity of Amino Acid Crystals by Mechanical Annealing for the Engineering of Fully Degradable Force Sensors

Biodegradable piezoelectric force sensors can be used as implantable medical devices for monitoring physiological pressures of impaired organs or providing essential stimuli for drug delivery and tissue regeneration without the need of additional invasive removal surgery or battery power. However, traditional piezoelectric materials, such as inorganic ceramics and organic polymers, show unsatisfactory degradability, and cytotoxicity. Amino acid crystals are biocompatible and exhibit outstanding piezoelectric properties, but their small crystal size makes it difficult to align the crystals for practical applications. Here, a mechanical-annealing strategy is reported for engineering all-organic biodegradable piezoelectric force sensors using natural amino acid crystals as piezoelectric materials. It is shown that the piezoelectric constant of the mechanical-annealed crystals can reach 12 times that of the single crystal powders. Moreover, mechanical annealing results in flat and smooth surfaces, thus improving the contact of the crystal films with the electrodes and leading to high output voltages of the devices. The packaged force sensors can be used to monitor dynamic motions, including muscle contraction and lung respiration, in vivo for 4 weeks and then gradually degrade without causing obvious inflammation or systemic toxicity. This work provides a way to engineer all-organic and biodegradable force sensors for potential clinical applications.

Technology Roadmap for Flexible Sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.

Advanced Electronic Packaging Technology: From Hard to Soft

Packaging is a pivotal step in electronic device manufacturing, determining the translational performance of bare chips [...].

Context-aware electromagnetic design for continuously wearable biosymbiotic devices

Imperceptible wireless wearable devices are critical to advance digital medicine with the goal to capture clinical-grade biosignals continuously. Design of these systems is complex because of unique interdependent electromagnetic, mechanic and system level considerations that directly influence performance. Typically, approaches consider body location, related mechanical loads, and desired sensing capabilities, however, design for real world application context is not formulated. Wireless power casting eliminates user interaction and the need to recharge batteries, however, implementation is challenging because the use case influences performance. To facilitate a data-driven approach to design, we demonstrate a method for personalized, context-aware antenna, rectifier and wireless electronics design that considers human behavioral patterns and physiology to optimize electromagnetic and mechanical features for best performance across an average day of the target user group. Implementation of these methods result in devices that enable continuous recording of high-fidelity biosignals over weeks without the need for human interaction.

Semiconductive and Biocompatible Nanofibrils from the Self-Assembly of Amyloid π-Conjugated Peptides

Owing to their capacity to self-assemble into organized nanostructures, amyloid polypeptides can serve as scaffolds for the design of biocompatible semiconductive materials. Herein, symmetric and asymmetric amyloid π-conjugated peptides were prepared through condensation of perylene diimide (PDI) with a natural amyloidogenic sequence derived from the islet amyloid polypeptide. These PDI-bioconjugates assembled into long and linear nanofilaments in aqueous solution, which were characterized by a cross-β-sheet quaternary organization. Current-voltage curves exhibited a clear signature of semiconductors, whereas the cellular assays revealed cytocompatibility and potential application in fluorescence microscopy. Although the incorporation of a single amyloid peptide appeared sufficient to drive the self-assembly into organized fibrils, the incorporation of two peptide sequences at the PDI's imide positions significantly enhanced the conductivity of nanofibril-based films. Overall, this study exposes a novel strategy based on amyloidogenic peptide to guide the self-assembly of π-conjugated systems into robust, biocompatible, and optoelectronic nanofilaments.

Effects of AC frequency on the capacitance measurement of hybrid response pressure sensors

E-skins consisting of soft pressure sensors are enabling technology for soft robots, bio-integrated devices, and deformable touch panels. A well-known bottleneck of capacitive pressure sensors (CPS) is the drastic decay in sensitivity with increasing pressure. To overcome this challenge, we have invented a hybrid-response pressure sensor (HRPS) that exhibits both the piezoresistive and piezocapacitive effects intrinsic to a highly porous nanocomposite (PNC) with carbon nanotube (CNT) dopants. The HRPS is constructed with two conductive electrodes sandwiching a laminated PNC and a stiff dielectric layer. We have simplified the hybrid response into a parallel resistor-capacitor circuit, whose output depends on the AC (alternating current) frequency used for the capacitance measurement. Herein, through theoretical analysis, we discover a dimensionless parameter that governs the frequency responses of the HRPS. The master curve is validated through experiments on the HRPS with various doping ratios, subject to different compressive strains, under diverse AC frequencies. In addition, the relative contribution of piezoresistive and piezocapacitive mechanisms are also found to vary with the three parameters. Based on this experimentally validated theory, we establish a very practical guideline for selecting the optimal AC frequency for the capacitance measurement of HRPSs.

An epifluidic electronic patch with spiking sweat clearance for event-driven perspiration monitoring

Sensory neurons generate spike patterns upon receiving external stimuli and encode key information to the spike patterns, enabling energy-efficient external information processing. Herein, we report an epifluidic electronic patch with spiking sweat clearance using a sensor containing a vertical sweat-collecting channel for event-driven, energy-efficient, long-term wireless monitoring of epidermal perspiration dynamics. Our sweat sensor contains nanomesh electrodes on its inner wall of the channel and unique sweat-clearing structures. During perspiration, repeated filling and abrupt emptying of the vertical sweat-collecting channel generate electrical spike patterns with the sweat rate and ionic conductivity proportional to the spike frequency and amplitude over a wide dynamic range and long time (> 8 h). With such 'spiking' sweat clearance and corresponding electronic spike patterns, the epifluidic wireless patch successfully decodes epidermal perspiration dynamics in an event-driven manner at different skin locations during exercise, consuming less than 0.6% of the energy required for continuous data transmission. Our patch could integrate various on-skin sensors and emerging edge computing technologies for energy-efficient, intelligent digital healthcare.

Utilizing Gradient Porous Graphene Substrate as the Solid-Contact Layer To Enhance Wearable Electrochemical Sweat Sensor Sensitivity

Wearable sweat monitoring represents an attractive opportunity for personalized healthcare and for evaluating sports performance. One of the limitations with such monitoring, however, is water layer formation upon cycling of ion-selective sensors, leading to degraded sensitivity and long-term instability. Our report is the first to use chemical vapor deposition-grown, three-dimensional, graphene-based, gradient porous electrodes to minimize such water layer formation. The proposed design reduces the ion diffusion path within the polymeric ion-selective membrane and enhances the electroactive surface for highly sensitive, real-time detection of Na⁺ ions in human sweat with high selectivity. We obtained a 7-fold enhancement in electroactive surface against 2D electrodes (e.g., carbon, gold), yielding a sensitivity of 65.1 ± 0.25 mV decade^-1 (n = 3, RSD = 0.39%), the highest to date for wearable Na⁺ sweat sensors. The on-body sweat sensing performance is comparable to that of ICP-MS, suggesting its feasibility for health evaluation through sweat.

Recent Advances in Stretchable and Wearable Capacitive Electrophysiological Sensors for Long-Term Health Monitoring

Over the past several years, wearable electrophysiological sensors with stretchability have received significant research attention because of their capability to continuously monitor electrophysiological signals from the human body with minimal body motion artifacts, long-term tracking, and comfort for real-time health monitoring. Among the four different sensors, i.e., piezoresistive, piezoelectric, iontronic, and capacitive, capacitive sensors are the most advantageous owing to their reusability, high durability, device sterilization ability, and minimum leakage currents between the electrode and the body to reduce the health risk arising from any short circuit. This review focuses on the development of wearable, flexible capacitive sensors for monitoring electrophysiological conditions, including the electrode materials and configuration, the sensing mechanisms, and the fabrication strategies. In addition, several design strategies of flexible/stretchable electrodes, body-to-electrode signal transduction, and measurements have been critically evaluated. We have also highlighted the gaps and opportunities needed for enhancing the suitability and practical applicability of wearable capacitive sensors. Finally, the potential applications, research challenges, and future research directions on stretchable and wearable capacitive sensors are outlined in this review.

Wireless interfaces for brain neurotechnologies

Wireless interfaces enable brain-implanted devices to remotely interact with the external world. They are critical components in modern research and clinical neurotechnologies and play a central role in determining their overall size, lifetime and functionality. Wireless interfaces use a wide range of modalities-including radio-frequency fields, acoustic waves and light-to transfer energy and data to and from an implanted device. These forms of energy interact with living tissue through distinct mechanisms and therefore lead to systems with vastly different form factors, operating characteristics, and safety considerations. This paper reviews recent advances in the development of wireless interfaces for brain neurotechnologies. We summarize the requirements that state-of-the-art brain-implanted devices impose on the wireless interface, and discuss the working principles and applications of wireless interfaces based on each modality. We also investigate challenges associated with wireless brain neurotechnologies and discuss emerging solutions permitted by recent developments in electrical engineering and materials science. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.

Are Liquid Metals Bulk Conductors?

Stretchable electronics have potential in wide-reaching applications including wearables, personal health monitoring, and soft robotics. Many recent advances in stretchable electronics leverage liquid metals, particularly eutectic gallium-indium (EGaIn). A variety of EGaIn electromechanical behaviors have been reported, ranging from bulk conductor responses to effectively strain-insensitive responses. However, numerous measurement techniques have been used throughout the literature, making it difficult to directly compare the various proposed formulations. Here, the electromechanical responses of EGaIn found in the literature is reviewed and pure EGaIn is investigated using three electrical resistance measurement techniques: four point probe, two point probe, and Wheatstone bridge. The results indicate substantial differences in measured electromechanical behavior between the three methods, which can largely be accounted for by correcting for a fixed offset corresponding to the resistances of various parts of the measurement circuits. Yet, even accounting for several of these sources of experimental error, the average relative change in resistance of EGaIn is found to be lower than that predicted by the commonly used bulk conductor assumption, referred to as Pouillet's law. Building upon recent theories proposed in the literature, possible explanations for the discrepancies are discussed. Finally, suggestions are provided on experimental design to enable reproducible and interpretable research.

Local Drug Delivery Strategies for Glioblastoma Treatment

Glioblastoma multiforme (GBM) is a brain tumor notorious for its malignancy. The key reason for the limited efficacy of standard treatment is the high recurrence rate of GBM, even after surgical resection. Hence, intensive postsurgical chemical therapies, such as the systemic delivery of various drugs and/or drug combinations, are typically followed after surgery. However, overcoming the blood-brain barrier by systemic administration to efficiently deliver drugs to the brain tumor remains a daunting goal. Therefore, various local drug delivery methods showing potential for improved therapeutic efficacy have been proposed. In particular, the recent application of electronic devices for the controlled delivery of chemotherapy drugs to GBM tissue has attracted attention. We herein review the recent progress of local drug delivery strategies, including electronics-assisted strategies, at the research and commercial level. We also present a brief discussion of the unsolved challenges and future research direction of localized chemotherapy methods for GBM.

Lab-on-a-Contact Lens: Recent Advances and Future Opportunities in Diagnostics and Therapeutics

The eye is one of the most complex organs in the human body, containing rich and critical physiological information (e.g., intraocular pressure, corneal temperature, and pH) as well as a library of metabolite biomarkers (e.g., glucose, proteins, and specific ions). Smart contact lenses (SCLs) can serve as a wearable intelligent ocular prosthetic device capable of noninvasive and continuous monitoring of various essential physical/biochemical parameters and drug loading/delivery for the treatment of ocular diseases. Advances in SCL technologies and the growing public interest in personalized health are accelerating SCL research more than ever before. Here, the current status and potential of SCL development through a comprehensive review from fabrication to applications to commercialization are discussed. First, the material, fabrication, and platform designs of the SCLs for the diagnostic and therapeutic applications are discussed. Then, the latest advances in diagnostic and therapeutic SCLs for clinical translation are reviewed. Later, the established techniques for wearable power transfer and wireless data transmission applied to current SCL devices are summarized. An outlook, future opportunities, and challenges for developing next-generation SCL devices are also provided. With the rise in interest of SCL development, this comprehensive and essential review can serve as a new paradigm for the SCL devices.

Wearable devices for continuous monitoring of biosignals: Challenges and opportunities

The ability for wearable devices to collect high-fidelity biosignals continuously over weeks and months at a time has become an increasingly sought-after characteristic to provide advanced diagnostic and therapeutic capabilities. Wearable devices for this purpose face a multitude of challenges such as formfactors with long-term user acceptance and power supplies that enable continuous operation without requiring extensive user interaction. This review summarizes design considerations associated with these attributes and summarizes recent advances toward continuous operation with high-fidelity biosignal recording abilities. The review also provides insight into systematic barriers for these device archetypes and outlines most promising technological approaches to expand capabilities. We conclude with a summary of current developments of hardware and approaches for embedded artificial intelligence in this wearable device class, which is pivotal for next generation autonomous diagnostic, therapeutic, and assistive health tools.

Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions

Surface electrode arrays are mainly fabricated from rigid or elastic materials, and precisely manipulated ductile metal films, which offer limited stretchability. However, the living tissues to which they are applied are nonlinear viscoelastic materials, which can undergo significant mechanical deformation in dynamic biological environments. Further, the same arrays and compositions are often repurposed for vastly different tissues rather than optimizing the materials and mechanical properties of the implant for the target application. By first characterizing the desired biological environment, and then designing a technology for a particular organ, surface electrode arrays may be more conformable, and offer better interfaces to tissues while causing less damage. Here, the various materials used in each component of a surface electrode array are first reviewed, and then electrically active implants in three specific biological systems, the nervous system, the muscular system, and skin, are described. Finally, the fabrication of next-generation surface arrays that overcome current limitations is discussed.

Island Effect in Stretchable Inorganic Electronics

Island-bridge architectures represent a widely used structural design in stretchable inorganic electronics, where deformable interconnects that form the bridge provide system stretchability, and functional components that reside on the islands undergo negligible deformations. These device systems usually experience a common strain concentration phenomenon, i.e., "island effect", because of the modulus mismatch between the soft elastomer substrate and its on-top rigid components. Such an island effect can significantly raise the surrounding local strain, therefore increasing the risk of material failure for the interconnects in the vicinity of the islands. In this work, a systematic study of such an island effect through combined theoretical analysis, numerical simulations and experimental measurements is presented. To relieve the island effect, a buffer layer strategy is proposed as a generic route to enhanced stretchabilities of deformable interconnects. Both experimental and numerical results illustrate the applicability of this strategy to 2D serpentine and 3D helical interconnects, as evidenced by the increased stretchabilities (e.g., by 1.5 times with a simple buffer layer, and 2 times with a ring buffer layer, both for serpentine interconnects). The application of the patterned buffer layer strategy in a stretchable light emitting diodes system suggests promising potentials for uses in other functional device systems.

Soft Capacitive Pressure Sensors: Trends, Challenges, and Perspectives

Soft pressure sensors are critical components of e-skins, which are playing an increasingly significant role in two burgeoning fields: soft robotics and bioelectronics. Capacitive pressure sensors (CPS) are popular given their mechanical flexibility, high sensitivity, and signal stability. After two decades of rapid development, e-skins based on soft CPS are able to achieve human-skin-like softness and sensitivity. However, there remain two major roadblocks in the way for practical application of soft CPS: the decay of sensitivity with increased pressure and the coupled response between in-plane stretch and out-of-plane pressure. In addition to existing strategies of building porous and/or high dielectric constant soft dielectrics, are there any other promising methods to overcome those bottlenecks? Are there any further considerations for the widespread deployment of e-skins? This perspective aims to shed some light on those topics.

Highly-integrated, miniaturized, stretchable electronic systems based on stacked multilayer network materials

Elastic stretchability and function density represent two key figures of merits for stretchable inorganic electronics. Various design strategies have been reported to provide both high levels of stretchability and function density, but the function densities are mostly below 80%. While the stacked device layout can overcome this limitation, the soft elastomers used in previous studies could highly restrict the deformation of stretchable interconnects. Here, we introduce stacked multilayer network materials as a general platform to incorporate individual components and stretchable interconnects, without posing any essential constraint to their deformations. Quantitative analyses show a substantial enhancement (e.g., by ~7.5 times) of elastic stretchability of serpentine interconnects as compared to that based on stacked soft elastomers. The proposed strategy allows demonstration of a miniaturized electronic system (11 mm by 10 mm), with a moderate elastic stretchability (~20%) and an unprecedented areal coverage (~110%), which can serve as compass display, somatosensory mouse, and physiological-signal monitor.

Recent Progress in Materials Chemistry to Advance Flexible Bioelectronics in Medicine

Designing bioelectronic devices that seamlessly integrate with the human body is a technological pursuit of great importance. Bioelectronic medical devices that reliably and chronically interface with the body can advance neuroscience, health monitoring, diagnostics, and therapeutics. Recent major efforts focus on investigating strategies to fabricate flexible, stretchable, and soft electronic devices, and advances in materials chemistry have emerged as fundamental to the creation of the next generation of bioelectronics. This review summarizes contemporary advances and forthcoming technical challenges related to three principal components of bioelectronic devices: i) substrates and structural materials, ii) barrier and encapsulation materials, and iii) conductive materials. Through notable illustrations from the literature, integration and device fabrication strategies and associated challenges for each material class are highlighted.

2D Heterostructures for Ubiquitous Electronics and Optoelectronics: Principles, Opportunities, and Challenges

A grand family of two-dimensional (2D) materials and their heterostructures have been discovered through the extensive experimental and theoretical efforts of chemists, material scientists, physicists, and technologists. These pioneering works contribute to realizing the fundamental platforms to explore and analyze new physical/chemical properties and technological phenomena at the micro-nano-pico scales. Engineering 2D van der Waals (vdW) materials and their heterostructures via chemical and physical methods with a suitable choice of stacking order, thickness, and interlayer interactions enable exotic carrier dynamics, showing potential in high-frequency electronics, broadband optoelectronics, low-power neuromorphic computing, and ubiquitous electronics. This comprehensive review addresses recent advances in terms of representative 2D materials, the general fabrication methods, and characterization techniques and the vital role of the physical parameters affecting the quality of 2D heterostructures. The main emphasis is on 2D heterostructures and 3D-bulk (3D) hybrid systems exhibiting intrinsic quantum mechanical responses in the optical, valley, and topological states. Finally, we discuss the universality of 2D heterostructures with representative applications and trends for future electronics and optoelectronics (FEO) under the challenges and opportunities from physical, nanotechnological, and material synthesis perspectives.

Highly Sensitive Capacitive Pressure Sensors over a Wide Pressure Range Enabled by the Hybrid Responses of a Highly Porous Nanocomposite

Past research aimed at increasing the sensitivity of capacitive pressure sensors has mostly focused on developing dielectric layers with surface/porous structures or higher dielectric constants. However, such strategies have only been effective in improving sensitivities at low pressure ranges (e.g., up to 3 kPa). To overcome this well-known obstacle, herein, a flexible hybrid-response pressure sensor (HRPS) composed of an electrically conductive porous nanocomposite (PNC) laminated with an ultrathin dielectric layer is devised. Using a nickel foam template, the PNC is fabricated with carbon nanotubes (CNTs)-doped Ecoflex to be 86% porous and electrically conductive. The PNC exhibits hybrid piezoresistive and piezocapacitive responses, resulting in significantly enhanced sensitivities (i.e., more than 400%) over wide pressure ranges, from 3.13 kPa^-1 within 0-1 kPa to 0.43 kPa^-1 within 30-50 kPa. The effect of the hybrid responses is differentiated from the effect of porosity or high dielectric constants by comparing the HRPS with its purely piezocapacitive counterparts. Fundamental understanding of the HRPS and the prediction of optimal CNT doping are achieved through simplified analytical models. The HRPS is able to measure pressures from as subtle as the temporal arterial pulse to as large as footsteps.

Gel-Based Luminescent Conductive Materials and Their Applications in Biosensors and Bioelectronics

The gel is an ideal platform for fabricating materials for bio-related applications due to its good biocompatibility, adjustable mechanical strength, and flexible and diversified functionalization. In recent decades, gel-based luminescent conductive materials that possess additional luminescence and conductivity simultaneously advanced applications in biosensors and bioelectronics. Herein, a comprehensive overview of gel-based luminescent conductive materials is summarized in this review. Gel-based luminescent conductive materials are firstly outlined, highlighting their fabrication methods, network structures, and functions. Then, their applications in biosensors and bioelectronics fields are illustrated. Finally, challenges and future perspectives of this emerging field are discussed with the hope of inspire additional ideas.